In 2013, the Nutrition for Growth Summit called for a Global Nutrition Report (GNR) to strengthen accountability in nutrition so that progress in reducing malnutrition could be accelerated. This article summarizes the results of the first GNR. By focusing on undernutrition and overweight, the GNR puts malnutrition in a new light. Nearly every country in the world is affected by malnutrition, and multiple malnutrition burdens are the “new normal.” Unfortunately, the world is off track to meet the 2025 World Health Assembly (WHA) targets for nutrition. Many countries are, however, making good progress on WHA indicators, providing inspiration and guidance for others. Beyond the WHA goals, nutrition needs to be more strongly represented in the Sustainable Development Goal (SDG) framework. At present, it is only explicitly mentioned in 1 of 169 SDG targets despite the many contributions improved nutritional status will make to their attainment. To achieve improvements in nutrition status, it is vital to scale up nutrition programs. We identify bottlenecks in the scale-up of nutrition-specific and nutrition-sensitive approaches and highlight actions to accelerate coverage and reach. Holding stakeholders to account for delivery on nutrition actions requires a well-functioning accountability infrastructure, which is lacking in nutrition. New accountability mechanisms need piloting and evaluation, financial resource flows to nutrition need to be made explicit, nutrition spending targets should be established, and some key data gaps need to be filled. For example, many UN member states cannot report on their WHA progress and those that can often rely on data >5 y old. The world can accelerate malnutrition reduction substantially, but this will require stronger accountability mechanisms to hold all stakeholders to account.

Objective: To assess the effect on the haemoglobin concentrations of schoolchildren of weekly iron tablets administered by teachers. Design: Sixty schools were randomly assigned to two groups: in 30 schools children were given weekly for 10 weeks a tablet providing 65 mg of iron and 0.25 mg of folic acid; in the other 30 schools no iron tablets were given. All children were dewormed and given vitamin A before the study began. The haemoglobin concentration of up to 20 randomly selected children in each school was estimated before and 2 weeks after the end of treatment. Setting: Rural community schools in Kolondieba district of Mali.

In order to increase overall VAS coverage and reduce regional disparities, it is suggested that mass VAS be organized on a regional level, prioritizing rural regions (Middle and Upper Guinea) and the city of Conakry.

Objectives: To assess vitamin A supplementation (VAS) coverage of children aged 6 -59 months and the factors that favour or limit this coverage during the National Nutrition Weeks in Mali. Design: Cross-sectional study. Interviews about demographic factors and children's adherence to the vitamin A capsule distribution programme were conducted. Professionals' knowledge of vitamin A and various aspects related to the supplementation strategy were assessed. Setting: Five regions out of the eight regions in the country, in addition to Bamako District. Three rural communes were selected in three regions to represent rural areas. Subjects: Parents or caregivers of children under 5 years of age, health agents who participated in the weeks, and community and administrative leaders. Results: At least 80% of the children received the supplement. More 'traditional' communication channels (town criers, friends and family members) appeared to be more effective in reaching the target groups than modern methods, i.e. radio and television. Mothers' possession of a radio (Pearson x 2 ¼ 5.03; P ¼ 0.025) and fathers' education (Pearson x 2 ¼ 19.02; P , 0.001), possession of a radio (Pearson x 2 ¼ 8.93; P ¼ 0.003) and listening to it (Pearson x 2 ¼ 7.62; P ¼ 0.006) all appeared to be statistically and significantly associated with children's coverage. In multivariate logistic regression analysis, only the study site (urban/rural) (P ¼ 0.004), 'traditional channels' (P ¼ 0.02) and fathers' education (P ¼ 0.04) were significantly associated with children's coverage. Knowledge about VAS was high among community and administrative leaders, and health professionals. The planning and implementation of activities at the district level were found to be good in general. Conclusion: National Nutrition Weeks provide a successful example of a periodic VAS strategy with high coverage among children aged 6-59 months in Mali. Campaigns aimed at informing and sensitising populations during the Nutrition Weeks should also target children's fathers. Keywords Vitamin A supplementationChild survival National Nutrition Weeks MaliVitamin A repletion was shown to reduce the mortality of children aged 6-59 months by 23-34% in areas where vitamin A deficiency (VAD) is prevalent 1 -4 . In sub-Saharan Africa, it is estimated that 42% of children under 5 years of age are at risk of VAD and that adequately controlling this deficiency can avert over 645 000 child deaths per year in the region . This prevalence is higher than the cut-off point of 5%, indicating that VAD is a public health problem in a population 7 . In order to tackle this situation, Mali developed and applied strategies q The Authors 2007

Objective: To review the prevalence, severity and determinants of anaemia among women in West and Central Africa (WCA) and raise awareness among policy makers and programme planners in the region. Design: Systematic descriptive review of data in the public domain of the ORC Macro MEASURE Demographic and Health Surveys, national nutrition surveys, oral and technical communications at regional meetings, studies published in scientific journals, and WHO and UNICEF databases. Setting: West and Central Africa region. Subjects: Women of childbearing age. Results: The prevalence of anaemia among pregnant and non-pregnant women is higher than 50 % and 40 %, respectively, in all countries. Within countries, this prevalence varies by living setting (rural v. urban), women's age and education. Across countries, socio-economic and climatic differences have no apparent association with the prevalence of anaemia among women. Several factors contribute either alone or jointly to the high rates of maternal anaemia in this region. These include widespread nutritional deficiencies; high incidence of infectious diseases; low access to and poor quality of health services; low literacy rates; ineffective design, implementation and evaluation of anaemia control programmes; and poverty. Conclusions: Addressing the multiple causes and minimizing the consequences of anaemia on maternal and child health and development in WCA require integrated multifactorial and multisectoral strategies. This also calls for unprecedented, historical and stronger political will and commitment that put adolescent girls and maternal health at the centre of the development agenda. Keywords Women Anaemia Urgent action West and Central AfricaMaternal anaemia continues to be a major barrier to women's health, social development and economic growth, especially in the developing world. The WHO estimates that, globally, anaemia affects 42 % (56?4 million) of pregnant women and 30 % (468?4 million) of non-pregnant women (including adolescent girls). In Africa, 57 % (17?2 million) of pregnant women and 48 % (70 million) of nonpregnant women (including adolescent girls) are anaemic (1) . In Sub-Saharan Africa, and more particularly in the West and Central Africa Region (WCAR),y high rates of anaemia continue unabated in women throughout their reproductive years. In WCAR, according to WHO classification, the prevalence of anaemia among women of reproductive age is of severe public health significance; i.e. at any point in time at least 40 % of women (15-49 years old) are anaemic (1) .These high rates represent significant constraints for achieving some of the Millennium Development Goals such as eradicating hunger and poverty (Goal 1), reducing child mortality (Goal 4) and improving maternal health (Goal 5). The adverse consequences of maternal anaemia include fatigue, decreased work capacity and poor pregnancy outcomes such as preterm birth, low birth weight, and increased risk of maternal death both during delivery and the postpartum period (2,3) . Even tho...