evidence-based blog of Filippo Dibari

Posts Tagged ‘evidence’

Perspective: What Does Stunting Really Mean? A Critical Review of the Evidence

In Under-nutrition on June 3, 2019 at 9:49 am

by Jef L LeroyEdward A Frongillo on Advance in Nutrition journal

Advances in Nutrition, Volume 10, Issue 2, March 2019, Pages 196–204,

Abstract

The past decade has seen an unprecedented increase in attention to undernutrition, and drastically reducing child stunting has become a global development objective. The strong focus on linear growth retardation and stunting has enabled successful advocacy for nutrition, but with this focus has come some confusion and misunderstanding about the meaning of linear growth retardation and stunting among researchers, donors, and agencies active in nutrition.

Motivated by the belief that a sharp focus will further accelerate progress in reducing undernutrition, we critically reviewed the evidence. The global attention to stunting is based on the premise that any intervention aimed at improving linear growth will subsequently lead to improvements in the correlates of linear growth retardation and stunting.

Current evidence and understanding of mechanisms does not support this causal thinking, with 2 exceptions: linear growth retardation is a cause of difficult births and poor birth outcomes. Linear growth retardation is associated with (but does not cause) delayed child development, reduced earnings in adulthood, and chronic diseases. We thus propose distinguishing 2 distinctly different meanings of linear growth retardation and stunting.

First, the association between linear growth retardation (or stunting) and other outcomes makes it a useful marker.

Second, the causal links with difficult births and poor birth outcomes make linear growth retardation and stunting outcomes of intrinsic value.

In many cases a focus on linear growth retardation and stunting is not necessary to improve the well-being of children; in many other cases, it is not sufficient to reach that goal; and for some outcomes, promoting linear growth is not the most cost-efficient strategy.

We appeal to donors, program planners, and researchers to be specific in selecting nutrition outcomes and to target those outcomes directly.

Training: 4th Annual Summer Institute for systematic reviews in nutrition for global policy-making

In Over-nutrition, Under-nutrition on March 17, 2017 at 3:14 pm
 

4th Annual Summer Institute for systematic reviews in nutrition for
global policy-making

 

World Health Organization (WHO)/Pan American Health Organization (PAHO) Collaborating Centre on implementation research in nutrition and global policy and Cochrane

Date: 24 July to 4 August 2017
Venue: Division of Nutritional Sciences, Cornell University Campus, Ithaca, NY, United States of America

Scope and purpose

The World Health Organization (WHO) follows a guideline development process, described in detail in the
WHO Handbook for Guideline Development (2nd edition), overseen by the Guidelines Review Committee (GRC) established by the Director-General in 2007. The WHO Guidelines Review Committee ensures that WHO guidelines are of a high methodological quality, developed using a transparent and explicit process, and are informed on high quality systematic reviews of the evidence using state-of–the art systematic search strategies, synthesis, quality assessments and methods.

The WHO Department of Nutrition for Health and Development has worked with the Cochrane editorial office and various groups within the Cochrane to produce systematic reviews for WHO nutrition guidelines since 2010. This allows for faster and prioritized completion of systematic reviews on the effects of interventions that contribute towards guideline development.

Cochrane is an international network of more than 28 000 people from over 120 countries working together to help health-care providers, policy-makers, and patients, their advocates and carers, make well-informed decisions about health care. This collaboration hosts the Cochrane Library and CENTRAL, the largest collection of records of randomized controlled trials in the world. On 24 January 2011, WHO awarded Cochrane a seat on the World Health Assembly, allowing the collaboration to provide input on WHO health resolutions.

In order to further increase capacity in systematic review methodology among nutrition scientists and practitioners, the WHO/PAHO Collaborating Centre on implementation research in nutrition and global policy, in collaboration with Cochrane has convened the Summer Institute for systematic reviews in nutrition for global policy-making in Ithaca, NY, United States of America since 2014. The 4th Annual Summer Institute will be held on 24 July to 4 August 2017.

This unique institute will bring together experts from WHO, PAHO, Cochrane, and Cornell University to train participants in the development of systematic reviews of nutrition interventions in public health following the Cochrane methodology. Participants will use the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool to assess the overall quality of evidence.

The WHO/Cochrane/Cornell University Summer Institute for systematic reviews in nutrition for global policy-making is intended for nutrition scientists and practitioners from various fields with interest in the application of scientific evidence in policy making. Applications from women and from nationals of low- and middle-income countries are particularly encouraged. Partial financial support is available for limited number of accepted participants.

The objectives of this programme are:

• To update and develop technical skills and knowledge in systematic reviews of nutrition and nutrition-sensitive interventions;
• To build understanding of the process for global policy making in nutrition, and evidence assessment and its challenges;
• To complete hands-on training in the development of Cochrane systematic reviews on a topic of immediate global health relevance in nutrition and public health.

For additional information, please see the Summer Institute website (here). To apply, please submit your application materials to DNSDirector@cornell.edu at your earliest convenience. The Institute will process applications as they are received, therefore on a rolling basis, and will close the class when the limit of participants is reached. Once accepted, participants will receive a link with additional information for registration.

For further information and specific application instructions, visit this link: http://who-cochrane-cornell-summer-institute.nutrition.cornell.edu/

 

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Stunting: latest evidence (open source)

In Under-nutrition on May 19, 2016 at 8:42 pm

Stop stunting: improving child feeding, women’s nutrition and household sanitation in South Asia.

Víctor M. Aguayo and Purnima Menon

http://onlinelibrary.wiley.com/doi/10.1111/mcn.12283/epdf

 

Childhood stunting: a global perspective.

Mercedes de Onis and Francesco Branca

http://onlinelibrary.wiley.com/doi/10.1111/mcn.12231/epdf

 

Reducing stunting by improving maternal, infant and young child nutrition in regions such as South Asia: evidence, challenges and opportunities.

Kathryn G. Dewey

http://onlinelibrary.wiley.com/doi/10.1111/mcn.12282/epdf

 

Feeding practices for infants and young children during and after common illness. Evidence from South Asia.

Kajali Paintal and Víctor M. Aguayo

http://onlinelibrary.wiley.com/doi/10.1111/mcn.12222/epdf

 

Improving women’s nutrition imperative for rapid reduction of childhood stunting in South Asia: coupling of nutrition specific interventions with nutrition sensitive measures essential.

Sheila C. Vir

http://onlinelibrary.wiley.com/doi/10.1111/mcn.12255/epdf

 

Can water, sanitation and hygiene help eliminate stunting? Current evidence and policy implications.

Oliver Cumming and Sandy Cairncross

http://onlinelibrary.wiley.com/doi/10.1111/mcn.12258/epdf

 

Preventing environmental enteric dysfunction through improved water, sanitation and hygiene: an opportunity for stunting reduction in developing countries.

Mduduzi N. N. Mbuya and Jean H. Humphrey

http://onlinelibrary.wiley.com/doi/10.1111/mcn.12220/epdf

 

Determinants of stunting and poor linear growth in children under 2 years of age in India: an in-depth analysis of Maharashtra’s comprehensive nutrition survey.

Víctor M. Aguayo, Rajilakshmi Nair, Nina Badgaiyan and Vandana Krishna

http://onlinelibrary.wiley.com/doi/10.1111/mcn.12259/epdf

 

Achieving behaviour change at scale: Alive & Thrive’s infant and young child feeding programme in Bangladesh.

Tina Sanghvi, Raisul Haque, Sumitro Roy, Kaosar Afsana, Renata Seidel, Sanjeeda Islam, Ann Jimerson and Jean Baker

http://onlinelibrary.wiley.com/doi/10.1111/mcn.12277/epdf

 

Evidence-based evolution of an integrated nutrition-focused agriculture approach to address the underlying determinants of stunting.

Nancy J. Haselow, Ame Stormer and Alissa Pries

http://onlinelibrary.wiley.com/doi/10.1111/mcn.12260/epdf

 

Estimating the cost of delivering direct nutrition interventions at scale: national and subnational level insights from India.

Purnima Menon, Christine M. McDonald and Suman Chakrabarti

http://onlinelibrary.wiley.com/doi/10.1111/mcn.12257/epdf

 

The costs of stunting in South Asia and the benefits of public investments in nutrition.

Meera Shekar, Julia Dayton Eberwein and Jakub Kakietek

http://onlinelibrary.wiley.com/doi/10.1111/mcn.12281/epdf

 

Understanding the null-to-small association between increased macroeconomic growth and reducing child undernutrition in India: role of development expenditures and poverty alleviation.

William Joe, Ramaprasad Rajaram and S. V. Subramanian

http://onlinelibrary.wiley.com/doi/10.1111/mcn.12256/epdf

 

Drivers of nutritional change in four South Asian countries: a dynamic observational analysis.

Derek Headey, John Hoddinott and Seollee Park

http://onlinelibrary.wiley.com/doi/10.1111/mcn.12274/epdf

 

Rethinking policy perspectives on childhood stunting: time to formulate a structural and multifactorial strategy.

S V Subramanian, Iván Mejía-Guevara and Aditi Krishna

http://onlinelibrary.wiley.com/doi/10.1111/mcn.12254/epdf

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