Menu ENN Search

Editorial

Dear Readers, a warm welcome to the 72nd issue of Field Exchange. 

As we publish this issue, we are conscious of many current crises where conflict is fuelling malnutrition: in the Democratic Republic of Congo, Ethiopia, Gaza, South Sudan, Sudan, Ukraine, and Yemen, to name just some. Where conflict is present, lack of access can severely limit humanitarian assessment and response, across all sectors including nutrition, exacerbating already difficult situations. These, in turn, are continually compounded by the effects of climate change and an increasing humanitarian funding gap1.  We greatly respect the continued efforts of all those working in such challenging circumstances to protect health and nutrition services and the lives of civilians caught up in humanitarian emergencies. Responding to such crises often necessitates innovative approaches – we welcome contributions to Field Exchange from those of you interested in sharing your programming experiences so that others can benefit from your learning. We recognise this alone cannot exact change, but we hope that in this way Field Exchange can continue to do what we can to support those experiencing crises.

In this edition, we revisit the topic of breastfeeding. Specifically, Smith et al. explore the value of human breastmilk, highlighting a triple win for health, environmental, and economic goals. As a predominantly dairy-based product, commercial formula milk has a significant impact on greenhouse emissions, which can be estimated using the ‘Green Feeding Tool’. In addition, another research-based tool, the ‘Mothers Milk Tool’, illuminates the hidden economic value that breastfeeding contributes to society through mothers’ unpaid care work. This article explores these two innovations to uncover breastfeeding’s critical contribution to sustainable health and development goals.

Two further articles focus on infant and young child feeding. Our first (Jomaa et al.) zooms in on Lebanon, where consistent efforts to improve breastfeeding and complementary feeding practices still run into challenges. Hearing from Action Against Hunger staff working in country, the authors disentangle existing knowledge gaps and cultural barriers to optimal practice and highlight how greater efforts are needed to support complementary feeding within high-risk, low-resource settings. In Zimbabwe, diet frequency and diversity of children aged 6–23 months also remains poor. Burns et al., writing about the multi-sectoral ‘Amalima Loko’ programme, show that a menu of locally available, predominantly indigenous foods can be used to develop feasible food-based recommendations for young children. The outcome? – a successful alternative to food transfers that could provide a blueprint for other settings.

On the theme of food systems, the article from Thurman et al. considers how generating consumer demand for healthier diets can drive positive change in food systems, but details how this is currently constrained by a lack of clear metrics. The authors describe their approach to developing common indicators (and trialling them in Bangladesh and Burkina Faso) and hope that these can inform longer-term efforts to develop a set of quality metrics that can measure programme efforts to generate consumer demand for nutritious diets. 

Also taking a food systems perspective, Fry and Sigh’s article  looks at changes in the food environment in urban and rural Cambodia, where traditional diets are being replaced with snack foods and sugar-sweetened beverages. Analysis of household survey data shows urban households procured more food from street vendors, markets, and mini marts. Interestingly, higher consumption of more processed unhealthy foods wasn’t necessarily replacing the consumption of healthier foods. Yet, disentangling these patterns from household economics and regional development is tricky. 

We also feature an extended piece from Somalia. In this special five-part article, Luc et al. delve into the spatial and temporal relationship between child wasting and food insecurity in Somalia. Some of the findings challenge key assumptions about that relationship. Results showing community-level clustering of wasting and food insecurity suggest the importance of capturing community-level drivers to support locally appropriate interventions and outcomes. Analysis of seasonal variation in child wasting showed two seasonal peaks that varied across livelihood zones and did not coincide with periods associated with the highest food insecurity. Results suggest that the assumption of food security as the primary causal factor of wasting might bias modelling crises and responses.

Building on the themes explored in the Somalia article, we selected three papers from the recent Acute Malnutrition in Africa’s Drylands series2. Venkat et al. highlight the importance of a nuanced understanding of seasonality in the region. Contrary to popular opinion, the primary peak in wasting incidence appears to occur in line with peak temperature and not in the preharvest period. In Chad, geospatial analysis showed that the distribution of child wasting and food insecurity were clustered (Luc et al.). Significantly, communities with high wasting prevalence were not the same as those with highest food insecurity. Fracassi et al. explore efforts to prevent wasting in Africa’s Drylands through a food systems lens. They found some common strengths between the eight countries studied (multistakeholder governance, existing policy frameworks, and costed interventions on social value chains and social transfers). The weaknesses – vulnerabilities from livelihoods, environment, and seasonality – need to be better addressed in policy and programme implementation. 

Finally, three of our summaries explore the neglected topic of child feeding and disability. A scoping review by Klein et al. finds there are insufficient policies, programmes, and evidence to support children with feeding difficulties and disabilities and their families. The limited resources and promising approaches that do exist are not standardised or universally used, with limited trained staff and insufficient funding to implement them. More specifically, Hayes et al. highlight how children with disabilities are excluded from malnutrition assessment with a lack of standardised methods to identify and monitor nutritional status. In response, the authors explore the use of mid upper arm circumference as of potential value in addressing this gap. Holt International’s Child Nutrition Programme aims to enhance the nutrition and feeding practices of vulnerable children, including orphans and abandoned children, many of whom have significant disabilities. Learnings from the evaluation by DeLacey et al. identify key factors for successful programming for this group as including local government engagement, secure funding, adequate staffing, continuous training, robust support systems, and efficient supply chains. In our next edition we hope to include a couple of original articles which home in more specifically on this important topic.

As always, this is just a brief rundown of the rich content that features across the breadth of this issue. We have more original articles and summaries to explore. Happy reading!

Anne, Nicky, Phil, and Tom

Read more...

1 Global Humanitarian Assistance Report 2023

2 https://journals.sagepub.com/toc/fnba/44/2_suppl

More like this

FEX: Special focus: Wasting patterns in Somalia

Gwenaelle Luc (Food and Agriculture Organization (FAO)), Modibo Keita (FAO), Baguinébié Bazongo (FAO), Brahima Diarra (FAO), Angelina Virchenko (FAO), Claudia...

FEX: Improving the way we address acute malnutrition in Africa’s drylands

View this article as a pdf Lisez cet article en français ici By Helen Young, Abdalmonim Osman, Dr. Marshak, Anne Radday, Emmanuella Olesambu, Nola Jenkins, Darana...

FEX: Seasonality of acute malnutrition and its drivers: a case study from eastern Chad

View this article as a pdf Summary of research 1 By Anastasia Marshak, Gwenaëlle Luc, Anne Radday and Helen Young Anastasia Marshak is a Senior Researcher at the...

FEX: Editorial

View this article as a pdf Dear readers, A warm welcome to the 68th edition of Field Exchange. As we bring you this edition, the world is facing a series of challenges:...

FEX: FEX 65 editorial themes

View this article as a pdf Dear readers, A warm welcome to the 65th edition of Field Exchange. This edition features a range of programming issues that unfortunately reflect...

FEX: Editorial

View this article as a pdf Dear readers, welcome to the 70th edition of Field Exchange. This edition features a diverse range of articles that we hope will stimulate your...

FEX: Unravelling community clustering in Chad

This is a summary of the following report: Luc G, Keita M, Houssoube F et al (2023) Community Clustering of Food Insecurity and Malnutrition Associated with Systemic Drivers in...

FEX: Seasonality in the African drylands: 15 years of evidence

This is a summary of the following paper: Venkat A, Marshak A, Young H et al. (2023) Seasonality of acute malnutrition in African drylands: Evidence from 15 years of SMART...

en-net: Technical series on the conceptual framework for addressing acute malnutrition in Africa’s drylands

Childhood wasting is an increasing global public health problem and studies have shown that emergency rates of global acute malnutrition persist in the longer-term in some...

FEX: Estimating the burden of wasting during COVID-19 based on empirical experiences in the Sahel

View this article as a pdf Lisez cet article en français ici By Saidou Magagi, Sumra Kureishy, Jessica Bourdaire and Katrien Ghoos Saidou Magagi is a monitoring,...

FEX: Short and long-term droughts, food security and child mortality in Ethiopia: Can sub-national surveys tell us more about the success of mitigation efforts?

Summary of presentation1 View this article as a pdf By Tefera Darge Delbiso, Chiara Altare, Jose Manuel Rodriguez-Llanes, Shannon Doocy and Debarati Guha-Sapir Tefera Darge...

FEX: A systematic review of nutrition interventions for mobile pastoralists

View this article as a pdf By Natasha Lelijveld and Emily Mates Natasha Lelijveld is a Senior Nutritionist at Emergency Nutrition Network (ENN). She previously worked at the...

FEX: The nutrition hotspot analysis: Prioritising intervention areas in the Sahel countries

View this article as a pdf Lisez cet article en français ici This article outlines the reflections, technical approach and development of a tool to identify the...

FEX: Editorial

Dear readers, Welcome to the 71st edition of Field Exchange, featuring a typically wide range of content from practitioners and researchers. This issue looks beyond the more...

FEX: Preventing child wasting in Africa’s Dryland through a food systems lens

This is a summary of the following paper: Fracassi P, Daget M, Seo S et al. (2023) Preventing Child Wasting in Africa's Dryland: An Exploratory Review of the Enabling...

FEX: Editorial

View this article as a pdf Editorial FEX67 Welcome to the 67th edition of Field Exchange which we are excited to announce includes a special subsection on the relationships...

FEX: Editorial perspective on the continuum of care for children with acute malnutrition

View this article as a pdf Lisez cet article en français ici By Jeremy Shoham and Marie McGrath, Field Exchange Co-Editors Rationale for FEX special edition We are...

FEX: Research gaps and priorities in nutrition in emergencies

View this article as a pdf Eilise Brennan is a Nutritionist at Emergency Nutrition Network (ENN) Natalie Sessions is a Senior Nutritionist at ENN This views piece summarises...

FEX: Human milk: A win-win-win for health, sustainability, and economics?

Julie Smith Honorary Associate Professor and ARC Future Fellow at The Australian National University Alessandro Iellamo Independent Consultant Tuan Nguyen Technical Advisor...

FEX: Nutritional care for children with feeding difficulties and disabilities

This is a summary of the following report: Klein A, Uyehara M, Cunningham A et al. (2023) Nutritional care for children with feeding difficulties and disabilities: A scoping...

Close

Reference this page

Editorial. Field Exchange 72, April 2024. p3. www.ennonline.net/fex/72/editorial

(ENN_7842)

Close

Download to a citation manager

The below files can be imported into your preferred reference management tool, most tools will allow you to manually import the RIS file. Endnote may required a specific filter file to be used.