Climate-Smart Agriculture (CSA) within the Feed the Future Project Portfolio of USAID-Bangladesh: A CCAFS Deep-Dive Review

As part of a global effort that will inform how Feed the Future tracks CSA across the 19 focus countries (plus aligned) the CCAFS and USAID/BFS team selected 5 to carry out a deeper analysis of their portfolio. A visit in August 2015 by personnel from CCAFS and USAID-BFS Washington to the Bangladesh Mission provided an opportunity to identify and discuss CSA-related activities within the country and the USAID zone of influence (ZOI). The five-day visit included a series of meetings with Mission staff, project implementing partners and the Bangladesh Department of Agricultural Extension. While the discussion scope emphasized the second of the above CSA objectives, adaptation, within Feed the Future (FTF) projects, the meetings included discussion of the other CSA objectives and USAID projects associated with Food for Peace and Global Climate Change. The visits were preceded by a document review of the Bangladesh Mission projects and relevant agriculture and climate change information available on the web. This report outlines key findings of the visit and suggests ways in which CSA can be further integrated into upcoming Feed the Future programming in Bangladesh

CCAFS Rwanda Deep Dive Assessment of Climate-Smart Agriculture (CSA) in the USAID Feed the Future Portfolio in Rwanda

As part of a global effort that will inform how Feed the Future tracks CSA across the 19 focus countries (plus aligned) the CCAFS and USAID/BFS team selected five to carry out a deeper analysis of their portfolio. A visit in June 2015 by CCAFS to the Rwanda Mission highlighted the importance of addressing the effects of climate change in the agricultural sector and the current and potential benefits of CSA in Feed the Future. The five-day visit included a number of meetings with USAID Mission staff, Feed the Future implementing partners, Government of Rwanda partners, and other stakeholders, as well as a field trip to one Feed the Future project in the Southern Region. The process also included a review of documentation on the five current projects in the Feed the Future portfolio, shared in advance of the visit by USAID Rwanda staff. This report outlines the key findings of the visit and highlights some ways in which CSA can be further incorporated into the Mission’s future programmin

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

CSA Programming and Indicator Tool: 3 Steps for increasing programming effectiveness and outcome tracking of CSA interventions

In the context of a collaboration with USAID Feed the Future, the CSA programming and indicator Tool has been designed to contribute to address both, the need of good instruments for programming and better metrics for tracking outcomes and impact and to allow multiple development agencies and agricultural focused programs to share a common framework on how they are currently addressing Climate-Smart Agriculture and how they can make their future programming process more climate-smart. The CSA Programming and Indicator Tool helps to examine the scope of a given program or intervention through the three dimensional lenses of Climate Smart Agriculture (Productivity/Income, Adaptation and Mitigation). This tool strengthens the planning phase of interventions in order to ensure that all potential CSA related outcomes (beyond productivity/income pillar) are properly included in the M&E design