Suchergebnisse

Many of the challenges facing children now are a function of the changing times, including increases in urbanization, political violence, changing family forms, and, in some a cases, decreased supplies of adequate food. This paper reviews the evolving nature of these risks. In addition, the paper analyzes the development of formal and informal strategies to ameliorate the vulnerability and promote the resilience of young children to these risks. The paper identifies four stages in the research process regarding risks for children: (1) identification of the risk; (2) clarification of etiology and consequences; (3) recognition of resilience among some individuals; and (4) definition of factors in resilience and implications for intervention. ; Non-PR ; IFPRI1 ; FCND

India's record of undernutrition presents a stubborn challenge. Given the multiple determinants of child undernutrition, effective action to tackle this problem in India and globally requires a range of inputs across various sectors. Delivering nutrition-specific and nutrition-sensitive interventions to entire populations requires that these various sectors come together at critical points and in meaningful ways to ensure delivery of key nutrition-related actions for communities and households. However, currently in India, a major challenge is bringing sectors together to deliver for a common goal. Although the lack of convergence is well documented, there lingers a substantial gap in articulating what needs to be assessed to ensure that convergence is indeed happening, or not happening. In an effort to close this gap, in this paper we describe a possible framework to enable convergence across sectors for action on nutrition. Our framework notes that issues related to convergence must be resolved in relation to three major steps in the policy process: policy formulation, implementation, and monitoring and evaluation. We articulate here questions related to convergence that must be asked at each of these stages of the policy process. We also conduct a desk review to analyze health and nutrition policies in India for evidence of attention to these aspects of convergence. ; Non-PR ; IFPRI1; Theme 8; Subtheme 8.1; GRP24; TANDI ; PHND

Sub-optimal infant and young child feeding (IYCF) practices are likely a significant contributor to high undernutrition rates in Viet Nam. To date, however, there has been no comprehensive review of IYCF practices in Viet Nam. The objectives of this paper were to review: 1) patterns/trends in IYCF in Viet Nam; 2) the barriers and facilitators to IYCF practices; and 3) interventions and policies and their effectiveness. Methods used include reviewing and analyzing existing data, summarizing and organizing the evidence into broad themes based on a pre-defined conceptual framework. Findings show that the proportion of children ever breastfed is almost universal and the median duration of breastfeeding is 13-18 months. However, exclusive breastfeeding for the first six months is low (8-17%) and appears to be declining over time. Information on complementary feeding is limited, but two key challenges are: early introduction, and low nutrient quality of complementary foods. Facilitators of optimal IYCF were support from 1) government progressive policies, 2) non-profit organizations and 3) family members. Barriers to optimal IYCF included 1) the lack of enforcement of, and compliance with the code of marketing breast milk substitutes, 2) inadequate knowledge among health care providers; and 3) maternal poor knowledge. These findings indicate that the evidence base on complementary feeding is weak in Viet Nam and needs to be strengthened. The review also reinforces that program and policy actions to improve IYCF in Viet Nam must target multiple stakeholders at different levels: the family, the health system and the private sector. ; ISI; IFPRI3 ; PHND ; PR

INTRODUCTION: Childhood stunting has declined in India between 2006 and 2016, but not uniformly across all states. Little is known about what helped some states accelerate progress while others did not. Insights on subnational drivers of progress are useful not just for India but for other decentralised policy contexts. Thus, we aimed to identify the factors that contributed to declines in childhood stunting (from 52.9% to 37.6%) between 2006 and 2016 in the state of Chhattisgarh, a subnational success story in stunting reduction in India. METHODS: We examined time trends in determinants of stunting using descriptive and regression decomposition analysis of National Family Health Survey data from 2005 to 2006 and 2015–2016. We reviewed nutrition-relevant policies and programmes associated with the drivers of change to construct a policy timeline. Finally, we interviewed multiple stakeholders in the state to understand the changes in the drivers of undernutrition. RESULTS: The regression decomposition analysis shows that multiple factors explain 66% of the change in stunting between 2006 and 2016. Improvements in three key drivers—health and nutrition services, household assets, and sanitation and hygiene—explained 47% of the change in stunting. A shared vision for impact, political stability and capable bureaucracy, state-level innovations, support from development partners and civil society, and community mobilisation were found to contribute to improvements in programmes for health, poverty and sanitation. CONCLUSION: Change in multiple sectors is important for stunting reduction and can be achieved in subnational contexts. More work lies ahead to close gaps in various determinants of stunting.

IFPRI3; ISI; B Promoting healthy food systems; G Cross-cutting gender theme; CRP4 ; PHND; NDO; A4NH ; PR ; CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)

OBJECTIVES: Global attention to reducing childhood stunting has increased the demand for guidance on translating policies into impact. Evidence from national-level success cases is emerging but little is known about how subnational entities can accelerate change. In India, despite a common national framework of programs/policies targeting many determinants of child growth, stunting reduction has varied across states. We aimed to understand drivers of change in stunting at state-level and to identify programmatic, social and political factors that contributed to these changes. METHODS: We studied three states that had achieved substantial stunting declines between 2005 and 2016 [Chhattisgarh (CG) 14 percentage points (pp); Gujarat (GJ) 13pp; Odisha (OD) 11 pp]. We used regression-decomposition analysis to assess contributions of various determinants of height-for-age Z-score (HAZ) using two rounds of national data. We reviewed nutrition-relevant policies and programs linked to these drivers of change and interviewed stakeholders in government, development partners (DPs), academia and civil society (n = 61) to understand how change occurred. RESULTS: Main contributors to gains in HAZ were coverage of health and nutrition interventions (21% CG; 11% GJ; 25% OD), household assets (10% CG; 13% GJ; 18% OD), and sanitation (7% CG; 6% GJ; 5% OD). Maternal education, age at marriage, community-level hygiene, and electrification also contributed. Political leadership and an outcome-focused vision were crucial for action. Although vision varied, capable administrators were able to secure adequate finances, strengthen implementation systems, and invest in state-specific innovations, creating an enabling environment for change. Varied actors, including civil society and DPs, played a catalytic role in spurring action through advocacy, technical and financial inputs, and vigilance. CONCLUSIONS: Similar drivers were responsible for stunting reduction in 3 states. Ingredients for success highlight the importance of political ...