Transform Nutrition Using evidence to inspire action Tue, 25 May 2021 15:26:20 +0000 en-US hourly 1 Transform Nutrition: A compendium of outputs Wed, 06 Feb 2019 06:58:50 +0000 Transform Nutrition are delighted to share a comprehensive Compendium of Outputs which catalogues all work undertaken by the consortium of 5 international partners between 2012–2017.

Guidance note on Frontline health workers Fri, 15 Sep 2017 17:44:09 +0000 Transform Nutrition has produced a Guidance note for donors and national government based on our 6 years of research on Frontline Health Workers:
pivots for mass behaviour change




Behavioral change for Improved Nutrition among Pastoralists in Ethiopia Thu, 07 Sep 2017 14:29:22 +0000 Pastoralists in Ethiopia

Ethiopia is one of the countries who managed to meet the nutrition target of MDG 1 by reducing the rate of stunting from 58% in 2000 to 40% in 2014 and wasting from 12% in 2000 to 9% in 2014.[1] Currently, the country is working towards the nutrition targets of SDG2. As of 2016, 38% of children in Ethiopia are chronically malnourished and 10% are acutely malnourished. [2]

However, the picture in pastoral areas like Somali Region of Ethiopia shows that the under-served and hard to reach segments of the population of the country need tailored ways to address the still prevailing situation of undernutrition. In Somali Region of Ethiopia, the prevalence of stunting (chronic malnutrition) is 27.4% as of 2016. In addition, the region has the highest proportion of children with acute malnutrition from all regions of Ethiopia having 22.7% wasting rate. Somali Region also has the highest prevalence of anaemia in children with a rate of 82.6% as compared to the national prevalence of 56%. Moreover, 12.8% of children in Somali region have severe anaemia. The highest prevalence of anaemia in women is also seen in Somali Region with 59% prevalence compared to 23% nationally. [3]

Nutrition sensitive interventions by VSF-Suisse in Ethiopia

To contribute to addressing the need to nutrition interventions in pastoral areas as Somali Region of Ethiopia, VSF-Suisse has implemented different nutrition sensitive interventions in the region. Linking agricultural and livestock interventions to community-based nutrition has been a flagship activity of the VSF-Suisse (and of the Ethiopia Programme in particular). Owing to the fact that the nutrition needs of under-served communities cannot be addressed by direct nutrition interventions alone, VSF-Suisse had nutrition sensitive livestock based interventions where animal source foods sourced from local markets like meat and milk were availed to households hosting children recurrently affected by acute malnutrition and recurrently admitted to therapeutic feeding centers. These interventions have proven to show changes on the availability of animal source foods at the household level.

To showcase one of these interventions in Kebriderhar and Shilabo Woredas of Somali region of Ethiopia in 2013, where 9 milking goats were provided to households hosting children affected by recurrent malnutrition, change was observed in the targeted households in terms of acute malnutrition, measured through MUAC (Mid-Upper Arm Circumference). A decreased percentage of children with MUAC <11cm from 33% before the intervention to 0% at 4 months after the provision of milking goats was observed. The percentage of children with MUAC for age <-3 SD, showing signs of acute malnutrition, had decreased from 56.8% before the intervention to 12.3% after the intervention.

Availing Animal Source Food was not Sufficient

In the intervention mentioned above, even though change was observed on one of the nutrition indicator of the targeted children, MUAC for age, it was noteworthy to observe that after they were provided with milking goats, none of the mothers were breastfeeding (from 12% before the intervention). This was one of the signals that availing animal source foods for households does not necessarily ensure the improvement of the overall nutrition situation and optimal nutrition practices. The main lesson drawn was that nutrition sensitive interventions are beyond linking specific livestock relief interventions with nutrition outcomes. This ignited the idea of thinking on optimal behavioral change communication interventions which suits pastoral areas like Somali Region of Ethiopia. The option lies on whether to integrate the conventional nutrition education or IEC/BCC interventions to our nutrition sensitive interventions or to look for other sustainable means of channeling our important message on optimal maternal, infant and young child nutrition practices.

Pastoral Community Platforms

Among the rural pastoral communities of Ethiopia’s Somali Regional State, VSF-Suisse has used the community platforms of Pastoral Field Schools (PFS) and Village Community Banks (VICOBAs) to improve communities’ resilience to recurring episodes of drought and other emergencies. The PFS approach is an adaptation of the interactive Farmer Field Schools (FFS) approach developed by the UN-FAO in Indonesia in 1989.  They are groups of community members who meet periodically to pool their observations on livestock production and on rangeland management and to experiment new production systems. VICOBAs, meanwhile, comprise groups of mainly women who are trained and then meet regularly to organise collective saving and loans for times of emergency or crisis.

Given that both of these pastoral community platforms are now integrated features of their communities, they have shown to have tremendous cumulative benefit by equipping them with critical nutrition-related messages.

The BCIN-Action Research

The action research entitled ‘Behavioral Change for Improved Nutrition among pastoralists in Ethiopia’ (BCIN) thus intended to bridge the knowledge gaps by providing the scientific evidence on the outcome of integrating Behavioral Change Communication (BCC) interventions into the routine activities of the existing pastoral platforms, the PFS and VICOBA groups.

BCIN was a quasi-experimental research conducted in two pastoralist districts, Moyale and Mubarek of Somali Region of Ethiopia. The action research evaluated both intervention communities and comparison communities where the intervention did not take place with the aim of appraising the impact of channeled messages on key nutrition practices. In line with this, a total of 942 mothers having children 0-23 months were interviewed, 471 of them were in each study leg.

As a result, the number of mothers who heard about exclusive breastfeeding, optimal young child feeding practices, food safety and personal hygiene through the PFS and VICOBA were higher for the intervention communities compared to the comparison communities.

One of the main findings of the action research shows that exclusive breast feeding, food safety and hygiene are influenced by the mother’s age, educational status, income, and prior information on the issues. It is also observed that 85.5% of the mothers in the intervention groups reported receiving the information through the community platforms compared to 14.2% from other sources. Also, the action research found out that pastoral- community platforms have potential for channeling messages on key maternal, infant and young-child nutrition practices.

[1] MDG report of Ethiopia, 2014

[2] Ethiopian Demographic Health Survey, 2016

[3] Ethiopian Demographic Health Survey, 2016

Agriculture for improved nutrition and health Wed, 06 Sep 2017 16:31:26 +0000 Our project partners Egerton University, Kenya convened a workshop Agro-biodiversity and Dietary diversity for optimal nutrition and health on Tuesday 22nd August, 2017 at the ARC Hotel Egerton University, Kenya. Forty-Five participants from academia, Ministry of Health, Ministry of Agriculture and NGOs working on Agriculture, nutrition and health gathered together with representative from County Government to discuss the important issue of tackling malnutrition and links between agriculture and Nutrition.  See workshop report.

They have also written a blog Agriculture for improved nutrition and health

Guidance note on Nutrition sensitive social protection and agriculture Thu, 31 Aug 2017 13:32:25 +0000 Transform Nutrition has produced a Guidance note for donors and national government based on our 6 years of research mainly in Bangladesh and Ethiopia on Nutrition sensitive social protection and agriculture. This note highlights 3 key areas for action.

Enabling environments for nutrition Thu, 31 Aug 2017 10:28:09 +0000 We have been working with Eldis to produce a key issues guide on Nutrition leadership and Capacity. The guide summarises all of Transform Nutrition research which has sought to answer the question – how can we build commitment to, and accountability for, scaling up nutrition-relevant actions? Eldis key issues guide : Enabling environments for nutrition

The role of social protection and agriculture in tackling chronic undernutrition Thu, 31 Aug 2017 10:14:40 +0000 We have been working with Eldis to produce a ‘key issues guide’ which summarises all of the research Transform Nutrition has done on How to maximize the impacts of investments in agriculture, social protection and women’s empowerment on nutrition. Eldis key issues guide : The role of social protection and agriculture in tackling chronic undernutrition

Nine key ingredients for transforming nutrition delivery Thu, 31 Aug 2017 10:11:24 +0000 We have been working with Eldis to produce a ‘key issues guide’ which summarises all of the research Transform Nutrition has done on how to choose the best interventions and delivery strategies to scale up nutrition. Nine key ingredients for transforming nutrition delivery- Lessons from a series of country-level case studies.

2017 Transform Nutrition South Asia symposium report Thu, 24 Aug 2017 10:45:37 +0000 The Transform Nutrition Research Consortium convened the research symposium ‘Evidence for action in South Asia’ on Saturday 8 July 2017, at the Yak and Yeti Hotel, Kathmandu, Nepal. Over a hundred participants from NGOs (national and international) and academia working on nutrition, health and public health, rural and social development gathered together with government officials from Nepal, India and Bangladesh, donor agency representatives and journalists to discuss the important issue of tackling undernutrition in South Asia

Transform Nutrition Learning Journey: Katharine Kreis, PATH, USA Thu, 17 Aug 2017 12:49:35 +0000 Kreis-1215I am Director of Strategic Initiatives and Lead for Nutrition Innovation at PATH, an international non-profit organisation in the field of global health innovation.

I first became interested in public health, epidemiology and nutrition when I was in the Peace Corps and I have maintained my interest in this area ever since. I went on to study Epidemiology and Global Health at graduate school and after a short stint working on an immunisation programme in Africa I became a Foreign Service Officer for USAID. I was at USAID for around 8 years focussing on the programmatic application and policy implications of maternal and child health and nutrition programmes.

After leaving USAID, I worked at the Bill and Melinda Gates Foundation in Seattle for about 10 years, eventually heading up the Nutrition Team.  Following that, I worked for the Swiss based Global Alliance for Improved Nutrition (GAIN) where I focused primarily on public-private partnerships to help address nutrition working on large scale fortification, infant and young child nutrition and the enabling environment.

Missing the Seattle vibe and focus on innovation, I took a position at PATH, which offered a workplace dedicated to innovating to improve health outcomes in low and middle income settings.  Initially, my primary role was focussed on strategic planning, which then led to a focus on nutrition innovation- assessing what types of tools and interventions might be instrumental in helping to address stunting, wasting, vitamin and mineral deficiencies and overweight/obesity

Just as we finished a strategic planning exercise to identify opportunities for innovations within the nutrition sector I took the Transform Nutrition Short Course in 2016. I was delighted to have the opportunity to join the wide range of participants in the course and it raised a number of considerations for how PATH could move forward in this field and leverage the expertise of a wide range of sectors  and disciplines to help solve nutrition challenges. In particular, I was interested in platforms for innovation, and business models such as incubators and accelerators that could be used in a public sector setting to source ideas, drive impact and  ‘crowd’ in ideas and knowledge from different perspectives. As a result, PATH has designed and developed an incubator approach which broadly looks to foster innovation in 4 key areas:

Develop and advance new tools and technologies to measure and improve nutrition outcomes, increase income opportunities, and increase food safety and food security, particularly in low- and middle-income countries.

Strengthen the collection and use of data, analytics, and knowledge about nutrition and how it intersects with other development sectors. This “nutrition intelligence” will help national and global leaders plan, implement, evaluate, and align efficient and effective policies and programs.

Strengthen the systems that bring food from producers to consumers so that systems are more effective, sustainable, efficient, and resilient. This includes identifying or protecting agricultural practices or food sources that can close nutritional gaps.

Develop and strengthen partnerships across disciplines and sectors so that nutrition solutions are holistic, effective, and build on the best information and expertise possible.

Through our nutrition innovation incubator approach, PATH is  working with a number of academic institutions, foundations and the private sector on several novel ideas targeted at improving nutrition outcomes.  These include development of a commercially available multiplex diagnostic with Quansys Bioscices that will enablable simultaneous measurement of a number of vitamin and mineral deficiencies using only a finger prick, new food-based delivery mechanisms for antibiotics for acutely malnourished children, a meta analysis looking at the contribution of tobacco use during pregnancy and growth outcomes, research on the potential for edible insects to be micro-farmed and improve diets, and work with Prestige, India’s largest producer of kitchen products, to modify their pressure cooker to add iron to food during the cooking process, among others.

We hope to redefine how we engage with the private sector to engage companies- from start-ups to very mature organisations across a number of sectors to help improve nutrition. Some of what I learned in the  Transform Nutrition course informed some of our work, and validated the need for new interventions.