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