All Publications

The Nutrition Innovation Lab provides support for research in Asia and Africa devoted to implementing effective interventions that integrate agriculture and nutrition activities to achieve a significant reduction in stunting among children less than 24 months of age and undernutrition in mothers. Our specific goals include: i) generation of empirical evidence of what works at scale (through applied research), and ii) support for enhanced institutional and human capacity to conduct research and implement effective nutrition activities at scale in future years.

Nutrition Smoothing: Can Proximity to Towns and Cities Protect Rural Children against Seasonal Variation in Agroclimatic Conditions at Birth?

Authors: Amelia F. Darrouzet-Nardi; Willliam A. Masters January 2017
A large literature links early-life environmental shocks to later outcomes. This paper uses seasonal variation across the Democratic Republic of the Congo to test for nutrition smoothing, defined here as attaining similar height, weight and mortality outcomes despite different agroclimatic conditions at birth. We find that gaps between siblings and neighbors born at different times of year are larger in more remote rural areas, farther from the equator where there are greater seasonal differences in rainfall and temperature. For those born at adverse times in...
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Food insecurity, but not HIV-infection status, is associated with adverse changes in body composition during lactation in Ugandan women of mixed HIV status

Authors: Elizabeth Widen; Claire Biribawa; Daniel Acidri; Winifred Achoko; Harriet Achola; Jeffrey Griffiths; Sera Young January 2017
A cohort of 246 women [36.5% of whom were HIV positive (HIV+) and were receiving ART] were followed to 12 mo postpartum. Repeated measures included weight, fat mass, fat-free mass, mid upper arm circumference, triceps skin fold thickness [which allowed for the derivation of arm muscle area (AMA) and arm fat area (AFA)], breastfeeding, and individual food insecurity. Longitudinal regression models were constructed to assess associations between HIV and food insecurity and changes in body composition over time.
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Markets, transportation infrastructure and food prices in Nepal

Authors: Gerald Shively; Ganesh Thapa December 2016
We study transportation infrastructure and food markets in Nepal over the period 2002 to 2010, combining monthly price data from 37 local and regional markets and 7 Indian border markets. We use a series of autoregressive models to study price determination, spatial and temporal price transmission, and price variance. We account for district-level agricultural production, correcting for bi-directional causality between output and prices using ground station rainfall data. In addition, to test hypotheses regarding the importance of transportation infrastructure we incorporate information on road and...
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Climatic conditions and child height: Sex-specific vulnerability and the protective effects of sanitation and food markets in Nepal

Authors: Prajula Mulmi; William A. Masters December 2016
Abstract Environmental conditions in early life are known to have impacts on later health outcomes, but causal mechanisms and potential remedies have been difficult to discern. This paper uses the Nepal Demographic and Health Surveys of 2006 and 2011, combined with earlier NASA satellite observations of variation in the Normalized Difference Vegetation Index (NDVI) at each child’s location and time of birth to identify the trimesters of gestation and periods of infancy when climate variation is linked to attained height later in life. We find...
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Optimizing the Multisectoral Nutrition Policy Cycle: A Systems Perspective

Authors: Sascha Lamstein; Amanda Pomeroy-Stevens; Patrick Webb; Eileen Kennedy December 2016
Based on the data collected in Uganda, Nepal, and Ethiopia, the papers included in this supplement fill a critical gap in evidence regarding multisectoral National Nutrition Action Plans. The studies offer new data and new thinking on how and why governance, effective financial decentralization, and improved accountability all matter for nutrition actions in low-income countries. This introductory paper offers an overview of the current state of evidence and thinking on the multisectoral nutrition policy cycle, including how governance and financing support that process. It also...
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Implementing Multisector Nutrition Programs in Ethiopia and Nepal: Challenges and Opportunities From a Stakeholder Perspective

Authors: Eileen Kennedy; Shibani Gosh; Kedar Baral; Dale Davis; Diplav Sapkota; Patrick Webb December 2016
Effective governance is essential for effective nutrition program implementation. There are additional challenges in launching multisector plans to enhance nutritional status. The present study compares the challenges and opportunities in Ethiopia and Nepal in designing and implementing a multisector plan for nutrition. A semi-quantitative questionnaire with open-ended questions was used to solicit information from senior national-level policy officials and other key stakeholders. The nature of the major nutrition problems in each country was similar; these include malnutrition (particularly stunting), food insecurity, and micronutrient malnutrition. The...
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Prioritizing and Funding the Uganda Nutrition Action Plan

Authors: Amanda Pomeroy-Stevens; Hannah Foehringer Merchant; Abel Muzoora; Ezekiel Mupere; Lidan Du December 2016
In 2010, Uganda began developing its first multisectoral nutrition plan, the Uganda Nutrition Action Plan (UNAP), to reduce malnutrition. While the UNAP signals high-level commitment to addressing nutrition, knowledge gaps remain about how to successfully implement such a plan. We tracked the UNAP’s influence on the process of priority setting and funding for nutrition from 2013 to 2015
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Assessing Progress in Implementing Uganda’s Nutrition Action Plan: District-Level Insights

Authors: Edgar Agaba; Shibani Ghosh; Jeffrey K. Griffiths December 2016
The 2011 Uganda Nutrition Action Plan (UNAP) established 2016 maternal and child nutrition targets. However, there is a lack of routine district-level data collection to assess UNAP implementation.  The Nutrition Innovation Lab collected serial household-level survey data (n = 3600) in 6 districts, including 2 UNAP implementation districts, in 2012 and 2014. Questionnaires focused on food security, nutrition, and health, among others, and included specific indicators relevant to UNAP’s targets.
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Prioritizing and Funding Nepal’s Multisector Nutrition Plan

Authors: Amanda Pomeroy-Stevens; Kusum Hachhethu; Indu Sharma; Jolene Wun December 2016
Nepal has a long tradition of designing good multisectoral nutrition policy. However, success of policy implementation has varied. More evidence on how to successfully carry out multisector nutrition policy is needed. This study used a mixed-method longitudinal design to track qualitative and budgetary changes related to MSNP processes nationally as well as in 3 districts. Qualitative changes in each study area were assessed through interviews, observation, news content, and meeting notes. Changes in allocations and expenditures were calculated based on budget documents, work plans, and validation...
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Measuring Nutrition Governance: An Analysis of Commitment, Capability, and Collaboration in Nepal

Authors: Patrick Webb; Grace Namirembe; Sabi Gurung; Diplav Sapkota; Winnie Fay Bell; Eileen Kennedy; Shailes Neupane; Swetha Manohar; Kedar Baral December 2016
Global commitments to nutrition have supported calls for better evidence to support effective investments at national level. However, too little attention has so far been paid to the role of governance in achieving impacts. This article explores the ways by which the commitment and capabilities of policy implementers affect collaborative efforts for achieving nutrition goals.
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Overcoming the Limits of Evidence on Effective Multisectoral Nutrition Policy

Authors: Madhu Kumar Marasini; Ssansa Mugenyi December 2016
The multisectoral approach has evolved as a popular instrument to attain nutrition goals and targets. But as policy makers, we need timely, relevant, and accurate information in order to effectively support these plans. This commentary comes from the members of the nutrition secretariats at the National Planning Commission in Nepal and the Office of the Prime Minister in Uganda on availability and use of evidence and the nutrition policy cycle. As has been highlighted in this supplement, some of the challenges we have faced include...
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Panel 3 Survey Report

Authors: Nutrition Innovation Lab November 2016
The goal of PoSHAN Community Studies is to understand the factors that link agriculture to nutrition. This involves researching the determinants of household food security, dietary intake, and nutritional status of children under 5 years of age and their mothers in relation to changes in agriculture and exposure to agricultural and microeconomic extension, as well as nutrition and health programs in Nepal. This descriptive report summarizes the main findings of the third panel survey.
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PoSHAN Panel 2 Final Report

Authors: Nutrition Innovation Lab October 2016
The goal of PoSHAN Community Studies is to understand the factors that link agriculture to nutrition. This involves researching the determinants of household food security, dietary intake, and nutritional status of children under 5 years of age and their mothers in relation to changes in agriculture and exposure to agricultural and microeconomic extension, as well as nutrition and health programs in Nepal. This descriptive report summarizes the main findings of the second panel survey conducted between May – July 2014.
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Duration of programme exposure is associated with improved outcomes in nutrition and health: the case for longer project cycles from intervention experience in rural Nepal

Authors: Laurie Miller; Neena Joshi; Mahendra Lohani; Beatrice Rogers; Meghan Kershaw; Robert Houser; Shibani Ghosh; Jeffrey Griffiths; Shubh Mahato; Patrick Webb September 2016
Economic growth and poverty reduction are not always sufficient to improve child health and nutritional status. Heifer International promotes livestock introduction and related training for community development and poverty alleviation. These programmes do not directly address child health or nutrition. To determine effects of its activities on these important outcomes, Heifer conducted a 4-year longitudinal investigation in rural Nepal. The intervention was associated with significantly improved child anthropometry (related to the duration of intervention exposure) and child health. Heifer activities represent a viable ‘nutrition sensitive’...
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Relationship of Stunting and Overweight in Egyptian children under five years of age: Trends and associated risk factors.

Authors: Nutrition Innovation Lab September 2016
Egypt’s emerging economy faces a dual burden wherein there is coexistence of under and over nutrition, either in the same population, community, household or same individual. The dual burden of disease can be extremely variable in its manifestation. It can, for example, be manifested as stunted children who are concurrently obese, or as stunted children who may not be currently obese but who are at risk of early onset chronic diseases. Secondary Analysis provided by the Nutrition Innovation Lab.  
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Aflacohort Study Field Operations and Accomplishments

Authors: Ashish Pokharel August 2016
This presentation was delivered to USAID by Ashish Pokharel in August, 2016 as an update and overview of the Nepal Aflatoxin birth study (Aflacohort), daily procedures, plus some of the early findings.
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Climatic Conditions and Child Height: Sex-Specific Vulnerability and the Protective Effects of Sanitation and Food Markets in Nepal

Authors: Prajula Mulmi; Steven Block; Gerald Shively; William Masters August 2016
This presentation was given at the AAEA Annual Meeting on August 2, 2016 by Prajula Mulmi.
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The association between food insecurity and depressive symptoms severity among pregnant women differs by social support category: a cross-sectional study

Authors: Barnabas Natamba; Jane Achan; Rebecca Stoltzfus; Sera Young August 2016
Abstract Common mental disorders, such as depression and anxiety, affect approximately 16% of pregnant women in low- and middle-income countries. Food insecurity (FI) has been shown to be associated with depressive symptoms. It has also been suggested that the association between FI and depressive symptoms is moderated by social support (SS); however, there is limited evidence of these associations among pregnant women living in low-income and middle-income countries. We studied the association between FI and depressive symptoms severity and assessed whether such an association varied...
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What Does It Cost to Improve Household Diets in Nepal? Using the Cost of the Diet Method to Model Lowest Cost Dietary Changes

Authors: Erin Biehl; Rolf Klemm; Swetha Manohar; Patrick Webb; Devendra Gauchan; Keith West July 2016
In August to September 2014, we collected market price and women’s food frequency data from 3 representative villages in Nepal’s mountains (Mahat Gaun, Jumla, n = 181 households), hills (Sitapur, Arghakhanchi, n = 166), and terai (Saigaun, Banke, n = 232) and verified local diets during women’s group discussions. Using the Cost of the Diet method, we compared models of the most nutritious version of a commonly consumed diet given locally available foods (“common diet”) with the cheapest possible diet meeting nutrient requirements, including foods...
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Learning Lab Indicators of Food Insecurity and Malnutrition

Authors: William Masters; Shibani Ghosh June 2016
This presentation was delivered by Drs. Shibani Ghosh and William Masters June 20-21, 2016 at the ANH Academy Week in Addis Ababa, Ethiopia.
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Fostering reflective trust between mothers and community health nurses to improve the effectiveness of health and nutrition efforts: An ethnographic study in Ghana, West Africa

Authors: Nana Ackatia-Armah; Nii Antiaye Addy; Shibani Ghosh; Laurette Dube June 2016
As the global health agenda shifts from the Millennium Development Goals (MDGs) to Sustainable Development Goals (SDGs), the need for effective preventive health efforts has gained prominence, particularly in low-income regions with poor health and nutrition outcomes. To address needs in communities with limited access to health services and personnel, it is important to develop strategies that can improve the effectiveness of nurses as they interact with the populations they serve. We contribute to informing such strategies by explaining how mothers’ “reflective trust” in community...
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Measuring Food and Nutrition Security: An Independent Technical Assessment and User’s Guide for Existing Indicators

Authors: Uma Lele; Joyce Kinabo; JV Meenakshi; Bharat Ramaswami; Winnie FL Bell; Sambuddha Goswami June 2016
The purpose of this document is to assist policy and program planners and implementers, designers and managers, evaluators and analysts to target interventions and measure progress in food security and nutrition. Indicators for concepts such as Measuring Food and Nutrition Security: Technical Assessment and User’s Guide Page 2 stunting and wasting, diet diversity and nutrient adequacy or food insecurity have proliferated in recent years, leading to widespread confusion about the best indicators for any given situation. Relatively few of the many available measures of food...
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Child dietary quality in rural Nepal: Effectiveness of a community-level development intervention

Authors: Amelia F Darrouzet- Nardi; Laurie C Miller; Shubh Mahato; Mahendra Lohani; Beatrice L Rogers May 2016
Nutrition-sensitive agricultural interventions have the potential to improve child dietary quality in rural households, as evidenced by a growing body of work which concurrently measures agricultural and nutrition indicators. Our objective was to investigate whether children in rural farming communities of Nepal participating in a community-level, nutrition-sensitive development intervention had improved dietary quality compared with children living in non-participating matched rural communities. Six rural communities of Nepal where livelihoods were predominantly agricultural were selected to participate in the phased implementation of a community-level development intervention...
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Protein Quality in the First Thousand Days of Life

Authors: Shibani Ghosh May 2016
The aim of this article is to provide an overview of the role of protein quality within the first 1000 days of life. The article outlines the importance of protein quality in pregnancy and early growth and examines the potential of high-quality protein in prevention of stunting and treatment of severe and moderate acute malnutrition. The article also provides a summary of the recent changes in protein quality evaluation and the development of a new index, the Digestibility Corrected Amino Acid Score, examining the opportunities...
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District Presentations: Effectiveness of Integrated Agriculture, Health Livelihood and Nutrition Interventions to Improve Maternal and Child Nutrition and Health in Rural Uganda: A Birth Cohort Study.

Authors: Bernard Bashaasha; Florence Kinyata April 2016
These presentations were made in various Ugandan Districts, covering data gathered during the Uganda Birth Cohort Study specific to each of those districts. The presentations were delivered in April of 2016 by Drs. Bernard Bashaasha and Florence Kinyata. Click on the district name to see its specific presentation. Agweng Aduku Agoro Apac Atanga Atyakc Ayer Buganagri Buyanja Bwizi Kebisoni Nyamweru Parombo Kibiito Rugyeyo Ruhija
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Effect of Nutrition-Sensitive Agricultural Extension Program on Nutrition Knowledge and Dietary Practices of Farming Households in Mukono District, Central Uganda

Authors: Elizabeth Asiimwe April 2016
This poster presentation discusses the outcomes of an extension program implemented in the Mukono District of Central Uganda. It was investigating the knowledge levels of nutrition among men and women, as well as factors that influenced diet diversity among farming households.
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From Food Quantity to Diet Quality: How the Race Against Malthus is Changing

Authors: William Masters April 2016
This presentation was delivered by Dr. William Masters, April 25, 2016 at the Tufts Research Day on Global Food Security.
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Aquaculture and Horticulture Programs: Impacts of Single vs. Multiple Interventions in Bangladesh

Authors: Patrick Webb March 2016
This presentation was given by Dr. Patrick Webb to the Technical Advisory Group as an update on the Nutrition Innovation Lab’s ongoing interventions in Bangladesh, and the preliminary findings. Dhaka, March 21st, 2016  
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The Big Picture for Global Hunger: Transitions in Agriculture, Public Policy, and Nutrition

Authors: William Masters March 2016
This presentation was given on March 18, 2016 at the Weatherhead Center for International Affairs’ Workshop on the Sustainability of the World’s Food and Farming Systems by Dr. William Masters.
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Vitamin Status among Breastfed Infants in Bhaktapur, Nepal

Authors: Manjeswori Ulak; Ram Chandyo; Oivind Midttun; Prakash Shrestha; Lauren Graybill; Tor Strand March 2016
Vitamin deficiencies are known to be common among infants residing in low- and middle-income countries but relatively few studies have assessed several biochemical parameters simultaneously. The objective of the study was to describe the status of vitamins (A, D, E, B6, B12 and folate) in breastfed infants. We measured the plasma concentrations of trans retinol, 25 hydroxy vitamin D, α-tocopherol, pyridoxal 5′-phosphate, cobalamin, folate, methylmalonic acid, homocysteine, hemoglobin and C-reactive protein from 467 randomly selected infants. One in five (22%) was deficient in at least...
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Got Baby Food? Understanding the Market for Packaged Complementary Foods in Developing Countries

Authors: William Masters February 2016
This presentation was delivered by Dr. William Masters on Feb. 3, 2016 as a Friedman School Seminar, Tufts University.
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Sustaining healthy diets: The role of capture fisheries and aquaculture for improving nutrition in the post-2015 era

Authors: Shakuntala Haraksingh Thilsted; Andrew Thorne-Lyman; Patrick Webb; Jessica Rose Bogard; Rohana Subasinghe; Michael John Phillips; Edward Hugh Allison February 2016
Fish production and trade contribute significantly to global agricultural output. Fish production in 2012 exceeded 158 million metrictons, while the value of international fish trade amounted to USD129 billion. An increasingly large share of fish entering global markets derives from aquaculture (the farming of aquatic animals and plants); the world’s fastest growing food production sector for more than four decades.  Much of fish produced and traded within low-income countries derives from capture fisheries (non-fed fish harvested from undomesticated ecosystems). These two production systems have important complementary roles in meeting rising demand for...
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Global dietary quality, undernutrition and non-communicable disease: a longitudinal modelling study

Authors: Rosemary Green; Jennifer Sutherland; Alan D Dangour; Bhavani Shankar; Patrick Webb January 2016
The objective is to determine the relationship between global dietary energy availability and dietary quality, and nutrition-related health outcomes.
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Head Growth of undernourished children in rural Nepal: Association with demographics, health, and diet

Authors: Laurie Miller; Neena Joshi; Beatrice Rodgers; Jeffrey Griffiths; Shubh Mahato; Padma Singh; Patrick Webb January 2016
Background: Brain development in early childhood is a key determinant of later cognition, social achievement and educational success. Head circumference (HC) measurements are a simple method to assess brain growth, yet reports of these measurements are uncommon in nutritional surveys of undernourished children. To cite this article: Laurie C. Miller, Neena Joshi, Mahendra Lohani, Rupa Singh, Nisha Bhatta, Beatrice Rogers, Jeffrey K. Griffiths, Shibani Ghosh, Shubh Mahato, Padma Singh & Patrick Webb (2016): Head growth of undernourished children in rural Nepal: Association with demographics, health...
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The prevalence of anemia and iron deficiency is more common in breastfed infants than their mothers in Bhaktapur, Nepal

Authors: R.K. Chandyo; Sigrun Henjum; P. Shrestha; L. Locks; Wafie Fawzi; Tor Strand December 2015
Iron deficiency anemia is a widespread public health problem, particularly in low- and middle-income countries. Maternal iron status around and during pregnancy may influence infant iron status. We examined multiple biomarkers to determine the prevalence of iron deficiency and anemia among breastfed infants and explored its relationship with maternal and infant characteristics in Bhaktapur, Nepal.
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New Metrics for the Evaluation of SDG2: Insights from the FSIN Technical Working Group on Measuring food and Nutrition Security

Authors: William Masters November 2015
This presentation was delivered by Dr. William Masters, Nov. 17-18, 2015 at the Technical Seminar on Evaluation of SDG2, IFAD Headquarters.
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Linking Agriculture, Food Security, Diet and Nutrition in Nepal: Insights from the USAID Nutrition Innovation Lab

Authors: Sudeep Shrestha November 2015
This presentation was delivered by Sudeep Shrestha in November 2015 at the International Conference on Maternal and Child Nutrition in Sri Lanka.
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Community Connector: Effectiveness of integrated Agriculture, health livelihood and nutrition interventions to improve maternal and child nutrition and health in rural Uganda: A birth cohort study

Authors: Nutrition Innovation Lab October 2015
This presentation was made to the Ugandan Community Connector and is an update on the Birth Cohort Study in Uganda on Oct. 20, 2015.
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Africa Day: Effectiveness of integrated Agriculture, health livelihood and nutrition interventions to improve maternal and child nutrition and health in rural Uganda: A birth cohort study

Authors: Nutrition Innovation Lab October 2015
This poster presentation was featured at the Africa Day for Food and Nutrition Security in Kampala Uganda on Oct. 28-30, 2015.
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Nutrition-Specific and Nutrition-Sensitive Interventions: Implications for Programming in Nepal

Authors: Patrick Webb October 2015
This presentation was delivered by Patrick Webb on Oct. 9, 2015 at the Seminar Institute of Medicine.
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The Global Pattern of Malnutrition: From undernutrition to obesity and diet-related disease

Authors: William Masters October 2015
This presentation was delivered Oct. 14, 2015 for the BIFAD event at the World Food Prize Borlaug Dialogue by Dr. William Masters.
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Nutrition Transition and Agricultural Transformation: A Preston Curve Approach

Authors: William Masters October 2015
This presentation was delivered by Dr. William Masters on Oct. 28, 2015 at Rutgers University.
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UNICEF: Timor-Leste Food and Nutrtion Survey 2013- Final Report

Authors: Nutrition Innovation Lab October 2015
UNICEF Report: The data collection for this survey was carried out between May and September 2013 among children aged 0-59 months and their non-pregnant mothers (aged 14 – 60 years). The survey assessed the risk factors for undernutrition based on Conceptual Framework of Malnutrition (UNICEF, 1990) which is being used for nutrition programming worldwide for the past 25 years. The prevalence of micronutrient deficiencies (vitamin A, iron, zinc, and iodine deficiency), and the iodine content of household iodised salt and aflatoxin exposure among children (aged 6 – 59...
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Understanding Agriculture to Nutrition Linkages: A Rapidly Moving Agenda

Authors: Nutrition Innovation Lab September 2015
Presentations from Sept 30th, 2015 in Washington DC on research findings from the first 5 years of our research in Asia and Africa. These are the compiled slides from 8 separate presentations from: Patrick Webb, Patrick, Gerald Shively, Keith West, Shibani Ghosh, Nassul Kabunga, Robin Shrestha, Bernard Bashaasha, and Jeffrey Griffiths. To view the presentations, click on the presentation below to see the recording. Understanding Agriculture to Nutrition Linkages: A Rapidly Moving Agenda Maura Mack  Opening Statements Patrick Webb  Mapping Nutrition Innovation Lab Research: How does it all...
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Agricultural Diversity and Child Stunting in Nepal

Authors: Gerald Shively; Celeste Sununtnasuk September 2015
This article investigates empirical connections between agriculture and child nutrition in Nepal. We augment the standard approach to explaining child nutrition outcomes by including information about household level agricultural production characteristics, including indicators of agricultural diversity. Data from the 2010/2011 Nepal Living Standards Survey (NLSS) are used in a series of regression models to explain stunting outcomes and variation in height-for-age Z-scores among 1,769 children 0–59 months of age. Results highlight the relative importance of overall agricultural yields, specific crop groups, and the consumption of own-production as factors correlated...
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Obesity and Stunting in Egypt, and The Roles of Water, Sanitation, and Mycotoxins

Authors: Jeffrey Griffiths August 2015
Presentation given by Dr. Jeff Griffiths for USAID Egypt in Cairo, Aug. 4, 2015
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Does Ethiopia’s Productive Safety Net Program improve child nutrition?

Authors: Bethelhem Legesse Debela; Gerald Shively August 2015
In this paper, we use data from Northern Ethiopia to study the links between a social protection program and child nutrition. Child malnutrition is one of the many challenges that pose a threat to economic growth in developing countries. It undermines educational attainment, lowers non-cognitive skills, leads to low labor productivity during adulthood, and  diverts attention and resources away from other development objectives. Ultimately, under-nutrition during childhood can lead to intergenerational poverty.
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Underlying Vitamin A Status Affects the Association between Dark Green Leafy Vegetable Intake and Serum Retinol and β-Carotene Concetrations among Pregnant Women in Nepal

Authors: Jamie Dorsey July 2015
This poster presentation examines levels of Vitamin A and B Carotene in pregnant women in Kathmandu Nepal.
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Alcohol Use Among Pregnant Ugandan Women of Mixed HIV Status is Associated with Social Environment and Food Insecurity

Authors: Shalean Collins; Barnabas Natamba; Angela Arbach; Elizabeth Widen; Pooja Desai; Hijab Khan; Jeffrey Griffiths; Sera Young July 2015
Antenatal alcohol use (AAU) is associated with poor health outcomes in maternal-infant dyads. However, AAU prevalence and risk factors are poorly understood, particularly in low-income settings. Therefore we studied correlates of any AAU among pregnant women receiving antenatal care in Gulu, Uganda.
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Valuing Women’s Time in Nutrition

Authors: Patrick Webb June 2015
Dr. Webb presents in London with the APPG. With renewed concerns for malnutrition in the context of post-2015 development framework, it is important to consider the directions taken by nutrition research and policy. Recent work in the areas of agriculture, nutrition and health is seeking to shed light on how agriculture can improve nutrition and health. Women are seen as important players in many of the pathways linking agriculture and nutrition. Women’s participation in agricultural work can contribute to nutrition via increased incomes, but it...
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Understanding Pathways of Better Nutrition: Poster Presentation

Authors: Edgar Agaba June 2015
This poster is a result of Edgar Agaba’s ALE-(Applied Learning Experience) research work that was completed last year in Uganda’s 2 districts of Lira and Kisoro.  Collaborators included MPH- ALE, JSI/SPRING Project, and the Nutrition Innovation Lab.  The poster was presented at the LCIRAH Research Conference, June 03-04, 2015.  
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Social support modifies the bidirectional linkages between food insercutiy and prenatal depresseive symptoms while domestic violence alters the unidirectional impact of food insecurity on prenatal depressive symptoms

Authors: Barnabas Natamba June 2015
This presentation by Barnabas Natamba examines and draws links between food security/ nutrition and social support/ mental health/ HIV status.
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Environmental Variability and Child Growth in Nepal

Authors: Gerald Shively; Celeste Sununtnasuk; Molly Brown June 2015
Data from the 2011 Nepal Demographic Health Survey are combined with satellite remotely sensed Normalized Difference Vegetation Index (NDVI) data to evaluate whether interannual variability in weather is associated with child health. For stunting, we focus on children older than 24 months of age. NDVI anomaly averages during cropping months are evaluated during the year before birth, the year of birth, and the second year after birth. For wasting, we assess children under 59 months of age and relate growth to NDVI averages for the...
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Strengthening Policy Actions and Governance for Nutrition

Authors: Patrick Webb; Amanda Pomeroy May 2015
This is the joint Nutrition Lab/SPRING presentation to USAID on common research activities in Nepal and Uganda regarding policy and governance for nutrition.  It was presented May 5th, 2015 in Washington DC.
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Agricultural policy for improved nutrition in Africa and Asia: evidence to guide the US Government’s investments in food security

Authors: William Masters; Brooke Colaiezzi; Katherine Dennison; Jeff Hill; Elizabeth Jordan-Bell; Ahmed Kablan; Melanie Thurber; Lorraine Weatherspoon; James Oehmke May 2015
The roundtable process was designed to complement numerous past and ongoing efforts to assemble and disseminate rigorous evidence on how agricultural change can best help to improve international nutrition, beginning with the first Lancet Maternal and Child Nutrition series in 2008 and its follow-up in 2013 and other systematic reviews (Webb and Kennedy 2014), as well as assessments from private groups such as the Copenhagen Consensus (2014) and the Global Panel on Agriculture and Food Systems for Nutrition (2014), international organizations such as the World...
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Urbanization, market development and malnutrition in farm households: evidence from the Demographic and Health Surveys, 1986–2011

Authors: Amelia Darrouzet-Nardi; William Masters May 2015
A principal effect of agricultural productivity growth is to accelerate urbanization by supplying food, labor and other resources to urban services and industry. Towns and cities may also grow for their own reasons, pulling food and resources out of rural areas. Whether pushed or pulled, the development of markets creates new opportunities for agricultural households. This study tests whether, on balance, proximity to older towns and cities has improved or worsened malnutrition among farm households in 43,850 survey clusters in 46 developing countries between 1986...
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Agricultural policy for improved nutrition in Africa and Asia: evidence to guide the US Government’s investments in food security

Authors: William Masters; Katherine Dennison; Jeff Hill; Elizabeth Jordan-Bell; Ahmed Kablan; Melanie Thurber; Lorraine Weatherspoon; James Oehmke May 2015
The roundtable process was designed to complement numerous past and ongoing efforts to assemble and disseminate rigorous evidence on how agricultural change can best help to improve international nutrition, beginning with the first Lancet Maternal and Child Nutrition series in 2008 and its follow-up in 2013 and other systematic reviews (Webb and Kennedy 2014), as well as assessments from private groups such as the Copenhagen Consensus (2014) and the Global Panel on Agriculture and Food Systems for Nutrition (2014), international organizations such as the World...
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Update on the Nutrition Innovation Lab Approach

Authors: Jeffrey Griffiths April 2015
Presentation given by Dr. Jeff Griffiths for USAID Malawi, April 15, 2015
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Maternal HIV infection, but not food insercutity access score, predicts the rate of weight change in pregnant women attending antenatal services in northern Uganda

Authors: Barnabas Natamba April 2015
This poster examines seasonal food security/ insecurity, MUAC measurements, and HIV status in Uganda.
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Maternal Food Insecurity is Associated with Loss of Fat, but not Lean Mass during Lactation among Ugandans of Mixed-HIV Status

Authors: E. Widen; B. Natamba; S. Ghosh; J. Griffiths April 2015
HIV-infected women lose more weight during lactation than HIV-uninfected women. Whether this loss is fat-mass (FM) or fat-free mass (FFM) is unknown, but important, as lean mass loss accelerates HIV progression.
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UNICEF: Timor-Leste Food and Nutrtion Survey 2013- Summary of Key Findings and Recommendations

Authors: Nutrition Innovation Lab April 2015
UNICEF Report: The data collection for this survey was carried out between May and September 2013 among children aged 0-59 months and their non-pregnant mothers (aged 14 – 60 years). The survey assessed the risk factors for undernutrition based on Conceptual Framework of Malnutrition (UNICEF, 1990) which is being used for nutrition programming worldwide for the past 25 years. The prevalence of micronutrient deficiencies (vitamin A, iron, zinc, and iodine deficiency), and the iodine content of household iodised salt and aflatoxin exposure among children (aged 6 – 59...
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Connecting the dots between human malaria, livestock, and under-nutrition: An unexpected pathway

Authors: Jeffrey Griffiths; Nassul Kabunga March 2015
Presentation given by Drs. Jeff Griffiths and Nassul Kabunga for USAID in Washington DC, March 15, 2015
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Microbial Decontamination of Fresh Produce (Strawberry) Using Washing Solutions

Authors: Naresh Shahi; Byungjin Min; Eunice A. Bonsi March 2015
This Tuskegee University study was carried out to determine the effect of natural antimicrobial washing solutions against microbial growths on fresh produce specifically strawberries. Selected washing solutions used for strawberry washing, and treatments were sterile water (control), white vinegar (VI), crude lemon juice extract (LE), VI+Origanum oil (VIO), LE+Origanum oil (LEO), and VI+LE+Origanum oil (VILEO).
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How strong is our evidence for effective management of wasting? A review of systematic and other reviews

Authors: Patrick Webb March 2015
A need for improved empirical evidence for the effectiveness of interventions used in the management of child wasting (moderate and/or severe acute malnutrition) has recently been highlighted. There is no lack of published studies in this field, but when examined through the lens of systematic review protocols, few of these studies stand up to rigorous methodological critique. This paper summarizes the current state of knowledge, as supported by high-quality research included in multiple systematic reviews. It also elaborates on the criteria and standards used in such reviews. The paper highlights...
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Household Malaria and Livestock: Linking Health, Nutrition & Agriculture

Authors: Nassul Kabunga; Jeffery Griffiths February 2015
Presentation on the benefits of Improved Dairy Cows.
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Dietary quality, undernutrition and disease: global patterns and trends over three decades

Authors: Rosemary Green; Jenny Sutherland; Alan Dangour; Bhavani Shankar; Patrick Webb February 2015
Recent studies have found evidence of an increasing polarization between healthy and unhealthy diets, with many high income countries having diets that are becoming more healthy, while in lower income countries diets are becoming more unhealthy. However, little is known about how the changing availability of different kinds of foods at a national level may be related to both undernutrition and NCDs.
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Malaria predicts maternal and child anemia in Uganda and is modulated by altitude and prior IRS

Authors: Jeffrey Griffiths February 2015
Presentation given by Dr. Jeff Griffiths for USAID in Kampala, Uganda, Feb. 10, 2015
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Why Food is Not Enough-Boston University

Authors: Jeffrey Griffiths February 2015
Presentation given by Dr. Jeff Griffiths at Boston University, February 27, 2015
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Why Food is Not Enough-BBNC

Authors: Jeffrey Griffiths January 2015
Presentation given by Dr. Jeff Griffiths at the Boston to Bangalore Nutrition Collaboration event, January 2015
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Low dietary diversity and micronutrient adequacy among lactating women in a peri-urban area of Nepal

Authors: Sigrun Henjum; Liv Elin Torheim; Andrew L Thorne-Lyman January 2015
The main objectives were to assess the adequacy of the micronutrient intakes of lactating women in a peri-urban area in Nepal and to describe the relationships between micronutrient intake adequacy, dietary diversity and sociodemographic variables. Breast-feeding is one of the most important factors that can influence child health in low- and middle-income countries. During lactation, women have increased requirements for energy and micronutrients. An inadequate maternal intake of certain nutrients during this period may have consequences for both the mother’s health and nutritional status, as well as those of the breast-fed...
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Update Presentation to USAID Mission in Nepal on Nutrition Innovation Lab

Authors: Maura Mack November 2014
Update Presentation for the Nutrition Innovation Lab’s 2014 progress in regards to the Lab’s mission statement and work in Asia. Delivered Nov. 21st, 2014.
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Does amount and kind of food brought by a Household vary by indices of wealth in Nepal

Authors: Erin Bihel November 2014
2014 Nutrition Innovation Lab’s Scientific Symposium in Kathmandu, Nepal, Poster presentation from Erin Bihel entitled, “Does amount and kind of food brought by a Household vary by indices of wealth in Nepal”
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Linking Antenatal and Postnatal Care, maternal health knowledge, and behavior among women in the PoSHAN Community Studies

Authors: Jamie Dorsey November 2014
The 2014 Annual Scientific Symposium in Katmandu Nepal, Jamie Dorsey’s poster presentation entitled, “Linking Antenatal and Postnatal Care, maternal health knowledge, and behavior among women in the PoSHAN Community Studies”.
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Is diversity in agriculture production linked to dietary diversity in among Nepalese Women? Findings from the PoSHAN Community Studies

Authors: Claire Fitch November 2014
2014 Nutrition Innovation Lab’s Scientific Symposium in Kathmandu, Nepal, Poster presentation from Claire Fitch entitled, “Is diversity in agriculture production linked to dietary diversity in among Nepalese Women? Findings from the PoSHAN Community Studies”
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“Eat your Fruits and Vegetables and Don’t Get Malaria”: Linkages between Agriculture, Nutrition, and Health in Uganda

Authors: Jeffrey Griffiths November 2014
Presentation given by Dr. Jeff Griffiths for the Center for Global Public Health Event at Tufts University, Nov. 20, 2014
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Nutrition Innovation Laboratory:Nepal Research and Capacity-Building Activities

Authors: Maura Mack November 2014
This presentation was given by Maura Mack as an update to USAID in Nepal on the nature of the Nutrition Innovation Lab’s work and progress in Nepal, November, 2014.
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Household food insecurity, maternal nutritional status, and infant feeding practices among HIV-infected Ugandan women receiving combination antiretroviral therapy

Authors: Sera Young; Flavia Luwedde; Paul Natureeba; Jane Achan ; Veronica Ades; Beth Osterbauer; Edwin Charlebois; Moses Kamya; Diane Havlir; Deborah Cohan November 2014
Household food insecurity (HHFI) may be a barrier to both optimal maternal nutritional status and infant feeding practices, but few studies have tested this relationship quantitatively, and never among HIV-infected individuals. We therefore described the prevalence of HHFI and explored if it was associated with poorer maternal nutritional status, shorter duration of exclusive breastfeeding (EBF) and fewer animal-source complementary foods. We assessed these outcomes using bivariate and multivariate analyses among 178 HIV-infected pregnant and breastfeeding (BF) women receiving combination antiretroviral therapy in the PROMOTE trial...
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Cover Image: Reliability and validity of the Center for Epidemiologic Studies- Depression scale in screening for depression among HIV infected and uninfected pregnant women attending antenatal services in northern Uganda

Reliability and validity of the Center for Epidemiologic Studies- Depression scale in screening for depression among HIV infected and uninfected pregnant women attending antenatal services in northern Uganda

Authors: Barnabas K. Natamba; Thomas O. Oyok; Angela Arbach; Jane Achan; Shibani Ghosh; Saurabh Mehta; Rebecca J. Stoltzfus; Jeffrey K. Griffiths; Sera L. Young November 2014
In the two decades since the first Global Burden of Disease (GBD) report was released in 1990, the impacts that HIV infection and major depressive disorders (MDDs) have had on medical and public health systems have changed profoundly. The 2010 GBD report indicates that HIV infection has risen from being the 33rd to the 5th contributor to the global burden of disease (Murray et al. 2013). At the same time, the disease burden attributable to MDDs has risen from being the 15th to the 11th....
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“I Have Remained Strong Because of That Food”: Acceptability and Use of Lipid-Based Nutrient Supplements Among Pregnant HIV-Infected Ugandan Women Receiving Combination Antiretroviral Therapy

Authors: SL Young; F Luwedde; B. Okia; P Natureeba; L. Johnson; C. Michel; M. Robine; E. Charlebois; D. Havlir November 2014
We evaluated the acceptability and use of macronutrient supplementation among HIV-infected pregnant Ugandan women receiving antiretroviral therapy in a clinical study (NCT 00993031). We first conducted formative research among 56 pregnant and lactating women to select a supplement regimen. Acceptability and use of the supplementation regimen (35 sachets of lipid-based nutrient supplements (LNS) and 4 or 6 kg of instant soy porridge for the household provided monthly) were evaluated among 87 pregnant women. Organoleptic assessments of LNS were favorable. Participants reported consuming LNS a mean...
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Cover-Brown et al 2014

Using satellite remote sensing and household survey data to assess human health and nutrition response to environmental change

Authors: Molly E. Brown; Kathryn Grace; Gerald Shively; Kiersten B. Johnson; Mark Carroll September 2014
Climate change and degradation of ecosystem services functioning may threaten the ability of current agricultural systems to keep up with demand for adequate and inexpensive food and for clean water, waste disposal and other broader ecosystem services. Human health is likely to be affected by changes occurring across multiple geographic and time scales. Impacts range from increasing transmissibility and the range of vectorborne diseases, such as malaria and yellow fever, to undermining nutrition through deleterious impacts on food production and concomitant increases in food prices....
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Determinants of Stunting and Severe Stunting among under-fives: Evidence from the 2011 Nepal Demographic and Health Survey

Authors: Rina Tiwari; Lynne M Ausman; Kingsley Emwinyore Agho September 2014
Stunting remains a major public health concern in Nepal as it increases the risk of illness, irreversible body damage and mortality in children. Public health planners can reshape and redesign new interventions to reduce stunting and severe stunting among children aged less than 5 years in this country by examining their determinants. Hence, this study identifies factors associated with stunting and severe stunting among children aged less than five years in Nepal.
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Cover Image:Reliability and validity of an individually-focused food insecurity access scale for assessing inadequate access to food among pregnant Ugandan women of mixed HIV status

Reliability and validity of an individually-focused food insecurity access scale for assessing inadequate access to food among pregnant Ugandan women of mixed HIV status

Authors: Barnabas K. Natamba; Angela Arbach; Hillary Kilama; Jane Achah; Jeffrey Griffiths; Sera Young August 2014
Food security occurs “when all people, at all times, have physical, social, and economic access to sufficient, safe, and nutritious food that meets their dietary needs and food preferences for an active and healthy life.” Food insecurity (FI) exists when these conditions are not met and is a major underlying cause of undernutrition enshrined in the UNICEF conceptual framework. FI is a major risk factor for adverse health outcomes among specific vulnerable populations including persons infected with HIV, women and children. Women’s responsibilities in managing family...
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Henjum et al 2014

Iron deficiency is uncommon among lactating women in urban Nepal, despite a high risk of inadequate dietary iron intake

Authors: Sigrun Henjum; Mari Manger; Eli Skeie; Manjeswori Ulak; Andrew L. Thorne-Lyman; Ram Chandyo; Prakash S. Shrestha; Lindsey Locks; Rune J. Ulvik; Wafaie W. Fawzi; Tor A. Strand July 2014
The main objective of the present study was to examine the association between dietary Fe intake and dietary predictors of Fe status and Hb concentration among lactating women in Bhaktapur, Nepal. We included 500 randomly selected lactating women in a cross-sectional survey. Dietary information was obtained through three interactive 24 h recall interviews including personal recipes. Concentrations of Hb and plasma ferritin and soluble transferrin receptors were measured. The daily median Fe intake from food was 17·5 mg, and 70% of the women were found...
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Research Brief #18: Food prices, their determinants and connections to child nutrition in Nepal

Authors: Gerald Shively; Ganesh Thapa July 2014
A majority of Nepalese households are net buyers of food and depend on markets for their food purchases (CBS 2011). As a result, market performance and food prices directly influence levels of household consumption. These, in turn, can influence nutrition outcomes. Given the potentially deleterious effects of high food prices on child nutrition outcomes in food-purchasing households, one of the important pathways to reducing child malnutrition rates over time is likely to be by increasing market efficiency and reducing food prices. A number of studies...
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LCIRAH Presentation: PoSHAN policy process

Authors: Patrick Webb June 2014
This presentation was given by Dr. Webb at the LCIRAH conference in June of 2014 and discusses nutrition policy using PoSHAN data.
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The Dynamics of Nutrition Program Implementation in Ethiopia: Facilitators and Constraints at National and Sub-National Level

Authors: Masresha Tessema June 2014
The Government of Ethiopia (GOE) is committed to improving the nutritional status of the population. The GOE has made significant progress in reducing malnutrition since 2000. The revised National Nutrition Program is aimed at accelerating the decrease in under nutrition through a multi sector nutrition plan. This study assessed the facilitators and constraints to adopting the NNP at the national and sub national level. Key issues were identified including leadership, coordination, awareness, capacity and budget. A series of recommendations derived from the study data are...
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Research Brief #17: Perceptions and Practices Relating to Nutrition Among Decision-Makers at KISAN sites of Nepal

Authors: Patrick Webb; Shibani Ghosh; Diplav Sapkota; Sabi Gurung June 2014
This research brief presents preliminary findings from work in Nepal that explores how multi- sectoral programming explicitly linking agriculture with health and nutrition achieves impacts on the ground. Recognition that “merely producing more food does not ensure food security or improved nutrition” (Herforth et al. 2012) begs questions about when, where and why does it, or does it not ensure food security or support improved nutrition? In particular, more understanding is needed of how various stakeholders involved in program and policy implementation at various levels...
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Achieving Concurrent Agricultural Productivity and Nutrition Goals through Research

Authors: Patrick Webb May 2014
Global Legume Researchers Meeting: this presentation examines the role of legumes in promoting better, more sustained solutions for improving global nutrition. Presented by Dr. Webb, May 2014, in Athens Greece.
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Research Brief #16: Perceptions and Practices Relating to Nutrition Among Decision-Makers at Suaahara sites of Nepal

Authors: Patrick Webb; Shibani Ghosh; Diplav Sapkota; Sabi Gurung May 2014
This brief presents preliminary findings from work in Nepal that explores such issues, including the processes, impacts, constraints and innovations in multi-sectoral programming that explicitly links agriculture with health and nutrition. The focus in this brief is on a first round of data, collected in 2013 under USAID’s Feed the Future Innovation Lab for Collaborative Research on Nutrition, aimed at assessing policymakers’ and programming professionals’ understanding of nutrition problems, challenges to multi-sector programming and potential solutions.
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Cover Image-Agricultural correlates of linear growth and key modifiers among children under two years in rural Uganda

Agricultural correlates of linear growth and key modifiers among children under two years in rural Uganda

Authors: Nilupa Gunaratna May 2014
Many sources have recently called for agricultural programs and policies to become more “nutrition-sensitive”, with the aim of harnessing agriculture to improve nutrition and health. Several researchers have described potential causal pathways through which agriculture could impact the nutrition and health of vulnerable populations. Stunting, or poor linear growth, particularly in young children is a key indicator. Reflecting chronic undernutrition, stunting can begin in utero, and studies have shown that it can be difficult to recover from faltering in linear growth during gestation and the...
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Cover Image: Land use change, fuel use and respiratory health in Uganda

Land use change, fuel use and respiratory health in Uganda

Authors: Pamela Jagger; Gerald Shively April 2014
This paper examines how biomass supply and consumption are affected by land use change in Uganda. We find that between 2007 and 2012 there was a 22% reduction in fuelwood sourced from proximate forests, and an 18% increase in fuelwood sourced from fallows and other areas with lower biomass availability and quality. We estimate a series of panel regression models and find that deforestation has a negative effect on total fuel consumed. We also find that access to forests, whether through ownership or proximity, plays...
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Research Brief #15: Governance of Nutrition Policies and Programming: Preliminary Findings from PoSHAN process research in Nepal

Authors: Nutrition Innovation Lab April 2014
This research brief presents preliminary findings from work in Nepal that explores how policy processes influence the implementation of nutrition-specific and nutrition-sensitive actions. At a time when the government’s Multi-Sector Nutrition Plan (MSNP) is being rolled out, and new multi-dimensional nutrition programmes are scaling up, this study captures insights and experiences of stakeholders from central government to ward-level service providers. Constituting a longitudinal prospective analysis of policy events as they unfold, the research considers what incentives or barriers affect collaboration within and across ministries, whether...
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Can Smallholder Fruit and Vegetable Production Systems Improve Household Food Security and Nutritional Status of Women?

Authors: Nassul Kabunga; Shibani Ghosh; Jeffrey Griffiths April 2014
This paper aims to empirically infer potential causal linkages between fruit and vegetable (F&V) production, individual F&V intake, household food security, and anemia levels for individual women caregivers of childbearing age. Using a unique and rich data set recently collected from rural smallholder Ugandan households, we show that the use of a qualitative tool to measure household food insecurity is robust and applicable in other contexts. We also show, using robust econometric methods, that women living in F&V-producer households have a significantly higher intake of...
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Overview of, and Opportunities for Collaboration with, the Nutrition Innovation Lab

Authors: Patrick Webb March 2014
Given as a webinar for USAID, this presentation details the work and mission of the Nutrition Innovation Lab, why our work is important, and possibilities for collaboration with other Innovation Labs.
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The Contribution of Agriculture to Nutrition: Thought Experiments and Experimental Thoughts

Authors: Patrick Webb March 2014
This presentation, given in Kathmandu by Patrick Webb, covers global nutrition statistics and examines the pathways between agriculture and nutrition in relation to those statistics.  March 2014.
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The Role of Horticulture and Aquaculture in Addressing Nutrition Needs

Authors: Patrick Webb March 2014
This presentation examines possible solutions for malnutrition sourced from the horticulture and aquaculture sectors, Patrick Webb, March 2014
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Cover Image: Impacts of agriculture on nutrition: Nature of the evidence and research gaps

Impacts of agriculture on nutrition: Nature of the evidence and research gaps

Authors: Patrick Webb; Eileen Kennedy March 2014
Demand for empirical evidence of “what works” for nutrition through agriculture has arguably never been higher. In the past few years, there has been a proliferation of interest in how to leverage agriculture to maximize its impacts on nutrition, particularly among mothers and children. The belief that “agriculture contributes not just to food production, but also to human nutrition and health” is widely held, and it underpins ongoing efforts globally to “make agricultural policies and programs nutrition-sensitive”. However, the search for solid empirical findings on...
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Cover Image: Research in Asia: Approach, Methods and Protocols

Research Briefing #14: Research in Asia: Approach, methods, And Protocols

Authors: Patrick Webb; Shibani Ghosh; Eileen Kennedy; K. West; Rolf Klemm; D. Sapkota; Swetha Manohar; Jeffrey K. Griffiths March 2014
At the 19th International Congress on Nutrition in Bangkok (in 2009), the United Nations’ Standing Committee on Nutrition concluded that “there is an urgent need to provide evidence- based information on food-based strategies and systems in order to make a case for their promotion. A series of scientific articles on food security interventions for nutrition should therefore be published to complement the public health interventions promoted by the Lancet Series [of 2008]. Sustainable food security approaches to nutrition require systemic, multidisciplinary and inter-sectoral approaches taking...
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Agriculture Sector approaches to addressing malnutrition

Authors: Patrick Webb February 2014
This Feed the Future Webinar presentation examines possible solutions for malnutrition sourced from the agriculture sector.  Presented by Dr. Webb in February of 2014.
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Nutrition Innovation Labs Overview and Opportunities for Collaboration

Authors: Patrick Webb February 2014
Given as a webinar for USAID in February 2014, this presentation details the work and mission of the Nutrition Innovation Lab, why our work is important, and possibilities for collaboration with other Innovation Labs.
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Cover Image: Agriculture, nutrition, and health in global development: typology and metrics for integrated interventions and research

Agriculture, nutrition, and health in global development: typology and metrics for integrated interventions and research

Authors: William A. Masters; Patrick Webb; Jeffrey K. Griffiths; Richard J. Deckelbaum February 2014
Despite rhetoric arguing that enhanced agriculture leads to improved nutrition and health, there is scant empirical evidence about potential synergies across sectors or about the mix of actions that best supports all three sectors. The geographic scale and socioeconomic nature of these interventions require integration of previously separate research methods. This paper proposes a typology of interventions and a metric of integration among them to help researchers build on each other’s results, facilitating integration in methods to inform the design of multisector interventions. The typology...
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Agricultural correlates of linear growth and key modifiers among children under two years in rural Uganda

Authors: Nilupa Gunaratna February 2014
Many sources have recently called for agricultural programs and policies to become more “nutrition-sensitive”, with the aim of harnessing agriculture to improve nutrition and health. Several researchers have described potential causal pathways through which agriculture could impact the nutrition and health of vulnerable populations. Stunting, or poor linear growth, particularly in young children is a key indicator. Reflecting chronic undernutrition, stunting can begin in utero, and studies have shown that it can be difficult to recover from faltering in linear growth during gestation and the...
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Cover Image:Proceedings of the 2nd Annual Scientific Sympoium August 13-14 2013

Research Briefing #13: Proceedings of the 2nd Annual Scientific Symposium

Authors: Raman Shrestha; Swetha Manohar; Rolf Klemm February 2014
The Nutrition Innovation Lab‘s 2nd annual scientific symposium held in Kathmandu, Nepal on August 13-14, 2013 under the theme “Science and Policy for Health, Agriculture and Economic Growth” facilitated the sharing of new research findings along the agriculture to nutrition pathway. Featuring 15 oral and 11 poster presentations, the two day meeting was attended by approximately 250 participants who represented researchers, field practitioners, government policymakers, donors (including the USAID mission) and 40 students from various Nepali institutions of higher education. The symposium included two keynote...
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Improved Dairy Cows in Uganda: Pathways to Poverty Alleviation and Improved Child Nutrition

Authors: Nassul Kabunga February 2014
There is limited empirical evidence on the linkages between agrotechnologies, poverty reduction and the pathways to better nutrition outcomes. The introduction and dissemination of improved dairy cow breeds in Uganda is arguably the most significant step taken to develop a modern and commercial dairy industry in the country over the last two decades. This study uses a nationally representative sample of Ugandan households to rigorously examine the impact of adoption of improved dairy cow breeds on enterprise-, household-, and individual child-level nutrition outcomes. We find...
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Cover Image: Letter to the Editor: Is the strength of association between indicators of dietary quality and the nutritional status of children being underestimated?

Letter to the Editor: Is the strength of association between indicators of dietary quality and the nutritional status of children being underestimated?

Authors: Andrew Thorne-Lyman; Donna Spiegelman; Wafaie W. Fawzi January 2014
The World Health Organization’s infant and young child feeding (IYCF) indicators were developed to fill multiple needs: to facilitate the assessment and comparison of IYCF practices across settings, to identify populations at risk and to evaluate the impact of interventions and measure progress towards achieving targets (World Health Organization 2008). Under- standing the relationships between these indicators and child anthropometric outcomes, as described in a recently published paper in Maternal & Child Nutrition (Jones et al. 2014), is relevant to many of these objectives because...
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No Rice in the House: Risk Factors and Association with Nutritional Status of Nepalese 9-13 year olds

Authors: Raman Shrestha; Rolph Klemm; Keith West January 2014
The aim of the study is to examine the association between household characteristics and “rise insecurity” as a measure of food insecurity and to explore the relationship between rice insecurity and the nutritional status of children 9-13 years of age in a rural population in Sarlahi District of Nepal.
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Cover Image: The prize and the price of good nutrition

The prize and the price of good nutrition

Authors: Patrick Webb December 2013
The global burden of disease is shifting rapidly. While in 1990, the top-ranked contributor to the global burden was child underweight, twenty years later we find that cancers and circulatory diseases contribute the most– accounting for 19% of global disability-adjusted life years (DALYs), with about a third of the total deriving from other non- communicable diseases (NCDs), including chronic respiratory, digestive, neurological, mental, endocrine, and other disorders1. By 2010, child underweight had dropped to 8th place in the ranking of contributors to the overall disease...
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Cover Image: Afterword: Now is the time

Afterword: Now is The Time

Authors: Patrick Webb September 2013
Chapter in The Road to Good Nutrition: A Global Perspective Does the world really need this book? Do the shelves of analysts and policymakers need the weight of yet another compendium of ideas, statistics and rhetoric? The answer, perhaps surprisingly, is yes. Such a book is needed now, more than ever, because it reflects the rapid convergence of opinion around priority problems and likely pathways towards solutions.
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Comprehensive Assessment of the Peanut Value Chain for Nutrition Improvement in Ghana

Authors: Shibani Ghosh; William Masters September 2013
The goal was to identify opportunities for new investment and interventions to improve nutrition and livelihoods on a commercial scale (through agriculture linking to commercial enterprises). This enhances our understanding of crop value chains particularly relevant to women, and to the issues around value chains involving aflatoxin-free foodstuffs.
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PoSHAN Community Studies: Finding Pathways to Accelerate Nutritional Impacts

Authors: Rolf Klemm; Keith West; Swetha Manohar August 2013
John Hopkins’ PoSHAN review at the 2nd Annual Scientific Symposium, August 2013.
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Repaving the Pathways: What do we need to know about processes that support program impacts?

Authors: Patrick Webb August 2013
This presentation goes in-depth to the assessment of support programs and interventions; giving hard evidence and suggesting indicators for the measurement of success. Given by Patrick Webb for USAID, August 2013.
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Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost?

Authors: Zulfiquar Bhutta; Jai Das; Arjumand Rizvi; Michelle Gaffey; Neff Walker; Susan Horton; Patrick Webb; Robert Black August 2013
Maternal undernutrition contributes to 800,000 neonatal deaths annually through small for gestational age births; stunting, wasting, and micronutrient deficiencies are estimated to underlie nearly 3·1 million child deaths annually. Progress has been made with many interventions implemented at scale and the evidence for effectiveness of nutrition interventions and delivery strategies has grown since The Lancet Series on Maternal and Child Undernutrition in 2008. We did a comprehensive update of interventions to address undernutrition and micronutrient deficiencies in women and children and used standard methods to assess emerging...
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Impact Pathways from Agricultural Research to Improved Nutrition and Health: Literature Analysis and Research Priorities

Authors: Patrick Webb June 2013
This paper contributes to ongoing work at many institutions aimed at identifying priority knowledge gaps, determining the best research approaches needed to fill those gaps, and exploring how to better support policy and programme implementation with sound empirical evidence of ‘what works’.
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Cover Image Baseling Report Uganda 2013

Assessing the Linkage Between Agriculture, Food Security, Nutrition and Health Among Women and Children in Rural Ugandan Households

Authors: Joyce Kikafunda Et Al. March 2013
There is significant movement globally and in Uganda on addressing issues of nutrition and health in vulnerable populations including women and children. This is especially important since approximately 0.5 million women die each year of pregnancy related complications linked under nutrition, while more than 5 million pre-school children die of preventable causes due to the combined effects of disease and under nutrition. There is some progress being made globally, with 63 countries as of 2010 on track to achieve the First Millennium Development Goal (MDG)...
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Cover Image: Market Analysis of Complementary Foods in Nepal

Research Brief #12: Market Analysis of Complementary Foods in Nepal

Authors: Richard Magnani; Anahit Gevorgyan; Kathleen Kurz February 2013
While best programming methods have been identified for many of the essential nutrition actions–e.g., breastfeeding, micronutrient tablet provision–the way forward for improving complementary feeding practices is much less clear, as is agriculture’s contribution. The vast majority of children in Nepal do not receive a minimum acceptable diet, and behavior change for complementary feeding within households has been difficult to achieve at scale. An underestimated constraint on child feeding is that the child’s food preparation takes a lot of mothers’ time, which is often already limited...
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Cover Image: Stocktaking: Agriculture Degree Programs in Nepal

Research Brief #11: Stocktaking: Agriculture Degree Programs in Nepal

Authors: Nutrition Innovation Lab January 2013
Recently, there have been renewed calls for the integration of nutrition, health, and agriculture to improve the nutritional status of populations. Whereas these sectors previously operated in separate realms, various frameworks have been propounded to highlight the importance of a multi‐sectoral approach and to establish links between the sectors to impact nutritional status. The 2008 Lancet Nutrition Series and the Scaling Up Nutrition (SUN) framework have provided evidence‐based interventions that have largely guided efforts at an integrated approach to address maternal and child undernutrition. The...
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Cover Image: Measuring the Links Between Agriculture and Child Health in Nepal

Research Brief #10: Measuring the Links Between Agriculture and Child Health in Nepal

Authors: Gerald Shively; Celeste Sununtnasuk; Molly Brown December 2012
We combine three distinct datasets to study the connections between agriculture and child health in Nepal. Demographic and Health Survey (DHS) data from 2006 are merged on the basis of common GIS data points with satellite remote sensed Normalized Difference Vegetation Index (NDVI) composites. Using these data we explore the association between the NDVI, a monthly proxy for agricultural production, and nutrition outcomes in children under age 5. We also employ nationally representative data from the 2003‐2004 Nepal Living Standards Survey (NLSS) to assess connections...
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Cover Image:Nutrition Degrees In Nepal: A Review of Current Offerings and Gaps

Research Brief #9: Nutrition Degree Programs In Nepal: A Review of Current Offerings and Gaps

Authors: Nutrition Innovation Lab November 2012
The Government of Nepal (GoN) has made a major commitment to improving the nutritional status of its population. For example, Nepal was one of the earliest countries to join the Scaling up Nutrition (SUN) Movement. As a SUN country, Nepal has articulated a clear strategy for scaling up direct nutrition interventions as well as identifying multi-sector strategies for improving nutrition. To this end, GoN in September 2012 released its Multi-Sector Nutrition Plan (MSNP) that will guide the government’s investment for the period 2013 to 2017....
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Cover Image: Sanitation in Nepal: Links to Nutrition and Research Priorities

Research Brief #8: Sanitation in Nepal: Links to Nutrition and Research Priorities

Authors: Patrick Webb; Jerry Shively; Prajula Mulmi October 2012
Globally, approximately 2.4 billion people do not have access to improved sanitation facilities, while 1.1 billion of those people practice open defecation (WHO 2012a; JMP 2012). Open defecation contributes substantially to the insanitary environment in which too many children grow up. About 2 million people die every year due to diarrheal diseases; most of them are children less than 5 years of age. Indeed, diarrhea is the second leading cause of death globally among children under 5, killing more young children than HIV/AIDS, malaria and...
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Research Brief #7: Agriculture, Food Security, and Nutrition in Nepal: Taking Stock and Defining Priorities

Authors: Sudeep Shrestha; Swetha Manohar; Rolf Klemm September 2012
The intent of the symposium was to share, understand and assimilate country- relevant evidence about factors that contribute to causal pathways that lead from agriculture to nutrition, in national, regional and local contexts. A national call for abstracts was made to researchers conducting work across these diverse but connected fields to present their work. The event was attended by approximately 140 participants from the scientific, research, program, policy maker and development partner communities. The symposium sought to understand, from data relevant to Nepal, (a) aspects...
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Research Brief #6: Aflatoxin

Authors: Gerald Shively August 2012
This brief explains the sources of aflatoxin, its importance in nutrition-related research, and its effects on humans, animals, and economics
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Cover Image:Integrating Agriculture and Nutrition Actions to Improve Maternal and Child Nutrition: Metrics for Coordinated Research

Research Brief #5: Integrating Agriculture and Nutrition Actions to Improve Maternal and Child Nutrition: Metrics for Coordinated Research

Authors: Nutrition Innovation Lab July 2012
There is a great need to establish solid, empirical knowledge of the effects of integrated programs targeting agriculture, nutrition and health (ANH), which are often complex, multi‐sector interventions. In particular, there is a need to develop metrics and measures that will allow researchers within the realm of agriculture‐health to understand the barriers, facilitators and drivers of nutrition impact—and to be able to rigorously say why and how a program succeeded or failed, as well as draw more generalizable lessons about the combination of inputs and...
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Integrating Agriculture and Nutrition Actions to Improve Maternal and Child Nutrition: Research on Program Impact Pathways

Authors: Patrick Webb June 2012
From a LCIRAH Workshop, June 21-22, 2012, London. There is a need to establish solid, empirical knowledge of the effects of integrated programs targeting agriculture, health and nutrition, which are often complex, multi-sector interventions. In particular, there is a need to develop metrics and measures that will allow researchers within the realm of agriculture-to-health to understand the barriers, facilitators and drivers of nutrition impact- and to be able to rigorously say why and how a program succeeded or failed, as well as draw more generalizable...
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Cover Image: Impacts of Agriculture on Nutrition: Nature of the Evidence and Research Gaps

Research Brief #4: Impacts of Agriculture on Nutrition: Nature of the Evidence and Research Gaps

Authors: Patrick Webb; Eileen Kennedy June 2012
In the last few years, there has been a proliferation of interest in how to leverage agriculture to maximize its impacts on nutrition, particularly among mothers and children (USAID 2011; Herforth 2012). The belief that “agriculture contributes not just to food production, but also to human nutrition and health” (IFPRI 2012) is widely held, and it underpins ongoing efforts globally to “make agricultural policies and programs nutrition-sensitive.”(BMGF 2012) However, the search for solid empirical findings of ‘what works’ in this arena has been stepped up...
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Cover Image: Agriculture, Food Security and Nutrition in Nepal: Taking Stock and Defining Priorities

Research Brief #3: Nutrition CRSP Scientific Symposium: Agriculture, Food Security and Nutrition in Nepal: Taking Stock and Defining Priorities

Authors: Sudeep Shrestha; Swetha Manoha; Rolf Klemm May 2012
The Nutrition Collaborative Research Support Program (CRSP)- Asia through its partner, Johns Hopkins Bloomberg School of Public Health, organized a two-day scientific symposium in Kathmandu, Nepal, co-hosted by the Department of Community Medicine and Public Health at the Institute of Medicine (IOM). The Nutrition CRSP is a multidisciplinary research consortium, which seeks to determine investments needed in agriculture, health and nutrition, institutional and human capacity development, and program development to achieve large-scale improvements in nutrition outcomes. The preliminary report of the 2011 Nepal Demographic Health...
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Cover Image:Nutrition CRSP Stakeholder Meeting: Selected Conclusions on Research Priorities for Nepal

Research Brief #2: Nutrition CRSP Stakeholder Meeting: Selected Conclusions on Research Priorities for Nepal

Authors: Nutrition Innovation Lab April 2012
In the context of commitments shown by the Government of Nepal to addressing the country’s nutrition challenges, the National Planning Commission, in collaboration with the Nutrition Collaborative Research Support Program (N/CRSP), organized a two‐day stakeholders’ forum to discuss research priorities in nutrition, health, and agriculture. The forum (held on November 21/22 2011) brought together 115 participants from across Nepal’s Government (National Planning Commission, Ministry of Health and Population, Ministry of Agriculture and Cooperatives, Ministry of Education, and Ministry of Local Development), as well as key...
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Risk Factors for Anemia in Non-Pregnant Women across the Agroecological Zones of Nepal

Authors: S. Manohar ; R. Shrestha; R. Rajbhandary; R. Klemm; Gauchan D; Adhikari R; Webb P; Ghosh S; West KPW Jr April 2012
Objective: Describe the prevalence of anemia in Nepali non-pregnant women of reproductive age by agroecological zone and potential risk factors.
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Cover Image: The Nutrition Collaborative Research Support Program (Nutrition CRSP): Planned Activities in Nepal

Research Brief #1: The Nutrition Collaborative Research Support Program (Nutrition CRSP): Planned Activities in Nepal

Authors: Nutrition Innovation Lab March 2012
Collaborative Research Support Programs (CRSPs) represent a long‐standing form of US government funding for research that facilitates partnerships among US‐based and developing‐country scholars on agriculture, food and nutrition issues of policy relevance globally. The CRSPs receive core funding from the Bureau for Food Security of USAID, as well as buy‐ins from USAID Missions and other parts of the Agency. The Nutrition CRSP is the most recently‐established of 10 existing CRSPs. As the first in a series of summaries of key issues, aimed at communicating progress...
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Mapping Nutrition Landscape in Mali

Authors: Shibani Ghosh; Jeffrey Griffiths, et al November 2011
Over the course of 3 months, Nutrition Innovation Labs-Africa assessed and mapped out existing Nutritional programs and support systems.
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A Review Stock Taking Report Nepal’s Private Sector Initiatives, Strategies and Interests in Nutrition

Authors: J. Adhikari October 2011
There is growing interest of private sector in food industries. This has come because of growing urbanization and better transportation opportunities as food now can be sent from one location to another at a fast rate than in the past. Moreover, the knowledge of food processing and quality is growing, and private sector has cashed this desire through establishing food processing industries. Agricultural industries have been the focus of the government since the start of planning for development started from the mid 1950s. The interest...
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A Review of Food Security and Human Nutrition Issues in Nepal

Authors: Gerald Shively September 2011
Nepal faces multiple development challenges, including chronic and wide spread food insecurity and adult and child malnutrition. Due to population growth, agricultural stagnation and a range of institutional failures, the threat of a serious food crisis in Nepal is substantial. The recent scaling back of WFP assistance means that food security conditions in some parts of Nepal will undoubtedly worsen in the near future. This paper presents a brief review of topics and available evidence regarding food security, malnutrition and related subjects in Nepal. It is intended to document important source...
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Stock taking Report Nutrition Sensitive Interventions for Agricultural Sector

Authors: J. Adhikari July 2011
Vulnerabilities to food insecurity are growing in Nepal. These vulnerabilities come from various factors – namely general decline in food production or agricultural growth, food price rise, seasonality in agricultural production, higher poverty rate in the food deficit areas, changes in food habits consuming junk food, especially in urban areas, lack of income and employment opportunities, lack of effective transportation for food distribution, especially in the hills and mountains, and chronic utilization problems such as inadequate access to health services, water and sanitation. Climate change...
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Working together to Improve Nutrition

Authors: Patrick Webb
This presentation examines the effectiveness of programmes and how to get more “bang for the buck” in terms of supplying evidence.
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Cover Image: Impact of tissue culture banana technology on farm household income and food security in Kenya

Impact of tissue culture banana technology on farm household income and food security in Kenya

Authors: Nassul S. Kabunga; Thomas Dubois; Matin Qaim
While tissue culture (TC) technology for vegetative plant propagation is gradually gaining in importance in Africa, rigorous assessment of broader welfare effects for adopting smallholder farm households is lacking. Using survey data and accounting for selection bias in technology adoption, we analyze the impact of TC banana technology on household income and food security in Kenya. To assess food security outcomes, we employ the Household Food Insecurity Access Scale (HFIAS) – a tool that has not been used for impact assessment before. Estimates of treatment-effects...
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