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Franziska Alesso-bendisch - One of the best experts on this subject based on the ideXlab platform.
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Resilience Challenges to Community Nutrition Security in Greater Miami
Community Nutrition Resilience in Greater Miami, 2020Co-Authors: Franziska Alesso-bendischAbstract:This chapter examines the challenges affecting Greater Miami’s environmental, social, and economic resilience. It looks at influencing factors and historical developments shaping the region, such as political environment, immigration, and events triggered by a changing climate. It then discusses the status quo of Community Nutrition resilience in Greater Miami based on selected food security and health parameters. It also examines in detail the main threats to Community Nutrition resilience in Greater Miami. These include a lack of focus, policy, and planning, as well as threats related to the steps of the food system and particularly the prevalent lack of health literacy. Finally, it introduces the subsequent chapters of the book.
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Prologue: Community Nutrition Resilience—What and Why
Community Nutrition Resilience in Greater Miami, 2020Co-Authors: Franziska Alesso-bendischAbstract:This chapter conceptualizes Community Nutrition resilience. It draws on a literature review related to resilience, delineating the term from the related terms “sustainability,” “transformability,” and “adaptability.” It examines resilience in an urban setting and then among communities. Subsequently, it looks at food security and identifies Nutrition as a critical component affecting the health, well-being, and opportunities of communities. It pays particular attention to how a changing climate affects food security. It then examines food systems and its constituent parts as the vehicle for delivering Community Nutrition resilience. Ultimately, it offers a definition of Community Nutrition resilience.
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Conclusions—Making Greater Miami’s Communities Nutrition Resilient
Community Nutrition Resilience in Greater Miami, 2020Co-Authors: Franziska Alesso-bendischAbstract:This final chapter provides recommendations on how to strengthen Community Nutrition resilience in Greater Miami. Based on interviews, literature review, and case study research, it offers actionable ideas in two areas: (1) planning and policy and (2) strengthening the food system. Several steps are identified to assign clear responsibility and focus on the issue, conduct robust assessments of critical communities on which to focus, and create the business case for multi-sectorial action. Recommendations are then made for the process of strengthening the food system, particularly increasing health literacy and cultural relevance of food for an increased uptake of healthy food options. Finally, it offers a vision for Greater Miami as a center of excellence for resilience and offers areas for future research.
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Taking (Community Nutrition) Resilience Action
Community Nutrition Resilience in Greater Miami, 2020Co-Authors: Franziska Alesso-bendischAbstract:This chapter examines how Greater Miami is responding to the resilience challenges introduced in Chapter 2 . It looks at political actions on federal, state, and county levels and discusses three key initiatives guiding resilience action in the region: the Southeast Florida Regional Climate Change Compact, Rockefeller Foundation’s 100 Resilient Cities, and Miami-Dade County’s Resilient305. A discussion follows of other programs and initiatives on the county level, for Miami-Dade, Broward, and Palm Beach counties, as well as what the main cities in the region are doing to address climate resilience and Community Nutrition resilience. Attempting to provide a complete picture of actions in the region, the chapter then examines what key institutions and organizations are doing to address these challenges.
Lluis Serra-majem - One of the best experts on this subject based on the ideXlab platform.
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Updating the Food-Based Dietary Guidelines for the Spanish Population: The Spanish Society of Community Nutrition (SENC) Proposal
Nutrients, 2019Co-Authors: Javier Aranceta-bartrina, Rosa M. Ortega, Lluis Serra-majem, Teresa Partearroyo, Ana M. López-sobaler, Gregorio Varela-moreiras, Carmen Pérez-rodrigoAbstract:Diet-related risk factors and physical inactivity are among the leading risk factors for disability and are responsible for a large proportion of the burden of chronic non-communicable diseases. Food-based dietary guidelines (FBDGs) are useful tools for Nutrition policies and public health strategies to promote healthier eating and physical activity. In this paper, we discuss the process followed in developing the dietary guidelines for the Spanish population by the Spanish Society of Community Nutrition (SENC) and further explain the collaboration with primary healthcare practitioners as presented in the context of the NUTRIMAD 2018 international congress of SENC. From a health in all policies approach, SENC convened a group of experts in Nutrition and public health to review the evidence on diet-health, nutrient intake and food consumption in the Spanish population, as well as food preparation, determinants and impact of diet on environmental sustainability. The collaborative group drafted the document and designed the graphic icon, which was then subject to a consultation process, discussion, and qualitative evaluation. Next, a collaborative group was established to plan a dissemination strategy, involving delegates from all the primary healthcare scientific societies in Spain. A product of this collaboration was the release of an attractive, easy-to-understand publication.
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Dairy products and health: a review of the epidemiological evidence
British Journal of Nutrition, 2006Co-Authors: Eva-elisa Álvarez-león, Blanca Román-viñas, Lluis Serra-majemAbstract:Evidence-based Nutrition is essential to move forward in the science of Community Nutrition. The present study is a review of the epidemiological evidence of dairy products and health. There is an inverse association between the intake of dairy products and hypertension, stroke and colorectal cancer. There is no evidence of an association between the consumption of dairy products and breast cancer. There is some evidence linking high-fat dairy products and an incremental risk of prostate cancer and weak evidence of the protective capacity of dairy products on bone health. More prospective studies should be developed in order to establish better evidence of the relationship between dairy products and health. Due to the importance of dairy products in public health Nutrition, quantitative recommendations should be established in the light of the scientific evidence.
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Best practices in Community Nutrition: challenges and commitments
Archivos Latinoamericanos De Nutricion, 2004Co-Authors: Lluis Serra-majemAbstract:Community Nutrition is a science in continuous evolution that needs to be adapted to changing Nutritional problems and to geographical, cultural and socieconomical diversity. Best practices in Community Nutrition is a concept that facilitates enhanced diffusion and application of knowledge through the analysis of properly designed, executed and evaluated experiences. The conclusions of the five presentations in the session organized by the Spanish Society of Community Nutrition at the XIII Latin American Conference on Nutrition are analyzed. Also, the major challenges and commitments are described: planning and forecasting, intersectorial collaboration, international cooperation, evaluation and monitoring, empowerment, training, fostering institutional support, Community participation, leadership, sustainability, continuity, transparency and dissemination. The needs to further develop cooperation and sharing of experiences in the area of Community Nutrition between Latin America and Spain is highlighted.
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Nutritional objectives for the Spanish population. Consensus from the Spanish Society of Community Nutrition
Public Health Nutrition, 2001Co-Authors: Lluis Serra-majem, Javier ArancetaAbstract:The objective of this paper is to present the development of the Nutritional Objectives for the Spanish Population. Preparation of draft documents contributed by different working groups was followed by a consensus meeting held in Bilbao on 5-7 October 2000, hosted by the Spanish Society of Community Nutrition and sponsored by the World Health Organisation. Establishing Nutritional guidelines was conducted by: (1) analysing current food and Nutritional data from Nutritional surveys, for intermediate objectives; and (2) reviewing current scientific knowledge for final objectives. The objectives include intermediate and ultimate figures, and comprise percentage of energy from macronutrients and fatty acids, fruit and vegetable consumption, frequency of sweets, physical activity and body mass index, folate, calcium, sodium, fluoride and iodine intake, dietary fibre, cholesterol, alcohol and duration of breast-feeding. The Nutritional objectives for the Spanish population create a rational framework for the development of dietary guidelines and Nutritional policies in Spain, within a Mediterranean context.
Javier Aranceta - One of the best experts on this subject based on the ideXlab platform.
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Community Nutrition in Spain: advances and drawbacks.
Nutrition Reviews, 2009Co-Authors: Javier Aranceta, Félix Lobo, Pilar Viedma, Gemma Salvador-castell, Emilio Martínez De Victoria, Rosa M. Ortega, Luis Bello, Josep A Tur-maríAbstract:Scientific evidence has placed Community Nutrition among the front-line strategies in health promotion. Community Nutrition in different regions of Spain has developed at an unequal pace. Early initiatives in the mid 1980s provided good-quality population data and established a basis for Nutrition surveillance including individual body measurements, dietary intake data, information on physical activity, and biomarkers. The Nutrition and Physical Activity for Obesity Prevention Strategy (NAOS) reinforces Community Nutrition action in Spain. Presented here is an overview of developments in Community Nutrition in Spain in recent years as well as potential trends under the scope of the NAOS.
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Community Nutrition
Archivos latinoamericanos de nutricion, 2004Co-Authors: Javier ArancetaAbstract:In the last 20 years, Public Health Nutrition focused mainly on the qualitative aspects which may influence the onset of chronic diseases, quality of life, physical and mental performance and life expectancy. This applied knowledge organised as part of preventive and health promotion programs led to the development of Community Nutrition. The aim of Community Nutrition actions is to adequate lifestyles related to food consumption patterns in order to improve the quality of life and contribute to health promotion of the population in the Community where programs and services are delivered. Key functions to develop in a Community Nutrition Unit consist in the identification and assessment of Nutrition problems in the Community as well as the design, implementation and evaluation of intervention programs by means of appropriate strategies. These should aim at different populations groups and settings, such as work places, schools, high risk groups or the general public. Nowadays, Community Nutrition work efforts should focus on three main aspects: Nutrition education in schools and in the Community; food safety and food security and the development and reinforcement of food preparation skills across all age groups. Social catering services, either in schools, the work place or at the Community level, need to ensure adequate Nutritional supply, provide foods contributing to healthy eating practices as well as to enhance culinary traditions and social learning. Food safety and food security have become a top priority in Public Health. The concepts referes to the availability of food safe and adequate as well as in sufficient amount in order to satisfy Nutrition requirements of all individuals in the Community. Social changes along new scientific developments will introduce new demands in Community Nutrition work and individual dietary counselling will become a key strategy. In order to face new challenges, Community Nutrition pactitioners require a high quality profesional training.
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Community Nutrition.
European journal of clinical nutrition, 2003Co-Authors: Javier ArancetaAbstract:Scientific evidence has placed Community Nutrition among the front line strategies in health promotion. Traditional food habits have progressively changed in the last few decades. The combination of changes in food patterns and sedentary lifestyles have contributed to a significant increase in the prevalence of overweight and obesity. Efforts in Community Nutrition should now focus on three key aspects: Nutrition education in schools and in the Community, food safety and enhanced culinary skills in all age groups. School meals and other catering services provided at work or Community sites should be consistent with the educational message. Catering services should ensure adequate Nutritional supply, foster healthy eating practices and encourage participation in gastronomic culture and social learning. Food safety includes the procurement of a safe adequate food supply in sufficient amounts to cover the Nutritional requirements of all individuals. It has become a priority for Public Health. Social changes along new scientific developments will introduce new demands into Community Nutrition and request a more important role for individually tailored advise. In order to face these challenges, Community Nutrition professionals need to be highly qualified and skilled.
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Nutritional objectives for the Spanish population. Consensus from the Spanish Society of Community Nutrition
Public Health Nutrition, 2001Co-Authors: Lluis Serra-majem, Javier ArancetaAbstract:The objective of this paper is to present the development of the Nutritional Objectives for the Spanish Population. Preparation of draft documents contributed by different working groups was followed by a consensus meeting held in Bilbao on 5-7 October 2000, hosted by the Spanish Society of Community Nutrition and sponsored by the World Health Organisation. Establishing Nutritional guidelines was conducted by: (1) analysing current food and Nutritional data from Nutritional surveys, for intermediate objectives; and (2) reviewing current scientific knowledge for final objectives. The objectives include intermediate and ultimate figures, and comprise percentage of energy from macronutrients and fatty acids, fruit and vegetable consumption, frequency of sweets, physical activity and body mass index, folate, calcium, sodium, fluoride and iodine intake, dietary fibre, cholesterol, alcohol and duration of breast-feeding. The Nutritional objectives for the Spanish population create a rational framework for the development of dietary guidelines and Nutritional policies in Spain, within a Mediterranean context.
Francis Delpeuch - One of the best experts on this subject based on the ideXlab platform.
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Has the first implementation phase of the Community Nutrition Project in urban Senegal had an impact
Nutrition, 2007Co-Authors: Agnès Gartner, Yves Kameli, Pierre Traissac, Agnès Dhur, Francis Delpeuch, Bernard MaireAbstract:Abstract Objective We evaluated the impact of the Community Nutrition Project (CNP) of Senegal, West Africa on the population. In poor urban districts, the CNP provided underweight 6- to 35-mo-old children with growth monitoring/promotion and food supplementation, and education for mothers for a period of 6 mo. Methods A before/after intervention and intervention zone (IZ)/control zone (CZ) design was used to assess whether CNP had an impact 18 mo after it began in Diourbel. Exhaustive samples included children 6–35 mo old in the CZ (n = 895 before and 917 after) and IZ (n = 912 and 759). The impact was assessed by the differential effect of the zone on changes in underweight, wasting, and stunting defined by the threshold of −2 or −3 z scores. Results The decrease in wasting was higher in the CZ (from 13.7% to 8.6% versus 11.3% to 10.8%, P = 0.042). Changes in stunting did not differ between zones (18.8% to 14.5% versus 15.1% to 14.7%, P = 0.21). However, in the IZ, severe wasting, stunting, and underweight disappeared in children 6–11 mo of age. In the CZ, the socioeconomic data and some outcomes in children reflected a favorable context independent of the CNP. Conclusion Despite a globally satisfactory decrease in malNutrition in the IZ, no impact was demonstrated because the same or an even larger decrease was observed in the CZ, highlighting the importance of relying on a quasi-experimental design. This may be explained in part by weaknesses in the process, which probably interfered with a potential impact, and by the high degree of population mobility, which could have interfered with efficiency assessed on a geographic scale.
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Applied Nutritional investigation Has the first implementation phase of the Community Nutrition Project in urban Senegal had an impact
2007Co-Authors: Agnès Gartner, Yves Kameli, Pierre Traissac, Agnès Dhur, Francis Delpeuch, Bernard MaireAbstract:Objective: We evaluated the impact of the Community Nutrition Project (CNP) of Senegal, West Africa on the population. In poor urban districts, the CNP provided underweight 6- to 35-mo-old children with growth monitoring/promotion and food supplementation, and education for mothers for a period of 6 mo. Methods: A before/after intervention and intervention zone (IZ)/control zone (CZ) design was used to assess whether CNP had an impact 18 mo after it began in Diourbel. Exhaustive samples included children 6-35 mo old in the CZ (n 895 before and 917 after) and IZ (n 912 and 759). The impact was assessed by the differential effect of the zone on changes in underweight, wasting, and stunting defined by the threshold of 2o r3 z scores. Results: The decrease in wasting was higher in the CZ (from 13.7% to 8.6% versus 11.3% to 10.8%, P 0.042). Changes in stunting did not differ between zones (18.8% to 14.5% versus 15.1% to 14.7%, P 0.21). However, in the IZ, severe wasting, stunting, and underweight disappeared in children 6-11 mo of age. In the CZ, the socioeconomic data and some outcomes in children reflected a favorable context independent of the CNP. Conclusion: Despite a globally satisfactory decrease in malNutrition in the IZ, no impact was demonstrated because the same or an even larger decrease was observed in the CZ, highlighting the importance of relying on a quasi-experimental design. This may be explained in part by weaknesses in the process, which probably interfered with a potential impact, and by the high degree of population mobility, which could have interfered with efficiency assessed on a geographic scale. © 2007 Elsevier Inc. All rights reserved.
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Process evaluation of the Senegal-Community Nutrition Project: an adequacy assessment of a large scale urban project.
Tropical Medicine and International Health, 2006Co-Authors: Agnès Gartner, Yves Kameli, Pierre Traissac, Bernard Maire, Francis DelpeuchAbstract:Although essential for understanding the reasons for success or failure of large scale Nutritional interventions process evaluation results are rarely reported. Our objective was to assess whether the process output objectives of the Community Nutrition Project (CNP) in Senegal West Africa were adequately met. An adequacy assessment study based on monitoring data for individuals collected during the CNP was used to assess fidelity extent and reach of participants recruitment and of the services provided. The CNP provided underweight or Nutritionally at risk 6- to 35-month-old children in poor districts with monthly growth monitoring and promotion and a weekly food supplementation for 6 month periods provided that mothers attended weekly Nutrition education sessions. An exhaustive sample of the participating children (n = 4084) in Diourbel was used for evaluation over the first 2 years. At recruitment only 66% of children were underweight (vs. 90% expected) varying with the CNP center and cohort and the childs sex and age. Attendance at growth monitoring reached expected levels (93% vs. 90%) whereas numbers of food supplements distributed and education sessions attended were lower than expected (45% vs. 90% and 62% vs. 80% respectively). At the end of follow-up 61% of underweight children recovered vs. 80% expected. Because of CNP design for underweight diagnosis and bias in the targeting process respect for selection criteria was low and consequently under coverage and leakage occurred. Besides a globally satisfactory process wide discrepancies were observed between CNP centres concerning the utilization and effectiveness of services. This formative evaluation helped diagnose weaknesses; ongoing feedback enabled the CNP to improve targeting and supply of supplements. It also informed a larger impact evaluation. Some generalizable lessons for similar programmes have been highlighted. (authors)
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Determinants of Nutrition improvement in a large-scale urban project: a follow-up study of children participating in the Senegal Community Nutrition Project.
Public Health Nutrition, 2006Co-Authors: Agnès Gartner, Yves Kameli, Pierre Traissac, Bernard Maire, Francis DelpeuchAbstract:Objective: To study individual determinants of differential benefit from the Senegal Community Nutrition Project (CNP) by monitoring improvement in children's weight-for-age index (WA) or underweight status (WA < -2 Z-scores) during participation. Design: A follow-up study using the CNP child monitoring data. Linear general models compared variations in WA according to 14 factors describing the beneficiaries and CNP services. Setting: Poor neighbourhoods of Diourbel, a large city in Senegal, West Africa. Over a 6-month period, the CNP provided underweight or Nutritionally at-risk 6-35-month-old children with monthly growth monitoring and promotion and weekly food supplementation, provided that mothers attended weekly Nutrition education sessions. Subjects: All the children who participated in the first two years of the project (n=4084). Results: Mean WA varied from -2.13 (standard deviation (SD) 0.82) to -1.58 (SD 0.81) Z-scores between recruitment and the end of the follow-up. The lower the child's initial WA, the greater was their increase in WA but the lower was the probability of recovery from underweight. Only 61% of underweight children recovered. Six months of CNP services may not be sufficient for catch-up growth of severely underweight children. The number of food supplement rations received was not a direct indicator of the probability of recovery. After adjustment for services received and initial WA, probability of recovery was lower in girls, in younger children, in twins and when mothers belonged to a specific ethnic group. Conclusions. Determinants of benefit from CNP differed from the risk factors for underweight. Identification of participants with a lower probability of recovery can help improve outcome. Moreover, an explanation for the lack of recovery could he that many underweight children are stunted but not necessarily wasted.
Agnès Gartner - One of the best experts on this subject based on the ideXlab platform.
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Has the first implementation phase of the Community Nutrition Project in urban Senegal had an impact
Nutrition, 2007Co-Authors: Agnès Gartner, Yves Kameli, Pierre Traissac, Agnès Dhur, Francis Delpeuch, Bernard MaireAbstract:Abstract Objective We evaluated the impact of the Community Nutrition Project (CNP) of Senegal, West Africa on the population. In poor urban districts, the CNP provided underweight 6- to 35-mo-old children with growth monitoring/promotion and food supplementation, and education for mothers for a period of 6 mo. Methods A before/after intervention and intervention zone (IZ)/control zone (CZ) design was used to assess whether CNP had an impact 18 mo after it began in Diourbel. Exhaustive samples included children 6–35 mo old in the CZ (n = 895 before and 917 after) and IZ (n = 912 and 759). The impact was assessed by the differential effect of the zone on changes in underweight, wasting, and stunting defined by the threshold of −2 or −3 z scores. Results The decrease in wasting was higher in the CZ (from 13.7% to 8.6% versus 11.3% to 10.8%, P = 0.042). Changes in stunting did not differ between zones (18.8% to 14.5% versus 15.1% to 14.7%, P = 0.21). However, in the IZ, severe wasting, stunting, and underweight disappeared in children 6–11 mo of age. In the CZ, the socioeconomic data and some outcomes in children reflected a favorable context independent of the CNP. Conclusion Despite a globally satisfactory decrease in malNutrition in the IZ, no impact was demonstrated because the same or an even larger decrease was observed in the CZ, highlighting the importance of relying on a quasi-experimental design. This may be explained in part by weaknesses in the process, which probably interfered with a potential impact, and by the high degree of population mobility, which could have interfered with efficiency assessed on a geographic scale.
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Applied Nutritional investigation Has the first implementation phase of the Community Nutrition Project in urban Senegal had an impact
2007Co-Authors: Agnès Gartner, Yves Kameli, Pierre Traissac, Agnès Dhur, Francis Delpeuch, Bernard MaireAbstract:Objective: We evaluated the impact of the Community Nutrition Project (CNP) of Senegal, West Africa on the population. In poor urban districts, the CNP provided underweight 6- to 35-mo-old children with growth monitoring/promotion and food supplementation, and education for mothers for a period of 6 mo. Methods: A before/after intervention and intervention zone (IZ)/control zone (CZ) design was used to assess whether CNP had an impact 18 mo after it began in Diourbel. Exhaustive samples included children 6-35 mo old in the CZ (n 895 before and 917 after) and IZ (n 912 and 759). The impact was assessed by the differential effect of the zone on changes in underweight, wasting, and stunting defined by the threshold of 2o r3 z scores. Results: The decrease in wasting was higher in the CZ (from 13.7% to 8.6% versus 11.3% to 10.8%, P 0.042). Changes in stunting did not differ between zones (18.8% to 14.5% versus 15.1% to 14.7%, P 0.21). However, in the IZ, severe wasting, stunting, and underweight disappeared in children 6-11 mo of age. In the CZ, the socioeconomic data and some outcomes in children reflected a favorable context independent of the CNP. Conclusion: Despite a globally satisfactory decrease in malNutrition in the IZ, no impact was demonstrated because the same or an even larger decrease was observed in the CZ, highlighting the importance of relying on a quasi-experimental design. This may be explained in part by weaknesses in the process, which probably interfered with a potential impact, and by the high degree of population mobility, which could have interfered with efficiency assessed on a geographic scale. © 2007 Elsevier Inc. All rights reserved.
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Process evaluation of the Senegal-Community Nutrition Project: an adequacy assessment of a large scale urban project.
Tropical Medicine and International Health, 2006Co-Authors: Agnès Gartner, Yves Kameli, Pierre Traissac, Bernard Maire, Francis DelpeuchAbstract:Although essential for understanding the reasons for success or failure of large scale Nutritional interventions process evaluation results are rarely reported. Our objective was to assess whether the process output objectives of the Community Nutrition Project (CNP) in Senegal West Africa were adequately met. An adequacy assessment study based on monitoring data for individuals collected during the CNP was used to assess fidelity extent and reach of participants recruitment and of the services provided. The CNP provided underweight or Nutritionally at risk 6- to 35-month-old children in poor districts with monthly growth monitoring and promotion and a weekly food supplementation for 6 month periods provided that mothers attended weekly Nutrition education sessions. An exhaustive sample of the participating children (n = 4084) in Diourbel was used for evaluation over the first 2 years. At recruitment only 66% of children were underweight (vs. 90% expected) varying with the CNP center and cohort and the childs sex and age. Attendance at growth monitoring reached expected levels (93% vs. 90%) whereas numbers of food supplements distributed and education sessions attended were lower than expected (45% vs. 90% and 62% vs. 80% respectively). At the end of follow-up 61% of underweight children recovered vs. 80% expected. Because of CNP design for underweight diagnosis and bias in the targeting process respect for selection criteria was low and consequently under coverage and leakage occurred. Besides a globally satisfactory process wide discrepancies were observed between CNP centres concerning the utilization and effectiveness of services. This formative evaluation helped diagnose weaknesses; ongoing feedback enabled the CNP to improve targeting and supply of supplements. It also informed a larger impact evaluation. Some generalizable lessons for similar programmes have been highlighted. (authors)
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Determinants of Nutrition improvement in a large-scale urban project: a follow-up study of children participating in the Senegal Community Nutrition Project.
Public Health Nutrition, 2006Co-Authors: Agnès Gartner, Yves Kameli, Pierre Traissac, Bernard Maire, Francis DelpeuchAbstract:Objective: To study individual determinants of differential benefit from the Senegal Community Nutrition Project (CNP) by monitoring improvement in children's weight-for-age index (WA) or underweight status (WA < -2 Z-scores) during participation. Design: A follow-up study using the CNP child monitoring data. Linear general models compared variations in WA according to 14 factors describing the beneficiaries and CNP services. Setting: Poor neighbourhoods of Diourbel, a large city in Senegal, West Africa. Over a 6-month period, the CNP provided underweight or Nutritionally at-risk 6-35-month-old children with monthly growth monitoring and promotion and weekly food supplementation, provided that mothers attended weekly Nutrition education sessions. Subjects: All the children who participated in the first two years of the project (n=4084). Results: Mean WA varied from -2.13 (standard deviation (SD) 0.82) to -1.58 (SD 0.81) Z-scores between recruitment and the end of the follow-up. The lower the child's initial WA, the greater was their increase in WA but the lower was the probability of recovery from underweight. Only 61% of underweight children recovered. Six months of CNP services may not be sufficient for catch-up growth of severely underweight children. The number of food supplement rations received was not a direct indicator of the probability of recovery. After adjustment for services received and initial WA, probability of recovery was lower in girls, in younger children, in twins and when mothers belonged to a specific ethnic group. Conclusions. Determinants of benefit from CNP differed from the risk factors for underweight. Identification of participants with a lower probability of recovery can help improve outcome. Moreover, an explanation for the lack of recovery could he that many underweight children are stunted but not necessarily wasted.