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Strengthening Institutional and Human Capacities to Design, Implement and Generate Evidence for Nutrition Sensitive Programming Including Policy and Investments in Livestock Programming In Kenya - TCP/KEN/3802







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    Project
    Creating Enabling Environments for Nutrition-Sensitive Food and Agriculture to Address Malnutrition - TCP/RAS/3602 2020
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    A contributing factor to malnutrition in the Asia and the Pacific region is a lack of crop diversity, which leads to a lack of diversity in diets as well. A major reason for this is that many countries in the region only focus on cultivating a small number of staple foods. Diversifying local crops is a cost-effective and sustainable way to strengthen local agriculture and food systems and combat malnutrition. The first step in supporting local agriculture and food systems by promoting crop and dietary diversification as a means of reducing malnutrition is creating an enabling environment to do so. This TCP project aimed to facilitate the development of this environment through the forming of links, the closing of gaps, and the development of policy recommendations in four countries in the Asia and the Pacific Region: Cambodia, Lao People’s Democratic Republic, Myanmar and Nepal. Its design included national policy reviews, evidence-based studies, and field studies to assess the existing issues related to crop diversity, dietary diversity and malnutrition, and their interdependence, as well as the preparation of national reports and policy documents to be synthesized and disseminated in the region. Drawing on FAO’s previous experience in the region, this project was based on a multisectoral, holistic food system approach that takes into account every step of the food value chain. It involved international development and research institutes, local and national ministries, Non-governmental Organizations (NGOs) and all actors along the food value chain. A major focus of the project was the identification of Neglected and Underutilized Species (NUS) that could be cultivated in the targeted countries and integrated into national policies on food and agriculture. In addition to supporting bio- and production diversity, NUS also address malnutrition, owing to the fact that they can provide essential vitamins, micronutrients and protein. Many are also climate resilient, sustainable, locally available, adaptable to marginal conditions and have commercial potential. These NUS are classified as Future Smart Foods (FSFs), and the project promoted their cultivation, as well as their integration and mainstreaming into national policies and plans.
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    Book (stand-alone)
    Livestock programming for nutritional improvements in children under five years of age and pregnant and lactating mothers
    Baseline report
    2022
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    The Livestock for Health (L4H) project is a collaborative effort between the Food and Agriculture Organization of the United Nations (FAO), United Nations Children’s Fund (UNICEF), the Marsabit County Government, the National Government of Kenya, the National Drought Management Authority (NDMA) and Washington State University (WSU). The project was made possible through the support provided by the Office of Technical and Program Quality, Bureau for Humanitarian Assistance, United States Agency for International Development (USAID), to determine the cost-effectiveness of livestock feeding interventions and nutritional counselling in reducing the risk of malnutrition among children and women in pastoral communities during the critical dry periods. The project was designed as a cluster randomized control trial with two intervention arms and one control group. Households in Intervention Arm 1 receive livestock feeds sufficient to maintain two tropical livestock units (TLUs) for 90 days during critical dry periods or drought and 7–14 days into the rain season. Households in Intervention Arm 2 receive similar livestock feeds and regular nutritional counselling carried out by trained community healthcare workers. Households in Arm 3 are the control group and do not receive any of the two interventions during the study period. The results from this baseline survey will be essential for comparing with other data which will be collected during the routine household data collection visits (six week follow-up and quarterly household visits) for monitoring trends in household milk yield, milk consumption (amount and frequency) and nutritional status across the intervention and control arms of the study over the study period. At baseline, both the intervention and control arms were comparable in household demographics, socio-economic characteristics, household livestock ownership, milk production and consumption, and maternal and child nutritional status and health. Additionally, the high prevalence of malnutrition in this study population and the data on health and intervention costs which will be collected in this study will allow for a cost-effectiveness analysis to determine if livestock feeding interventions and nutritional counselling are cost-effective in reducing the risk of malnutrition among children and women in pastoral communities during the critical dry periods.
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    Article
    Nutrition-Sensitive Social Protection Programs within Food Systems 2021
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    Investments in social assistance programs (SAPs) in low- and middle-income countries (LMICs) are increasing. As investments increase, the objectives of these programs are expanding from focusing on reducing poverty to addressing other social issues such as improving diets and nutrition. At the same time, there is increasing interest in addressing all forms of malnutrition within the framework of food systems. Given the intersections between SAPs and food systems, we reviewed the effectiveness of SAPs (agriculture asset transfers, cash transfers, in-kind transfers, vouchers, public works, and school meals programs) for reducing all forms of malnutrition across the lifecycle within a food systems framework. As several programs included multiple treatment arms, each representing a unique program design, we used study arm as the unit of analysis and assessed the proportion of study arms with positive or negative program impacts on diet and nutrition outcomes among men, women and children. The majority of the studies included in this review were from evaluations of agriculture asset, cash, and in-kind transfer programs. There was clear evidence of positive impacts on women’s and children’s diet-related outcomes. Very few studies assessed program impact on women’s nutritional status outcomes. However, there was some evidence of impacts on increasing body mass index and hemoglobin concentration (Hb) with in-kind transfer programs. Among children, several study arms across the agriculture asset, cash, and in-kind transfer programs found positive impacts on increasing height-for-age Z-score (33%-45% of study arms) and weight-for-height Z-score (33%-50% of study arms) and decreasing the prevalence of wasting (43%-60% of study arms). Cash and in-kind transfer programs also found positive effects on reducing stunting prevalence in 33% and 45% of study arms, respectively. Lastly, a few study arms assessed program impact on increasing Hb with some evidence of positive impacts in in-kind and school feeding programs. There was a paucity of relevant evidence of the effectiveness of voucher and public works programs on diet and nutrition outcomes, for men’s outcomes, and on micronutrient status. Several challenges remain in understanding the potential for SAPs to improve diet and nutrition outcomes within food systems including the heterogeneity of program and evaluation designs, populations targeted by the programs, and included in evaluations and indicators used to assess impact. Addressing these challenges in future evaluations is important for informing program and policy actions to improve the effectiveness of SAPs within food systems for improving diet and nutrition outcomes across the lifecycle.

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