We propose a set of "best-practice complementary feeding behaviors," which were derived by combining principles of psychosocial care with current knowledge in nutritional sciences. We provide a theoretical rationale for assessing and describing complementary feeding practices in terms of what is fed, how food is prepared and given, who feeds the child, when food is fed (frequency and scheduling), and the feeding environment (where). We also discuss the significance of selected sociocultural determinants of these practices for the design of interventions. We then review 18 case studies in relation to these practices and their determinants. The exercise, in which we abstracted data from ethnographic reports, revealed areas of congruence and deviations from best-practice behaviors. The data on feeding practices are described with a common framework to facilitate comparison across sites. Key themes emerging from the studies include the significance of the larger family, the effects of competing maternal time demands, and the importance of parental perceptions and cultural constructs in affecting complementary feeding practices. Finally, we discuss the implications of the findings for future interventions.

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Coordination across sectors to address undernutrition with its varied underlying causes remains a challenge in developing countries. In Afghanistan, harmonization of health and agriculture policies and actions to reduce endemic undernutrition occurred during 2002-2007. This qualitative case study explores the forms of harmonization, enabling features and constraints in the policy process. We interviewed 57 stakeholders (39 central level, 18 provincial) involved in public nutrition or food security issues. Forms of harmonization included written policies, reseach, training and advocacy. Important features of the policy process included: policy entrepreneurs with operational and strategic capacity, consensus-building using a shared causal framework, working groups and strategic alliances. This case presents an interesting alternative to a national nutrition coordinating body, an approach that has met with mixed results, often due to the lack of authority, budget, and operational capacity of such a body to oversee ministries and enforce national nutrition objectives. Mid-level professionals mobilized into task forces achieved much with the support of national and international partners. This study highlights the importance of building capacity for sustaining change through local institutions.

Afghanistan, Women, Anemia, Iron, Food, Social network,