Priority interventions to improve maternal and child diets in Sub‐Saharan Africa and South Asia

Abstract

Nutrition‐sensitive interventions to improve overall diet quality are increasingly needed to improve maternal and child health. This study demonstrates feasibility of a structured process to leverage local expertise in formulating programmes tailored for current circumstances in South Asia and Africa. We assembled 41 stakeholders in 2 regional workshops and followed a prespecified protocol to elicit programme designs listing the human and other resources required, the intervention's mechanism for impact on diets, target foods and nutrients, target populations, and contact information for partners needed to implement the desired programme. Via this protocol, participants described 48 distinct interventions, which we then compared against international recommendations and global goals. Local stakeholders' priorities focused on postharvest food systems to improve access to nutrient‐dense products (75% of the 48 programmes) and on production of animal sourced foods (58%), as well as education and social marketing (23%) and direct transfers to meet food needs (12.5%). Each programme included an average of 3.2 distinct elements aligned with those recommended by United Nations system agencies in the Framework for Action produced by the Second International Conference on Nutrition in 2014 and the Compendium of Actions for Nutrition developed for the Renewed Efforts Against Child Hunger initiative in 2016. Our results demonstrate that a participatory process can help local experts identify their own priorities for future investments, as a first step in a novel process of rigorous, transparent, and independent priority setting to improve diets among those at greatest risk of undernutrition.

Who is the Woman in Women’s Nutrition? A Narrative Review of Evidence and Actions to Support Women’s Nutrition throughout Life

“…In addition, although there were interventions that targeted adolescent girls and women of reproductive age, they were fewer and less well evaluated than interventions that targeted women as mothers. This aligns with findings from other research which illustrated a higher proportion of programs targeting pregnant and lactating women and women with young children (209). We also found major gaps in the targeting of interventions for older women.…”

Designing programs to improve diets for maternal and child health: estimating costs and potential dietary impacts of nutrition-sensitive programs in Ethiopia, Nigeria, and India

“…For each proposed program, the following information was discussed: (1) the description of the program; (2) the mechanisms for impact on dietary behaviours; (3) the target foods and nutrients to be increased; (4) the location and demographic characteristics of the target population; (5) the lead authority and implementing organization for the program; (6) the types and costs of resources required for program implementation, using an ingredients approach (unit needs and costs) and separately considering start-up, recurring costs and evaluation; and (7) the additional regional expert contacts relevant to that program. Additional details on the methods and results of these two regional meetings are documented elsewhere ( Masters et al 2017 ).…”

Navigating the politics and processes of food systems transformation: guidance from a holistic framework

“…Systemic capacities are the diverse skills, instincts, abilities, processes, and resources needed by (public sector) organizations to enhance the creation and maintenance of alternative food system actions, while strategic capacities are decision-making forums or multistakeholder platforms in which food systems discussions occur (Gillespie et al, 2013). The objective of capacity building is inherent in most development interventions in the developing world, where this challenge is more pressing (Morkel and Ramasobama, 2017;Masters et al, 2018;Babu, 2020). Although initiatives in these areas of systemic and strategic capacity building are encouraging, the persistent challenges, especially at local level in LMICs, means government activities are often entangled within competition for scarce resources (Wu et al, 2015;Qiao et al, 2019).…”