American Journal of Clinical Nutrition, January 2012
Study on New Corn-Soy Blend (CSB++) for Treatment of Moderate Acute Malnutrition among Children in Malawi
It’s estimated that 35 million children suffer from moderate acute malnutrition (MAM) worldwide. In response to a need for an alternative, effective and affordable supplementary food for children with MAM, the World Food Programme developed a new corn-soy blend recipe fortified with oil and dry skim milk called “CSB++”. In a recent FANTA-2 study in Malawi, a locally produced CSB++ was compared to both a locally produced soy ready-to-use supplementary food (RUSF) and an imported soy/whey RUSF for a group of children aged 6–59 months with MAM. Although children who received CSB++ required 2 days longer to recover and gained slightly less weight than the children receiving the RUSFs did, the recovery rate for the tested CSB++ was similar to that of the soy RUSF and the soy/whey RUSF. This study, “A novel fortified blended flour, corn-soy blend “plus-plus,” is not inferior to lipid-based ready-to-use supplementary foods for the treatment of moderate acute malnutrition in Malawian children,” has been published in the American Journal of Clinical Nutrition and is available at no cost by using the following link to the online article.
 Read the e-print of the article
Government of Sudan CMAM Training Course on Inpatient Management of Severe Acute Malnutrition: Training Materials (2011)
FANTA-2, in collaboration with national partners in Sudan, adapted and built on the World Health Organisation (WHO)'s 1999 publication Management of severe malnutrition: A manual for physicians and other senior health workers, WHO's 2002 Training course on the management of severe malnutrition, the 2009 Government of Sudan Community-Based Management of Severe Acute Malnutrition manual, and other materials to develop training materials for inpatient management of severe acute malnutrition (SAM) designed for physicians, nurses, and nutritionists in hospitals in Sudan. While the training course focuses on inpatient care, the training materials are compatible with the Community-Based Management of Acute Malnutrition (CMAM) approach and the Sudan context.
 Learn more about training materials
 Uganda Nutrition Action Plan 2011–2016
The Government of Uganda has developed a 5‑year Uganda Nutrition Action Plan (UNAP), a framework for addressing the country’s nutrition issues. The goal of this plan is to improve the nutrition status of all Ugandans, with emphasis on women of reproductive age, young children, and infants. The plan is intended to reduce the magnitude of malnutrition in Uganda and its impact on the individual, the household, the community, and the nation at large. The government also produced a short document targeted at district- and lower-level leaders to raise awareness of the nutrition situation in Uganda and to introduce the UNAP.
Learn more about Uganda's Nutrition Action Plan
New USAID Global Health e‑Learning Course on Nutrition Published
Inadequate maternal and child nutrition is the underlying cause of 3.5 million deaths every year and 35
percent of the disease burden for children under 5 years of age. Universal coverage of proven nutrition-related interventions could reduce overall mortality of children under 3 by 25 percent. This e-learning course, the first of several planned on nutrition, discusses the basic
concepts of good nutrition and common nutritional deficiencies, the magnitude of
malnutrition in different populations, vulnerable groups and the causes of undernutrition,
and key indicators and ways of measuring them. It also outlines the major population-based
interventions to improve nutritional status.
The course, authored by FANTA-2 and produced by JHUCCP, is available through the USAID Global Health e-Learning Center website. All courses are available free to anyone interested, however, registration is required.
Go to the USAID Global Health e-Learning Center website
 Report on the Review of the Integration of Community-Based Management of Acute Malnutrition into the Ghana Health System, August/September 2010 (2011)
As part of initiating the Community-Based Management of Acute Malnutrition (CMAM) approach in Ghana in 2009, a Severe Acute Malnutrition Support Unit (SAM SU) was established by the Ghana Health Service (GHS) to provide technical assistance countrywide as CMAM scaled up. Each region has commenced CMAM service implementation in one or two districts within a limited number of outpatient care and inpatient care sites. These sites will serve as learning sites for the region to inform gradual scale-up to other districts in the region.
The SAM SU requested FANTA-2 to conduct a review of CMAM activities at the learning sites, including plans for scaling up. The objectives of the review were to assess the integration of CMAM services into the learning sites, assess learning sites’ performance, review recent plans and initiatives to scale up CMAM in Ghana, and provide recommendations for strengthening those plans.
Read more about the report
 Review of Community-Based Management of Acute Malnutrition Implementation in West Africa, Summary Report (2011)
This report summarizes the findings of reviews of implementation of Community-Based Management of Acute Malnutrition (CMAM) in four West African countries (Burkina Faso, Mali, Mauritania, and Niger). The report discusses the key determinants to achieving maximum impact of CMAM integration, scale-up, and quality improvement. The determinants are grouped in five domains: the enabling environment for CMAM, competencies for CMAM, access to CMAM services, access to CMAM supplies, and quality of CMAM. Optimal practices, a summary of findings, constraints, and practical recommendations are provided for each key determinant.
Download the summary report
 Toolkit: For Countries Applying for Funding of Food and Nutrition Programs Under the Global Fund to Fight AIDS, Tuberculosis and Malaria (Round 11)
The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) is the largest multilateral donor funding services for people living with HIV, people affected by HIV and AIDS, and people with active tuberculosis. An interagency team, consisting of the World Food Programme (WFP), the World Health Organization (WHO), the United States President’s Emergency Plan for AIDS Relief (PEPFAR), and the United States Agency for International Development (USAID)‐funded Food and Nutrition Technical Assistance II Project (FANTA‐2), worked to create the Toolkit: For Countries Applying for Funding of Food and Nutrition Programs under the Global Fund to Fight AIDS, Tuberculosis and Malaria (Round 11) to strengthen Round 11 proposals for Global Fund funding. The toolkit can be used by countries considering inclusion of food and nutrition activities for the first time and by experienced countries that want to scale up their response or broaden the range of their food and nutrition support activities to address emerging problems. The toolkit provides potential Round 11 applicants with the information needed to include a food and nutrition component in their Global Fund proposals, have food and nutrition more consistently integrated into them, and improve the overall quality of their applications.
Download the toolkit
 Household Hunger Scale (2011)
FANTA-2, in collaboration with the Food and Agriculture Organization of the United Nations (FAO) and Tufts University, developed the Household Hunger Scale (HHS), a field-practical method and simple tool to measure household food deprivation and compare data across cultures. The HHS can help improve geographic targeting of food insecurity interventions and monitoring and evaluation of food security policies and programs. The HHS is an indicator for both the United States Agency for International Development (USAID) Food for Peace program and Feed the Future initiative.
Learn more about the Household Hunger Scale
 Materials for Mozambique's Nutrition Rehabilitation Program (2011)
FANTA-2 was one of a group of partners that assisted the Mozambique Ministry of Health in developing national protocols, training materials, and job aids for the national Nutrition Rehabilitation Program (Programa de Reabilitação Nutricional [PRN]). The PRN is based on the Community-Based Management of Acute Malnutrition (CMAM) approach.
The Manual for Nutrition Treatment and Rehabilitation, Volume I (Manual de Tratamento e Reabilitação Nutricional, Volume I) contains protocols for the treatment of acute malnutrition for children 0–15 years with or without HIV and/or tuberculosis. The manual is accompanied by job aids, which are aimed at helping implementation of inpatient and outpatient treatment. The Facilitators Training Guide and Participants Handouts are used to train health facility staff and community-based health workers. All materials are in Portuguese.
Learn more about the materials
 Acceptability of a Lipid-Based Nutrient
Supplement among Guatemalan Infants and Young Children (2011)
This study assessed the acceptability of lipid-based nutrient supplements (LNS) among children 6–18 months of age in Suchitepéquez, Guatemala. A new flavor (cinnamon) was developed and tested alongside the “regular” peanut LNS flavor. A 2-day test-feeding trial using a cross-over design was carried out to test both LNS flavors, followed by a 2-week home-use trial. LNS was mixed with a small quantity of home-prepared complementary food. The proportion of LNS consumed by the children, and the caregivers’ organoleptic preferences and perceptions of product use were assessed. The study concluded that both LNS flavors were acceptable in this population, with a tendency toward a higher acceptability for the peanut flavor.
Download the study
 Challenges for Safe Replacement Feeding among HIV-Positive Mothers in Hai Phong and Ho Chi Minh City, Vietnam: A Qualitative Study of Mothers, Fathers, Health Care Providers, and Other Experts (2011)
In 2009 FANTA-2, in partnership with the Center for Global Health and Development at Boston University and the Institute of Social and Medical Studies in Vietnam, conducted a study of infant and young child feeding (IYCF) practices among HIV-positive women in two Vietnamese cities with high HIV prevalence, Hai Phong and Ho Chi Minh City. The study’s primary purpose was to determine whether HIV-positive women could safely follow the advice of health care providers to provide replacement feeding to their infants.
The study report explores informants’ reported practices in light of the conditions for safe replacement feeding specified in the 2010 World Health Organization Guidelines on HIV and infant feeding. The report’s recommendations to the Government of Vietnam, which is currently revising its guidelines for prevention of mother-to-child transmission of HIV, include policy and capacity building actions to support the greatest likelihood of HIV-free survival of children. The report is accompanied by a research note that summarizes the study findings and recommendations.
Download the technical report and note
 USAID Office of Food for Peace Occasional Paper 7
Gender Integration in USAID Bureau for Democracy, Conflict, and Humanitarian Assistance Office of Food for Peace Operations (2011)
Overcoming gender inequality is a key element of reducing global hunger. In 2009, USAID’s Office of Food for Peace (FFP) declared an enhanced focus on gender as essential to food security and included the evaluation of “gender equity in the access to and control over resources and benefits” as a review criterion for evaluation of Title II program applications. To operationalize this focus on gender, FFP requested FANTA-2 support to identify how to integrate and mainstream gender in all its activities.
This occasional paper, developed by FANTA-2 with extensive input from FFP staff in Washington and at Missions, as well as from implementing partners, recommends various stages and steps to strengthen FFP and Title II Awardees’ capacity to integrate and mainstream gender in all FFP-funded activities. This guidance will enable FFP to develop a strategy on how to strengthen its capacity and understanding of gender mainstreaming and identifies milestones to monitor progress and evaluate results.
Download the Occasional Paper from usaid.gov
 Zambia Nutrition Guidelines for Care and Support of People Living with HIV and AIDS (2011)
Zambia Counseling Flipchart – Eating and Living Well with HIV and AIDS: Good Nutrition Makes a Difference (2011)
Zambia has been hit hard by HIV and AIDS. Zambia’s Ministry of Health, National AIDS/AIDS/STI/TB Council, and National Food and Nutrition Commission worked with partners to revise the 2004 Nutrition Guidelines for Care and Support of People Living with HIV and AIDS and 2006 flipchart Eating and Living Well with HIV and AIDS: Good Nutrition Makes a Difference to provide updated information to individuals and organizations on nutrition assessment, counseling, and support (NACS) for people living with HIV (PLHIV). NACS has become an effective and replicable approach for meeting the nutritional needs of malnourished PLHIV in clinical settings, significantly enhancing the care and treatment provided, and meeting the needs of HIV-affected individuals, such as clinically malnourished adult PLHIV and pregnant or lactating HIV-positive women.
The updated guidelines are the basis for all NACS activities in Zambia and serve as a point of reference for all partners involved in nutrition support activities. The updates to the guidelines and the flipchart harmonize the entry and exit criteria for nutrition product support between the existing Integrated Management of Acute Malnutrition (IM-AM) program and the NACS program.
Download the guidelines
and flipchart
Anthropometry: Assessing Children Under 5 Bookmark
(2011)
FANTA-2 has produced an updated bookmark that presents clear information on the anthropometry used to assess the nutritional status of children under 5 years of age. Common definitions, cutoffs, and classifications are detailed in an easy-to-use format. This bookmark replaces the FANTA bookmarks published from 2002 through 2006, and is available in English, French and Spanish.
Learn how to download or order hardcopies of the bookmark
 Technical Note No. 12
Introducing a Simple Measure
of Household Hunger for
Cross-Cultural Use (2011)
After nine years of research and testing, FANTA-2, in collaboration with the Food and Agriculture Organization of the United Nations (FAO) and Tufts University, has developed the Household Hunger Scale (HHS), a field-practical method and simple tool to measure household food deprivation that allows for valid comparison across cultures. The HHS can help improve geographic targeting of food insecurity interventions and M&E of food security policies and programs. The HHS will soon become a USAID Food for Peace required indicator, as well as a Feed the Future indicator.
Read more about the Technical Note
CMAM Costing Tool (2011)
Community-Based Management of Acute Malnutrition (CMAM) is an innovative approach for managing acute malnutrition in children within the community that enables early detection of cases, expanded access to treatment in decentralized sites, greater community involvement and support, and extended coverage. The CMAM Costing Tool is a Microsoft Excel-based application that estimates the costs of implementing CMAM at the national, sub-national, and district levels. The Costing Tool calculates the inputs and financial resources required to establish, maintain, or expand CMAM services. This information helps managers determine whether their plans for CMAM are financially feasible, identify the resources needed, and formulate an effective implementation plan. The Costing Tool can also support the promotion and management of CMAM services. Government or NGO stakeholders in a country or region where acute malnutrition is prevalent can use the CMAM Costing Tool to plan for implementation of specific CMAM components and forecast the resources required.
Read more about the tool
 Meeting on Nutrition Assessment, Counseling, and Support in HIV Services: Strategies, Tools, and Progress, September 14–17, 2010, Jinja, Uganda, Meeting Report (2011)
Ninety-eight participants from 18 countries met to share tools and experiences and to disseminate promising approaches in nutrition assessment, counseling, and support (NACS) programming. NACS is the primary model supported by the United States President’s Emergency Fund for AIDS Relief (PEPFAR) for integrating nutrition services into clinical HIV care and treatment services.
The meeting report details the meeting objectives, processes, and key issues identified.
Download the report
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