Identifying priority countries for scaling up small-quantity lipid-based nutrient supplements
Navideh Noori1, Christine P Stewart2, Christine M McDonald2,3
1Institute for Disease Modeling, Gates Foundation, Seattle, Washington, USA Navideh.Noori@gatesfoundation.org.
Insights
Small-quantity lipid-based nutrient supplements (SQ-LNS) can prevent child malnutrition and mortality. Scaling up SQ-LNS in high-burden countries, primarily in Sub-Saharan Africa, is crucial to address the global nutrition crisis.
Area of Science:
- Global Health
- Nutritional Science
- Pediatric Health
Background:
- Undernutrition causes nearly half of deaths in children under 5 globally.
- Small-quantity lipid-based nutrient supplements (SQ-LNS) are proven to prevent wasting, stunting, anemia, and mortality in children aged 6-23 months in low- and middle-income countries (LMICs).
- The current global food insecurity and nutrition crisis necessitates urgent scale-up of effective preventive interventions like SQ-LNS.
Purpose of the Study:
- To identify countries with the highest burden of child wasting, stunting, and mortality to prioritize SQ-LNS scale-up.
- To assess the potential impact of SQ-LNS on child mortality, stunting, and wasting using a care cascade model.
- To identify high-burden subnational regions within the top 20 countries for targeted interventions.
Main Methods:
- Analysis of national survey data (Demographic and Health Survey, Multiple Indicator Cluster Surveys) and the Lives Saved Tool to identify countries with the highest child malnutrition and mortality burdens.
- Application of a care cascade model using national-level estimates to project the impact of SQ-LNS.
- Subnational analysis in the 20 highest-burden countries using the most recent available survey data.
Main Results:
- The top 20 countries with the highest burden of child wasting, stunting, and mortality were identified, with many located in Sub-Saharan Africa and some in South/Southeast Asia.
- Some identified countries had survey data older than 10 years, highlighting potential data gaps.
- The care cascade model indicated that widespread provision of SQ-LNS could avert a substantial number of stunting and wasting cases and deaths.
- Several high-burden countries also face significant acute food insecurity.
Conclusions:
- The majority of the top 20 countries are concentrated in Sub-Saharan Africa, with others in South and Southeast Asia.
- This geographical clustering emphasizes the critical need for focused interventions in these regions to combat child malnutrition.
- Targeted scale-up of SQ-LNS in these high-burden areas presents a significant opportunity to reduce child mortality and morbidity.
Introduction:
Undernutrition is a cause of nearly half of all deaths among children under 5 years old. Small-quantity lipid-based nutrient supplements (SQ-LNS) have been shown to prevent child wasting, stunting, anaemia and mortality among children 6-23 months of age in low- and middle-income countries (LMICs). Scaling up effective preventive interventions is urgent given the current global food insecurity and nutrition crisis.
Method:
To prioritise SQ-LNS scale-up activities, we identified countries with the highest burdens of wasting, stunting and all-cause mortality among children 6-23 months of age at the national level using the most recent national survey data including the Demographic and Health Survey and Multiple Indicator Cluster Surveys, as well as the Lives Saved Tool in LMICs. National-level estimates informed a care cascade model to assess the potential impact of SQ-LNS on all-cause mortality, stunting and wasting. We also conducted a subnational level analysis among the 20 highest burden countries with the most recent available survey data to identify the highest burden regions.
Results:
Our analysis identified the top 20 countries with the highest burden of the three outcomes as: Niger, South Sudan, Yemen, Sudan, Somalia, Democratic Republic of Congo, Eritrea, Nigeria, Central African Republic, Guinea, Equatorial Guinea, Chad, Papua New Guinea, Benin, Mali, Angola, Pakistan, Timor-Leste, Sierra Leone and Côte d'Ivoire, although for some countries the survey data were collected >10 years ago. Some of these countries also ranked high in population estimates of acute food insecurity. The care cascade model demonstrates that a large number of cases of stunting and wasting and deaths could be potentially averted if SQ-LNS is provided.
Conclusion:
Most of the top 20 countries are in Sub-Saharan Africa, with a few in South and Southeast Asia. This geographical concentration underscores the urgent need for targeted interventions in these regions to prevent child malnutrition.
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