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With research staff from more than 60 countries, and offices across the globe, IFPRI provides research-based policy solutions to sustainably reduce poverty and end hunger and malnutrition in developing countries.

researcher spotlight

Kalyani Raghunathan

Kalyani Raghunathan is Research Fellow in the Poverty, Gender, and Inclusion Unit, based in New Delhi, India. Her research lies at the intersection of agriculture, gender, social protection, and public health and nutrition, with a specific focus on South Asia and Africa. 

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experts

Nutrition, Diets, and Health

Rebecca Brander

Research Fellow

Rebecca Brander

Bio

Rebecca Brander is a Research Fellow with the Nutrition, Diets, and Health Unit, and is based at IFPRI-Washington, DC.

Nutrition, Diets, and Health

Publications

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Abstract

The cost and cost-effectiveness of integrating wasting prevention into screening in facility- and community-based platforms in Burkina Faso and Mali

2024Brander, Rebecca L.; Puett, Chloe; Becquey, Elodie; Leroy, Jef L.; Ruel, Marie T.; Sessou, Fidele Eric; Huybregts, Lieven
Details

The cost and cost-effectiveness of integrating wasting prevention into screening in facility- and community-based platforms in Burkina Faso and Mali

Objectives: The release of the new WHO guideline on the prevention and treatment of child wasting identified a dearth of rigorous evidence on the cost-effectiveness of wasting-related interventions, and especially so for interventions that integrate prevention into screening. We estimated the cost and cost-effectiveness of integrating prevention interventions – behavior change communication (BCC) and small quantity lipid-based nutrient supplements (SQ-LNS) – into a facility-based platform in Burkina Faso with enhanced BCC and a community-based platform in Mali with standard BCC.

Year published

2024

Authors

Brander, Rebecca L.; Puett, Chloe; Becquey, Elodie; Leroy, Jef L.; Ruel, Marie T.; Sessou, Fidele Eric; Huybregts, Lieven

Citation

Brander, Rebecca L.; Puett, Chloe; Becquey, Elodie; Leroy, Jef L.; Ruel, Marie T.; Sessou, Fidele Eric; and Huybregts, Lieven. 2024. The cost and cost-effectiveness of integrating wasting prevention into screening in facility- and community-based platforms in Burkina Faso and Mali. Current Developments in Nutrition 8 (Supplement 2): 102929. https://doi.org/10.1016/j.cdnut.2024.102929

Country/Region

Burkina Faso; Mali

Keywords

Africa; Sub-saharan Africa; Western Africa; Disease Prevention; Wasting Disease (nutritional Disorder); Cost Analysis; Costs

Language

English

Access/Licence

Open AccessCC-BY-NC-ND-4.0

Links

https://doi.org/10.1016/j.cdnut.2024.102929 Source record

Record type

Abstract

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Abstract

Can Growth Monitoring and Promotion (GMP) improve child growth and development? A critical review of the epidemiological foundations

2024Leroy, Jef L.; Larson, Leila M.; Brander, Rebecca L.; Frongillo, Edward A.; Ruel, Marie T.; Avula, Rasmi
Details

Can Growth Monitoring and Promotion (GMP) improve child growth and development? A critical review of the epidemiological foundations

Objectives: GMP programs have been globally implemented for many decades, but the epidemiological foundations of GMP have never been reviewed. We evaluated whether commonly used GMP criteria can be used for diagnosis or screening, i.e., if they accurately identify current or predict subsequent inadequate growth or development in individual children. Methods: We conducted a critical review of the literature and analyzed growth patterns in well-nourished children. We estimated the predictive accuracy of commonly used GMP criteria by regressing growth status and developmental scores at 18 and 24 months on these criteria during infancy, using longitudinal data from high-, middle-, and low-income countries. The root mean square error (RMSE), sensitivity (Se) and specificity (Sp) were used as measures of predictive accuracy. Results: Healthy children follow highly variable growth trajectories which challenges the notion that growth information alone can be used to distinguish between current or subsequent healthy or inadequate growth in individual children. The most used GMP criteria (low weight-for-age Z-score, inadequate weight gain) do not provide a clear diagnosis because they cannot distinguish between being too thin or too short. GMP criteria are also not meaningful for screening individual children because they do not accurately predict (low Se, low Sp, and high RMSE) inadequate growth later in childhood. The same holds for growth indices which do not accurately identify individual children at risk of concurrent or later suboptimal development. Conclusions: GMP, as currently designed, does not have the epidemiological basis needed to justify its widescale implementation. Our results do not challenge the need to support parents of young children, but research is needed to identify how regular meetings with parents can be optimized to improve the nutrition, health, and development of their young children in LMICs.

Year published

2024

Authors

Leroy, Jef L.; Larson, Leila M.; Brander, Rebecca L.; Frongillo, Edward A.; Ruel, Marie T.; Avula, Rasmi

Citation

Leroy, Jef L.; Larson, Leila M.; Brander, Rebecca L.; Frongillo, Edward A.; Ruel, Marie T.; and Avula, Rasmi. Can Growth Monitoring and Promotion (GMP) improve child growth and development? A critical review of the epidemiological foundations. Current Developments in Nutrition 8 (Supplement 2). https://doi.org/10.1016/j.cdnut.2024.102966

Keywords

Child Growth; Child Development; Epidemiology; Nutrition; Health

Language

English

Access/Licence

Open AccessCC-BY-NC-ND-4.0

Links

https://doi.org/10.1016/j.cdnut.2024.102966 Source record

Record type

Abstract

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Journal Article

Prevalence and correlates of stunting among a high-risk population of Kenyan children recently hospitalized for acute illnesses

2024
Atlas, Hannah E.; Brander, Rebecca L.; Tickell, Kirkby D.; Bunyige, Lucy; Oongo, Susan; McGrath, Christine J.; John-Stewart, Grace C.; Richardson, Barbra A.; Singa, Benson O.; Denno, Donna M.
…more Walson, Judd L.; Pavlinac, Patricia B.
Details

Prevalence and correlates of stunting among a high-risk population of Kenyan children recently hospitalized for acute illnesses

Stunting (length/height-for-age z-score < –2) is associated with significant morbidity and mortality among children under 5 years of age in sub-Saharan Africa. Children who are stunted and recently hospitalized for acute illness may be at particularly elevated risk for post-discharge mortality. In this cross-sectional analysis, we measured the prevalence of stunting at hospital discharge and identified host, caregiver, and environmental correlates of stunting among children aged 1–59 months in Western Kenya enrolled in the Toto Bora Trial. Child age- and site-adjusted prevalence ratios were estimated using Poisson regression. Of the 1,394 children included in this analysis, 23% were stunted at hospital discharge. Older children (12–23 months and 24–59 months versus 0–5 months) had a higher prevalence of stunting (adjusted prevalence ratio [aPR]: 1.58; 95% CI: 1.04–2.36 and aPR: 1.59; 95% CI: 1.08–2.34, respectively). HIV-exposed, uninfected children (aPR: 1.94; 95% CI: 1.39–2.70), children with HIV infection (aPR: 2.73; 95% CI: 1.45–5.15), and those who were never exclusively breastfed in early life (aPR 2.51; 95% CI: 1.35–4.67) were more likely to be stunted. Caregiver education (primary school or less) and unimproved sanitation (pit latrine without slab floor or open defecation) were associated with increased risk of stunting (aPR: 1.94; 95% CI: 1.54–2.44; aPR: 1.99; 95% CI: 1.20–3.31; aPR: 3.57; 95% CI: 1.77–7.21, respectively). Hospital discharge represents an important opportunity for both identifying and delivering targeted interventions for nutrition-associated poor outcomes among a high-risk population of children.

Year published

2024

Authors

Atlas, Hannah E.; Brander, Rebecca L.; Tickell, Kirkby D.; Bunyige, Lucy; Oongo, Susan; McGrath, Christine J.; John-Stewart, Grace C.; Richardson, Barbra A.; Singa, Benson O.; Denno, Donna M.; Walson, Judd L.; Pavlinac, Patricia B.

Citation

Atlas, Hannah E.; Brander, Rebecca L.; Tickell, Kirkby D.; Bunyige, Lucy; Oongo, Susan; McGrath, Christine J.; et al. 2023. Prevalence and correlates of stunting among a high-risk population of Kenyan children recently hospitalized for acute illnesses. American Journal of Tropical Medicine and Hygiene 110(2): 356-363. https://doi.org/10.4269/ajtmh.23-0050

Country/Region

Kenya

Keywords

Eastern Africa; Sub-saharan Africa; Africa; Children; Hospitals; Morbidity; Mortallity; Stunting

Language

English

Access/Licence

Limited Access

Links

https://doi.org/10.4269/ajtmh.23-0050 Source record

Record type

Journal Article