Infant & Child Nutrition

		WHO and UNICEF Child Growth Standards and the Identification of Severe Acute Malnutrition in Infants and Children, May 2009 WHO and UNICEF Meeting Report on Strengthening Action to Improve Feeding of Infants and Young Children 6-23 Months of Age in Nutrition and Child Health Programmes

See Also: Assessments, Monitoring & Evaluation; Community Therapeutic Care; Emergency Nutrition; Food Aid; HIV/AIDS; Household Food Consumption; Women and Adolescent Nutrition

Malnutrition contributes to more than half of all under-five childhood deaths throughout the developing world. The associated effects of poverty, inadequate household access to food, infectious disease, and inadequate breastfeeding and complementary feeding practices often lead to illness, growth faltering, nutrient deficiencies, delayed development, and death, particularly during the first two years of life.

There is universal consensus on the importance of infant and young child feeding as a key determinant of child nutrition. Maternal and child health and nutrition (MCHN) programs also commonly include activities to address infant and young child feeding. FANTA-2 works to improve infant and child nutrition and health outcomes by strengthening food security and nutrition policy, strategies, and programs. An area of emphasis in FANTA-2's work is improving the assessment, monitoring, and evaluation of infant and young child feeding in the six through 23 months age period. Appropriate feeding practices are complex and age-specific, and the need for improved indicators to better assess infant and young child feeding (IYCF) is increasingly recognized.

FANTA-2 indicators and measurement guidelines improve the collection, tabulation, analysis, interpretation, and presentation of infant and young child feeding data. FANTA-2 also supports research on dietary diversity, an essential component of infant and young child feeding, and explores the relationship between child nutritional status and infant and child feeding practices. Results from these activities influence the design of frequently used data collection instruments, such as the Knowledge, Practice, and Coverage (KPC) and Demographic Health Survey (DHS) and help partners better assess and measure changes in infant and child nutrition.

PROFILES [http://www.fantaproject.org/about/profiles.shtml] is a process for nutrition policy analysis and advocacy that uses spreadsheet models to estimate the functional consequences of malnutrition in terms that policymakers understand and care about. To underscore the importance of nutrition in child survival efforts, the FANTA project funded the development of a model to quantify the effects of improvements in nutritional status, measured as weight-for-age, on child mortality. The model is based on work conducted by Cornell researchers David Pelletier and Ed Frongillo in which they determined that improvements in child nutritional status over the past three decades have contributed significantly to improvements in child survival, even taking into consideration socio-economic and policy changes during this same period (download their report "Changes in child survival are strongly associated with changes in malnutrition in developing countries," 2003).

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	A brief description of each publication is provided below. By choosing the publication title, you are able to read a detailed description and to download the publication.

1. Nutrition Counseling for People Living with HIV and/or Tuberculosis in Cote d’Ivoire: Flipchart and Flipchart User's Guide (2011): To help facility-based providers and community counselors promote the uptake of key nutrition behaviors among people living with HIV (PLHIV) and/or tuberculosis in Cote d’Ivoire, FANTA-2 completed the nutrition counseling materials, Conseils en Nutrition Pour Les PVVIH et/ou Malades de la Tuberculose (Nutrition Counseling for PLHIV and/or Tuberculosis),and developed an accompanying user’s guide, Guide D’Utilisation de la Boite a Images Pour le Conseil en Nutrition Des Personnes Infectees et Affectees Par le VIH et/ou Malades de la Tuberculose (Guide to Using the Flipchart for Nutrition Counseling for Persons Infected or Affected by HIV and/or Tuberculosis).

2. Government of Sudan CMAM Training Course on Inpatient Management of Severe Acute Malnutrition: Training Materials: 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 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.

3. Uganda National Action Plan 2011-2016 with District Messages (2011): 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. 

4. Report on the Review of the Integration of Community-Based Management of Acute Malnutrition into the Ghana Health System, August/September 2010 (2011): The 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.

5. Review of Community-Based Management of Acute Malnutrition Implementation in West Africa, Summary Report (2011): This report summarizes the findings of reviews 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, which 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.

6. 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 will soon be an indicator for both the USAID Food for Peace program and Feed the Future initiative.

7. 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.

8. 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.

9. 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): A report of the results from 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 report is accompanied by a research note that summarizes the study findings and recommendations.

10. Zambia Nutrition Guidelines for Care and Support of People Living with HIV and AIDS, and Zambia Counseling Flipchart – Eating and Living Well with HIV and AIDS: Good Nutrition Makes a Difference (2011): 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). 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.

11. Anthropometry: Assessing Children Under 5 Bookmark (2011): FANTA-2 has produced a 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 multiple languages.

12. Household Hunger Scale: A Cross-Cultural Method to Measure Household Hunger (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.

13. PM2A: Title II Preventing Malnutrition In Children Under Two Approach and the Title II Technical Reference Materials, Revised November 2010: A new edition of the USAID Office of Food for Peace's Technical Reference Materials (TRM) on PM2A has been released. The PM2A TRM provides guidance for current and potential multi-year non-emergency program Awardees and is based on current program knowledge and experience. This version includes a discussion of family planning as a useful complementary health service, and also includes updated terminology.

14. The Nutrition Program Design Assistant: A Tool for Program Planners (NPDA) (2010): This two-part tool was developed to help nutrition program planning teams design community-based nutrition programs. A simple Reference Guide and Workbook, the NPDA is best used in collaboration with a range of partners, including ministry staff, community leaders and representatives and local organizations. The NPDA provides a framework for programmers to analyze the nutrition situation and offers guidance for design teams to choose the most appropriate nutrition approaches based on the specific context and need. It also helps programmers avoid an approach that would be inappropriate or ineffective in the specific context.

15. Training Guide for Community-Based Management of Acute Malnutrition (CMAM) (2008/2010): FANTA-2 worked with partners to develop a generic Training Guide for Community-Based Management of Acute Malnutrition (CMAM). The first version of the training guide in English was released in November 2008. While working on the French translation of the guide, FANTA-2 incorporated new WHO recommendations into the French version. Due to high demand, we are releasing the French version of the training guide while still working on updating the original English version.

16. Generic Guidelines and Job Aids for Community-Based Management of Acute Malnutrition (CMAM), November 2010 Draft Version (2010): FANTA-2 is working with partners to create a package of Community-based Management of Acute Malnutrition (CMAM) generic guidelines and job aids that can be adapted at the country level using national guidelines, local considerations, and WHO recommendations. The current November 2010 draft is still being reviewed and finalized, however, it is being shared due to high demand.

17. Indicators for Assessing Infant and Young Child Feeding Practices Series (2008-2010): As the culmination of a World Health Organization (WHO)-led effort to develop and reach consensus on a set of simple, valid and reliable infant and young child feeding (IYCF) indicators, this publication series describes and provides guidance for collection of eight core and seven optional IYCF indicators that can be assessed in population-based surveys, including the Demographic and Health Survey (DHS), Multiple Indicator Cluster Survey (MICS) and Knowledge, Practice, Coverage Survey (KPC).

18. Interim National Guidelines for Community-Based Management of Severe Acute Malnutrition in Ghana (2010): These interim guidelines are designed to be a practical guide for field implementers and policy makers, and were adapted specifically for the Ghanaian health system. All service providers, including clinicians, nurses, nutritionists, dietitians, and other health care providers involved in the management of SAM in the country, should use the guidelines for the management of SAM in both inpatient and outpatient facilities. The interim guidelines will be reviewed and finalized after 1 year as part of the process of creating the final National Guidelines for Community-Based Management of SAM in Ghana.

19. With co-funding from the Inter-Agency Standing Committee (IASC) Global Nutrition Cluster (GNC), FANTA-2 and UC Davis produced Use of Lipid-based Nutrient Supplements (LNS) to Improve the Nutrient Adequacy of General Food Distribution Rations for Vulnerable Sub-groups in Emergency Settings available from the UC Davis website. The report describes the potential role of LNS in improving the nutritional quality of foods provided in emergency settings and the optimal formulation of LNS for various target groups (e.g., infants and young children, pregnant and lactating women) in this context. The report will be published as a supplement in Maternal and Child Nutrition in 2010.

20. Community-Based Management of Severe Acute Malnutrition Interim Manual for Sudan, Version 1.0 (2009): This manual is intended to be used by health and nutrition managers and health care providers working at different levels of health and nutrition service provision in Sudan, as well as national training institutions and implementing partners involved in pre- or in-service training. The manual will be reviewed after 1 year, and community-based management of moderate acute malnutrition will be added to the next version of the manual to complete the overall community-based approach.

21. Supplementary Feeding with Fortified Spreads Results in Higher Recovery Rates than with a Corn/Soy Blend in Moderately Wasted Children, Journal of Nutrition (2009): Moderately wasted children in sub-Saharan Africa are typically treated with corn/soy blended flour (CSB) but this intervention has shown limited effectiveness. Fortified spreads (FS) which are energy-dense, lipid-based pastes with added powdered micronutrients can be used as supplementary foods instead. Supplementary Feeding with Fortified Spreads Results in Higher Recovery Rates than with a Corn/Soy Blend in Moderately Wasted Children presents results from a randomized clinical effectiveness trial which found that moderately wasted children who received FS were more likely to recover than those who received CSB.

22. Nutrition and HIV/AIDS: A Training Manual for Nurses and Midwives (2008): Nutrition and HIV/AIDS: A Training Manual for Nurses and Midwives is designed to provide nursing school instructors with materials that they can use to teach nursing students the knowledge and skills needed for nutrition care and support of PLHIV. While designed to be used for pre-service training, it can also be used or adapted for in-service training.

23. International Workshop on the Integration of Community-Based Management of Acute Malnutrition, Workshop Report Published by the Emergency Nutrition Network (ENN) (2008): The Workshop Report for the April 2008 International Workshop on the Integration of Community-Based Management of Acute Malnutrition (CMAM) provides an overview of the overarching issues, obstacles and successes encountered in the integration of CMAM into national health systems. These range from the importance of Ministry of Health leadership, the need to strengthen capacities at most levels of a health system, and provide simple protocols to facilitate implementation, to the critical need for open and frequent information sharing. The report highlights presentations and discussions by international experts in CMAM, including those from USAID, UNICEF, WHO, developing country Ministries of Health and NGO-implementers.

24. Precision, Time, and Cost: A Comparison of Three Sampling Designs in an Emergency Setting (2008) An article reporting on the FANTA and SC/US field test in Sudan, "Precision, Time, and Cost: A Comparison of Three Sampling Designs in an Emergency Setting", has been published in Emerging Themes in Epidemiology.

25. Review of Community-based Management of Acute Malnutrition (CMAM) in the Post-emergency Context: Synthesis of Lessons on Integration of CMAM into National Health Systems (2008): With Community Management of Acute Malnutrition (CMAM) incorporated into government health facilities and protocols to varying degrees in Ethiopia, Malawi and Niger, USAID's FANTA Project undertook a comprehensive review of the challenges, successes and lessons learned from the experience in these three countries. The synthesis report discusses recommendations for successful and sustainable integration of CMAM, outlining specific steps donors, Ministries of Health, the UN and NGOs can take to facilitate the process and next steps needed to expand the knowledge and evidence base for CMAM integration.

26. Essential Nutrition Actions in Public Health Programs in Ethiopia (2008): The Essential Nutrition Actions (ENA) package is an approach to expand the coverage of seven affordable and evidence-based actions to improve the nutritional status of women and children, especially those under two years of age. FANTA’s Review of Incorporation of Essential Nutrition Actions into Public Health Programs in Ethiopia found that the approach has been incorporated into the Ethiopia Federal Ministry of Health system and multilateral and NGO programming, however, improved training and other steps are necessary to further institutionalize the approach. The review, requested by USAID/Ethiopia, examined a number of facilitating and inhibiting factors to ENA integration in the context of Ethiopia’s health system.

27. Comparing Preventive and Recuperative Approaches to Targeting Maternal and Child Health and Nutrition Programs in Haiti (2007): FANTA's five-year effectiveness study on food-assisted nutrition programs demonstrated that a preventive approach is more effective in reducing child malnutrition than a recuperative approach: after three years, the prevalence of stunting, underweight and wasting was significantly lower in the preventive communities than in communities where a recuperative approach had been used. In preventive approaches to food-assisted maternal and child health and nutrition programs, food is provided to all children 6-24 months in target areas with a high prevalence of malnutrition, thus supporting growth and preventing malnutrition. In recuperative approaches, food is used to rehabilitate children (typically those under five) already suffering from malnutrition.

28. Girl Guides Anemia Prevention Badge Project (2007): FANTA and the Regional Center for Quality of Health Care (RCQHC), in partnership with the African Regional Office of the World Association of Girl Guides and Girl Scouts (WAGGGS), designed the Girl Guides Anemia Prevention Badge Project, a program to reach adolescent girls in East and Southern Africa with information and activities on anemia prevention and control. Under the program, Girl Guides (ages 7-18) can earn a badge in anemia prevention through educational programs and community involvement in anemia control. FANTA and RCQHC developed an Anemia Prevention Badge Handbook and Workbook for the Girl Guides as well as a training manual for Girl Guide leaders.

29. Developing and Validating Simple Indicators of Dietary Quality and Energy Intake of Infants and Young Children in Developing Countries: Summary of Findings from Analysis of 10 Data Sets (2006): Clear guidance for the international community on optimal infant and young child feeding (IYCF) practices has been achieved with the publication of the Guiding Principles for Complementary Feeding of the Breastfed Child (PAHO/WHO 2003) and Guiding Principles for the Non-Breastfed Child 6-24 Months of Age (WHO 2005). Over the past several years, FANTA has implemented a multi-stage initiative to develop a set of indicators to assess IYCF practices and to monitor and evaluate progress on improving IYCF practices worldwide. FANTA has worked with IFPRI, University of California at Davis, WHO, and collaborating researchers from several developing countries to develop and validate indicators of feeding practices, specifically related to the frequency of feeding and nutrient density of complementary foods, for infants and young children 6 through 23 months of age in developing countries.

30. Community-based Therapeutic Care (CTC): A Field Manual (October 2006): Community-based Therapeutic Care (CTC): A Field Manual provides program managers, practitioners, and technical specialists addressing severe acute malnutrition with the essential design, implementation and evaluation protocols for implementing the CTC approach. As the CTC model is evolving, this first edition does not provide a step-by-step workbook for implementers, but rather offers a solid foundation to build CTC programs at local and national levels. The manual is a product of a collaboration between Valid International, Concern Worldwide, USAID’s FANTA Project, and Development Cooperation Ireland. Support for FANTA for the development of CTC and the production of the manual came from the Office of Foreign Disaster Assistance (OFDA) and the Office of Health, Infectious Diseases and Nutrition at the U.S. Agency for International Development.

31. Food and Nutrition Bulletin Volume 27, No. 3: Proceedings of an Informal Consultation on Community-based Management of Severe Malnutrition in Children (September 2006) : A special supplement was produced by the United Nations University publication Food and Nutrition Bulletin to present the proceedings of the 2005 WHO and Standing Commitee on Nutrition (SCN)'s informal consultative meeting on community-based management of severe malnutrition in children in Geneva. With support from FANTA, the meeting brought together some 50 international experts and representatives from the World Food Program (WFP), the United Nations High Commissioner for Refugees (UNHCR), the Red Cross, research institutions, major international non-governmental organizations, and representatives of ministries of health. The consultation agreed on guiding principles for the implementation of community-based management of severe acute malnutrition and next steps for updating global recommendations and country level health policies for the inclusion of management of severe acute malnutrition as an essential intervention towards achieving the MDGs for poverty and child mortality reduction. Next steps include the creation of field guidelines and training modules will be developed based on the general principles, conclusions, and recommendations derived from the meeting, which, if implemented on a large scale, will prevent thousands of child deaths.

32. Infant and Young Child Feeding Update (September 2006): Adequate nutrition is critical to child health and development. The period from birth to two years of age is particularly important because of the rapid growth and brain development that occurs during this time. The Infant and Young Child Feeding (IYCF) Update provides data on key indicators, including new summary IYCF indicator for children 6-23 months. The data are taken from the results of the Demographic and Health Surveys (DHS) conducted between 1998 and 2004 in 43 countries in five regions of the world: sub-Saharan Africa, North Africa/West Asia/Europe, Central Asia, South/Southeast Asia, and Latin America and the Caribbean. Feeding practices included in this update are related to breastfeeding practices, feeding solid and semi-solid foods to breastfed and non-breastfed children, micronutrient intake, and feeding during diarrhea. IYCF Update was produced by USAID's MEASURE DHS Project implemented by ORC/Macro.

33. Impact of Title II MCHN Programs on the Nutritional Status of Children (2004): This paper presents the results of a recent review of the impact of Title II MCHN programs on the prevalence of stunting and underweight in target populations. Information on the impact of the Title II MCHN program on child nutritional status was available for 29 programs. The review focused on Title II MCHN programs that ended in 2000 and 2001, for which final evaluation or annual results reports with data on anthropometry were available.

34. Anthropometric Indicators Measurement Guide (2003): This guide, revised in 2003, focuses on the anthropometric assessment of infants and children to assist PVOs in improving their M&E. It includes information on how to collect, analyze, and report on key anthropometric indicators.

35. Changes in Child Survival are Strongly Associated with Changes in Malnutrition in Developing Countries (2002): This report examines the relationship between changes in child and under-5 mortality rates in developing countries in the past two or three decades and changes in the general nutritional status of children during the same period. Building on earlier work, Pelletier and Frongillo use population-level (rather than child-level) estimates of mortality and malnutrition, examine dynamic relationships (changes in malnutrition and changes in mortality) and use a much larger data set of developing countries. This report has important implications for child survival policies and programs. The report concludes that gaps in coverage of selected child survival interventions are more likely and more serious in the more malnourished populations.

36. Assessing Care: Progress Towards the Measurement of Selected Childcare and Feeding Practices and Implications for Programs (2002): An important sub-theme of the Accra Urban Food and Nutrition Study (AUFNS) was the specific role of childcare as one determinant of the nutritional status of children. The objectives of this report, which is based on findings from the AUFNS, were to summarize progress toward the measurement of selected childcare and feeding practices and discuss the feasibility of these measurements in research and program contexts. The report includes an extensive literature review on measuring selected dimensions of care.

37. Summary Indicators for Infant and Feeding Practices: An Example from the Ethiopia Demographic and Health Survey 2000 (2002): This document describes analysis of the infant and child feeding data available in the Ethiopia Demographic and Health Survey 2000 (EDHS). The main purpose of the analysis is to support USAID/Ethiopia in the use and interpretation of the infant/child feeding practices data. More broadly, the goal is to promote greater use of the rich information on feeding practices contained in the DHS data sets, and to demonstrate the usefulness of this information for exploring relationships between infant/child feeding practices and nutritional status outcomes.

38. A Multiple-Method Approach to studying Childcare in an Urban Environment. The Case of Accra, Ghana (2002): The objective of the Accra Urban Food and Nutrition Study (AUFNS), located at http://www.ifpri.org/pubs/ib/ib9_ghana.pdf, was to gain an understanding of urban poverty and of the relationships between poverty, food insecurity, and malnutrition in a major African city. This report summarizes AUFNS findings, specifically regarding the importance of care as an input to child nutrition and aims to answer research questions on the importance of care as an input to child nutrition, which care practices seem to be the most crucial for child nutrition, which maternal and household resources contribute the most to enhancing care in Accra, the program and policy responses that promote optimal childcare practices in this urban context, and how the three research approaches used to measure childcare in this study complement each other.

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*Please note that links to these sites do not imply that FANTA supports either the organization listed or the views and content presented.

CORE Group [http://www.coregroup.org]
CORE Group fosters collaborative action and learning among its 50+ members to advance the effectiveness and scale of community-focused public health practices. Established in 1997, CORE Group is a 501c(3) membership association based in Washington D.C. comprised of citizen-supported NGOs that work internationally in resource poor settings to improve the health of mothers, children, and communities.

Child Survival Technical Support (CSTS) [http://www.childsurvival.com]
This project provides technical support to PVOs funded by the USAID Child Survival program. The site includes a database of consultants and projects, key child survival articles, recent child survival project information and USAID relevant documents. Regular updates on new research and publications are also provided.

Food and Agriculture Organization (FAO) [http://www.fao.org/]
FAO works to alleviate poverty and hunger by promoting agricultural development, improved nutrition and the pursuit of food security. The Food and Agriculture Organization is active in land and water development, plant and animal production, forestry, fisheries, economic and social policy, investment, nutrition, food standards and commodities and trade. It also plays a major role in dealing with food and agricultural emergencies. FAO’s website has news and detailed information on the program areas listed above, special programs, statistical databases, links to regional offices, and hundreds of publications, many of which are available on-line. Visitors can also search or browse through more than 3,000 pictures in FAO's Photo Library.

International Baby-Food Action Network (IBFAN) [http://www.ibfan.org]
The International Baby-Food Action Network promotes breastfeeding and optimal infant feeding practices. IBFAN consists of public interest groups working worldwide to reduce infant and child morbidity and mortality. The website provides information about IBFAN's activities, members, resources and publications.

International Food Policy Research Institute (IFPRI) [http://www.ifpri.org]
A well-organized site from the International Food Policy Research Institute (IFPRI), which operates as part of the Consultative Group on International Agricultural Research (CGIAR). The site contains the full text of current and past issues of the Institute's quarterly newsletter Research Perspectives, and full text versions of over 100 research reports and abstracts, all of which can be downloaded. The comprehensive Research Themes section gives project information on subthemes organized under four principal sections: Environment and Production Technology, Food Consumption and Nutrition, Markets and Structural Studies, and Trade and Macroeconomics.

LINKAGES [http://linkagesproject.org]
The LINKAGES Project (1996-2006) worked worldwide to improve nutrition and reproductive health by providing technical support to promote breastfeeding through influencing behavior change, improving health service delivery, and advocating policy change. In addition to providing information about the LINKAGES Project, the site lists available publications and has an extensive list of annotated links organized by subject area.

Pan American Health Organization (PAHO) [http://www.paho.org/Selection.asp?SEL=TP&LNG=ENG&CD=HNUTRNSFT]
The Food and Nutrition Program of the Pan American Health Organization contributes, through technical cooperation, to design, implementation, and evaluation of interventions to improve food security and the malnutrition situation in the Americas. The site has links to the Institute of Nutrition of Central America and Panama (INCAP) and the Caribbean Food and Nutrition Institute (CFNI).

US Agency for International Development (USAID)'s Global Health Bureau [http://www.usaid.gov/our_work/global_health/]
The U.S. Agency for International Development (USAID) is the federal government agency that implements America’s foreign assistance programs. USAID's commitment to improving global health includes confronting global health challenges through improving the quality, availability, and use of essential health services. USAID's strategy for global health seeks to stabilize world population and protect human health through programs in maternal and child health, HIV/AIDS, family planning and reproductive health, infectious diseases, environmental health, nutrition and other life-saving areas.

UNICEF [http://www.unicef.org/]
UNICEF, the only UN organization dedicated exclusively to children, works with other UN bodies, governments and NGOs to improve children’s lives through community-based services in primary health care, basic education, and safe water and sanitation in developing countries. The website provides information on child rights, a searchable database, downloadable publications, statistics, and program activities and research. The site also has links to UNICEF’s Progress of Nations and The State of the World’s Children reports, educational projects and interactive pages for children, and multimedia exhibitions.

United Nations System Standing Committee on Nutrition (SCN) [http://www.unscn.org]
The United Nations System Standing Committee on Nutrition is the focal point for harmonizing the policies and activities on nutrition of the UN system. Its role is to serve as a coordinating mechanism, for exchange of information and technical guidance, and to act dynamically to help the UN respond to nutritional problems. The site provides links to SCN news and reports on nutrition worldwide.

World Bank [http://www.worldbank.org/html/extdr/thematic.htm]
This site contains information on World Bank nutrition activities and publications. They also publish a weekly compendium of food and hunger news from around the world.

World Health Organization's (WHO) Nutrition for Health and Development [http://www.who.int/nutrition/en/]
The World Health Organization’s Nutrition for Health and Development Program works to strengthen and support the capabilities and effectiveness of member states for assessing and addressing nutrition problems and develops and maintains global nutrition databases to help states, organizations, and institutions working to fight malnutrition. Information about the Program’s activities and outputs, research, publications (some available on-line) and the Global Nutrition Data Banks can be accessed from the home page.

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