Measuring childcare practices

Malnutrition afflicts nearly 170 million preschool children in developing countries, or every third child under the age of five. It plays a role in more than half of all preschooler child deaths—over 5 million preventable deaths per year. Those who survive often fail to achieve their full mental and physical potential. The scourge of child malnutrition undermines both economic growth and equity.

Neither sufficient food in the community nor sufficient food in the household ensures that vulnerable young children will be adequately nourished. In addition to access to food, young children need a healthy and sanitary environment and nurturing care. The first two to three years of life are now recognized as a critical window of opportunity for interventions to ensure child survival, health, and development. It is during these very early years of life that care and feeding practices
can determine who survives and who thrives.

Well-nourished and well-nurtured children grow and develop physically, cognitively, emotionally, and socially. They are more likely to do well in school and to fully develop their potential to contribute to national development than are poorly nourished or poorly nurtured children. Failure to protect and ensure child survival and development entails many costs for families, communities, and nations.

Globally, both governments and nongovernmental organizations are engaged in a variety of programs directed toward ensuring child survival and development. IFPRI’s research on nutrition and household welfare contributes to these goals. But in order to monitor progress and evaluate the effectiveness of nutrition programs, staff need simple indicators to assess improvements in child care and feeding. The
adoption of such indicators will facilitate the formulation and implementation of national nutrition strategies based on best practices in child survival and development.

With a strong focus on methodology, the authors of this review bridge a gap between researchers and technical program staff by describing program measurement approaches, problems, and solutions. The authors also highlight the simpler measurement methods and indicators without sacrificing measurement validity. The immediate aim of this work is to offer practical suggestions to enhance monitoring and evaluation of child nutrition programs. Ultimately, this can contribute to the overarching goals of accelerating progress in eradicating child malnutrition and achieving the Millennium Development Goal of cutting child mortality by two-thirds by 2015.