Comparison of Methods to Assess Consumption of Micronutrient Powders Among Young Children in Nepal.

Background: Assessing micronutrient powder (MNP) consumption is the key for monitoring program performance; no gold standard exists for assessing consumption in nutrition programs.

Objective: To compare estimates of MNP consumption assessed by maternal report versus observed unopened MNP sachets in the household.

Methods: Cross-sectional household surveys of children aged 6 to 23 months were conducted to assess an MNP project in Nepal; eligible children received 60 sachets per distribution.

Applying Positive Deviance for Improving Compliance to Adolescent Anemia Control Program in Tribal Communities of India.

Background: Positive deviance (PD) is an asset-based social and behavior change communication strategy, utilizing successful outliers within a specific context. It has been applied to tackling major public health problems but not adolescent anemia.

Objective: The study, first of its kind, used PD to improve compliance to adolescent anemia control program in Jharkhand, India, where anemia prevalence in adolescent girls is 70%, and program compliance is low.

Partnering with women collectives for delivering essential women's nutrition interventions in tribal areas of eastern India: a scoping study.

Background: We examined the feasibility of engaging women collectives in delivering a package of women's nutrition messages/services as a funded stakeholder in three tribal-dominated districts of Odisha, Jharkhand and Chhattisgarh States, in eastern India. These districts have high prevalence of child stunting and poor government service outreach.

Methods: Conducted between July 2014 and March 2015, an exploratory mix-methods design was adopted (review of coverage data and government reports, field interviews and focus group discussion with multiple stakeholders and intended communities) to assess coverage of women's nutrition services.

High Prevalence of Vitamin B12 Deficiency and No Folate Deficiency in Young Children in Nepal.

Many children in low- and middle-income countries may have inadequate intake of vitamin B12 and folate; data confirming these inadequacies are limited. We used biochemical, demographic, behavioral and anthropometric data to describe the folate and vitamin B12 concentrations among six- to 23-month-old Nepalese children. Vitamin B12 (serum B12 < 150 pmol/L) and folate deficiencies (red blood cell (RBC) folate < 226.

Identifying acceptability and price points for purchasing micronutrient powders for children 2 to 5 years old in Nepal.

Background And Objective: Little is known about purchasing micronutrient powders (MNP) for children 2-5 years. We describe acceptability for purchasing and price points for MNP for children 2-5 years among caregivers living in districts where free MNP are distributed for children 6-23 months.

Methods And Study Design: Crosssectional surveys conducted 3 months after MNP program implementation in 2 districts; 15 months after implementation in 2 different districts.

Micronutrient powder use and infant and young child feeding practices in an integrated program.

Integrated infant and young child feeding (IYCF)/micronutrient powder (MNP) programs are increasingly used to address poor IYCF practices and micronutrient deficiencies in low-income settings; however, little is known about how MNP use may affect IYCF practices. We describe how MNP use was associated with IYCF practices in a pilot program in select districts of Nepal where free MNP for children 6-23 months were added to an existing IYCF platform. Representative cross-sectional surveys were conducted in pilot districts with mothers of eligible children at 3 months (plains ecozone, n=1054) or 15 months (hill ecozone, rural only, n=654) after implementation of an integrated MNP/IYCF program.

Predictors of micronutrient powder intake adherence in a pilot programme in Nepal.

Objective: Poor adherence to recommended intake protocols is common and a top challenge for micronutrient powder (MNP) programmes globally. Identifying modifiable predictors of intake adherence could inform the design and implementation of MNP projects.

Design: We assessed high MNP intake adherence among children who had received MNP ≥2 months ago and consumed ≥1 sachet (n 771).

Predictors of micronutrient powder sachet coverage in Nepal.

Many countries implement micronutrient powder (MNP) programmes to improve the nutritional status of young children. Little is known about the predictors of MNP coverage for different delivery models. We describe MNP coverage of an infant and young child feeding and MNP intervention for children aged 6-23 months comparing two delivery models piloted in rural Nepal: distributing MNPs either by female community health volunteers (FCHVs) or at health facilities (HFs).

Antenatal Iron-Folic Acid Supplementation Reduces Neonatal and Under-5 Mortality in Nepal.

Background: Antenatal iron-folic acid (IFA) supplementation improves maternal anemia and poor pregnancy outcomes. Antenatal use of IFA supplements also has an effect on child survival.

Objective: The current study investigated the effect of antenatal IFA supplements on the risk of childhood mortality in Nepal over a 15-y period from 1996 to 2011.

The contribution of child health days to improving coverage of periodic interventions in six African countries.

Background: Child Health Days have been implemented since the early 2000s in a number of sub-Saharan African countries with support from UNICEF and other development partners with the aim to reduce child morbidity and mortality.

Objective: To estimate the effect of Child Health Days on preventive public health intervention coverage, and possible trade-offs of Child Health Days with facility-based health systems coverage, in sub-Saharan Africa.

Methods: Data were assembled and analyzed from population-based sample surveys and administrative records and from local government sources, from six countries.

Identifying priorities for emergency intervention from child wasting and mortality estimates in vulnerable areas of the Horn of Africa.

Background: The relation between anthropometric measures and mortality risk in different populations can provide a basis for deciding how malnutrition prevalences should be interpreted.

Objective: To assess criteria for deciding on needs for emergency interventions in the Horn of Africa based on associations between child wasting and mortality from 2000 to 2005.

Methods: Data were analyzed on child global acute malnutrition (GAM) prevalences and mortality estimates from about 900 area-level nutrition surveys from Ethiopia, Kenya, Somalia, Sudan, and Uganda; data on drought, floods, and food insecurity were added for Kenya (Rift Valley) and Ethiopia, from Food and Agriculture Organization (FAO) reports at the time.

Fluctuations in wasting in vulnerable child populations in the Greater Horn of Africa.

Background: Malnutrition in preschool children, usually measured as wasting, is widely used to assess possible needs for emergency humanitarian interventions in areas vulnerable to drought, displacement, and related causes of food insecurity. The extent of fluctuations in wasting by season, year-to-year, and differential effects by livelihood group, need to be better established as a basis for interpretation together with ways of presenting large numbers of survey results to facilitate interpretation.

Objective: To estimate levels of and fluctuations in wasting prevalences in children from surveys conducted in arid and semiarid areas of the Greater Horn of Africa according to livelihood (pastoral, agricultural, mixed, migrant), season or month, and year from 2000 to 2006.

Impact of drought and HIV on child nutrition in Eastern and Southern Africa.

Background: Intermittent food insecurity due to drought and the effects of HIV/AIDS affect child nutritional status in sub-Saharan Africa. In Southern Africa in 2001-3 drought and HIV were previously shown to interact to cause substantial deterioration in child nutrition. With additional data available from Southern and Eastern Africa, the size of the effects of drought and HIV on child underweight up to 2006 were estimated.