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Page 1. Generating Further Reductions of Child Malnutrition in India's BIMARU States: What are the Options Now? F. James Levinson, Jessica Barney, Lucy Bassett, Werner Schultink ... F. James Levinson, Jessica Barney, Lucy... more
Page 1. Generating Further Reductions of Child Malnutrition in India's BIMARU States: What are the Options Now? F. James Levinson, Jessica Barney, Lucy Bassett, Werner Schultink ... F. James Levinson, Jessica Barney, Lucy Bassett, Werner Schultink Introduction ...
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... Micronutrient Deficiencies Deficiencies in key vitamins and minerals— especially iron, vitamin A, zinc ... malnutrition have used two primary strategies: supplementation and food fortification, with some ... crops to boost... more
... Micronutrient Deficiencies Deficiencies in key vitamins and minerals— especially iron, vitamin A, zinc ... malnutrition have used two primary strategies: supplementation and food fortification, with some ... crops to boost mi-cronutrient content, as with Golden Rice fortified with vitamin ...
Research Interests: Nutrition, Primary Health Care, Health Care, Economic Growth, Child Development, and 15 moreHuman Development, Public Health, Micronutrients, Reproductive health, Intervention, Iodine, Physicians, Medicines, Income, Institutionalization, Dissemination, Living Standards, Information System, births, and Gross Domestic Product
Indonesian Micronutrient Reference Report A Report to the Micronutrient Initiative and the World Bank Abstract: This report has been designed as a user-friendly reference source for the Government of Indonesia and for organizations and individuals involved in activities designed to reduce micronu...more
The common practice of reducing food consumption during pregnancy is recognized as a primary cause of poor pregnancy outcomes and, in turn, malnutrition among young children in many developing countries including Bangladesh. This paper... more
The common practice of reducing food consumption during pregnancy is recognized as a primary cause of poor pregnancy outcomes and, in turn, malnutrition among young children in many developing countries including Bangladesh. This paper analyzes data from the 1998 Mid-Term Evaluation of the Bangladesh Integrated Nutrition Project (BINP) to identify the determinants of pregnancy food consumption. The analysis found that
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During the past fifteen years, there has been a significant increase in efforts to monitor and evaluate large scale nutrition projects. This, in turn, stems from an increased appreciation of the importance of M&E in such projects, and... more
During the past fifteen years, there has been a significant increase in efforts to monitor and evaluate large scale nutrition projects. This, in turn, stems from an increased appreciation of the importance of M&E in such projects, and from more stringent demands being made by donors. This paper seeks to draw some lessons from this experience drawing on a large number of projects for which M&E documentation is available. These include the Tamil Nadu Integrated Nutrition Project in South India, the Bangladesh Integrated Nutrition Project, the Iringa Project in Tanzania, the Posyandu projects in Indonesia, the Integrated Child Development Service (ICDS) program in India, the UNICEF-assisted Dular project in Bihar state in India, the HKI Nutrition Focused Child Survival Project in Mali, the CARE-assisted Child Survival Project in Nicaragua, the Enhanced Outreach Strategy of the Ethiopian Child Survival Project, Save the Children (US) positive deviance-based projects in Vietnam and its J...
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OBJECTIVE: Undernutrition is a major public health concern and afflicts between 15-30% of adolescents in Sub Saharan Africa. A significant gender difference in adolescent nutritional status has been observed in several developing country... more
OBJECTIVE: Undernutrition is a major public health concern and afflicts between 15-30% of adolescents in Sub Saharan Africa. A significant gender difference in adolescent nutritional status has been observed in several developing country studies, with boys appearing to be twice as undernourished as girls. We sought to examine the associations among undernutrition, gender, and sexual maturation in a sample of adolescents from Tanzania. METHODS: This cross-sectional study examined the nutritional status of 670 individuals aged 10-19 years from 28 villages in Kilosa District, Tanzania. Undernutrition was defined as BMI for Age <5th percentile of the NCHS/WHO reference. Logistic regression models tested associations between gender, sexual maturation, and the outcome variable, undernutrition. We also included an interaction term to represent the cross-product of male and mid-adolescence, a period associated with peak linear growth. RESULTS: The prevalence of undernutrition in this sam...
Food insecurity is highly prevalent in many developing countries, with negative implications for the health and well-being of affected populations. At the community level, household food security status is affected by inequitable... more
Food insecurity is highly prevalent in many developing countries, with negative implications for the health and well-being of affected populations. At the community level, household food security status is affected by inequitable distribution and access to foods. Within households, variation in food allocation influences individual nutritional adequacy. Researchers have argued that age, gender, or household status in developing country societies may influence parents' preferential allocation of food and health care. Examination of intra-household food distribution is pivotal to understanding differential nutritional outcomes among household members. The relationship between adolescent dietary intakes in the context of household food security status in less-developed countries is not well understood. Presently the bulk of intra-household food allocation research focuses on unequal distribution between males and females and between adults and young children. We examined data from ...
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Positive deviance is increasingly employed in international development activities to permit the utilization of proven local solutions. Including positive deviance methods in evaluation analysis, particularly in places like Bihar, India,... more
Positive deviance is increasingly employed in international development activities to permit the utilization of proven local solutions. Including positive deviance methods in evaluation analysis, particularly in places like Bihar, India, where the rates of child underweight hover at 55%, can help identify project activities and household characteristics that affect key outcomes. These can, in turn, inform decision-making regarding the intensification of particularly promising activities. To apply positive deviance analysis to the Dular program in Bihar, a community-based nutrition program that seeks to improve the impact of India's Integrated Child Development Services on young children. In order to assure that desired program outcomes were not dependent on higher economic status, the analysis isolated a subset of program beneficiaries--the poorest children with the best nutritional outcomes--and examined the behavioral and project factors that may have brought about positive re...
Research Interests: Program Evaluation, Nutrition and Dietetics, Health Behavior, International Development, Poverty, and 15 moreChild Development, Health Education, Health Policy, India, Humans, Female, Male, Infant, Mothers, Nutritional Status, Hygiene, Educational Status, Consumer Participation, food Nutrition, and Child preschool
A follow-up study of malnutrition and its determinants among children 6 to 24 months of age was carried out in rural areas of Punjab State in India 30 years after the original study, and following a period of rapid economic growth. The... more
A follow-up study of malnutrition and its determinants among children 6 to 24 months of age was carried out in rural areas of Punjab State in India 30 years after the original study, and following a period of rapid economic growth. The original 1971 study had found a high prevalence of mortality and malnutrition and the worst gender difference in nutritional status ever recorded in an Indian study. The 2001 follow-up study found dramatic reductions in child mortality, child malnutrition, gender-based imbalances in child well-being and care, and family size, the result of participatory economic growth coupled with broad-based educational, health, and family-planning services. Despite overall improvements in caloric intake, however, 40% of lower-class children in 2001 were still consuming less than 50% of their caloric allowance. With minimal gender-based abortion and significantly reduced neglect and mortality offemale children, gender balance among children in this area of rural Pun...
Research Interests: Nutrition and Dietetics, Nutrition, Economic Growth, Food, Developing Countries, and 15 moreHealth, India, Humans, Female, Male, Gender Difference, Infant, Nutritional Status, Family Planning, Infant Mortality, Child mortality, Cross Sectional Studies, Family Size, Energy Intake, and Child preschool
Monitoring data from the Bangladesh Integrated Nutrition Project and new data collected for this purpose were analyzed to assess the effects of targeted project services, including supplementation of food, on malnourished pregnant women... more
Monitoring data from the Bangladesh Integrated Nutrition Project and new data collected for this purpose were analyzed to assess the effects of targeted project services, including supplementation of food, on malnourished pregnant women (women with a body mass index [BMI] of < or = 18.5 in early pregnancy). Monitoring data on 456 women--195 receiving food supplement and 261 not receiving supplement--were collected from 17 upazilas (sub-districts) in four districts of Bangladesh. The assessment found that, despite lower economic status, the women with low BMI receiving supplementation of food and intensified services were more likely to have adequate pregnancy-related weight gain than the more economically-advantaged women with higher BMI. Primigravidae receiving supplementation were also more likely to have adequate pregnancy-related weight gain than the better-off non-supplemented primigravidae (85.7% vs 51.9%, p = 0.044). The mean birth-weights of infants of the supplemented wo...
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A positive deviance inquiry was conducted in Al-Minia, Upper Egypt, to identify factors associated with achievement of good pregnancy outcomes despite limited resources. As compared with women with poor weight gain (n = 30), low-income... more
A positive deviance inquiry was conducted in Al-Minia, Upper Egypt, to identify factors associated with achievement of good pregnancy outcomes despite limited resources. As compared with women with poor weight gain (n = 30), low-income women with weight gain greater than 1.5 kg per month in the second trimester of pregnancy (n = 11) were more likely to report multiple antenatal care contacts (80% versus 43%), increased rest during pregnancy (67% versus 7%), and more consumption of meat (33% versus 13%) and vegetables (82% versus 37%), and were less likely to report symptoms consistent with urinary tract infection (50% versus 90% with dysuria and 0% versus 57% with cloudy or reddish urine). Similar characteristics distinguished low-income women in a more economically advantaged community whose newborns weighed more than 3 kg (n = 18) as compared with mothers of smaller newborns (n = 18). These characteristics were similar to those identified in the National Research Center's Al-M...
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The positive deviance approach identifies and promotes existing uncommon healthy behaviours. A positive deviance-informed antenatal project was pilot-tested in Al-Minia Governorate, Upper Egypt, during 2003-2004, after a positive deviance... more
The positive deviance approach identifies and promotes existing uncommon healthy behaviours. A positive deviance-informed antenatal project was pilot-tested in Al-Minia Governorate, Upper Egypt, during 2003-2004, after a positive deviance study in 2000 found that successful pregnancies had increased consumption of meat and vegetables, daytime rest, and antenatal care; less second-hand smoke exposure; and symptoms of no urinary tract infection. Accordingly, health facilities were upgraded in target and comparison areas to provide quality antenatal care, including treatment of urinary tract infection. Additionally, in the target villages, women at-risk of delivering low-birth-weight infants were enrolled in weekly 'IMPRESS' (improved pregnancy through education and supplementation) sessions with counselling and supplemental food. In total, 519 women (344 target, 175 comparison) were enrolled in the third or fourth month of pregnancy and were followed through delivery. Birth-we...
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In seeking to improve the micronutrient contents of a food supplement used in a major community-based nutrition project in Bangladesh, operations research was conducted to compare the provision of needed micronutrients through additional... more
In seeking to improve the micronutrient contents of a food supplement used in a major community-based nutrition project in Bangladesh, operations research was conducted to compare the provision of needed micronutrients through additional food sources (fresh or dried fruits or vegetables), a micronutrient multi-mix, and a combination of the two. Micronutrient gaps (the difference between micronutrient requirements and actual micronutrient intake) were estimated for four groups of project beneficiaries, with target intakes defined as requirements for iron, calcium, zinc, vitamin A, vitamin C, riboflavin, niacin, and vitamin B12 recommended by the Food and Agriculture Organization/World Health Organization. Primary focus was placed on iron and vitamin A. Cost and bulk constraint analyses, based on cost of supplement, feasibility of delivery, and serving volume needed to achieve micronutrient targets, were used for comparing the supplement options. In terms of these analyses, the micron...
Research Interests: Demography, Biology, Evaluation, Developing Countries, Health, and 15 moreBangladesh, Adolescent, Food Fortification, Humans, Case Study, Female, Feasibility Studies, Infant, Dietary Supplements, Cost effectiveness, Fruit and vegetables, Adult, Cost Benefit Analysis, Health surveys, and Child preschool
Household food security is an emerging public health issue and the rural elderly people are one of the most vulnerable groups for the household food security. This cross-sectional study was conducted in Barobaria union of Gofargaon... more
Household food security is an emerging public health issue and the rural elderly people are one of the most vulnerable groups for the household food security. This cross-sectional study was conducted in Barobaria union of Gofargaon upazila of Mymensingh district to assess the nutritional status of rural elderly (?60 years) in relation to the household food security. A total of 118 purposively selected elderly were interviewed and measured for height and weight following a standard protocol. The mean (SD) age of the respondents was 68.6 (7.3) years and gender participation was equally represented. Majority (68.6%) of the respondents was illiterate and 92% were Muslims. Mean family size and monthly family income was estimated to be 5.5 and Taka 6106, respectively and 70% of the rural elderly were found to be dependent on their family members as they were not involved in income generation and most of the respondents were the members of joint family. Only about 29% of the total elderly ...
Indonesian Micronutrient Reference Report A Report to the Micronutrient Initiative and the World Bank Abstract: This report has been designed as a user-friendly reference source for the Government of Indonesia and for organizations and individuals involved in activities designed to reduce micronu...more
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Most large-scale nutrition surveys carried out in developing countries have been conducted to compile or update national or regional data that are independent of project activities. At the same time, a growing number of large scale... more
Most large-scale nutrition surveys carried out in developing countries have been conducted to compile or update national or regional data that are independent of project activities. At the same time, a growing number of large scale projects are developing monitoring and evaluation systems that also build on periodic baseline and evaluation surveys to assess whether project objectives are being met, and whether improvements in nutritional status observed are indeed attributable to the interventions. Donors and governments are demanding increasingly rigorous evaluations to assess whether their operational investments are cost-effective. Such information also guides the direction of future activities. One intervention, the Bangladesh Integrated Nutrition Project (BINP), has been using baseline and evaluative surveys since 1996 to assess its performance and to inform decision making. The project is widely acknowledged to be one of the most impressive large-scale, community-based nutriti...
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The civil wars in Sudan have resulted in the displacement of roughly 60,000 people in the White Nile State. Internally displaced people (IDP) in Kosti, Sudan face food and nutrition insecurity, as well as poor health and environmental... more
The civil wars in Sudan have resulted in the displacement of roughly 60,000 people in the White Nile State. Internally displaced people (IDP) in Kosti, Sudan face food and nutrition insecurity, as well as poor health and environmental conditions, which are compounded by economic hardships. The data used in this study is from the ADRA/Sudan Kosti Food Security Initiative Baseline Survey. The Adventist Development and Relief Agency (ADRA) planned to carry out a nutrition and health intervention program targeted at the IDP in the Kosti region of Sudan. The aim of the program was to enhance health and nutritional conditions by improving primary health care, supplemental feeding, water security, and sanitation. The statistical analysis reported here focused on the health and nutrition conditions of children aged 6 to 24 months and the determinants of these conditions.
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Resumo: Enfoca la necesidad de cambios institucionales significativos, incluyendo la consolidación de los programas de nutrición dentro de una sola entidad administrativa y la descentralización de la responsabilidad en torno a la... more
Resumo: Enfoca la necesidad de cambios institucionales significativos, incluyendo la consolidación de los programas de nutrición dentro de una sola entidad administrativa y la descentralización de la responsabilidad en torno a la implementación del programa. ...
Page 1. Generating Further Reductions of Child Malnutrition in India&amp;amp;#x27;s BIMARU States: What are the Options Now? F. James Levinson, Jessica Barney, Lucy Bassett, Werner Schultink ... F. James Levinson, Jessica Barney, Lucy... more
Page 1. Generating Further Reductions of Child Malnutrition in India&amp;amp;#x27;s BIMARU States: What are the Options Now? F. James Levinson, Jessica Barney, Lucy Bassett, Werner Schultink ... F. James Levinson, Jessica Barney, Lucy Bassett, Werner Schultink Introduction ...
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... 2 Reducing Chronic Malnutrition in Peru: A Proposed National Strategy Beatrice L. Rogers, Serena Rajabiun, James Levinson, and Katherine Tucker February 2002 ... Beatrice L. Rogers1, Serena Rajabiun2, James Levinson3, and Katherine... more
... 2 Reducing Chronic Malnutrition in Peru: A Proposed National Strategy Beatrice L. Rogers, Serena Rajabiun, James Levinson, and Katherine Tucker February 2002 ... Beatrice L. Rogers1, Serena Rajabiun2, James Levinson3, and Katherine Tucker4 Executive Summary ...
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Recognizing the increasing reliance being placed on caring practices in large scale nutrition programs, a study was undertaken in the context of one such program, the Bangladesh Integrated Nutrition Project, to examine the effects of... more
Recognizing the increasing reliance being placed on caring practices in large scale nutrition programs, a study was undertaken in the context of one such program, the Bangladesh Integrated Nutrition Project, to examine the effects of womenâs time constraints on the successful ...
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ABSTRACT
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The Feinstein International Center strives to improve the lives and livelihoods of communities caught up in complex emergencies, war, and other crises. ... Established in 1996 as part of the Friedman School of Nutrition Science and Policy... more
The Feinstein International Center strives to improve the lives and livelihoods of communities caught up in complex emergencies, war, and other crises. ... Established in 1996 as part of the Friedman School of Nutrition Science and Policy at Tufts University, the Center carries out field-based research in complex emergency environments. ... To view additional publications listings from Friedman Faculty with HNRCA research, please visit www.pubmed.gov and search by the scientist's last name and initials. For example, John Q. Smith would be "Smith JQ."