Desk-review: Determinants of undernutrition and existing m-Health services in Tanzania

This desk-based review forms part of the external impact evaluation of m-Nutrition in Tanzania. The evaluation is being conducted by a consortium of researchers from Gamos, the Institute of Development Studies (IDS) and the International Food Policy Research Institute (IFPRI). M-Nutrition is a global initiative supported by DFID, organised by GSMA, and implemented by in-country mobile network operators (MNOs) to use mobile technology to improve the nutritional status of children and their mothers. In Tanzania m-Nutrition is added to the existing m-Health platform ‘Healthy Pregnancy, Healthy Baby’ (HPHB), an SMS programme run by Wazazi Nipendeni, with the aim of improving women’s dietary intake, infant and young child feeding (IYCF) and child anthropometry. Objectives of the desk reviewIn line with the primary objectives of the impact evaluation (i.e. to assess the impact of m-nutrition on child under nutrition, IYCF and female dietary diversity), the review sets out to identify, review and summarise existing literature on: a) Determinants of undernutrition in Tanzania (with a specific focus on determinants of women’s dietary diversity and IYCF); and b) The use of mobile phone technology for health in Tanzania (with a specific focus on experiences, lessons learnt and impact of existing m-Health and m-Nutrition interventions)

Learning From the Past: Framing of Undernutrition in India Since Independence and Its Links to Agriculture

Understanding policy debates from the past can help to explain and address the challenges of today. Agriculture can play an important role in the reduction of undernutrition in India. However, the nutrition-enhancing potential of agriculture remains underused. In order to understand the roots for the weak links between agriculture and nutrition in contemporary India, this paper follows the evolution of the policy debates on nutrition and agriculture from India’s Independence to the present. The frame analysis reveals several substantial shifts in the framing. Undernutrition has been framed as a health issue (1950-’65), a problem of food shortage (1965-’75), a multidimensional poverty challenge (1975-’97) and a nutrition and food security issue (after 1997). The framing of agriculture remained more or less unchanged until the early 2000s, with agriculture being portrayed as a key driver of economic growth and the foundation of food security. During the last 10-15 years the awareness of the potential of agriculture for a balanced, diversified and nutritious diet gradually increased in the policy debates; however, deeply-rooted beliefs and perceptions about agriculture remain and may hinder the development of more nutrition-sensitive agricultural programmes and policies.UK AidDepartment for International Development (DFID

Desk-review: Smallholder farming, nutrition and m-Agriculture services in Ghana

This desk-based review forms part of the external impact evaluation of m-Nutrition in Ghana. The evaluation is being conducted by a consortium of researchers from Gamos, the Institute of Development Studies (IDS) and the International Food Policy Research Institute (IFPRI). M-Nutrition is a global initiative supported by DFID, organised by GSMA, and implemented by in-country mobile network operators (MNOs) to use mobile technology to improve the nutritional status of children and their mothers. In Ghana m-Nutrition is added to the existing m-Agriculture platform Farmers’ Club, a service that offers agricultural information via SMS (short message service) and voice, access to an expert helpline and free calls to other Farmers’ Club members. Informed by the primary outcomes of the impact evaluation (i.e. to assess the impact of m-nutrition on income, productivity and dietary diversity of smallholder farmers), the review will summarise existing evidence on: a) Characteristics of smallholder agriculture in Ghana (with a specific focus on agriculture production and income); b) Determinants of dietary intake in rural Ghana; and c) The use of mobile phones for agriculture in Ghana (with a specific focus on factors that may influence up-take of mobile phone-based information)

The experience of physical activity and the transition to retirement: a systematic review and integrative synthesis of qualitative and quantitative evidence.

BACKGROUND: The transition to retirement has been recognised as a critical turning point for physical activity (PA). In an earlier systematic review of quantitative studies, retirement was found to be associated with an increase in recreational PA but with a decrease in PA among retirees from lower occupational groups. To gain a deeper understanding of the quantitative review findings, qualitative evidence on experiences of and views on PA around the transition to retirement was systematically reviewed and integrated with the quantitative review findings. METHOD: 19 electronic databases were searched and reference lists were checked, citations tracked and journals hand-searched to identify qualitative studies on PA around the transition to retirement, published between January 1980 and August 2010 in any country or language. Independent quality appraisal, data extraction and evidence synthesis were carried out by two reviewers using a stepwise thematic approach. The qualitative findings were integrated with those of the existing quantitative systematic review using a parallel synthesis approach. RESULTS: Five qualitative studies met the inclusion criteria. Three overarching themes emerged from the synthesis of these studies: these related to retirees' broad concepts of PA, the motives for and the challenges to PA in retirement. Integrative synthesis of the qualitative findings with the quantitative evidence offered several potential explanations for why adults might engage in more recreational PA after the transition to retirement. These included expected health benefits, lifelong PA patterns, opportunities for socialising and personal challenges, and the desire for a new routine. A decrease in PA among retirees from lower occupational groups might be explained by a lack of time and a perceived low personal value of recreational PA. CONCLUSIONS: To encourage adoption and maintenance of PA after retirement, interventions should promote health-related and broader benefits of PA. Interventions for retirees from lower occupational groups should take account of busy post-retirement lifestyles and the low personal value that might be attributed to recreational PA. Future research should address predictors of maintenance of recreational PA after the transition to retirement, the broader benefits of PA, and barriers to PA among retirees from lower occupational groups.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

How do couples influence each other’s physical activity behaviours in retirement? An exploratory qualitative study

BACKGROUND: Physical activity patterns have been shown to change significantly across the transition to retirement. As most older adults approach retirement as part of a couple, a better understanding of how spousal pairs influence each other’s physical activity behaviour in retirement may help inform more effective interventions to promote physical activity in older age. This qualitative study aimed to explore and describe how couples influence each other’s physical activity behaviour in retirement. METHODS: A qualitative descriptive study that used purposive sampling to recruit seven spousal pairs with at least one partner of each pair recruited from the existing EPIC-Norfolk study cohort in the east of England, aged between 63 and 70 years and recently retired (within 2-6 years). Semi-structured interviews with couples were performed, audio-recorded, transcribed verbatim and analysed using data-driven content analysis. RESULTS: Three themes emerged: spousal attitude towards physical activity, spouses’ physical activity behaviour and spousal support. While spouses’ attitudes towards an active retirement were concordant, attitudes towards regular exercise diverged, were acquired across the life course and were not altered in the transition to retirement. Shared participation in physical activity was rare and regular exercise was largely an individual and independent habit. Spousal support was perceived as important for initiation and maintenance of regular exercise. CONCLUSIONS: Interventions should aim to create supportive spousal environments for physical activity in which spouses encourage each other to pursue their preferred forms of physical activity; should address gender-specific needs and preferences, such as chances for socialising and relaxation for women and opportunities for personal challenges for men; and rather than solely focusing on promoting structured exercise, should also encourage everyday physical activity such as walking for transport

Understanding ‘Urban Youth’ and the Challenges they face in Sub-Saharan Africa: Unemployment, Food Insecurity and Violent Crime

Much of Africa is urbanising fast and its young population is projected to constitute the largest labour force in the world. While urbanisation can be linked closely with economic development, we also know that it is the least developed countries that have younger populations than the rest of the world. This duality implies that understanding the nature of risks and vulnerabilities faced by urban youth, how they are impacted by them, as well as how they respond to and may be resilient against them, continue to be important questions for furthering development in sub-Saharan Africa. A key conceptual debate surrounds how the category of ‘youth’ is understood, as several definitions of the term exist, ranging from age bands to social or cultural framings. In this paper we look to review how the various definitions of ‘youth’ relate to three dominant discourses about poverty and vulnerability in urbanising Africa: (1) food insecurity; (2) unemployment/joblessness; and (3) violence/insecurity. By doing so, we seek to identify if and when these are responsive to youth needs and practical in terms of policy efforts aiming to reduce poverty and vulnerability in urban areas.UK Department for International Developmen

Maharashtra’s Child Stunting Declines: What is Driving Them? Findings of a Multidisciplinary Analysis

Between 2006 and 2012, Maharashtra’s stunting rate among children under two years of age was reported to decline by 15 percentage points – one of the fastest declines in stunting seen anywhere at any time. This was seemingly more remarkable because it occurred within a context where Indian stunting levels nationally are regularly characterised as stuck or static. Maharashtra, the second largest state in India with a population of over 100 million people, appears to represent a major departure from the norm. This report aims to understand the driving factors behind this rapid decline. The report draws on three source papers written by the authors, which are summarised in this overview paper: one drawing on secondary data (section 2 – Haddad 2014), one drawing on primary survey data (section 3 – Haddad and Valli 2014) and one drawing on primary qualitative data (section 4 – Barnett and Nisbett 2014).1 As will become clear, the three papers, using different methods and written by different combinations of the three principal authors, arrive at very similar conclusions, giving us greater confidence in their validity. This overview first surveys the literature to describe the broad economic, political and social changes occurring within the state in the 2000–2012 period. In what kind of environment did these declines in stunting occur? Second, the paper analyses two child-level surveys undertaken in 2006 and 2012 to describe the distribution of stunting declines, identify factors correlated with the higher stunting (and wasting) rates in both years and to assess whether the relationship between stunting, wasting and its correlates has profoundly changed. Third, we conducted interviews and focus group discussions with key stakeholders in academia, civil society, government, international partner organisations, media and the private sector to identify the perceived critical factors for the decline in stunting. The final section of the paper concludes with a series of messages that we believe are important for nutrition policymaking in India and globally