Scaling Up Nutrition in the Democratic Republic of Congo

Shekar, Meera; Mattern, Max; Laviolette, Luc; Eberwein, Julia Dayton; Karamba, R. Wendy; Akuoku, Jonathan Kweku

doi:10.1596/28529

Cited by 7 publications

(9 citation statements)

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“…Issues of childhood diarrheal diseases and food security have not previously been assessed through the CRM, and particularly in a rural, developing country setting. Due to the complexity of these global health issues and the high level of urgency to address childhood diarrhea and malnutrition in Mali, it is undoubtedly essential to integrate the community viewpoints and attitudes in these discussions and to verify how invested they are in resolving these issues [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Current community perceptions and behaviors to address diarrheal disease and food security are essential to consider prior to any program implementation. Health behavior change at the community level and identification of existing community resources and national nutrition program policies will incite co-creation of programs that are socio-culturally motivated and engage positive health promotion behaviors [ 6 ]. The Community Readiness Model (CRM) is a tool that integrates social and cultural contexts to understand how an issue is perceived by the community and what types of strategies can be developed at the community level.…”

Section: Introductionmentioning

confidence: 99%

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Assessing Community Readiness to Reduce Childhood Diarrheal Disease and Improve Food Security in Dioro, Mali

Borresen

Stone

Boré

et al. 2016

IJERPH

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Diarrhea and malnutrition represent leading causes of death for children in Mali. Understanding a community’s needs and ideas are critical to ensure the success of prevention and treatment interventions for diarrheal disease, as well as to improve food security to help reduce malnutrition. The objective of this study was to incorporate the Community Readiness Model (CRM) for the issues of childhood diarrheal disease and food security in Mali to measure baseline community readiness prior to any program implementation. Thirteen key respondents residing in Dioro, Mali were selected based on varied social roles and demographics and completed two questionnaires on these public health issues. The overall readiness score to reduce childhood diarrheal disease was 5.75 ± 1.0 standard deviation (preparation stage). The overall readiness score to improve food security was 5.5 ± 0.5 standard deviation (preparation stage). The preparation stage indicates that at least some of the community have basic knowledge regarding these issues, and want to act locally to reduce childhood diarrhea and improve food security and nutrition. Proposed activities to increase community readiness on these issues are provided and are broad enough to allow opportunities to implement community- and culturally-specific activities by the Dioro community.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessing Community Readiness to Reduce Childhood Diarrheal Disease and Improve Food Security in Dioro, Mali

Borresen

Stone

Boré

et al. 2016

IJERPH

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“…Unit cost data were obtained from peer-reviewed publications, grey literature, costed national nutrition plans, and data collected by the World Bank as part of a series of nutrition costing studies ( Shekar et al . 2014 , 2015a , 2015b ). If unit cost data were unavailable for a given intervention in a given country, unit costs for a neighbouring country in the same region were used.…”

Section: Methodsmentioning

confidence: 99%

Reaching the global target to reduce stunting: an investment framework

Shekar

Kakietek

D'Alimonte

et al. 2017

Health Policy and Planning

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Childhood stunting, being short for one’s age, has life-long consequences for health, human capital and economic growth. Being stunted in early childhood is associated with slower cognitive development, reduced schooling attainment and adult incomes decreased by 5–53%. The World Health Assembly has endorsed global nutrition targets including one to reduce the number of stunted children under five by 40% by 2025. The target has been included in the Sustainable Development Goals (SDG target 2.2). This paper estimates the cost of achieving this target and develops scenarios for generating the necessary financing. We focus on a key intervention package for stunting (KIPS) with strong evidence of effectiveness. Annual scale-up costs for the period of 2016–25 were estimated for a sample of 37 high burden countries and extrapolated to all low and middle income countries. The Lives Saved Tool was used to model the impact of the scale-up on stunting prevalence. We analysed data on KIPS budget allocations and expenditure by governments, donors and households to derive a global baseline financing estimate. We modelled two financing scenarios, a ‘business as usual’, which extends the current trends in domestic and international financing for nutrition through 2025, and another that proposes increases in financing from all sources under a set of burden-sharing rules. The 10-year financial need to scale up KIPS is US$49.5 billion. Under ‘business as usual’, this financial need is not met and the global stunting target is not reached. To reach the target, current financing will have to increase from US$2.6 billion to US$7.4 billion a year on average. Reaching the stunting target is feasible but will require large coordinated investments in KIPS and a supportive enabling environment. The example of HIV scale-up over 2001–11 is instructive in identifying the factors that could drive such a global response to childhood stunting.

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“…Deficiency in multiple nutrients may render individuals vulnerable to a plethora of communicable and noncommunicable diseases. Such vulnerability is bound to have major implications for nutrition and health policy making, and for the design and implementation of multisectoral nutrition-sensitive interventions (Shekar et al 2015).…”

Section: List Of Figuresmentioning

confidence: 99%

“…Bank study on the scaling up of different nutrition interventions in the DRC (Shekar et al 2015). Some of the key cost-effective interventions are vitamin A supplementation, deworming, behavior change communication, acute malnutrition programming, public provision of complementary food or micronutrients, iron-folic acid supplementation, promotion of intake of iodized salt and iron-fortified flour, and zinc supplementation with oral rehydration salts for management of diarrhea.…”

Section: E Contribution Of Dimensions To Ndimentioning

confidence: 99%