Analysis of Child Undernutrition Intervention Priorities Among Nutrition Stakeholders from Multiple Low and Middle-Income Countries
Wang, Sophia Siyan
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Background: World Health Assembly 2025 targets call for reducing and maintaining the global prevalence of wasting (weight-for-height z score [WHZ] < - 2 SD) among children under five to below 5%. However, currently interventions that prevent wasting are characterized into two “camps” of preventing stunting and preventing severe wasting through treating moderate acute malnutrition (MAM); this makes estimating pooled effectiveness on wasting difficult. There is clear overlap and there needs to be a better understanding how program makers and policy makers understand these interventions. Methods: 2 separate questionnaires were developed (one for national organization and one for multi-national organizations). These questionnaires were used during the 23 key informant interviews that were conducted over Skype. The interviews were transcribed and then coded through Dedoose; the codes were then categorized into families. Then the excepts for the codes were analyzed. Additionally, the nutrition strategy for 12 different organizations (national and multi-national) were analyzed to understand the current interventions of various organizations. Results: The 15 original codes were grouped into 5 families. Family 1: Intervention types and categorization (nutrition supplementation, nutrition education, intervention types and categories). There are various interventions cited by the respondents and they mainly are types of supplementation or education to both mothers and infants. Family 2: Treatment of moderate acute malnutrition and prevention of wasting (wasting and acute, importance of MAM, moderate severe, wasting prevention examples, wasting prevention types). Wasting and acute malnutrition are interchangeable words and while malnutrition prevention is important, there is a shift towards preventing stunting. Family 3: Factors used to target nutrition interventions (nutrition status, child age, multiple outcomes). Interventions are targeted at all children up to a certain age or for those who are malnourished. Family 4: Recognition of nutrition “camps” and ideas for building harmonization (camps, harmonization). In general, the camps are focused on developmental issues such as stunting or emergency issues such as wasting. While respondents agree there should be harmonization, there are practical barriers currently. Family 5: Research perspectives (Research perspectives). There is great research in understanding the importance and impact of malnutrition, but it is not reaching policy makers. The nutrition strategies of the organizations showed that multi-national organizations are more likely to implement multi-sectoral approaches and that the wasting prevention strategies that are well researched and known to be life-saving are being implemented. Conclusion: While each organization has a different focus area, their main concern was for children to grow well and prevent them from being malnourished. Most organizations agree that there should be harmonization and a multi-sectoral approach and acknowledge that there will be barriers to achieving this such as funding and manpower.
- Nutritional sciences