The DHS Program User Forum
Discussions regarding The DHS Program data and results
Home » DHS-8 Questionnaire Review - Archived » Core questionnaire: Nutrition » Updated Indicators for Infant and Young Child Feeding (IYCF)
Updated Indicators for Infant and Young Child Feeding (IYCF) [message #16777] Fri, 01 March 2019 14:16 Go to next message
DataDENT is currently offline  DataDENT
Messages: 11
Registered: January 2019
Member
An inter-agency technical consultation to review WHO-UNICEF Infant and Young Child Feeding (IYCF) indicators was held in July 2018. An outcome of this consultation was the recommendation to develop three new indicators of unhealthy dietary practices in children, measured by consumption in the last 24 hours of: (i) sugar-sweetened beverages; (ii) "junk" food; (iii) zero fruit or vegetable. The guidance on the new indicators is scheduled to be finalized in 2019. We propose to include these three indicators in the DHS-8 core questionnaire, which could be calculated by modifying existing Q650.

1. Sugar-sweetened beverage consumption
Definition: Percentage of children 6-23 months who consumed sugar-sweetened beverages during the previous day.

2. Junk food consumption
Definition: Percentage of children 6-23 months of age who consumed sweet or savory junk foods during the previous day.

3. Zero fruit and vegetable consumption
Definition: Percentage of children 6-23 months of age who consumed no fruits or vegetables during the previous day.

Attached to this post is a completed submission form with full justification for the recommendation.

----------

This recommendation originated in the September 2018 Technical Consultation on Measuring Nutrition in Population-Based Household Surveys and Associated Facility Assessments--a 2-day working meeting convened by the Bill & Melinda Gates Foundation and United States Agency for International Development in collaboration with the World Health Organization (WHO) and United Nations Children's Fund (UNICEF), and coordinated by Data for Decisions to Expand Nutrition Transformation (DataDENT). The consultation included more than 60 technical experts, survey program representatives from DHS, MICS, LSMS and SMART, country data stakeholders, and donors from the nutrition measurement community.

This recommendation was authored by Alissa Pries (Helen Keller International (HKI)) and reviewed by Julia Krasevec (UNICEF), Chika Hayashi (UNICEF), Megan Deitchler (Intake Center for Dietary Assessment), Mary Arimond (Intake Center for Dietary Assessment), and Mduduzi Mbuya (Global Alliance for Improved Nutrition (GAIN)).

This recommendation is endorsed by the WHO-UNICEF Technical Expert Advisory Group on Nutrition Monitoring (TEAM). Out of the 10 sets of recommendations endorsed by TEAM, this recommendation was prioritized as Tier 1 of 3 (critical data need).

This recommendation is also endorsed by Countdown to 2030, Alive & Thrive, the nutrition team at the Bill & Melinda Gates Foundation, and the Department of International Health at the Johns Hopkins Bloomberg School of Public Health.
Re: Updated Indicators for Infant and Young Child Feeding (IYCF) [message #16876 is a reply to message #16777] Tue, 12 March 2019 13:36 Go to previous messageGo to next message
dniyeha is currently offline  dniyeha
Messages: 4
Registered: March 2019
Member
I endorse this recommendation. In Tanzania many institutions including Helen Keller International support MIYCAN/ IYCF counseling at both health facilities and household level, but we do not have nationally representative coverage numbers for these interventions. These are important interventions we therefore need coverage numbers to understand our performance.
Re: Updated Indicators for Infant and Young Child Feeding (IYCF) [message #16904 is a reply to message #16777] Wed, 13 March 2019 21:40 Go to previous messageGo to next message
SUN Movement MEAL Team
Messages: 9
Registered: March 2019
Member
The SUN Movement strongly supports the inclusion of these three indicators to provide more information on unhealthy diet practices in young children that contribute to the growing burden of overweight and obesity in SUN countries.
Re: Updated Indicators for Infant and Young Child Feeding (IYCF) [message #16925 is a reply to message #16777] Thu, 14 March 2019 05:12 Go to previous messageGo to next message
Mauro Brero is currently offline  Mauro Brero
Messages: 12
Registered: March 2019
Member
UNICEF Tanzania Nutrition team proposes to maintain indicators 1 and 2. For indicator 3 we propose that the indicator is stated in a positive way instead of the current form. We suggest that the indicator should be percent of children who consumed fruits or vegetables.

The 3 indicators are very relevant in the country and the information will be used to support current effort to address the double burden of malnutrition, focusing on prevention of overweight and obesity among vulnerable groups.

UNICEF Tanzania Nutrition team.

[Updated on: Thu, 14 March 2019 05:15]

Report message to a moderator

Re: Updated Indicators for Infant and Young Child Feeding (IYCF) [message #16931 is a reply to message #16777] Thu, 14 March 2019 05:36 Go to previous messageGo to next message
Geeta Verma is currently offline  Geeta Verma
Messages: 5
Registered: March 2019
Member
I fully support the addition of these three indicators.
For indicator 3 while it is preferable to ask a positive question.
Re: Updated Indicators for Infant and Young Child Feeding (IYCF) [message #17020 is a reply to message #16777] Fri, 15 March 2019 07:03 Go to previous messageGo to next message
Rolf Klemm is currently offline  Rolf Klemm
Messages: 7
Registered: March 2019
Member
Helen Keller International (HKI) endorses the recommendation for inclusion of updated indicators for infant and young child feeding in DHS-8.
There is a need to expand understanding of diets among children under two years of age in the face of evolving food environments. Many countries combatting child undernutrition are now concurrently struggling with overnutrition. Studies by HKI and others have shown marked consumption of unhealthy foods such as sugar-sweetened beverages (SSB) and junk foods among young children in Asia and Africa (Huffman et al., 2014), with rates among 12-23 month-old children as high as 74% in Dakar, Senegal, 84% in Kathmandu Valley, Nepal, and 87% in Bandung, Indonesia (Feeley et al., 2017, Pries et al., 2017; Green et al., in press). Further research among 1-2 year olds in Kathmandu Valley has also found that nearly one-quarter of energy intakes from foods come from unhealthy snack foods/beverages (Pries et al., in press).
DHS measurement of unhealthy dietary patterns during the complementary feeding period, such as consumption of nutrient-poor foods (SSB and junk foods) and low intake of fruits/vegetables, would allow tracking of trends over time within countries, and comparisons across countries/regions in varying stages of the double burden of malnutrition. This data would be invaluable for targeting of programs, and for informing policy to safeguard young child nutrition. Where data indicate high consumption of SSB and junk foods or low consumption of fruits/vegetables among young children, governments and NGOs such as HKI can focus programmatic efforts on increasing consumption of nutrient-rich, locally available foods during the complementary feeding period and developing strategies to limit consumption of unhealthy foods and beverages.

References:
Huffman, S. L., Piwoz, E. G., Vosti, S. A. & Dewey, K. G. Babies, soft drinks and snacks: a concern in low and middle-income countries? Matern. Child Nutr. 10, 562574 (2014).
Feeley, A. B. et al. Promotion and consumption of commercially produced foods among children: Situation analysis in an urban setting in Senegal. Matern. Child Nutr. 12, 6476 (2016).
Pries, A.M. et al. Consumption of commercially produced snack foods and sugar-sweetened beverages during the complementary feeding period in four African and Asian urban contexts. Matern. Child Nutr. 13, e12412 (2017).
Green, M. et al. High proportions of children below 3 years of age consume commercially produced snack foods and sugar-sweetened beverages in Bandung City, Indonesia. Matern. Child Nutr. (in press)

Re: Updated Indicators for Infant and Young Child Feeding (IYCF) [message #17024 is a reply to message #16777] Fri, 15 March 2019 07:05 Go to previous messageGo to next message
Paula Kawiche is currently offline  Paula Kawiche
Messages: 9
Registered: March 2019
Member
I indorse these questions
Re: Updated Indicators for Infant and Young Child Feeding (IYCF) [message #17039 is a reply to message #16777] Fri, 15 March 2019 08:01 Go to previous messageGo to next message
aperry is currently offline  aperry
Messages: 9
Registered: March 2019
Member
The DFID Nutrition Policy team endorses this proposal - as more countries are experiencing rapid shifts in diets towards less healthy foods that will limit health and development of people particularly children this information is essential to enable effective investment and to monitor progress.
Re: Updated Indicators for Infant and Young Child Feeding (IYCF) [message #17044 is a reply to message #16777] Fri, 15 March 2019 08:10 Go to previous messageGo to next message
Marie Ruel is currently offline  Marie Ruel
Messages: 11
Registered: April 2014
Member
I fully endorse the addition of these important questions that nicely complement existing IYCF questions and will help assess other aspects of the quality of complementary foods.
Re: Updated Indicators for Infant and Young Child Feeding (IYCF) [message #17119 is a reply to message #17044] Fri, 15 March 2019 14:16 Go to previous messageGo to next message
salayon is currently offline  salayon
Messages: 7
Registered: January 2019
Member
The addition of these questions is forward thinking and advances our thinking about quality of diets. I endorse these recommendations.
Re: Updated Indicators for Infant and Young Child Feeding (IYCF) [message #17132 is a reply to message #17119] Fri, 15 March 2019 14:42 Go to previous messageGo to next message
EstherG is currently offline  EstherG
Messages: 7
Registered: March 2019
Member
Bernard van Leer Foundation endorses these recommendations
Re: Updated Indicators for Infant and Young Child Feeding (IYCF) [message #17158 is a reply to message #16777] Fri, 15 March 2019 15:17 Go to previous messageGo to next message
PATH is currently offline  PATH
Messages: 8
Registered: March 2019
Member
Thanks to DataDENT for compiling these recommendations.

We agree with the reinstatement of collection indicators #1 and #2 in light of emerging dietary patterns.
Indicator #3, consider dropping this as it can be calculated from already collected diet data. If this will still be included, the indicator should be re-formulated, as others have mentioned above e.g. Percentage of children 6-23 months of age who consumed any fruit or vegetable during the previous day.
Re: Updated Indicators for Infant and Young Child Feeding (IYCF) [message #17179 is a reply to message #16777] Fri, 15 March 2019 15:29 Go to previous messageGo to next message
1000 Days is currently offline  1000 Days
Messages: 10
Registered: March 2019
Member
1,000 Days is the leading non-profit organization working in the U.S. and around the world to improve nutrition and ensure women and children have the healthiest first 1,000 days.
We strongly support this recommendation and the priority is was given by the recommenders as a critical data need. Nutritious complementary feeding is extremely important for a child's healthy physical and cognitive development. As diets around the world become more complex, this data is critical and will highlight the need for better policies to improve the food environment and support caregivers, so children get the nutrition they need.
Re: Updated Indicators for Infant and Young Child Feeding (IYCF) [message #17337 is a reply to message #16777] Fri, 15 March 2019 17:50 Go to previous messageGo to next message
Erin Milner is currently offline  Erin Milner
Messages: 9
Registered: February 2019
Member
USAID supports this recommendation.
Re: Updated Indicators for Infant and Young Child Feeding (IYCF) [message #17343 is a reply to message #17337] Fri, 15 March 2019 18:00 Go to previous messageGo to next message
ktripp is currently offline  ktripp
Messages: 6
Registered: March 2019
Member
Abt Associates supports this recommendation. Suggests some additions to proposed language might be needed. #1 Any sweet drinks, such as soft drinks/fizzy drinks/soda /chocolate drinks? suggest addition of "tea with sugar" and "drinks where sugar is added" . In many households surveys we have seen a high consumption of plan water, milk and chocolate drink (Horlicks, Ovaltine, Milo) where additional sugar is added and may not be captured if not specifically asked.

For #2 they are suggesting adding this "Any sweet junk foods, such as chocolates/ sweets/ candies/ sweet biscuits/pastries/cakes?" suggest adding buns/doughnuts (or local term) to this list
Any savory junk foods, such as crisps/chips/salted biscuits/instant noodles?" suggest adding pies/ fried snacks




Re: Updated Indicators for Infant and Young Child Feeding (IYCF) [message #17419 is a reply to message #17337] Fri, 15 March 2019 23:31 Go to previous message
Judy Canahuati is currently offline  Judy Canahuati
Messages: 9
Registered: March 2019
Member
La Leche League International supports this recommendation
Previous Topic: Food Fortification: Household Coverage of Fortifiable Foods
Next Topic: Assessment of Child Growth
Goto Forum:
  


Current Time: Thu Dec 12 20:15:04 Eastern Standard Time 2019