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Nutrition Research: Measuring Outcomes in the Field Panel at IFADC 2012 Patrick Webb May 2012

Nutrition Research: Measuring Outcomes in the Field Panel at IFADC 2012 Patrick Webb May 2012. Main foci of Phase 1 Review science on nutrient needs (incl. HIV/AIDS) Recommend new formulations, commodity mixes, programming approaches

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Nutrition Research: Measuring Outcomes in the Field Panel at IFADC 2012 Patrick Webb May 2012

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  1. Nutrition Research: Measuring Outcomes in the Field Panel at IFADC 2012 Patrick Webb May 2012

  2. Main foci of Phase 1 • Review science on nutrient needs (incl. HIV/AIDS) • Recommend new formulations, commodity mixes, programming approaches • Account for industry feasibility, cost, programming issues • Propose mechanisms for enhanced processes (product review/approval, purchasing/procurement, problems)

  3. Main foci of Phase 2 • Further consultation on science and operational realities • Convergence (as appropriate) with WFP, etc. • Food technology/processing/packaging issues • Analysis of costing, programming needs, field trials • Further enhancement of inter-institutional coordination processes (guidance, procurement approaches, etc.)

  4. Where things stand today (i) • FAQR preparing field trials in Malawi and (?) • Feasibility/effectiveness of programming FBFs with ‘new’ (A/D) oil • Consumer acceptability of newly formulated products • Viability of new packaging/BCC, programming approaches • Cost-effectiveness of packaging, programming. • Scenario-building (cost of alternative approaches and products)

  5. 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. Bangladesh Longitudinal, cluster-randomized design. Participants enrolled in pregnancy, followed through 36 months post-partum. Random assignment to: 1) LNS for children for 18 months, from 6-24m 2) MNP for children for 18 months, from 6-24m 3) LNS for mothers (preg./lact. 6m postpartum), and their children for 18 months, from 6-24m. 4) Control

  6. 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 6-18m • Treatment arms include nutrition education with 2 local Bangla recipes, WFP’s Supercereal+, Plumpy'doz®, and nutrition education only (control).

  7. 5. WFP (in collaboration with many others) • Malawi (LaGroneet al., AJCN): MAM treated no less effectively with CSB++ than with SPP® or peanut/soy paste. • Similar work in Burkina coming (comparing MAM treatment • with Plumpy'Sup, CSB++, Misola, local foods + MNP). • Also Burkina Faso, study by ITM (Belgium) and IRSS (BF) • using P’Doz® or CSB++ vs counseling for MAM treatment). • Proposalfor MAM treatment study with Achamum in India, • compared to current protocols. • 5. Epicentre/MSF in Niger on preventive approaches

  8. 5. MSF and others … Source: Langendorf et al./MSF/WFP/Epicentre (2012)

  9. PRELIMINARY results • Goal: Assess impacts on SAM and GAM (6-23m) of different • food supplement and/or cash combinations (over 16m) • Incidence SAM and GAM significantly less in CSB++/cash and • CSB++/food than CSB++ alone. • 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)

  10. Source: Langendorf et al./MSF (2012)

  11. Source: Langendorf et al./MSF (2012)

  12. Conclusions • Still much to learn about what works where. • Many on-going trials/studies (biological, economic, programmatic). • Limited cross-donor coordination of research agenda (prevention/treatment, 6-24m/0-59m, products in basket and in context, like-with-like). • Little or no research on how to institutionalize (standardize) effective practices, at scale. • Limited links to broader FTF, agriculture-nutrition agendas.

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