The following abstract was presented at the Implementation Science and Global Health satellite meeting on March 17, 2010 at Bethesda, Maryland.
Kenneth H Brown, MD
Professor of Nutrition
Director, International and Community Nutrition Program
University of California, Davis
- Maternal and Child Health and Nutrition in Bangladesh, D43-TW001267 (Project Information in NIH RePORTER)
- International Clinical, Operational, and Health Services research and Training Award (ICOHRTA)
- PI: Kenneth H Brown, MD, Department of Nutrition and Program in International and Community Nutrition, University of California, Davis, and Helen Keller International, Dakar, Senegal
The Program in International and Community Nutrition of the University of California, Davis (UCD) and the Africa Regional Office of Helen Keller International (HKI), a non-governmental organization, have established a joint program to promote collaborative nutrition-related and program-linked implementation research in sub-Saharan Africa, using the respective strengths of each participating organization. In particular, the University provides research expertise through participation of faculty members, postdoctoral research fellows, and graduate students in program planning and evaluation; and HKI provides program management expertise, access to ongoing nutrition programs for conducting applied research, identification of program-related research needs, and strong channels for program and policy advocacy. Financial support for individual projects is provided by the donor agencies that support the respective intervention programs and/or traditional health research funding agencies. The general research methods that are employed include: 1) formative research for program design, 2) critical evaluations of factors associated with program coverage and utilization, and 3) efficacy and effectiveness trials of program impact. UCD and HKI are also collaborating with UNICEF and the West African Health Organization to promote the creation of a Regional Initiative for Public Nutrition Research and Training.
The specific research topics investigated under the linkage program include community-based management of acute malnutrition (CMAM), infant and young child nutrition (IYCN), control of micronutrient deficiencies, with a particular focus on vitamin A supplementation (VAS) and zinc supplementation, and industrial-scale food fortification (FF). In the area of CMAM research, we studied the effects of a novel, community-based nutritional screening platform, using measurements of mid-upper arm circumference in the context of the Malian semi-annual National Nutrition Week. We are also carrying out a community-based trial to measure the incidence of moderate and severe acute malnutrition and to assess the impact of different dietary treatment regimens on continued program participation and recovery from moderate acute malnutrition. In the area of IYCN, we have completed a situational analysis of national policies, training materials, intervention program coverage, and program impact in six Sahelian countries; and we are now assisting with identifying relevant research priorities.
Research on VAS involves post-event coverage surveys to determine the factors that predict which children do or do not receive vitamin A supplements, so the programs can better target the “hard to reach.” Research on zinc interventions includes evaluation of methods to assess zinc status and studies of the optimal dose (amount and frequency) of supplemental zinc and potential delivery systems. In the area of food fortification, we are conducting fortification rapid assessment (“FRAT”) surveys to identify suitable food vehicles for fortification, and we are completing evaluations of the population coverage and nutritional impact of food fortification programs.
This new approach to linking an academic institution responsible for scientific research and an agency charged with program implementation provides a model for conducting implementation research more efficiently than is possible with each type of agency working independently. More financial resources should be directed to encourage such institutional arrangements and provide longer term sustainability.
Updated April 2010