Improving nutritional status among urban poor children in sub-Saharan Africa: An evidence-informed Delphi-based consultation

In sub-Saharan Africa (SSA), rapid urbanisation coupled with the high prevalence of infant and young child (IYC) undernutrition in low-income settings means that interventions to support IYC nutrition are a priority. Little is known about how urbanisation influences IYC feeding (IYCF) practices and evidence-based interventions to improve IYC health/nutrition in the urban poor are lacking. Therefore, this research aimed to: 1) systematically review evidence on interventions for improving the nutritional status of IYC aged 6-23 months living in urban poor areas (PROSPERO CRD42018091265); and, 2) engage stakeholders to identify the highest-ranking evidence gaps for improving IYCF programmes/policies. First, a rapid systematic review was conducted. This focused on literature published regarding nutrition specific and nutrition-sensitive complementary feeding interventions in urban poor areas, specifically low-income informal settlements, in low‐ and middle‐income countries (LMICs). Six intervention studies met the review inclusion criteria. Intervention adherence was generally high, and indicators of maternal knowledge and IYC nutritional intake typically increased because of the interventions, but the impact on anthropometric status was small. Second, stakeholders working across SSA were engaged via a Delphi-based approach to identify priority areas for future intervention. Stakeholders reported that a situational analysis was required to better understand IYCF in urban poor areas, particularly the causes of IYC undernutrition, and highlighted the need to involve local communities in defining how future work should proceed. Together, these findings indicate a need for more evidence regarding IYCF, and the factors that drive it, in urban poor areas across LMIC settings, but particularly in SSA

Inventory on the dietary assessment tools available and needed in africa: a prerequisite for setting up a common methodological research infrastructure for nutritional surveillance, research, and prevention of diet-related non-communicable diseases

<p><i>Objective:</i> To carry out an inventory on the availability, challenges, and needs of dietary assessment (DA) methods in Africa as a pre-requisite to provide evidence, and set directions (strategies) for implementing common dietary methods and support web-research infrastructure across countries. <i>Methods:</i> The inventory was performed within the framework of the “Africa's Study on Physical Activity and Dietary Assessment Methods” (AS-PADAM) project. It involves international institutional and African networks. An inventory questionnaire was developed and disseminated through the networks. Eighteen countries responded to the dietary inventory questionnaire. <i>Results:</i> Various DA tools were reported in Africa; 24-Hour Dietary Recall and Food Frequency Questionnaire were the most commonly used tools. Few tools were validated and tested for reliability. Face-to-face interview was the common method of administration. No computerized software or other new (web) technologies were reported. No tools were standardized across countries. <i>Conclusions:</i> The lack of comparable DA methods across represented countries is a major obstacle to implement comprehensive and joint nutrition-related programmes for surveillance, programme evaluation, research, and prevention. There is a need to develop new or adapt existing DA methods across countries by employing related research infrastructure that has been validated and standardized in other settings, with the view to standardizing methods for wider use.</p