La desnutrició en el món

Un repte actual, un compromís de futu

Exploring the new indicator Minimum Dietary Diversity-Women. Results from Burkina Faso.

Improving the quality of women's diet is the best way to stop the inter-generational cycle of malnutrition. The Minimum Dietary Diversity Women is a global indicator recently endorsed to monitor nutrition sensitive actions and programs aimed at improving the diet of women of reproductive age. This report explores the potential use of the indicator for programmatic action, and gauges how the indicator relates to other dimensions, and how sensitive it is to changes, in urban and rural Burkina Faso.JRC.H.4-Monitoring Agricultural Resource

Barriers and Facilitators for Exclusive Breastfeeding within the Health System and Public Policies from In-Depth Interviews to Primary Care Midwives in Tenerife (Canary Islands, Spain)

The aim of this study is to describe the perspectives of Primary Care midwives regarding factors that benefit or are detrimental to exclusive breastfeeding (EBF) within the health system and public policies. The study was carried out in Tenerife (Canary Islands, Spain) and is based on qualitative methodology. Twenty in-depth interviews were carried out with midwives who work in Primary Care centres in Tenerife, using a content analysis approach. The transcript data were then encoded following an inductive approach. The factors, according to midwives, that affect EBF, with regard to the healthcare system, are related to training of healthcare professionals in breastfeeding and their support to women during pregnancy, childbirth and postnatal care. Regarding public policies, midwives believe the maternity leave periods in Spain, together with a lack of laws and social policies to protect EBF are detrimental. The findings from our study show that there is a need to boost training and the role of professionals in EBF and, at the same time, promote protective policies that foster equality, favouring, among other issues, the work-life balance.This research was funded by the Spanish Health Research Fund (PIFIISC 19/15). Canary Islands Foundation Health Research Institute of the Canary Islands (FIISC). CIF: G76208396 Barranco de la Ballena, s/n Edificio Anexo al Hospital Universitario de Gran Canaria “Negrín” 35019—Las Palmas de Gran Canaria, Canary Island, Spain.S

Así influyen el sistema sanitario y las políticas públicas en la lactancia materna exclusiva

Artículo de divulgación publicado en The Conversation España el día 12/05/2022.Las tasas de este tipo de lactancia en España son del 28 %, muy por debajo de lo recomendado por la OMS. Las escasas políticas económicas, laborales y sanitarias que protejan la crianza frenan el alcance de los objetivos marcados por la OMS.N

Children's dietary diversity and related factors in Rwanda and Burundi: A multilevel analysis using 2010 Demographic and Health Surveys

BACKGROUND: One of the reported causes of high malnutrition rates in Burundi and Rwanda is children's inadequate dietary habits. The diet of children may be affected by individual characteristics and by the characteristics of the households and the communities in which they live. We used the minimum dietary diversity of children (MDD-C) indicator as a proxy of diet quality aiming at: 1) assess how much of the observed variation in MDD-C was attributed to community clustering, and 2) to identify the MDD-C associated factors. METHODS: Data was obtained from the 2010 Demographic and Health Surveys of Burundi and Rwanda, from which only children 6 to 23 months from rural areas were analysed. The MDD-C was calculated according to the 2007 WHO/UNICEF guidelines. We computed the intra-class coefficient to assess the percentage of variation attributed to the clustering effect of living in the same community. And then we applied two-level logit regressions to investigate the association between MDD-C and potential risk factors following the hierarchical survey structure of DHS. RESULTS: The MDD-C was 23% in rural Rwanda and 16% in rural Burundi, and a 29% of its variation in Rwanda and 17% in Burundi was attributable to community clustering. Increasing age and living standards were associated with higher MDD-C in both countries, and only in Burundi also increasing level of education of the mother's partner. In Rwanda alone, the increasing ages of the head of the household and of the mother at first birth were also positively associated with it. Despite the identification of an important proportion of the MDD-C variation due to clustering, we couldn't identify any community variable significantly associated with it. CONCLUSIONS: We recommend further research using hierarchical models, and to integrate dietary diversity in holistic interventions which take into account both the household's and the community's characteristics the children live in.The authors received no specific funding for this work.S

Assessing market incentive policies in Kenya with a food security and nutrition perspective: a macro-microsimulation approach

Kenya, such as other African countries, is particularly concerned about the achievement of the Sustainable Development Goal #2 (SDG #2: zero hunger), and its associated consequences for the society. Empirical evidence about food security and nutrition in Kenya accounts for deficiencies in food access, food sufficiency and food quality at the household level. These deficiencies are among others the causes of all forms of malnutrition (stunting, wasting and overweight), which can lead to cognitive impairment, limited immunity to diseases, low educational performance, increased risk of chronic disease and even mortality cases of children in this country. To solve the food security and nutrition problems in Kenya is a challenging issue because of the different dimensions to be tackled (economic, environmental, educational, health and sanitation) and also because of the heterogeneity that characterizes households (income and food expenditure, education level of households’ head, regional sanitation coverage, access to potable water / waste water system, etc.). In the recent past, the Government of Kenya supported the construction of a roughly €1.1 billion fertilizer plant in Eldoret in the framework of a fertilizer cost reduction strategy aiming at stabilizing fertilizer prices and making fertilizer more accessible through local manufacturing, blending and bulk procurement. Increasing the domestic production of fertilizers should reduce the price of fertilizer, making them more accessible for farmers. Co-authors of this report, employing the STatic Applied General Equilibrium for DEVelopment (STAGE-DEV) Computable General Equilibrium (CGE) model, calibrated on a Social Accounting Matrix Kenya 2014, evaluated the impact on food security of the creation of the fertiliser plant together with three additional policy scenarios (market access, extension and subsidies removal). For the purpose of this study, we developed a macro-micro simulation model, based on the previously developed CGE and policy scenarios and on microsimulations using the Kenya Integrated Household Budged Survey 2015/2016. The objective is to produce new set of food security indicators using macro-micro model linkages and it is purely methodological. The policy results, which should be taken with some caution, are discussed in terms of initial economic (per capita income), food security (household dietary diversity and dietary energy consumption) and children’s nutritional (stunting, wasting) status at the household level. Furthermore, national results are disaggregated by metropolitan areas (Nairobi and Mombasa) and the rest of urban and rural zones of the country. Main results suggest that increasing fertilizers’ availability coupled with increasing market access through the improvement of infrastructures and the reduction of transport costs (market access scenario) will increase overall purchasing power. Supporting pro-poor growth, this development will benefit the most those households with lower diet diversity and higher stunting rates. This policy scenario also leads to the largest increases in diet energy consumption, with similar distributive results as for the purchasing power impact. Increasing fertilizers’ availability paired with improving crops productivity in agricultural practices (extension scenario) leads to the largest increase in energy consumption, particularly from fats in the diet, among households with low diet diversity. Average protein and carbohydrate consumption at national level increase the most within the market access scenario. The results confirm the findings of the previous report. Increasing fertilizer availability in Kenya is not enough to improve food security in the country. The contribution of complementary policies, such as increasing the market access for fertilizers and agriculture by improving the rural infrastructure or improving the extension services to train small-holder farmers about fertilizer and land use, that give farmers better access to input and output markets is needed.JRC.D.4-Economics of Agricultur

Assessing market incentive policies in Kenya with a food security and nutrition perspective: a macro-microsimulation approach

Kenya, such as other African countries, is particularly concerned about the achievement of the Sustainable Development Goal #2 (SDG #2: zero hunger), and its associated consequences for the society. Empirical evidence about food security and nutrition in Kenya accounts for deficiencies in food access, food sufficiency and food quality at the household level. These deficiencies are among others the causes of all forms of malnutrition (stunting, wasting and overweight), which can lead to cognitive impairment, limited immunity to diseases, low educational performance, increased risk of chronic disease and even mortality cases of children in this country. To solve the food security and nutrition problems in Kenya is a challenging issue because of the different dimensions to be tackled (economic, environmental, educational, health and sanitation) and also because of the heterogeneity that characterizes households (income and food expenditure, education level of households’ head, regional sanitation coverage, access to potable water / waste water system, etc.). In the recent past, the Government of Kenya supported the construction of a roughly €1.1 billion fertilizer plant in Eldoret in the framework of a fertilizer cost reduction strategy aiming at stabilizing fertilizer prices and making fertilizer more accessible through local manufacturing, blending and bulk procurement. Increasing the domestic production of fertilizers should reduce the price of fertilizer, making them more accessible for farmers. Co-authors of this report, employing the STatic Applied General Equilibrium for DEVelopment (STAGE-DEV) Computable General Equilibrium (CGE) model, calibrated on a Social Accounting Matrix Kenya 2014, evaluated the impact on food security of the creation of the fertiliser plant together with three additional policy scenarios (market access, extension and subsidies removal). For the purpose of this study, we developed a macro-micro simulation model, based on the previously developed CGE and policy scenarios and on microsimulations using the Kenya Integrated Household Budged Survey 2015/2016. The objective is to produce new set of food security indicators using macro-micro model linkages and it is purely methodological. The policy results, which should be taken with some caution, are discussed in terms of initial economic (per capita income), food security (household dietary diversity and dietary energy consumption) and children’s nutritional (stunting, wasting) status at the household level. Furthermore, national results are disaggregated by metropolitan areas (Nairobi and Mombasa) and the rest of urban and rural zones of the country. Main results suggest that increasing fertilizers’ availability coupled with increasing market access through the improvement of infrastructures and the reduction of transport costs (market access scenario) will increase overall purchasing power. Supporting pro-poor growth, this development will benefit the most those households with lower diet diversity and higher stunting rates. This policy scenario also leads to the largest increases in diet energy consumption, with similar distributive results as for the purchasing power impact. Increasing fertilizers’ availability paired with improving crops productivity in agricultural practices (extension scenario) leads to the largest increase in energy consumption, particularly from fats in the diet, among households with low diet diversity. Average protein and carbohydrate consumption at national level increase the most within the market access scenario. The results confirm the findings of the previous report. Increasing fertilizer availability in Kenya is not enough to improve food security in the country. The contribution of complementary policies, such as increasing the market access for fertilizers and agriculture by improving the rural infrastructure or improving the extension services to train small-holder farmers about fertilizer and land use, that give farmers better access to input and output markets is needed.Fil: Ramos, Maria Priscila. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Instituto Interdisciplinario de Economía Política de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Económicas. Instituto Interdisciplinario de Economía Política de Buenos Aires; ArgentinaFil: Custodio, Estefania. Joint Research Centre; EspañaFil: Jiménez Calvo, Sofía. Universidad de Zaragoza; España. Joint Research Centre; EspañaFil: Mainar Causapé, Alfredo. Joint Research Centre; EspañaFil: Boulanger, Pierre. Joint Research Centre; EspañaFil: Ferrari, Emanuele. Joint Research Centre; Españ

Global analysis of food and nutrition security situation in food crisis hotspots

This report provides a global overview of food insecurity due to different crises and natural disasters to support programming of the Pro-resilience Actions (PRO-ACT) funding mechanism, a component of the Global Public Goods and Challenges (GPGC) thematic programme of the European Union. The analysis covers the period January 2015-January 2016 that has been marked by food crises in several countries because of extreme weather events due the El Niño phenomenon but also because of conflicts and political crises. In a number of countries, in particular in West Africa, food insecurity remains a major concern because of chronic vulnerability despite good crop production in 2015.JRC.H.4-Monitoring Agricultural Resource

Assessing the use of acute malnutrition indicators for nutrition surveillance: Results from 682 283 child observations in 27 low- and middle-income countries

Surveillance with anthropometric indicators is crucial to detect any deterioration in the nutritional status of a population as it provides information on trends to monitor progress and effectiveness of interventions and facilitates geographical and contextual situation analysis which informs prioritization of actions and allocation of resources. For this purposes it is essential that the indicators used to monitor the situation yield comparable results. However, the two indicators most widely used to identify children´s acute malnutrition (AM), the weight-for-height/length Z-score (WHZ) and the absolute value of mid-upper arm circumference (MUAC) provide discrepant results when applied to the same populations. The aim of this report is to shed light on the relationships between WHZ and MUAC in identifying possible population level patterns of acute malnutrition, and explore how they relate to individual characteristics such as sex, age or stunting status, in order to guide their interpretation and use to inform nutrition interventions. The MUAC for age (MUACZ) is also assessed to explore further possibilities of using this indicator as part of population based surveillance taking into account the age bias that exists when assessing children for acute malnutrition using absolute MUAC measurement only. The JRC-UNICEF collaboration was set up to collate, harmonise and analyse a large dataset composed of surveys from 19 West and 7 East African countries and Yemen. In total, 135 national and subnational representative surveys containing 682,283 child observations from 27countries (2011-2018) were collated. We use descriptive statistics and regression analyses to analyse these data. The findings show that WHZ and MUAC measurements identify different manifestations of acute malnutrition and are thus complementary and additive, rather than alternative or exchangeable. Overall and in most of the countries the global acute malnutrition prevalence was lower when using MUAC as compared to WHZ or MUACZ. However, results at country and regional level differed from findings described in other multi-country studies, suggesting that the relationship between the indicators doesn´t follow a geographical pattern (no regional or country pattern can be identified), but rather depend on the sample characteristics of the population surveyed. Importantly, sex, age, and stunting status were confirmed to impact how children are diagnosed as acutely malnourished by the different indicators. Whereas absolute MUAC consistently identifies more acutely malnourished children in younger age groups (below 2 years), MUAC for age (MUACZ) identifies more acute malnutrition in older children. And in relation to the sex of the child, depending on the indicator, the prevalence of acute malnutrition is higher among girls (MUAC) or among boys (WHZ and MUACZ). Conversely, acute malnutrition was consistently higher among stunted children (compared to non-stunted children) across the three indicators, although MUACZ invariably identified the highest number of AM children within the stunted children, as compared to MUAC and WHZ. Finally, these discrepancies can result in discordant situation analysis if the same severity thresholds are applied to all AM population estimates, independently of the indicator used. At the time being, the only global thresholds prescribed to categorize the severity of AM within populations are the ones defined by WHO for wasting based on WHZ. In conclusion, the recommendation is to always specify the indicator used to diagnose acute malnutrition when reporting nutrition outcomes, as well as to disaggregate results by sex, age (below and at/above 24 months) and stunting status for better interpretation. The use of MUAC for age showed potential to improve estimation of acute malnutrition for surveillance but requires additional research. Also, further investigations are needed to define global thresholds to describe severity of acute malnutrition at population level when using the different indicators. Alternatively, to reconsider the age targeting of surveys to 0-23 months, in line with 1000 days programming, and to develop population threholds specific of this age group. Meanwhile, the WHO population based thresholds to interpret the severity of global acute malnutrition for children under five years should be used exclusively for WHZ, and for the acute malnutrition derived from absolute MUAC we recommend to use alternative methods such as the one developed by the Integrated Food Security Phase Classification initiative.S

Low dietary diversity and intake of animal source foods among school aged children in Libo Kemkem and Fogera districts, Ethiopia

Background A low dietary diversity score (DDS) and low consumption of food from animal sources (ASF) are among the factors related to malnutrition in school-aged children living in Libo Kemkem and Fogera (Ethiopia). Objectives This study aimed to identify associated determinants for low dietary diversity and lack of consumption of ASF. Methods In 2009, a cross-sectional survey was carried out in May, at the end of the lean season. Socio-demographic characteristics and diet habits were collected from 886 school-aged children. Additionally, 516 children from rural sites were followed up in the post-harvest season, in December of the same year. Bivariate and multivariable statistical methods were employed to assess low DDS and ASF intake and their association with different factors. Results Up to 80% and 60% of school-aged children living in rural and urban sites, respectively, ate ≤ 3 food groups the day before the survey. The percentage of children consuming ASF was significantly higher in urban settings (64% vs 18%). In the rural areas, if the head of the household was male (OR: 1.91; 95%CI: 1.00-3.65) and older than 40 years (OR: 1.56; 95%CI: 1.02-2.38) the child had a lower DDS in the lean season, while differences by socioeconomic indexes were observed in the post-harvest season. Males took more ASF than females in rural settings (OR: 1.73; 95%CI: 1.14-2.62) and differences by socioeconomic indexes were observed in both settings in the lean season, though not in post-harvest survey. Conclusions The findings of this study revealed that the diet among school-aged children in Libo Kemkem and Fogera districts lacked diversity, and that the intake of foods from animal sources was low, especially among rural girls. To effectively tackle malnutrition, dietary diversification strategies oriented to the local needs are recommended.JRC.H.4-Monitoring Agricultural Resource