Accelerating Progress to Meet 2030 Goals to Improve Child and Maternal Nutrition

 

The recently launched UNICEF-World Health Organization (WHO) 2017 Countdown to 2030 report shows mixed results for childhood health and nutrition. The 81 Countdown countries have made progress, but remain far from universal coverage for most essential interventions for reproductive, maternal, newborn, child health, and nutrition. The report presents detailed country and equity profiles on women’s, children’s and adolescents’ health for countries that together account for 95 percent of maternal deaths and 90 percent of deaths among children under five.

Countdown to 2030 Report/UNICEF

To galvanize attention and mobilize action around priorities in maternal and child nutrition, various global targets have been set, including the United Nations' 2030 Agenda for Sustainable Development and the WHO’s Every Woman Every Child Global Strategy for Women's, Children's and Adolescent's Health (2016–2030). The Countdown to 2030 report systematically tracks progress towards achieving these. IFPRI is a member of the Countdown to 2030 collaboration.

In the accompanying Countdown to 2030 paper published in The Lancet on tracking progress towards universal coverage for reproductive, maternal, newborn, and child health, Countdown collaborators have underscored the need to accelerate the rate of decline in prevalence of maternal and child mortality, stillbirths, and stunting among children under five, to achieve the Sustainable Development Goals by 2030. Such efforts will require a rapid scale-up of effective interventions to all population groups within affected countries, supported by improvements in underlying socioeconomic conditions, including women’s empowerment.

India is one of the priority Countdown countries, and as the findings of this report reflect, is still a long way from achieving universal coverage for most essential interventions in these key health and nutrition areas. The Countdown work has been an inspiration for POSHAN’s research and data visualization work on coverage of interventions across the continuum of care in Indian states. POSHAN’s state-level Policy Notes, based on updated coverage data now available in NFHS-4 (2016), reveal that the coverage of interventions for mothers and children in the first 1,000 days has improved substantially over time, but challenges remain. There are significant state-level variabilities in the coverage for some interventions. Coverage during pregnancy is generally high, up to 75 percent for some interventions, like pregnancy registration. However, coverage of nutrition interventions integrated into pregnancy care is low at less than 33 percent for women who consumed iron and folic acid supplements. During delivery, coverage is high: Nearly 80 percent for interventions pertaining to institutional delivery, skilled birth attendance, and birth registration. However, coverage of interventions for lactating women remains much lower than 50 percent.

An effective way to track a country’s progress towards any global goals is to apply them at the national level. In India, there is much optimism pegged on the recently launched National Nutrition Mission, which aims to reduce stunting, undernutrition, and low birth weight by 2 percent and anemia by 3 percent annually, covering states and districts in a phased manner over three years (2017-20), benefiting more than 100 million people. Meeting these goals will require that India deploy the interventions already in the policy framework at high coverage, reaching across states and districts. Analyzing coverage levels and trends is an important first step in prioritizing interventions where gaps are large and where efforts need to be scrutinized and accelerated.

As 2017 Countdown to 2030 report points out, to address the targets at the global and national levels, it is important to focus on the strengthening of vital statistics, understanding drivers of coverage change, and obtaining better data on early childhood development and adolescent health. In India, the government think tank NITI Aayog now has a Nutrition Dashboard that provides nutrition charts of India's states and districts and examines coverage of some (but not all) critical interventions. POSHAN’s district-level interactive maps and 640 District Nutrition Profiles also provide disaggregated data and detailed in-depth analyses.

In addition to outcomes and coverage, it is also important to focus on the indirect and underlying determinants, like sanitation and hygiene, access to drinking water, women’s literacy, girls’ age at marriage, etc. Countdown’s national profiles and POSHAN’s state and district profiles provide ready reckoners for an assessment of these underlying drivers and help to identify the gaps that need to be closed to accelerate change in health and nutrition outcomes.

Changes in health outcomes will only become a reality with changes in coverage of interventions and in the drivers of these outcomes. Promising beginnings have been made on the nutrition and health landscape and there is much anticipation on the horizon. However, efforts to address coverage and drivers now need to be strategically navigated to catalyse progress towards 2030, both globally and in India.

Purnima Menon and Stuart Gillespie are Senior Research Fellows with IFPRI's Poverty, Health and Nutrition Division and members of the Countdown to 2030 Collaboration: Menon participated in the Coverage Technical Working Group; Gillespie in the overall Technical Review Group. Pratima Mathews is an IFPRI Communications Specialist. This post originally appeared on the POSHAN blog.

Undernutrition Garners Little Attention in Indian Media

Undernutrition is an emergency in India, where almost half of all children under the age of three are underweight. However, even in the face of such a crisis, this issue garners little attention in Indian media.

POSHAN Media Fellows
POSHAN Media Fellows

To address the lack of nutrition reporting in India, POSHAN and OneWorld Foundation implemented the six-month OneWorld-POSHAN Fellowship on Maternal and Child Undernutrition from May–December 2013. Six journalists from various media outlets such as The New York Times, Dainik Jagran, The Hindu, Chapte Chapte, The Hindustan Times, and www.newsclick.in participated in the program.

On March 19th, POSHAN and OneWorld organized a workshop with the six media fellows to share their learnings from their reporting from the field. The workshop focused on their experiences and observations during the course of their travels to various parts of the country collectively preparing over 30 pieces on mother and child undernutrition.

Many fellows spoke about the huge problems they saw in the field with nutrition services for the poor. For example, Mukesh Kejriwal of Dainik Jagran presented photos exposing flaws with the Integrated Child Development Services (ICDS) scheme. One photo showed a broken-down Anganwadi centre without a roof. He spoke about the lack of commitment of officials at the centres that he visited, and how in one centre, the officials had locked up the materials that were meant to be used for the welfare of children.

Malavika Vyawahare from The New York Times spoke about how there is no proper compilation of nutrition data on which the government can actually base its work. She also spoke of an instance in which she saw a modern, electric weighing machine in an Anganwadi centre in a tribal district in Maharashtra, which was useless because that part of the country is not connected to the electricity grid.

Neha Dikshit, who wrote her articles for www.newsclick.in, focused on the fact that some of the government schemes meant to improve the plight of rural women and children have in fact been detrimental for them. She mentioned how a Haryana government scheme providing cash assistance to marriageable women led to teen marriages, deaths of pregnant girls, and parents started forced schools to give under-age certificates.

Pankaj Jaiswal, from The Hindustan Times, spoke about the existence of undernutrition in the so-called 'well fed' urban population. Thanking the fellowship program for raising his awareness on the issues, he said that he is likely to keep writing on the issue.

Freelance journalist Saadia Azim spoke about how migrants are facing the brunt of nutrition problems. During her travels to villages in Bengal, she found that poor diet haunted all migrants, regardless of caste, religion, or even region. For her, a huge issue was that nobody was even talking about malnutrition as an election issue.

The fellows concluded the meeting with a consensus on how much more the media needs to do in terms of reporting on nutrition. They stressed that the issue of undernutrition has an impact on national security and wellbeing of the country and thus needs to be taken up much more in the media and addressed by the government.

Learn more by visiting the OneWorld-POSHAN Fellowship on Maternal and Child Undernutrition site to read all the news articles.

Submission Guidelines and Form: Research Abstract

Research Abstract Submission Guidelines and Form

Background on Abstract Themes

POSHAN_Transform_Nutrition_5You are invited to submit abstracts of your work to be presented at the conference by April 25, 2014. To understand what evidence is emerging from studies on cross-sectoral interventions to improve nutrition, we invite researchers to submit research abstracts on ongoing or completed studies that can provide evidence on process outcomes or impact of cross-sectoral interventions on nutrition. Examples of research abstracts could include but are not limited to the following:

  • Research on nutrition programs and interventions that were led by more than one sector. Research methods, tools, and resources to conduct research on how sectors can be brought together and the impact of multisectoral on intersectoral collaboration on nutrition services or outcomes are of particular interest. Types of research featured in this focus area include policy and stakeholder analysis, operational research, or program evaluations.

Submissions are also being accepted for Implementation Abstracts. Abstract submissions which do not clearly fall under Research or Implementation topic areas of interest, but are relevant to the theme of the event, will still be considered.

Abstract Submission and Review Process

Abstracts must be submitted by Friday April 25, 2014,at 5pm IST.

A review committee from POSHAN and Transform Nutrition will select 10–12 of the submitted abstracts to be featured as written case studies and oral presentations at the conference. The committee will review these based on 1) relevance to the event theme, 2) practical application, and 3) clarity and completeness of abstract.

The committee will also select an additional 20–25 abstracts to be presented as posters. Abstracts chosen for presentation at the conference or for poster will be notified by email by May 30, 2014.

Selected Abstracts

If your abstract is accepted as a case study, a team of writers from POSHAN and Transform Nutrition will work with you between June-August, 2014 to develop a 4-page case study that will be printed and distributed at the conference. The team will also be available to assist you in preparing a related slide presentation on the case that you will present at the conference.

For those abstracts selected as posters, guidelines will be provided to you on what to include on these.

Questions? We would love to hear from you. Send us an email at IFPRI-POSHAN@cgiar.org

Together for Nutrition 2014: Conference Announcement and Call for Abstracts

TN-2014POSHAN (Partnerships and Opportunities to Strengthen and Harmonize Actions for Nutrition in India) and Transform Nutrition are pleased to announce the conference Together for Nutrition 2014: Working Across Sectors to Improve Nutrition in India, which will be held October 29–30, 2014, in New Delhi.

This conference will serve as an important platform for learning and facilitating discussion around the challenging task of bringing diverse sectors together to improve maternal and child nutrition in India. The conference is intended to bring together evidence that can inform and support current policy and program initiatives for nutrition that require cross-sectoral action by two or more sectors, such as the Government of India’s Multisectoral Program to Address Maternal and Child Malnutrition in 200 Selected High-Burden Districts.  Attendees will have the opportunity to explore how decisions and actions in different sectors can influence nutrition, and how effective cross-sectoral actions can be planned, implemented and assessed. Specific objectives of the conference are to:

  • Provide a platform for dialogue on how to advance multisectoral or intersectoral collaboration in India
  • Showcase examples of collaboration between various sectors on program development and implementation to address nutrition
  • Examine approaches for research on multisectoral and intersectoral collaboration and convergence in India
  • Explore how the current public policy and environment provides opportunities and challenges for multisectoral or intersectoral approaches addressing nutrition in India
  • Provide opportunity for networking among nutrition professionals and those working across sectors

Examples of working across sectors will include:

  • State nutrition missions that include multi- or inter-sectoral coordination and convergence
  • District-level convergence to bring health and ICDS together to strengthen delivery of nutrition-specific interventions
  • Block-level operational planning and implementation of cross-sectoral  actions
  • Engaging self-help groups to create demand and strengthen local accountability for health and nutrition services at the village level

To learn more about the conference, please read our conference backgrounder.

Also, please see the following to learn more about the current state of working across sectors in nutrition in India:
•       Working Multisectorally to Improve Nutrition: Global Lessons and Current Status in India (Garrett et al. 2014)
•       The Operational Evidence Base for Delivering Direct Nutrition Interventions in India (Avula et al. 2013)
•       Analyzing Intersectoral Convergence to Improve Child Undernutrition in India (Ved and Menon 2012)
•       Strengthening the Role of Agriculture for a Nutrition Secure India (Kadiyala, Joshi, Dev et al. 2011)

Abstract Submission

Abstracts must be submitted by Friday April 25, 2014,at 5pm IST.

Click to access Implementation Abstract Submission Guidelines and Form
Click to access Research Abstract Submission Guidelines and Form

Questions? We would love to hear from you. Send us an email at IFPRI-POSHAN@cgiar.org

New Abstract Digest on Maternal and Child Nutrition Research – Issue 7

We are pleased to release Issue 7 of our bi-monthly Abstract Digest on maternal and child nutrition. This issue features interesting publications examining nutrition from both a biological and political lens, in India and beyond. Highlights include:

Abstract Digest-Issue 07
Abstract Digest-Issue 07
Click to download PDF (708 Kb)

Abstract Digest-Issue 07

  • A special open-access issue of Annals of the New York Academy of Sciences on integrating nutrition and early childhood development interventions
  • Two articles from Advances in Nutrition discussing 1) how nutrition research can become more useful in informing global nutrition guidelines (Stoltzfus 2014), and 2) arguing for the need to develop implementation science to enable stronger delivery of adequate nutrition to those in need (Habicht and Pelto 2014).
  • One study in Bio Medical Education identifying gaps in South Asian postgraduate nutrition programs to build capacity to address the current public health nutrition challenges (Khandelwal et al. 2014).
  • Two reviews, one providing an overview of the evidence-base for nutritional deficits in early life and greater risk for non-communicable diseases in later life (Langley-Evans 2014) and the other recommending investments in improving maternal autonomy to improve child nutritional status (Carlson et al. 2014).
  • Several articles focusing specifically on malnutrition in India, including on determinants of anemia (Anand 2013), vitamin A programming in India and its reach (Aguayo 2014), and management of severe acute malnutrition (Singh et al. 2014; Kumar et al. 2013).

 

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