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Measuring the coverage of nutrition interventions along the continuum of care: time to act at scale
  1. Stuart Gillespie1,
  2. Purnima Menon1,
  3. Rebecca Heidkamp2,
  4. Ellen Piwoz3,
  5. Rahul Rawat3,
  6. Melinda Munos2,
  7. Robert Black2,
  8. Chika Hayashi4,
  9. Kuntal Kumar Saha5,
  10. Jennifer Requejo2
  1. 1 Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, District of Columbia, USA
  2. 2 International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  3. 3 Global Development Program, Bill and Melinda Gates Foundation, Seattle, Washington, USA
  4. 4 Monitoring and Statistics, Unicef USA, New York, New York, USA
  5. 5 Nutrition for Health and Development, Organisation mondiale de la Sante, Geneva, Switzerland
  1. Correspondence to Dr Stuart Gillespie; s.gillespie{at}cgiar.org

Abstract

The global community is committed to addressing malnutrition. And yet, coverage data for high-impact interventions along the continuum of care remain scarce due to several measurement and data collection challenges. In this analysis paper, we identify 24 nutrition interventions that should be tracked by all countries, and determine if their coverage is currently measured by major household nutrition and health surveys. We then present three case studies, using published literature and empirical data from large-scale initiatives, to illustrate the kind of data collection innovations that are feasible. We find that data are not routinely collected in a standardised way across countries for most of the core set of interventions. Case studies—of growth monitoring and screening for acute malnutrition, infant and young child feeding counselling, and nutrition monitoring in India—highlight both challenges and potential solutions. Advancing the nutrition intervention coverage measurement agenda is essential for sustained progress in driving down rates of malnutrition. It will require (1) global consensus on a core set of validated coverage indicators on proven, high-impact nutrition-specific interventions; (2) the inclusion of coverage measurement and indicator guidance in WHO intervention recommendations; (3) the incorporation of these indicators into data collection mechanisms and relevant intervention delivery platforms; and (4) an agenda for continuous measurement improvement.

  • health systems
  • nutrition
  • prevention strategies
  • Child health
  • maternal health

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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Footnotes

  • Handling editor Seye Abimbola

  • Contributors SG: chaired working group discussions that led to the manuscript, contributed to its conceptualisation and structure; led on introduction, discussions and conclusions; coordinated all inputs of coauthors through multiple drafts, reviewed and edited full manuscript. PM: contributed to conceptualisation of manuscript; reviewed global guidance to prepare table 1 and online supplementary table, reviewed data availability and questionnaires, prepared case studies on IYCF counselling and India; conducted literature review for research in context section; reviewed and edited full manuscript. RH: contributed to conceptualisation of manuscript; reviewed data availability and questionnaires, prepared case studies on growth monitoring; reviewed and edited full manuscript. EP: contributed to the conceptualisation of the manuscript, reviewed interventions, contributed to background and conclusion text; and reviewed and edited the full manuscript. RR: contributed to the conceptualisation of the manuscript, reviewed interventions, contributed to the background and conclusion sections, and reviewed and edited the full manuscript. MM: contributed to the measurement considerations; reviewed and edited the full manuscript. RB: contributed on key interventions and data availability, reviewed and edited the full manuscript. CH: contributed on routine administrative systems; reviewed full manuscript. KKS: contributed to the priority interventions and data availability, reviewed and edited the full manuscript. JR: contributed to conceptualisation of the manuscript, reviewed and edited each version of the manuscript, prepared final version of table 1 and online supplementary table and helped organise the discussions of the working group.

  • Funding This study was funded by Bill and Melinda Gates Foundation, Grant Number: Countdown to 2030.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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