hehe f foundationoundation g glancelance · malnutrition—one of the most complex challenges for...
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1
THE FOUNDATION AT A GLANCETHE FOUNDATION AT A GLANCE
FOCUSED AND GLOBAL – THE FOUNDATION FOR THE STUDY OF THE PROBLEMS OF NUTRITION IN THE WORLD
HIGH-IMPACT – RESEARCH PROJECTS TO REDUCE MALNUTRITION
INNOVATIVE – FOR SUCCESS
CAPACITY BUILDING – AS A BASIS FOR IMPROVEMENT
SUSTAINABILITY – A KEY MISSION
ENDURABLE NUTRITION – THE PRESCRIPTION FOR SUCCESS
PUBLIC HEALTH – ORIENTATED
EVIDENCE-BASED – PROACTIVITY
PARTNERSHIP – FOR LONG-TERM SUCCESS
SOLUTION – ORIENTED ACTION RESEARCH
enLINK - ing FOR A BETTER WORLD
23
4 6 18 28 48 54 64 66 72
NUTRITION
TABL
E OF C
ONT
ENTS
enLINK-in
g FO
R A B
ETTE
R W
ORL
D
CA
PAC
ITY
BUIL
DIN
G
PUBL
IC H
EALT
H OR
IENT
ATED
CA
PAC
ITY
BUIL
DIN
G
PUBL
IC H
EALT
H O
RIEN
TATE
D
PRES
IDEN
T’S
MES
SAG
E
PRO
JECT
S IN
ITIA
TED B
Y TH
E FO
UND
ATIO
N:
T HE en
LIN
K IN
ITIA
TIVE
OTH
ER A
CTI
VITI
ES
V ISI
ON
PRO
FILE
OF
A N
UTR
ITIO
N IN
STIT
UTE
ON
GO
ING
PRO
JEC
TS
PUBL
ICA
TIO
NS
THE
FOU
ND
ATI
ON
THE
CO
UN
CIL
4
evid
ence
to
su
pp
ort
ex
clus
ive
bre
astf
eed
ing
ha
s ac
cum
ulat
ed,
than
ks
to
a b
ette
r un
der
stan
din
g
of
the
early
dev
elo
pm
ent
of
the
hum
an i
ntes
tinal
im
mun
e sy
stem
and
its
rel
atio
n to
the
mat
urat
ion
and
fun
ctio
ning
of
the
gut
. It
has
bec
om
e cl
ear
that
b
reas
t m
ilk i
s an
eve
n m
ore
co
mp
lex
pro
duc
t th
an
pre
vio
usly
tho
ught
, su
pp
ort
ing
no
t o
nly
the
heal
thy
gro
wth
o
f th
e in
fant
, b
ut
also
th
e d
evel
op
men
t o
f th
e g
ut m
icro
bio
ta a
nd t
he i
ntes
tinal
im
mun
e sy
stem
, w
hich
har
bo
rs m
ore
cel
ls o
f th
e im
mun
e sy
stem
tha
n al
l oth
er ly
mp
hoid
org
ans
tog
ethe
r. O
n p
age
34 o
f th
is r
epo
rt,
Alla
n W
alke
r p
rese
nts
new
p
rote
ctiv
e p
rop
ertie
s an
d f
unct
ions
of
bre
ast
milk
. B
eyo
nd t
he w
ell-k
now
n p
rote
ctio
n o
f th
e in
fant
by
com
po
nent
s o
f the
ad
aptiv
e im
mun
e sy
stem
suc
h as
Ig
A,
bre
ast
milk
als
o c
ont
ains
co
mp
one
nts
cap
able
o
f sup
po
rtin
g to
lera
nce
of b
enef
icia
l mic
roo
rgan
ism
s an
d
dam
pen
ing
an
in
flam
mat
ory
re
spo
nse,
b
oth
hi
ghl
y su
pp
ort
ive
for
the
pro
gre
ssiv
e co
loni
satio
n o
f th
e g
ut b
y b
enef
icia
l m
icro
org
anis
ms.
In
turn
, th
e g
ut m
icro
bio
ta c
ont
ribut
e to
the
“ed
ucat
ion”
o
f th
e im
mun
e sy
stem
; th
ey p
rovi
de
ener
gy
sour
ces
and
vita
min
s to
the
ho
st.
They
als
o c
ont
ribut
e to
in
test
inal
ep
ithel
ial
inte
grit
y an
d r
epre
sent
a b
arrie
r ag
ains
t co
loni
satio
n w
ith m
icro
bia
l pat
hog
ens.
Tak
en
tog
ethe
r, th
e co
ntrib
utio
n o
f th
e m
oth
er’s
milk
—w
hich
is
hig
hly
adap
ted
to
her
ow
n in
fant
and
the
ir co
mm
on
envi
ronm
ent—
to
the
pro
tect
ion
of
the
infa
nt,
the
mat
urat
ion
of
its i
ntes
tinal
muc
osa
and
its
im
mun
e sy
stem
, is
eve
n m
ore
im
po
rtan
t th
an
pre
vio
usly
tho
ught
. In
real
ity, t
he p
rote
ctiv
e fu
nctio
ns
des
crib
ed b
y A
llan
Wal
ker
are
not
“new
” p
er s
e;
wha
t is
new
are
the
pre
cio
us r
esul
ts o
f th
e re
sear
ch
wo
rk, w
hich
ena
ble
s us
to
und
erst
and
the
pro
cess
.A
ctio
n is
bad
ly n
eed
ed t
o i
ncre
ase
the
low
rat
es
of
excl
usiv
e b
reas
tfee
din
g
in
man
y p
arts
o
f th
e w
orld
if
we
wan
t to
fig
ht
mal
nutr
itio
n an
d
the
man
y d
isea
ses
rela
ted
to
it,
and
the
Fo
und
atio
n d
oes
giv
e hi
gh
prio
rity
to s
uch
pro
ject
s. I
nitia
tives
us
ing
no
vel
stra
teg
ies
to e
nco
urag
e b
reas
tfee
din
g
are
wel
com
e.
One
su
cces
sful
ex
amp
le—
to
be
cop
ied
an
d
exp
and
ed—
is
a st
udy
sup
po
rted
b
y th
e Fo
und
atio
n an
d p
ublis
hed
thi
s ye
ar (
1, 2
). Th
e in
vest
igat
ors
, a
mul
tidis
cip
linar
y te
am f
rom
Chi
na
and
A
ustr
alia
, sh
ow
th
at
in
Chi
na
sho
rt
pho
ne
mes
sag
es
sent
to
b
reas
tfee
din
g
mo
ther
s ca
n b
e su
cces
sful
in in
crea
sing
exc
lusi
ve b
reas
tfee
din
g, b
ut
ther
e is
stil
l a lo
ng w
ay t
o g
o.
Mal
nutr
itio
n—o
ne o
f th
e m
ost
co
mp
lex
chal
leng
es
for
pub
lic
heal
th
in
the
wo
rld
—is
th
e re
sear
ch
sub
ject
o
f m
ost
p
roje
cts
sub
mit
ted
to
o
ur
Foun
dat
ion.
In
th
is
annu
al
rep
ort
, W
alte
r W
ahli
(pag
e 38
) ex
pla
ins
how
muc
h m
alnu
triti
on,
whi
ch
affe
cts
40%
of
the
wo
rld’s
po
pul
atio
n, is
no
w c
ause
d
equa
lly b
y un
der
nutr
itio
n an
d o
vern
utri
tio
n. H
e em
pha
size
s th
at
mal
nutr
itio
n—th
roug
h ep
igen
etic
m
od
ifica
tions
of g
ene
exp
ress
ion—
may
hav
e se
rious
co
nseq
uenc
es f
or
the
heal
th o
f no
t o
nly
one
, b
ut
also
su
bse
que
nt
gen
erat
ions
. H
ow
ca
n w
e b
est
inte
rrup
t th
is v
icio
us c
ircle
, es
pec
ially
in
coun
trie
s w
here
the
bur
den
of
mal
nutr
itio
n is
hig
hest
? O
ne
of
the
log
ical
ap
pro
ache
s is
to
giv
e hi
gh
prio
rity
to t
he f
ight
ag
ains
t m
alnu
triti
on
in y
oun
g w
om
en,
in
ord
er
to
pro
tect
th
e fe
tus
dur
ing
p
reg
nanc
y,
and
in
infa
nts
and
yo
ung
chi
ldre
n, f
or
who
m t
he
imp
act
of
mal
nutr
itio
n in
lat
er l
ife i
s hi
ghe
st.
Man
y p
roje
cts
sup
po
rted
by
the
Foun
dat
ion
dur
ing
the
p
ast
five
year
s co
ncen
trat
ed o
n th
ese
seg
men
ts o
f th
e p
op
ulat
ion,
usi
ng v
ario
us a
pp
roac
hes.
One
was
en
cour
agin
g e
xclu
sive
bre
astf
eed
ing
dur
ing
the
firs
t si
x m
ont
hs o
f life
, whi
ch is
rec
og
nize
d t
o b
e th
e b
est
heal
th-p
rom
otin
g
mea
sure
fo
r in
fant
s,
pro
tect
ing
th
em
agai
nst
bo
th
und
er-
and
o
vern
utrit
ion.
B
ut
the
rate
s o
f ex
clus
ive
bre
astf
eed
ing
men
tione
d i
n m
any
sub
mitt
ed p
roje
cts
are
alar
min
gly
lo
w,
oft
en
in c
oun
trie
s w
ith a
ver
y hi
gh
bur
den
of m
alnu
triti
on.
E
xclu
sive
b
reas
tfe
ed
ing
h
as
alw
ays
be
en
reco
mm
end
ed w
ith c
onv
inci
ng a
rgum
ents
by
the
WH
O a
nd o
ther
inte
rnat
iona
l org
anis
atio
ns a
s w
ell a
s b
y he
alth
pro
fess
iona
ls. B
ut in
rece
nt y
ears
ad
diti
ona
l
PRES
IDEN
T’S M
ESSA
GE
67
One
of
the
Foun
dat
ion’
s m
ain
aim
s is
the
tra
nsfe
r o
f sc
ient
ific
an
d
tech
nolo
gic
al
kno
wle
dg
e to
lo
w-in
com
e co
untr
ies.
Th
e Fo
und
atio
n ad
vanc
es
nutr
itio
nal
scie
nce
bot
h b
y su
pp
orti
ng
nutr
itio
n re
sear
ch
pro
ject
s in
es
tab
lishe
d
inst
itut
es
and
un
iver
siti
es
and
b
y g
ivin
g
focu
sed
su
pp
ort
to
ex
isti
ng n
utri
tion
sch
ools
and
ed
ucat
iona
l pro
gra
ms.
To
furt
her f
ulfil
the
man
dat
e of
the
Co
unci
l and
als
o en
cour
age
sust
aina
ble
imp
rove
men
t in
nut
riti
on, a
p
roac
tive
str
ateg
ic a
rea
of a
ctiv
itie
s w
as in
trod
uced
in
200
3: T
he e
nLIN
K In
itia
tive
.
This
yea
r th
e m
obile
enL
INK
nut
riti
on li
bra
ry t
runk
ha
s b
een
add
ed. I
n ad
dit
ion
seve
ral e
-boo
ks h
ave
bee
n ad
ded
to
the
dig
ital
lib
rary
.
THE
enLI
NK
INIT
IATI
VE
• P
rom
otio
n o
f sp
ecifi
c re
sear
ch q
uest
ions
• T
he e
nLIN
K d
igita
l lib
rary
• S
mal
l mo
bile
enL
INK
lib
rary
tru
nk in
Eng
lish
& F
renc
h &
Sp
anis
h
• T
he la
rge
enLI
NK
lib
rary
tru
nk
One
of
the
Foun
dat
ion’
s m
ain
aim
s is
the
tra
nsfe
r o
f sc
ient
ific
an
d
tech
nolo
gic
al
kno
wle
dg
e to
lo
w-i
nco
me
coun
trie
s. T
he F
oun
dat
ion
adva
nces
nu
trit
iona
l sc
ienc
e b
oth
by
sup
po
rtin
g n
utri
tio
n re
sear
ch p
roje
cts
in e
stab
lishe
d i
nsti
tute
s an
d
univ
ersi
ties
and
by
giv
ing
fo
cuse
d s
upp
ort
to
exis
ting
nut
riti
on s
choo
ls a
nd e
duc
atio
nal p
rog
ram
s.
To fu
rthe
r fu
lfil t
he m
and
ate
of t
he C
ounc
il an
d a
lso
enco
urag
e su
stai
nab
le i
mp
rove
men
t in
nut
riti
on,
a p
roac
tive
, str
ateg
ic a
rea
of a
ctiv
itie
s w
as in
trod
uced
in
200
3: T
he e
nLIN
K In
itia
tive
.
enLINK
PROJ
ECTS
INIT
IATE
D BY
THE F
OUND
ATIO
N
89
“Don
’t fi
nd fa
ult.
Fin
d a
rem
edy.
” H
enry
For
d
THE
enLI
NK
INIT
IATI
VE
Sust
aina
bili
ty a
nd p
ublic
-hea
lth re
leva
nce
are
key
issu
es
for
all
activ
ities
of
the
Foun
dat
ion.
Res
earc
h p
roje
cts
need
to
resu
lt in
a s
hort
- an
d lo
ng-t
erm
pub
lic-h
ealth
im
ple
men
tatio
n. K
now
led
ge
and
kno
w-h
ow h
ave
to b
e su
stai
nab
le a
t al
l lev
els
of t
he p
opul
atio
n.
The
vast
ex
per
ienc
e of
th
e Fo
und
atio
n’s
Cou
ncil
mem
ber
s as
wel
l as
the
Foun
dat
ion’
s p
ast a
ctiv
ities
led
to
the
crea
tion
of th
e en
LIN
K In
itiat
ive,
a p
roje
ct w
hich
ill
ustr
ates
the
pro
activ
ity o
f th
e Fo
und
atio
n re
gar
din
g
its c
ore
issu
es.
This
ini
tiativ
e fo
cuse
s on
inf
orm
atio
n tr
ansf
er i
n th
e ar
ea o
f nu
triti
on a
nd m
alnu
triti
on a
s w
ell
as o
n th
e re
solu
tion
of
spec
ific
rese
arch
q
uest
ions
an
d
thei
r im
ple
men
tatio
n at
the
pub
lic-h
ealth
lev
el.
The
core
co
mp
eten
ce
and
ac
tivity
of
th
e Fo
und
atio
n is
th
e su
pp
ort
of n
utrit
ion
rese
arch
in
low
-inco
me
coun
trie
s.
The
enLI
NK
initi
ativ
e is
an
add
-on
to o
ur k
ey a
ctiv
ities
to
imp
rove
the
res
earc
h ca
pac
ity.
The
nam
e en
LIN
K c
omes
fro
m t
he o
ld E
nglis
h ve
rb
“to
enlin
k”,
mea
ning
“to
con
nect
, as
by
links
” or
“t
o ch
ain
tog
ethe
r”.
The
anal
ysis
of
the
sem
antic
re
latio
ns
of
“enl
ink”
re
veal
s re
late
d
wor
ds
whi
ch
illus
trat
e ou
r ce
ntra
l con
cep
ts a
nd a
ims:
to
conn
ect,
to
join
, to
asso
ciat
e, t
o un
ite, t
o tie
, to
conj
oin.
Our
mis
sion
is
to l
ink
and
joi
n cu
lture
s; t
o as
soci
ate
and
con
join
inst
itutio
ns a
nd p
eop
le lo
cally
to s
tud
y an
d
dim
inis
h th
e p
rob
lem
s of
mal
nutr
ition
glo
bal
ly.
Mal
nutr
ition
ca
n on
ly
be
solv
ed
by
“enl
inki
ng”—
conn
ectin
g—
diff
eren
t st
rate
gie
s an
d
app
roac
hes.
M
alnu
triti
on h
as t
o b
e ad
dre
ssed
uni
vers
ally
by
join
t st
rate
gie
s w
hich
ad
dre
ss m
any
leve
ls,
look
ing
at
the
leve
l of
med
ical
issu
es (s
uch
as in
fect
ion)
and
hyg
iene
(s
uch
as w
ater
qua
lity)
, pro
pos
ing
cha
nges
at
the
leve
l of
ag
ricul
ture
as
wel
l as
in th
e so
ciet
y at
larg
e, a
nd, l
ast
but
not
leas
t, w
orki
ng to
imp
rove
the
leve
l of e
duc
atio
n an
d in
form
atio
n.
The
dig
ital
enLI
NK
lib
rary
is
curr
ently
offe
ring
fre
e fu
ll-te
xt a
cces
s to
8 n
utrit
ion
jour
nals
and
mor
e th
an
30 e
-boo
ks.
The
libra
ry is
acc
essi
ble
fre
e of
cha
rge
to
reg
iste
red
use
rs w
ho a
ll re
ceiv
e a
per
sona
l pas
swor
d—
reg
istr
atio
n is
als
o fr
ee a
s lo
ng a
s th
e ap
plic
ant
com
es
from
a lo
w-in
com
e co
untr
y. T
he li
bra
ry is
con
tinuo
usly
up
dat
ed a
nd a
dap
ted
to s
pec
ific
need
s an
d in
resp
onse
to
use
r fe
edb
ack.
Evi
den
ce a
nd c
onte
nt w
hich
mak
e it
into
tex
tboo
ks a
re u
sual
ly m
ore
pra
ctic
e-re
late
d t
han
the
rese
arch
kno
wle
dg
e fr
om l
ates
t fin
din
gs
whi
ch i
s p
ublis
hed
in r
esea
rch
jour
nals
. The
refo
re t
he w
eig
ht o
f th
e lib
rary
lies
mor
e in
the
e-te
xtb
ook
sect
ion
to a
ssur
e a
goo
d b
asic
kno
wle
dg
e tr
ansf
er a
s w
ell a
s kn
owle
dg
e ac
cess
ibili
ty.
Des
pite
all
the
adva
nces
in
info
rmat
ion
tech
nolo
gy,
b
ooks
and
prin
ted
mat
eria
ls w
ill r
emai
n in
dis
pen
sab
le.
Dur
ing
the
rep
ortin
g p
erio
d,
smal
l an
d l
arg
e tr
unks
w
ere
sent
to
diff
eren
t in
stitu
tions
in A
fric
a. T
he e
nLIN
K
trun
ks in
itiat
ive
conc
lud
ed a
t th
e en
d o
f 20
14, a
nd f
or
the
mom
ent t
he m
ajor
effo
rts
will
be
focu
sed
on
dig
ital
cont
ent.
THE
enLI
NK
INIT
IATI
VE
Th
e en
LIN
K In
itia
tive
has
fou
r m
ain
leve
ls:
1.
e xp
lora
tion
in n
utrit
ion
– b
uild
ing
pra
ctic
al
rese
arch
cap
acity
2.
educ
atio
n in
nut
ritio
n
3.
elec
tro
nic
nutr
itio
n –
the
enLI
NK
dig
ital
libra
ry
4.
end
urab
le n
utrit
ion
1110
SOLUTIONS5
UTUTTUUUUUTTTTTTTTD
O N
OT
NEG
LECT
TH
E BA
SIS
For
near
ly 5
0 ye
ars,
the
Nes
tlé
Foun
dat
ion
has
pro
mo
ted
nut
riti
on
rese
arch
in
low
- an
d l
ow
er-
mid
dle
-inco
me
coun
trie
s to
imp
rove
hea
lth a
nd w
ell-
bei
ng. D
urin
g a
ll th
ese
year
s th
e ai
m o
f th
e su
pp
ort
ha
s b
een
to d
evel
op
and
str
eng
then
loca
l cap
acity
. Th
e lo
cal
ow
ners
hip
of
the
rese
arch
id
ea a
nd t
he
rese
arch
act
ivit
ies
was
and
sti
ll is
a c
entr
al a
spec
t fo
r fu
ndin
g.
The
resu
lt o
f th
is lo
ngst
and
ing
str
ateg
y ar
e m
ore
tha
n 50
0 p
ublis
hed
res
earc
h p
aper
s an
d
oft
en l
oca
l o
r ev
en i
nter
natio
nal
imp
lem
enta
tion
of
the
find
ing
s. T
he r
esea
rch
pro
ject
s sp
an t
he w
hole
en
LIN
K c
ircle
(Fi
g.
1),
and
the
y ha
ve c
ont
ribut
ed t
o
bet
ter
heal
th a
nd n
utrit
ure
of
the
who
le p
op
ulat
ion,
b
ut e
spec
ially
of w
om
en a
nd c
hild
ren.
The
“Hea
lth I
mp
act
Pyra
mid
” (1
), as
als
o d
iscu
ssed
in
las
t ye
ar’s
rep
ort
, un
der
lines
the
im
po
rtan
ce o
f a
pri
ori
tize
d g
lob
al a
pp
roac
h to
im
pro
ve h
ealt
h an
d n
utri
ture
by
focu
sing
on
spec
ific
pub
lic h
ealt
h is
sues
in
a hi
erar
chic
al a
pp
roac
h. S
oci
o-e
cono
mic
d
ete
rmin
ants
o
f h
eal
th
(i.e
. so
cio
-eco
no
mic
in
equa
lity,
po
vert
y, h
ous
ing
, et
c.)
are
at t
he b
ase
of
the
pyr
amid
. Ep
idem
iolo
gic
al d
ata
fro
m t
he la
st f
ew
year
s em
pha
size
the
imp
ort
ance
of
soci
o-e
cono
mic
d
eter
min
ants
as
the
maj
or
dri
ver
for
the
glo
bal
d
isea
se b
urd
en a
nd u
ntim
ely
dea
th. N
early
hal
f of t
he
wo
rld p
op
ulat
ion
lives
on
less
than
2.5
0 U
SD p
er d
ay;
80%
live
on
less
tha
n 10
USD
per
day
(2)
. W
ell o
ver
90%
of t
hese
ind
ivid
uals
live
in lo
w-in
com
e co
untr
ies,
th
e m
ajo
rity
of t
hem
bei
ng w
om
en a
nd c
hild
ren.
Mo
st d
isea
ses
dis
pro
po
rtio
nally
aff
ect
the
po
or.
Thi
s is
esp
ecia
lly t
he c
ase
for
infe
ctio
us d
isea
ses
and
acc
ord
ing
ly t
he t
erm
“in
fect
ious
dis
ease
s o
f p
ove
rty”
(ID
P) h
as b
een
coin
ed (
3).
Thes
e d
isea
ses
incl
ude
the
neg
lect
ed tr
op
ical
dis
ease
s (N
TD) a
s w
ell
as t
he “
clas
sic”
inf
ecti
ons
of
mal
aria
, tu
ber
culo
sis
and
HIV
(3)
. Th
e su
mm
ary
term
“in
fect
ious
dis
ease
s o
f p
ove
rty”
im
plie
s th
at i
t is
no
t en
oug
h to
co
ntro
l o
nly
one
dis
ease
; in
stea
d,
the
who
le p
acka
ge
of
dis
ease
s ne
eds
to b
e ad
dre
ssed
, whi
ch m
eans
tha
t a
mo
re h
olis
tic, b
ut a
t th
e sa
me
time
also
mo
re c
ausa
l, b
asic
ap
pro
ach
need
s to
be
cho
sen
for t
he c
ont
rol o
r el
imin
atio
n o
f the
se d
isea
ses
(3, 4
).
“Neg
lect
ed t
rop
ical
dis
ease
s” is
a w
ell-c
hose
n te
rm
po
intin
g t
o a
key
asp
ect:
the
se d
isea
ses
have
bee
n ne
gle
cted
. A
long
the
sam
e lin
es,
the
geo
gra
phi
c ar
eas
with
a h
igh
dea
th a
nd d
isea
se to
ll fr
om “
dis
ease
s o
f p
ove
rty”
hav
e b
een
neg
lect
ed r
egar
din
g b
asic
Fig
ure
1:
The
enLI
NK
cir
cle:
The
fiv
e ce
ntra
l fie
lds
of
inte
rven
tion
fo
r th
e co
ntro
l of
m
alnu
trit
ion,
hu
nger
and
pov
erty
ENLI
NK
CIRC
LE
1213
heal
th c
are,
cre
atio
n o
f a h
ealth
wo
rkfo
rce,
ed
ucat
ion
(incl
udin
g li
tera
cy),
kno
wle
dg
e sy
nthe
sis
and
sha
ring
an
d,
last
but
no
t le
ast,
kno
wle
dg
e im
ple
men
tatio
n.
The
num
ber
s o
f phy
sici
ans
cite
d b
elo
w a
s w
ell a
s th
e tw
o W
orld
map
per
map
s (s
ee F
igur
e le
gen
d) c
onv
ey
a ve
ry c
lear
—an
d o
ften
sti
ll ig
nore
d—
mes
sag
e.
Pub
lic h
ealt
h an
d n
utri
tio
n kn
ow
led
ge
cann
ot
be
imp
lem
ente
d w
itho
ut a
func
tiona
l co
mm
unity
-bas
ed
heal
th c
are
syst
em a
nd a
n ad
equa
tely
tra
ined
sta
ff.
As
we
all k
now
, th
ese
dis
ease
s ca
n b
e co
ntro
lled
in
man
y re
gio
ns o
f th
e w
orld
—us
ually
in t
he N
ort
hern
, w
ealt
hy p
arts
of
the
glo
be
(4).
Ho
wev
er,
ther
apy
and
es
pec
ially
p
reve
ntio
n an
d
targ
eted
p
ublic
he
alth
str
ateg
ies
at t
he l
evel
of
the
com
mun
itie
s (i.
e. c
om
mun
ity-
bas
ed i
nter
vent
ions
) w
ill r
educ
e th
is d
isea
se b
urd
en a
lso
in t
he p
oo
r, d
isad
vant
aged
re
gio
ns o
f the
wo
rld (5
). To
ach
ieve
this
, a b
asic
hea
lth
care
sys
tem
with
an
adeq
uate
num
ber
of
hosp
itals
, co
mm
unit
y-b
ased
hea
lth
cent
ers
equi
pp
ed w
ith
med
ical
do
cto
rs, n
urse
s an
d h
ealth
wo
rker
s is
nee
ded
. T
he l
atte
r st
rate
gy
is h
amp
ered
by
the
sho
rtag
e o
f he
alth
car
e p
erso
nnel
. Th
e g
lob
al m
edic
al a
nd
par
amed
ical
wo
rkfo
rce
is i
n cr
isis
in
mo
st l
ow
- an
d
low
er-m
idd
le-in
com
e co
untr
ies
(6).
It s
eem
s d
iffic
ult
to e
stim
ate
the
size
of
the
heal
thca
re w
ork
forc
e in
m
any
pla
ces
of t
he w
orld
: Ho
yler
et
al. r
epo
rted
tha
t no
nat
iona
l d
ata
abo
ut t
he h
ealt
h w
ork
forc
e w
ere
foun
d f
or
23 o
f th
e 57
co
untr
ies
cons
ider
ed b
y th
e W
HO
to
be
in a
hea
lth w
ork
forc
e cr
isis
(7).
The
sam
e ar
ticle
rep
ort
s th
at a
cro
ss lo
w-in
com
e co
untr
ies,
the
g
ener
al s
urg
eon
den
sity
ran
ged
fro
m 0
.13
to 1
.57
per
100
,000
po
pul
atio
n (7
). Th
e o
bst
etric
ian
den
sity
w
as fo
und
to
be
as lo
w a
s 0.
042
per
100
,000
and
the
an
esth
esio
log
ist
den
sity
in
som
e g
eog
rap
hic
area
s w
as s
imp
ly n
on-
exis
tent
(7).
Just
fo
r co
mp
aris
on,
the
g
ener
al s
urg
eon
den
sity
in
the
US
is a
pp
roxi
mat
ely
4.82
in
rura
l an
d 8
.48
in u
rban
are
as (
8).
Acc
ord
ing
to
a r
ecen
t W
HO
rep
ort
, 11
of
the
47 S
ub-S
ahar
an
Afr
ican
nat
ions
do
no
t ha
ve a
med
ical
sch
oo
l an
d
24 h
ave
onl
y o
ne e
ach
(6).
As
com
par
ed t
o m
any
oth
er n
umb
ers,
the
se m
edic
al s
cho
ol
num
ber
s ar
e ea
sy t
o c
olle
ct a
nd m
ost
lik
ely
corr
ect—
sinc
e th
ey
do
no
t re
qui
re a
sp
ecifi
c ep
idem
iolo
gic
sam
plin
g
tech
niq
ue o
r sp
ecifi
c d
efin
itio
n cr
iteria
but
onl
y th
e ab
ility
to
co
unt
up t
o 1
68,
corr
esp
ond
ing
to
the
nu
mb
er o
f m
edic
al s
cho
ols
in
Sub
-Sah
aran
Afr
ica
(6).
(Fo
r co
mp
aris
on:
in t
he U
SA, t
here
are
mo
re t
han
140
offi
cial
ly a
ccre
dite
d M
D-g
rant
ing
inst
itutio
ns.)
The
rela
tio
n b
etw
een
po
vert
y an
d p
oo
r he
alth
is
wel
l es
tab
lishe
d.
Usu
ally
po
vert
y is
reg
ard
ed a
s th
e ca
use
of
ill h
ealth
. H
ow
ever
, it
is w
ell
kno
wn
that
p
oo
r he
alth
is
also
the
driv
er f
or
incr
easi
ng p
ove
rty.
Th
is b
i-dire
ctio
nalit
y le
ads
to a
vic
ious
circ
le.
An
old
sa
ying
att
ribut
ed to
Sch
open
haue
r rea
ds
that
“H
ealth
is
no
t ev
eryt
hing
, b
ut e
very
thin
g i
s no
thin
g w
itho
ut
heal
th”.
Esc
ape
from
pov
erty
sta
rts
with
goo
d h
ealth
; ye
t im
pai
red
hea
lth i
s o
ne o
f th
e m
ajo
r d
river
s o
f p
ove
rty.
The
cen
tral
imp
ort
ance
of
bas
ic h
ealth
car
e
at th
e co
mm
unity
leve
l and
the
key
role
of c
omm
unity
-b
ased
int
erve
ntio
ns i
n th
e he
alth
and
ed
ucat
iona
l se
cto
r b
eco
mes
sel
f-ex
pla
nato
ry.
Thes
e g
eog
rap
hic
hots
pot
s of
pov
erty
-rel
ated
dis
ease
s ar
e al
so c
lass
ified
as
“re
sour
ce-li
mite
d a
reas
”—a
mor
e ap
pro
pria
te te
rm
mig
ht b
e “r
esou
rce-
neg
lect
ed a
reas
”.
Thi
s co
nste
llati
on
calls
fo
r th
e in
vest
men
t in
lo
cal
cap
aciti
es a
nd c
apac
ity b
uild
ing
thr
oug
h ed
ucat
ion,
tr
ansf
er a
nd s
ynth
esis
of k
now
-ho
w, t
rain
ing
of h
ealth
ca
re p
rofe
ssio
nals
and
bui
ldin
g o
f a
heal
th c
are
and
ed
ucat
iona
l inf
rast
ruct
ure.
Imp
lem
enta
tion
of t
he v
ast
kno
wle
dg
e in
dis
ease
pre
vent
ion
and
the
rap
y ca
n o
nly
be
succ
essf
ul if
the
re is
loca
l cap
acity
.
The
Foun
dat
ion
reco
gni
zed
sin
ce it
s ea
rly d
ays
that
it
is t
he lo
cal c
apab
ility
and
cap
acity
whi
ch is
cru
cial
fo
r an
y im
pro
vem
ent
and
fur
ther
dev
elo
pm
ent.
W
ell-
trai
ned
pro
fess
iona
ls a
t al
l le
vels
rem
ain
the
bas
is f
or
heal
th m
aint
enan
ce a
nd p
ove
rty
red
uctio
n.
This
is
wha
t th
e Fo
und
atio
n ha
s p
ursu
ed f
or
near
ly
50 y
ears
: b
uild
lo
cal
cap
acit
y in
nut
riti
on
rese
arch
(o
ften
in
the
per
son
of
phy
sici
ans)
fo
r a
loca
l, su
stai
nab
le im
ple
men
tatio
n. A
pp
licab
le k
now
led
ge
is
the
bes
t cur
renc
y to
co
mb
at m
alnu
triti
on
and
red
uce
po
vert
y.
Map
Leg
end
: P
hysi
cian
Wo
rkfo
rce
(ab
ove
):
The
larg
est
num
ber
of
p
hysi
cian
s ar
e fo
und
in
C
hina
(co
rres
pon
din
g t
o th
e la
rges
t te
rrit
ory
on
the
map
). A
hom
ogen
eous
dis
trib
utio
n of
doc
tors
co
rres
pon
din
g t
o th
e w
orld
pop
ulat
ion
wou
ld r
esul
t in
a r
ate
of 1
24 p
hysi
cian
s p
er 1
00,0
00 in
div
idua
ls.
As
can
be
seen
cl
earl
y,
mor
e th
an
50%
of
th
e p
hysi
cian
wor
kfor
ce i
s b
ased
in
terr
itor
ies
whe
re
abou
t 1/
5 of
the
wor
ld p
opul
atio
n is
livi
ng.
On
the
othe
r en
d o
f th
e sp
ectr
um, t
he w
orst
-ser
ved
1/5
of
the
wor
ld p
opul
atio
n ha
s on
ly 2
% o
f th
e p
hysi
cian
w
orkf
orce
. Te
rrit
ory
size
on
the
map
cor
resp
ond
s to
the
pro
por
tion
of
all
phy
sici
ans
(doc
tors
) th
at
wor
k in
the
cor
resp
ond
ing
cou
ntry
or
terr
itor
y.
Mat
erna
l Mo
rtal
ity
(bo
tto
m):
A
ccor
din
g t
o th
e W
HO
, ev
ery
day
ap
pro
xim
atel
y 80
0 w
omen
die
fro
m p
reve
ntab
le c
ause
s re
late
d t
o p
reg
nanc
y an
d/o
r ch
ildb
irth
. Th
e m
ap s
how
s th
at
the
hig
hest
rat
es o
f m
ater
nal m
orta
lity
are
foun
d in
th
e So
uthe
rn h
emis
phe
re.
In d
evel
opin
g c
ount
ries
th
e m
ater
nal
mor
talit
y ra
tio
is
arou
nd
230
per
10
0,00
0 liv
e b
irth
s—in
cer
tain
cou
ntri
es t
his
rate
is
as h
igh
as 1
,000
. The
siz
e of
the
diff
eren
t te
rrit
orie
s co
rres
pon
ds
to t
he p
rop
orti
on o
f d
eath
s of
wom
en
dur
ing
the
pre
gna
ncy
per
iod
, up
to
6 w
eeks
aft
er
giv
ing
bir
th.
© w
ww
.wor
ldm
app
er.o
rg
1514
THE e
nLIN
K LIB
RARY
- 7D
/24H
you
can
easi
ly f
ind
rel
iab
le a
nd e
vid
ence
-bas
ed
info
rmat
ion
on
nutr
itio
n an
d h
ealt
h-re
late
d t
op
ics.
In
the
enL
INK
lib
rary
the
re i
s no
dan
ger
of
bei
ng
dro
wne
d in
the
info
rmat
ion
floo
d.
The
enL
INK
use
rs h
ave
acce
ss,
wit
h th
e he
lp o
f O
vid
SP,
to e
-jo
urna
ls a
nd b
oo
k co
nten
t. F
urth
er,
user
s ca
n ta
ke a
dva
ntag
e o
f Ovi
dSP
’s se
arch
, ale
rtin
g,
and
res
ults
man
agem
ent
too
ls t
o s
tay
curr
ent
on
thei
r re
sear
ch
inte
rest
s.
The
la
ngua
ge
op
tio
ns
(Eng
lish
or
Fren
ch)
mak
e th
e us
e o
f th
is t
oo
l ev
en
mo
re u
ser-
frie
ndly
. The
re a
re n
o “
op
enin
g h
our
s” fo
r th
is li
bra
ry –
enL
INK
can
be
acce
ssed
7d
/24h
. If
yo
u ar
e fr
om
a l
ow
-inc
om
e co
untr
y an
d i
f yo
u ar
e w
ork
ing
in
your
co
untr
y o
f o
rig
in,
app
ly a
t w
ww
.enl
ink.
org
to
b
eco
me
a
reg
iste
red
u
ser.
(Ple
ase
read
the
inst
ruct
ions
car
eful
ly a
nd f
ollo
w t
he
gui
del
ines
. Reg
istr
atio
n an
d u
se o
f the
enL
INK
lib
rary
ar
e b
oth
free
of c
harg
e.)
enLI
NK
use
r st
atis
tics
(a
s o
f Dec
emb
er 3
1, 2
014)
• 25
2 re
gis
tere
d u
sers
• R
egis
trat
ions
fro
m 2
0 co
untr
ies
• R
egul
ar a
cces
s fr
om u
sers
livi
ng in
Mor
occo
, U
gan
da,
Gha
na, N
iger
ia, E
thio
pia
, Ind
ones
ia,
Mya
nmar
, Vie
tnam
, Nep
al, K
enya
, Sud
an,
Cam
eroo
n an
d T
ogo
• A
vera
ge
dur
atio
n of
acc
ess:
11
min
utes
• M
ost
freq
uent
ly a
cces
sed
jour
nal:
Nut
riti
on
Tod
ay
Mos
t fr
eque
ntly
acc
esse
d b
ooks
: Ess
enti
als
of
Life
Cyc
le N
utri
tion
, Mod
ern
Nut
riti
on in
Hea
lth
and
Dis
ease
, and
Ess
enti
als
of H
uman
Nut
riti
on
e-jo
urna
ls in
nut
riti
on
e-te
xtb
oo
ks
e-b
oo
ks
Ther
e is
no
ed
ucat
ion
and
ad
vanc
emen
t in
res
earc
h w
itho
ut a
cces
s to
inf
orm
atio
n. I
nfo
rmat
ion
and
in
form
atio
n ac
cess
is
a
bas
is
for
adva
ncem
ent
for
anyb
od
y in
any
asp
ect
of
life,
and
the
rig
ht t
o
info
rmat
ion
is a
ctua
lly o
ne o
f the
bas
ic h
uman
rig
hts
as a
ncho
red
in t
he U
nive
rsal
Dec
lara
tion
of
Hum
an
Rig
hts.
Eig
ht y
ears
ag
o, t
he F
oun
dat
ion
cons
truc
ted
th
e In
tern
et-b
ased
enL
INK
dig
ital l
ibra
ry o
f nu
triti
on
rese
arch
, whi
ch is
no
w a
pp
reci
ated
by
user
s in
nea
rly
20 lo
w-in
com
e co
untr
ies.
The
enLI
NK
lib
rary
is
a co
ncer
ted
act
ion
bet
wee
n O
VID
Tec
hno
log
ies,
cer
tain
pub
lishe
rs,
and
the
Fo
und
atio
n. A
s o
f D
ecem
ber
201
4, A
nnua
l Rev
iew
s,
OV
ID T
echn
olo
gie
s, W
olt
ers
Klu
wer
Hea
lth,
Inc
., an
d L
ipp
inco
tt W
illia
ms
& W
ilkin
s p
artic
ipat
e in
the
en
LIN
K li
bra
ry t
o o
ffer
hig
h-le
vel d
igita
l co
nten
t.
For
nutr
itio
n in
form
atio
n, t
he e
nLIN
K l
ibra
ry i
s fo
r m
any
user
s an
est
ablis
hed
and
ap
pre
ciat
ed s
our
ce
of
info
rmat
ion.
Aft
er a
rec
ent
“bo
ost
er”
wit
h a
new
Int
erne
t ap
pea
ranc
e, n
ew j
our
nals
, an
d m
any
new
e-b
oo
ks i
n nu
trit
ion
and
, la
st b
ut n
ot
leas
t, a
co
mp
lete
ly n
ew te
chno
log
ical
infr
astr
uctu
re p
latf
orm
, us
er r
egis
trat
ion
and
usa
ge
incr
ease
d a
gai
n. T
he
enLI
NK
lib
rary
targ
ets
ind
ivid
ual u
sers
in lo
w-in
com
e co
untr
ies
who
are
inte
rest
ed in
nut
ritio
n an
d n
utrit
ion
rese
arch
.
Pres
entl
y 8
jour
nals
and
33
e-b
oo
ks a
re a
cces
sib
le
in f
ull-
text
mo
de.
Use
rs w
ill f
ind
the
co
nten
t an
d
info
rmat
ion
they
nee
d i
n a
smal
l nu
mb
er o
f hi
gh-
qua
lity
sour
ces.
“Sm
all
but
bea
utifu
l”,
as o
ne u
ser
told
us:
the
enL
INK
lib
rary
is s
mal
l, b
ut n
ever
thel
ess
D/24
H
gt
in r
esea
rch
rch
mat
ion
andnd
dva
ncem
ent
vanc
emen
t th
e ri
ght
to
heri
ght
tohu
man
rig
hts
hum
an r
ight
s o
n o
f H
uman
o
no
fH
uman
cons
truc
ted
y
of
nutr
itio
nio
n se
rs in
nea
rlyarly
on
bet
wee
nrs
, an
d t
hethe
ual R
evie
ws,
w
sH
ealt
h, I
nc.,
nc.,
cip
ate
in t
heco
nten
t.
libra
r y i
s fo
r fo
r ia
ted
so
urcerce
ster
” w
ith
as,
and
man
yan
y no
t le
ast,
aaur
e p
latf
orm
, , a
gai
n. T
heT
he
low
-inco
me
me
and
nut
ritio
n
e ac
cess
ible
cont
ent
andnd
b
er o
f hi
gh-
gh-
as o
ne u
ser
ser
neve
rthe
less
1617
Col
our:
ora
nge
Hei
ght
: 1.0
m
Wei
ght
: 80
kg
Num
ber
of
boo
ks: 3
5
Num
ber
of
bro
chur
es, b
ookl
ets,
etc
: 120
Tota
l num
ber
of
pag
es: 3
0,00
0
The
ora
nge
libra
ry
THE
ENLI
NK
LIBR
ARY
TRU
NKS
Who
do
es n
ot
kno
w t
he f
amo
us b
oo
k W
here
the
re
is n
o d
oct
or
by
Dav
id W
erne
r? T
his
bo
ok
and
man
y o
ther
s ar
e in
clud
ed
in
the
ora
nge
enLI
NK
b
oo
k tr
unk
fro
m t
he F
oun
dat
ion
sinc
e “w
here
the
re i
s no
In
tern
et”,
bo
oks
are
ind
isp
ensa
ble
.
Ther
e is
no
ed
ucat
ion
with
out
acc
ess
to in
form
atio
n.
In t
od
ay’s
wo
rld,
info
rmat
ion
acce
ss i
s eq
uate
d w
ith
acce
ss t
o t
he I
nter
net
and
oth
er e
lect
roni
c m
edia
. Ye
t d
esp
ite
all
the
dev
elo
pm
ents
in
in
form
atio
n te
chno
log
y an
d c
om
put
er s
cien
ce,
this
sta
tem
ent
is i
n p
art
a m
isco
ncep
tion.
It
is w
ell
kno
wn
that
a
com
bin
ed,
inte
gra
ted
acc
ess
to h
ybrid
co
llect
ions
o
f p
rinte
d
and
el
ectr
oni
c re
sour
ces
is
at
pre
sent
th
e m
ost
po
wer
ful
too
l fo
r ed
ucat
ion.
In
add
itio
n,
ther
e ar
e m
any
geo
gra
phi
c ar
eas
with
out
acc
ess
to
the
Inte
rnet
or
onl
y at
hig
h co
st.
Ther
e th
e m
ob
ile
enLI
NK
lib
rary
tru
nk fi
lls t
he g
ap.
The
mo
bile
enL
INK
lib
rary
co
nsis
ts o
f an
ora
nge
met
al
trun
k co
ntai
ning
mo
re t
han
120
bo
oks
, b
roch
ures
an
d g
uid
elin
es f
rom
the
fie
ld o
f nu
triti
on
and
hea
lth.
Nut
ritio
n ca
nno
t b
e vi
ewed
sep
arat
ely
fro
m o
ther
d
isci
plin
es, e
spec
ially
med
icin
e, a
gric
ultu
re o
r p
ublic
he
alth
. A
cco
rdin
gly
, th
e en
LIN
K t
runk
als
o c
ont
ains
b
oo
ks s
uch
as H
arris
on’
s te
xtb
oo
k o
f med
icin
e an
d a
te
xtb
oo
k o
f tr
op
ical
med
icin
e. O
ne c
an f
ind
“d
ow
n to
ear
th”,
rea
dy-
to-u
se g
uid
elin
es f
or
the
trea
tmen
t o
f se
vere
mal
nutr
itio
n o
r th
e co
nstr
uctio
n o
f a
hom
e g
ard
en.
The
enLI
NK
tr
unk
has
the
sam
e si
ze
and
la
yout
as
the
Blu
e Tr
unk
Lib
rary
fro
m t
he W
orld
Hea
lth
Org
aniz
atio
n (W
HO
). Th
e en
LIN
K t
runk
was
cre
ated
as
an
add
itio
n to
the
WH
O B
lue
Trun
k Li
bra
ry a
nd
cove
rs
the
maj
or
issu
es
aro
und
th
e th
eory
an
d
pra
ctic
e o
f nut
ritio
n.
The
enLI
NK
nut
ritio
n lib
rary
tru
nk w
as o
ffere
d a
s a
pre
sent
fre
e o
f ch
arg
e (in
clud
ing
fre
e sh
ipm
ent)
to
se
lect
ed n
utrit
ion
inst
itute
s in
low
-inco
me
coun
trie
s.
Ord
er f
orm
s fo
r th
e en
LIN
K t
runk
s ar
e av
aila
ble
on
the
Foun
dat
ion’
s w
ebsi
te.
Ho
wev
er,
2014
was
the
la
st y
ear
whe
re a
lar
ger
qua
ntity
of
smal
l an
d l
arg
e en
LIN
K t
runk
s w
as s
hip
ped
. N
ow
onl
y a
few
sm
all
com
ple
te
trun
ks
rem
ain
avai
lab
le,
whi
ch
will
b
e sh
ipp
ed s
hort
ly.
For
the
mo
men
t th
e ce
ntra
l fo
cus
will
be
on
the
dis
trib
utio
n o
f d
igita
l co
nten
t vi
a th
e d
igita
l enL
INK
lib
rary
.
So fa
r a to
tal o
f 165
trun
ks h
ave
bee
n sh
ipp
ed to
mo
re
than
30
diff
eren
t co
untr
ies.
Dur
ing
201
4, 1
9 sm
all
and
3 l
arg
e tr
unks
wer
e sh
ipp
ed t
o 7
ins
titut
ions
in
6 co
untr
ies.
Tw
elve
o
f th
e 19
sm
all
trun
ks
wer
e sh
ipp
ed t
o F
renc
h-sp
eaki
ng c
oun
trie
s o
r in
stitu
tions
.
The
larg
e tr
unk
ENG
LISH
Col
our:
ora
nge
Hei
ght
: 33
cm
Wei
ght
: 30
kg
Num
ber
of
boo
ks: 1
0
Num
ber
of
bro
chur
es, b
ookl
ets,
etc
: 40
Tota
l num
ber
of
pag
es: 1
0,00
0
The
smal
l tru
nkEN
GLI
SH, F
REN
CH &
SPA
NIS
H
THE
ENLI
NK
TRUN
K
1819
OTH
ER A
CTIV
ITIE
SN
EW R
ESEA
RCH
PRO
JEC
TS
INST
ITU
TIO
NA
L SU
PPO
RT
OTH
ER C
APA
CIT
Y-BU
ILD
ING
AC
TIVI
TIES
OTH
ER A
CTIV
ITIE
S
2021ETHIOPIA
PAKISTAN
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RES
EARC
H P
ROJE
CTS
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EMEN
TARY
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OD
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TRIT
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P M
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ING
FOO
D S
ECU
RITY
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OTA
FORG
OTT
EN C
ROPS
FOO
D S
OVE
REIG
NTY
NU
TRIT
ION
CO
UN
SELL
ING
COM
PLEM
ENTA
RY FO
OD
Eff
ects
of
feed
ing
sty
le a
nd f
iber
co
nten
t o
f co
mp
lem
enta
ry f
oo
ds
on
the
app
etit
e o
f E
thio
pia
n in
fant
s
Kal
eab
Bay
e
Cen
ter
for
Foo
d S
cien
ce a
nd N
utrit
ion
Ad
dis
Ab
aba
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vers
ityA
dd
is A
bab
a, E
thio
pia
USD
39,
392
Und
ernu
triti
on
and
m
icro
nutr
ient
d
efic
ienc
ies
are
hig
hly
pre
vale
nt
in
dev
elo
pin
g
coun
trie
s.
Thes
e d
efic
ienc
ies
are
asso
ciat
ed
wit
h p
oo
r g
row
th,
imp
aire
d c
og
nitiv
e d
evel
op
men
t an
d p
oo
r he
alth
st
atus
. In
Eth
iop
ia,
44%
of
child
ren
und
er f
ive
year
s o
f ag
e ar
e st
unte
d. A
fter
the
age
of t
wo
, the
neg
ativ
e ef
fect
s o
f st
unti
ng
are
irre
vers
ible
. Lo
w
die
tary
in
take
s ar
e am
ong
the
im
med
iate
det
erm
inan
ts o
f p
oo
r nu
triti
ona
l sta
tus
and
can
be
rela
ted
to
sub
ject
fa
cto
rs,
feed
ing
sty
le,
or
the
foo
d c
hara
cter
istic
s.
Die
tary
int
ake
surv
eys
on
infa
nt a
nd y
oun
g c
hild
ren
in E
thio
pia
hav
e in
dic
ated
tha
t en
erg
y an
d n
utrie
nt
inta
kes
wer
e b
elo
w
reco
mm
end
atio
ns
and
th
at
care
giv
ers
are
oft
en c
onc
erne
d o
ver t
he lo
w a
pp
etite
o
f th
eir
child
ren.
Whe
ther
thi
s is
ass
oci
ated
to
the
hi
gh
fiber
co
nten
ts o
f the
co
mp
lem
enta
ry fo
od
s th
at
are
pre
par
ed f
rom
hig
h-ex
trac
tion-
rate
flo
urs
and
/o
r to
inap
pro
pria
te f
eed
ing
sty
les
rem
ains
unk
now
n.
The
pro
po
sed
pro
ject
aim
s to
eva
luat
e th
e ef
fect
of
resp
ons
ive
feed
ing
and
ext
ract
ion
rate
of f
lour
s us
ed
for
com
ple
men
tary
fo
od
pre
par
atio
n o
n th
e d
ieta
ry
inta
kes
of
9- t
o 1
2-m
ont
h-o
ld i
nfan
ts i
n th
e co
ntex
t o
f rur
al E
thio
pia
. The
cur
rent
feed
ing
sty
les
of i
nfan
ts
in E
thio
pia
will
firs
t b
e ev
alua
ted
thr
oug
h in
-ho
me
ob
serv
atio
n o
f fe
edin
g e
pis
od
es t
o t
hen
def
ine
and
fo
rmul
ate
resp
ons
ive
feed
ing
mes
sag
es a
dap
ted
to
th
e lo
cal c
ont
ext.
The
se m
essa
ges
will
be
del
iver
ed
to c
areg
iver
s th
roug
h tr
aini
ng s
essi
ons
, and
the
effe
ct
of
ado
ptin
g t
he m
essa
ges
on
the
die
tary
int
akes
of
infa
nts
will
be
eval
uate
d t
hro
ugh
in-h
om
e w
eig
hed
m
eal
ob
serv
atio
ns u
sing
a w
ithin
-sub
ject
cro
sso
ver
des
ign.
Whe
ther
die
tary
inta
ke is
influ
ence
d b
y flo
ur
extr
actio
n ra
te a
nd h
ow
thi
s af
fect
s th
e o
utco
mes
o
f re
spo
nsiv
e fe
edin
g w
ill a
lso
be
eval
uate
d.
The
inta
ke o
f tw
o t
est
mea
ls f
orm
ulat
ed f
rom
hig
h- a
nd
low
-ext
ract
ion-
rate
flo
urs
will
be
eval
uate
d,
in t
he
pre
senc
e/ab
senc
e o
f res
po
nsiv
e fe
edin
g.
GAP M
APPI
NGN
utri
tio
n G
ap M
ap: A
co
mp
rehe
nsiv
e m
app
ing
, q
ualit
y as
sess
men
t an
d
sum
mar
y o
f nu
trit
ion-
rele
vant
sys
tem
atic
re
view
s
Zulfi
qar
A. B
hutt
a
Ag
a K
han
Uni
vers
ityK
arac
hi, P
akis
tan
and
The
Ho
spita
l fo
r Si
ck C
hild
ren
Toro
nto
, Ont
ario
, Can
ada
USD
100
,050
Ther
e ha
s b
een
a re
cent
res
urg
ence
of
nutr
ition
as
a p
riorit
y on
the
glo
bal
hea
lth a
nd d
evel
opm
ent a
gen
da
(for
exam
ple
, th
e SU
N m
ovem
ent
and
the
rec
ent
don
or f
inan
cing
com
mitm
ents
) d
ue t
o th
e in
crea
sing
co
ncer
ns
abo
ut
the
stag
natio
n in
im
pro
vem
ents
in
nu
triti
ona
l st
atus
. Th
e 20
13
Lanc
et
Serie
s o
n M
ater
nal
and
C
hild
N
utrit
ion
pre
sent
ed
the
late
st
avai
lab
le e
vid
ence
for
a s
et o
f ke
y nu
triti
on-s
pec
ific
inte
rven
tions
an
d
a ra
nge
of
nutr
itio
n-se
nsiti
ve
pro
gra
ms,
and
out
lined
prio
ritie
s fo
r p
rimar
y re
sear
ch
in b
oth
dom
ains
. Oth
er p
revi
ous
initi
ativ
es t
o id
entif
y g
aps
and
met
hod
olog
ical
wea
knes
ses
in t
he e
xist
ing
sy
stem
atic
re
view
lit
erat
ure
on
nutr
itio
n-re
leva
nt
inte
rven
tions
hav
e b
een
pur
sued
, and
hig
hlig
hted
the
exis
ting
div
ersi
ty b
etw
een
the
met
hod
s, c
onte
xtua
l ad
just
men
ts,
conc
lusi
ons
an
d
reco
mm
end
atio
ns.
How
ever
, the
scop
e ha
s bee
n lim
ited
to c
erta
in se
lect
ed
area
s fr
om t
he b
road
er n
utrit
ion
dom
ain.
To
bui
ld
upon
and
com
ple
men
t th
e p
revi
ous
wor
k, t
his
stud
y p
rop
oses
to
und
erta
ke a
com
pre
hens
ive
map
pin
g,
qua
lity
asse
ssm
ent
and
sum
mar
y of
exi
stin
g e
vid
ence
sy
nthe
ses
that
sp
an t
he b
road
ran
ge
of n
utrit
ion-
rele
vant
inte
rven
tions
. We
will
gro
und
thi
s ex
erci
se in
th
e co
ncep
tual
fram
ewor
k th
at g
uid
ed th
e 20
13 L
ance
t se
ries,
whi
ch o
utlin
es th
e m
ulti-
leve
l and
mul
ti-se
ctor
al
pat
hway
s b
y w
hich
im
pro
ved
nut
ritio
n an
d i
ts l
ong
-te
rm b
enef
its c
an b
e re
aliz
ed. T
his
fram
ewor
k p
rese
nts
the
norm
ativ
e la
ndsc
ape
of p
oten
tial
nutr
ition
act
ion
agai
nst
whi
ch w
e w
ill m
ap a
nd c
ritic
ally
ass
ess
the
exis
ting
b
ody
of
evid
ence
sy
nthe
ses
on
nutr
ition
-re
leva
nt i
nter
vent
ions
. Th
en t
he r
esea
rche
rs w
ill b
e ab
le t
o id
entif
y ar
eas
in w
hich
evi
den
ce s
ynth
eses
are
in
suffi
cien
t or
lac
king
alto
get
her.
The
gap
map
will
en
com
pas
s g
aps
in t
he t
heor
y an
d i
mp
lem
enta
tion
stra
teg
ies
for
nutr
ition
-rel
ated
int
erve
ntio
ns a
nd t
he
cons
eque
nt
lack
of
im
ple
men
tatio
n/ap
plic
atio
n of
th
e cu
rren
t kn
owle
dg
e. I
t w
ill a
lso
hig
hlig
ht t
he g
aps
in t
he a
pp
licat
ion
of t
he c
urre
nt k
now
led
ge
in c
erta
in
coun
trie
s/re
gio
ns o
f the
wor
ld.
In 2
014
the
Cou
ncil
dec
ided
to
fun
d 7
res
earc
h p
roje
cts.
2223
INDONESIA
IRANFO
OD
SECU
RITY
A c
oho
rt a
naly
sis
of
the
sust
aina
bili
ty o
f fo
od
inse
curi
ty c
ont
rol p
rog
ram
s in
the
no
rthw
est
of
Iran
Saee
d D
astg
iri
Dep
artm
ent
of C
om
mun
ity a
nd F
amily
Med
icin
eFa
culty
of M
edic
ine
Tab
riz U
nive
rsity
of M
edic
al S
cien
ces
Tab
riz, I
ran
USD
30,
000
Foo
d s
ecur
ity h
as b
een
def
ined
as
acce
ss b
y al
l p
eop
le a
t al
l tim
es t
o e
noug
h fo
od
for
an a
ctiv
e an
d
heal
thy
life.
Fo
od
ins
ecur
ity,
how
ever
, is
fre
que
nt
in
bo
th
dev
elo
ped
an
d
dev
elo
pin
g
coun
trie
s,
affe
ctin
g f
rom
5%
to
25%
of
the
gen
eral
po
pul
atio
n.
Beg
inni
ng i
n 20
09,
a p
rog
ram
was
fun
ded
by
the
Nes
tlé
Foun
dat
ion
to
asse
ss
foo
d
inse
curit
y,
its
influ
enci
ng
fact
ors
an
d
cont
rol
mea
sure
s in
th
e no
rthw
este
rn r
egio
n o
f Ira
n, a
nd t
o d
evel
op
a p
ublic
he
alth
m
od
el
to
red
uce
the
rate
o
f ho
useh
old
fo
od
in
secu
rity
in
the
reg
ion.
A
cco
rdin
g
to
the
find
ing
s, t
he p
reva
lenc
e o
f fo
od
ins
ecur
ity d
eclin
ed
by
7.3%
af
ter
the
inte
rven
tion.
N
ow
, fo
ur
year
s af
ter
the
inte
rven
tion
was
co
mp
lete
d,
a tim
e d
urin
g
whi
ch t
here
hav
e b
een
toug
h sa
nctio
ns a
gai
nst
Iran
, re
sulti
ng in
a r
emar
kab
le in
crea
se in
the
pric
es,
and
d
ecre
ase
in t
he a
vaila
bili
ty a
nd a
cces
sib
ility
of
foo
d
in th
e co
untr
y, w
e w
ant t
o lo
ok
at th
e su
stai
nab
ility
of
the
pre
vio
us p
rog
ram
in t
he s
ame
sett
ing
. Th
e to
tal
po
pul
atio
ns in
the
area
(2,9
11 h
ous
eho
lds
with
a to
tal
of
15,0
70 i
ndiv
idua
ls)
in t
hree
sub
urb
an d
istr
icts
in
the
nort
hwes
t o
f Ir
an w
ere
recr
uite
d i
n th
e p
revi
ous
p
rog
ram
. Thi
s ne
w p
rop
osa
l int
end
s to
follo
w u
p t
he
sam
e p
op
ulat
ion
afte
r fo
ur y
ears
fo
r th
e fo
llow
ing
o
bje
ctiv
es:
1) t
o r
e-as
sess
the
fo
od
ins
ecur
ity i
n th
e st
udy
po
pul
atio
n, 2
) to
re-
asse
ss t
he c
ause
s o
f fo
od
in
secu
rity
in t
he s
tud
y p
op
ulat
ion,
and
3)
to e
xplo
re
the
sust
aina
bili
ty o
f the
inte
rven
tions
.
MIC
ROBI
OTA
Min
imiz
ing
the
neg
ativ
e ef
fect
of
iro
n su
pp
lem
enta
tio
n an
d f
ort
ific
atio
n o
n g
ut
mic
rob
iota
usi
ng lo
cal r
eso
urce
s
Siti
Hel
mya
ti
Scho
ol o
f Hea
lth N
utrit
ion
Facu
lty o
f Med
icin
eU
nive
rsita
s G
adja
h M
ada
Yog
yaka
rta,
Ind
one
sia
USD
49,
948
Iro
n su
pp
lem
enta
tion
and
fo
rtifi
catio
n ar
e ef
fect
ive
way
s to
ove
rco
me
iron
def
icie
ncy
anae
mia
but
the
y ha
ve a
neg
ativ
e ef
fect
on
gut
mic
rob
iota
bal
ance
. Pa
tho
gen
ic
bac
teria
ne
ed
iron
for
gro
wth
; th
us,
iron
sup
ple
men
tatio
n ca
n in
duc
e th
e ra
pid
gro
wth
o
f g
ut p
atho
gen
s. E
DTA
is
a st
rong
met
al c
hela
tor,
so
usi
ng N
aFeE
DTA
is
a p
ote
ntia
l w
ay t
o i
ncre
ase
the
bio
avai
lab
ility
of
iron
in o
rder
to
pre
vent
the
iro
n up
take
by
pat
hog
ens.
NaF
eED
TA c
an i
ncre
ase
the
iron
abso
rptio
n tw
o t
o t
hree
tim
es b
ette
r th
an
FeSO
4, e
ven
in th
e p
rese
nce
of p
hytic
aci
d. P
rob
iotic
s co
ntrib
ute
in m
aint
aini
ng g
ut m
icro
bio
ta b
alan
ce a
nd
pro
duc
e sh
ort
cha
in fa
tty
acid
. Pre
bio
tics
can
sup
po
rt
pro
bio
tics
by
pro
vid
ing
sel
ectiv
e su
bst
rate
s fo
r its
g
row
th.
This
stu
dy
is t
o d
eter
min
e th
e ef
fect
iven
ess
of
the
adm
inis
trat
ion
of
synb
iotic
fer
men
ted
milk
d
urin
g ir
on
sup
ple
men
tatio
n an
d f
ort
ifica
tion
on
gut
m
icro
bio
ta b
alan
ce. T
he s
ubje
cts
will
be
116
child
ren
(8-1
3 ye
ars
old
) w
ith d
eple
ted
iro
n (s
erum
fer
ritin
1
5 g
/L).
Sub
ject
s w
ill b
e d
ivid
ed r
and
om
ly i
nto
g
roup
s re
ceiv
ing
: 1)
ir
on
sup
ple
men
t (F
eSO
4 sy
rup
, 10
mg
Fe)
; 2)
iro
n su
pp
lem
ent
and
syn
bio
tic
ferm
ente
d
milk
; 3)
fo
rtifi
ed
cass
ava
bis
cuit
s (N
aFeE
DTA
, 10
m
g
Fe);
and
4)
fo
rtifi
ed
cass
ava
bis
cuits
and
syn
bio
tic f
erm
ente
d m
ilk.
Synb
iotic
is
mad
e fr
om
an
Ind
one
sian
loca
l iso
late
of L
acto
bac
illus
p
lant
arum
Dad
13 a
nd fr
ucto
-olig
osa
ccha
rides
(FO
S).
The
inte
rven
tion
will
be
carr
ied
out
for
thre
e m
ont
hs,
dur
ing
w
hich
tim
e iro
n sy
rup
o
r b
iscu
its
will
b
e g
iven
tw
ice
a w
eek
and
milk
six
tim
es a
wee
k. G
ut
mic
rob
iota
(lac
tob
acill
i, L.
pla
ntar
um, b
ifid
ob
acte
ria,
E. c
oli,
ente
roba
cter
ia,
Shig
ella
sp,
and
Sal
mon
ella
sp)
w
ill b
e d
eter
min
ed b
y cu
lture
tech
niq
ue w
ith s
elec
tive
med
ia a
gar
and
qua
ntita
tive
real
tim
e-PC
R.
Ferr
itin
will
b
e m
easu
red
w
ith
Elis
a,
haem
og
lob
in
wit
h az
idim
ethe
mo
glo
bin
. Inc
rem
enta
l Co
st E
ffec
tiven
ess
Rat
io
(ICE
R)
anal
ysis
w
ill
be
per
form
ed
to
kno
w
the
mo
st e
ffec
tive
inte
rven
tion.
Aft
er f
inis
hing
thi
s st
udy,
we
will
co
llab
ora
te w
ith t
he l
oca
l co
mm
unity
, es
pec
ially
wo
men
’s g
roup
s an
d th
e lo
cal g
ove
rnm
ent,
to
gua
rant
ee t
he s
usta
inab
ility
of t
he p
roje
ct.
FORG
OTT
EN C
ROP
The
effi
cacy
of
bio
fort
ifie
d p
earl
mill
et
in a
ran
do
miz
ed c
ont
rolle
d t
rial
wit
h ch
ildre
n <
2y
in r
ural
Eas
tern
Ken
ya
Mue
ni N
dik
u &
Jo
an S
abat
e
Dep
artm
ent
of F
amily
and
Co
nsum
er S
cien
ces,
Sc
hoo
l of S
cien
ce a
nd T
echn
olo
gy
Uni
vers
ity o
f Eas
tern
Afr
ica
(UE
AB
)B
arat
on,
Ken
ya
and
Dep
artm
ent
of N
utrit
ion
Scho
ol o
f Pub
lic H
ealth
Lom
a Li
nda
Uni
vers
ityLo
ma
Lind
a, C
alifo
rnia
, USA
USD
141
,475
In K
enya
, thi
rty
per
cent
of
child
ren
youn
ger
tha
n fiv
e ar
e st
unte
d a
s a
resu
lt of
chr
onic
mal
nutr
ition
. Stu
ntin
g
in
the
first
tw
o ye
ars
of
life
lead
s to
irr
ever
sib
le
dam
age,
incl
udin
g s
hort
er a
dul
t hei
ght
, low
er a
ttai
ned
sc
hool
ing
, re
duc
ed a
dul
t in
com
e, r
educ
ed I
Q a
nd
dec
reas
ed o
ffsp
ring
birt
h w
eig
ht.
Unt
il 50
yea
rs a
go,
p
earl
mill
et w
as a
sta
ple
cro
p i
n Ea
ster
n K
enya
, b
ut
it ha
s no
w b
een
rep
lace
d b
y m
aize
in
man
y ar
eas.
D
r. N
dik
u’s
doc
tora
l re
sear
ch,
cond
ucte
d i
n 20
09,
esta
blis
hed
tha
t ch
ildre
n in
thi
s re
gio
n d
eriv
e ab
out
62-6
8% o
f the
ir d
aily
ene
rgy
from
gra
in a
nd in
dic
ated
th
at t
hose
who
sub
sist
ed o
n p
earl
mill
et h
ad a
15%
hi
ghe
r m
ean
ener
gy
inta
ke
than
th
ose
relia
nt
on
mai
ze.
They
als
o ha
d a
gre
ater
int
ake
of m
ost
key
nutr
ient
s. T
his
pro
ject
will
be
a d
ieta
ry in
terv
entio
n tr
ial
with
bio
fort
ified
pea
rl m
illet
in t
he U
kam
ban
i reg
ion,
cu
rren
tly
sub
sist
ing
on
m
aize
. O
ur
pre
viou
s p
ilot
pro
ject
, con
duc
ted
rece
ntly
and
fund
ed b
y th
e N
estlé
Fo
und
atio
n, e
stab
lishe
d t
hat
villa
ges
with
mai
ze a
s th
eir
mai
n fo
od w
ill w
elco
me
a ch
ang
e to
pea
rl m
illet
. Th
is s
tud
y w
ill b
e co
nduc
ted
with
150
hou
seho
lds
in
two
arm
s ov
er t
hree
yea
rs.
All
hous
ehol
ds
will
hav
e ch
ildre
n 0
to 1
2 m
onth
s ol
d a
t b
asel
ine.
The
follo
win
g
step
s w
ill b
e ta
ken:
Yea
r 1
– Id
entif
y ap
pro
pria
te
villa
ges
; d
esig
n an
ed
ucat
iona
l p
rog
ram
fo
r b
oth
pre
par
ing
an
d
inco
rpor
atin
g
pea
rl m
illet
in
to
the
dai
ly d
iet;
netw
ork
with
the
Min
istr
y of
Ag
ricul
ture
to
st
art
recr
uitm
ent;
colle
ct b
asel
ine
dat
a an
d s
tart
the
in
terv
entio
n. Y
ear
2 –
Con
duc
t tr
ial:
gro
up 1
vill
ages
ar
e th
e co
ntro
l an
d g
roup
2 i
s an
int
erve
ntio
n w
ith
bio
fort
ified
pea
rl m
illet
; col
lect
bio
log
ical
sam
ple
s an
d
anth
rop
omet
ric in
dic
ator
s fr
om c
hild
ren
in b
oth
villa
ge
gro
ups.
Ye
ar
3 –
Com
ple
te
inte
rven
tion;
an
alyz
e b
iolo
gic
al a
nd a
nthr
opom
etric
dat
a; d
raft
pub
licat
ion;
re
por
t re
sults
; d
evel
op
ong
oing
U
EAB
co
mm
unity
se
rvic
e p
roje
cts
to c
ontin
ue.
2425
MEXICOBURKINA FASO
FOO
D SO
VERE
IGNT
YP
rom
oti
ng f
oo
d s
ove
reig
nty
thro
ugh
a co
op
erat
ive
mo
del
fo
r su
stai
nab
le
org
anic
far
min
g in
the
May
an R
egio
n C
ristin
a O
sorio
Vaz
que
z
Uni
vers
idad
Inte
rcul
tura
l May
a d
e Q
uint
ana
Qui
ntan
a R
oo
, Méx
ico
and
Uni
vers
ity o
f Tw
ente
Ens
ched
e, N
ethe
rland
s
USD
20,
000
Ag
ricu
ltur
al
coo
per
ativ
es
are
emer
gin
g
as
an
econ
omic
al
tern
ativ
e m
odel
to
im
pro
ve
the
lives
an
d
nutr
ition
of
ru
ral
fam
ilies
in
ea
ster
n M
exic
o.
Thro
ugho
ut t
he s
ocia
l ec
onom
y, t
he f
amili
es w
ith
fem
ale
lead
ersh
ip h
ave
dev
elop
ed a
soc
ial
stru
ctur
e th
at h
elp
s th
em a
chie
ve f
ood
sov
erei
gnt
y fo
r th
eir
child
ren.
Th
e M
exic
an
go
vern
men
t ha
s a
hist
ory
o
f p
ater
nalis
m;
the
lack
o
f ap
pro
pria
te
pub
lic
pol
icie
s is
rem
edie
d w
ith a
lar
ge
num
ber
of
soci
al
pro
gra
ms
whi
ch a
re c
reat
ed t
o p
reve
nt t
he g
row
ing
p
over
ty in
the
Mex
ican
pop
ulat
ion
with
hig
h ra
tes
of
mal
nutr
ition
. The
ben
efic
iarie
s of
the
se r
esou
rces
are
th
e vu
lner
able
cla
sses
of s
ocie
ty: c
hild
ren,
eld
erly
and
w
omen
, b
ut t
hese
effo
rts
are
inef
ficie
nt b
ecau
se t
he
situ
atio
n in
volv
es s
truc
tura
l p
rob
lem
s in
the
cou
ntry
. Lo
okin
g fo
r qua
lity
food
for t
heir
fam
ilies
and
a s
ourc
e of
inc
ome,
fem
ale
agric
ultu
ral
pro
duc
ers
in e
aste
rn
Mex
ico
wor
k to
get
her,
exch
ang
ing
the
ir p
rod
ucts
as
a w
ay t
o im
pro
ve t
heir
nutr
ition
al le
vel b
y ob
tain
ing
a
varie
ty o
f fru
its a
nd v
eget
able
s fo
r th
eir
cons
ump
tion,
an
d o
n th
e co
mm
erci
al s
ide
they
gat
her t
heir
pro
duc
ts
to o
bta
in t
he l
arg
est
rep
rese
ntat
ion
in t
he m
arke
t. C
oop
erat
ives
are
bas
ed o
n th
e va
lues
of
self-
help
, se
lf-re
spon
sib
ility
, d
emoc
racy
, eq
ualit
y,
equi
ty
and
so
lidar
ity. C
oop
erat
ive
mem
ber
s b
elie
ve in
the
ethi
cal
valu
es o
f ho
nest
y, s
ocia
l res
pon
sib
ility
and
sol
idar
ity.
Bas
ed o
n th
is d
efin
ition
, the
fig
ure
of t
he c
oop
erat
ive
is d
efin
ed a
s an
aut
onom
ous
asso
ciat
ion
of p
erso
ns
who
ha
ve
bee
n un
ited
vo
lunt
arily
to
m
eet
thei
r co
mm
on e
cono
mic
, so
cial
and
cul
tura
l g
oals
in
the
figur
e of
a d
emoc
ratic
ally
con
trol
led
com
pan
y. S
ome
of t
he c
oop
erat
ives
loc
ated
in
the
May
an r
egio
n of
M
exic
o p
rese
nt
a su
cces
sful
m
odel
of
op
erat
ion,
w
hich
allo
ws
the
May
an w
omen
of t
he r
egio
n to
hav
e a
heal
thie
r nu
triti
on a
nd t
o ob
tain
a h
ighe
r in
com
e ex
chan
gin
g t
heir
pro
duc
ts.
It is
nec
essa
ry t
o id
entif
y th
e re
pre
sent
ativ
e el
emen
ts o
f the
se s
ucce
ssfu
l cas
es
in o
rder
to
rep
licat
e th
e m
odel
in t
he M
ayan
reg
ion,
w
ith t
he g
oal o
f pro
mot
ing
goo
d p
ract
ices
.
FEED
ING
PRAC
TICE
SE
ffec
t o
f p
erso
naliz
ed n
utri
tio
nal
coun
selli
ng o
n ch
ild g
row
th a
nd f
eed
ing
p
ract
ices
in B
urki
na F
aso
Yass
inm
e E
lyse
e So
mas
se
Inst
itut
sup
érie
ur d
es s
cien
ces
de
la S
anté
(IN
SSA
) U
nive
rsité
Po
lyte
chni
que
de
Bo
bo
-Dio
ulas
soB
ob
o D
ioul
asso
, Bur
kina
Fas
o
USD
20,
000
Infa
nts a
re p
artic
ular
ly v
ulne
rab
le d
urin
g th
e tr
ansi
tion
per
iod
w
hen
com
ple
men
tary
fe
edin
g
beg
ins
to
sup
ple
men
t b
reas
t-fe
edin
g. I
n so
uthw
este
rn B
urki
na
Faso
, ina
pp
rop
riate
co
mp
lem
enta
ry f
eed
ing
is m
ore
o
ften
due
to
ina
deq
uate
kno
wle
dg
e ab
out
fee
din
g
pra
ctic
es t
han
to t
he l
ack
of
foo
d.
A c
onv
entio
nal
gro
up e
duc
atio
n o
ffer
ed b
y a
pre
vio
us N
GO
pro
gra
m
in t
he r
egio
n sh
ow
ed i
nsuf
ficie
nt e
ffec
t o
n in
fant
fe
edin
g p
ract
ices
. Th
ey a
im a
t te
stin
g t
he e
ffec
t o
f p
erso
naliz
ed c
oun
selli
ng o
f ca
reg
iver
s o
n ch
ildre
n’s
gro
wth
and
co
mp
lem
enta
ry f
eed
ing
pra
ctic
es in
thi
s re
gio
n o
f B
urki
na F
aso
, as
sum
ing
tha
t p
erso
naliz
ed
coun
selli
ng
enha
nces
fe
edin
g
pra
ctic
es
and
co
nseq
uent
ly a
chi
ld’s
gro
wth
. A
co
unse
lling
gui
de
will
be
dev
elop
ed b
y m
eans
of a
rap
id a
nthr
opol
ogic
al
asse
ssm
ent
pro
ced
ure
(RA
P) i
n o
rder
to
tak
e in
to
acco
unt
the
key
det
erm
inan
ts o
f in
fant
fee
din
g. T
he
effe
ct o
f p
erso
naliz
ed c
oun
selli
ng a
dm
inis
tere
d b
y co
mm
unity
hea
lth w
ork
ers
(CH
W)
will
be
asse
ssed
in
a c
lust
er-r
and
om
ized
tria
l w
here
the
vill
ages
will
fo
rm t
he r
and
om
izat
ion
units
, w
ith 1
6 vi
llag
es in
the
in
terv
entio
n g
roup
and
16
in th
e co
ntro
l gro
up. I
n th
e in
terv
entio
n ar
m, t
he c
oun
selli
ng w
ill b
e d
one
dur
ing
ho
me
visi
ts m
ont
hly
for
6 m
ont
hs. I
n th
e co
ntro
l arm
, ca
reg
iver
s w
ill r
ecei
ve a
mo
nthl
y g
roup
ed
ucat
ion
at
a co
mm
unity
cen
ter f
or 6
mo
nths
als
o. T
hey
will
enr
oll
the
mo
ther
s an
d t
heir
child
ren
(ag
ed 6
-7 m
ont
hs)
afte
r o
bta
inin
g c
ons
ent.
The
y w
ill t
rain
the
nur
ses
of
four
hea
lth c
ente
rs, w
ho w
ill in
tur
n tr
ain
the
CH
W a
s co
unse
llors
. The
out
com
es a
re c
hild
wei
ght
gai
n an
d
seco
ndar
y co
mp
lem
enta
ry f
eed
ing
pra
ctic
es, h
eig
ht
gai
n, d
ieta
ry d
iver
sity
, an
d h
ous
eho
ld f
oo
d s
ecur
ity.
The
stud
y w
ill e
nab
le c
om
mun
ity a
nd h
ealth
-fac
ility
ca
pac
ity b
uild
ing
and
will
info
rm n
utrit
ion
po
licy
and
p
ract
ices
in
Bur
kina
Fas
o w
here
a n
atio
nal
po
licy
of
heal
th s
yste
m i
nteg
ratio
n o
f co
mm
unity
-bas
ed
activ
ities
was
dev
elo
ped
in 2
012.
The
to
tal
dur
atio
n o
f the
stu
dy
is 1
5 m
ont
hs.
27
INSTIT
UTIO
NAL S
UPPO
RT AN
D O T
HER C
APAC
ITY-BU
ILDIN
G ACT
IVITIE
S
On
e o
f th
e m
ajo
r ai
ms
of
the
Ne
stlé
Fo
und
atio
n is
the
tra
nsfe
r o
f su
stai
nab
le
cap
acit
y-b
uild
ing
kn
ow
led
ge
to
lo
w-
inco
me c
ountr
ies.
Duri
ng
20
14
seve
ral
spec
ific
cap
acit
y-b
uild
ing
act
ivit
ies
wer
e su
pp
ort
ed.
APAC
ITY
2727
AFR
ICA
N J
OU
RNA
L O
F FO
OD
, A
GRI
CU
LTU
RE, N
UTR
ITIO
N A
ND
DEV
ELO
PMEN
T
Loca
l cr
eati
on
and
d
isse
min
atio
n o
f nu
trit
ion
know
led
ge
is o
f g
reat
im
por
tanc
e. T
here
are
onl
y a
few
nut
ritio
n jo
urna
ls o
n th
e A
fric
an c
ontin
ent,
one
of
them
bei
ng t
he A
fric
an J
ourn
al o
f Fo
od,
Ag
ricul
ture
, N
utri
tio
n an
d
Dev
elo
pm
ent
(AJF
AN
D)
(see
al
so
http
://w
ww
.ajfa
nd.n
et).
The
AJF
AN
D
is
mea
nt
to
crea
te a
war
enes
s o
f th
e m
ultip
licity
of
chal
leng
es
faci
ng A
fric
a th
at le
ad to
ab
ject
pov
erty
and
des
titut
ion.
Th
e Fo
und
atio
n is
sup
por
ting
this
imp
orta
nt e
ffort
with
a
reg
ular
con
trib
utio
n fo
r th
e in
fras
truc
ture
as
wel
l as
for
each
issu
e. T
he jo
urna
l is
only
ava
ilab
le a
s a
web
-b
ased
pub
licat
ion.
The
sub
mis
sion
of
orig
inal
art
icle
s an
d o
ther
con
trib
utio
ns c
an o
nly
be
enco
urag
ed.
DIS
SEM
INAT
ION
OF
RESE
ARCH
RES
ULTS
Dur
ing
20
14
the
Foun
dat
ion
sup
po
rted
se
vera
l re
sear
cher
s to
at
tend
co
nfer
ence
s in
th
e U
nite
d
Stat
es, A
sia
as w
ell a
s E
uro
pe
to p
rese
nt r
esul
ts fr
om
th
eir
rese
arch
pro
ject
s w
hich
wer
e su
pp
ort
ed b
y th
e Fo
und
atio
n.
THE
ENLI
NK
TRU
NK
Dur
ing
thi
s ye
ar 1
9 sm
all a
nd t
hree
larg
e tr
unks
wer
e sh
ipp
ed t
o s
even
inst
itutio
ns in
six
co
untr
ies.
Tw
elve
o
f th
e 19
sm
all
trun
ks
wer
e sh
ipp
ed
to
Fren
ch-
spea
king
co
untr
ies.
The
feed
bac
k fr
om
enL
INK
tru
nk
user
s cl
early
und
ersc
ore
s th
at b
oo
ks w
ill m
ost
lik
ely
not
dis
app
ear.
A f
ew y
ears
ag
o it
was
ass
umed
tha
t e-
bo
oks
and
e-d
ocu
men
ts w
oul
d c
anni
bal
ize
prin
ted
b
oo
ks.
Sinc
e p
rinte
d b
oo
ks a
re c
lose
to
per
fect
ion
they
will
inst
ead
out
live
any
dig
ital b
oo
k.
ENLI
NK
TRU
NKS
FO
R TH
E C
ENTR
E FO
R H
EALT
H P
ROM
OTI
ON
Fo
r 49
ye
ars,
th
e C
entr
e fo
r H
ealt
h Pr
om
oti
on
in
Kan
gu-
May
umb
e,
loca
ted
in
th
e p
rovi
nce
Bas
C
ong
o,
has
bee
n o
ne
of
the
key
inst
itutio
ns
to
pro
mo
te h
ealth
and
hea
lth e
duc
atio
n in
the
Co
ngo
. D
r. J
acq
ues
Co
urte
joie
and
his
tea
m a
re k
ey p
laye
rs
in p
rom
otin
g g
oo
d h
ealth
and
in
the
pro
duc
tion
as
wel
l as
dis
trib
utio
n o
f ed
ucat
iona
l m
ater
ial
in t
he
Co
ngo
. A
ctua
lly t
hey
are
one
of
the
few
fun
ctio
nal
inst
itute
s in
th
is
coun
try
dev
elo
pin
g
and
p
rintin
g
affo
rdab
le
heal
th-p
rom
oti
on
mat
eria
ls,
incl
udin
g
bo
oks
on
nutr
itio
n. T
his
year
10
Fren
ch e
nLIN
K tr
unks
w
ere
pro
vid
ed b
y th
e Fo
und
atio
n to
the
Cen
tre’
s lib
rary
as
w
ell
to
som
e la
rger
co
mm
unity
he
alth
ce
ntre
s an
d h
osp
itals
in t
he B
as C
ong
o.
ENLI
NK
DIG
ITA
L LI
BRA
RY
Aft
er r
egul
ar i
mp
rove
men
ts a
nd u
pd
ates
of
the
enLI
NK
lib
rary
, th
e us
er n
umb
ers
of
the
libra
ry h
ave
incr
ease
d c
ont
inuo
usly
, re
achi
ng 2
52 r
egis
tere
d
user
s at
the
end
of
2014
. Th
e en
LIN
K l
ibra
ry i
s a
wel
com
ed in
form
atio
n so
urce
fo
r in
div
idua
l use
rs a
s w
ell a
s lib
raria
ns in
man
y lo
w-in
com
e co
untr
ies.
Bas
ed
on th
e us
er s
tatis
tics,
the
enLI
NK
lib
rary
see
ms
to h
ave
bec
om
e a
wid
ely
used
and
ap
pre
ciat
ed in
form
atio
n so
urce
.
NEW
ED
ITIO
N O
F N
UTR
ITIO
N E
T SA
NTÉ
A
ND
“BI
BLIO
THÈQ
UES
MÉD
ICA
LES”
FO
R 1
0 N
URS
ING
SC
HO
OLS
In n
early
20
Afr
ican
co
untr
ies,
Fre
nch
is o
ne o
f th
e o
ffic
ial
lang
uag
es.
Eng
lish
as t
he g
lob
al l
ang
uag
e in
ed
ucat
ion
and
res
earc
h as
wel
l as
dai
ly l
ife s
till
rem
ains
a h
and
icap
. Th
ere
are
not
man
y p
ract
ical
b
oo
ks o
n ap
plie
d n
utrit
ion
in F
renc
h. A
cco
rdin
gly
, in
th
e ye
ar
2013
th
e Fo
und
atio
n su
pp
ort
ed
the
pri
ntin
g
cost
fo
r a
250-
pag
es
pap
erb
ack
bo
ok
entit
led
Nut
ritio
n et
san
té (
“Nut
ritio
n an
d H
ealth
”)
by
Dr.
Jac
que
s C
our
tejo
ie,
Cen
tre
de
Pro
mo
tion
de
Sant
é (C
PS)
in K
ang
u-M
ayum
be
(Co
ngo
). In
201
4 N
utrit
ion
et s
anté
was
prin
ted
and
in
add
itio
n, t
en
nurs
ing
sch
oo
ls in
the
Co
ngo
wer
e eq
uip
ped
with
a
com
pila
tion
of
460
diff
eren
t ed
ucat
iona
l b
roch
ures
, m
anua
l and
bo
oks
. The
se “
bib
lioth
èque
s m
édic
ales
” w
ill la
y th
e g
roun
d f
or
a ed
ucat
iona
l lib
rary
in t
hese
nu
rsin
g s
cho
ols
. The
sch
oo
ls a
re lo
cate
d t
hro
ugho
ut
the
Co
ngo
—in
U
niki
s,
Sayo
, K
isan
gan
i, B
udja
la,
Kun
gu,
Ng
ulu,
Gem
ena
and
Ike
la.
In I
kela
, th
ree
diff
eren
t in
stitu
tions
hav
e b
een
equi
pp
ed w
ith t
he
“bib
lioth
èque
s m
édic
ales
”.
The
CPS
is o
ne o
f the
maj
or p
rod
ucer
s o
f ed
ucat
iona
l m
ater
ials
fo
r m
edic
al d
oct
ors
, nu
rses
and
mid
wiv
es
in t
he C
ong
o.
The
bo
oks
are
no
t o
nly
dis
trib
uted
lo
cally
—fo
r in
stan
ce,
all
mid
wife
ry
scho
ols
in
th
e C
ong
o d
epen
d o
n ed
ucat
iona
l m
ater
ial
fro
m t
he
CPS
—b
ut
also
to
o
ther
Fr
ench
-sp
eaki
ng
Afr
ican
co
untr
ies.
CPS
fill
s a
gap
fo
r Fr
anco
pho
ne A
fric
a. I
n th
e C
ong
o, a
s in
man
y o
ther
co
untr
ies,
prin
ted
bo
oks
ar
e an
d w
ill b
e in
dis
pen
sab
le f
or
the
near
and
mo
st
likel
y al
so d
ista
nt fu
ture
.
2829
332
VISI
ON
200
7SU
STA
INA
BLE
INTE
NSI
FIC
ATI
ON
NEW
ASP
ECTS
OF
BREA
STFE
EDIN
G M
ALN
UTR
ITIO
N: W
HA
T C
AN
WE
DO
?
APP
LIED
NU
TRIT
ION
LIN
EAR
PRO
GRA
MM
ING
VISI
ON
Dur
ing
all
the
year
s, t
he F
ound
atio
n ha
s p
ursu
ed
a fo
od-b
ased
ap
pro
ach
to r
educ
e m
alnu
triti
on.
In
agre
emen
t with
this
str
ateg
y, G
ord
on C
onw
ay o
utlin
es
the
bas
ic c
once
pts
of
the
sust
aina
ble
int
ensi
ficat
ion
app
roac
h in
ag
ricul
ture
, an
ap
pro
ach
for
optim
izin
g
the
agric
ultu
ral
outp
ut
by
optim
ized
us
age
of
all
avai
lab
le r
esou
rces
. Th
is s
trat
egy
is v
ery
pro
mis
ing
al
so a
t th
e le
vel
of “
fam
ily f
arm
ing
”, w
here
foo
d
is
pro
duc
ed
loca
lly
for
loca
l co
nsum
ptio
n.
In
the
sam
e lin
e, A
llan
Wal
ker
offe
rs n
ew e
vid
ence
for
the
“i
nten
sific
atio
n” o
f bre
ast f
eed
ing
—th
e b
asic
nut
ritur
e
for
heal
th a
nd w
ell-b
eing
in
late
r lif
e. S
imila
rly,
our
coun
cil
mem
ber
W
alte
r W
ahli
und
erlin
es
foo
d
adeq
uacy
for
op
timal
ep
igen
etic
s. T
u N
gu
reca
lls t
he
conc
ept
of “
app
lied
nut
ritio
n”, w
hich
was
dev
elop
ed
to s
ucce
ssfu
l fun
ctio
nalit
y b
y th
e V
ietn
ames
e so
ldie
rs
and
tra
nsfe
rred
to
the
pop
ulat
ion
in V
ietn
am.
Fina
lly,
one
of o
ur g
rant
reci
pie
nts,
Um
i Fah
mid
a, te
lls u
s ho
w
“lin
ear
pro
gra
mm
ing
” ca
n b
e us
ed t
o ch
oose
the
rig
ht f
ood
to
avoi
d n
utrie
nt d
efic
ienc
ies.
All
artic
les
und
ersc
ore
th
at
“int
ensi
ficat
ion”
o
f a
foo
d-b
ased
ap
pro
ach
still
bea
rs s
igni
fican
t p
oten
tial.
3130
imp
air
gro
wth
, m
enta
l d
evel
op
men
t an
d i
mm
unity
to
dis
ease
s ar
e co
mm
on
in b
oth
ad
ults
and
chi
ldre
n in
man
y su
b-S
ahar
an c
oun
trie
s. I
n th
e D
emo
crat
ic
Rep
ublic
of C
ong
o, f
or e
xam
ple
, vita
min
-A d
efic
ienc
y in
chi
ldre
n un
der
five
is a
s hi
gh
as 6
1 p
er c
ent,
hig
her
still
for i
ron
def
icie
ncie
s, w
hich
are
est
imat
ed to
affe
ct
71 p
er c
ent
of c
hild
ren
und
er fi
ve.
Whe
n it
com
es t
o f
ind
ing
so
lutio
ns,
I b
elie
ve t
here
is
a p
ract
ical
pat
hway
tha
t ca
n no
t o
nly
cata
lyse
ec
ono
mic
g
row
th
and
im
pro
ve
the
livel
iho
od
s o
f A
fric
a’s
mill
ions
o
f sm
allh
old
er
farm
ers,
b
ut
also
ac
hiev
e fo
od
and
nut
ritio
n se
curit
y fo
r th
e co
ntin
ent.
This
pat
hway
is s
usta
inab
le in
tens
ifica
tion.
Wha
t is
Sus
tain
able
Int
ensi
fica
tio
n?
A
rap
idly
g
row
ing
p
opul
atio
n,
incr
easi
ng
dem
and
fo
r nu
triti
ous
food
s in
clud
ing
live
stoc
k p
rod
ucts
, an
d
the
urg
ent
need
to
add
ress
ala
rmin
g le
vels
of h
ung
er
and
mal
nutr
ition
, all
req
uire
a r
esp
onse
in w
hich
food
p
rod
uctio
n is
inte
nsifi
ed. Y
et sc
arci
ties i
n re
sour
ces s
uch
as la
nd, w
ater
and
soi
l fer
tility
mak
e th
is a
cha
lleng
e.
“Sus
tain
able
Int
ensi
ficat
ion”
(SI
) is
an
app
roac
h th
at
ensu
res
this
in
crea
sed
fo
od
p
rod
uctio
n ha
s le
ss
imp
act o
n th
e en
viro
nmen
t, re
qui
res
few
er in
put
s su
ch
as l
and
and
wat
er,
and
ens
ures
the
nat
ural
res
ourc
e b
ase
upon
whi
ch a
gric
ultu
re d
epen
ds
is s
usta
ined
, an
d in
dee
d im
pro
ved
, for
futu
re g
ener
atio
ns.
The
2012
M
ont
pel
lier
Pane
l re
po
rt
“Sus
tain
able
In
tens
ifica
tio
n:
A
New
Pa
rad
igm
fo
r A
fric
an
Ag
ricul
ture
” ex
plo
res
the
thre
e p
illar
s of
SI—
gen
etic
, ec
olog
ical
and
soc
io-e
cono
mic
—an
d d
emon
stra
tes
that
SI
coul
d h
old
the
key
to
Imp
rove
d p
rod
uctio
n,
inco
me
and
nut
ritio
n in
sub
-Sah
aran
Afr
ica.
Gen
etic
Int
ensi
fica
tio
n to
Im
pro
ve
the
Nut
riti
ona
l Qua
lity
of
Foo
d
Gen
etic
int
ensi
ficat
ion,
for
exa
mp
le,
can
invo
lve
the
dis
sem
inat
ion
of n
ew v
arie
ties
of s
tap
le c
rop
s, o
r b
reed
s of
liv
esto
ck
with
im
pro
ved
nu
triti
ve
valu
e.
Har
vest
Plus
is c
arry
ing
out
exe
mp
lary
wor
k on
fort
ifyin
g
stap
le
food
s w
ith
vita
min
s an
d
mic
ronu
trie
nts.
In
Rw
and
a, t
en n
ew b
ean
varie
ties
that
are
ric
her
in
iron
have
bee
n re
leas
ed in
the
cou
ntry
sin
ce 2
011,
in
ord
er t
o im
pro
ve n
utrit
ion.
By
the
end
of
2013
, som
e 70
0,00
0 fa
rmer
s w
ere
gro
win
g th
ese
iron
bea
ns, w
hich
p
rovi
de
up t
o 45
per
cen
t of
dai
ly ir
on n
eed
s.
In K
enya
, D
r. Sh
eila
Om
meh
is
rese
arch
ing
how
to
b
reed
a
chic
ken
that
is
d
isea
se-r
esis
tant
, w
eig
hts
arou
nd
4 ki
log
ram
mes
an
d
pro
duc
es
250
egg
s a
year
—ab
out
thre
e tim
es
the
wei
ght
an
d
yiel
d
of
ind
igen
ous
chic
kens
. Th
is i
mp
rove
d c
hick
en c
ould
ha
ve a
pro
foun
d i
mp
act
on t
he n
utrit
ion
of r
ural
fa
mili
es t
hat
rely
on
lives
tock
for
thei
r d
aily
mea
ls.
Eco
log
ical
Int
ensi
fica
tio
n ca
n H
elp
to
Div
ersi
fy D
iets
Ano
ther
ap
pro
ach
to S
I is
eco
log
ical
inte
nsifi
catio
n.
Eco
log
ical
pro
cess
es,
such
as
mut
ualis
m b
etw
een
cro
p p
lant
s, t
he d
estr
uctio
n o
f p
ests
by
thei
r na
tura
l en
emie
s, a
nd t
he m
icro
bia
l dec
ay o
f o
rgan
ic m
atte
r ca
n b
e su
stai
nab
ly
inte
nsifi
ed.
To
red
uce
the
com
pet
itio
n b
etw
een
cro
ps,
int
ercr
op
pin
g u
tiliz
es
the
mut
ually
ben
efic
ial r
elat
ions
hip
s th
at a
rise
whe
n tw
o o
r m
ore
cro
ps
are
gro
wn
in a
sso
ciat
ion,
eith
er a
s m
ixtu
res
or
rota
tions
. N
utrit
ion
is n
ot
onl
y d
epen
den
t o
n hi
ghe
r vi
tam
in
and
nu
trie
nt
inta
ke,
but
al
so
on
a m
ore
va
ried
d
iet.
Pla
ntin
g l
egum
ino
us c
rop
s su
ch a
s b
eans
and
g
roun
dnu
ts t
hat
natu
rally
fix
nitr
og
en i
nto
the
so
il an
d im
pro
ve n
itro
gen
up
take
imp
rove
s p
lant
gro
wth
, an
d
pla
ntin
g
cro
ps
amid
le
gum
ino
us
Faid
herb
ia
tree
s th
at s
hed
the
ir le
aves
and
pro
vid
e nu
triti
ous
m
ulch
has
als
o p
rove
d t
o m
ake
soil
heal
thie
r. Th
is in
tu
rn p
rovi
des
bet
ter
harv
ests
tha
t ca
n le
ad t
o h
ighe
r in
com
es,
alo
ngsi
de
pro
tein
-ric
h an
d n
utrie
nt-d
ense
cr
op
s to
cre
ate
heal
thie
r d
iets
. Fa
mili
es c
an a
lso
div
ersi
fy t
heir
die
ts a
nd p
rovi
de
a su
stai
nab
le s
our
ce o
f nu
triti
ous
fo
od
s w
ith h
om
e o
r ki
tche
n g
ard
ens.
The
se a
re ri
sing
in n
umb
er in
Nig
er,
Som
alia
, G
hana
and
Ken
ya.
As
hom
e g
ard
ens
can
hous
e a
varie
ty o
f cr
op
s an
d l
ives
tock
in
one
sm
all
area
, im
pro
ving
the
int
ricat
e re
latio
nshi
ps
the
cro
ps
and
live
sto
ck h
ave
with
one
ano
ther
can
sig
nific
antly
b
oo
st p
rod
uctio
n.
Org
aniz
atio
ns
sup
po
rtin
g
the
upta
ke
of
hom
e g
ard
ens,
su
ch
as
the
Foo
d
and
A
gri
cult
ure
Org
aniz
atio
n (F
AO
) N
utri
tio
n an
d
Co
nsum
er
Pro
tect
ion
Div
isio
n,
enco
urag
e th
e p
lant
ing
o
f sp
inac
h an
d o
ther
lea
fy v
eget
able
s, c
arro
ts,
lent
ils
and
fr
uits
, as
w
ell
as
keep
ing
liv
esto
ck
such
as
ch
icke
ns,
go
ats,
duc
ks a
nd f
ish.
Far
m A
fric
a, a
UK
-b
ased
ch
arity
, an
d
its
par
tner
s ar
e al
so
wo
rkin
g
to d
evel
op
cro
pp
ing
of,
and
mar
kets
fo
r, A
fric
an
ind
igen
ous
veg
etab
les
(AIV
s) in
Tan
zani
a an
d K
enya
as
imp
ort
ant
sour
ces
of n
utrie
nts
and
inco
me.
Soci
o-e
cono
mic
Int
ensi
fica
tio
n
can
Imp
rove
Acc
ess
to F
oo
d
Imp
rovi
ng
acce
ss
to
mar
kets
fo
r st
aple
cr
op
s as
w
ell
as f
ruits
and
veg
etab
les
can
help
to
im
pro
ve
a fa
mily
’s in
com
e an
d a
bili
ty t
o b
uy a
var
iety
of
foo
ds
that
are
no
t p
rod
uced
at
hom
e. If
sm
allh
old
er
farm
ers
and
en
trep
rene
urs
alo
ng
the
agric
ultu
ral
valu
e ch
ain
are
sup
po
rted
with
the
rig
ht s
kills
and
fin
ance
to
gro
w t
heir
bus
ines
ses
to t
ake
adva
ntag
e o
f m
arke
t o
pp
ort
uniti
es,
an i
nten
sifie
d v
alue
cha
in
can
imp
rove
inco
mes
. Fo
r ex
amp
le, S
ESA
CO
Fo
od
s C
om
pan
y si
tuat
ed i
n K
amp
ala,
Ug
and
a p
rod
uces
hi
gh-
valu
e nu
trit
ious
fo
od
s m
ade
fro
m
mai
ze
mill
et,
soyb
eans
, g
roun
dnu
ts
and
se
sam
e.
Wit
h b
usin
ess
dev
elo
pm
ent
sup
po
rt
fro
m
the
Ug
and
a
Sir
Go
rdo
n C
onw
ayPr
ofe
sso
r o
f Int
erna
tiona
l Dev
elo
pm
ent
Dire
cto
r, A
gric
ultu
re fo
r Im
pac
tC
entr
e fo
r E
nviro
nmen
tal P
olic
yFa
culty
of N
atur
al S
cien
ces
Imp
eria
l Co
lleg
eLo
ndo
n, U
KM
edw
ay, K
ent,
UK
SUST
AIN
ABL
E IN
TEN
SIFI
CA
TIO
N
FOR
FOO
D S
ECU
RITY
AN
D H
EALT
H
IN A
FRIC
A
Afr
ica’
s fo
od
and
far
min
g s
ecto
r re
ceiv
ed r
enew
ed
atte
ntio
n in
201
4, a
s th
e A
fric
an U
nio
n d
esig
nate
d it
th
e “Y
ear
of
Ag
ricul
ture
and
Fo
od
Sec
urity
.” Y
et it
is
not
onl
y th
e q
uant
ity o
f fo
od
ava
ilab
le t
hat
has
bee
n un
der
scr
utin
y, b
ut a
lso
the
nut
ritio
nal q
ualit
y o
f th
is
foo
d. I
ndee
d, “
foo
d a
nd n
utrit
ion
secu
rity”
has
no
w
bec
om
e th
e ne
w n
orm
.
The
bur
den
of m
alnu
triti
on
in A
fric
a w
eig
hs h
eavi
ly o
n th
e co
ntin
ent’s
po
pul
atio
n. F
ort
y p
er c
ent
of c
hild
ren
suffe
r st
unte
d
gro
wth
as
a
resu
lt o
f in
adeq
uate
nu
triti
on.
Def
icie
ncie
s in
vita
min
A, z
inc
and
iro
n th
at
SUST
AIN
ABLE
INTE
NSI
FICA
TIO
N
3332
Dev
elo
pm
ent
Trus
t, S
ESA
CO
up
gra
ded
the
ir fo
od
-p
roce
ssin
g f
acili
ties,
inc
reas
ed p
urch
ases
fro
m l
oca
l fa
rmer
s, h
ired
ad
diti
ona
l st
aff
and
exp
and
ed s
ales
to
nei
ghb
our
ing
co
untr
ies,
driv
ing
eco
nom
ic a
ctiv
ity
fro
m t
he fa
rm t
o t
he c
ons
umer
.
Nut
rien
t-d
ense
Fo
od
Req
uire
s Fe
rtile
So
ils
Foo
d b
egin
s lif
e in
the
so
il an
d n
utrie
nt-p
oo
r so
ils
will
pro
duc
e nu
trie
nt-p
oo
r cr
op
s. T
he l
ates
t re
po
rt
fro
m t
he M
ont
pel
lier
Pane
l (a
gro
up o
f Eur
op
ean
and
A
fric
an e
xper
ts t
hat
I ch
air)
, “N
o O
rdin
ary
Mat
ter:
C
ons
ervi
ng,
Res
torin
g a
nd E
nhan
cing
Afr
ica’
s So
ils”,
d
raw
s at
tent
ion
to t
he i
mp
ort
ance
of
soil
to A
fric
a’s
foo
d a
nd n
utrit
ion
secu
rity
and
eco
nom
ic g
row
th.
It
is e
stim
ated
tha
t 65
per
cen
t o
f A
fric
a’s
arab
le l
and
is
d
egra
ded
. Po
vert
y,
clim
ate
chan
ge,
p
op
ulat
ion
pre
ssur
es a
nd i
nad
equa
te f
arm
ing
pra
ctic
es a
ll le
ad
to a
co
ntin
uous
dec
line
in t
he h
ealth
of
Afr
ican
so
ils,
whi
lst
the
eco
nom
ic
loss
is
es
timat
ed
at
USD
68
b
illio
n p
er y
ear.
Co
nver
sely
, bet
ter
land
man
agem
ent
pra
ctic
es c
oul
d d
eliv
er u
p t
o U
SD 1
.4 t
rillio
n g
lob
ally
in
incr
ease
d c
rop
pro
duc
tion—
35 t
imes
the
loss
es.
Imp
rove
d n
utrit
ion
is o
ne o
f the
man
y g
oal
s fo
r w
hich
Su
stai
nab
le I
nten
sific
atio
n sh
ow
s th
e w
ay f
orw
ard
. A
hea
lthie
r p
op
ulat
ion
is n
ot
onl
y m
ore
pro
sper
ous
, b
ut m
ore
pro
duc
tive.
Pro
duc
ing
mo
re, h
ighe
r q
ualit
y fo
od
s w
ith le
ss a
nd im
pro
ving
acc
ess
to t
hese
fo
od
s ar
e so
me
of
the
gre
ates
t ch
alle
nges
we
face
glo
bal
ly.
The
ado
ptio
n o
f Su
stai
nab
le
Inte
nsifi
catio
n co
uld
m
ake
ove
rco
min
g t
hese
cha
lleng
es p
oss
ible
.
3534
fact
ors
(hy
dro
cort
iso
ne,
tran
sfo
rmin
g g
row
th f
acto
r-b
eta
[TG
Fß],
etc)
ing
este
d in
am
nio
tic fl
uid
and
ear
ly
bre
ast m
ilk m
ay s
timul
ate
the
inte
stin
e to
dev
elo
p th
e ca
pac
ity t
o e
stab
lish
inte
stin
e im
mun
e ho
meo
stas
is.
Ho
wev
er,
it ha
s b
eco
me
rece
ntly
ap
par
ent
that
the
in
itial
co
loni
zatio
n p
roce
ss a
fter
birt
h is
nec
essa
ry t
o
actu
ally
act
ivat
e m
uco
sal p
rote
ctiv
e fu
nctio
n.
Init
ial B
acte
rial
Co
loni
zati
on
and
Ho
st D
efen
se
Ove
r th
e la
st
half
ce
ntur
y,
the
hum
an
dis
ease
b
urd
en i
n d
evel
op
ed c
oun
trie
s ha
s sh
ifted
fro
m
pre
do
min
antl
y in
fect
iou
s to
im
mu
ne
-me
dia
ted
d
ise
ase
s (a
lle
rgie
s an
d
auto
imm
un
e
dis
eas
e [t
ype
1 d
iab
etes
, cel
iac
dis
ease
, inf
lam
mat
ory
bo
wel
d
isea
se]).
Thi
s ha
s b
een
pri
ncip
ally
due
to
pub
lic
heal
th m
easu
res
(vac
cina
tion,
use
of
antib
iotic
s an
d
a cl
eane
r env
ironm
ent)
that
are
a p
art o
f the
Wes
tern
lif
esty
le, r
esul
ting
in a
str
ikin
g d
ecre
ase
in m
icro
bio
ta
that
initi
ally
col
oniz
e th
e ne
wb
orn
inte
stin
e. D
isru
ptio
n o
f in
itia
l co
loni
zati
on
caus
ed b
y ce
sare
an s
ecti
on,
p
erin
atal
use
of a
ntib
iotic
s, o
r dys
bio
sis,
for e
xam
ple
, ha
s a
sho
rt-a
nd lo
ng-t
erm
eff
ect o
n m
uco
sal i
mm
une
heal
th,
resu
ltin
g i
n a
failu
re t
o a
chie
ve i
mm
une
hom
eost
asis
and
an
incr
ease
d p
rop
ensi
ty t
o e
xpre
ss
alle
rgy
and
o
the
r im
mu
ne
-me
dia
ted
d
ise
ase
s.
Ext
ensi
ve b
asic
and
clin
ical
inve
stig
atio
n ha
s re
veal
ed
the
imp
ort
ance
of
a d
iver
se i
ntes
tina
l m
icro
bio
ta
in i
nnat
e an
d a
dap
tive
im
mun
e re
spo
nses
. Th
is i
s p
artic
ular
ly tr
ue a
t the
tim
e o
f neo
nata
l dev
elo
pm
ent
of
inte
stin
al h
ost
def
ense
s. R
ecen
tly,
clin
ical
stu
die
s ha
ve u
nder
sco
red
the
im
po
rtan
ce o
f d
iet
as a
n en
viro
nmen
tal d
eter
min
ant o
f int
estin
al c
olo
niza
tion.
Fo
r ex
amp
le,
the
mic
rob
iota
of
Afr
ican
chi
ldre
n,
ing
esti
ng a
hig
h-fib
er d
iet
wit
hout
ani
mal
fat
and
p
rote
in, i
s st
rikin
gly
diff
eren
t fro
m E
uro
pea
n ch
ildre
n in
ges
ting
a p
red
om
inan
tly W
este
rn d
iet
(pro
cess
ed
foo
ds
wit
h hi
gh
satu
rate
d f
atty
aci
ds)
, as
is
thei
r re
spec
tive
dis
ease
bur
den
. Die
t as
an
envi
ronm
enta
l d
eter
min
ant
of
inte
stin
al m
icro
bio
ta i
s p
arti
cula
rly
imp
ort
ant
in t
he n
ewb
orn
per
iod
whe
n co
loni
zing
b
acte
ria h
as a
pro
foun
d e
ffec
t o
n th
e d
evel
op
men
t o
f ho
st d
efen
se.
Bre
astf
eed
ing
and
Inte
stin
al C
olo
niza
tio
n
It is
cur
rent
ly a
ccep
ted
tha
t ex
clus
ive
bre
astf
eed
ing
o
f ne
wb
orn
inf
ants
has
a p
rofo
und
eff
ect
on
the
init
ial
colo
niza
tio
n o
f th
e g
ut.
No
t o
nly
are
div
erse
m
icro
bio
log
ic
phy
la
(larg
e fa
mili
es
of
bac
teri
a)
stim
ulat
ed,
but
in
th
e fi
rst
few
w
eeks
o
f lif
e sp
ecifi
c he
alth
-pro
mo
ting
sp
ecie
s (B
ifid
ob
acte
ria,
La
cto
bac
illus
and
Bac
tero
ides
) ap
pea
r in
the
infa
nt’s
in
test
ine.
The
se s
pec
ific
bac
teri
a ha
ve b
een
sho
wn
to s
tim
ulat
e d
evel
op
men
t o
f th
e in
fant
’s o
wn
host
d
efen
ses,
in
clud
ing
th
e se
cret
ion
of
po
lym
eric
Ig
A a
ntib
od
ies,
and
red
ucti
on
in t
he i
nfla
mm
ato
ry
resp
ons
e, e
.g.,
incr
ease
in
infla
mm
ato
ry c
yto
kine
s
(IL-8
, IL
-6),
in c
linic
al s
tud
ies.
In
add
itio
n, s
pec
ific
neo
nata
l b
acte
rial
sp
ecie
s st
imul
ate
an i
ncre
ase
in T
-reg
ulat
ory
lym
pho
cyte
s an
d t
heir
cyt
oki
nes
(IL-1
0 an
d T
GF-
ß)
to c
ont
rib
ute
inte
stin
al i
mm
une
hom
eost
asis
. H
ow
is
th
e ac
tive
st
imul
atio
n o
f in
test
inal
imm
unity
acc
om
plis
hed
by
bre
astf
eed
ing
? Se
vera
l re
cent
stu
die
s ha
ve h
elp
ed t
o i
llum
inat
e th
is p
roce
ss.
Bre
ast
milk
, p
arti
cula
rly
colo
stru
m,
pro
vid
es a
lar
ge
po
rtio
n o
f it
s nu
trie
nt c
ont
ent
as
non-
dig
esti
ble
o
ligo
sacc
hari
des
(8
%
of
tota
l n
utr
ien
ts).
Th
ese
u
nab
sorb
ed
o
ligo
sacc
har
ide
s en
ter
the
colo
n un
dig
este
d a
nd a
ct a
s su
bst
rate
fo
r b
acte
ria
ferm
enta
tio
n, r
esul
ting
in
an i
ntra
lum
inal
ac
id m
ilieu
and
inc
reas
ed s
hort
-cha
in f
atty
aci
ds
(lact
ate,
ace
tate
, p
rop
rioni
c ac
id a
nd b
utyr
ate)
. Th
e ac
id m
ilieu
env
iro
nmen
t fa
cilit
ates
the
pro
lifer
atio
n o
f h
eal
th-p
rom
oti
ng
b
acte
ria
and
th
e
sho
rt-
chai
n fa
tty
acid
sp
ecifi
cally
aff
ects
T-r
egul
ato
ry
cells
thr
oug
h re
cep
tors
on
thei
r su
rfac
e le
adin
g
to i
mm
une
hom
eost
asis
. It
has
bee
n sh
ow
n th
at
bre
ast
milk
olig
osa
ccha
rides
use
d a
s th
e so
le s
our
ce
of
carb
on
for
Bifi
do
bac
teri
a in
fant
is,
a ne
ona
tal
heal
th-p
rom
otin
g b
acte
rium
, no
t o
nly
pre
fere
ntia
lly
incr
ease
s p
rolif
erat
ion
of
this
bac
teri
um b
ut a
lso
st
imul
ates
its
spec
ific
bac
teria
l gen
es w
hich
co
ntro
l en
tero
cyte
typ
e ju
ncti
ons
and
ant
i-in
flam
mat
ion.
Th
is s
ame
pro
lifer
atio
n d
oes
no
t o
ccur
whe
n in
fant
s ar
e fe
d f
orm
ula.
The
se o
bse
rvat
ions
und
ersc
ore
th
e im
po
rtan
ce o
f b
reas
tfee
din
g i
n es
tab
lishi
ng a
n ap
pro
pri
ate
colo
nizi
ng m
icro
bio
ta a
nd i
ts e
ffec
t o
n no
rmal
muc
osa
l im
mun
e d
efen
se,
an i
mp
ort
ant
pro
tect
ive
inte
stin
al fu
nctio
n.
The
Bre
ast
Milk
Mic
rob
iom
e
Unt
il re
cent
ly i
t w
as a
ssum
ed t
hat
bre
ast
milk
was
st
erile
and
aff
ecte
d d
evel
op
men
t o
f in
test
inal
ho
st
def
ense
prin
cip
ally
thro
ugh
its in
dire
ct p
assi
ve e
ffect
s o
n in
dig
eno
us c
olo
nizi
ng b
acte
ria. H
ow
ever
, sev
eral
st
udie
s o
ver
the
last
dec
ade
sug
ges
t th
at a
sp
ecifi
c b
acte
rial m
icro
bio
me
exis
ts in
bre
ast
milk
itse
lf. T
his
bre
ast
milk
mic
rob
iom
e is
no
t ju
st c
ont
amin
atio
n b
y m
icro
bio
ta o
n th
e m
oth
er’s
ski
n su
rro
und
ing
the
ar
eola
and
nip
ple
or m
icro
bio
ta in
the
infa
nt’s
mo
uth,
b
ut a
pp
ears
to
be
rep
rese
ntat
ive
of
mat
erna
l g
ut
mic
rob
iota
. Ani
mal
stu
die
s ha
ve s
how
n th
at m
ater
nal
gut
mic
rob
iota
can
cro
ss a
n in
crea
sing
ly p
erm
eab
le
gut
bar
rier,
bec
om
e en
gul
fed
by
mac
rop
hag
es a
nd
lym
pho
cyte
s an
d th
en m
igra
te to
the
mam
mar
y g
land
, w
here
the
mic
rob
es a
re d
epo
site
d in
to b
reas
t m
ilk.
Thes
e o
bse
rvat
ions
hav
e b
een
par
tial
ly c
onf
irm
ed
wit
h lim
ited
hu
man
st
udie
s sh
ow
ing
in
crea
sed
in
test
inal
per
mea
bili
ty t
o m
icro
bio
ta a
nd c
ircul
atin
g
hum
an b
loo
d m
acro
pha
ges
with
in e
ngul
fed
bac
teria
. Th
e nu
mb
er o
f b
acte
ria in
bre
ast
milk
(103
per
cc)
is
cons
ider
ably
less
tha
n in
test
inal
co
loni
zing
bac
teria
(1
014 p
er c
c) a
nd t
he r
ole
of
bre
ast
milk
mic
rob
iota
in
the
est
ablis
hmen
t o
f th
e ne
wb
orn
int
esti
ne’s
m
icro
bio
me
rem
ains
to b
e es
tab
lishe
d. H
ow
ever
, it i
s
W. A
llan
Wal
ker,
M.D
.C
onr
ad T
aff P
rofe
sso
r o
f Nut
ritio
n an
d P
edia
tric
sH
arva
rd M
edic
al S
cho
ol
Muc
osa
l Im
mun
olo
gy
and
Bio
log
y R
esea
rch
Cen
ter
Mas
sach
uset
ts G
ener
al H
osp
ital f
or
Chi
ldre
nC
harle
sto
wn,
Mas
sach
uset
ts, U
SA
NEW
PRO
TECT
IVE
PRO
PERT
IES A
ND
FUN
CTIO
NS O
F BRE
AST M
ILK
Gen
eral
Bre
ast
Milk
Pro
tect
ive
Func
tio
ns
It h
as b
een
kno
wn
for
seve
ral
dec
ades
tha
t th
e in
ges
tio
n o
f b
reas
t m
ilk,
par
ticu
larl
y co
lost
rum
, p
rovi
des
the
new
bo
rn in
fant
with
pas
sive
pro
tect
ion
agai
nst
the
extr
aute
rine
env
iro
nmen
t un
til
its
ow
n d
efen
ses
can
dev
elo
p.
Pro
tect
ive
fact
ors
in
bre
ast
milk
(p
IgA
, la
cto
ferr
in,
lyso
sym
e, e
tc.)
are
incr
ease
d
init
ially
and
the
n ar
e re
duc
ed o
ver
the
per
iod
of
lact
atio
n as
the
new
bo
rn d
evel
op
s its
ow
n p
rote
ctiv
e m
uco
sal
func
tio
ns.
Wha
t is
les
s un
der
sto
od
is
how
th
e ne
wb
orn
in
fant
d
evel
op
s it
s o
wn
inte
stin
al
pro
tect
ion.
It
ha
s b
een
sug
ges
ted
th
at
tro
phi
c
NEW
ASP
ECTS
OF B
REAS
TFEE
DIN
G
3736
exci
ting
to s
pec
ulat
e th
at h
ealth
-pro
mo
ting
bac
teria
in
bre
ast m
ilk w
ith it
s b
acte
rial p
rolif
erat
ing
co
mp
one
nts
may
be
ano
ther
fact
or i
n th
e d
evel
op
men
t of n
ewb
orn
p
rote
ctio
n ag
ains
t p
oss
ible
dis
ease
sta
tes
in t
he
new
bo
rn e
nviro
nmen
t as
a re
sult
of i
nitia
l co
loni
zatio
n.
Sum
mar
y
Bre
ast m
ilk h
as b
een
cons
ider
ed to
pro
vid
e im
po
rtan
t p
assi
ve p
rote
ctiv
e p
rop
erti
es f
or
the
new
bo
rn t
o
adju
st t
o t
he e
xtra
uter
ine
envi
ronm
ent.
We
have
re
cent
ly b
egun
to
ap
pre
ciat
e its
ro
le in
act
ivat
ing
the
ne
wb
orn
’s o
wn
inte
stin
al d
efen
ses.
Thi
s d
evel
op
men
t o
f in
test
inal
ho
st d
efen
se l
ead
ing
to
ho
meo
stas
is
is i
n la
rge
par
t m
edia
ted
by
the
init
ial
bac
teri
al
colo
niza
tio
n p
roce
ss.
Bre
astf
eed
ing
is
th
e m
ost
im
po
rtan
t en
viro
nmen
tal
stim
ulus
to
an
app
rop
riat
e in
itial
co
loni
zatio
n o
f the
gut
.
3938
Wal
ter
Wah
li, P
h.D
.
Lee
Ko
ng C
hian
Sch
oo
l of M
edic
ine
Nan
yang
Tec
hno
log
ical
Uni
vers
itySi
ngap
ore
&
C
ente
r fo
r In
teg
rativ
e G
eno
mic
sU
nive
rsity
of L
ausa
nne
Laus
anne
Switz
erla
nd
FORT
Y PE
RCEN
T O
F TH
E W
ORL
D
POPU
LATI
ON
IS M
ALN
OU
RISH
ED:
WH
AT
CA
N W
E D
O A
BOU
T IT
?In
201
0, f
or
the
first
tim
e in
our
hum
an h
isto
ry, t
here
w
ere
equa
l num
ber
s o
f ove
rwei
ght
and
und
erw
eig
ht,
mal
nour
ishe
d p
eop
le. U
nfo
rtun
atel
y, t
his
was
no
t th
e re
sult
of
a re
duc
tion
of
hung
er;
rath
er,
it w
as d
ue
to t
he d
ram
atic
inc
reas
e in
ove
rwei
ght
ind
ivid
uals
. B
etw
een
1980
and
201
3, t
he n
umb
er o
f o
verw
eig
ht
peo
ple
ro
se f
rom
857
mill
ion
to 2
.1 b
illio
n. T
his
is
mo
re th
an th
e to
tal w
orld
po
pul
atio
n in
192
7, th
e ye
ar
it fir
st r
each
ed 2
bill
ion.
Dur
ing
the
sam
e p
erio
d, t
he
num
ber
of
und
erw
eig
ht p
eop
le c
hang
ed v
ery
little
, w
ith 9
8% l
ivin
g i
n lo
w-in
com
e an
d m
idd
le-in
com
e co
untr
ies
(LM
ICs)
. Ta
ken
tog
ethe
r, cl
ose
to
40%
of
MAL
NUT
RITI
ON
: W
HAT C
AN W
E DO
?
tod
ay’s
wo
rld p
op
ulat
ion
is m
alno
uris
hed
and
suf
fers
fr
om
a d
efic
ienc
y o
r an
exce
ss o
f the
nut
rient
s ne
eded
fo
r he
alth
y liv
ing
. The
se m
alno
uris
hed
peo
ple
sha
re
hig
h le
vels
of i
llnes
ses,
dis
abili
ties,
sho
rter
life
sp
ans,
an
d re
duc
ed p
rod
uctiv
ity, a
nd re
pre
sent
the
big
ges
t p
ublic
hea
lth p
rob
lem
hum
anity
has
eve
r fa
ced
.
Und
ernu
triti
on
is
pre
vale
nt
in
LMIC
s an
d
affe
cts
mo
ther
s an
d
child
ren
prim
arily
. It
is
re
spo
nsib
le
for
ove
r a
third
of
child
dea
ths
and
cau
ses
11%
of
the
glo
bal
dis
ease
bur
den
. In
co
ntra
st,
mo
re a
dul
ts
in
hig
h-in
com
e co
untr
ies
(HIC
s)
are
ove
rwei
ght
; ho
wev
er, i
t is
bec
om
ing
mo
re a
nd m
ore
pre
vale
nt in
th
e ur
ban
po
pul
atio
ns o
f LM
ICs,
whi
ch n
ow
hav
e to
fa
ce t
he d
oub
le b
urd
en o
f und
er-
and
ove
rnut
ritio
n.
Ther
e is
an
alar
min
g in
crea
se o
f ove
rwei
ght
chi
ldre
n,
and
thi
s ra
te h
as n
early
trip
led
ove
r th
e la
st 3
0 ye
ars.
As
with
und
ernu
triti
on,
it
is i
mp
erat
ive
to
add
ress
mat
erna
l an
d c
hild
ove
rnut
ritio
n. H
ow
will
th
is
epid
emic
im
pac
t th
e fu
ture
he
alth
o
f th
ese
ob
ese
child
ren
and
pub
lic h
ealth
in
gen
eral
? Th
e ea
rlier
yo
u ar
e ex
po
sed
to
ob
esity
, th
e ea
rlier
the
o
nset
of
com
plic
atio
ns—
incl
udin
g t
ype
2 d
iab
etes
, ca
rdio
vasc
ular
d
isea
se,
met
abo
lic
synd
rom
e,
and
ca
ncer
—m
ay
occ
ur.
Sim
ilarl
y,
the
und
ernu
trit
ion
of
mo
ther
s is
ass
oci
ated
with
po
or
feta
l g
row
th,
and
mal
nutr
itio
n in
the
firs
t ye
ars
of
life
lead
s to
irr
ever
sib
le d
amag
e w
ith r
esp
ect
to g
row
th,
leve
l o
f sc
hoo
ling
, an
d l
ater
chr
oni
c d
isea
ses.
It
do
es
not
com
e as
a
surp
rise
that
ch
ildre
n’s
mat
urin
g
bo
die
s ar
e es
pec
ially
vul
nera
ble
to
the
det
rimen
tal
heal
th e
ffect
s o
f m
alnu
triti
on.
It
is t
he i
rrev
ersi
bili
ty
of
thes
e im
pai
rmen
ts t
hat
is p
artic
ular
ly a
larm
ing
. E
ven
tho
ugh
it m
ight
ap
pea
r sh
ock
ing
to
ad
dre
ss
und
ernu
triti
on
and
ove
rnut
ritio
n at
the
sam
e le
vel,
it is
the
po
ore
st p
op
ulat
ions
tha
t ar
e m
ost
affe
cted
in
bo
th s
ituat
ions
. Fur
ther
par
alle
ls in
clud
e th
e im
pac
t o
n p
ublic
hea
lth a
nd t
he e
cono
mic
bur
den
.
Ext
rao
rdin
arily
, we
kno
w t
od
ay t
hat
the
heal
th o
f the
g
rand
child
ren
of
wo
men
who
wer
e m
alno
uris
hed
d
urin
g t
heir
pre
gna
ncy
can
be
affe
cted
. H
ow
can
d
elet
erio
us
effe
cts
of
mal
nutr
itio
n in
p
reg
nant
m
oth
ers
be
pas
sed
on
to s
ubse
que
nt g
ener
atio
ns
and
af
fect
th
eir
child
ren’
s ch
ildre
n?
Ob
vio
usly
, a
bet
ter
und
erst
and
ing
of t
he c
ause
s o
f the
long
-ter
m
and
so
met
imes
irr
ever
sib
le e
ffect
s o
f m
alnu
triti
on
is n
eed
ed t
o d
evel
op
bet
ter
inte
rven
tions
ag
ains
t it.
Thi
s tr
ansg
ener
atio
nal
influ
ence
of
bio
log
ical
ly
imp
rinte
d e
nviro
nmen
tal
chan
ges
is
reco
gni
zed
by
scie
ntis
ts a
s an
ep
igen
etic
effe
ct i
n ac
tion.
The
se
ob
serv
ed
mo
difi
catio
ns
cann
ot
be
exp
lain
ed
by
chan
ges
at
the
leve
l o
f th
e g
enet
ic c
od
e, b
ut a
re
the
resu
lt o
f ep
igen
etic
alte
ratio
ns.
Thes
e ch
ang
es
cons
ist
of
the
add
itio
n o
r re
mo
val
of
chem
ical
g
roup
s o
n g
enet
ic
mat
eria
l o
r o
n th
e hi
sto
ne
pro
tein
s su
rro
und
ing
it.
The
gen
es t
hem
selv
es a
re
not
alte
red
, but
the
gen
e ac
tivity
is. A
ltho
ugh
thes
e ep
igen
etic
m
od
ifica
tio
ns
are
usua
lly
reve
rsib
le,
som
e ca
n b
e p
asse
d o
n to
the
nex
t g
ener
atio
n,
whi
ch e
xpla
ins
why
a c
hild
’s g
enes
can
car
ry t
race
s o
f m
alnu
triti
on
that
affe
cted
a g
rand
mo
ther
. Th
us,
the
fight
ag
ains
t m
alnu
triti
on
mus
t ad
apt
to t
he
effe
cts
of
epig
enet
ic i
nher
itanc
e to
bet
ter
man
age
the
targ
eted
po
pul
atio
ns.
Nut
ritio
nal
inte
rven
tions
ai
med
at
savi
ng t
he l
ives
of
child
ren
in t
he s
hort
te
rm
are
not
eno
ugh.
Th
ey
mus
t al
so
focu
s o
n re
duc
ing
the
risk
of d
evel
op
ing
ver
y se
rious
dis
ease
s la
ter
on,
and
of
pas
sing
on
epig
enet
ic a
ncho
red
p
red
isp
osi
tions
to
fut
ure
child
ren.
It
is u
ncle
ar h
ow
lo
ng i
t w
ill t
ake
to d
evel
op
ap
pro
ache
s th
at w
ill
add
ress
ep
igen
etic
p
rog
ram
min
g,
but
th
ey
are
ind
isp
ensa
ble
for p
rom
otin
g th
e lo
ng-t
erm
hea
lth o
f th
e b
enef
icia
ries
and
the
ir o
ffsp
ring
.
Trem
end
ous
ad
vanc
es
have
b
een
mad
e in
un
der
stan
din
g
our
g
enet
ic
herit
age.
D
urin
g
our
lo
ng n
atur
al h
isto
ry,
hund
red
s o
f g
enes
hav
e b
een
sub
ject
to
po
sitiv
e se
lect
ion,
oft
en i
n re
spo
nse
to
nutr
itio
n an
d
div
erse
hu
man
ac
tiviti
es.
In
Afr
ica,
th
e g
eno
me
of
hum
ans
was
sha
ped
by
nutr
ient
-g
ene
inte
ract
ions
. O
n th
eir
exit
fro
m A
fric
a 50
,000
ye
ars
ago
, hu
man
s sp
read
ove
r th
e w
hole
glo
be,
fa
cing
new
env
ironm
ents
and
cha
lleng
es,
som
e o
f w
hich
wer
e im
po
sed
by
natu
re,
such
as
an i
ce a
ge.
O
ther
, m
ore
num
ero
us c
hang
es w
ere
self-
imp
ose
d,
incl
udin
g t
he d
om
estic
atio
n o
f an
imal
s an
d p
lant
s an
d
chan
ges
in
p
olit
ical
o
rgan
izat
ion,
an
d
wer
e im
po
sed
by
incr
ease
s in
po
pul
atio
n d
ensi
ties
and
se
den
tary
lif
e.
Thes
e cu
ltura
l ch
ang
es
rep
rese
nt
som
e o
f th
e m
any
mo
difi
catio
ns in
hum
an s
elec
tion
that
ha
ve
imp
acte
d
our
g
eno
me.
A
n ill
ustr
ativ
e ex
amp
le i
s th
e sp
read
ing
of
the
lact
ose
-to
lera
nce
alle
le t
o h
igh
freq
uenc
ies
in l
ess
than
9,0
00 y
ears
in
Eur
op
ean,
Afr
ican
, an
d M
idd
le E
aste
rn d
airy
ing
p
op
ulat
ions
. Thi
s co
nfer
red
an
adva
ntag
e to
peo
ple
ab
le
to
dig
est
lact
ose
, th
e m
ain
sug
ar
in
milk
. Si
mila
rly,
it is
tho
ught
tha
t d
urin
g t
heir
conq
uest
of
the
Paci
fic, t
he a
nces
tors
of p
rese
nt-d
ay P
oly
nesi
ans
wer
e su
bje
ct t
o s
tarv
atio
n an
d c
old
str
ess
dur
ing
th
eir l
ong
op
en-o
cean
jour
neys
. Sel
ectio
n o
f an
alle
le
of
the
per
oxi
som
e p
rolif
erat
or-
activ
ated
re
cep
tor
gam
ma
coac
tivat
or
1-al
pha
, w
hich
co
nfer
s hi
ghe
r en
erg
y ef
ficie
ncy,
rep
rese
nted
an
adva
ntag
e at
tha
t tim
e, b
ut it
is n
ow
ass
oci
ated
with
incr
ease
d t
ype
2 d
iab
etes
sus
cep
tibili
ty in
pre
sent
-day
Po
lyne
sian
s.
Tod
ay’s
hum
an p
op
ulat
ions
will
res
po
nd d
iffer
ently
to
nut
ritio
nal
inte
rven
tions
bas
ed o
n th
eir
cultu
ral
hist
ory
and
eth
nic
bac
kgro
und
. Nut
ritio
nal p
rog
ram
s w
ill h
ave
to a
dap
t as
we
gai
n kn
ow
led
ge
of n
utrit
ion-
gen
e in
tera
ctio
ns.
As
with
clo
thin
g,
one
siz
e d
oes
no
t fit
all!
We
need
to
det
erm
ine
the
bes
t nu
triti
on
that
co
nfer
s lo
ng-t
erm
tra
nsg
ener
atio
nal
ben
efits
, p
artic
ular
ly fo
r wo
men
of r
epro
duc
tive
age,
pre
gna
nt
wo
men
, and
yo
ung
chi
ldre
n in
diff
eren
t p
arts
of
the
glo
be.
Thi
s ai
m m
ay n
ot b
e fu
lfille
d fo
r sev
eral
yea
rs;
yet,
po
wer
ful t
echn
olo
gie
s w
ill c
ont
inue
to
dev
elo
p
and
gen
erat
e ne
w k
now
led
ge
that
will
co
ntrib
ute
to
this
go
al.
4140
Perh
aps
the
big
ges
t cha
lleng
e in
the
field
of n
utrit
ion
is h
ow
to
tra
nsla
te t
he r
apid
gro
wth
in
bio
med
ical
an
d g
enet
ic/e
pig
enet
ic k
now
led
ge
into
fo
od
s th
at
can
be
mad
e av
aila
ble
to
tho
se w
ho n
eed
the
m
mo
st,
oft
en i
n re
mo
te r
ural
are
as.
Firs
t, t
here
is
a ne
ed fo
r ed
ucat
iona
l and
rese
arch
effo
rts
on
nutr
itio
n in
LM
ICs,
as
wel
l as
in
HIC
s, t
o i
mp
rove
nut
ritio
nal
liter
acy.
R
ecen
t d
evel
op
men
ts
in
info
rmat
ion
tech
nolo
gy
coul
d h
elp
trem
end
ous
ly. T
he e
mer
gen
ce
of
Mas
sive
Op
en O
nlin
e C
our
ses
(MO
OC
s) p
rovi
des
to
p-le
vel u
nive
rsity
co
urse
s fo
r fr
ee t
o la
rge
num
ber
s o
f st
uden
ts.
Thu
s,
low
er-c
ost
an
d
hig
h-q
ualit
y ed
ucat
ion
can
be
mad
e av
aila
ble
to
d
isfa
vore
d
gro
ups,
whi
ch o
ften
co
-loca
lize
with
po
pul
atio
ns i
n ne
ed o
f b
ette
r nu
triti
on.
Lar
ger
gro
ups
of
peo
ple
w
ill b
e ab
le t
o p
rom
ote
res
earc
h to
dev
elo
p l
oca
lly-
bas
ed
solu
tions
w
here
ver
po
ssib
le,
incl
udin
g
the
pro
mo
tion
of
nutr
itio
n lit
erac
y to
co
mm
unity
hea
lth
wo
rker
s vi
a o
utp
ost
hea
lth c
ente
rs. H
ow
ever
, thi
s w
ill
not
be
suffi
cien
t. T
he i
nter
natio
nal
nutr
itio
n sy
stem
w
ill a
lso
hav
e to
bet
ter
inte
gra
te t
he j
oin
t ef
fort
s o
f ac
adem
ia,
rese
arch
, ci
vil
soci
ety,
priv
ate
sect
or,
and
d
ono
r o
rgan
izat
ions
to
im
ple
men
t g
lob
al p
rog
ram
s b
acke
d b
y so
und
nat
iona
l po
licie
s an
d re
qui
ring
so
lid
loca
l po
litic
al s
upp
ort
.
4342
Pro
fess
or
Tu G
iay
was
bo
rn in
a v
illag
e o
n th
e b
anks
o
f th
e R
ed R
iver
. H
e ex
per
ienc
ed a
diff
icul
t lif
e in
hi
s yo
uth,
gro
win
g u
p i
n a
po
or
fam
ily,
but
tha
nks
to h
is h
ard
-wo
rkin
g m
oth
er a
nd h
is o
wn
clev
erne
ss
and
will
po
we
r h
e a
chie
ved
a h
igh
ed
uca
tio
nal
le
vel.
Dur
ing
war
tim
e he
wo
rked
in t
he V
ietn
ames
e P
op
ular
Arm
y as
a h
ygie
nist
-nut
riti
oni
st.
In 1
946,
th
e re
sist
ance
bro
ke o
ut i
n th
e w
hole
co
untr
y. T
he
Res
ista
nce
Arm
y an
d p
eop
le h
ad t
o le
ave
the
citi
es
and
tow
ns fo
r the
str
ugg
le w
aged
in th
e co
untr
ysid
e an
d
mo
un
tain
ou
s ar
eas
, an
d
the
y fa
ced
g
reat
ch
alle
nges
. Mal
aria
, hun
ger
, vit
amin
def
icie
ncy,
and
d
isea
ses
asso
ciat
ed w
ith
lack
of
hyg
iene
in f
eed
ing
(s
uch
as
cho
lera
, d
yse
nte
ry,
and
typ
ho
id f
eve
r)
wer
e ra
mp
ant.
Thu
s nu
trit
ion
and
fo
od
hyg
iene
as
wel
l as
key
pub
lic h
ealt
h is
sues
bec
ame
a ce
ntra
l to
pic
to
ens
ure
the
heal
th o
f the
Peo
ple
’s a
nd A
rmy
Res
ista
nce.
Und
er P
rofe
sso
r G
iay’
s g
uid
ance
, th
e m
agaz
ine
Enj
oy
Life
po
pul
ariz
ed t
o t
he s
old
iers
an
d p
eop
le a
hea
lthy
life
styl
e, b
asic
kno
wle
dg
e o
f hy
gie
ne,
soun
d n
utri
tio
n, a
nd s
trat
egie
s to
co
ntro
l m
alar
ia—
the
mo
st i
mp
ort
ant
heal
th p
rob
lem
s o
f th
at t
ime.
He
par
tici
pat
ed in
the
bat
tle
at D
ien
Bie
n P
hu i
n 19
54.
He
inst
itut
ed a
n em
pha
sis
on
pro
per
h
ygie
ne
, w
ith
tw
elv
e s
pe
cifi
c re
com
me
nd
atio
ns
for
ind
ivid
ual
and
co
llect
ive
hyg
iene
, w
hich
was
ad
op
ted
fo
r ap
plic
atio
n ac
ross
the
ent
ire
arm
y.
Am
ong
the
tw
elve
hyg
iene
issu
es, s
even
are
rela
ted
to
me
al h
ygie
ne
, n
ame
ly w
ash
ing
on
e’s
han
ds
bef
ore
a m
eal,
cutt
ing
fin
ger
nails
sho
rt,
pro
tect
ing
fo
od
fro
m f
lies,
no
t d
rink
ing
unb
oile
d w
ater
, us
ing
tw
o p
airs
of c
hop
stic
ks o
r al
tern
ativ
ely
the
two
end
s o
f cho
pst
icks
to
pic
k up
foo
d a
nd p
ush
rice
into
the
m
out
h d
urin
g a
mea
l, no
t sp
oili
ng t
he w
ater
so
urce
, an
d c
om
ple
tely
filli
ng t
he s
epti
c ho
le a
fter
use
. Thi
s hy
gie
ne d
isci
plin
e he
lped
to e
nsur
e th
at th
e so
ldie
rs
rem
aine
d h
ealt
hy,
and
lai
d t
he b
asis
fo
r th
e vi
cto
ry
at t
he D
ien
Bie
n P
hu b
attl
e. T
his
key
kno
wle
dg
e im
ple
men
ted
in t
he a
rmy
then
tri
ckle
d d
ow
n to
the
p
op
ulat
ion.
In t
he w
ar,
the
op
po
site
sid
e co
ncen
trat
ed t
heir
at
tack
s o
n th
e no
rthe
rn a
reas
of
the
coun
try,
on
the
sup
ply
rout
e fr
om
No
rth
to S
out
h—th
e H
o C
hi M
inh
Trai
l—o
n lo
gis
tic
stat
ions
of
bat
tlef
ield
s, a
nd o
n b
lock
ing
the
tra
nsfe
r o
f ce
real
s an
d f
oo
d f
rom
the
p
rovi
sio
nally
occ
upie
d t
o t
he li
ber
ated
zo
nes.
The
key
que
stio
n at
that
tim
e w
as h
ow
to e
nsur
e th
e tr
ansp
ort
atio
n o
f sup
plie
s, w
hich
urg
ed t
he s
olu
tio
n o
f a h
ost
of c
om
plic
ated
pro
ble
ms.
Wit
h co
lleag
ues,
P
rofe
sso
r G
iay
carr
ied
out
res
earc
h w
hich
hel
ped
d
istr
ibut
e fo
od
to
the
bat
tlef
ield
s w
here
no
ric
e o
r an
y o
ther
fo
od
co
uld
be
pro
duc
ed o
r b
oug
ht. O
ne
wel
l-kno
wn
solu
tion
was
the
“fo
ur-b
ag ri
ce-p
acki
ng”
stra
teg
y. R
ice
was
a s
tap
le f
oo
d,
and
500
g o
f ri
ce
was
the
min
imum
dai
ly r
atio
n fo
r th
e so
ldie
rs.
But
un
husk
ed a
nd g
roun
d ri
ce in
bag
s co
uld
be
pre
serv
ed
for
onl
y si
x m
ont
hs o
n av
erag
e, a
fter
whi
ch i
t w
as
spo
ilt b
y w
orm
s an
d in
sect
s. I
n ad
dit
ion,
rai
n w
ater
dur
ing
tra
nsp
ort
atio
n o
r st
ora
ge
was
a p
erm
anen
t ri
sk. T
he q
uest
ion
was
ho
w t
o t
rans
fer
rice
fro
m t
he
No
rth
to s
upp
ort
the
so
ldie
rs a
nd p
op
ulat
ion
in
the
Sout
h. H
is g
roup
, in
co
ord
inat
ion
wit
h ex
per
ts,
man
aged
to
fin
d t
he s
olu
tio
n in
usi
ng “
herm
etic
ri
ce p
acki
ng”.
Ric
e tr
ansp
ort
ed t
o t
he b
attl
efie
ld
was
pac
ked
in
four
bag
s: t
he i
nner
mo
st b
ag w
as
mad
e o
f hem
p a
s fo
r co
mm
on
rice
bag
s; c
ove
ring
it
out
sid
e w
as a
po
lyes
ter b
ag, p
rote
ctin
g ri
ce fr
om
the
chlo
rid
e sm
ell e
man
atin
g f
rom
the
out
er, t
hird
, PV
C
bag
tha
t p
reve
nted
hum
idit
y; a
nd t
he o
uter
mo
st
bag
was
ag
ain
of h
emp
and
pro
tect
ed a
gai
nst s
hock
an
d t
ears
. R
ice
pac
ked
thi
s w
ay c
oul
d l
ast
two
to
th
ree
year
s if
pro
per
ly p
rese
rved
. R
ainw
ater
co
uld
no
t d
amp
en i
t, a
nd t
he q
ualit
y o
f th
e ri
ce w
as w
ell
pre
serv
ed i
n un
der
gro
und
cac
hes,
und
amag
ed b
y th
e en
emy
or
the
toxi
c ch
emic
als
rep
ort
ed f
rom
se
vera
l bat
tlef
ield
s. D
urin
g th
e Q
uang
Tri
cam
pai
gn,
ri
ce b
ags
wer
e d
rop
ped
at
the
hig
her
sect
ion
of t
he
Thac
h H
an R
iver
for
our
arm
y to
pic
k up
at
the
low
er
sect
ion
of
the
rive
r. D
urin
g t
he e
nem
y b
lock
ade
of
our
po
int,
the
ric
e b
ags
float
ed o
n th
e se
a an
d w
ere
bro
ught
ash
ore
by
the
risi
ng t
ide.
“Fo
ur-b
ag r
ice
pac
king
” w
as a
lso
the
bas
is o
f im
pro
ved
ric
e an
d
foo
d s
tora
ge
stra
teg
ies
for
the
po
pul
atio
n.
Ano
ther
of
thei
r us
eful
res
earc
h ap
pro
ache
s an
d
final
ly s
olu
tio
ns w
as t
he u
tiliz
atio
n o
f ed
ible
wild
ve
get
able
s. V
ietn
am s
tart
ed to
so
lve
the
pro
ble
m o
f th
e la
ck o
f veg
etab
les
dur
ing
mili
tary
op
erat
ions
by
pro
cess
ing
drie
d v
eget
able
s, d
ried
whi
te ra
dis
h, a
nd
dri
ed w
ater
mo
rnin
g-g
lory
. Onc
e m
ore
, diff
icul
ties
in
tran
spo
rtat
ion
mad
e th
e su
pp
ly o
f gre
en v
eget
able
s im
po
ssib
le.
We
trie
d t
o c
onv
ey g
reen
bea
ns t
o
arm
y un
its
for
thei
r so
akin
g i
nto
sp
rout
s, b
ut a
co
ntin
uous
cat
erin
g o
f gre
en b
eans
to
all
arm
y un
its
was
im
po
ssib
le.
The
bes
t so
luti
on
was
to
pro
mo
te
loca
l se
lf-p
rod
ucin
g o
f g
reen
veg
etab
les
amo
ng
arm
y un
its.
On
the
hig
h p
late
aux
of
Vie
tnam
, wat
er
is s
carc
e d
urin
g t
he d
ry s
easo
n. W
e ha
d a
law
in
the
arm
y th
at w
aste
wat
er b
e sa
ved
, so
we
coul
d
gro
w s
om
e d
roug
ht-r
esis
tant
veg
etab
les.
Thi
s la
w
help
ed a
num
ber
of
hig
h-p
late
aux
arm
y un
its
to
par
tial
ly r
eso
lve
the
pro
ble
m o
f g
reen
veg
etab
le
cons
ump
tio
n in
the
dry
sea
son.
Fur
ther
, si
x b
ota
ny
stud
y g
roup
s g
athe
red
420
sp
ecie
s o
f w
ild e
dib
le
veg
eta
ble
s,
pri
nte
d
the
ir
pic
ture
s,
org
aniz
ed
d
ocu
men
tati
on,
and
tra
ined
all
off
icer
s an
d s
old
iers
as
wel
l as
civ
ilian
s in
har
vest
ing
wild
veg
etab
les.
C
erta
in u
nits
in
thei
r ye
arly
rep
ort
s ca
lcul
ated
the
y ha
d c
olle
cted
hun
dre
ds
of
tons
of
wild
veg
etab
les,
w
ith
the
min
imum
co
nsum
pti
on
aver
age
of
100
g p
er c
apit
a/d
ay.
Tho
se r
ice
bag
s an
d e
dib
le w
ild
veg
etab
les
cont
rib
uted
to
pre
vent
ing
and
tre
atin
g
two
co
mm
on
dis
ease
s th
at c
ause
d n
ota
ble
lo
ss i
n th
e b
attl
efie
ld d
urin
g t
he f
irst
yea
rs o
f w
ar in
So
uth
Vie
tnam
: b
erib
eri
and
nig
ht-b
lind
ness
. A
lso
, th
is
kno
wle
dg
e w
as t
rans
ferr
ed t
o t
he l
oca
l p
op
ulat
ion
and
slo
wly
bet
ter
heal
th e
volv
ed t
hank
s to
lo
cally
im
ple
men
ted
kno
wle
dg
e.
Tu N
gu,
MD
Vin
utas
Nut
ritio
n A
sso
ciat
ion
Han
oi
Vie
tnam
THE
ROO
TS O
F APP
LIED
NUT
RITI
ON
IN
VIE
TNAM
: FRO
M TH
E AR
MY
TO
THE
POPU
LATI
ON
Talk
ing
ab
out
nut
riti
on
in V
ietn
am,
we
will
nev
er
forg
et t
he c
ont
rib
utio
ns o
f P
rofe
sso
r Tu
Gia
y, a
n em
inen
t V
ietn
ames
e nu
trit
ioni
st. I
niti
ally
he
tack
led
th
e
pro
ble
m
of
kee
pin
g
Vie
tnam
ese
so
ldie
rs
nutr
itio
us a
nd h
ealt
hy, a
nd la
ter t
his
kno
wle
dg
e w
as
tran
sfer
red
and
ap
plie
d t
o t
he w
hole
po
pul
atio
n.
He
was
th
e f
ou
nd
ing
dir
ect
or
of
the
Vie
tnam
N
atio
nal
In
stit
ute
of
Nu
trit
ion
, an
d t
he
Vie
tnam
N
utr
itio
n
Ass
oci
atio
n,
and
h
e
est
ablis
he
d
the
farm
ing
sys
tem
kno
wn
as “
VAC
”, w
hich
pro
vid
es
foo
d a
nd n
utri
tio
n to
fee
d t
he a
rmy
and
als
o t
he
po
pul
atio
n na
tio
nwid
e.
APPL
IED
NUT
RITI
ON
4544
Aft
er t
he w
ar,
Dr.
Tu G
iay
bec
ame
Dir
ecto
r o
f th
e N
atio
nal R
esea
rch
Pro
gra
m to
imp
rove
the
nutr
itio
nal
stat
us o
f the
Vie
tnam
ese
peo
ple
. Am
ong
the
ten
stat
e-fo
cuse
d s
tud
ies,
alo
ng w
ith
maj
or
pro
ble
ms
such
as
ener
gy,
co
mm
unic
atio
n, a
nd t
he e
xplo
itat
ion
of
the
Red
Riv
er a
nd M
eko
ng d
elta
s an
d H
igh
Plat
eaux
, one
g
oal
was
to
imp
rove
mea
l co
nsti
tuen
ts. A
s a
resu
lt o
f th
ese
activ
ities
, the
Nat
iona
l Ins
titut
e o
f Nut
ritio
n w
as
esta
blis
hed
in
1980
. G
iay
was
the
fo
und
er a
nd t
he
first
dir
ecto
r o
f th
is I
nsti
tute
(19
81-1
993)
. U
nder
his
d
irect
ion,
the
Inst
itut
e ha
s co
ntri
but
ed re
mar
kab
ly to
th
e nu
trit
ion
pro
gra
m in
Vie
tnam
. Wit
h hi
s re
put
atio
n an
d
exp
eri
en
ce,
he
ar
ran
ge
d
for
go
vern
me
nt
sup
po
rt a
nd i
nter
nati
ona
l co
op
erat
ion
to t
rain
sta
ff
and
und
erta
ke m
ajo
r p
roje
cts
to h
elp
im
pro
ve t
he
nutr
itio
nal s
tatu
s o
f peo
ple
in t
hat
very
diff
icul
t ti
me.
Pro
f. Tu
Gia
y is
the
init
iato
r o
f th
e “V
AC
” m
ove
men
t (V
AC
: g
ard
en,
fish
-po
nd,
anim
al h
usb
and
ry)
now
w
idel
y ac
cep
ted
and
exp
and
ed t
hro
ugh
the
who
le
coun
try.
VA
C is
an
inte
gra
ted
farm
ing
sys
tem
in w
hich
g
ard
enin
g, a
nim
al h
usb
and
ry, a
nd w
ater
foo
d c
ultu
re
are
com
bin
ed t
o y
ield
the
bes
t re
sult
s, a
nd a
ll th
e p
ote
ntia
ls a
vaila
ble
are
ful
ly u
sed
in
a w
ise
man
ner
and
res
idue
s ar
e al
so r
ecyc
led
fo
r us
e. T
he V
AC
sy
stem
has
a s
cien
tific
bas
is i
n p
revi
ous
exp
erie
nce
and
e
ne
rgy-
savi
ng
as
w
ell
as
was
te-r
ecy
clin
g
stra
teg
ies.
The
VA
C s
yste
m h
elp
s to
incr
ease
inco
me,
im
pro
ve t
he e
nvir
onm
ent,
and
pro
vid
e g
oo
d f
oo
d,
thus
im
pro
ving
hea
lth
and
nut
riti
on.
It
was
cle
ar
in V
ietn
am t
hat
as t
he V
AC
sys
tem
was
pro
vid
ing
en
cour
agin
g r
esul
ts,
it c
oul
d h
elp
far
mer
s le
ad a
b
ette
r lif
e, s
tab
ilize
the
ir r
ural
so
cial
co
ndit
ions
, an
d k
eep
the
m f
rom
hav
ing
to
tre
k to
the
cit
ies.
T
he V
ietn
ames
e G
ard
ener
s’ A
sso
ciat
ion
(VA
CV
INA
-
VAC
Vie
tnam
) w
as s
et u
p i
n 19
88,
and
to
day
the
A
sso
ciat
ion
has
bra
nche
s in
all
pro
vinc
es a
nd c
itie
s o
f th
e co
untr
y. I
t ha
s he
ld m
any
trai
ning
co
urse
s to
he
lp i
ts m
emb
ers
crea
te t
heir
ow
n lo
cal
Eco
-VA
C
syst
ems.
Man
y V
ietn
ames
e fa
mili
es h
ave
ove
rco
me
hung
er a
nd p
ove
rty
wit
h th
e VA
C s
yste
m. I
t is
a lo
ng-
term
int
erve
ntio
n th
at i
s no
w u
sed
to
im
pro
ve t
he
nutr
itio
nal s
tatu
s o
f peo
ple
in o
ther
co
untr
ies
as w
ell,
and
eve
n th
e Fo
od
and
Ag
ricu
ltur
e O
rgan
izat
ion
of
the
UN
ad
op
ted
man
y as
pec
ts o
f th
e VA
C s
yste
m in
th
eir
stra
teg
ies
to g
lob
ally
red
uce
mal
nutr
itio
n.
Tu G
iay
was
a v
ery
soci
able
per
son,
eag
er to
lear
n. H
e ap
pre
ciat
ed a
nd k
new
ho
w to
ap
ply
the
exp
erie
nce
of
the
old
peo
ple
and
the
help
of i
nter
natio
nal f
riend
s to
ad
apt
app
lied
nut
riti
on
to t
he V
ietn
ames
e si
tuat
ion.
H
e w
as a
pio
neer
in t
he fi
eld
of a
pp
lied
nut
riti
on
and
p
rim
ary
heal
th c
are.
He
enha
nced
the
ro
le o
f lo
cally
av
aila
ble
foo
ds
in n
utrit
iona
l int
erve
ntio
ns to
imp
rove
th
e he
alth
of t
he p
eop
le. H
e w
as a
n ac
tive
pro
mo
ter
of
nutr
itio
n kn
ow
led
ge
amo
ng t
he p
op
ulat
ion,
and
th
e so
cial
izat
ion
of
heal
th s
ervi
ces
rece
ived
ard
ent
sup
po
rt f
rom
him
and
his
co
lleag
ues.
To
day
the
g
lob
al n
utri
tio
n co
mm
unit
y p
rom
ote
s “c
om
mun
ity-
bas
ed f
oo
d a
nd n
utri
tio
n p
rog
ram
s” u
sing
oft
en a
rath
er th
eore
tical
ap
pro
ach.
In V
ietn
am th
e VA
C s
yste
m i
s fu
ncti
ona
l an
d i
t ca
n o
nly
be
hop
ed t
hat
this
co
ncep
t w
ill s
urvi
ve t
he
glo
bal
izat
ion
of f
oo
d a
nd li
fest
yle.
4746
FBD
Gs,
inc
lud
ing
co
mp
lem
enta
ry f
oo
d r
eco
mm
en-
dat
ions
(C
FR)
for
child
ren
less
tha
n tw
o y
ears
of
age,
and
fo
od
-bas
ed r
eco
mm
end
atio
ns (
FBR
) fo
r o
ther
ag
e g
roup
s ar
e o
ften
des
igne
d t
hro
ugh
exp
ert
com
mitt
ees
mee
ting
at t
he c
oun
try
leve
l. Th
e p
roce
ss
invo
lved
incl
udes
the
com
mitt
ee’s
dra
ftin
g th
e FB
DG
s b
ased
on
dat
a re
gar
din
g n
utrit
ion-
rela
ted
dis
ease
s,
foo
d a
vaila
bili
ty a
nd in
take
pat
tern
s, a
nd th
en h
avin
g
rele
vant
int
eres
t g
roup
s re
view
the
FB
DG
pri
or
to
its
soci
aliz
atio
n to
the
co
mm
unit
y. M
ore
rec
entl
y,
an a
pp
roac
h ca
lled
lin
ear/
go
al p
rog
ram
min
g (
LP)
has
bee
n in
tro
duc
ed t
o d
evel
op
and
eva
luat
e FB
Rs.
Th
is L
P ap
pro
ach
offe
rs a
dva
ntag
es c
om
par
ed to
the
conv
enti
ona
l ap
pro
ach
in t
erm
s o
f ti
me,
ob
ject
ivit
y an
d
stre
ngth
o
f ev
iden
ce
upo
n w
hich
to
b
ase
dec
isio
ns o
n th
e fin
al F
BR
s (1
).
Wha
t is
LP
?LP
is
a m
athe
mat
ical
mo
del
ling
ap
pro
ach
whi
ch
can
iden
tify
an
op
tim
al d
iet,
i.e
. o
ne t
hat
can
fulfi
ll as
man
y as
po
ssib
le o
f th
e nu
trie
nt r
equi
rem
ents
(“
GO
ALS
”)
wh
ile
sim
ult
ane
ou
sly
taki
ng
in
to
acco
un
t m
ult
iple
var
iab
les
incl
ud
ing
lo
cal
foo
d
avai
lab
ility
, fo
od
pat
tern
s, f
oo
d p
ort
ions
, fo
od
co
st,
foo
d a
ffo
rdab
ility
and
the
die
t’s e
nerg
y co
nten
t (“
CO
NST
RA
INTS
”) (1
-2).
Wha
t ca
n o
ne a
chie
ve w
ith
LP?
LP c
an b
e us
ed to
form
ulat
e an
d e
valu
ate
FBR
s. U
sing
LP
one
can
id
enti
fy w
hat
nutr
ient
(s)
is/a
re p
rob
lem
nu
trie
nt(s
) in
a sp
ecifi
c co
mm
unity
and
can
cat
ego
rize
whe
ther
the
pro
ble
m n
utrie
nts
are
par
tial o
r ab
solu
te
pro
ble
m n
utrie
nts.
A “
par
tial p
rob
lem
nut
rient
” is
a
nutr
ient
fo
r w
hich
the
req
uire
men
t ca
n b
e ac
hiev
ed
in a
die
t us
ing
lo
cal
foo
ds,
but
to
the
det
rim
ent
of
achi
evin
g t
he r
equi
rem
ent
of
at l
east
one
oth
er
nutr
ient
. O
n th
e o
ther
han
d,
an “
abso
lute
pro
ble
m
nutr
ient
” is
a n
utri
ent
for
whi
ch t
he r
equi
rem
ent
cann
ot
be
achi
eved
usi
ng l
oca
l fo
od
s un
less
the
re
is a
cha
nge
in f
oo
d a
vaila
bili
ty a
nd f
oo
d p
atte
rn (
2).
This
pro
vid
es u
sefu
l inf
orm
atio
n o
n o
ther
nec
essa
ry
com
ple
men
tary
int
erve
ntio
ns,
incl
udin
g a
gri
cult
ure
inte
rven
tion
to a
dd
or
incr
ease
loca
l pro
duc
e ric
h in
th
at p
artic
ular
nut
rient
, a b
ehav
ior-
bas
ed a
pp
roac
h to
en
cour
age
exp
and
ing
the
foo
d b
aske
t of a
par
ticul
ar
age
gro
up, o
r a
fort
ifica
tion
pro
gra
m.
LP i
s a
po
wer
ful
too
l to
id
enti
fy n
utri
ent-
rich
fo
od
s an
d t
he e
xten
t to
whi
ch t
hese
fo
od
s ca
n fil
l the
gap
in
the
pro
ble
m n
utrie
nts.
In t
he a
rea
whe
re a
cer
tain
m
icro
nutr
ient
def
icie
ncy
is p
reva
lent
, th
ere
may
be
foo
d r
eso
urce
s w
hich
hav
e no
t b
een
utili
zed
to
the
fu
ll ex
tent
po
ssib
le.
In o
ur r
ecen
t w
ork
in I
ndo
nesi
a an
d M
yanm
ar, f
or e
xam
ple
, LP
has
bee
n us
ed to
sho
w
how
muc
h in
take
of
the
pro
ble
m n
utri
ents
can
be
cont
ribut
ed b
y m
orin
ga
(dru
mst
ick
leaf
) an
d r
ose
lle
leaf
, re
spec
tive
ly.
One
can
als
o u
se L
P to
sim
ulat
e al
tern
ativ
e co
mb
inat
ions
of
foo
d-b
ased
ap
pro
ache
s su
ch a
s na
tura
lly o
ccur
ing
nut
rient
-den
se f
oo
ds
and
m
anuf
actu
red
fo
rtifi
ed f
oo
ds
(3),
or
to i
den
tify
the
op
tim
al f
req
uenc
y o
f ho
me
fort
ifica
tio
n w
hen
die
t ha
s b
een
op
timiz
ed. A
s a
CFR
/FB
R d
evel
op
ed u
sing
LP
is c
om
pat
ible
with
loca
l fo
od
pat
tern
s, th
e ch
ance
o
f its
suc
cesf
ul a
do
ptio
n an
d s
usta
inab
le p
ract
ice
is
gre
ater
. We
have
ob
serv
ed g
oo
d c
om
plia
nce
to t
he
CFR
in a
n in
terv
entio
n st
udy
to p
rom
ote
co
nsum
ptio
n o
f ch
icke
n liv
er,
fish
and
anc
hovy
as
iron-
, zi
nc-
and
ca
lciu
m-r
ich
foo
ds
in L
om
bo
k, In
do
nesi
a (4
).
Ho
w c
an w
e ap
ply
LP
?LP
req
uire
s re
liab
le d
ata
on
foo
d a
vaila
bili
ty,
foo
d
pat
tern
s, p
ort
ion
size
s an
d n
utrie
nt c
om
po
sitio
n fr
om
th
e fo
od
co
mp
osi
tio
n ta
ble
. Th
e co
st o
f av
aila
ble
fo
od
s an
d h
ow
muc
h is
affo
rdab
le fo
r the
co
mm
unity
id
eally
sho
uld
als
o b
e co
llect
ed t
hro
ugh
mar
ket
surv
eys
and
gro
up d
iscu
ssio
n. In
our
pre
vio
us s
tud
ies,
(4
,5)
also
sup
po
rted
by
the
Nes
tlé
Foun
dat
ion,
we
used
a 1
-day
wei
ghe
d d
iet
reco
rd t
o c
om
e up
with
ac
cura
te p
ort
ion
size
s, a
nd c
om
bin
ed th
at w
ith 1
-day
24
-ho
ur d
ieta
ry r
ecal
l and
a 5
-day
fo
od
tal
ly in
ord
er
to c
om
e up
with
a 7
-day
fo
od
pat
tern
. Alte
rnat
ivel
y,
whe
n o
nly
1-d
ay 2
4-ho
ur re
call
dat
a is
ava
ilab
le, s
uch
as w
hen
anal
yzin
g re
sults
from
the
natio
nal s
urve
y d
ata
of I
ndo
nesi
a (2
), w
e ha
ve u
sed
a m
etho
d to
det
erm
ine
the
max
imum
num
ber
of
serv
ing
s p
er w
eek,
fo
r in
div
idua
l fo
od
s, fr
om
the
per
cent
age
of c
hild
ren
who
co
nsum
ed th
em b
y us
ing
the
dis
trib
utio
n o
f a s
um o
f b
ino
mia
l ran
do
m v
aria
ble
s (6
).
LP a
naly
sis
can
be
per
form
ed u
sing
line
ar o
ptim
izat
ion
(Exc
el’s
solv
er f
unct
ion)
in M
icro
soft
Exc
el (
7) a
nd in
O
ptif
oo
d s
oft
war
e (8
). Se
vera
l alte
rnat
ive
sets
of C
FRs
to b
e te
sted
are
tho
se in
whi
ch th
e fo
od
gro
ups
in th
e nu
trit
iona
l o
pti
mal
LP
die
t ha
d a
hig
her
num
ber
of
serv
ing
s p
er w
eek
than
the
ob
serv
ed m
edia
n nu
mb
er
of
serv
ing
s p
er w
eek
for
the
po
pul
atio
n. T
he f
inal
C
FR/F
BR
may
als
o in
clud
e in
div
idua
l fo
od
s (o
r th
eir
equi
vale
nt f
oo
d s
ub-g
roup
) th
at,
in t
he n
utri
tio
nal
op
tim
al L
P d
iet,
co
ntri
but
ed a
t le
ast
5% o
f th
e p
rob
lem
nut
rient
s. A
ltern
ativ
e se
ts o
f the
se in
div
idua
l C
FRs/
FBR
s ar
e th
en t
este
d a
nd c
om
par
ed o
n th
e b
asis
of
thei
r m
inim
ized
nut
rient
co
nten
t an
d a
fin
al
set
of
CFR
s is
sel
ecte
d t
hat
ensu
res
at le
ast
70%
of
the
FAO
/WH
O re
com
men
ded
nut
rient
inta
ke (R
NI)
(9)
for
mo
st n
utrie
nts.
Onc
e an
op
timal
CFR
is id
entif
ied
an
d p
ilot t
este
d, f
eed
bac
k fr
om
the
pilo
t tes
t can
als
o
be
inco
rpo
rate
d in
to L
P fo
r fu
rthe
r re
finem
ent
of t
he
reco
mm
end
atio
ns.
Futu
re e
xpec
tati
on
Giv
en th
e us
eful
ness
of L
P, it
will
pla
y an
imp
ort
ant r
ole
in
im
pro
ving
the
nut
riti
ona
l st
atus
of
imp
ove
rish
ed
po
pul
atio
ns e
spec
ially
in
low
-res
our
ce s
ettin
gs.
We
exp
ect m
ore
inno
vatio
ns o
n LP
ap
plic
atio
n to
imp
rove
m
ater
nal a
nd c
hild
nut
ritio
n an
d h
ealth
in t
he fu
ture
.
Um
i Fah
mid
a, P
hDSo
uthe
ast
Asi
an M
inis
ters
of E
duc
atio
n O
rgan
izat
ion
Reg
iona
l Cen
ter
for
Foo
d a
nd N
utrit
ion
(SE
AM
EO
RE
CFO
N)
Uni
vers
ity o
f Ind
one
sia
Sale
mb
a R
aya
Jaka
rta,
Ind
one
sia
LIN
EAR
PRO
GRA
MM
ING
TO IM
PRO
VE
MAT
ERN
AL A
ND C
HIL
D N
UTRI
TIO
N A
ND
HEA
LTH
The
wo
rld
po
pul
atio
n hi
t 7
bill
ion
in 2
011
and
is
exp
ecte
d t
o r
each
10
bill
ion
in t
he y
ear
2050
. W
hile
in
crea
sing
po
pul
atio
n d
eman
ds
for
mo
re f
oo
d a
nd
foo
d s
ecur
ity b
eco
me
ever
mo
re i
mp
ort
ant,
qua
lity
foo
d n
one
thel
ess
rem
ains
the
crit
ical
iss
ue a
s th
e co
nseq
uenc
es o
f p
oo
r d
iet,
esp
ecia
lly i
n p
reg
nant
w
om
en,
infa
nt a
nd y
oun
g c
hild
ren,
are
eno
rmo
us.
A
foo
d-b
ased
d
ieta
ry
gui
del
ine
(FB
DG
) w
hich
is
co
mp
atib
le
wit
h fo
od
su
pp
ly,
envi
ronm
enta
lly
sust
aina
ble
and
ad
dre
sses
the
po
tent
ial
nutr
itio
nal
pro
ble
ms
in a
sp
ecifi
c p
opul
atio
n is
ther
efor
e ne
cess
ary
giv
en th
e d
iver
sity
acr
oss
the
wor
ld in
thes
e as
pec
ts.
LINEA
R PRO
GRAM
MIN
G
4849
PROF
ILE O
F A
N UTR
ITION
INST
ITUTE
5051
Cyp
rian
Kat
ong
o, P
hD
Dep
artm
ent
of
Bio
log
ical
Sci
ence
sU
nive
rsit
y o
f Z
amb
iaLu
saka
Zam
bia
The
Uni
vers
ity o
f Za
mb
ia,
loca
ted
in
Lusa
ka,
is t
he
hig
hest
-ran
ked
uni
vers
ity in
Zam
bia
. It
has
a st
uden
t p
op
ulat
ion
of a
bo
ut 2
5,00
0. T
here
are
eig
ht d
iffer
ent
pub
lic u
nive
rsiti
es in
Zam
bia
, to
get
her
offe
ring
mo
re
than
15
0 d
egre
e an
d
po
stg
rad
uate
co
urse
s.
The
Uni
vers
ity o
f Za
mb
ia i
n Lu
saka
has
nin
e fa
culti
es,
amo
ng
whi
ch
is
the
Scho
ol
of
Nat
ural
Sc
ienc
es,
whi
ch h
ous
es th
e D
epar
tmen
t of B
iolo
gic
al S
cien
ces.
Th
ere
is n
o n
atio
nal
nutr
itio
n in
stitu
te a
nd a
lso
no
D
epar
tmen
t o
r In
stitu
te o
f N
utrit
ion
per
se
at t
he
Uni
vers
ity o
f Za
mb
ia.
Ho
wev
er,
ther
e is
so
me
wo
rk
bei
ng d
one
in t
he D
epar
tmen
t o
f Fo
od
Sci
ence
and
Te
chno
log
y in
the
Sch
oo
l of A
gric
ultu
ral S
cien
ces,
in
the
Facu
lty o
f M
edic
ine,
and
in
the
Dep
artm
ents
of
Bio
log
ical
Sci
ence
s an
d C
hem
istr
y in
the
Sch
oo
l o
f N
atur
al S
cien
ces.
In a
dd
itio
n, p
ublic
hea
lth n
utrit
ion-
rela
ted
act
iviti
es a
re p
ursu
ed in
diff
eren
t dep
artm
ents
o
f th
e M
inis
try
of
Hea
lth.
All
thes
e d
iffer
ent
pla
yers
co
llab
ora
te c
lose
ly.
In
the
Dep
artm
ent
of
Bio
log
ical
Sc
ienc
es,
wo
rk
on
hum
an n
utrit
ion
is s
pea
rhea
ded
by
Dr.
Cyp
rian
Kat
ong
o,
Seni
or
Lect
urer
and
Hea
d o
f D
epar
tmen
t.
Dr.
Kat
ong
o h
as b
een
wo
rkin
g i
n co
llab
ora
tion
with
o
ther
co
lleag
ues
with
in t
he U
nive
rsity
of
Zam
bia
, m
ainl
y fr
om
th
e D
epar
tmen
t o
f C
rop
Sc
ienc
e in
th
e Fa
culty
of
Ag
ricul
ture
, w
here
new
var
ietie
s o
f b
eans
(Ph
aseo
la v
ulg
aris
) b
eing
pro
duc
ed t
hro
ugh
mut
atio
n b
reed
ing
(th
roug
h irr
adia
tion)
are
bei
ng
eval
uate
d f
or
dis
ease
and
dro
ught
res
ista
nce.
Oth
er
colle
ague
s fr
om
the
Dep
artm
ent
of C
hem
istr
y in
the
Sc
hoo
l of N
atur
al S
cien
ces
are
asse
ssin
g th
e nu
triti
on
valu
e o
f the
se n
ew v
arie
ties
of b
eans
. In
add
itio
n, th
e D
epar
tmen
t o
f Fo
od
Sci
ence
and
Tec
hno
log
y in
the
Sc
hoo
l o
f A
gric
ultu
ral
Scie
nces
offe
rs a
BSc
deg
ree
in F
oo
d S
cien
ce a
nd T
echn
olo
gy
in w
hich
sub
ject
s o
n hu
man
nut
ritio
n ar
e ta
ught
.
THE U
NIV
ERSI
TY O
F ZAM
BIA
ZAM
BIA
AR
EA
Tota
l: 75
2,61
4 km
2
Ara
ble
land
: 6.
9 %
PO
PU
LATI
ON
Tota
l:
15,0
21,0
02
(201
4 es
t.)
Urb
an p
op
ulat
ion:
39
.5%
(201
0)
Und
er a
ge
15:
46.9
%
Med
ian
age:
17
yea
rs
(m
ale
16.9
yea
rs /
fem
ale
17.2
yea
rs)
Net
mig
ratio
n ra
te (p
er 1
000)
: -1
.4
Rat
e o
f urb
aniz
atio
n:
4.5%
ann
ual
rate
of c
hang
e (2
014
est.
)
PO
PU
LATI
ON
GR
OW
TH R
ATE
Tota
l:
2.8%
(201
0 es
t.)
Urb
an a
reas
: 42
% (2
010
est.
)
Tota
l fer
tility
rat
e:
5.7
child
ren
bo
rn/
wo
man
(201
4 es
t.)
GN
P (p
er c
apita
):
$1,5
00 (2
008
est.
)
LIFE
EX
PE
CTA
NC
Y A
T B
IRTH
Tota
l: 50
.9 y
ears
Mal
e: 5
0.3
year
s /
Fem
ale:
51.
6 ye
ars
MO
RTA
LITY
RA
TES
Birt
hs a
tten
ded
by
skill
ed
heal
th p
erso
nnel
: 46
% (2
012)
Neo
nata
l mo
rtal
ity r
ate
(201
0):
29/1
000
Infa
nt m
ort
ality
rat
e at
birt
h:
66.6
/100
0
Infa
nt m
ort
ality
rat
e (u
nder
1):
56/1
000
(201
2)
Und
er-f
ive
mo
rtal
ity r
ate
(201
0):
89/1
000
Und
er-f
ive
mo
rtal
ity r
ate,
ran
k:
25
Mat
erna
l mo
rtal
ity r
ate
(201
0):
440/
100,
000
live
birt
hs
Life
exp
ecta
ncy
at b
irth
(201
0):
50.9
yea
rs
INFA
NT
AN
D Y
OU
NG
CH
ILD
FE
ED
ING
Si
x-m
ont
h ex
clus
ive
b
reas
tfee
din
g r
ate
(201
2):
61%
Ear
ly in
itiat
ion
of
bre
astf
eed
ing
(200
7-20
11):
56%
Tim
ely
com
plim
enta
ry fe
edin
g
rate
(6-9
mo
nths
): 94
%
Chi
ldre
n w
ho a
re s
till
bre
astf
eed
ing
(12-
23 m
ont
hs):
41%
KE
Y N
UTR
ITIO
NA
L A
NTH
RO
PO
ME
TRY
Low
Birt
h W
eig
ht:
11%
Und
erw
eig
ht
(mo
der
ate
and
sev
ere)
: 15
%
Stun
ting
in c
hild
ren
< 5
yea
rs:
45%
(20
12)
Prev
alen
ce o
f was
ting
(m
od
erat
e an
d s
ever
e):
5% (2
006-
2010
)
MIC
RO
NU
TRIE
NT
DE
FIC
IEN
CIE
SPe
rcen
tag
e o
f ho
useh
old
s co
nsum
ing
io
diz
ed s
alt
(200
8-20
12):
77
%
OTH
ER
PA
RA
ME
TER
SM
edia
n ag
e at
firs
t b
irth
amo
ng
wo
men
25-
29 (2
007
est)
: 19
.2
Birt
h re
gis
trat
ion
(%
, urb
an /
rur
al):
28%
/ 9
%
Tota
l ad
ult
liter
acy
rate
: 61
.4%
Prim
ary
scho
ol n
et e
nro
lmen
t
ratio
(%),
2008
-201
1:
97%
% o
f po
pul
atio
n us
ing
imp
rove
d
sani
tatio
n fa
cilit
ies,
201
2, t
ota
l: 42
.8%
% o
f po
pul
atio
n us
ing
imp
rove
d s
anita
tion
fa
cilit
ies,
201
2, u
rban
: 55
.8%
% o
f po
pul
atio
n us
ing
imp
rove
d s
anita
tion
fa
cilit
ies,
201
2, r
ural
: 33
.2%
% o
f po
pul
atio
n us
ing
imp
rove
d d
rinki
ng-w
ater
so
urce
s, 2
012,
to
tal:
64%
Imm
uniz
atio
n 20
11, 1
-yea
r-o
ld c
hild
ren
im
mun
ized
ag
ains
t m
easl
es:
83%
Imm
uniz
atio
n 20
11, 1
-yea
r-o
ld c
hild
ren
imm
uniz
ed
agai
nst
po
lio:
83%
Imm
uniz
atio
n 20
11, 1
-yea
r-o
ld c
hild
ren
imm
uniz
ed
agai
nst
DPT
: 78
%
Ant
enat
al c
are
cove
rag
e (%
), at
leas
t
four
vis
its (2
007)
: 60
%
Del
iver
y ca
re c
ove
rag
e (%
), sk
illed
att
end
ant
at
birt
h (u
rban
/ r
ural
): 83
% /
31%
Phys
icia
n d
ensi
ty:
0.07
/1,0
00
5253
Our
dep
artm
ent i
s co
llab
ora
ting
with
co
lleag
ues
fro
m
oth
er in
stitu
tions
suc
h as
the
Co
pp
erb
elt
Uni
vers
ity,
whe
re w
ork
is
bei
ng c
arrie
d o
ut o
n th
e nu
triti
ona
l va
lue
of e
dib
le in
sect
s su
ch a
s g
rass
hop
per
s, te
rmite
s an
d c
ater
pill
ars.
Ano
ther
co
ncer
ted
res
earc
h ac
tion
is t
akin
g p
lace
with
the
Tro
pic
al D
isea
ses
Res
earc
h C
entr
e,
whe
re
wo
rk
on
the
vita
min
-A
and
iro
n nu
trit
iona
l st
atus
of
vuln
erab
le c
hild
ren
is b
eing
ca
rrie
d o
ut.
In a
dd
itio
n, a
n im
po
rtan
t co
llab
ora
tion
is w
ith t
he N
atio
nal F
oo
d a
nd N
utrit
ion
Co
mm
issi
on
of
Zam
bia
, w
hich
is
the
go
vern
men
tal
pro
mo
tiona
l an
d a
dvi
sory
org
an o
n m
atte
rs c
onc
erni
ng fo
od
and
nu
triti
on
in Z
amb
ia, a
nd w
hose
fo
cus
is o
n ch
ildre
n,
pre
gna
nt w
om
en a
nd la
ctat
ing
mo
ther
s.
Dr.
Kat
ong
o’s
initi
al
wo
rk
star
ted
in
20
08,
whe
n la
bor
ator
y sp
ace
was
sec
ured
and
the
firs
t p
roje
ct
fund
ed,
a p
ilot
stud
y (s
upp
ort
ed b
y th
e N
estl
é Fo
und
atio
n in
201
0) w
hich
foc
usse
d o
n d
eter
min
ing
th
e io
din
e nu
triti
on s
tatu
s b
asel
ine
amon
g p
reg
nant
w
omen
in
area
s of
Zam
bia
whe
re t
he p
opul
atio
n is
at
hig
h ris
k fo
r io
din
e d
efic
ienc
y d
isor
der
s (ID
D).
The
dis
tric
ts in
clud
ed w
ere
Mp
ika,
Kap
uta
and
Kas
emp
a,
whe
re
loca
l p
eop
le
pro
duc
e an
d
cons
ume
loca
l sa
lt w
hich
is
not
iod
ised
. B
efor
e st
artin
g t
he p
ilot
stud
y, D
r. K
aton
go
was
tra
ined
in
urin
ary
salt
iod
ine
det
erm
inat
ion
at th
e N
utrit
iona
l Int
erve
ntio
n Re
sear
ch
Uni
t of
the
Med
ical
Res
earc
h C
ounc
il of
Sou
th A
fric
a in
Cap
e To
wn
thro
ugh
a So
uth-
Sout
h co
llab
orat
ion
whi
ch c
ontin
ues
to b
e en
cour
aged
bec
ause
it ta
ps
into
th
e ric
h lo
cal
know
led
ge
and
cap
acity
. Th
is t
rain
ing
w
as a
lso
sup
por
ted
by
the
Nes
tlé F
ound
atio
n. U
rine
and
hou
seho
ld s
alt
sam
ple
s fr
om p
reg
nant
wom
en
from
the
thr
ee d
istr
icts
wer
e an
alys
ed. U
nfor
tuna
tely
, th
e re
sults
fr
om
urin
ary
iod
ine
anal
ysis
w
ere
not
relia
ble
bec
ause
of c
onta
min
atio
n in
the
Bio
chem
istr
y La
bor
ator
y of
the
Tro
pic
al D
isea
ses
Rese
arch
Cen
tre.
H
owev
er, t
he r
esul
ts f
rom
the
mar
ket
and
hou
seho
ld
salt
anal
ysis
wer
e re
liab
le a
nd th
ey re
veal
ed th
at th
ere
was
inad
equa
te io
din
e in
the
sal
t co
nsum
ed in
the
se
dis
tric
ts.
Late
r th
e g
roup
lea
der
was
inv
olve
d i
n th
e 20
11
Nat
iona
l ID
D S
urve
y fo
r Za
mb
ia o
n b
ehal
f of
the
N
atio
nal
Foo
d
and
N
utrit
ion
Co
mm
issi
on
of
the
Min
istr
y of
Hea
lth w
ith t
he s
upp
ort
of U
SAID
and
U
NIC
EF.
This
su
rvey
w
as
bas
ed
on
scho
ol-g
oing
ch
ildre
n w
ho w
ere
dra
wn
from
a 3
0-sc
hool
sam
ple
fr
om
all
10 p
rovi
nces
of
Zam
bia
. B
oth
uri
ne a
nd
hous
eho
ld s
alt
sam
ple
s w
ere
anal
ysed
fo
r io
din
e co
nten
t. Th
e ov
eral
l res
ults
ind
icat
ed a
deq
uate
iod
ine
nutr
ition
am
ong
the
scho
ol-g
oing
chi
ldre
n of
Zam
bia
, b
ut
the
resu
lts
for
Kas
emp
a an
d
Kap
uta
show
ed
that
th
e ch
ildre
n in
th
ese
two
dis
tric
ts
wer
e no
t g
ettin
g e
noug
h io
din
e in
the
ir sa
lt an
d w
ere
at r
isk
of
IDD
. Th
e ur
inar
y io
din
e co
ncen
trat
ion
in t
his
surv
ey
was
car
ried
out
at
the
Tanz
ania
Foo
d a
nd N
utrit
ion
Com
mis
sion
in
Dar
-es-
Sala
am i
n Ta
nzan
ia w
hile
the
sa
lt io
din
e d
eter
min
atio
n w
as c
arrie
d o
ut a
t th
e Fo
od
and
Dru
g C
ontr
ol L
abor
ator
y in
Lus
aka,
Zam
bia
. Onc
e
mor
e a
very
pro
duc
tive
and
rew
ard
ing
Sou
th-S
outh
co
llab
orat
ion.
Th
e D
epar
tmen
t o
f B
iolo
gic
al
Scie
nces
’ ai
ms
in
the
field
of
nutr
itio
n in
the
nea
r fu
ture
are
in
the
follo
win
g a
reas
, with
wel
l-def
ined
ob
ject
ives
:
(i)
Mo
nito
ring
the
IDD
pre
vale
nce
in Z
amb
ian
wo
men
and
chi
ldre
n un
der
the
ag
e o
f fiv
e us
ing
urin
ary
iod
ine
conc
entr
atio
n as
a p
roxy
w
ith a
vie
w t
o h
elp
red
uce
the
pre
vale
nce
to
WH
O a
ccep
tab
le le
vels
. The
gro
up is
als
o
inte
rest
ed in
det
erm
inin
g t
he a
deq
uacy
of
salt
iod
isat
ion,
pac
kag
ing
and
sto
rag
e w
ith a
vi
ew t
o h
elp
ens
ure
adeq
uate
sal
t io
dis
atio
n,
pro
per
sal
t p
acka
gin
g a
nd p
rop
er s
alt
sto
rag
e.(ii
) M
oni
torin
g v
itam
in A
nut
ritio
n st
atus
am
ong
p
rimar
y-sc
hoo
l chi
ldre
n w
ith t
he v
iew
to
en
sure
ad
equa
te v
itam
in A
inta
ke.
(iii)
Mo
nito
ring
iro
n nu
triti
on
stat
us a
mo
ng
prim
ary-
scho
ol c
hild
ren
with
the
vie
w
to e
nsur
e ad
equa
te ir
on
inta
ke.
(iv)
Mo
nito
ring
the
am
oun
t o
f vita
min
C a
nd
esse
ntia
l min
eral
s in
co
mm
on
foo
ds
on
the
Zam
bia
n m
arke
t to
ens
ure
adeq
uate
acc
ess
to v
itam
ins
and
ess
entia
l ele
men
ts.
(v)
Mo
nito
ring
the
nut
ritio
n st
atus
of v
ulne
rab
le
pre
gna
nt a
nd la
ctat
ing
mo
ther
s to
ens
ure
thei
r he
alth
and
tha
t o
f the
ir ch
ildre
n an
d
unb
orn
chi
ldre
n.
In o
rder
to
ach
ieve
the
ob
ject
ives
sta
ted
ab
ove
, th
e g
roup
in
our
dep
artm
ent
in 2
012
emb
arke
d o
n se
ttin
g u
p a
nut
ritio
n la
bo
rato
ry in
the
Dep
artm
ent o
f B
iolo
gic
al S
cien
ces,
and
the
new
lab
ora
tory
is s
o f
ar
equi
pp
ed w
ith a
sta
te-o
f-th
e-ar
t sp
ectr
op
hoto
met
er
and
re
late
d
equi
pm
ent
for
the
anal
ysis
o
f fo
od
sa
mp
les
as w
ell a
s hu
man
blo
od
and
urin
e sp
ecim
ens.
It
is
hop
ed t
hat
soo
n a
Nat
iona
l N
utrit
ion
Inst
itute
w
ill b
e se
t up
in Z
amb
ia, e
spec
ially
at
the
Uni
vers
ity
of
Zam
bia
to
co
nso
lidat
e nu
triti
on
rese
arch
an
d
inte
rven
tion
in Z
amb
ia a
imed
at
imp
rove
d n
utrit
ion
amo
ng t
he p
eop
le o
f Zam
bia
.
5455
ONG
OIN
G PR
OJE
CTS
522150
41 59
55
1
56
32
58
36
3515
28
3049
19
4734 51
137
463831
255
16
257
3723
26 6 3
9
2710
39
4353
11
54
440
45
4212
20
22
1417
188
24
3344
48
29
5756
TITLE
PRINCIPAL INVESTIGATOR
MICRONUTRIENTS BREASTFEEDING
TITLE
PRINCIPAL INVESTIGATOR
John
Muy
ong
aM
aker
ere
Uni
vers
ity,
Dep
artm
ent
of
Foo
d S
cien
ce
and
Tec
hno
log
y, K
amp
ala,
Ug
and
a
Alic
e M
bo
gan
ie M
wan
gi
Uni
vers
ity o
f N
airo
bi,
Ap
plie
d N
utrit
ion
Pro
gra
mm
e,
Uth
iru-N
airo
bi,
Ken
ya
Nat
halie
Cha
rpak
The
Kan
gar
oo
Fo
und
atio
n, B
og
ota
, Co
lom
bia
Go
dfr
ed E
gb
iU
nive
rsity
of
Gha
na, N
og
uchi
Mem
oria
l Ins
titut
e fo
r M
edic
al R
esea
rch,
Leg
on,
Gha
na
Dw
i Nas
titi I
swar
awan
tiSE
AM
EO
Reg
iona
l C
ente
r fo
r Fo
od
and
Nut
ritio
n,
Jaka
rta,
Ind
one
sia
Susa
nne
Mo
ntg
om
ery
Lom
a Li
nda
Uni
vers
ity, S
cho
ol o
f Pub
lic H
ealth
, Lo
ma
Lind
a, C
alifo
rnia
, USA
Ng
uyen
Van
Nhi
enN
atio
nal I
nstit
ute
for
Foo
d C
ont
rol,
Han
oi,
Vie
tnam
Ke
Che
nC
heng
du
Mat
erna
l an
d
Chi
ldre
n’s
Hea
lth
Car
e H
osp
ital,
Che
ngd
u, S
ichu
an, C
hina
Mar
ie M
od
estin
e K
ana
Sop
Uni
vers
ity o
f D
oua
la,
Facu
lty o
f Sc
ienc
e, D
oua
la,
Cam
ero
on
Bea
tric
e O
lub
uko
la O
gun
ba
Ob
afem
i Aw
olo
wo
Uni
vers
ity, D
epar
tmen
t o
f Fam
ily,
Nut
ritio
n an
d C
ons
umer
Sci
ence
s, Il
e ife
, Nig
eria
1 20
07
/ Io
din
e su
pp
lem
enta
tio
n in
m
ild-
to-m
od
erat
ely
iod
ine-
def
icie
nt,
pre
gna
nt
wo
men
: E
ffect
s o
n p
reg
nanc
y o
utco
me
and
inf
ant
dev
elo
p-
men
t
2 20
08
/ Im
pro
ving
m
icro
nutr
ient
st
atus
o
f C
hine
se c
hild
ren
usin
g d
ieta
ry s
piru
lina
3 20
08 /
Effe
cts
of
vita
min
A s
upp
lem
enta
tion
dur
ing
lac
tatio
n o
n in
fant
s’ a
ntib
od
y re
spo
nse
to
hep
atiti
s B
vac
cine
in C
hina
4 20
08 /
Im
pac
t o
f vi
tam
in A
and
zin
c su
pp
le-
men
tatio
n o
n p
atho
gen
-sp
ecifi
c d
iarr
heal
dis
ease
in
Mex
ican
chi
ldre
n
5 20
09 /
Effe
ct o
f m
ater
nal
zinc
sup
ple
men
ta-
tion
dur
ing
pre
gna
ncy
and
lac
tatio
n o
n in
fant
s’ i
m-
mun
ity
6 20
11 /
Effe
ct o
f so
ybea
n su
pp
lem
enta
tion,
p
aras
ite c
ont
rol a
nd n
utrit
ion
educ
atio
n o
n iro
n st
a-tu
s o
f ad
ole
scen
t g
irls
in r
ural
Chi
na
7 20
14 /
Min
imiz
ing
the
neg
ativ
e ef
fect
of
iron
sup
ple
men
tatio
n an
d f
ort
ifica
tion
on
gut
mic
rob
iota
us
ing
loca
l res
our
ces
8 20
08 /
Info
rmat
ion
and
ed
ucat
ion
to s
upp
ort
an
d p
rom
ote
exc
lusi
ve b
reas
tfee
din
g
Sum
itra
Mut
hayy
a St
Jo
hn’s
Nat
iona
l A
cad
emy
of
Hea
lth
Scie
nces
, In
stitu
te o
f Po
pul
atio
n H
ealth
and
Clin
ical
Res
earc
h,
Ban
gal
ore
, Ind
ia
Shi-a
n Yi
nN
atio
nal
Inst
itute
o
f N
utrit
ion
and
Fo
od
Sa
fety
, B
eijin
g, C
hina
Zhxi
u W
ang
Nan
jing
Med
ical
Uni
vers
ity,
Scho
ol o
f Pu
blic
Hea
lth,
Nan
jing
, Chi
na
Kur
t Lo
ngU
nive
rsity
of
Que
ensl
and
, D
ivis
ion
of
Inte
rnat
iona
l an
d In
dig
eno
us H
ealth
, Bris
ban
e, A
ustr
alia
Mo
ham
mad
Bak
htia
r H
oss
ain
ICD
DR
, B
, C
linic
al
Res
earc
h D
ivis
ion,
M
oha
khal
i-D
haka
, Ban
gla
des
h
Lei L
iM
edic
al C
olle
ge
of X
iam
en U
nive
rsity
, Sim
ing
Dis
tric
t,
Xia
men
, Chi
na
Siti
Hel
mya
ti G
adja
h M
ada
Uni
vers
ity,
Sc
hoo
l o
f H
ealt
h an
d
Nut
ritio
n, F
acul
ty o
f Med
icin
e, Y
og
yaka
rta,
Ind
one
sia
Ad
a C
Uw
aeg
but
eM
icha
el O
kpar
a U
nive
rsity
of
Ag
ricul
ture
, U
mua
hia,
N
iger
ia
9 20
07 /
Po
tent
ial o
f am
aran
th g
rain
see
ds
to
imp
rove
the
nut
ritio
n an
d h
ealth
sta
tus
of
scho
ol
child
ren
10
2007
/ I
mp
rovi
ng n
utrit
iona
l st
atus
of
chil-
dre
n ag
ed 6
-18
mo
nths
in a
sem
i-arid
are
a in
Ken
ya:
The
po
tent
ial o
f am
aran
th s
eed
flo
ur
11
2008
/ N
utrit
ion,
ana
emia
, g
row
th a
nd o
xy-
gen
wea
ning
in lo
w-b
irth-
wei
ght
oxy
gen
-dep
end
ent
infa
nts
in a
Kan
gar
oo
Clin
ic
12
2010
/ E
ffect
of
fish
mea
l an
d V
itam
in C
o
n th
e iro
n st
atus
of
Gha
naia
n ch
ildre
n co
nsum
ing
co
wp
ea-b
ased
foo
d
13
2010
/ I
nten
sive
nut
ritio
n an
d h
ygie
ne e
du-
catio
n fo
r im
pro
ving
nut
rient
inta
ke o
f chi
ldre
n (6
-11
mo
nths
)
14
2010
/ T
estin
g t
he e
ffica
cy o
f an
aud
io p
ro-
gra
m a
nd d
iscu
ssio
n g
uid
e in
pro
mo
ting
exc
lusi
ve
bre
astf
eed
ing
in C
amer
oo
n, A
fric
a
15
2010
/ E
ffica
cy o
f co
mb
ined
sel
eniu
m a
nd
iron
sup
ple
men
tatio
n o
n m
icro
nutr
ient
st
atus
o
f sc
hoo
l chi
ldre
n 16
20
11 /
Effe
ct o
f ho
okw
orm
elim
inat
ion
and
vi
tam
in A
int
erve
ntio
n o
n an
aem
ic s
tatu
s o
f p
re-
scho
ol c
hild
ren
in S
ichu
an, C
hina
(res
ubm
issi
on)
17
2012
/ F
oo
d-b
ased
ap
pro
ache
s to
red
uce
child
hoo
d n
utrie
nts-
ener
gy
mal
nutr
itio
n in
Ban
gan
g
com
mun
ity, C
amer
oo
n
18
2012
/ D
ram
a fo
r b
ehav
iour
-cha
nge
com
mu-
nica
tion
on
bre
astf
eed
ing
and
co
mp
lem
enta
ry fe
ed-
ing
pra
ctic
es in
rur
al a
reas
of O
sun
Stat
e, N
iger
ia
INFANT AND CHILD NUTRITION
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MATERNAL NUTRITION CHILD BEHAVIOURALDEVELOPMENT
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PRINCIPAL INVESTIGATOR
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PRINCIPAL INVESTIGATOR
27
2010
/ U
rinar
y io
din
e co
ncen
trat
ion
of
pre
g-
nant
wo
men
in Z
amb
ia a
s an
ind
icat
or o
f the
ir io
din
e nu
triti
on
stat
us
28
2010
/ P
re-c
onc
eptio
nal v
s g
esta
tiona
l fo
od
su
pp
lem
ents
an
d
pre
gna
ncy
out
com
es
in
rura
l V
ietn
am
29
2011
/ A
sses
smen
t o
f io
din
e st
atus
in p
reg
-na
nt w
om
en a
nd w
eani
ng in
fant
s in
eas
tern
reg
ion
of
Nep
al
30
2013
/ I
mp
act
of
pre
-pre
gna
ncy
mic
ronu
tri-
ent
sup
ple
men
tatio
n o
n in
fant
gro
wth
and
dev
elo
p-
men
t 31
20
09 /
Fo
od
-bas
ed in
terv
entio
n an
d p
sych
o-
soci
al s
timul
atio
n to
im
pro
ve g
row
th a
nd d
evel
op
-m
ent
of <
24m
o In
do
nesi
an c
hild
ren
32
2011
/ E
ffect
s o
f m
ater
nal
iod
ine
sup
ple
-m
enta
tion
in a
n ar
ea o
f m
ild i
od
ine
def
icie
ncy
on
infa
nt d
evel
op
men
t to
2 y
ears
(a
follo
w-o
n st
udy
to
our
pre
vio
us N
estlé
Fo
und
atio
n g
rant
)
33
2012
/ M
ater
nal
zinc
nut
ritio
n: I
ts i
nflu
ence
o
n hu
man
hea
lth a
nd d
evel
op
men
t in
Per
uvia
n ch
il-d
ren
34
201
3 /
Foo
d-b
ased
int
erve
ntio
n an
d p
sy-
cho
soci
al s
timul
atio
n to
im
pro
ve c
hild
gro
wth
and
d
evel
op
men
t: F
irst
follo
w-u
p s
tud
y
Cyp
rian
Kat
ong
oC
op
per
bel
t U
nive
rsity
, Sc
hoo
l o
f M
athe
mat
ics
and
N
atur
al S
cien
ces,
Kitw
e, Z
amb
ia
Tu N
gu
Nat
iona
l In
stit
ute
of
Nut
riti
on,
D
epar
tmen
t o
f A
pp
lied
Nut
ritio
n an
d N
utrit
iona
l Sur
veill
ance
at
the
Nat
iona
l Ins
titut
e o
f Nut
ritio
n, H
ano
i, V
ietn
am
AK
Nep
alK
oira
la I
nstit
ute
of
Hea
lth S
cien
ces,
Dep
artm
ent
of
Bio
chem
istr
y, K
athm
and
u, N
epal
Phuo
ng H
ong
Ng
uyen
Th
aing
uyen
Med
ical
Sch
oo
l, Th
aing
uyen
, Vie
tnam
Um
i Fah
mid
aU
nive
rsity
of
Ind
one
sia,
SE
AM
EO
RE
CFO
N, J
akar
ta,
Ind
one
sia
K S
riniv
asan
St. J
ohn
’s R
esea
rch
Inst
itute
, Ban
gal
ore
, Ind
ia
Nel
ly Z
aval
eta
Inst
ituto
de
Inve
stig
acio
n N
utric
iona
l, Li
ma,
Per
u
Um
i Fah
mid
aU
nive
rsity
of
Ind
one
sia,
SE
AM
EO
RE
CFO
N, J
akar
ta,
Ind
one
sia
Joyc
e Lo
uise
Cru
z Ig
naci
o
Uni
vers
ity o
f Th
e Ph
ilip
pin
es L
os
Ban
os,
Co
lleg
e o
f E
cono
mic
s an
d M
anag
emen
t, L
agun
a, P
hilip
pin
es
Eva
riste
Mitc
hikp
e U
nive
rsity
of A
bo
mey
Cal
avi,
Dep
artm
ent o
f Nut
ritio
n an
d F
oo
d S
cien
ces,
Co
tono
u, B
enin
Kal
eab
Bay
e
Ad
dis
Ab
aba
Uni
vers
ity, C
ente
r fo
r Fo
od
Sci
ence
and
N
utrit
ion,
Ad
dis
Ab
aba,
Eth
iop
ia
Yass
inm
e E
lyse
e So
mas
se
Poly
tech
nic U
nive
rsity
of B
ob
o-D
ioul
asso
, Dep
artm
ent
of P
ublic
Hea
lth, B
ob
o-D
ioul
asso
, Bur
kina
Fas
o
Che
n Zu
pei
Tia
njin
Med
ical
Uni
vers
ity, I
nstit
ute
of E
ndo
crin
olo
gy,
T
ianj
in, C
hina
Naj
at M
okh
tar
Ibn
Tofa
il U
nive
rsity
, Nut
ritio
n U
nit,
Ken
itra,
Mo
rocc
o
Tow
fida
Jaha
n Si
dd
iqua
ICD
DR
, B
, N
utri
tio
nal
Bio
chem
istr
y La
b,
Dha
ka,
Ban
gla
des
h
Ho
ng J
iang
Fu
dan
Uni
vers
ity, S
cho
ol o
f Pu
blic
Hea
lth, S
hang
hai,
Chi
na
19
2013
/ I
nfan
t an
d y
oun
g c
hild
fee
din
g a
nd
care
pra
ctic
es o
f ca
reg
iver
s in
the
Pro
vinc
e o
f A
lbay
, Ph
ilip
pin
es
20
2013
/ F
orm
ulat
ion
and
cha
ract
eriz
atio
n o
f in
fant
flo
urs
usin
g s
piru
lina
po
wd
er i
n re
pla
cem
ent
of m
ultiv
itam
in-m
iner
al c
om
ple
x
21
2014
/
Effe
cts
of
feed
ing
st
yle
and
fib
er
cont
ent
of
com
ple
men
tary
fo
od
s o
n th
e ap
pet
ite o
f E
thio
pia
n in
fant
s
22
2014
/
Eff
ect
of
per
sona
lized
nu
trit
iona
l co
unse
lling
on
child
gro
wth
and
feed
ing
pra
ctic
es in
B
urki
na F
aso
23
2008
/ T
he d
evel
op
men
t o
f ne
w n
orm
s fo
r in
dic
ato
rs o
f io
din
e st
atus
dur
ing
pre
gna
ncy
and
its
imp
act
on
the
pre
vale
nce
of
men
tal
reta
rdat
ion
in
child
ren
24
2009
/ I
mp
act
of
dai
ly c
ons
ump
tion
of
vita
-m
in-A
-fo
rtifi
ed o
il o
n b
reas
t m
ilk v
itam
in A
co
ncen
-tr
atio
n an
d v
itam
in A
sta
tus
of
lact
atin
g M
oro
ccan
w
om
en
25
2009
/ R
ole
of
vita
min
B12
sup
ple
men
ta-
tion
dur
ing
pre
gna
ncy
and
po
stp
artu
m t
o a
llevi
ate
nutr
itio
nal a
naem
ia in
Ban
gla
des
hi w
om
en a
nd t
heir
infa
nts
26
2010
/
SMS
and
w
eb-b
ased
su
pp
ort
fo
r ap
pro
pria
te
infa
nt
feed
ing
to
p
reve
nt
child
hoo
d
ob
esity
in u
rban
Chi
na
6061
OTHER RESEARCH AREASFORGOTTEN CROPS / AGRICULTURE
TITLE
PRINCIPAL INVESTIGATOR
39
2014
/ T
he e
ffica
cy o
f bio
fort
ified
pea
rl m
illet
in
a r
and
om
ized
co
ntro
lled
tria
l with
chi
ldre
n <
2y in
ru
ral E
aste
rn K
enya
40
2014
/ P
rom
otin
g f
oo
d s
ove
reig
nty
thro
ugh
a co
op
erat
ive
mo
del
for
sust
aina
ble
org
anic
farm
ing
in
the
May
an R
egio
n, M
exic
o
41
2008
/ C
ause
s an
d c
ont
rol o
f fo
od
inse
curit
y:
A p
ilot
mo
del
in t
he N
ort
hwes
t o
f Ira
n
42
2010
/ Im
pro
ving
nut
ritio
nal s
tatu
s o
f sch
oo
l-ch
ildre
n th
roug
h co
nsum
ptio
n o
f co
wp
ea:
A f
oo
d
sove
reig
nty
per
spec
tive
43
2010
/ P
ilot
stud
y to
ass
ess
the
acce
pta
bili
ty
of
pea
rl m
illet
gra
in a
t m
acro
- an
d m
icro
-leve
ls i
n ru
ral E
aste
rn K
enya
44
2011
/ E
ffect
iven
ess
of
nutr
itio
n p
acka
ge
in
imp
rovi
ng g
row
th o
f ru
ral
child
ren
(6-2
3 m
ont
hs):
A
clus
ter
rand
om
ised
tria
l
45
2012
/ P
rena
tal
and
yo
ung
chi
ld n
utrit
iona
l su
pp
lem
enta
tion
and
ear
ly c
hild
hoo
d b
od
y co
mp
o-
sitio
n, g
row
th a
nd d
evel
op
men
t
Mue
ni H
elle
n N
dik
u &
Sab
até
Joan
Uni
vers
ity
of
Eas
tern
A
fric
a,
Bar
ato
n Sc
hoo
l o
f Sc
ienc
e an
d T
echn
olo
gy,
Eld
ore
t, K
enya
Lom
a Li
nda
Uni
vers
ity, S
cho
ol o
f Pub
lic H
ealth
, Lo
ma
Lind
a, C
alifo
rnia
, USA
Cris
tina
Oso
rio-V
azq
uez
Uni
vers
idad
In
terc
ultu
ral
May
a d
e Q
uint
ana
Ro
o,
Qui
ntan
a R
oo
, Mex
ico
Saee
d D
astg
iriTa
briz
U
nive
rsity
o
f M
edic
al
Scie
nces
, Fa
culty
o
f M
edic
ine,
Tab
riz, I
ran
Ab
dul
-Raz
ak A
biz
ari
Scho
ol o
f Med
icin
e an
d H
ealth
Sci
ence
s, C
om
mun
ity
Nut
ritio
n D
epar
tmen
t, T
amal
e, G
hana
Mue
ni H
elle
n N
dik
uU
nive
rsit
y o
f E
aste
rn
Afr
ica,
B
arat
on,
Sc
hoo
l o
f Sc
ienc
es a
nd T
echn
olo
gy
and
Dep
artm
ent
of
Pub
lic
Hea
lth, E
ldo
ret,
Ken
ya
Kis
sa B
.M. K
ulw
aSo
koin
e U
nive
rsity
o
f A
gric
ultu
re,
Dep
artm
ent
of
Foo
d S
cien
ce a
nd T
echn
olo
gy,
Mo
rog
oro
, Tan
zani
a
Mo
mo
do
u K
Dar
bo
eM
RC
Inte
rnat
iona
l Nut
ritio
n G
roup
, Ban
jul,
Gam
bia
TITLE
PRINCIPAL INVESTIGATOR
35
2010
/ T
he r
ole
of
sub
-clin
ical
inf
lam
mat
ion
on
mic
ronu
trie
nt s
tatu
s o
f M
yanm
ar a
do
lesc
ent
girl
s d
urin
g m
icro
nutr
ient
sup
ple
men
tatio
n
36
2011
/ E
xplo
ratio
n o
f Mya
nmar
rur
al c
areg
iv-
ers’
co
ncep
ts o
n ch
ildho
od
dia
rrhe
al d
isea
se (
6 -2
4 m
ont
hs)
and
its
man
agem
ent
rela
ted
to
OR
S us
e an
d fe
edin
g
37
2009
/ A
pilo
t st
udy
of
scho
ol-b
ased
pee
r ed
ucat
ion
and
ob
esity
-rel
ated
beh
avio
urs
in a
do
les-
cent
s in
Bei
jing
, Chi
na
38
2011
/ A
mul
ti-ap
pro
ach
inte
rven
tion
to e
m-
po
wer
po
syan
du
nutr
itio
n p
rog
ram
to
co
mb
at t
he
mal
nutr
itio
n p
rob
lem
in r
ural
are
as
Min
Kya
w H
tet
SEA
ME
O T
RO
PME
D N
etw
ork
, Jak
arta
, Ind
one
sia
Kha
ing
Mar
Zaw
Uni
vers
ity o
f In
do
nesi
a, S
EA
ME
O R
EC
FON
, Jak
arta
, In
do
nesi
a Zh
aohu
i Cui
Uni
vers
ity
of
Syd
ney,
Th
e G
eorg
e In
stit
ute
for
Inte
rnat
iona
l Hea
lth, S
ydne
y, A
ustr
alia
Ali
Kho
msa
nB
og
or
Ag
ricu
ltur
al
Uni
vers
ity,
D
epar
tmen
t o
f C
om
mun
ity N
utrit
ion,
Bo
go
r, In
do
nesi
a
IMMUNE DEFENSEAND INFECTION
EPIDEMIOLOGICTRANSITION
NUTRITIONEDUCATION
6362
OTHER RESEARCH AREAS
Lwin
Mar
Hla
ing
Uni
vers
ity o
f In
do
nesi
a, S
EA
ME
O R
EC
FON
, Jak
arta
, In
do
nesi
a
Iqb
al M
. Hus
ein
Gad
jah
Mad
a U
nive
rsit
y,
Scho
ol
of
Med
icin
e,
Mak
assa
r, In
do
nesi
a
Taw
and
a M
uzhi
ngi
Tuft
s U
nive
rsity
, Avo
ndal
e, H
arar
e, Z
imb
abw
e
Kitt
i Sra
nach
aro
enp
ong
Mah
ido
l U
nive
rsit
y,
Inst
itut
e o
f N
utri
tio
n,
Phut
tam
ont
hon,
Tha
iland
G T
afer
eH
awas
sa
Uni
vers
ity,
H
uman
N
utri
tio
n,
Haw
assa
, E
thio
pia
Dum
a O
ctav
ia F
rans
isca
Uni
vers
ity o
f In
do
nesi
a, S
EA
ME
O R
EC
FON
, Jak
arta
, In
do
nesi
a
Ab
ebe
Geb
rem
aria
m
Jim
ma
Uni
vers
ity,
Dep
artm
ent
of
Pop
ulat
ion
And
Fa
mily
Hea
lth, J
imm
a, E
thio
pia
Fred
eric
k D
Kao
na
Uni
vers
ity o
f Za
mb
ia,
Mw
eng
u So
cial
and
Hea
lth
Res
earc
h C
ente
r, N
do
la, Z
amb
ia
Man
olo
Maz
arie
go
s In
stitu
te o
f Nut
ritio
n o
f Cen
tral
Am
eric
a an
d P
anam
a (IN
CA
P), G
uate
mal
a C
ity, G
uate
mal
a
TITLE
PRINCIPAL INVESTIGATOR46
20
12 /
Op
timiz
ed c
om
ple
men
tary
fee
din
g
vers
us ir
on
sup
ple
men
tatio
n o
n m
icro
nutr
ient
sta
tus
and
gut
mic
rob
iota
of c
hild
ren
(resu
bm
issi
on)
47
2012
/ E
ffect
s o
f d
ieta
ry/l
ifest
yle
coun
selli
ng
on
risk
of
maj
or
card
iova
scul
ar e
vent
s in
CA
D a
nd
non-
CA
D p
op
ulat
ion
in In
do
nesi
a (re
sub
mis
sio
n)
48
2012
/ C
ons
umer
acc
epta
bili
ty o
f sp
irulin
a in
Zi
mb
abw
e, a
nd e
ffect
of
coo
king
on
spiru
lina
pro
vi-
tam
in A
car
ote
noid
s
49
2012
/ S
usta
inab
le c
om
mun
ity-b
ased
dia
be-
tes
pre
vent
ion
pro
gra
m b
y lif
esty
le m
od
ifica
tion
for
at-r
isk
po
pul
atio
ns in
Tha
iland
50
2012
/ C
om
mun
ity s
alt
iod
izat
ion
and
rel
a-tio
n o
f io
din
e in
take
to V
isua
l Inf
orm
atio
n Pr
oce
ssin
g
(VIP
) of E
thio
pia
n in
fant
s
51
2012
/ E
ffect
of
nutr
ient
-den
se c
om
ple
men
-ta
ry f
oo
d o
n ca
tch-
up g
row
th o
f In
do
nesi
an m
od
er-
atel
y st
unte
d c
hild
ren
52
2013
/ C
hild
-cen
tere
d c
oun
selin
g a
nd h
om
e-b
ased
fo
od
pro
duc
tion
to i
mp
rove
die
tary
ad
equa
-cy
and
gro
wth
of
youn
g c
hild
ren
in s
out
hwes
tern
E
thio
pia
53
2013
/ A
sses
s th
e im
pac
t o
f p
ublic
hea
lth
serv
ices
dis
trib
utio
n o
f vi
tam
in A
in
the
und
er-f
ive
child
ren
in r
emo
te r
ural
Zam
bia
54
2013
/ B
ehav
ior c
hang
e an
d n
utrit
ion
asso
ci-
ated
with
inte
gra
ted
mat
erna
l/ch
ild h
ealth
, nut
ritio
n an
d a
gric
ultu
re p
rog
ram
OTHER RESEARCH AREAS
TITLE
PRINCIPAL INVESTIGATOR
55
2013
/
Hea
lthy
kitc
hens
, he
alth
y ch
ildre
n:
A s
choo
l-bas
ed c
lust
er r
and
omiz
ed c
ontr
olle
d t
rial
56
2013
/ N
utrit
ion
and
fo
od
sec
urity
: Im
pac
t o
f so
il fe
rtili
ty a
nd p
rod
uctiv
ity o
f ho
me
gar
den
s o
n fa
m-
ily n
utrit
ion
(resu
bm
issi
on)
57
2013
/ S
tud
y o
n ef
fect
s o
f ex
cess
iod
ine
and
th
e to
lera
ble
up
per
inta
ke le
vel o
f io
din
e fo
r ch
ildre
n (P
ilot
stud
y)
58
2014
/ N
utrit
ion
gap
map
: A
co
mp
rehe
nsiv
e m
app
ing
, q
ualit
y as
sess
men
t an
d s
umm
ary
of
nutr
i-tio
n-re
leva
nt s
yste
mat
ic r
evie
ws
59
2014
/ A
co
hort
ana
lysi
s o
f th
e su
stai
nab
ility
o
f fo
od
inse
curit
y co
ntro
l pro
gra
ms
in t
he n
ort
hwes
t o
f Ira
n
Nad
ine
Sahy
oun
& H
ala
Gha
ttas
Uni
vers
ity o
f Mar
ylan
d, D
epar
tmen
t o
f Nut
ritio
n an
d
Foo
d S
cien
ce,
Co
lleg
e Pa
rk,
Mar
ylan
d,
USA
and
A
mer
ican
Uni
vers
ity o
f B
eiru
t, C
ente
r fo
r R
esea
rch
on
Pop
ulat
ion
and
Hea
lth, B
eiru
t, L
eban
on
U R
San
gak
kara
†, c
ont
inue
d b
y Ja
naki
Mo
hott
iU
nive
rsity
o
f Pe
rad
eniy
a,
Facu
lty
of
Ag
ricul
ture
, Pe
rad
eniy
a, S
ri La
nka
Wan
qi Z
hang
T
ianj
iin M
edic
al U
nive
rsity
, Pu
blic
Hea
lth C
olle
ge,
T
ianj
in, C
hina
Zulfi
qar
Ahm
ed B
hutt
a A
ga
Kha
n U
nive
rsity
Ho
spita
l, C
ente
r o
f E
xcel
lenc
e in
Wo
men
and
Chi
ld H
ealth
, Kar
achi
, Pak
ista
n
Saee
d D
astg
iri
Tab
riz
Uni
vers
ity
of
Med
ical
Sc
ienc
es,
Facu
lty
of
Med
icin
e, T
abriz
, Ira
n
6465
PUBLICATIONS
PUBL
ICA
TIO
NS
Dia
na R
, Kh
omsa
n A
, Su
kand
ar D
, Ri
yadi
H.
Nut
ritio
n ex
tens
ion
and
hom
e ga
rden
int
erve
ntio
n in
Pos
yand
u:
Impa
ct o
n nu
triti
on k
now
ledg
e, v
eget
able
con
sum
ptio
n an
d in
take
of v
itam
in A
. Pak
ista
n J
Nut
r 201
4;13
:88-
92.
Egbi
G, S
tein
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sied
u M
, Kw
esi F
S, A
yi I,
Ofo
su W
, Set
orgl
o J,
Klo
bodu
SS,
Arm
ar-K
lem
esu
M. A
naem
ia a
mon
g sc
hool
ch
ildre
n ol
der t
han
five
year
s in
the
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ion
of G
hana
. Pa
n A
fr M
ed J
201
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pl 1
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Fahm
ida
U, K
olop
akin
g R,
San
tika
O, S
riani
S, U
mar
J, H
tet
MK,
Fer
guso
n E.
Effe
ctiv
enes
s on
impr
ovin
g kn
owle
dge,
pr
actic
es,
and
inta
kes
of «
key
prob
lem
nut
rient
s» o
f a
com
plem
enta
ry fe
edin
g in
terv
entio
n de
velo
ped
by u
sing
lin
ear p
rogr
amm
ing:
exp
erie
nce
in L
ombo
k, In
done
sia.
Am
J
Clin
Nut
r 201
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ublis
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omek
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esce
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ilk. F
ood
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Shar
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ivas
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erm
ann
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The
iodi
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salt
prog
ram
me
in B
anga
lore
, In
dia
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ides
ade
quat
e io
dine
inta
kes
in p
regn
ant w
omen
an
d m
ore-
than
-ade
quat
e io
dine
inta
kes
in t
heir
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ren.
Pu
blic
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ann
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Hig
h pr
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ence
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erna
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othy
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des
pite
ade
quat
e io
dine
stat
us
in I
ndia
n pr
egna
nt w
omen
in t
he f
irst
trim
este
r. Th
yroi
d 20
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Jian
g H
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ng D
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essa
ge se
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infa
nt
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ings
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a c
omm
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ed st
udy
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Khom
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eraw
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atch
iya
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ewi M
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duca
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ervi
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ualit
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osya
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Kulw
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ren
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at C
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ess
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ritio
n ed
ucat
ion
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tices
, die
tary
ad
equa
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nd g
row
th o
f in
fant
s an
d yo
ung
child
ren
in
rura
l Tan
zani
a: r
atio
nale
, des
ign
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ster
ra
ndom
ised
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l. BM
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atio
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ct o
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aize
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ridge
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rtifi
ed w
ith g
rain
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aran
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r m
icro
nutr
ient
pow
der
cont
aini
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aFeE
DTA
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inta
ke a
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Feed
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thei
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othe
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n Ba
ngan
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illet
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tain
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omm
unity
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eroo
n. In
t J B
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chno
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Suna
rti
E. E
mpo
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fam
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embe
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o im
prov
e ch
ild n
utrit
iona
l sta
tus.
Int
Fede
ratio
n fo
r H
ome
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omic
s 20
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ectio
n 3:
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Uke
gbu
PO, A
nyik
a-El
ekah
J, U
wae
gbut
e A
C, I
gnat
ious
J,
Eche
ndu
CA
, Nkw
oala
CC
, Nze
agw
u O
C, A
sum
ugha
VU
, H
enry
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eze
HN
. Bre
astfe
edin
g kn
owle
dge,
bel
iefs
and
pr
actic
es o
f mot
hers
in U
mua
hia
nort
h lo
cal g
over
nmen
t: a
base
line
stud
y. N
iger
ian
J N
utr S
cien
ces
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12.
Voss
enaa
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oak
CM
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lom
ons
NW
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halle
nges
in
the
elab
orat
ion
of a
fiel
d in
terv
iew
inst
rum
ent
to c
aptu
re
info
rmat
ion
for
the
eval
uatio
n of
adh
eren
ce t
o th
e W
HO
/PA
HO
Gui
ding
Prin
cipl
es fo
r C
ompl
emen
tary
Fee
ding
of
the
Brea
stfe
d C
hild
(Par
ticip
atio
n N
F in
the
prin
ting
cost
s).
Food
and
Nut
ritio
n Bu
lletin
201
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Wija
ya-E
rhar
dt M
, Mus
limat
um S
, Erh
ardt
JG
. Effe
ct o
f an
educ
atio
nal i
nter
vent
ion
rela
ted
to h
ealth
and
nut
ritio
n on
pr
egna
nt w
omen
in t
he v
illag
es o
f cen
tral
Jav
a pr
ovin
ce,
Indo
nesi
a. H
ealth
Edu
catio
n Jl
201
4;73
:370
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The
publ
icat
ions
are
ava
ilabl
e fre
e of
cha
rge
upon
requ
est.
6667
GU
IDE
LIN
ES
FOR
GR
AN
T A
PP
LIC
ATI
ON
S TO
TH
E N
EST
LÉ F
OU
ND
ATI
ON
PURP
OSE
The
N
estl
é Fo
und
atio
n in
itia
tes
and
su
pp
ort
s re
sear
ch
in
hum
an
nutr
itio
n w
ith
pub
lic-h
ealt
h re
leva
nce
in l
ow
-inco
me
and
lo
wer
-mid
dle
-inco
me
coun
trie
s ac
cord
ing
to
the
Wo
rld B
ank
clas
sific
atio
n (s
ee h
ttp
://w
ww
.wor
ldb
ank.
org
). Th
e re
sults
of
the
rese
arch
p
roje
cts
sho
uld
id
eally
p
rovi
de
a b
asis
fo
r im
ple
men
tatio
n an
d a
ctio
n w
hich
will
lea
d t
o
sust
aina
ble
ef
fect
s in
th
e st
udie
d
po
pul
atio
ns
as
gen
eral
ly a
pp
licab
le t
o t
he p
op
ulat
ion
at la
rge.
The
y sh
oul
d
also
en
able
in
stitu
tion
stre
ngth
enin
g
and
cap
acity
bui
ldin
g in
a s
usta
inab
le m
anne
r in
the
ho
st
coun
try,
and
fur
ther
co
op
erat
ion
and
co
llab
ora
tion
bet
wee
n in
stitu
tions
in
dev
elo
ped
and
dev
elo
pin
g
coun
trie
s.
The
Foun
dat
ion
exp
ects
res
earc
h p
rop
osa
ls t
o b
e p
rimar
ily t
he i
nitia
tive
of
loca
l re
sear
cher
s fr
om
the
d
evel
op
ing
co
untr
ies.
Ho
wev
er,
the
Foun
dat
ion
will
b
e in
clin
ed to
co
nsid
er fa
vour
ably
tho
se a
pp
licat
ions
m
ade
join
tly b
y sc
ient
ists
fro
m d
evel
op
ed c
oun
trie
s
THE
FOUN
DAT
ION
The
Nes
tlé
Foun
dat
ion
for
the
Stud
y o
f Pr
ob
lem
s o
f N
utri
tio
n in
the
Wo
rld
was
est
ablis
hed
in
1966
by
a d
onat
ion
from
the
Nes
tlé
Com
pan
y on
the
occ
asio
n of
it
s ce
nten
ary.
The
Fou
ndat
ion
is in
dep
end
ent
and
sel
f-co
nsti
tuti
ng a
nd i
s m
anag
ed b
y a
Co
unci
l co
nsis
ting
of
fiv
e in
tern
atio
nally
wel
l-kno
wn
scie
ntis
ts a
s C
ounc
il M
emb
ers.
The
Fou
ndat
ion
is a
nd h
as b
een
finan
cial
ly
and
op
erat
iona
lly in
dep
end
ent
of t
he N
estl
é C
omp
any
sinc
e it
s in
cep
tion
. The
off
ices
of t
he N
estl
é Fo
und
atio
n ar
e in
Lau
sann
e, S
wit
zerl
and
.
68
with
tho
se f
rom
dev
elo
pin
g c
oun
trie
s p
rovi
ded
it
is
clea
r th
at t
he in
itiat
ive
will
res
ult
in c
apac
ity b
uild
ing
an
d h
uman
-res
our
ce d
evel
op
men
t in
the
lat
ter
and
th
at th
e b
ulk
of t
he b
udg
et is
sp
ent i
n th
e d
evel
op
ing
co
untr
y.
CURR
ENT
POLI
CY
Sust
aina
ble
im
pro
vem
ent
in h
uman
nut
ritio
n is
one
o
f the
maj
or i
ssue
s in
the
po
rtfo
lio o
f the
Fo
und
atio
n.
Dur
ing
m
ore
th
an
40
year
s,
bas
ic
and
ap
plie
d
rese
arch
in
nu
triti
on
has
bee
n su
pp
ort
ed
by
the
Foun
dat
ion
in o
ver
50 d
evel
op
ing
co
untr
ies.
In
view
o
f the
pas
t ac
tiviti
es o
f the
Fo
und
atio
n as
wel
l as
the
wo
rld’s
situ
atio
n at
the
tur
n o
f th
e m
illen
nium
, it
was
re
cog
nize
d t
hat
the
pub
lic-h
ealth
rel
evan
ce o
f th
e su
pp
ort
ed re
sear
ch a
s w
ell a
s as
pec
ts o
f sus
tain
abili
ty,
cap
acit
y b
uild
ing
an
d
educ
atio
nal
issu
es
sho
uld
ha
ve
a hi
ghe
r p
riorit
y.
Thus
, p
riorit
y is
g
iven
to
p
roje
cts
whi
ch
lead
to
su
stai
nab
le
dev
elo
pm
ents
w
ith
stro
ng
elem
ents
o
f ca
pac
ity
bui
ldin
g,
and
th
e im
ple
men
tatio
n o
f th
e re
sults
o
f a
rese
arch
p
roje
ct s
houl
d b
e im
med
iate
and
sus
tain
able
. Hig
hly
sop
hist
icat
ed n
utrit
ion
rese
arch
of
mai
nly
acad
emic
in
tere
st w
itho
ut p
ublic
-hea
lth r
elev
ance
has
lo
wer
p
riorit
y fo
r su
pp
ort
, as
do
so
lely
lab
ora
tory
-bas
ed
stud
ies
or
anim
al e
xper
imen
tatio
n.
RESE
ARC
H T
OPI
CS
At
pre
sent
th
e Fo
und
atio
n’s
wo
rk
is
pri
mar
ily
conc
erne
d
wit
h hu
man
nu
trit
ion
rese
arch
is
sues
d
ealin
g w
ith:
(1)
mat
erna
l an
d
child
nu
trit
ion,
in
clud
ing
b
reas
tfee
din
g a
nd c
omp
lem
enta
ry f
eed
ing
,
(2)
mac
ro-
and
mic
ronu
trie
nt d
efic
ienc
ies
and
im
bal
ance
s,
(3)
inte
ract
ions
bet
wee
n in
fect
ion
and
nut
riti
on,
and
(4) n
utri
tion
ed
ucat
ion
and
hea
lth
pro
mot
ion.
The
pre
cise
prio
ritie
s an
d g
oal
s o
f th
e Fo
und
atio
n ar
e m
od
ified
fro
m t
ime
to t
ime
to m
eet
emer
gin
g
pub
lic-h
ealth
and
nut
ritio
nal n
eed
s in
the
dev
elo
pin
g
wo
rld.
Stud
ies
in o
ther
are
as o
f hu
man
nut
ritio
n re
sear
ch
mig
ht a
lso
be
cons
ider
ed, a
s lo
ng a
s th
ey a
re d
ealin
g
with
pro
ble
ms
of
mal
nutr
itio
n in
elig
ible
co
untr
ies
(see
ab
ove
). O
ther
are
as o
f re
sear
ch m
ay p
oss
ibly
b
e co
nsid
ered
fo
r su
pp
ort
if
the
app
lican
t ca
n o
ffer
spec
ific
and
co
nvin
cing
evi
den
ce a
nd ju
stifi
catio
n fo
r th
e ch
oic
e o
f the
res
earc
h to
pic
.
Fund
ed p
roje
cts
are
usua
lly o
f o
ne-
to t
hree
-yea
r d
urat
ion.
Pro
ject
s w
ith a
hig
h p
ote
ntia
l fo
r ef
fect
ive
and
sus
tain
able
imp
rove
men
t of t
he n
utrit
iona
l sta
tus
as w
ell
as a
hig
h ca
pac
ity-b
uild
ing
co
mp
one
nt w
ill
be
fund
ed p
refe
rent
ially
. The
bud
get
of
the
pro
ject
s m
ust
be
app
rop
riate
and
rea
sona
ble
and
has
to
be
just
ified
in d
etai
l. O
ne o
f th
e Fo
und
atio
n’s
mai
n ai
ms
is t
he t
rans
fer
of
scie
ntifi
c an
d t
echn
olo
gic
al k
now
led
ge
to t
arg
et
coun
trie
s.
In
case
s w
here
Fo
und
atio
n-sp
ons
ore
d
rese
arch
pro
ject
s ar
e re
aliz
ed i
n co
llab
ora
tion
with
sc
ient
ists
at
univ
ersi
ties
and
res
earc
h in
stitu
tes
in
hig
h-in
com
e co
untr
ies,
at
leas
t 75
% o
f th
e b
udg
et
has
to b
e ea
rmar
ked
fo
r us
e w
ithin
the
lo
w-in
com
e co
untr
y.
The
Foun
dat
ion
doe
s no
t no
rmal
ly f
und
:
(1) p
roje
cts
wit
h lo
w p
ublic
-hea
lth
rele
vanc
e
(2) p
roje
cts
wit
h d
oub
tful
sus
tain
abili
ty
(3)
pro
ject
s la
ckin
g
tran
sfer
o
f sc
ient
ific
, te
chni
cal a
nd e
duc
atio
nal k
now
led
ge,
i.e.
lack
ing
a
cap
acit
y-b
uild
ing
com
pon
ent
(4) l
arg
e-b
udg
et p
roje
cts,
mea
ning
pro
ject
s th
at
exce
ed U
SD 1
00,0
00 p
er y
ear
or U
SD 3
00,0
00
over
the
tot
al d
urat
ion
of a
3-y
ear
pro
ject
(5) n
utri
tion
sur
veys
or
surv
eilla
nce
stud
ies
(6)
rese
arch
on
fo
od
pol
icy,
fo
od
pro
duc
tion
an
d f
ood
tec
hnol
ogy
exce
pt
whe
n lin
ked
to
an
inte
rven
tion
wit
h hi
gh
pot
enti
al f
or s
usta
inab
le
imp
rove
men
t of
the
nut
riti
onal
sta
tus
(7) i
n vi
tro
and
/or
anim
al e
xper
imen
ts.
ELIG
IBLE
INST
ITU
TIO
NS
Elig
ible
in
stitu
tions
ar
e d
epar
tmen
ts
or
inst
itute
s fr
om
un
iver
sitie
s,
hosp
itals
, an
d
oth
er
inst
itutio
ns
of
hig
her
educ
atio
n in
lo
w-
or
low
er-m
idd
le-in
com
e co
untr
ies.
Jo
int
app
licat
ions
fro
m m
ore
tha
n o
ne
inst
itutio
n (e
spec
ially
So
uth-
Sout
h)
are
wel
com
ed.
Join
t ap
plic
atio
ns f
rom
mo
re t
han
one
ins
titut
ion
invo
lvin
g a
No
rth-
Sout
h co
llab
ora
tion
may
als
o b
e co
nsid
ered
. Fo
r p
roje
ct a
pp
licat
ions
dem
ons
trat
ing
N
ort
h-So
uth
colla
bo
rati
on,
it
is
im
po
rtan
t th
at
the
follo
win
g c
riter
ia a
re f
ulfil
led
: (i)
the
Prin
cip
al
Inve
stig
ato
r is
fr
om
th
e So
uth
and
th
e p
rop
osa
l ha
s re
leva
nce
to n
utrit
iona
l p
rob
lem
s o
f th
e So
uth;
(ii
) th
e m
ajo
rity
of
the
bud
get
is
earm
arke
d f
or
the
Sout
h; a
nd (
iii)
dem
ons
trat
ion
upo
n co
mp
letio
n o
f th
e p
roje
ct o
f in
stitu
tion-
and
cap
acity
bui
ldin
g i
n a
sust
aina
ble
man
ner
in t
he S
out
h.
The
cap
acity
-bui
ldin
g c
om
po
nent
rep
rese
nts
a co
re
issu
e fo
r al
l ap
plic
atio
ns
to
the
Foun
dat
ion.
Th
is
mea
ns t
hat
ever
y ap
plic
atio
n ne
eds
to d
emo
nstr
ate
a tr
aini
ng a
nd h
uman
-res
our
ce a
nd c
apac
ity-b
uild
ing
co
mp
one
nt fo
r the
dev
elo
pin
g w
orld
. Id
eally
gra
dua
te
stud
ents
or y
oun
g in
vest
igat
ors
sho
uld
pla
y a
key
role
an
d,
whe
re p
oss
ible
, b
e d
esig
nate
d a
s th
e Pr
inci
pal
In
vest
igat
or (
PI),
i.e. b
e th
e p
rimar
y g
rant
ap
plic
ant,
or
Co
-PI.
Est
ablis
hed
rese
arch
ers
can
neve
rthe
less
ap
ply
b
ut n
eed
to
cle
arly
ind
icat
e th
e ca
pac
ity-b
uild
ing
co
mp
one
nt
and
th
e d
esig
nate
d
ben
efic
iarie
s.
All
app
licat
ions
nee
d t
o c
lear
ly s
tate
the
cap
acity
- an
d
hum
an-r
eso
urce
-bui
ldin
g
com
po
nent
s in
th
e ho
st
coun
try
as w
ell
as t
he l
ong
-ter
m s
usta
inab
ility
of
rese
arch
in
the
host
ins
titut
ion.
Ap
plic
atio
ns f
rom
in
div
idua
ls w
ho a
re n
on-
affil
iate
d re
sear
cher
s an
d n
ot
atta
ched
to
res
earc
h o
r ac
adem
ic in
stitu
tions
can
be
cons
ider
ed o
nly
in v
ery
spec
ial c
ases
.
TYPE
S O
F A
WA
RDS
The
Nes
tlé F
oun
dat
ion
offe
rs d
iffer
ent
awar
d a
nd
gra
nt c
ateg
orie
s, s
om
e o
f th
em u
sing
a m
od
ular
70
to a
fo
cuse
d d
evel
op
men
t o
f ca
pac
ity a
nd k
now
-ho
w
and
hu
man
-res
our
ce
dev
elo
pm
ent
in
the
corr
esp
ond
ing
inst
itutio
n.
HO
W T
O A
PPLY
Inte
rest
ed s
cien
tists
sho
uld
firs
t su
bm
it a
lett
er o
f in
tent
in
whi
ch t
hey
des
crib
e ve
ry b
riefly
the
kin
d
of
pro
ject
the
y w
oul
d l
ike
to u
nder
take
, in
clud
ing
an
es
timat
ed
bud
get
. In
stru
ctio
ns
for
the
lett
er
of
inte
nt a
re a
vaila
ble
on
the
Foun
dat
ion
web
site
at
w
ww
.nes
tlef
oun
dat
ion.
org
. Fo
r a
sub
mis
sio
n o
f a
lett
er o
f in
tent
onl
y th
e d
ow
nlo
adab
le f
orm
o
n o
ur w
ebsi
te s
houl
d b
e us
ed.
If th
e su
gg
este
d
pro
ject
is
com
pat
ible
with
the
Fo
und
atio
n’s
curr
ent
fund
ing
po
licy,
ap
plic
ants
will
rece
ive
an in
vita
tion
to
sub
mit
a fu
ll g
rant
pro
po
sal.
The
gui
del
ines
fo
r th
e su
bm
issi
on
of a
full
gra
nt p
rop
osa
l are
als
o a
vaila
ble
o
n o
ur w
ebsi
te. O
ther
fo
rmat
s w
ill n
ot
be
acce
pte
d,
neith
er f
or
the
lett
er o
f in
tent
no
r fo
r th
e fu
ll g
rant
ap
plic
atio
ns.
In t
he l
ette
r o
f in
tent
and
in
the
gra
nt a
pp
licat
ion,
d
etai
led
, ev
iden
ce-b
ased
in
form
atio
n ab
out
th
e p
ublic
-hea
lth
rele
vanc
e o
f th
e p
roje
ct
as
wel
l as
its
im
med
iate
im
pac
t an
d s
usta
inab
ility
hav
e to
be
rep
ort
ed. T
his
par
t o
f the
ap
plic
atio
n is
as
imp
ort
ant
as t
he s
cien
tific
sec
tion
of t
he a
pp
licat
ion.
Res
earc
h g
rant
ap
plic
atio
ns
are
eval
uate
d
twic
e a
year
b
y th
e Fo
und
atio
n’s
Co
unci
l, a
gro
up
of
ind
epen
den
t in
tern
atio
nal s
cien
tists
. Th
e fu
ndin
g o
f p
roje
cts
is p
rimar
ily b
ased
on
the
scie
ntifi
c q
ualit
y,
pub
lic-h
ealth
rel
evan
ce i
n th
e sh
ort
and
lo
ng t
erm
, su
stai
nab
ility
, cap
acity
-bui
ldin
g c
om
po
nent
and
, las
t b
ut n
ot
leas
t, b
udg
et c
ons
ider
atio
ns.
Ap
plic
atio
ns a
re a
ccep
ted
thr
oug
hout
the
yea
r, an
d
the
Foun
dat
ion
enco
urag
es a
pp
lican
ts to
sub
mit
thei
r p
rop
osa
ls e
arly
to
allo
w s
uffic
ient
tim
e fo
r in
tern
al a
s w
ell
as e
xter
nal
revi
ews.
All
sub
mis
sio
ns s
houl
d b
e m
ade
elec
tro
nica
lly b
y e-
mai
l. Fi
nal
dea
dlin
es f
or
sub
mis
sio
n ar
e Ja
nuar
y 10
and
May
10
for
the
Sprin
g
and
Fal
l Co
unci
l Mee
ting
s, r
esp
ectiv
ely.
For
mo
re in
form
atio
n co
nsul
t w
ww
.nes
tlef
oun
dat
ion.
org
app
roac
h;
for
exam
ple
, th
e Pi
lot
Gra
nt
Pro
gra
m
rep
rese
nts
the
star
ting
gra
nt m
od
ule
for
a la
ter
Full
Gra
nt R
esea
rch
app
licat
ion.
The
elig
ibili
ty c
riter
ia a
s w
ell
as t
he r
esea
rch
ob
ject
ives
and
to
pic
s ha
ve t
o
be
fulfi
lled
no
mat
ter
wha
t th
e aw
ard
cat
ego
ry (
for
furt
her
det
ails
see
ww
w.n
estle
foun
dat
ion.
org
):
A.
Res
earc
h G
rant
s
B.
Inst
itut
iona
l Sup
po
rt
Inst
itutio
nal s
upp
ort
invo
lves
the
sup
po
rt o
f res
earc
h o
r ed
ucat
iona
l pro
ject
s in
sp
ecifi
c in
stitu
tions
in lo
w-
or
low
er-m
idd
le-in
com
e co
untr
ies
whi
ch c
ont
ribut
e
GGrraa
nntt
ttyypp
eeDD
eesscc
rriipp
ttiioo
nnBB
uudd
ggee
tt((ii
nnUU
SSDD
))Tr
aini
ngG
rant
(TG
)
Pilo
tG
rant
(PG
)
Smal
lRes
earc
hG
rant
(SG
)
Larg
eR
esea
rch
Gra
nt(L
G)
Re
- Ent
ryG
rant
s
The
Pilo
t G
rant
(PG
) Pro
gra
m o
f the
Fo
und
atio
n
pro
vid
es s
upp
ort
fo
r p
ilot
rese
arch
tha
t ha
s a
hig
h p
ote
ntia
l to
le
ad
to
a su
bse
que
nt
full
rese
arch
pro
ject
gra
nt.
Usu
ally
the
Fo
und
atio
n
do
es n
ot
sup
po
rt n
utrit
iona
l su
rvey
res
earc
h,
but
o
ften
to
b
e ab
le
to
iden
tify
area
s o
f
pro
ble
ms
for
po
tent
ial
inte
rven
tion
one
has
to
colle
ct b
asel
ine
dat
a. I
f a
pilo
t st
udy
(pre
-stu
dy
or
bas
elin
e st
udy)
will
cre
ate
the
need
ed d
ata
for
a la
rger
res
earc
h p
roje
ct,
the
PG p
rog
ram
may
ass
ist
this
. Th
e p
ilot
stud
y an
d P
G u
sual
ly
rep
rese
nt
the
star
ting
p
oin
t fo
r a
late
r fu
ll
rese
arch
gra
nt a
pp
licat
ion
(i.e.
, a
SG o
r LG
) to
the
Foun
dat
ion.
To e
nco
urag
e p
ost
-gra
dua
te s
tud
ents
to
ret
urn
to
thei
r o
wn
coun
trie
s an
d
to
aid
th
em
in
esta
blis
hing
the
ir ca
reer
s, t
he F
oun
dat
ion
will
sup
po
rt
a re
sear
ch
pro
gra
mm
e fo
r el
igib
le
cand
idat
es.
The
host
ins
titut
ion
will
nee
d t
o
gua
rant
ee a
po
st f
or
the
retu
rnee
and
ens
ure
care
er d
evel
op
men
t w
ithin
the
ho
st i
nstit
utio
n.
Co
ntrib
utio
n o
f su
pp
ort
to
th
e el
igib
le
cand
idat
e fr
om
the
ho
st i
nstit
utio
n is
ess
entia
l,
whi
le
sup
po
rt
and
co
llab
ora
tion
fro
m
the
ove
rsea
s in
stitu
tion
whe
re th
e ca
ndid
ate
trai
ned
is h
elp
ful.
The
Trai
ning
Gra
nt (
TG)
Pro
gra
m s
upp
ort
s a
smal
l re
sear
ch p
roje
ct s
uch
as a
MSc
or
PhD
thes
is p
roje
ct o
r an
oth
er t
rain
ing
end
eavo
ur.
The
Smal
l Res
earc
h G
rant
(SG
) pro
vid
es s
upp
ort
for
a sm
all r
esea
rch
stud
y. T
his
may
rep
rese
nt a
cont
inua
tion
of a
TG
or
a PG
.
Full
gra
nt a
pp
licat
ion
of
a co
mp
lete
res
earc
h
pro
po
sal a
cco
rdin
g t
o t
he g
uid
elin
es.
up t
o 2
0,00
0 in
to
tal
up t
o 2
0,00
0 in
to
tal
up t
o 5
0,00
0 in
to
tal
up t
o 5
0,00
0 in
to
tal
up t
o 1
00,0
00 p
er
year
to
a
max
imum
of
300,
000
for
3 ye
ars
72
COUN
CIL
THE COUNCIL
Susanne Suter, MD President Nestlé FoundationProfessor Emeritus of Pediatrics, University of Geneva, Geneva, Switzerland
Benjamin Caballero, MD, PhDProfessor of International Health and Maternal and Child HealthJohns Hopkins Bloomberg School of Public HealthJohns Hopkins University, Baltimore , Maryland, USA
Dominique Darmaun, MD, PhDUniversity Hospital of Nantes, INRA U 1280, CRNH, Hotel-Dieu, Nantes, FranceNemours Children’s Clinic, Division of Endocrinology, Diabetes and Metabolism, University of Florida, Jacksonville, Florida, USA Ann Prentice, PhDDirector and Head of the Nutrition and Bone Health GroupMRC Human Nutrition Research (HNR)Elsie Widdowson Laboratory Cambridge, UK
Prakash S. Shetty, MD, PhD*Professor of Public Health Nutrition, Institute of Nutrition, University of Southampton, Southampton, UK Editor-in-Chief, European Journal of Clinical NutritionFormer Professor of Human Nutrition, London School of Hygiene and Tropical Medicine, LondonFormer Chief, Nutrition Planning, Assessment & Evaluation, Food & Nutrition Division, Food and Agriculture Organization of the United Nations (FAO), Rome, Italy (* not on the picture)
Kraisid Tontisirin, MD, PhDProfessor, Mahidol University, Salaya Campus, Nakhon Pathom, ThailandFormer Director, Nutrition and Consumer Protection Division, Food and Agriculture Organization of the United Nations (FAO), Rome, Italy
Walter Wahli, PhDProfessor Emeritus, University of LausanneFounding Director of the Center for Integrative Genomics (CIG), University of Lausanne, Lausanne, SwitzerlandVisiting Professor, Lee Kong Chian School of Medicine, Imperial College London and Nanyang Technological University, Singapore
DIRECTOR Paolo M. Suter, MD, MSProfessor of Medicine, Clinic and Policlinic of Internal Medicine, University Hospital, Zurich, Switzerland
SECRETARIAL OFFICES
Catherine LiebAssistant to the Director
AUDITOR Ernst & Young AG, Lausanne, Switzerland
The Council of the Foundation consists of five Council Members and Advisors. All Council Members and Advisors are internationally well-known scientists with a specific expertise in different fields of nutrition. The Council is self-constituting and operates independently. The Foundation is directed jointly by the Director and the President of the Foundation.