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by IFPRI | June 14, 2019

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Measuring coverage of infant and young child feeding counselling interventions: A framework and empirical considerations for survey question design
Choufani, Jowel; Kim, Sunny S.; Nguyen, Phuong Hong; Heidkamp, Rebecca A.; Grummer-Strawn, Laurence M.; Saha, Kuntal K.; Hayashi, Chika; Mehra, Vrinda; Alayon, Silvia; Menon, Purnima. Article in press

Abstract | View

Most countries implement nutrition counselling interventions as part of programmes to support breastfeeding and complementary feeding. However, data to track coverage of counselling interventions are rarely available. As a result, little is known about the coverage of counselling on infant and young child feeding (IYCF). Survey‐based data collection systems generally collect data on IYCF practices but do not collect data on coverage of interventions to support IYCF, and those surveys that do collect this information do not do so consistently. We present a framework to guide the design of survey questions to measure IYCF counselling coverage. We provide examples of how large‐scale surveys for programme evaluation and national monitoring have included survey questions to address these data gaps. Our review suggests that elements relevant to designing survey questions to capture coverage of counselling interventions include timing of contact, target behaviour and message content, place of contact, type of service provider, frequency of contact and mode of intervention. Application of this framework may help strengthen harmonized measurement of IYCF counselling coverage to enable better tracking of programme investments, document progress in scaling up nutrition services and allow for cross‐country comparisons. Thus, improving measurement of counselling coverage may lead to improved reach of programmes to support optimal IYCF practices.
Early breastfeeding practices contribute to exclusive breastfeeding in Bangladesh, Vietnam and Ethiopia
Nguyen, Phuong Hong; Kim, Sunny S.; Tran, Lan Mai; Menon, Purnima; Frongillo, Edward A.. Article in press

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Limited evidence exists on the complex relationship among interventions, early initiation of breastfeeding (EIBF), prelacteal feeding and exclusive breastfeeding (EBF). We examined whether early breastfeeding practices are associated with EBF and how much improving EIBF and non‐prelacteal feeding contributes to increased prevalence of EBF. Survey data were collected in 2010 and 2014 as part of impact evaluations of Alive & Thrive (A&T) interventions to improve infant and young child feeding (IYCF) practices in Bangladesh, Vietnam and Ethiopia. Multivariable logistic regression analyses were used to examine effects of interventions and early breastfeeding practices on EBF. Structural equation modelling quantified the direct and indirect effects of interventions (via improving EIBF and non‐prelacteal feeding) on EBF. Although breastfeeding is nearly universal in all three countries (≥98%), delayed initiation of breastfeeding is prevalent (>60%) and prelacteal feeding is common. EIBF alone was not associated with EBF, whereas non‐prelacteal feeding was associated with 1.6–3.5 higher odds of EBF. Intervention exposure affected breastfeeding practices in all three countries; these impacts were amplified among those who practiced EIBF or non‐prelacteal feeding [odds ratio (OR) = 11 and 27.5 in Bangladesh and 6.5 and 11.5 in Vietnam, respectively]. The paths through EIBF and non‐prelacteal feeding explained 13%–18% of the effect of the interventions on EBF. Early breastfeeding practices influence EBF, but interventions aimed only at the initiation and early days of breastfeeding will be inadequate to promote EBF. Social and behaviour change interventions should simultaneously target EIBF, non‐prelacteal feeding and EBF to support optimal breastfeeding practices.
Validation of 24‐h dietary recall for estimating nutrient intakes and adequacy in adolescents in Burkina Faso
Arsenault, Joanne E.; Moursi, Mourad; Olney, Deanna K.; Becquey, Elodie; Ganaba, Rasmane. Article in press

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Data on dietary nutrient intakes of adolescents in low‐ and middle‐income countries (LMIC) is lacking partly due to the absence of validation studies of the 24‐h recall method in adolescents. We conducted a validation study of 24‐h recall (24HR) compared with observed weighed records (OWR) in adolescents (n = 132, 10–11 years; n = 105, 12–14 years). Dietary data were collected for the same day by both methods by conducting the 24HR the day after the OWR. For OWR, all foods consumed by adolescents from the first to last meal of the day were weighed; for 24HR adolescents reported foods consumed using portion aids. Food intakes were converted to nutrients. Nutrient intakes by both methods were tested for equivalence by comparing the ratios (24HR/OWR) with equivalence margins of within ±10%, 15% and 20% of the ratio. Prevalences of inadequacy (POIs) were obtained using the NCI method. Mean ratios for energy were 0.88 and 0.92, for younger and older adolescents, respectively, and other nutrients ranged between 0.84 and 1.02. Energy intakes were equivalent within the 15% bound, and most nutrients fell within the 20% bound. POI was overestimated by 24HR, but differences were less than 25 percentage points for most nutrients. Half of adolescents omitted foods in recalls, mainly sweet or savoury snacks, fruits and beverages. Our study showed that adolescents underestimated intakes by 24HR; however, the degree of underestimation was generally acceptable for 12–14‐year‐olds within a bound of 15%. Errors could possibly be reduced with further training and targeted probing.
Modeling and simulation of recurrent phenotypic and genomic selections in plant breeding under the presence of epistasis
Ali, Mohsin; Zhang, Luyan; DeLacy, Ian; Arief, Vivi; Dieters, Mark; Pfeiffer, Wolfgang H.; Wang, Jiankang; Li, Huihui. Article in press

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Recurrent selection is an important breeding method for population improvement and selecting elite inbreds or fixed lines from the improved germplasm. Recently, a computer simulation tool called QuMARS has been developed, which allows the simulation and optimization of various recurrent selection strategies. Our major objective in this study was to use the QuMARS tool to compare phenotypic recurrent, marker-assisted recurrent, and genomic selections (abbreviated respectively as PS, MARS and GS) for both short- and long- term breeding procedures. For MARS, two marker selection models were considered, i.e., stepwise (Rstep) and forward regressions (Forward). For GS, three prediction models were considered, i.e., genomic best linear unbiased predictors (GBLUP), ridge regression (Ridge), and regression by Moore-Penrose general inverse (InverseMP). To generate genotypes and phenotypes for a given individual during simulation, one additive and two epistasis genetic models were considered with three levels of heritability. Results demonstrated that selection responses from GBLUP-based GS and MARS (Forward) were consistently greater than those from PS under the additive model, particularly in early selection cycles. In contrast, selection response from PS was consistently superior over MARS and GS under epistatic models. For the two epistasis models, total genetic variance and the additive variance component were increased in some cases after selection. Through simulation, we concluded that GS and PS were effective recurrent selection methods for improved breeding of targeted traits controlled by additive and epistatic quantitative trait loci (QTL). QuMARS provides an opportunity for breeders to compare, optimize and integrate new technology into their conventional breeding programs.
Observability of food safety losses in maize: Evidence from Kenya
Hoffmann, Vivian; Mutiga, Samuel K.; Harvey, Jagger W.; Nelson, Rebecca J.; Milgroom, Michael G.. Article in press

Demand for aflatoxin‐safe maize in Kenya: Dynamic response to price and advertising
Hoffmann, Vivian; Moser, Christine; Herrman, Timothy J.. Article in press

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In countries where regulatory enforcement is weak, voluntary third‐party verification of firms' food safety processes can allow concerned consumers to select safer products. However, due in part to their legal ambiguity, and the potential to attract additional regulatory scrutiny, food safety claims are rarely made by firms. As a result, the impact of such claims on consumer demand is not well understood. We examine how labeling maize as tested for aflatoxin, a carcinogen also associated with stunting in children, affects sales. By randomly varying the timing and intensity of a marketing campaign to promote the first maize flour brand in Kenya labeled as tested for aflatoxin, we characterize dynamic consumer response to information about food safety. We find an immediate response in sales to marketing alone, which disappears as soon as marketing ceases. Sales remain elevated in the weeks after a temporary discount is offered, but this effect also fades over time and is not associated with greater awareness of the firm's food safety claims. These results suggest that it is unrealistic to expect for‐profit firms serving mass markets in low‐ and middle‐income countries to invest heavily in marketing based on food safety claims.
Food safety consciousness and consumers’ milk purchasing behavior: Evidence from a developing country
Thapa, Ganesh; Kumar, Anjani; Roy, Devesh; Joshi, Pramod Kumar. Article in press

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We study the effects of food safety awareness on consumers’ milk purchasing behavior in Nepal. We conducted consumer survey and employed an instrumental variable regression. We find education, income, and social network to influence food safety consciousness (FSC). Our results indicate the positive impact of FSC on weekly milk expenditure and probability of purchasing milk from milk cooperatives. Any policy that helps to improve the FSC levels will likely increase the purchase of safe milk from the modern market outlet, and lack of such awareness raising policies has prevented the market for safe food from evolving and expanding.
Incidence correction factors for moderate and severe acute child malnutrition from two longitudinal cohorts in Mali and Burkina Faso
Barba, Francisco M.; Huybregts, Lieven; Leroy, Jef L.. Article in press

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Child acute malnutrition (AM) is an important cause of child mortality. Accurately estimating its burden requires cumulative incidence data from longitudinal studies which are rarely available in low-income settings. In the absence of such data, the AM burden is approximated using prevalence estimates from cross-sectional surveys and the incidence correction factor K⁠, obtained from the few available cohorts that measured AM. We estimated K factors for severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) from AM incidence and prevalence using representative cross-sectional baseline and longitudinal data from two cluster-randomized controlled trials (Innovative Approaches for the Prevention of Childhood Malnutrition—PROMIS) conducted between 2014 and 2017 in Burkina Faso and Mali. We compared K estimates using a complete (weight-for-length z score, mid-upper arm circumference (MUAC), edema) and partial (MUAC, edema) definition of SAM and MAM. K estimates ranged from 9.4 and 5.7 for SAM, and from 4.7 and 5.1 for MAM in Burkina Faso and Mali, respectively. The MUAC and edema-based definition of AM did not lead to different K estimates. Our results suggest that K can be reliably estimated when only MUAC and edema-based data are available. Additional studies, however, are required to confirm this finding in different settings.
Effects of dose and duration of zinc interventions on risk factors for Type 2 Diabetes and Cardiovascular Disease: A systematic review and meta-analysis
Pompano, Laura M.; Boy, Erick. Article in press

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No meta-analysis has examined the effect of dose and duration of zinc interventions on their impact on risk factors for type 2 diabetes (T2D) or cardiovascular disease (CVD). This study aimed first to compare the effects of zinc interventions dichotomized as low versus high dose (<25 mg/d and ≥25 mg/d, respectively) and short versus long duration (<12 wk and ≥12 wk, respectively) on risk factors for T2D and CVD. Second, it discusses the results from the low-dose and long-duration meta-analyses as a foundation for understanding what impact a zinc-biofortification intervention could have on these risk factors. The PubMed and Cochrane Review databases were searched through January 2020 for full-text, human studies providing zinc supplements (alone) at doses ≤75 mg/d and a placebo. Data on study and sample characteristics and several T2D and CVD risk factors were extracted. There were 1042 and 974 participants receiving zinc and placebo, respectively, from 27 studies. Low-dose zinc supplementation (<25 mg/d) significantly benefited fasting blood glucose, insulin resistance, triglycerides, total cholesterol, and LDL cholesterol. High-dose zinc supplementation (≥25 mg/d) benefited glycated hemoglobin and insulin resistance. Short-duration interventions (<12 wk) benefited fasting blood glucose, insulin resistance, and triglycerides, while long-duration studies (≥12 wk) benefited fasting blood glucose, triglycerides, and total and LDL cholesterol. Effect sizes for low-dose and long-duration interventions were of equal or greater magnitude to those from high-dose or short-duration interventions. Low-dose and long-duration zinc supplementation each improved more risk factors for T2D and CVD than high-dose and short-duration interventions, respectively. It is currently unknown whether low doses of zinc delivered over long durations via a biofortified crop would similarly impact these risk factors. However, this review suggests that low-dose, long-duration zinc intake from supplements, and potentially biofortification, can benefit risk factors for T2D and CVD.
Determining a global mid-upper arm circumference cut-off to assess underweight in adults (men and non-pregnant women)
Tang, Alice M.; Chung, Mei; Dong, Kimberly R.; Bahwere, Paluku; Bose, Kaushik; Nguyen, Phuong Hong. Article in press

Impact of COVID-19 on agricultural markets: Assessing the roles of commodity characteristics, disease caseload and market reforms
Varshney, Deepak; Roy, Devesh; Meenakshi, J. V.. Article in press

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This paper assesses the impact of the spread of COVID-19 and the lockdown on wholesale prices and quantities traded in agricultural markets. We compare whether these impacts differ across non-perishable (wheat) and perishable commodities (tomato and onion), and the extent to which any adverse impacts are mitigated by the adoption of a greater number of agricultural market reform measures. We use a granular data set comprising daily observations for 3 months from nearly 1000 markets across five states and use a double- and triple- difference estimation strategy. Expectedly, our results differ by type of commodity and period of analysis. While all prices spiked initially in April, they recovered relatively quickly, underscoring the importance of time duration for analysis. Wheat prices were anchored in large part by the minimum support price, while tomato prices were lower in some months. Supply constraints began easing in May with greater market arrivals perhaps reflecting distress sales. Market reform measures did help in insulating farmers from lower prices, but these effects are salient for the perishable goods, and not so much for wheat where the government remained the dominant market player. Taken together, these results point to considerable resilience in agricultural markets in dealing with the COVID-19 shock, buffered by adequate policy support.
Nutrition transition in Vietnam: Changing food supply, food prices, household expenditure, diet and nutrition outcomes
Harris, Jody; Nguyen, Phuong Hong; Tran, Lan Mai; Huynh, Phuong Nam. Article in press

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While literature has noted the presence of a nutrition transition in terms of changing nutrition outcomes in Vietnam, very limited evidence linking changes in upstream food system factors to downstream diet and nutrition changes exists. Combining available data from different sources and analyzing it through a conceptual food systems framework, our study examines different pathways of nutrition transition through food supply, food prices, household food expenditures, diets, and nutrition outcomes in Vietnam. Our findings show that while Vietnam is at the start of its nutrition transition, change is happening rapidly. Undernutrition is falling, obesity is rising, and nutrition-related chronic diseases account for a significant burden of diseases and death. In terms of changes in healthful foods, the supply of vegetables and fruits is plentiful, and expenditure on vegetables remains consistent and small. Notably however, vegetable consumption has dropped, and increasing meat and milk consumption have been double-edged swords for nutrition. In terms of foods associated with the negative sides of the nutrition transition, the availability of sweets and sweetened beverages has risen in recent years, with oils and fats rising less. The expenditure share on food eaten away from home, in many contexts a marker for less healthful diets, has increased over time. While these changes are typical of a nutrition transition, Vietnam is also somewhat of an outlier in some respects: wet markets and daily fresh food purchases continue to dominate food purchasing behaviour, and food eaten away from home means a different thing in a country renowned for its diverse and healthy street food and roadside restaurant culture. While this study brings together important data on the food system drivers of a nutrition transition in Vietnam, it cannot link each of these issues into a standard statistical model of change due to data gaps at different levels, calling for data collection improvement in future diet and food systems research. Vietnamese health policy explicitly acknowledges nutrition transition issues, with targets for obesity reduction. This work on the food system drivers of the nutrition transition points to the need to further adapt policy in other sectors beyond health, however. At the same time as making nutrient-rich foods more accessible, nutrient-poor or ultra-processed foods need to be made less accessible and desirable if additional income is to contribute to a healthy diet in limiting Vietnam’s emerging nutrition transition.
Income variability, evolving diets, and elasticity estimation of demand for processed foods in Nigeria
de Brauw, Alan; Herskowitz, Sylvan. Article in press

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We present evidence on evolving dietary patterns in Nigeria using six rounds of household consumption data from the Nigerian General Household Survey panel between 2011 and 2016. First, following conventional definitions in the literature, we show that Nigeria has not shown any aggregate increase in consumption of highly processed foods over this period, contrary to patterns observed elsewhere in the region. In fact, consumption of highly processed foods at home has declined, while food consumed away from home, often assumed to be highly processed, has risen substantially. We then show that estimates of food expenditure elasticities of different food types are highly sensitive to different estimation approaches and raise concerns about some frequently used methods in the literature. In the absence of credible exogenous variation, we argue for the importance of panel methods and household fixed effects to control for time invariant factors likely to confound cross‐sectional estimates. Finally, we examine semiparametric Engel curves for different food groups and find that apparent curvature in the relationships between food budget shares and overall food expenditure levels in the raw data become nearly linear when removing variation explained by time‐invariant household factors.
Quantitatively evaluating the cross-sectoral and one health impact of interventions: A scoping review and application to antibiotic resistance
Naylor, Nichola R.; Lines, Jo; Waage, Jeff; Wieland, Barbara; Knight, Gwenan M.. Article in press

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Current published guidance on how to evaluate antibiotic resistance (ABR) from a One Health perspective has focussed on the evaluation of intervention design and of the implementation process. For efficient resource allocation, it is also important to consider quantitative measures of intervention impact. In particular, there has been little discussion of how to practically evaluate ABR-related agri- and aquaculture interventions from a public health perspective. Lessons can be learned from other One Health and cross-sectoral intervention impact evaluations. WebofScience, EconLit, PubMed and grey literature were searched for literature quantitatively evaluating interventions across humans, animals and/or the environment. The review included 90 studies: 73 individual evaluations (from 72 papers) and 18 reviews, all including some measure of human impact, but only 29 papers covered all three One Health perspectives (human, animal and environmental). To provide decision makers with expected outcome estimates that are related to their objective, evaluations should provide outcome estimates from multiple different perspectives; individual, microeconomic and/or macroeconomic perspectives across the One Health system should be taken into account. Based on the methods found in this review, a multi-level compartmental modelling approach for ABR-related intervention evaluation is proposed. The outcomes of such models can then feed into multi-criteria-decision analyses that weigh outcomes alongside other chosen outcome estimates (for example equity or uncertainty). It is key that future quantitative evaluation models on ABR-related interventions are shared (for example through open source code sharing websites) to avoid duplication of effort and to enable more comprehensive estimates of intervention impact to be modelled in the future.
Genetic variability, diversity and interrelationship for twelve grain minerals in 122 commercial pearl millet cultivars in India
Govindaraj, Mahalingam; Yadav, O. P.; Rajpurohit, B. S.; Kanatti, A.; Rai, Kedar N.; Dwivedi, Sangam L.. Article in press

Ordering of high-density markers by the k-optimal algorithm for the traveling-salesman problem
Zhang, Luyan; Li, Huihui; Meng, Lei; Wang, Jiankang. Article in press

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Construction of accurate and high-density linkage maps is a key research area of genetics. We investigated the efficiency of genetic map construction (MAP) using modifications of the k-Optimal (k-Opt) algorithm for solving the traveling-salesman problem (TSP). For TSP, different initial routes resulted in different optimal solutions. The most optimal solution could be found only by use of as many initial routes as possible. But for MAP, a large number of initial routes resulted in one optimal order. k-Opt using open route length gave a slightly higher proportion of correct orders than the method of adding one virtual marker and using closed route length. Recombination frequency (REC) and logarithm of odds (LOD) score gave similar proportions of correct order, higher than that given by genetic distance. Both missing markers and genotyping error reduced ordering accuracy, but the best order was still achieved with high probability by comparison of the optimal orders from multiple initial routes. Computation time increased rapidly with marker number, and 2-Opt took much less time than 3-Opt. The 2-Opt algorithm was compared with ordering methods used in two other software packages. The best method was 2-Opt using open route length as the criterion to identify the optimal order and using REC or LOD as the measure of distance between markers. We describe a unified software interface for using k-Opt in high-density linkage map construction for a wide range of genetic populations.
Predictors of intention to integrate biofortified orange-fleshed sweetpotato in child feeding: A field information experiment in rural Kenya
Lagerkvist, Carl Johan; Mutiso, Janet Mwende; Okello, Julius Juma; Muoki, Penina; Oluoch-Kosura, Willis; Heck, Simon. Article in press

Can household dietary diversity inform about nutrient adequacy? Lessons from a food systems analysis in Ethiopia
Mekonnen, Daniel Ayalew; Talsma, Elise F.; Trijsburg, Laura; Linderhof, Vincent; Achterbosch, Thom; Nijhuis, Aafke; Ruben, Ruerd; Brouwer, Inge D.. Article in press

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This study examined the use of the household dietary diversity score (HDDS) to assess household nutrient adequacy in Ethiopia. It also examined the correlates of HDDS following the food systems framework. Results show that the average nutrient consumption in Ethiopia varies by place of residence and by income profile, where households in urban areas and those in the higher income quintiles rank favorably. Among 13 nutrients under study, we found nutrient inadequacy for fat, calcium, zinc, riboflavin, niacin, folate, vitamin C and vitamin A ranging between 46% and 89%, and the prevalence of inadequacy for vitamin B12 to be up to 100%. Econometric results showed that HDDS is a strong predictor of a household’s mean probability of nutrient adequacy (MPA), and that an HDDS of 10 is the minimum threshold at which HDDS can improve household MPA. We found suggestive evidence within the food systems that improving household-incomes, access to health and transport services are beneficial to improve HDDS and nutrient consumption in Ethiopia.
Early intensification of backyard poultry systems in the tropics: A case study
Chaiban, C.; Robinson, T. P.; Fèvre, E. M.; Ogola, J.; Akoko, J.; Gilbert, M.; Vanwambeke, S. O.. Article in press

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Poultry production is an important way of enhancing the livelihoods of rural populations, especially in low- and middle-income countries (LMICs). As poultry production in LMICs remains dominated by backyard systems with low inputs and low outputs, considerable yield gaps exist. Intensification can increase poultry productivity, production and income. This process is relatively recent in LMICs compared to high-income countries. The management practices and the constraints faced by smallholders trying to scale-up their production, in the early stages of intensification, are poorly understood and described. We thus investigated the features of the small-scale commercial chicken sector in a rural area distant from major production centres. We surveyed 111 commercial chicken farms in Kenya in 2016. We targeted farms that sell the majority of their production, owning at least 50 chickens, partly or wholly confined and provided with feeds. We developed a typology of semi-intensive farms. Farms were found mainly to raise dual-purpose chickens of local and improved breeds, in association with crops and were not specialized in any single product or market. We identified four types of semi-intensive farms that were characterized based on two groups of variables related to intensification and accessibility: (i) remote, small-scale old farms, with small flocks, growing a lot of their own feed; (ii) medium-scale, old farms with a larger flock and well located in relation to markets and (iii) large-scale recently established farms, with large flocks, (iii-a) well located and buying chicks from third-party providers and (iii-b) remotely located and hatching their own chicks. The semi-intensive farms we surveyed were highly heterogeneous in terms of size, age, accessibility, management, opportunities and challenges. Farm location affects market access and influences the opportunities available to farmers, resulting in further diversity in farm profiles. The future of these semi-intensive farms could be compromised by several factors, including the competition with large-scale intensive farmers and with importations. Our study suggests that intensification trajectories in rural areas of LMICs are potentially complex, diverse and non-linear. A better understanding of intensification trajectories should, however, be based on longitudinal data. This could, in turn, help designing interventions to support small-scale farmers.