Prevention of Child Wasting: Results of a Child Health & Nutrition Research Initiative (CHNRI) prioritization Exercise

For which topic were research priorities identified?

child wasting

In which location was the research priority setting conducted?

international

Why was it conducted at all?

There are an estimated 49.5 million wasted children under five years of age. The decline in the global prevalence of wasting has been slow, from 7.9% in 2012 to 7.3% in 2018; just 37 (19%) out of 194 countries are on track to achieve the World Health Assembly (WHA) 2025 target of maintaining prevalence of wasting below 5.0%. World hunger appears to be on the rise after a prolonged decline. Although wasting is commonly considered an acute condition due to its relatively rapid onset and resolution compared to other manifestations of undernutrition such as stunting, the contributing factors and effects can be long term. A recent analysis of the WHA targets highlighted the lack of robust studies on effective interventions to prevent wasting and a strong tendency in the global nutrition community to focus on stunting prevention and wasting treatment rather than wasting prevention.

What was the objective?

to identify and prioritize the main outstanding research questions in relation to wasting prevention to inform future research agendas

What was the outcome?

a ranking list of 10 research questions

How long did the research prioritization take?

November 2018 - February 2019

Which methods were used to identify research priorities?

CHNRI approach

How were the priorities for research identified exactly?

Step 1: initial list of 94 research questions was developed by expert input. Step 2: experts refined and reduced the list to 40 key research questions. Step 3: survey: participants were asked to consider future interventions resulting from the stated research questions and judge how each question might meet each of the four criteria

Which stakeholders took part?

Specialists in nutrition, infant and child growth and epidemiology. Survey: 146 participants: most participants worked in program implementation with a third working for non-governmental organizations (NGOs) (n=47, 32%), a fifth for United Nations (UN) agencies (n=25, 17%) and a small proportion for national governments (n=7, 5%). Research organizations represented a quarter of participants (n=37, 25%).

How were stakeholders recruited?

The survey link was circulated via the EG, the Incidence of Acute Malnutrition group, the Management of Atrisk Mothers and Infants (MAMI) group, the Wasting and Stunting (WaSt) group (N=828), circulation lists from no Wasted Lives [27], the Department for International Development (DFID), Global Nutrition Report-Independent Expert Group, Health Systems groups, International Lipid-Based Nutrient Supplements (iLNS) project lists, Maximising the Quality of Scaling Up Nutrition+ (MQSUN+ subscribers' list), Leveraging Agriculture for Nutrition in South Asia (LANSA) consortium, cluster coordinator lists (health, WASH, food security), the United Nation's Children fund (UNICEF) publications sharing list; and the ENN website [28] and social media accounts.

Were stakeholders actively involved or did they just participate?

Stakeholders were mere participants of the research prioritization process; they were not actively involved in the process.