Nutrition Research: Measuring Outcomes in the Field
Panel at IFADC 2012
Patrick WebbMay 2012
Main foci of Phase 1
1. Review science on nutrient needs (incl. HIV/AIDS)
2. Recommend new formulations, commodity mixes, programming approaches
3. Account for industry feasibility, cost, programming issues
4. Propose mechanisms for enhanced processes (product review/approval, purchasing/procurement, problems)
Main foci of Phase 2
1. Further consultation on science and operational realities
2. Convergence (as appropriate) with WFP, etc.
3. Food technology/processing/packaging issues
4. Analysis of costing, programming needs, field trials
5. Further enhancement of inter-institutional coordination processes (guidance, procurement approaches, etc.)
Where things stand today (i)
1. FAQR preparing field trials in Malawi and (?)
1. Feasibility/effectiveness of programming FBFs with ‘new’ (A/D) oil
2. Consumer acceptability of newly formulated products3. Viability of new packaging/BCC, programming
approaches4. Cost-effectiveness of packaging, programming.5. Scenario-building (cost of alternative approaches and
products)
2. ILNS trials – Malawi, Ghana, Burkina Faso, Bangladesh
1. Acceptability of LNS formulations for various target groups 2. Efficacy of low cost formulations of LNS for 6-24m(Malawi)‐ 3. Optimal zinc to include in LNS (Burkina Faso) 4. Efficacy of LNS for preg./lact. women (Malawi, Ghana) 5. Economic analysis of delivery systems, cost effectiveness‐
e.g. BangladeshLongitudinal, cluster-randomized design. Participants enrolled in pregnancy, followed through 36 months post-partum. Random assignment to:
1) LNS for children for 18 months, from 6-24m2) MNP for children for 18 months, from 6-24m3) LNS for mothers (preg./lact. 6m postpartum), and their children for 18 months, from 6-24m.4) Control
3. Johns Hopkins (collaboration with ICDDR,B, WFP and DSM)
USDA funded, 5-arm trial in Bangladesh (summer 2012):
Assess efficacy of different complementary foods on growth, body composition and development.5,400 infants 6-18mTreatment arms include nutrition education with 2 local Bangla recipes, WFP’s Supercereal+, Plumpy'doz®, and nutrition education only (control).
5. WFP (in collaboration with many others)
1.Malawi (LaGrone et al., AJCN): MAM treated no less effectively with CSB++ than with SPP® or peanut/soy paste. 2.Similar work in Burkina coming (comparing MAM treatment with Plumpy'Sup, CSB++, Misola, local foods + MNP).
1.Also Burkina Faso, study by ITM (Belgium) and IRSS (BF) using P’Doz® or CSB++ vs counseling for MAM treatment).
•Proposal for MAM treatment study with Achamum in India, compared to current protocols.
5. Epicentre/MSF in Niger on preventive approaches
5. MSF and others …
Source: Langendorf et al./MSF/WFP/Epicentre (2012)
Source: Langendorf et al./MSF (2012)
PRELIMINARY results
Goal: Assess impacts on SAM and GAM (6-23m) of different food supplement and/or cash combinations (over 16m)
1.Incidence SAM and GAM significantly less in CSB++/cash and CSB++/food than CSB++ alone.2.Incidence of SAM and GAM not significantly different between CSB++/cash and CSB++/food or SPP®.3. Lower incidence of SAM in CSB++ versus cash alone.
Source: Langendorf et al./MSF (2012)
Source: Langendorf et al./MSF (2012)
1. Still much to learn about what works where.
2. Many on-going trials/studies (biological, economic, programmatic).
3. Limited cross-donor coordination of research agenda (prevention/treatment, 6-24m/0-59m, products in basket and in context, like-with-like).
4. Little or no research on how to institutionalize (standardize) effective practices, at scale.
5. Limited links to broader FTF, agriculture-nutrition agendas.
Conclusions