Suchergebnisse

Globally, undernutrition is related to almost half of the deaths in children younger than five years of age. It leads to large human and economic costs to countries through increased morbidity and mortality in childhood, poor child growth and development, and hinders adult work capacity and productivity. These consequences, in turn, have serious implications for national development. Eliminating malnutrition has, therefore, been on the forefront of the political agenda of many countries worldwide and for global movements such as Scaling Up Nutrition (SUN). Extensive evidence on what nutrition-specific interventions work to reduce malnutrition exists. Less is known, however, about how to effectively implement these interventions at scale, and what mix of interventions is needed to effectively address the multiple co-existing nutrition problems in different contexts (including nutrition-sensitive programs). Additionally, greater clarity is needed on the role that commitment, program and policy coherence, and context-specific factors, play in creating enabling environments to reduce malnutrition. The Stories of Change (SoC) case studies, originally conducted in Bangladesh, Ethiopia, India (Odisha state), Nepal, Senegal, and Zambia, and now in Rwanda, aim to fill some of these knowledge gaps by examining the "drivers of change" in reducing malnutrition across different contexts. ; PR ; IFPRI1; CRP4; Capacity Strengthening; 2 Promoting Healthy Diets and Nutrition for all; 5 Strengthening Institutions and Governance; Voice for Change Partnership; Stories of Change in Nutrition; Rwanda SSP ; PHND; A4NH ; CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)

Social inclusion is defined by the World Bank Group as the process of improving the terms of individuals and groups to take part in society, and the process of improving the ability, opportunity, and dignity of those disadvantaged based on their identity to take part in society. Groups can be excluded based on several characteristics or life circumstances. These include poverty, gender, age, religion, ethnicity and disability, among others. Within a country context, social exclusion implies that excluded groups are not able to fully participate in their country's political, economic, and social life and often are unable to fully benefit from programs and policies intended to benefit the population at large. As Indonesia's economy continues to grow, it is essential that issues of social inclusion be considered in nutrition-related policies and programs. This is especially important as often socially excluded groups are those most at risk of health and nutrition problems. ; Non-PR ; IFPRI1; Voice for Change Partnership; CRP4 ; PHND; A4NH ; CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)

The Strengthen PSNP4 Institutions and Resilience (SPIR) Development Food Security Activity (DFSA) in Ethiopia is a five-year project (2016-2021) supporting implementation of the fourth phase of the Productive Safety Net Programme (PSNP4) as well as providing complementary livelihood, nutrition, gender and climate resilience activities to strengthen the program and expand its impacts. The main objectives of SPIR are to enhance resilience to shocks and livelihoods and improve food security and nutrition for rural households vulnerable to food insecurity. Activities under SPIR are organized into four Purposes: 1) livelihoods, 2) nutrition, 3) women's and youth empowerment, and 4) climate resilience. In each of these Purposes, SPIR provides community-level programming, training of government staff involved in public service delivery at the woreda (district) and kebele (subdistrict) level, and targeted livelihood transfers. IFPRI is conducting an experimental, quantitative impact evaluation of SPIR designed to measure the causal impact of multisectoral "graduation model" packages of livelihoods, nutrition, gender equity and mental health interventions for improving outcomes in several domains, including livelihoods, food security, child nutrition, women's empowerment, mental health and intimate partner violence (IPV). The impact evaluation uses a clustered randomized controlled trial (RCT) design with four intervention arms (three treatments and a control group) to test the relative effectiveness of these packages of interventions to improve outcomes for PSNP4 beneficiaries. This midline report of the impact evaluation presents evidence from the first 15 months of the project on program performance and the effectiveness of delivery. The midline survey was conducted from July 25 to October 23, 2019 during which time a total of 3,968 households were interviewed out of the target of 4,082 households for the entire study sample. ; Non-PR ; IFPRI5; CRP2; SPIR ; PHND; PIM ; CGIAR Research Program on Policies, Institutions, and Markets (PIM)

Since its inception in 2005, the Productive Safety Net Program (PSNP) has been a cornerstone of the Ethiopian government's strategy for poverty alleviation, disaster risk management and rural development. The PSNP provides food or cash transfers targeted to poor households in the form of payments for seasonal labor on public works (PW) or as direct support (DS) to households whose primary income earners are elderly or disabled. With more than 8 million beneficiaries, the PSNP is one of the largest social protection programs in Sub-Saharan Africa. The PNSP has played an important role in improving the lives of poor Ethiopian households by reducing household food insecurity, increasing asset holdings and improving agricultural productivity (Berhane et al. 2014; Hoddinott et al. 2017). The fourth phase of the Productive Safety Net Program (PSNP4) began operating in 2016. Under PSNP4, the Government of Ethiopia (GOE) undertook a new round of targeting to identify client households. GOE also added a new objective to the PSNP to improve the nutritional status of women and children by better linking PSNP clients to health and nutrition services and through nutrition conditionalities (World Bank 2014). PNSP4 also included an enhanced livelihood transfer program to strengthen livelihoods and build assets, seeking to improve on the performance past livelihood transfer components of the PSNP. ; Non-PR ; IFPRI5; CRP2; SPIR ; PHND; PIM ; CGIAR Research Program on Policies, Institutions, and Markets (PIM)

OBJECTIVES: Eliminating malnutrition is on many countries' political agendas but knowledge of how enabling environments are created and used is needed. We assessed the drivers of change in stunting reduction among children <5 y of age in Rwanda and contributors to differential reduction over 10–25 y. METHODS: We conducted in-depth interviews on changes in nutrition with nutrition stakeholders at national (n = 32), district (n = 38), and community (n = 20) levels, and community focus group discussions (n = 40) in 10 purposefully selected districts in Rwanda's 5 provinces. In each province, we selected 1 district with decreased stunting and 1 where no change or an increase occurred (2010–2015). We also used regression decomposition analysis to investigate drivers of change in stunting with Demographic and Health Surveys (2005, 2010, and 2015) data. RESULTS: Respondents believed peace and security along with improved leadership and decentralization helped to create an enabling environment for change. Rwanda experienced increased political and institutional commitment to nutrition indicated by adoption of a multisectoral policy and reinforced with horizontal coordination platforms and plans at national and sub-national levels, but greater financial commitment is needed according to respondents. Vertical coordination across administrative levels improved through communication, staff working on nutrition at these levels, and relationships between nutrition actors. From respondent reports, health and agricultural programs and increased availability and use of health services helped improve nutrition; differences between study districts included climate change challenges, food insecurity, weak horizontal and vertical coherence, and weak implementation of coordination plans. Supporting this, giving birth in a health facility, attending ≥4 antenatal care visits, antenatal care quality, fertility, parental education, household wealth, and health insurance coverage drove stunting reduction from the regression ...

Eliminating malnutrition is on many countries' political agendas but knowledge of how enabling environments are created and used is needed. We assessed the drivers of change in stunting reduction among children <5 y of age in Rwanda and contributors to differential reduction over 10–25 y. ; IFPRI5; CRP4; Rwanda SSP ; PHND; A4NH ; Non-PR ; CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)