Category: Region

Focus on Nutrition During National Women’s Health Week

By:  Blythe Thomas, Initiative Director, 1,000 Days of FHI Solutions

Minerva Delgado, Director of Coalitions & Advocacy, Alliance to End Hunger

Not nearly enough time or attention is spent discussing and acting upon when “good nutrition” for an individual should start. The answer? Before the individual is even born. This week is National Women’s Health Week and marks an important time for the nutrition and anti-hunger community, individuals, and policymakers, to reflect on what we can do to promote and improve the health of women, children and families. We must focus on supporting policies that build a healthier and more equitable future for all pregnant, birthing, postpartum, and parenting people and their children.  

The 1,000-day window, which spans from pregnancy to age 2, marks one of the most crucial times to provide vital maternal and infant nutrition interventions. The nutrition community has coalesced around this critical window working to ensure mothers, children and families have access to the nutrition they need for vibrant futures. This goal is unfortunately – but unsurprisingly – difficult to achieve across the board. Factors such as race or where a child is born should not affect health and well-being; however, this is a reality in many communities. In particular, families of color and low-income families are more often overburdened with barriers to accessing nutrition and are under-resourced. As a result, there are glaring disparities in the health and well-being of women and children from these households. 

Adequate nutrition is fundamental to the overall well-being of a community because good nutrition impacts more than just physical health. Good maternal nutrition during pregnancy fuels the development of a baby’s rapidly growing brain so by the time that a baby is born, their brain will contain 100 billion neurons. We also know, for example, that children with access to healthier, more nutritious meals are better able to concentrate in school and enjoy better educational outcomes. Similarly, adults who can easily access and maintain a healthy diet benefit from improved health and economic opportunities. Addressing inequities in access to healthy and nutritious foods cannot be ignored. We must prioritize interventions that give every family the opportunity to be healthy.  

To that end, there are a number of programs that merit continued support and strong expansions, such as the Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the Child and Adult Care Food Program (CACFP). For example, WIC has bridged the gap between medicine, food, and nutrition better than almost any federal program, leading to improved nutrition intake, healthier pregnancies and improved birth outcomes. Congress has temporarily increased the overall value of WIC’s fruit and vegetable benefit (or Cash Value Benefit (CVB)) through the end of September 2022. So far, this has led to better access to nutritious foods for over 4.7 million WIC participants. Making the increased benefit permanent will significantly close nutrition gaps for women and their children. 

Improving nutrition also means supporting programs like the recently expired monthly Child Tax Credit (CTC). The revamped CTC monthly payment proved to have an astonishing impact on lifting children and families out of poverty. In 2021, Congress expanded the CTC and made the full credit available to low-income families who previously did not qualify because their earnings were too low. Families were allowed to receive the credit in monthly increments, which was vital in helping families with their everyday expenses like buying nutritious food. It is estimated that 3.7 million children were kept out of poverty in December 2001 when the last child tax credit payments were made. Further, nearly half of families who received the tax credits used the extra funds to purchase food helping to address nutrition insecurity around the country. In January, the first month without the deposits, those gains were lost and 3.7 million children again fell into poverty. 

But we must support the overall health and well-being of women and families with comprehensive approaches to address the root causes of poverty and malnutrition. Employers must implement family-friendly policies and programs in workplaces and communities to support women at home and at work. This includes providing workers with sufficient paid family leave, as well as ensuring equitable access to the lactation services and support women need to meet their breastfeeding goals. These policies help make the workplace and our society a safe and enabling environment. The recent pandemic and subsequent inflation have highlighted not only the critical nature of poverty and nutrition programs, but also the vulnerabilities and gaps in supporting those who need it most. All future policies must prioritize making programs more equitable and effective. While Congress has many competing priorities, we know that voters across all demographics deeply care about ensuring women and their children have access to the nutrition they need to be healthy. For example, a recent bipartisan poll by ALG Research/McLaughlin & Associates, on behalf of the National WIC Association and Alliance to End Hunger, reveals strong support for WIC among likely 2022 voters – 83% total support for the program, and approximately 75% support for expanding the value of the WIC food package, expanding postpartum eligibility, and modernizing WIC services.  

This week, let’s reflect once again on the fundamental importance of nutrition for women and girls across the country, and urge Congress to make access to healthy foods and investment in nutrition programs a priority. Ensuring the health and well-being of those who are pregnant and their children is critically important to our nation’s future and requires both focus and determination of policymakers and advocates. 

1,000 Days, an initiative of FHI Solutions, fights to win support for policies and investments in the wellbeing of mothers, babies and toddlers in the U.S. and around the world. 

Alliance to End Hunger unites diverse sectors to address today’s hunger and malnutrition needs and to solve the root causes of hunger at home and abroad. 

Paid Family Medical Leave Remains Critical for Low-Income Pregnant and Postpartum Women

By: Daphna Dror, PHD, RD

The lack of national, comprehensive, and paid family medical leave in the United States has significant consequences for low-income women, especially those who are pregnant or have recently given birth. Many women risk their own or their child’s health to continue working throughout pregnancy and the early postpartum period in order to pay bills and provide for dependents. Only seven states and the District of Columbia have passed their own paid leave programs, meaning far too many new mothers must choose between caring for themselves and bonding with their newborn or making ends meet. 

Paid leave:

  • Supports healthier pregnancies. Financial concerns due to lost wages may prevent low-income women from seeking regular prenatal care, which itself is associated with better pregnancy and birth outcomes. Paid leave reduces the risk of preterm birth, low birthweight, and infant mortality (1). 
  • Increases breastfeeding initiation and duration. The American Academy of Pediatrics recommends exclusive breastfeeding for 6 months followed by a combination of complementary foods and breastmilk for at least 12 months (2), yet new mothers who plan to return to work before 12 weeks or to work full time are less likely to opt for exclusive breastfeeding (3). A recently published study of participants in the USDA Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) found that amongst women who had worked prenatally, returning to work within 3 months postpartum significantly decreased the odds of breastfeeding for the first year (4). Paid time off can alleviate the financial stress of combining work and breastfeeding (5,6).
  • Improves the physical and mental health of mother and baby postpartum. While postpartum depression (PPD) occurs in approximately 11% of all US mothers, a qualitative study in low-income women found that 35% experienced PPD or sadness (1). Nearly one third of low-income mothers who returned to work reported that employers were not understanding of postpartum needs, most commonly requiring more time off (1). Mothers who have access to paid leave and other work accommodations can minimize financial strain and career disruptions while improving their own health, their baby’s health and their bond with their baby.
  • Reduces maternal and infant racial and ethnic disparities. Women of color are disproportionately affected by lack of access to paid leave, exacerbating perinatal health disparities (7). Compared with Caucasians, African-American mothers in the United States are more than three times as likely to die of pregnancy-related causes (8); infants born to African-American mothers have more than twice the mortality rate of infants born to Caucasian mothers (9). Women of color are overrepresented in part-time, seasonal, and low-wage jobs, employment categories least likely to offer paid leave (7).

Of 41 high- and middle-income countries, the U.S. is unique in lacking nationwide paid maternity leave, paternity leave, or parental leave (10). Only 19% of U.S. workers have access to paid family medical leave, with even lower access amongst those who work part-time, in low-wage industries, at small firms, or who are not unionized (11). Universal access to paid family leave is imperative to ensure that all families in the United States have a healthy first 1,000 days and a strong foundation to thrive.

References

1.     McClanahan Associates, Inc., 1,000 Days. Qualitative Paid Leave Report: Furthering our Case for Paid Leave in the United States.

2.     Eidelman AI, Schanler RJ. Breastfeeding and the Use of Human Milk. Pediatrics. 2012 Mar;129(3):e827-41.

3.     Mirkovic KR, Perrine CG, Scanlon KS, Grummer-Strawn LM. In the United States, a Mother’s Plans for Infant Feeding Are Associated with Her Plans for Employment. J Hum Lact. 2014 Aug;30(3):292–7.

4.     Hamner HC, Chiang KV, Li R. Returning to Work and Breastfeeding Duration at 12 Months, WIC Infant and Toddler Feeding Practices Study-2. Breastfeed Med. 2021 Dec;16(12):956–64.

5.     Rojjanasrirat W, Sousa VD. Perceptions of breastfeeding and planned return to work or school among low-income pregnant women in the USA. J Clin Nurs. 2010 Jul;19(13–14):2014–22.

6.     Johnson AM, Kirk R, Muzik M. Overcoming Workplace Barriers: A Focus Group Study Exploring African American Mothers’ Needs for Workplace Breastfeeding Support. J Hum Lact. 2015 Aug;31(3):425–33.

7.     Goodman JM, Williams C, Dow WH. Racial/ethnic inequities in paid parental leave access. Health Equity. 2021 Oct 13;5(1):738–49.

8.     Howell EA. Reducing disparities in severe maternal morbidity and mortality. Clin Obstet Gynecol. 2018 Jun;61(2):387–99.

9.     Ely DM. Infant Mortality in the United States, 2018: DataFrom the Period Linked Birth/Infant Death File. National Center for Health Statistics; 2020 Jul.

10.     Chzhen Y, Gromada A, Rees G. Are the World’s Richest Countries Family Friendly? Policy in the OECD and EU. Florence, Italy: UNICEF Office of Research; 2019.

11.     National Compensation Survey: Employee Benefits in the United States. U.S. Department of Labor, U.S. Bureau of Labor Statistics; 2019 Mar.

The importance of food systems and the environment for nutrition

Published: 24 November 2020

Publication: The American Journal of Clinical Nutrition

Authors: Jessica Fanzo, Alexandra L Bellows, Marie L Spiker, Andrew L Thorne-Lyman, and Martin W Bloem

Read the original paper here.

Summary 

  • Food systems contribute to and are vulnerable to ongoing climate and environmental changes that threaten their sustainability
  • We’re going to need more research to tell us what food policy changes we should make to ensure everyone has access to nutritious food despite the impacts of climate change.
  • We need to think about this key question: how can both human and planetary health thrive while meeting the demands of a growing human population, and if we can’t have it all, what trade-offs are we willing to live with?

Background

  • Food systems involve the production, processing, packaging, distribution, marketing, purchasing, consumption, and waste of food.
  • By “transforming” (improving) food systems, we could make healthy food more accessible and reduce environmental impact 
  • We need a lot more research to figure out how best to structure this transformation
  • Silos within the field make this research harder

Research Gaps

The impact of climate change on food systems

  • The link between climate and food systems is getting more and more attention, but there are still a lot of gaps in our knowledge. Specifically, we need more research on:
    •  The “missing middle” of the food supply chain (aka anything other than people’s diets and agricultural production) 
    • How climate change will affect non-staple crops (most research to date has only looked at staple crops).
    • How to create context-specific policies (eg. financial incentives, targeted messaging campaigns etc.) that encourage/allow people to eat sustainable diets and how to measure whether these policies are working:

Food systems 

  • Diets. We need more information on:  
    • The best way to measure how sustainable someone’s diet is
    • How people’s diets are changing as incomes rise
    • Healthy, locally appropriate, and sustainable diets are sometimes at odds with one another. How should we prioritize?
      • “One of the shortcomings of the EAT–Lancet Commission report was that it provided a single healthy reference diet for the world, and did not take into account that healthy and sustainable diets may differ in their availability, accessibility, and cost at the global, regional, and individual levels. Even more so, what is considered healthy is not always sustainable, and what is considered a sustainable diet is not always a healthy one.”
  • Food safety. We need more information on:
    • The danger of using pesticides and chemicals, and whether these dangers affect consumer purchases.
    • The danger of plastics (in food packaging, production etc.).
  • Food loss and waste.  We need more information on:
    • How to measure and reduce food waste/loss.

Interesting Stats

  • “Some models suggest that changes in food availability due to climate change, specifically reduced availability of fruit and vegetables, are estimated to result in an additional 529,000 deaths by 2050.”
  • “Globally, agriculture and livestock production utilize ∼40% of arable land account for ∼70% of fresh water withdrawn for human purposes, and are responsible for ∼11% of GHG emissions (although some estimates range from 11% to 24% depending on what is counted).”
  • “​​Food wasted at the retail and consumer levels alone averages 1217 calories, 33 g protein, 6 g fiber, and 286 g Ca per person per day.”

Figure: Link between food systems and the environment

The COVID-19 crisis will exacerbate maternal and child undernutrition and child mortality in low- and middle-income countries

Published: July 2021

Publication: Nature Food

Authors: Saskia Osendarp, Jonathan Kweku Akuoku , Robert E. Black , Derek Headey, Marie Ruel , Nick Scott , Meera Shekar, Neff Walker, Augustin Flory , Lawrence Haddad, David Laborde , Angela Stegmuller , Milan Thomas  and Rebecca Heidkamp

Read the original paper here.

Summary:

  • COVID-related disruptions to food and health systems mean cases of malnutrition around the world are likely to get worse.
    • People also have less money and therefor are turning to less expensive sources of calories such as starchy staples and eating fewer nutrient-dense foods.
  • The study authors used statistical models to predict what these disruptions would do to malnutrition rates.
  • They calculated “optimistic”, “moderate” and “pessimistic” outcomes.
  • After the paper’s publication, the authors stated the pessimistic outcomes are the most likely.
  • Using the pessimistic model as the authors recommend, they predict that by the end of 2022, COVID-19-related disruptions could result in an additional:
    • 13.6  million wasted children 
    • 3.6 million stunted children 
    • 283,000 additional child deaths
    • 4.8 million maternal anaemia cases
    • 3 million children born to women with a low BMI 
    • US$44.3 billion in future productivity losses due to excess stunting and child mortality.
  • To make up for the demands of the projected undernutrition increases, the authors predict we will need an additional $1.7 billion per year.
  • The report also predicts that ODA for nutrition will be 19% less through 2030 than it would have been without COVID, accompanied by a similar decrease in domestic health budgets.
  • We could save a lot of babies from being born small, preterm or stillbirth by a) switching the prenatal vitamins we give out from iron folic acid (IFA) to multiple micronutrient supplements (MMS) and b) Give balanced energy and protein supplements to malnourished pregnant women.
  • The report argues1 that fewer children would be impacted if we move funding away from providing complementary foods and instead allocate resources toward:
    • Balanced energy protein supplementation
    • Breastfeeding promotion
    • IYCF counseling at 6–23 months of age in food-secure households
    • Wasting treatment
    • Vitamin A supplementation

  • These numbers should make it clear to decision makers that the pandemic is causing levels of undernutrition to rise in LMICs and that we need to urgently increase ODA and domestic funding to address this crisis.

Key Quotes:

  • “The COVID-19 pandemic has created a nutritional crisis in LMICs. Without swift and strategic responses by subnational, national, regional and international actors, COVID-19 will not only reverse years of progress and exacerbate disparities in disease, malnutrition and mortality, but will also jeopardize human capital development and economic growth for the next generation.”
  • “While women of reproductive age and young children are largely spared COVID-19’s direct effects (that is, serious disease and death), our projections demonstrate that, regardless of the scenario, the COVID-19 crisis is expected to have dramatic indirect effects on maternal and child undernutrition and child mortality in the current generation.”
  • “The nutritional impacts of the COVID-19 crisis could have massive, long-term productivity consequences that could extend to future generations. Poor nutrition during early life stunts both physical and cognitive development, affects schooling performance and adult productivity, increases the risks of overweight/obesity and diet-related non-communicable diseases later in life, and triggers the intergenerational transmission of malnutrition.”

1 The article notes that “The optimal results and allocative efficiency gains will vary across countries, depending on demographics, epidemiological factors and baseline intervention coverages, as well as context-specific costs, priority targets, delivery platforms and other constraints.”

Scaling Up Impact on Nutrition: What Will It Take?

Published: 07 July 2015

Publication: Advances in Nutrition

Authors: Stuart Gillespie, Purnima Menon, and Andrew L Kennedy

Read the original paper here.

Summary:

  • Even though scaling is important to the nutrition community, people have different ideas about what the term means. 
  • If we’re going to successfully scale nutrition interventions, we need a clear and consistent definition of what the word means.
  • This paper analyses 36 scaling frameworks (from multiple sectors), and distills these frameworks into nine “critical elements” for successfully scaling nutrition projects:
  1. Have a vision/goal:  From the beginning, it is important that everyone agrees on what the project is trying to achieve and how you will measure success. 
  2. Focus on evidence-based interventions: only scale interventions that have already been tested and that are effective at a smaller scale.  
  3. Context matters.  Make sure that any programs you try to scale take into account all the challenges and opportunities of the surrounding environment (policies, institutions, culture etc.). If there are big barriers, make sure your intervention can work around them or don’t scale it there. 
  4. Drivers for scale up include high-level political support, an engaged nutrition champion to spark support, national and local ownership of the intervention, and performance incentives for individual frontline workers or  whole organizations.
  5. Identify scaling-up strategy, processes, and pathways: Be clear about exactly what you’re trying to scale and how you’re going to do it. These measures can be quantitative (expansion in geographical coverage, budget, or size), functional (increase in types of activities and integration with other programs), political (increases in political power and engagement), and organizational (strengthened organization capacity)
  6. Make sure there is strategic and operational capacity to scale up.  Capacity can be improved through nutrition leadership and training.
  7. Governance:  Recognize that successful scaling means managing trade-offs (for example between demonstrating short-term success and building sustainable systems) and make sure governments at different levels have a coherent way of working together.
  8. Financing:  Not only do you need to have enough money, but that money needs to be reliable and flexible. Interventions also cost different amounts depending where you are, so wherever possible make sure your budget is based on local data and prices.
  9. Monitoring, evaluation, learning, and accountability:  We need a lot more evidence on the impact of and lessons learned from scaling. Make sure to collect and disseminate data as you go.

Ensuring Women Have Access to Proper Nutrition Grows Their Power

Image Source: Jonathan Torgovnik, Getty Images, Images of Empowerment

By: Megan Deitchler, Initiative Director, Intake; Sandy Remancus, Initiative Director, Alive & Thrive; Blythe Thomas, Initiative Director, 1,000 Days

Every person has the fundamental human right to access safe, affordable, and nutritious foods, but women and girls are twice as likely to suffer from malnutrition as men and boys due to a combination of biological, social, and cultural factors. We must do better to change this reality. Ahead of this year’s International Women’s Day, 1,000 Days and our sister Initiatives at FHI Solutions, Alive & Thrive and Intake, are calling for greater action to improve the nutrition of women and girls worldwide.

We know that well-nourished women and girls are healthier, more productive, and more likely to finish school. Malnutrition is a barrier that keeps women from accessing their full potential, which reinforces women’s oppression in all aspects of their lives. Good nutrition and women’s empowerment go hand in hand. A more intentional focus that targets improving women’s’ and girls’ nutrition is critical to making concrete, cost-effective, and sustainable improvements to the status of girls around the world. Simply put – ensuring women have access to proper nutrition can help them grow their power. Consequently, gender equality and increasing women’s decision-making powers are crucial to overcome nutritional vulnerabilities and break the inter-generational cycle of malnutrition.

Good nutrition is an essential building block in our fight for gender equality, but our approaches thus far have been siloed. Considering the interlinks between a woman’s health and her ability to claim her agency, actors and service providers across health, social protection, agriculture, and women’s empowerment sectors must prioritize optimal nutrition for women in their own right. Failure to harness a nuanced approach to these interlinked issues, from the community level to the global, will continue to leave women behind.

Over the next two years, FHI Solutions will work hand in hand with our diverse and multi-sectoral allies, ranging from community organizations to government leaders, to galvanize global- and country-level momentum for a compelling Women’s Nutrition Action Agenda. Through this Action Agenda, we aim to:

  1. Advance women’s nutrition as a global development priority of major donors and in target priority low- and middle-income countries (LMICs)
  2. Inform and inspire more and better use of new and existing financing for nutrition on priority World Health Assembly nutrition targets (anemia, low birthweight, and exclusive breastfeeding) from target LMICs and donors
  3. Influence delivery platform gatekeepers in health, including primary health care / Universal Health Coverage platforms, as well as other sectors to integrate preventive nutrition interventions in target LMICs
  4. Advocate for the use of reliable, validated metrics, such as the Global Diet Quality Score, to track progress in achieving healthy diets for all, especially women and girls

Nutrition programming is an underleveraged tool in the fight to advance girls’ rights and empowerment. By leveraging targeted nutrition interventions as a key part of gender equality programming, women’s empowerment actors can give a cost-effective boost to their investments and move the world back closer to reaching Sustainable Development Goal 5 – SDG 5. We are committed to working together with critical partners, both inside the global nutrition community and beyond, as we build a multi-sectoral policy, advocacy, and communications effort to inspire national and international commitment to, and scaled-up investment for, women’s nutrition. We must ensure the nutrition and health of girls and women to fully support their ability to build vibrant lives of their own making.

Kicking Off #March4Nutrition – Join Us All Month Long

In honor of National Nutrition Month, 1,000 Days is kicking off our annual #March4Nutrition campaign to amplify the importance of nutrition for moms and babies around the world. We invite you to follow #March4Nutrition on Facebook, Instagram, and Twitter all month long and join the conversation. 

This #March4Nutrition, we’ll get back to basics and focus on good nutrition in the 1,000-day window. Throughout pregnancy, infancy and beyond, families need good nutrition, breastfeeding support, and nurturing care in order to thrive. 

Every week in March, we’ll dive deep into a new theme and explore how nutrition lays the foundation for brighter, healthier futures. Find more information below and check out our social media toolkit full of graphics and messages to share with your online communities!  

Week 1 March 1-8: Women’s nutrition – Access to proper nutrition can help women grow their power. 

Week 2 March 9-16: Benefits of breastfeeding – Breastfeeding has critical benefits for both moms and babies.  

Week 3 March 17-24: Healthy foods and drinks for babies and toddlers – Growing babies need good nutrition to flourish. 

Week 4 March 25-31: Raise your voice – Help us spark action to change the world for moms, babies and families, 1,000 days at a time.  

At 1,000 Days, we believe that every family, everywhere deserves the opportunity to have a healthy 1,000-day window and beyond – and that starts with access to good nutrition. 

Join us this month as we #March4Nutrition for moms and babies! 

Why Nutrition Matters

Nutrition in the First 1,000 Days – Why It Matters

Good nutrition during pregnancy and the first years of a child’s life provides the essential building blocks for brain development, healthy growth and a strong immune system. In addition, a growing body of scientific research indicates that the foundations for lifelong health—including predispositions to obesity and certain chronic diseases—are largely set during this 1,000 day period.

There are three crucial stages in the first 1,000 days: pregnancy, infancy and early childhood. During pregnancy, a mother’s health and eating habits have a significant impact on the development and future well-being of a child. If a mother’s diet is not giving her the nutrients she needs to support a healthy pregnancy and her baby’s development or if it is contributing to excessive weight gain—or both—it can have serious, long-term consequences.

From birth through the first year, breastfeeding provides unparalleled brain-building benefits and gives babies the healthiest start to life. Because of the unsurpassed benefits of breastfeeding, the world’s leading health agencies including the World Health Organization (WHO) and the American Academy of Pediatrics (AAP) recommend that babies are fed only breastmilk for their first 6 months, but many mothers lack the support they need to meet this recommendation.

And, finally, beginning at 6 months of age, children should eat a diverse diet of nutrient-rich foods to help fuel their growth and development and shape their taste preferences for healthy foods. Throughout early childhood, parents and other caregivers should also teach healthy eating habits and make sure that water and other non-sugar-sweetened beverages become a consistent part of a child’s diet. Deficiencies in key nutrients, poor eating habits and unhealthy weight gain during the early years of a child’s life can set the stage for numerous developmental and health problems down the road.

From India to Indiana, Kenya to Kentucky, mothers and children everywhere need good nutrition and nurturing care in the first 1,000 days to thrive. Yet too many families in the U.S. and throughout the world do not get the food, healthcare or support they need. Whether your organization works to end the crisis of malnutrition in low- and middle-income countries, or you’re focused on the urgent needs of families especially in the United States, thank you for working with us to create a healthier and more equitable future for all pregnant and birthing people, parents, and their children.

CDC Guest Post: Journal Series To Spotlight Importance of Early Nutrition for Health

Guest Blog Post from Dr. Ruth Petersen, Director of CDC’s Division of Nutrition, Physical Activity, and Obesity

Good nutrition is essential in keeping current and future generations of Americans healthy across the lifespan. Good nutrition is especially important during the 1,000 days from a woman’s pregnancy through the child’s second birthday. During this time, optimal nutrition is critical for the child’s brain development, their healthy growth, and setting them on a trajectory for lifelong health. 

Yet today, too many families struggle to obtain optimal nutrition during the first 1,000 days. Only a third of women gain the recommended amount of weight during pregnancy and about 16% of pregnant women have iron deficiency. Although most infants receive some breast milk, most are not exclusively breastfeeding or continuing to breastfeed as long as recommended, and 60% of mothers do not breastfeed for as long as they intend to. Among 1-year-olds, on a given day, fewer than half have eaten a vegetable, and 1 in 3 consume a sugary drink. And about 1 in 7 households with children is food insecure, with deep disparities by race and ethnicity.

At the Centers for Disease Control and Prevention’s Division of Nutrition, Physical Activity, and Obesity, we promote and support implementation of programs and activities to improve nutrition before pregnancy, during pregnancy, and through a child’s second birthday. This includes optimal breastfeeding and complementary feeding practices. We support state and community partners by providing data, evidence-based strategies, and practical tools.

The American Journal of Public Health (AJPH), in collaboration with 1,000 Days, intends to publish a special issue exploring the importance of the 1,000-day window from pregnancy to age 2 for maternal and child nutrition and health in the United States. Scheduled for publication in early November 2022, the supplement will highlight how policies, systems, and environments affect the nutrition of mothers and children during the first 1,000 days. It will also summarize the state of the science and research needs related to maternal and child nutrition in the United States. View the full call for papers for complete instructions for submission.

This special issue presents an important opportunity to illuminate the challenges and solutions to ensuring optimal nutrition for mothers and young children in the United States, and to highlight proven policies, strategies, and other solutions to eliminate inequities and health disparities.

The Nutrition Year of Action in Review: 5 Things that Give Us Hope

It’s easy to be pessimistic about the current state of global nutrition. Malnutrition still kills more kids in an average year than the population of Chicago, and leaves millions more with permanently stunted brain development and life-long health problems. COVID-related disruptions to food and health systems have exacerbated these numbers, with experts predicting that by the end of 2022 we’ll see an additional 13.6 million cases of wasting, the most deadly type of malnutrition. To top it all off, experts are now saying that we’ve been underestimating how much it will cost to reach our global nutrition targets, and that with the additional demand from the pandemic we now need to mobilize at least $10.8 billion every year just to stay on track.

On December 8, the 3rd Nutrition for Growth Summit wrapped up the 2021 Nutrition Year of Action, a pledging event that could not have come at a more urgent time. And despite all the challenges ahead, we want to take a moment to celebrate some of the things that give us hope as we conclude the Nutrition Year of Action and move into 2022. Here are our top five:

  1. Breadth and depth of high-burden country commitments

As N4G hosts, the Government of Japan created an inclusive environment that helped encourage and support governments to prepare bold commitments to accelerate progress on the nutritional issues in their countries. This support helped facilitate new commitments from 70 countries with a high burden of malnutrition. Commitments ranged from financial, policy, programmatic, and impact to cut across the five themes of the Summit: Health, Food, Resiliency, Financing, Data/Accountability. This is great news, in part because steadily increasing domestic resource mobilization is a key component of nutrition financing models toward the WHA targets. We are hopeful that the large number of new commitments from high-burden countries will help offset the rising cost of these interventions.

  1. New vehicles for innovative financing

Donors are increasingly turning to innovative financing mechanisms to fill funding gaps and leverage new funding streams. One great example is the Nutrition Match Fund launched this year by the Children’s Investment Fund Foundation (CIFF), UNICEF, and the Bill & Melinda Gates Foundation. The fund helps to mobilize domestic resources for nutrition by providing a 1-to-1 match for any money governments spend on essential tools to combat undernutrition such as purchasing ready-to-use therapeutic foods to treat wasting. The fund has unlocked nearly $4 million of incremental domestic resources, and is already attracting additional donor investment. We are hopeful that advancements like this one in nutrition supply financing will help prevent supply chain disruptions and offer one solution for the low coverage rates of many nutrition interventions.

  1. Progress on UN wasting treatment reform

An update to the UN’s wasting management protocols has been a long time coming. The reform process began in 2020 with the launch of the Global Action Plan (GAP) on Child Wasting. Though the GAP fell short of expectations in many ways, we are heartened by the steps the UN has taken to advance this work in 2021, including releasing operational country roadmaps for the GAP. Another step forward is the WHO and UNICEF’s ongoing evidence review to update global and national guidelines on wasting treatment. This review will reflect the growing evidence that there are simpler, cheaper, and more efficient ways to detect and treat wasting to open the door for reaching more children.

  1. Nutrition accountability at the forefront

One of the major outcomes from the 2021 Nutrition Year of Action is the launch of the Global Nutrition Report’s (GNR) Nutrition Accountability Framework (NAF). The NAF is the world’s first comprehensive accountability platform for nutrition, helping to ensure all commitment-makers put their promises into tangible action. Commitments must be SMART and align with national nutrition plans. The platform inspires bold and measurable commitments that drive progress on nutrition. At 1,000 Days, we believe holding ourselves and our leaders accountable is a crucial component of scaling evidence-based nutrition interventions.

  1. Renewed US leadership in the global nutrition space

In 2019 – the lead-up to the original 2020 N4G dates – the US was pulling back from international obligations and seemed unlikely to make any sort of substantial commitment at N4G. By December 2021, the US has not only publicly committed up to $11 billion over three years to combat global malnutrition, but sent USAID Administrator Power to make the announcement. The commitment builds on the Biden Administration’s repeated nods to the importance of good nutrition, especially in the wake of the pandemic. Though it is still unclear how the US will fulfill its financial commitment and how much (if any) of the $11 billion is new money, US commitments throughout the Nutrition Year of Action signal its plans to remain at the forefront of the fight against global malnutrition. As the sector’s largest donor, and in the face of a notable lack of commitment from the UK, US leadership will be a key component of any successful nutrition effort. As advocates continue to socialize the Nourish the Future proposal in 2022, the Administration’s demonstrated commitment to global nutrition is a welcome signal for more to come.

On top of these successes, we saw a host of other positive developments for nutrition, such as the addition of multiple micronutrients to the WHO Essential Medicines List, a growing adoption of the new OECD DAC nutrition policy marker, and the recent release of the Global Financing Facility’s Nutrition Roadmap. Ultimately, Summit participants from around the world pledged over $27 billion toward global nutrition at a time when donor fatigue is high and every country in the world is facing outsized domestic challenges. 2021 was a year of setbacks in our fight against malnutrition, but the new tools and resources coming out of the Nutrition Year of Action give us hope that the state of global nutrition will look better in 2022 and beyond.