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Effectiveness and Cost-Effectiveness of Small-Quantity Lipid-Based Nutrient Supplements (SQ-LNS) for Preventing Child Malnutrition, Improving Child Survival and Promoting Healthy Development

May 4-6, 2022

Online

  • Part 1 | Evidence base for efficacy and effectiveness of SQ-LNS: Who benefits most?

    May 4, 9:30 - 11:00am ET

    Small-quantity lipid-based nutrient supplements (SQ-LNS, ~20 g/day) were designed to provide multiple micronutrients embedded in a food base that also provides essential fatty acids and small amounts of energy and protein, targeted towards preventing malnutrition in vulnerable populations. This webinar will report results of recent meta-analyses examining the effects of SQ-LNS for children aged 6-24 months on child growth, anemia, iron status, development and mortality. Based on individual participant data (IPD) analyses of pooled data from 14 randomized controlled trials (n ~37,000), children who received SQ-LNS had a 12¨C14% lower prevalence of stunting, wasting, and underweight; were 16¨C19% less likely to score in the lowest decile for language, social-emotional, and motor development; had a 16% lower prevalence of anemia; and had a 64% lower prevalence of iron-deficiency anemia compared with control group children. In a separate meta-analysis, all-cause child mortality between 6 and 24 months was reduced by 27%. The webinar will include discussion of which subgroups may experience greater benefits from SQ-LNS, based on the IPD meta-analyses. This information may be useful in decision-making with regard to integration of this intervention within coordinated strategies to prevent child malnutrition, improve child survival, and promote healthy development.

    Presentations:

    Overview of meta-analyses of child SQ-LNS, and effects on growth outcomes

    Speaker: Kathryn Dewey, Distinguished Professor Emerita, Institute for Global Nutrition, University of California, Davis

    Effects of SQ-LNS on child anemia and iron status

    Speaker: K. Ryan Wessells, Associate Project Scientist, Institute for Global Nutrition, University of California, Davis

    Effects of SQ-LNS on child development

    Speaker: Elizabeth Prado, Associate Professor, Institute for Global Nutrition, University of California, Davis

    Effects of LNS on child mortality

    Speaker: Christine Stewart, Director, Institute for Global Nutrition, Professor of Nutrition and Corinne L. Rustici Endowed Chair in Applied Human Nutrition, University of California, Davis

    Discussion

    Moderator: Deon Filmer, Director, Development Research Group, World Bank
     

    Part 2 | Costs, cost-efficiency and cost-effectiveness of interventions that include SQ-LNS

    May 6, 9:30 - 11:00am ET

    Considerations of cost, cost-effectiveness, and financial feasibility should inform policy discussions about incorporating SQ-LNS into strategies to improve child nutrition, survival and development. This webinar will report results of 4 studies of cost-effectiveness or cost-efficiency of interventions that included SQ-LNS for young children. The first presentation will describe a modeling framework to estimate the cost and cost-effectiveness of SQ-LNS, and the results of that framework when applied in the context of SQ-LNS delivery via community health workers in rural Uganda. The second presentation will describe cost-effectiveness estimates for a pilot project implemented via the government community-based nutrition program in Madagascar. The third presentation will report cost-efficiency results from effectiveness trials implemented using a community-based platform in Mali and a facility-based platform in Burkina Faso. The fourth presentation will report findings from a model related to the potential for cost-effectiveness of SQ-LNS within an integrated package of maternal and pediatric preventive and curative interventions in rural Niger.

    Presentations:

    The cost-effectiveness of SQ-LNS for prevention of child death and malnutrition and promotion of healthy development: modeling results for Uganda

    Speaker: Katherine (Katie) Adams, Associate Project Scientist, Institute for Global Nutrition, University of California, Davis

    Cost-effectiveness estimates for the MAHAY project in Madagascar

    Speaker: Emanuela Galasso, Senior Economist, Development Research Group, World Bank

    Cost-efficiency analyses of the PROMIS interventions in Mali and Burkina Faso

    Speaker: Lieven Huybregts, Senior Research Fellow, International Food Policy Research Institute

    Potential for cost-effectiveness of SQ-LNS within the 1000 Days Program in Niger

    Speakers: Kevin Phelan, Senior Nutrition Advisor, ALIMA and Marta Viola, Senior Analyst, Analysis Group

    Discussion

    Moderator: Alaka Holla, Senior Economist, Office of the Chief Economist for Human Development, World Bank

  • PART ONE

    Distinguished Professor Emerita, Institute for Global Nutrition, University of California, Davis

    Kathryn Dewey, PhD, is Distinguished Professor Emerita of Nutrition at the University of California, Davis. She was a co-founder of the UC Davis Program in International and Community Nutrition (now the Institute for Global Nutrition) and served as its Director from 2007 to 2018. Dr. Dewey¡¯s research focuses on maternal and child nutrition in vulnerable populations, with an emphasis on interventions to prevent malnutrition during the first 1000 days. She has led numerous randomized trials and cohort studies in the United States, Mexico, Costa Rica, Honduras, Guatemala, Peru, Ghana, Malawi, and Bangladesh. Dr. Dewey was Project Director for the International Lipid-based Nutrient Supplements (iLiNS) Project, an international research consortium that developed and evaluated a novel approach to enrich diets with small-quantity lipid-based nutrient supplements, designed for prevention of malnutrition in pregnant and lactating women and their children under the age of two in low- and middle-income countries. Her professional service includes extensive consultation for WHO, UNICEF and other organizations. She is currently a member of the Board of Directors for the Global Alliance for Improved Nutrition, the U.S. Food and Nutrition Board, the WHO Guidelines Development Group on Complementary Feeding, and several other advisory and guideline development committees.

    Associate Project Scientist, Institute for Global Nutrition, University of California, Davis

    Ryan Wessells, PhD, is an Associate Project Scientist in the Department of Nutrition, and a member of the Institute for Global Nutrition, at the University of California, Davis. Her research is focused on maternal and young children nutrition in low-income countries, with specific expertise in zinc and other micronutrient deficiencies, and the evaluation of preventive and therapeutic interventions designed to improve nutritional status and functional outcomes in these populations. Research themes include dietary and biochemical assessment of nutritional status, the assessment of nutrient absorption from complementary foods using stable isotope techniques, and relationships between nutritional status, environmental enteric dysfunction and infection. In addition, she has experience in dietary intake assessment and the use of linear programming to design food-based recommendations to ensure nutrient adequacy. She has worked in Burkina Faso, Niger, The Gambia, Ghana and Lao PDR. She received her PhD in Nutritional Biology from the University of California, Davis with a designated emphasis in international nutrition, and additional training in epidemiology and biostatistics.

    Associate Professor, Institute for Global Nutrition, University of California, Davis

    Elizabeth Prado, PhD, is an Associate Professor in the Department of Nutrition and Institute for Global Nutrition at the University of California Davis. She specializes in nutrition and child development during early life and directs the Translational Research in Early Life Learning for Impact at Scale (TRELLIS) lab. Like a vine, children need both nurturing care and strong support structures to ensure their healthy growth and development to their full potential. Parents and caregivers are like the gardeners that tend and nurture the vine so that it can grow and flourish. Policies and programs, from the national to community level, are like the trellis that supports the vine to grow. Dr. Prado¡¯s research applies findings from basic science on nutrition and other environmental influences on brain development to conduct research informing how policies and programs can best support parents and caregivers in their vital work of providing the nurturing care children need to thrive. Research approaches include (1) assessing developmental outcomes of efficacy, effectiveness and impact evaluations, (2) longitudinal cohort studies, (3) systematic reviews and meta-analyses, and (4) methodological studies and reviews on assessing child development and cognition in low- and middle-income contexts.

    Director, Institute for Global Nutrition, Professor of Nutrition and Corinne L. Rustici Endowed Chair in Applied Human Nutrition, University of California, Davis

    Christine Stewart, PhD, is Director of the Institute for Global Nutrition, Professor in the Department of Nutrition, and the Corinne L. Rustici Endowed Chair in Applied Human Nutrition at the University of California, Davis. She received her MPH from the Tulane University School of Public Health and Tropical Medicine and PhD from the Johns Hopkins Bloomberg School of Public Health. Her research focuses on the design and evaluation of nutrition and health interventions for women and young children in low income communities. She examines the effects of these interventions on growth, health, and development throughout the life course. She utilizes primarily community-based randomized controlled trials, longitudinal studies, and meta-analyses to synthesize evidence to inform improvements in programs or policy. She collaborates extensively with multi-disciplinary and multi-national teams and has had recent projects in Kenya, Tanzania, Malawi, Bangladesh, and Ecuador.

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    Deon Filmer (Moderator)

    Director, Development Research Group

    Deon Filmer is Director of the Research Group at the World Bank. He has previously served as Acting Research Manager in the Research Group, Co-Director of the World Development Report 2018: Learning to Realize Education¡¯s Promise, and Lead Economist in the Human Development department of the Africa Region of the World Bank. He works on issues of human capital and skills, service delivery, and the impact of policies and programs to improve human development outcomes¡ªwith research spanning the areas of education, health, social protection, and poverty and inequality. He has published widely in refereed journals, including studies of the impact of demand-side programs on schooling and learning; the roles of poverty, gender, orphanhood, and disability in explaining education inequalities; and the determinants of effective service delivery.

    PART TWO

    Associate Project Scientist, Institute for Global Nutrition, University of California, Davis

    Katherine (Katie) Adams, PhD, is an Associate Project Scientist with the Institute for Global Nutrition at the University of California, Davis. As an applied micro-economist, her research interests are at the intersection of economics and maternal and early childhood nutrition in low- and middle-income countries. Her current research is focused on developing tools and methods for using secondary data to assess the costs, effectiveness, and cost-effectiveness of nutrition interventions. Dr. Adams is part of the Condiment Micronutrient Innovation Trial (CoMIT) Project and Micronutrient Action Policy Support (MAPS) Project teams.

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    Emanuela Galasso

    Senior Economist, Development Research Group, World Bank

    Emanuela Galasso, PhD, is a Senior Economist in the Development Research Group (Poverty and Inequality Team) at the World Bank. Her research explores how the design of social protection, labor, and human capital interventions shape household and children's wellbeing. Her current research focuses on understanding the complementarities of nutrition, health and early childhood interventions, as well as the complementarities of social assistance programs and social and employment services in low- and middle-income countries.

    Senior Research Fellow, International Food Policy Research Institute

    Lieven Huybregts, PhD, is a senior research fellow in the Poverty, Nutrition, and Health Division at the International Food Policy Research Institute based in Washington DC. His main research focuses on integrating nutrition-sensitive interventions into health systems in the global south. He designed and conducted more than 10 impact evaluations and clinical trials to improve child and maternal nutrition during the first 1,000 days of life in Sub Saharan Africa in collaboration with NGO's and local research institutes. He acts as the chair of the IFPRI Institutional Review Board. Dr. Huybregts holds a PhD in Applied Biological Sciences (major nutrition) and an MSc in Bioscience Engineering (major food sciences), both from Ghent University, Belgium.

    Headshot of Kevin Phelan

    Kevin Phelan

    Senior Nutrition Advisor, ALIMA and Marta Viola, Senior Analyst, Analysis Group

    Kevin P.Q. Phelan, MSc, is the Senior Nutrition Advisor for ALIMA, the Alliance for International Medical Action, based in Paris. In addition to providing technical field support, he has developed and documented operational and clinical research in areas of nutrition and health. Before joining ALIMA he worked for Doctors Without Borders/M¨¦decins Sans Fronti¨¨res (MSF) for more than a decade in various roles, from crisis communications to Nutrition Working Group Leader.

    Headshot of Marta Viola

    Marta Viola

    Senior Analyst, Analysis Group

    Marta Viola, MSc, is a Senior Analyst in the healthcare practice at Analysis Group, where she consults on cases involving health economics and outcomes research. She holds a BSc in Medical Neuroscience and an MSc in Global Health, and has experience in economic evaluation of health technologies across multiple therapeutic areas. She has been acting as a pro bono consultant for ALIMA (The Alliance for International Medical Action) to evaluate the potential cost-effectiveness of small-quantity lipid-based nutrient supplementation.

    Senior Economist, Office of the Chief Economist for Human Development, World Bank

    Alaka is Program Manager of the World Bank¡¯s Strategic Impact Evaluation Fund, a multi-donor trust fund that promotes the use of rigorous evidence to design policies to improve education, health, access to quality water and sanitation, and early childhood development in low and middle income countries. She received her PhD in Economics from Brown University in 2007 and completed post-doctoral work at Harvard University and Innovations for Poverty Action. After joining the World Bank as a Young Professional in 2009, she has worked in both research and operational settings across a diverse set of country contexts, including as a core team member of the World Development Report 2015: Mind, Society, and Behavior. Her research has focused on the quality of service delivery, discrimination, early childhood development and education, and cost analysis.

EVENT DETAILS

  • DATES: May 4 (9:30 - 11:00am ET) and May 6 (9:30 - 11:00am ET)
  • CONTACT: siefimpact@worldbank.org