Promoting healthy growth and preventing childhood stunting advisory committee meeting

Background

The Department of Nutrition, World Health Organization (WHO) is implementing the project Promoting healthy growth and preventing childhood stunting (the Healthy Growth Project) with financial support from the Bill and Melinda Gates Foundation. The overall goal was to create global awareness of the link between healthy growth and complementary feeding, and develop tools and a framework to promote healthy growth in countries with a high burden of stunting.

Associated goals are to shift national focus from underweight to stunting; to highlight the association between undernutrition in early life and the development of overweight/obesity, with the attendant risk of non-communicable diseases; and to contribute to the achievement of the 2012 World Health Assembly stunting reduction target for 2025 (Resolution WHA 65.6).

Activities have been directed by three objectives; namely, generate new data on the distribution and determinants of healthy growth; communication and advocacy on the link between poor complementary feeding and growth, and supporting countries to set and implement stunting reduction agendas; and assisting countries to roll out the WHO Child Growth Standards while promoting best practices for growth assessment and infant and young child feeding.

Among the most significant outputs of the project is the WHO conceptual framework on Childhood Stunting: Context, Causes and Consequences which was developed to inform programmatic efforts addressing stunting. The framework illustrates how the causes of stunting are embedded in a complex set of contextual factors and therefore require to be addressed using a variety of nutrition-specific and nutrition-sensitive interventions. Contributing to initiatives by governments and other partners, country activities supported through the project have focused on:

1. Providing tools to facilitate the setting of national annual stunting reduction targets and the agendas to achieve them
2. Advocacy for increasing national investment in improved IYCF and the systematic monitoring of associated child growth
3. Technical support for growth assessment and counselling to improve IYCF
4. Developing materials and techniques to support facility- and community-based health workers to:
   • assess and interpret child growth
   • communicate their observations to caregivers, and
   • engage caregivers as partners in the efforts required to prevent stunting

This is the final year of the project’s implementation; a time for stock-taking and documentation of what the project has achieved and its potential contribution to implementation of the Maternal, infant and young child nutrition agenda with a view to achieving the World Health Assembly targets for 2025.

Objectives of the meeting

General objective

Evaluate progress on the project objectives, lessons learnt and how the experience gathered could be used to support global and country efforts towards achievement of World Health Assembly targets for 2025, with specific emphasis on stunting reduction.

Specific objectives

• Review the goals the project set out to achieve and to what extent the various outputs are contributing to their achievement
• Identify facilitators and barriers that influenced achievement of the project objectives
• Reflect on the experience from the implementation of the project in Burkina Faso, Côte d’Ivoire and United Republic of Tanzania and draw lessons for future efforts in pursuit of the WHO nutrition agenda
• Review if and how (or why not) the WHO conceptual framework has contributed to analytical/programmatic efforts around childhood stunting and, in light of emerging evidence, how alternative presentations of the framework’s various components could help guide continuing efforts to reduce stunting
• Based on a critical review of community-level interventions by health extension workers, consider how the WHO conceptual framework could inform the development of intervention packages and composite skill sets for frontline workers

Expected outputs

• A balanced assessment of progress made against project objectives and goals
• Enablers and barriers to effective project implementation and mitigation strategies identified
• Milestones identified for countries to work towards by the project’s end date (December 2015) and guidance received from the AC on how to perpetuate its gains for stunting reduction
• Future uses identified of how the WHO conceptual framework can be better used to inform stunting reduction programmes and actions
• A vision of how outputs and learning from the project will contribute to the WHO nutrition agenda for maternal, infant and young child nutrition