Driver hand positions on the steering wheel while merging into motorway traffic

It has been suggested that a driver's hand position on the steering wheel can reflect the perceived risk of the road context (Walton, D., & Thomas, J. A. (2005). Naturalistic observations of driver hand positions. Transportation Research Part F, 8. 229-238, Thomas, J. A., & Walton, D. (2007). Measuring perceived risk: Self-reported and actual hand positions of SUV and car drivers. Transportation Research Part F, 10, 201-207). These original studies were based on field observations where only a part of the steering wheel could be viewed. In the present study hand positions were observed in a driving simulator during the performance of a demanding task: merging into motorway traffic. In the current study the whole steering wheel could be observed and hand positions were classified in three categories: high control, medium control, and low control. Differences in hand position between different traffic conditions were limited, and hand position did not correlate with self-reported risk or self-reported mental effort, but changes in hand positions do seem to be associated with changes in workload demand. It is therefore concluded that hand position can give some information about mental workload. (C) 2010 Elsevier Ltd. All rights reserved

Can integrated agriculture - nutrition programs change gender norms on land and asset ownership? Evidence from Burkina Faso.

There is a high degree of interest in the potential for agricultural programs to be designed and implemented to achieve health and nutrition objectives. Policymakers have often looked to the experience of civil society organizations in designing and implementing such programs, particularly in different social and cultural contexts. For the past 20 years, Helen Keller International (HKI) has implemented homestead food production programs in Asia and recently has started to adapt and implement these programs in Africa south of the Sahara. The goal of these programs is to improve the nutritional status of and young children through a number of production and nutrition interventions. These interventions are targeted to mothers under the presumption that increasing women’s access to and control over productive assets and enhancing women’s human capital to improve production and health and nutrition care practices will translate into improved nutritional status for their children. However, there is very little evidence documenting the ways in which HKI’s homestead food production programs influence women’s access to and control over productive assets and enhance women’s human capital in ways that may improve nutritional outcomes. This paper uses a mixed-methods approach to analyze the impact of HKI’s Enhanced-Homestead Food Production pilot program in Burkina Faso on women’s and men’s assets and on norms regarding ownership, use, and control of those assets. Even though men continue to own and control most land and specific assets in the study area, women’s control over and ownership of assets has started to change, both in terms of quantifiable changes as well as changes in people’s perceptions and opinions about who can own and control certain assets. The paper also discusses the implications of such changes for program sustainability

An integrated agriculture - nutrition program in Burkina Faso can change gender norms on land and asset ownership.

Helen Keller International (HKI) carried out a two-year Enhanced-Homestead Food Production (E-HFP) pilot program (2010–2012) in Gourma Province in eastern Burkina Faso. The program’s goal was to improve women’s and children’s nutrition and health outcomes through production and nutrition interventions. One way in which the program sought to improve its production and nutrition out-comes was by directly increasing women’s access to and control over productive assets. To accomplish this objective, HKI trained women and gave them inputs for raising small animals and growing nutrient-rich foods, as well as health-and nutrition -related education delivered through a behavior change communication (BCC) strategy (Dillon et al. 2012). HKI partnered with the Gender, Agriculture, and Assets Project (GAAP) to measure the impact of the program’s interventions on men’s and women’s accumulation, ownership, and control over productive assets, and to assess changes in norms and perceptions regarding the ownership, use, and control over these assets

Stories of Change in Nutrition from Africa and Asia: an Introduction to a Special Series in Food Security

Malnutrition in all its forms continues to be a massive global challenge, and the past decade has seen a growing political attention to addressing malnutrition in different contexts. What has been largely missing so far, and is in growing demand from countries, is tangible, practical and rigorous insights and lessons (from other countries or contexts) on how to translate this burgeoning political momentum into effective policies and programme implementation strategies – and ultimately impact on the ground. This new climate of learning from experience and evidence led to the launch in 2015 of the Stories of Change initiative. This series presents a second wave of studies from six countries (Tanzania, Rwanda, Vietnam, Ghana, Burkina Faso, Nigeria,) and three Indian states (Chhattisgarh, Gujarat, Tamil Nadu). These provide clear evidence combined with compelling narratives on what drives success in addressing all forms of malnutrition – evidence that is necessary for turning global momentum into actual results on the ground. This introductory Opinion is published with the first set of papers. It will be followed by a thorough synthesis of papers as a conclusion of the Series. We hope that the lessons embedded in these Stories of Change will inform and inspire the deliberations and outcomes of the UN Food Systems Summit and the second Nutrition for Growth Summit to be held this year, and the actions of those in the global food and nutrition system working for positive change

Understanding the role of intersectoral convergence in the delivery of essential maternal and child nutrition interventions in Odisha, India: a qualitative study.

BACKGROUND: Convergence of sectoral programs is important for scaling up essential maternal and child health and nutrition interventions. In India, these interventions are implemented by two government programs - Integrated Child Development Services (ICDS) and National Rural Health Mission (NRHM). These programs are designed to work together, but there is limited understanding of the nature and extent of coordination in place and needed at the various administrative levels. Our study examined how intersectoral convergence in nutrition programming is operationalized between ICDS and NRHM from the state to village levels in Odisha, and the factors influencing convergence in policy implementation and service delivery. METHODS: Semi-structured interviews were conducted with state-level stakeholders (n = 12), district (n = 19) and block officials (n = 66), and frontline workers (FLWs, n = 48). Systematic coding and content analysis of transcripts were undertaken to elucidate themes and patterns related to the degree and mechanisms of convergence, types of actions/services, and facilitators and barriers. RESULTS: Close collaboration at state level was observed in developing guidelines, planning, and reviewing programs, facilitated by a shared motivation and recognized leadership for coordination. However, the health department was perceived to drive the agenda, and different priorities and little data sharing presented challenges. At the district level, there were joint planning and review meetings, trainings, and data sharing, but poor participation in the intersectoral meetings and limited supervision. While the block level is the hub for planning and supervision, cooperation is limited by the lack of guidelines for coordination, heavy workload, inadequate resources, and poor communication. Strong collaboration among FLWs was facilitated by close interpersonal communication and mutual understanding of roles and responsibilities. CONCLUSIONS: Congruent or shared priorities and regularity of actions between sectors across all levels will likely improve the quality of coordination, and clear roles and leadership and accountability are imperative. As convergence is a means to achieving effective coverage and delivery of services for improved maternal and child health and nutrition, focus should be on delivering all the essential services to the mother-child dyads through mechanisms that facilitate a continuum of care approach, rather than sectorally-driven, service-specific delivery processes

Understanding Drivers of Stunting Reduction in Nigeria from 2003 to 2018: a Regression Analysis

Nigeria is a high burden country for stunting. Stunting reduction has been slow and characterized by unequal progress across the 36 states and federal capital territory of the country. This study aimed to assess the changes in prevalence of stunting and growth determinants from 2003 to 2018, identify factors that predicted the change in stunting, and project future stunting prevalence if these predicted determinants improve. Trend and linear decomposition analyses of growth outcomes and determinants were conducted using 2003, 2008, 2013, and 2018 Nigeria Demographic and Health Survey data. Pooled data included 57,507 children 0 to 59 months old. Findings show that stunting and severe stunting significantly reduced from 43 to 37% and 23% to 17%, respectively (p < 0.001), between 2003 and 2018. Disturbingly, height-for-age z-scores at birth significantly decreased, indicating risks of potential future stunting increase. Improvements in nine stunting determinants (maternal body mass index, maternal height, ≥ 4 antenatal care visits, health facility delivery, reduced child illnesses, asset index, maternal education, paternal education, and preceding birth interval) predicted stunting reductions in children 0–59 months. Few of these nine determinants improved in subpopulations with limited stunting progress. Intra-sectoral and multisectoral coordination were potentially inadequate; 12% of children had received all of three selected health sector interventions along a continuum of care and 6% had received all of six selected multisector interventions. Forward looking projections suggest that increased efforts to improve the nine predictors of stunting change can reduce under-five stunting in Nigeria to ≤ 27% in the short term.Bill and Melinda Gates Foundatio

Stories of Change in Nutrition in Ghana: a focus on stunting and anemia among children under-five years (2009 – 2018)

The current study aimed to understand why child stunting and anemia (CS&A) rates declined in Ghana between 2009 and 2018, and which priority policies and programs will further improve nutrition outcomes. Trends and potential drivers of stunting (height-for-age z-score<-2.0 SD) and anemia (hemoglobin<11.0 g/dL), and decomposition analysis of DHS data (2003 to 2014) were conducted. The quantitative evidence was triangulated with Net-Map analysis of nutrition stakeholder relationships and infuence, desk review of policies and programs 2009–2019, and in-depth interviews with 25 stakeholders who provided additional insights to explain CS&A trends. Declines in stunting (29.6%) and anemia (14.1%) in children were observed at the national level, but with important subgroup variations. Decomposition analyses identifed changes in the household, maternal, and child characteristics (including wealth, use of antenatal services, maternal education, and immunization) as correlates of anemia reduction. Stunting reduction was linked with changes in bed-net utilization, household wealth, and pregnancy care service utilization. Additionally, multiple policies and programs initiated/implemented across multiple sectors were considered potentially relevant to CS&A reduction over time, including those focused on infant and young child feeding, water and sanitation, social protection, and health care access. Initiation/strengthening of these interventions was stimulated by awareness creation and subsequently increased prioritization of stunting. However, program delivery was limited by defcits in government funding, perceived low priority of child anemia, low implementation capacity and coverage, and weak coherence across sectors. Reduced CS&A resulted from improved access to services implemented across multiple sectors, albeit limited by implementation scale and capacity. Further reduction in CS&A requires enhanced multi-sectorally coordinated actions and capacity

Leveraging agriculture for nutrition in South Asia: What do we know, and what have we learned?

Despite significant improvements over recent decades, rates of undernutrition remain high in South Asia, with adverse impacts on morbidity and mortality. Overweight/obesity, among children and adults, is now an additional and major public health concern. While agriculture has the potential to improve nutrition through several pathways, this potential is currently not being realised in the region. The Leveraging Agriculture for Nutrition in South Asia (LANSA) research consortium (2012–2018) set out to improve understanding about how agriculture and related food policies and programs in South Asia (specifically in India, Bangladesh, Pakistan and Afghanistan) can be better conceptualised and implemented in order to enhance impacts on nutrition outcomes, especially those of young children and adolescent girls. This paper provides a snapshot of the agriculture-nutrition nexus in the region, outlines the pathways through which agriculture can influence nutrition outcomes, elaborates on the objectives of the LANSA research consortium within this context, and highlights the core findings of the six papers that form the body of this Special Issue. The paper ends with five key lessons that have emerged from this research, during this decade