Changing behavior through agriculture-nutrition integration: field experience and results. Regional Technical Committee meeting of the Scaling Up Sweetpotato Through Agriculture and Nutrition (SUSTAIN) project, 11–12 September 2018, Kigali, Rwanda

The Regional Technical Committee meeting of SUSTAIN in Kigali, held in September 2018, was organized to disseminate the results from the analyses of data from surveys, monitoring, and focus group discussions on SUSTAIN and VISTA–Tanzania projects. These analyses were conducted to provide insight into the implementation of the projects and also to shed light on the likely reasons for the observations made in the quantitative analysis. Results from field discussions with CIP partners – local and international NGOs, local government institutions, national and international organizations, the private sector, and donors – were also shared

Association Between Nutrition Social Behavior Change Communication and Improved Caregiver Health and Nutrition Knowledge and Practices in Rural Tanzania

Background: Efforts to improve infant and young child feeding practices include the use of nutrition behavior change communication among caregivers of children under 5 years. We assessed the association between monthly participation in community-level nutrition group meetings on caregiver health and nutrition knowledge and practices (KPs). Methods: Data from a community-based cross-sectional survey conducted in the Eastern and Southern Highland Zones of Tanzania were used. Indices were developed for caregivers' knowledge of nutrition, health and childcare, household (HDD) and young child dietary diversity (CDD), and vitamin A (VA) intakes. The comparison of means and proportions was assessed using Student's t-test and the Chi-square test, respectively, between the caregivers participating in nutrition group meetings and non-participants. The impact of the number of nutrition meeting attendance on caregiver KPs scores was examined using multiple regression. Results: Of 547 caregivers surveyed, 49.7% attended nutrition group meetings and received information on nutrition social behavior change communication (SBCC). Overall, 28% of participating women had a moderate level of nutrition knowledge, 62% had a high level of VA knowledge, and 57% had a high level of health and childcare knowledge. Participation in nutrition group meetings was significantly associated with the health and childcare knowledge score (HKS), HDD and CDD scores, and household and young child VA intake; the magnitude of the associations was greater for caregivers who attended at least four meetings. Conclusion: The findings emphasize the need for programs that seek to address the issues present in the use of nutrition SBCC at the community level to improve maternal or caregiver KPs and subsequently the nutrition status of infants and young children

Association between infection and nutritional status among infants in a cohort study of vitamin A in western Kenya

BackgroundInfection is associated with impaired nutritional status, especially for infants younger than 5 years. ObjectivesWe assessed the impact of infection indicated by both acute phase proteins (APP), C-reactive protein (CRP), and alpha-1-acid-glycoprotein (AGP), and as reported by maternal recall on the nutritional status of infants. Materials and methodsA total of 505 pregnant women were enrolled in a nested longitudinal cohort study of vitamin A (VA). Data from 385 children are reported here. The incidence and severity of respiratory infection and diarrhea (previous 14 days) were assessed by maternal recall; infant/child feeding practices were collected. Infant weight, recumbent length, and heel-prick capillary blood were taken at 9 months postpartum. Indicators of the VA status [retinol binding protein (RBP)], iron status (Hb, ferritin), and subclinical inflammation APP, CRP (>5 mg/L), and AGP (>1 g/L) were determined. Impacts of infection on the infant nutritional status were estimated using logistic regression models. ResultsInfection prevalence, based on elevated CRP and AGP levels, was 36.7%. For diarrhea reported symptoms, 42.4% of infants at 9 months had no indication of infection as indicated by CRP and AGP; for acute respiratory reported symptoms, 42.6% had no indication of infection. There was a significant positive association with infection among VA-deficient (RBP < 0.83 mu mol/L) infants based on maternal reported symptoms but not with iron deficiency (ferritin < 12 mu g/L). The odds of having infection, based on increased CRP and AGP, in underweight infants was 3.7 times higher (OR: 3.7; 95% CI: 2.3, 4.5; P = 0.019). Infants with iron deficiency were less likely (OR: 0.40; 95% CI: 0.1, 0.7; P = 0.001) to have infection based on CRP and AGP, while infants with VA deficiency were five times more likely (OR: 5.06; 95% CI: 3.2, 7.1; P = 0.0001) to have infection. ConclusionAcute phase proteins are more useful in defining infection in a population than reported symptoms of illness. Not controlling for inflammation in a population while assessing the nutritional status might result in inaccurate prevalence estimation