ABSTRACT DIGEST ON MATERNAL AND CHILD NUTRITION RESEARCH – ISSUE 24

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In this issue of Abstract Digest, we bring to you articles that examine the spatial heterogeneity and correlates of child malnutrition in districts of India, contributing factors for undernutrition in Indian children, national level programs that address the issue of malnutrition, and many other informative articles. Here are some of the highlights:

• Bora and Saikia (2018) analysed India’s population-based cross-sectional data from the National Family Health Survey (NFHS) conducted in 2015–2016, and provided an update on district-level disparities in the neonatal mortality rate (NMR) and the U5MR with special reference to Sustainable Development Goal 3 (SDG3) on preventable deaths among new-borns and children under five.
• Through a systematic review and meta-analysis of observational studies, Hume-Nixon and Kuper (2018) evaluated the association between childhood disability and malnutrition in low- and middle- income countries (LMICs) and concluded that children with disabilities are a vulnerable group for undernutrition in LMICs.
• A review article by Sesikeran and colleagues (2018) on child malnutrition in low- and middle-income countries, with special focus on India, highlighted the importance of promoting exclusive breastfeeding and appropriate complementary feeding practices, training the health service providers on counselling mothers and caregivers on breastfeeding and complementary feeding, and actions from multiple sectors and at multiple levels for the implementation of effective nutritional intervention programs.
• Using data from the recent round of National Family Health Survey (NFHS 2015–16), Khan and Mohanty (2018) examined the spatial heterogeneity and meso-scale correlates of child malnutrition across 640 districts of India and concluded that reduction of poverty, improving women’s education and health, sanitation and child feeding knowledge is crucial to reduce the prevalence of malnutrition across India.
• In the Handbook of Famine, Starvation, and Nutrient Deprivation:
  • Masoud and colleagues (2018) examined various contributing factors for undernutrition in Indian children and emphasized on addressing the biological and social risk factors responsible for poor nutrition in children under age five.
  • Soni and colleagues (2018) reviewed existing national level programs that address child nutrition, detailed their performance, and recommended changes that can enhance their impact on child nutrition.
• The MAL-ED Network Investigators re-analysed stool specimens from the multisite MAL-ED cohort study (2018) of children aged 0–2 years. The quantitative molecular diagnostics improved estimates of pathogen-specific burdens of childhood diarrhoea in the community setting. These data could improve the management of diarrhoea in low-resource settings.
• Spears (2018) quantitatively investigated the hypothesis that differences in sanitation, especially in the population density of open defecation, can statistically account for the differences in average child height across developing countries and explain India's gap relative to sub-Saharan Africa.
• Madan and colleagues (2018) conducted a comprehensive review of the influence of seasonal variation on undernutrition during the first 1000 days of life in rural South Asia reporting on six proximal determinants of undernutrition. They reported a compelling finding of significant seasonal variation for at least one determinant of undernutrition in all the available studies.
• Bliss and colleagues (2018) conducted a systemic review and found evidence that caregivers are able to use mid-upper arm circumference (MUAC) to detect severe acute malnutrition (SAM) in their children with minimal risk and many potential benefits to early case detection and coverage.
• Grellety and Golden (2018) showed that children with a low weight-for-height Z-score (WHZ) have at least as high a mortality risk as those with a low MUAC. The relative number of cases of SAM by MUAC alone, WHZ alone and those with both criteria have a dominant effect on the proportion of all SAM-related deaths that would occur in children excluded from treatment by a MUAC-only program.
• Mejia and colleagues (2018) assessed country cases for regulatory framework of public health interventions to provide vitamins and minerals and determined qualitatively whether there were provisions in the regulations that called for coordination among programs to ensure their innocuousness.
• DeFries and colleagues (2018) calculated intake of iron and other micronutrients from 84 food items from 1983 to 2011 and concluded that loss of coarse cereals in the Indian diet has substantially reduced iron intake without compensation from other food groups, particularly in states where rice rather than wheat replaced coarse cereals.
• Mukhopadhyay and colleagues (2018) assessed the role of fetal sex in modifying the effect of maternal macronutrient intake on the risk of small-for-gestational age (SGA) birth through a prospective, observational cohort study and concluded that higher carbohydrate and lower fat intakes early in pregnancy were associated with increased risk of male SGA births.
• Kulkarni’s research study highlighted that suboptimal lean body mass seems to be the link between the two forms of malnutrition, and these two problems need to be considered as dual manifestations of a common problem of the low-quality diets lacking important food groups such as dairy and other animal source foods.
• India State-Level Disease Burden Initiative CVD Collaborators (2018) analysed the prevalence and disability-adjusted life-years (DALYs) due to cardiovascular diseases and the major component causes in the states of India from 1990 to 2016 and presented the changing patterns of cardiovascular diseases and their risk factors.
• McAlpine and colleagues (2018) described the design, development, and evaluation of the Maternal Outcomes and Nutrition Tool (MONT), a novel cross‐cultural digital dietary data collection tool.
• Using the fourth round of district level household survey (DLHS-4), Rahman and Pallikadavath (2018) analysed the effects of Janani Suraksha Yojana (safe motherhood scheme, or JSY) on the utilization of several maternal and child health care (MCHC services under the continuum of care.
• Gupta and colleagues (2018) conducted a qualitative research to elicit various stakeholders’ (government and policy-related stakeholders, industry, civil Society, consumers) perspectives on a salt reduction strategy for India and found that most of the stakeholders were in alignment with the need for a salt reduction programme in India to prevent and control hypertension and related cardiovascular disease (CVD).
• Ved and colleagues (2018) analysed some of the key strategies for improving India’s Village Health Sanitation and Nutrition Committees (VHSNCs) functioning and concluded that while revised guidelines and training and support for facilitation are crucial in strengthening VHSNCs, deeper social reforms, health systems change and decentralisation are also needed to sustain VHSNCs as key mechanisms for community health governance.
• To address the paucity of case studies examining the experience of boundary‐spanning actors (BSAs) in the context of low‐ and middle-income countries, Pelletier and colleagues (2018) examined their experiences with multisectoral nutrition (MSN) in four Sub‐Saharan African countries and concluded that under the right conditions, intentional boundary spanning can be a feasible and acceptable practice within a multisectoral, complex adaptive system in low‐ and middle‐income countries.
• Gillespie and colleagues (2018) presented evidence from the Transform Nutrition research consortium (2012-2017), to inform and inspire action to address undernutrition in four high-burden countries (India, Bangladesh, Kenya, and Ethiopia) and globally.
• von Grebmer and colleagues (2018) presented the 2018 Global Hunger Index (GHI) report that focuses on hunger and the rising levels of forced migration—two interlinked challenges that require long-term action and political solutions.
• Building on the recently published Health Policy and Systems Research (HPSR) Reader on Human Resources for Health (HRH), George and colleagues (2018) have reflected on the added value of HPSR underpinning HRH.
• Ruducha and colleagues (2018) expanded the understanding of village dynamics in India and how first degree social and advice networks and cognitive perceptions of recently delivered women (RDW) in areas with and without women’s Self-Help Groups (SHGs) affect immediate breastfeeding.
• George and colleagues (2018) examined the equity effects of community action for maternal health led by Non-Government Organizations (NGOs) on facility deliveries and then examined the underlying implementation processes with implications for strengthening accountability of maternity care across three districts in Gujarat, India.

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