Food value chain interventions and nutritional outcomes: a review of evidence and recommendations for future assessments.

Food value chains (FVC) have become an important framework for the assessment of interventions to improve nutritional outcomes during the past decade, and recent literature indicates considerable agreement about FVC importance and potential impact pathways. Despite the usefulness of the FVC framework, the majority of studies reviewed provide only conceptual models or descriptive analyses of linkages with nutrition, limiting their usefulness for quantitative assessment of intervention impacts. Fewer than five studies of 113 reviewed measure the impacts of FVC interventions on nutritional outcomes or provide study protocols for that purpose. In addition to randomized controlled trials, comparative analysis and systems modeling methods will provide relevant evidence about the effectiveness of FVCs for improvement of nutrition.

The food, fuel, and financial crises affect the urban and rural poor disproportionately: a review of the evidence.

The vulnerability of the urban poor to the recent food and fuel price crisis has been widely acknowledged. The unfolding global financial crisis, which brings higher unemployment and underemployment, is likely to further intensify this vulnerability. This paper reviews the evidence concerning the disproportionate vulnerability of the urban compared with the rural poor to these types of shocks. It reviews some of the unique characteristics of urban life that could make the urban poor particularly susceptible to price and financial shocks and summarizes the evidence regarding the disproportionate vulnerability of the urban poor. The focus is on impacts on poverty, food insecurity, and malnutrition. The review shows that although the urban poor are clearly one of the population groups most affected by the current (and previous) crises, the rural poor, landless, and net buyers are in no better position to confront the crisis without significant suffering. The poorest of the poor are the ones who will be most affected, irrespective of the continent, country, or urban or rural area where they live. The magnitude and severity of their suffering depends on their ability to adapt and on the specific nature, extent, and duration of the coping strategies they adopt. A better understanding of how these coping strategies are used and staggered is critical to help design triggers for action that can prevent households from moving to more desperate measures. Using these early coping strategies as early warning indicators could help prevent dramatic losses in welfare.

Improving results for nutrition: a commentary on an agenda and the need for implementation research.

Research and implementation often exist in separate worlds. To improve results for nutrition, the nutrition research community needs to go beyond "what" works to understand "how" it works. If they do not, nutrition research risks becoming irrelevant to the needs of those who actually make policies and implement programs. Researchers must prioritize research on effectiveness of policies and programs. They should incorporate knowledge and tools of social sciences, including economics, sociology, political science, and management into their work. They should pay greater attention to environmental and institutional variables and understand change strategies, knowledge utilization, and policy processes. Fundamentally, research on implementation should use a systematic approach to produce generalizable evidence and conceptual models, tools, and methods that are communicated effectively to policymakers and programmers. Nutrition researchers need not expand far beyond their disciplinary comfort zone to do this, but they do need to build bridges with other fields to have greater success in addressing nutritional challenges.

Stunted child-overweight mother pairs: prevalence and association with economic development and urbanization.

This paper explores the prevalence of the coexistence of a stunted child and an overweight mother in the same household (SCOWT), a somewhat paradoxical phenomenon when found in the developing world. It tests whether this phenomenon is associated with a country's level of economic development and urbanization and, by implication, the nutrition transition. It then highlights policy directions for public nutrition. Data from 42 Demographic and Health Surveys in Africa, Asia, and Latin America were used. Stunting was defined as height-for-age < -2 SD of the reference population, and maternal overweight as a body-mass index > 25 kg/m2. World Bank and United Nations figures were used for gross domestic product (GDP) per capita (an indicator of economic development) and for level of urbanization. Descriptive statistics were derived, and regression analysis was used to model the association between economic development, urbanization, and the prevalence of pairs of stunted children and overweight mothers. The prevalence of this phenomenon is generally below 10%, except in four countries, three of them in Latin America. The phenomenon is generally more prevalent in Latin America than in Africa, though not necessarily more prevalent in urban than in rural areas. The analysis finds that the phenomenon is associated with economic development, but not urbanization, and that it does differ between urban and rural areas and regions. The association with GDP per capita supports the hypothesis that SCOWT increases with economic development, up to a point. SCOWT appears to be most prevalent, as expected, in those countries in the midst of the nutrition transition. Recognizing this phenomenon is important for delineating strategies that respond to the differential needs of individuals within the household and do not just affect the household as a whole. This may become especially important with future economic development and, potentially, urbanization.