IFPRI Publications: Journal Articles

The impact of spatial shifts of paddy fields on CH4 emissions in China, 1990–2020

The two sides of migration in Central America: Aggregate and distributional impacts in Guatemala

International migration affects labor supply, production patterns, and external income flows in origin countries, yet our understanding of its economy-wide and distributional consequences remains limited, particularly with regard to the role of return migration. This study integrates detailed microdata on migrant profiles into a general equilibrium model applied to Guatemala to examine how emigration and return migration affect macroeconomic performance, sectoral dynamics, and household welfare. We simulate three scenarios: a reference scenario reflecting recent-historical emigration patterns (MIG-0), a reduced-emigration scenario (MIG-1), and a net-return migration scenario (MIG-2), capturing recent shifts in emigration and return flows by skill level. Results reveal trade-offs between aggregate economic performance and distributional impacts across households. Compared to a baseline economy with no mobility, Gross Domestic Product (GDP) rises modestly under the reference scenario (+0.2 percent) and by additional 0.3–0.5 percentage points under the reduced-emigration and net-return scenarios, driven by expanded labor supply from returnees and currency depreciation. Non-agro-processing manufacturing shows the largest expansion (up to 1.8 percent), reflecting its strong labor-absorption potential. Household welfare, especially among remittance-dependent households, is highly sensitive to these flows, with income and consumption declining under the two counterfactual migration scenarios. These findings underscore the need for policies that facilitate returnee reintegration and strengthen social protection for remittance-dependent households, ensuring that the macroeconomic gains from migration adjustments translate into equitable welfare improvements.

After quantification: Insights from India’s Soil Health Card scheme

As the concept of soil health gains prominence, it becomes increasingly important to examine how states design and implement soil health policies. Does soil health offer a novel pathway to enact and legitimize institutional changes toward more sustainable farming systems, or does it risk becoming another neologism that preserves status quo, productivist agriculture? We explore these questions through an analysis of one of the most ambitious state-led initiatives organized around soil health: India’s Soil Health Card (SHC) scheme. The SHC scheme seeks to provide every farmer in the country with bi-annual soil test reports, based on the assumption that improved information will encourage more judicious use of fertilizers and pesticides. The assumption reflects a broader emphasis within the agricultural sciences on the importance of quantifying soil health. Drawing on government documents and farmer perception studies (n = 38), we find that although farmers view the cards positively, they make few substantive changes to their farming practices. As an illustrative case, India’s grand SHC scheme shows that quantification alone is insufficient and could even dampen momentum for transformative policy reforms. Effective and durable change lies in pairing efforts to quantify soil health with (a) plural epistemic approaches to knowledge production, (b) participatory models for knowledge dissemination, and (c) structural reforms in the agri-food system that address issues around land tenure and subsidies.

Hcropland30: A hybrid 30-m global cropland map generated by leveraging global land cover products and Landsat data via deep learning

Integrated hydrological and economic assessment of hydropower and irrigation development in Sudan under climate change

Demands for water, energy, and food are rapidly increasing in many low- and middle-income countries, driving the development of large-scale hydropower and irrigation projects. As climate change poses major risks and uncertainties for large-scale infrastructure investments, it is essential to stress-test infrastructure development plans to address these challenges and strengthen resilience. The Nile is one of the world’s longest rivers, draining approximately 10% of Africa’s land surface; Sudan accounts for around 40% of the basin area, and several new large hydropower and irrigation infrastructure projects are planned. We develop an integrated analytical framework for the Nile River system, utilizing 16 climate projections from the Coupled Model Intercomparison Project (CMIP) 6 and hydrological, river system, and Computable General Equilibrium models to evaluate the biophysical and economic impacts of hydropower and irrigation development in Sudan under climate change. The results indicate a projected increase in the naturalized streamflow of the Nile by 2050 due to climate change. A phased hydropower and irrigation development strategy in Sudan – targeting a total of 1,500 MW of hydropower capacity and approximately one million hectares of irrigated wheat – is projected to increase annual hydropower generation by up to 8.1 TWh and expand total wheat area by 283% by 2050. These developments increase the undiscounted national Gross Domestic Product (GDP) during 2030–2050 by US$ 0.1 to 0.4 billion per year, with larger increases occurring under high economic growth pathways. This research highlights the interconnected nature of climate change, water resource development, and economic performance, underscoring the importance of integrated assessment in informing investment decisions.

Do ultra-poor graduation programs build women’s resilience to weather shocks? Evidence from rural Ethiopia

We assess whether layering an ultra-poor graduation program on Ethiopia’s Productive Safety Net Programme (PSNP) protects women and their households from localized weather shocks. Using panel data from a large cluster-randomized trial matched with detailed weather records, we identify community-level exposure to dryness shocks. Women who are exposed to dryness shocks experience deteriorating nutritional status (in conjunction with declining household food security and assets) and a significant increase in the risk of intimate partner violence. However, access to the graduation program fully buffers women from any increase in intimate partner violence, and partially buffers women and their households against other adverse effects. Further analysis suggests that improved household savings likely drives the program’s protective impact.

The impact of targeted transfer programs on labour supply: Evidence from rural China

Preservation of the IFPRI record: A case study of institutional repository mergers and migrations

At its core, a repository migration is the transfer of records from one system to another. In some cases, it is more of an unraveling, repair, relocation, and rebuilding of a historic property. In 2024, the International Food Policy Research Institute (IFPRI) library undertook its second migration from an independent CONTENTdm repository to a shared DSpace repository. The institute set an ambitious goal to complete the migration within a single contract cycle with CONTENTdm. Since 2012, the repository has functioned as a bibliographic metadata layer serving the main corporate website, numerous project sites, and the global consortium (CGIAR) website, as well as a digital publishing platform and institutional metrics and reporting system. The team started working with a combination of tools, including: Microsoft Excel, OpenRefine, and custom scripts. Microsoft Excel allowed staff to easily see and manipulate large amounts of data across different metadata fields. OpenRefine (version 3.7) was instrumental in normalizing and cleaning name and keyword variations, as well as locating and editing a single repeated datapoint. The scripts, created by a member of the team and author of this paper, saved hours of time and allowed the team to meet ambitious goals. The team successfully migrated over 20,000 records within 13 months while simultaneously improving metadata quality. Prior to the migration, about half of journal articles lacked external links and several dozen PDFs had been lost over time. Additionally, from 2008–2017, IFPRI’s records experienced an average of 40% link rot. All of these issues were resolved during this process. Furthermore, the IFPRI record is now interoperable with the other CGIAR institutions and external search engines. While repository and metadata management remain ongoing tasks, this migration represents a significant step forward in preserving institutional knowledge, adopting established standards and best practices in knowledge management, supporting consortium activities, and enhancing the visibility of agricultural research outputs.

Collecting Holistic Evidence on Agroecology Performance to Accelerate Sustainable Food System Transitions

A growing body of research shows the potential of agroecology for enabling a shift to planet-friendly and socially just agrifood systems through context-specific transition pathways. We conduct a scoping review to identify and evaluate the potential of 42 existing agroecology adherence and/or agricultural performance assessment tools to generate credible, legitimate, salient and transferable evidence to inform these transitions. Results show that while multiple relevant tools exist, each of them can be strengthened in at least one area. While most tools are transferable (low time and resource requirements) and have legitimacy (open access with transparent methods), tools have variable saliency (holistic scope inclusive of local priorities) and credibility (use scientific design principles and quality assurance processes). For a subset of 11 tools collecting multidimensional performance data, analysis of 263 identified indicators showed there is a bias towards economic measures (notably income, yield, and resilience), while certain social (e.g. land tenure, traditional knowledge retention) and environmental (e.g. climate mitigation) aspects are regularly overlooked. Through a multidisciplinary process engaging experts across 8 countries, we develop a Holistic Localized Performance Assessment for agroecology (HOLPA) framework that integrates and builds on positive features of existing multidimensional agroecology performance assessments tools and overcomes key limitations. The HOLPA framework for analysis, agroecology indicators, key performance indicators, and low-cost localization process can be used to strengthen agroecology performance assessments, empowering landscape actors to identify evidence-based pathways towards agrifood systems where both people and nature can thrive.

Food on the go: How engagement with the food environment affects adolescent diets in northern Vietnam

As adolescents grow older, they increasingly engage with the food environment. Our study aimed to: 1) assess the contribution of prepared out of home (POH) foods to the healthiness of adolescent diets and 2) identify socio-demographic factors associated with POH foods intake in a rural, a peri-urban, and an urban area of Vietnam. We conducted a cross-sectional survey among 11–19-year-old adolescents (n = 2,861) and collected socio-demographic and dietary intake data (24-hour recall). The healthiness and micronutrient adequacy of diets was assessed using the Global Diet Quality Score (GDQS) and the micronutrient adequacy ratio (MAR) respectively. We used regression analyses with robust standard errors (to account for school-level clustering) to assess the consequences and identify the drivers of POH food intake. Over 80% of adolescents consumed foods POH on the previous day, contributing 22–26% of daily energy intake. Healthy food groups were underrepresented in POH foods, which were higher in fat, saturated fat, and sodium, but also had higher micronutrient density than foods prepared at home. POH intake was associated with higher energy intake and micronutrient adequacy, but lower diet healthiness. Socioeconomic status, female sex, pocket money, and smartphone ownership were associated with POH consumption, with site-specific differences. Food environments should be made healthier through front-of-package warning labels, reformulation (e.g., reducing milk fat and sugar), and restrictions on the marketing and availability of unhealthy foods combined with the promotion of healthy foods, snacks and meals.

Associations between hygiene practices and carcass contamination by Escherichia coli and coliforms in bovine slaughter facilities in rural Kenya

Carcass contamination during slaughter poses a significant threat to meat safety and public health, particularly in low- and middle-income countries. This cross-sectional study, conducted in 25 bovine slaughter facilities in Busia County, Kenya, assessed contamination levels at four anatomical sites on cattle carcasses: rump, flank, brisket, and neck. The study also examined the association between slaughterhouse hygiene practices and microbial contamination by Escherichia coli and coliforms. A total of 193 carcasses were sampled after carcass dressing before sectioning, and E. coli and coliform loads were quantified using MC-Media Pad®. Statistical analyses revealed that contamination levels varied significantly across carcass sampling sites for both coliforms (p = 0.008) and E. coli (p = 0.026), with the brisket showing markedly higher contamination than the rump for coliforms (median 2.15 vs 1.61 log10 CFU/cm2, p = 0.004) and E. coli (median 1.04 vs 0 log10 CFU/cm2, p = 0.020). Key risk factors for increased contamination included carcass contact with the floor, splashing water from wet floors, and visible fecal matter on animal hides. These findings highlight the need for targeted hygiene interventions during slaughter, improved infrastructure, and stronger enforcement of meat safety regulations to reduce contamination and ensure safer meat products for consumers.

From farmer-centred design to algorithmic participation: Navigating technical demands and normative discourses in digital extension

Digital extension and farmer-centric design are increasingly presented as complementary strategies for transforming agricultural innovation systems: digital extension promises scale and efficiency, while farmer-centric design is expected to ensure relevance, inclusivity, and legitimacy. This paper challenges the assumption that these approaches are naturally aligned. Through Critical Discourse Analysis, we examine how farmer-centricity is enacted within digital extension initiatives and how its normative commitments are reshaped as digital platforms evolve. Empirically, we analyse two digital extension platforms developed between 2014 and 2024, one in the Global North and one in the Global South. Drawing on public-facing media, organisational records, design documents, and technical walkthroughs of each platform, we trace how normative, technical, and interpretive frames interact across different phases of platform development. Our findings show that, in early phases, digital extension is framed as enabling farmer-centric design, supporting decentralised design practices, epistemic pluralism, and farmer sovereignty. Over time, however, farmer-centricity becomes instrumentalised to support the scaling of digital extension through data generation, peer diffusion, and environmental accountability, placing new forms of labour and responsibility onto farmers without a commensurate redistribution of authority. These tensions are not resolved but reconfigured through design practices, often obscured by the rhetoric of empowerment and responsiveness. We conceptualise this dynamic as algorithmic participation: a form of participation mediated through digital infrastructures that anticipate and steer farmer engagement in ways that stabilise existing innovation logics. The paper contributes to debates on farmer-centric design and digital extension by showing how even well-intentioned practices can reproduce structural inequalities.

A participatory framework to assess agricultural sustainability: Cover cropping as an illustrative example

This study developed an analysis‐oriented agricultural sustainability framework to assess how on‐farm biodiversity‐enhancing agricultural practices impact outcome‐based indicators of environmental, economic, and social sustainability. Building on an existing national‐scale agricultural sustainability assessment framework, we adapted it to evaluate farm‐level practices. Using an iterative design, we engaged stakeholders through a farmer survey and workshop to refine indicator selection and ensure contextual relevance. We used biodiversity‐enhancing practices in the Midwestern United States as an illustrative example of how the framework could be applied. Workshop participants were asked to use cover crops as an example to consider how this class of practices affected agricultural sustainability. Our findings highlight that stakeholder engagement during framework development can improve the relevance and specificity of indicator selection, supporting more targeted quantitative analysis for decision‐making.

The gendered effects of rainfall shocks on stunting: Evidence from Papua New Guinea

Rainfall fluctuations significantly reduce welfare for poor rural households in low- and middle-income countries dependent on rainfed agriculture for consumption, and the effects of these shocks can be borne disproportionately by vulnerable household members, particularly children and girls. We present new evidence around the effects of rainfall fluctuations on child anthropometric status in Papua New Guinea, an understudied context characterized by some of the highest stunting rates in the world. We show that negative fluctuations in rainfall within the first 12 months of life lead to a reduction in height-for-age and weight-for-age (though not stunting), but this effect is observed only for girls.

Cost-effectiveness analysis of iron, vitamin A, and zinc biofortification in selected low- and middle-income countries: A modelling study

Background Crop biofortification is an important tool to improve micronutrient deficiency, but the evidence of its cost-effectiveness remains limited. Objectives This study aims to estimate the cost-effectiveness of biofortified crops to address iron, zinc, and vitamin A deficiency in 13 countries. Methods We used the burden of disease (BoD) measured in disability-adjusted life years (DALYs) compiled by the Institute for Health Metrics and Evaluation (IHME), supplemented by a literature review, to quantify DALYs resulting from micronutrient deficiencies. Data and assumptions from the Food and Agriculture Organization of the United Nations (FAO) were used to estimate micronutrient intake and the potential impact of biofortification on micronutrient intake to calculate the efficacy of biofortification in reducing DALYs under conservative, moderate, and optimistic scenarios. The cost was estimated for 30 years (2024-2053) while the benefits were for 20 years (2034-2053). An incremental cost-effectiveness ratio (ICER), defined as additional cost per DALY averted, was estimated. Results The total cost of biofortification programs varied across countries, ranging from $4.28 million in Guatemala to $34.04 million in Nigeria over 30 years. The ICERs of biofortification varied by type of crop and country; regardless, all are cost-effective using GDP-based cut-offs, except for biofortified cassava and sweet potatoes in Zimbabwe. For example, for iron biofortification of beans under the conservative scenario, ICER was as low as $58.04 per DALY averted in Kenya and as high as $535.52 per DALY averted in Zimbabwe, demonstrating the range of cost-effectiveness of the intervention among the countries selected for the study. A similar pattern was found for iron biofortification of pearl millet; vitamin A biofortification of cassava, maize, and sweet potatoes; and zinc biofortification of rice, wheat, and maize in most countries. Conclusion Biofortification of staple crops by selective plant breeding is potentially cost-effective to address iron, zinc, and vitamin A deficiencies.

Adolescent-selected food intake and engagement with the external food environment contribute to unhealthy diets in Accra, Ghana

Background As adolescents gain autonomy, they interact more independently with their food environments, increasing their vulnerability to rapidly changing and often unhealthy food environments. In Accra, Ghana, unhealthy foods and beverages are widely available and heavily marketed. Objective To assess the healthiness and nutrient adequacy of adolescents’ diets in Accra; and to examine whether diet healthiness is associated with independent adolescent food selection and their engagement with home, school and outlet food environments. Methods We conducted a cross-sectional study using quantitative 24-hour dietary recalls among 911 adolescents aged 12 to 18 years living in five low- and five middle-class neighborhoods in Accra. For each food and beverage consumed, we documented who selected it and where it was obtained and consumed. We calculated the Global Diet Quality Score (GDQS) and the prevalence of adequate intake for fruits and vegetables, protein, fiber, total sugar, total fat, saturated fat and 11 micronutrients. Mixed effects models assessed associations between independent adolescent food selection and food acquisition location (home, school, or other food outlets), and diet healthiness and macro- and micronutrient intake. Results A large proportion of adolescents consumed excessive amounts of total sugar (49%) and total fat (44%) and inadequate amounts of fruits and vegetables (98%), fiber (45%), and eight of the eleven micronutrients assessed (39-100%). Greater adolescent-selected food intake (62% of energy intake, on average) was associated with lower GDQS and intakes of fruit and vegetables, protein, fiber, and six micronutrients, and with higher sugar intake (P<0.05). Greater reliance on foods from the external food environment (school: 14%, other outlets: 46%) showed similar associations with poorer dietary indicators. Conclusion Strengthening the design, implementation and enforcement of coordinated food policy bundles is needed to shift adolescents’ preferences towards healthy foods, and reduce the availability, accessibility, and appeal of unhealthy options in their food environments.

Wildfire shocks, labor markets, and public policies: Economy-wide evidence from a Mediterranean country

Using the 2017 Portuguese wildfires as empirical evidence from a Mediterranean climate country, this paper assesses the economy-wide and employment effects of wildfire-related capital and labor shocks through a static computable general equilibrium (CGE) model with an extended labor-market framework. The analysis focuses on how wildfire shocks interact with labor markets, affect aggregate welfare, and condition the effectiveness of public policy responses. The results show that labor-market disruptions amplify economic losses beyond direct physical damage. Among the policy scenarios examined, comprehensive responses combining infrastructure investment, sector-specific support, and household transfers provide the strongest mitigation of aggregate losses. Recovery and mitigation policies generate the strongest positive effects on GDP, while the fire suppression-cost scenario alone has limited effectiveness. Employment impacts are concentrated in the primary and tourism-related sectors, particularly forestry, agriculture, transport, and accommodation. The findings highlight the importance of maintaining labor-force participation during climate disasters and of combining capital restoration with household support. By quantifying the economy-wide trade-offs between wildfire damage, labor-market disruption, and public-response channels, the paper provides evidence relevant to wildfire-prone Mediterranean economies and to broader environmental-development debates.

A gender-just food systems transition

Healthier diets: A global economic modelling study of income and employment impacts across regions

Interest has grown in how to achieve healthy, sustainable, and affordable human diets. The potential income and employment effects of a transition towards healthier diets have received much less attention. We simulate aggregate and sectoral income and employment for business-as-usual and healthier diets for all geographic regions up to 2050 using scenario-based modelling. These healthier diets can increase food’s share of household expenditure in some regions, for example from 18% to 25% in East and Central Africa in 2050. Our results suggest that a global shift towards healthier diets leads to a reallocation of primary factors of production, especially low-skilled labour and capital, from non-agricultural sectors to crop agriculture in parts of sub-Saharan Africa and South Asia. Notably, in 2050, with healthier diets, agriculture’s share of low-skilled labour increases by 3.2 percentage points in East and Central Africa and 1.5 percentage points in South Asia excluding India. Although Gross Domestic Product increases in these regions relative to business-as-usual, this reallocation raises agriculture’s share of Gross Domestic Product, consistent with a slower pace of long-run structural transformation. The reallocation leads to a mild increase in wages for low-skilled workers relative to high-skilled workers in most of these regions, compared to business-as-usual. However, in parts of sub-Saharan Africa, food price increases outweigh wage gains for low-skilled labour, reducing real purchasing power. Policies that encourage healthier diets may also alter income and employment and reduce economic welfare of poor populations in some regions, so care is needed in policy design to avoid adverse unintended consequences.

Interpersonal communication and maternal behavioral practice: A case study of explanatory causal machine learning in Nepal

Background There is increasing interest not only in whether a program produced impacts but also the mechanisms through which the impacts were produced. Studies of nutrition interventions have frequently highlighted the role of nutrition education interventions, but few studies have investigated the paths through which those interventions achieve impact. Objectives We assessed the total effect of maternal exposure to interpersonal communication with a frontline worker on behavioral practice and the degree to which that effect operated through 2 key pathways: improved awareness and knowledge. We also conducted a comparative case study examining the differences between machine learning (ML) and structural equation model (SEM) approaches. Methods We used data from the endline cross-sectional survey of the quasi-experimental Suaahara study of 2040 mothers with a child less than 2 years of age. We estimated the total effect of maternal exposure to interpersonal communication with a frontline worker on her nutrition-related practices and the indirect effects through improvements in awareness and knowledge using ML and conventional SEMs. Models were adjusted for household, child, and maternal factors as well as household location. Results Maternal exposure to interpersonal communication with a frontline worker translated into practicing more of the ideal, promoted nutrition-related practices. Both methods suggested a similar total effect—ML: 0.58 (95% CI: 0.37, 0.78) and SEM: 0.60 (95% CI: 0.49, 0.72). ML models, however, attributed a much larger proportion of that total effect to indirect effects operating through awareness and knowledge (ML: 0.24; 95% CI: 0.15, 0.33; SEMs: 0.16; 95% CI: 0.09, 0.21). Conclusions Interpersonal communication improved nutrition-related practices, in part due to increasing one’s awareness and knowledge. The disparities in results between ML and SEMs suggested that the production of effects is a more complex, nonlinear or interactive function of awareness, knowledge, treatment and covariates than what is captured by simple linear models.

How do migrants fare in Africa’s urban labour markets?

Absent to care? The effect of parental migration on children’s nutrition, health, and cognition in rural Gansu Province of China

Enhancing farmers’ access to neglected crop seeds for healthy diets in a changing climate: six recommendations for policy action

Food insecurity and poor diets undermine human health, livelihoods, and aspirations. Climate change further exacerbates the problem of achieving zero hunger. Promoting the production of a diverse portfolio of nutrient-dense, climate-resilient crops enables food supply for healthy diets in the coming years and decades. Many are underutilized even though they are considered opportunity crops, with an unrealized potential to improve food security and dietary quality amid climate change. Limited access to quality seed for these crops is a major bottleneck in their supply, as the current policy environment does not support farmers in broadening their portfolio with these crops. This paper identifies three key challenges that should be addressed to enable farmers to access quality seed of opportunity crops at scale. These are to make the diversity of opportunity crops (i) a priority for policy (ii) available for evaluation and breeding, and (iii) accessible to farmers, especially women and other disadvantaged groups. Six policy actions are recommended to address these challenges, which, if implemented, are likely to have both short- and long-term impacts in increasing farmers’ access to quality seeds of opportunity crops. Adopting these policy actions will help mainstream opportunity crops into seed systems as part of a broader strategy to diversify food systems from seed to plate.

Trends, determinants, and anthropometric consequences of low birthweight in Indian children: A prospective analysis of national data

Background Low birthweight (LBW) is a major concern for child survival and growth, and India accounts for the highest number of such cases globally. Studies have examined determinants of birthweight and child growth but little evidence exists on how birthweight influences growth outcomes during early childhood. This paper examines associations between maternal, household, and health-related factors, LBW, and growth faltering, and explores childhood growth trajectories across birthweight groups. Methods Data from three waves of India’s National Family Health Survey were used to examine heaping-adjusted trends and predictors of LBW. Regression-based decomposition was used to quantify the way in which changes in predictors could reduce future LBW prevalence. Trajectories of childhood anthropometry by LBW status and determinants were examined by using smoothing and regression methods. Results The LBW prevalence between 2000 and 2020 was 20% (unadjusted) and 40% (heaping-adjusted). Improvements in maternal stature, weight, household wealth, and antenatal care coverage could yield the largest future reductions in LBW. Children born with LBW had 1.5 times higher odds of being underweight and 1.3 times higher odds of stunting. Maternal short stature, underweight, and poverty were associated with higher odds of subsequent anthropometric faltering regardless of LBW. Conclusion Findings show the dominant role of maternal nutrition in birthweight and childhood growth outcomes. Once a child is born with LBW, there is limited potential to prevent subsequent anthropometric failure. To break the intergenerational cycle of undernutrition, programs must prioritize improved nutrition for girls beginning early in life and sustained through adolescence and preconception.

The state of global food insecurity measurement: A mix of methods, and a mix of messages

Robust food insecurity indicators are needed for monitoring development targets, emergency responses, and rationally allocating foreign aid. For decades, global food security monitoring relied on the FAO’s prevalence of undernourishment, but this indicator’s fundamental limitations led the FAO to develop the Food Insecurity Experience Scale (FIES) and adopt the unaffordability of the healthy diet. In parallel, The World Bank monitors monetary poverty, arguably a food insecurity indicator in its own right. In this study we assess whether this larger suite of indicators agrees on: (a) which countries are most food insecure; and (b) whether global food insecurity is really deteriorating. Unfortunately, this new mix of methods produces mixed messages. Longstanding criticisms of the prevalence of undernourishment still apply, while rising undernourishment in the past decade is driven by modelled increases in calorie inequality that are inconsistent with income inequality trends. The FIES fares no better: severe FIES food insecurity is higher in several Latin American and Caribbean countries than in extremely food-insecure African countries such as Niger. The World Bank’s poverty and healthy diet affordability monitoring efforts are significantly constrained by systematically fewer household surveys in poorer and more crisis-affected countries. How can this situation be improved? First, experience-based indicators need to be more rigorously evaluated for cross-cultural comparability, and alternatives need to be considered. Second, international agencies and national governments should pool resources to implement coordinated, high-frequency, multi-purpose surveys – focusing on poor and crisis-affected countries – to jointly monitor food insecurity, poverty and malnutrition, as well as their root causes.

Beyond infrastructure: Linking multiple-use water services and experiences with household water insecurity in rural Mali

Over the last decade, the international development community has recognized that rural and peri-urban households in lower- and middle-income countries use the same sources of water for both domestic and productive uses. To increase access to these water resources, governments and NGOs introduced the concept of multiple-use water services (MUS). As a proposed development strategy, MUS takes people’s multiple water needs as the starting point for planning and investing in new water services or upgrading existing domestic or productive systems traditionally designed for single uses. While studies have suggested benefits of MUS, such as improved water productivity and economic gains for subsistence farming communities, evidence remains context dependent. The research community has yet to examine the specific influence of MUS on household water insecurity, defined as the inadequate, unreliable, or unaffordable access to water necessary for a healthy life. That is, does MUS reduce experiences with water insecurity at the household scale? To address this critical question, the study examined the correlation between household water insecurity, measured by the Household Water Insecurity Experiences (HWISE) scale, and household use of single water sources for both domestic and productive purposes using data from a survey of 1,082 households in Mali, West Africa. The study finds that households practicing year-round MUS report significantly lower water insecurity than seasonal MUS households. These findings indicate an association, rather than a causal relationship, between sustained MUS practice and lower household water insecurity and suggest that reliable, year-round water availability may underpin both. However, MUS is not a panacea for household water insecurity, and improving household water security will require attention to the reliability, availability, and seasonal stability of water services in addition to support for multiple water uses.

Rural labor supply and recall window sensitivity

Lack of availability of administrative records on informal and seasonal labor participation dictates reliance on self-reported measures in many rural settings in developing countries. A common survey approach relies on annual recall to capture labor activities. Using a panel of rural households in Malawi, this study conducts a survey experiment to test the effect of annual recall on reported labor supply relative to quarterly interviews using ninety-day recall windows. Annual recall reduces reported labor participation and months worked by 20 percent. These reductions are greater for activities further in the past and when labor supply is reported by proxy. The profile of households’ primary respondents, predominantly male and older, can induce meaningful biases against women and youth. The study additionally shows that recall window choice can significantly alter estimates of the relationship between labor supply and education. These findings are especially relevant for impact evaluations and studies with constrained sample sizes.

Power, policy, and practice: Political economy perspectives on agroecological transitions

A robust spectral-temporal index for cross-regional mapping of plastic-mulched farmland using decametric-resolution images

Food systems policy coherence: A ten-country assessment

Policy coherence is widely recognised as essential for achieving food systems transformation, but attempts to assess food systems policy coherence have been limited to date in terms of their scope of topics and geographies and lack of comparable methods. This paper introduces the Food Systems Policy Coherence (FSPC) Diagnostic Tool and uses it to analyse food systems policy coherence across 10 low- and middle-income countries in Africa and Asia through key informant interviews (n = 189) and review of policy documents (n = 808). The FSPC Diagnostic Tool considers two aspects of policy coherence: (1) the structures and mechanisms that may contribute to achieving stronger policy process coherence and (2) coherence between policies from six sectors and ten common food systems goals. Regarding the former, all countries analysed had strong framework documents for cross-sectoral food policy, backed by high-level political commitment, but they tended to be much weaker when it came to capacity for implementation and especially monitoring and accountability. Policy coherence across sectors was generally strong for the goals of climate change adaptation and social protection but weaker for goals of healthy diets for all, adequate wages for food system workers, and climate change mitigation through food systems. Trade policy was the policy area with the greatest incoherence with a diverse range of food systems goals. The results offer the most comprehensive analysis of food systems policy coherence to date. The tool makes a useful contribution to measuring policy coherence and can serve as both a foundation for future research and enhance accountability for achieving coherent policy outcomes.

Familiar strangers: The role of diaspora networks in foreign investment and long-run development

Responsible use of artificial intelligence and machine learning for food security early warning systems

Does adoption of organic vegetable farming really improve the welfare of vegetable farmers? Evidence from Ghana

Inflammation and micronutrient status of children and adolescents in 12 countries are only weakly associated: The BRINDA Project

Food systems performance evaluated against targets and benchmarks reveals urgent gaps and a path to 2050

Despite national and international commitments to food systems transformation and an increasing adoption of common indicators, no comprehensive targets have been established against which progress can be measured. Here, building on the Food Systems Countdown Initiative framework, we identify existing targets—based on internationally agreed commitments and normative goals—and establish benchmarks—based on empirically derived peer performance reference values at the global, regional and income group levels—for 44 Food Systems Countdown Initiative indicators. We also assess countries’ historical progress and the rate of change required to achieve targets and benchmarks over two different timescales. We show that current progress is insufficient to meet 2030 targets and benchmarks at global level. Comparing countries’ status to regional and income benchmarks, which are generally less ambitious, yields better performance across indicators and regions, although gaps remain. Achieving most targets and benchmarks by 2050 is possible if countries correct course and accelerate progress, but certain indicators will require considerable investment and intervention.

Adaptive policies balancing trade, productivity and cropland increases can support Zambia’s nutrition security under future climate shocks

Policies in sub-Saharan Africa are constrained by a limited knowledge of climate change extremes and a focus on agricultural production rather than nutrition supply. Here we model the impacts of future extremes on national-level calorie and nutrient supply in Zambia for production and nutrition focused policy scenarios. We identify the specific cropland, yield and import increases required to achieve climate-resilient nutrition security and highlight policy options.

Climate finance allocation and its impact on agricultural emissions in Asian countries

In the agriculture, forestry and fisheries sectors, Climate Finance has become a vital mechanism for boosting resilience and lowering emissions. With a main focus on finance and emission patterns, the study covers 38 Asian countries between the years 2002 and 2023. System Generalized Method of Moments econometric model is used to investigate the impact of agricultural climate finance on greenhouse gas emissions. The findings show that Asia receives more of adaptation fund than mitigation fund for agriculture sector, with the largest shares going to Southern and Central Asia. India ranks top among receiving climate finance from various international sources in terms of both overall and sector-specific allocations. Econometric model shows that climate funding has a significant delayed negative effect on emissions, with reductions of around 0.3 MtCo2e for every US$ 1 million invested. These findings highlight the need for consistent, multi-year investments, focused project designs and capacity building in order to achieve long-term emission reductions. Simultaneously, persistent allocation gaps need more robust regulatory frameworks to better allocate climate finance to agriculture, forestry and fisheries sector which will lead to increased ecological resilience and foster mitigation success throughout Asia.

Bridging agronomic science and context specific farm-level advisory through generative AI for rice systems in India

Agriculture is increasingly characterized by a data paradox, while the sector generates massive volumes of genomic, climatic, remote sensing, and field data. Translating this information into actionable, farm-level insights remains a critical bottleneck. Traditional advisory mechanisms cannot operate at the spatial scales or provide the context-specificity needed for climate adaptation and food security. The work presents GenAI as a transformative interface that makes advanced agricultural science, including crop simulation models and remote sensing diagnostics, accessible to rice farmers in India through natural language, provided that challenges related to data sovereignty, infrastructure gaps, and the need for human oversight in advisory systems are effectively addressed. We trace the shift from static, rule-based expert systems to dynamic foundation models capable of complex reasoning and multimodal analysis. The paper critically reviewed the rise of crop-specific LLM agro-advisory model architectures, such as SeedLLM Rice and IPM-AgriGPT, which outperform general-purpose models by utilizing specialized scientific corpora to reduce hallucinations. Main attention is on the hybrid integration framework of LLMs with Knowledge Graphs (KGs) for factual grounding, and connecting with process-based simulators (e.g., DSSAT, APSIM) to make biophysical modelling more accessible through natural language. Furthermore, the manuscript examines the fusion of satellite, drone, and smart phone imagery with vision-language models, enabling real-time, context-aware diagnostics for smallholder farmers. The review concludes that while GenAI has the potential to support more equitable forms of precision agriculture, it can only do so under specific conditions. Its success depends on resolving infrastructure gaps, ensuring data sovereignty, and maintaining a “human-in-the-loop” architecture to guarantee scientific rigour and social inclusion.

Productivity gains and work conditions in coercive labor markets: Experimental evidence from the Bangladesh brick sector

Productivity growth in competitive labor markets can improve worker welfare over time through higher wages or better conditions, but it is unclear if productivity gains benefit workers in coercive labor markets (where force or threats shape employment). We examine this issue in the Bangladesh brick sector using a randomized trial that introduced a more efficient production method. Despite large productivity improvements, we find no reduction in (high) rates of labor trafficking or child labor. These findings suggest that in the short-term, productivity growth alone may be insufficient to improve work conditions in coercive settings.

Diets, fruit and vegetable intake, and nutritional status in Benin, Fiji, the Philippines, Sri Lanka, and Tanzania: Foreword

Improving diets can improve nutrition and health outcomes. In this supplement, evidence from five low-and-middle-income countries on the country specific dietary (including F&V) intake patterns, nutrition issues and evaluated solutions to improve diets across population groups is presented. Based on this evidence, the final paper offers perspectives and future priorities.

Information framing effects on diet choices among Chinese urban residents

Unhealthy diets have become a leading contributor to death and disability globally. The current Chinese diet falls short of a healthy diet, including too much meat, oil, salt, and sugar while having insufficient levels of whole grains, fruits, nuts, and milk. Transforming Chinese dietary patterns has become urgent. This paper compares the effectiveness of information framing effects on enhancing Chinese consumers’ healthy diet choices, varied by information content, source, and presentation. The survey is conducted across six Chinese cities, with a sample of 3150 urban consumers. Chinese consumers’ healthy diet choices are measured using an online discrete choice experiment. Four different diet patterns were used to label each of the product alternatives in the experiment, which varied in taste and cost. Results reveal that compared to positive information; negatively framed healthy information is more effective in increasing Chinese consumers’ valuations for healthy diets. Consumer valuation of a healthy whole diet is significantly enhanced when the information is from social celebrities, compared to information from a scientific source. Moreover, when health information is disclosed via social media, its effectiveness in promoting healthy diet choices is significantly reduced. Our findings have implications for designing and implementing nutrition policies and programs in China and other developing countries.

Under the gun: Military and paramilitary actors in Sudan’s agrifood system

Armed actors are entrenched in the agrifood systems of several low- and middle-income countries, often with implications for agricultural transformation and democratic transitions. This paper focuses on the Sudanese Armed Forces (SAF) and Rapid Support Forces (RSF) in Sudan’s agrifood system. Through over 50 semi-structured stakeholder interviews, the paper traces how these actors gained their foothold in the agrifood system and how they interact with the private sector across diverse value chains. We argue that their investments in certain value chains depend on whether the formal private sector is already involved and the degree of technical complexity required for more profitable product upgrading. Based on these considerations, we uncover four strategies used in different value chains: exclusive capture and rent-extraction, biased competition through licencing and quota allocations, acquiescence to private competitors when value-addition is too complex, and innovation when profit potential is high and the private sector is absent. We demonstrate these strategies with respect to livestock, wheat, gum Arabic, and horticulture, with secondary applications to other commodities. Since economic competition between SAF and RSF was a major factor in the outbreak of the 2023-armed conflict, identifying these strategies expands insights about the political economy antecedents of large-scale conflict.

Digital and technology-enabled approaches in dietary assessment: Addressing bias, error, and feasibility in population- and community-based research

Dietary intake data are essential for understanding diet–disease relationships, informing policy, and evaluating nutrition interventions. This is particularly challenging in population- and community-based research, where varying dietary patterns, motivation to participate, and practical constraints limit the feasibility of highly controlled dietary assessment methods. Advances in digital tools, mobile technologies, and artificial intelligence are transforming how dietary data are collected, processed, and analyzed. This narrative review examines how digital and technology-enabled approaches impact key sources of bias and error across the stages of dietary assessment, including sample selection, participant reporting, food classification, and nutrient composition assignment. We also assess the feasibility of implementing these approaches in large-scale research settings, considering cost, infrastructure, respondent burden, and scalability. Although many technologies have the potential to reduce specific sources of bias and measurement error, such as recall limitations, interviewer effects, and misclassification, they may simultaneously introduce new challenges, including selection bias, increased analytic complexity, and high development or implementation costs. These trade-offs are most pronounced in large and heterogeneous study populations, where assessment methods must balance accuracy with feasibility across diverse contexts. Constraints related to connectivity, device access, and technical capacity may further limit implementation in low-resource settings. Technological innovations offer significant opportunities to improve dietary assessment, but their value depends on context-specific trade-offs between accuracy and feasibility. Careful consideration of these factors is essential when selecting methods for population- and community-based nutrition research.

Uncovering the climate vulnerability of China’s poverty alleviation frontiers

Crop diversification in Nepal (1990–2022): Policies, practices, and pathways forward

Nepal’s agriculture remains predominantly cereal-based, with rice occupying most of the cultivated area and forming the dietary staple. This dependence heightens vulnerability to climate shocks, market volatility, and nutritional imbalance. Despite long-standing policy commitments to crop diversification, evidence on progress and policy effectiveness remains limited, and fragmented. This study systematically reviews agricultural policies to investigate the evolution of crop diversification in Nepal, evaluate the programs to promote crop diversification, and empirically assesses diversification trends from 1990 to 2024, highlighting key gaps and structural constraints. We used a mixed-methods approach. A systematic scoping review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework analyzed 15 periodic plans, 18 sectoral policies, and initially over 70 donor-funded projects; after screening, 23 programs were included for detailed analysis from 1956 to 2024. Complementarily, quantitative analysis using Simpson’s Diversity Index (SDI) measured diversification trends over 32 years (1990–2022). SDI was also mapped district-wise for visual analysis of the changes in diversification over the past three decades. The systematic review recognizes policies and programs have endorsed crop diversification as a strategy to enhance agricultural output, promote ecological balance and strengthen socio-economic resilience. Persistent challenges such as weak market linkages, poor storage and cold-chain infrastructure, quality assurance gaps, and fragmented value chains have constrained impact. Structural issues such as declining public investment, climate risks, and labor migration further impede progress. The quantitative analysis shows a modest increase in crop diversification over the past three decades, with a noticeable slowdown after 2015. This study provides the first longitudinal assessment linking policy evolution with diversification outcomes, emphasizing the need for integrated, value chain–oriented, and climate-resilient diversification strategies.

Representation increases women’s influence in climate deliberations: Evidence from community-managed forests in Malawi

Women’s inclusion is now the norm in global and local initiatives to combat climate change. We examine how women’s representation affects climate deliberations using the case of community-managed forests in Malawi. We run a lab-in-the-field experiment randomly varying the gender composition of six-member groups asked to deliberate on policies to combat local overharvesting. We find that any given woman has relatively more influence in group deliberations when women make up a larger share of the group, a change driven by men’s assessments of women’s influence. Women’s presence also shifts the content of deliberations toward prospective solutions for which women have socially recognized expertise (cooking and replanting). Despite these changes, women and men do not prefer different deforestation policies, and women’s presence does not meaningfully affect group decisions. Our work demonstrates how women’s presence shapes climate deliberations but also calls into question claims that women’s inclusion will necessarily affect climate decisions.

Determinants of infant and young child feeding practices of children with severe acute malnutrition in agrarian and pastoralist settings of Ethiopia

Previous research has established determinants of young child feeding (IYCF) practices in the general child population, but determinants of these practices in children with severe acute malnutrition (SAM) are unknown. This study assessed the determinants of IYCF practices among children aged 6–23 months with SAM and under SAM treatment in a pastoralist and a predominantly agrarian setting in Ethiopia. As part of the baseline survey for the R-SWITCH cluster randomized control trial, we screened ~28,000 under-fives and included 486 children aged 6–23 months with SAM and under SAM treatment. Multivariable regression analysis was used to identify determinants on household, caregiver and child levels. Minimum meal frequency (MMF) was similar between children from the agrarian (53.9%) and pastoralist (51.9%) setting. The prevalence of children with minimum dietary diversity (MDD) was low overall but higher among pastoralist children (31.5%) than children from the agrarian setting (19.0%; p = 0.012). The consumption of egg/flesh foods was lower among pastoralist children (5.6%) than agrarian children (16.9%, p = 0.085). Caregiver literacy was positively associated with a higher likelihood of MMF (IRR = 1.21; 95% CI:1.02–1.43; p = 0.030), while caregiver depression was associated with a lower likelihood of MMF (RR = 0.97; 95% CI:0.95–0.99; p = 0.003). Improved water source (RR = 1.59; 95% CI:1.06–2.38; p = 0.037), caregiver literacy (RR = 2.04; 95% CI:1.25–3.34; p = 0.002), caregiver MDD (RR = 2.21; 95% CI:1.60–3.05; p ≤ 0.001), older children(RR = 1.05; 95% CI: 1.02–1.08;p ≤ 0.001), and pastoralist setting (RR = 1.62; 95% CI:1.07–2.44; p = 0.014) were associated with a significantly higher likelihood of meeting MDD. Conversely, caregiver depression (RR = 0.94; 95% CI:0.90–0.97; p < 0.001), caregiver mobility restriction (IRR = 0.94; 95% CI:0.89–1.00; p = 0.025), and food insecurity (RR = 0.64; 95% CI:0.41–1.01; p = 0.05) were associated with reduced MDD likelihood. Caregiver community involvement (IRR = 1.12; 95% CI:1.00–1.26; p = 0.038), caregiver MDD (RR = 1.67; 95% CI:1.10–2.53; p = 0.043), and older children (RR = 1.08; 95% CI:1.05–1.12; p < 0.001) were associated with increased egg/flesh-food consumption among children, while living in a pastoralist setting was associated with reduced it (RR = 0.36; 95% CI:0.13–0.97; p = 0.038). Integrated and Targeted interventions recommended: caregiver literacy/depression support to improve IYCF; livelihood-specific foods (eggs/flesh, fruits/vegetables); WaSH enhancements; community engagement; and IYCF counseling within CMAM programs.

Barriers and factors associated with treatment coverage of severe acute malnutrition among children 6–59 months in agrarian and pastoralist areas of Ethiopia

Severe acute malnutrition remains a major public health concern, yet a large proportion of affected children do not receive appropriate treatment. Understanding the barriers and associated factors is essential for informing targeted, context‐specific interventions. A door‐to‐door screening campaign among children aged 6–59 months was conducted from May to September 2024 in Kersa (agrarian) and Jeldessa (pastoralist) woredas of Ethiopia. The treatment coverage of severe acute malnutrition was 12.8% (95% CI: 9.0%–17.9%). The most frequently reported barriers to treatment included lack of awareness of the child’s nutritional status, time and financial constraints, and absence of family permission. Multivariable analysis revealed that household wealth index (aPR: 2.9; 95% CI: 1.5–5.5), use of water treatment methods (aPR: 4.6; 95% CI: 1.7–11.9), recent community MUAC screening (aPR: 12.0; 95% CI: 5.4–26.8), availability of treatment services at a nearby health post (aPR: 3.2; 95% CI: 1.1–9.9), and possession of a vaccination card (aPR: 3.2; 95% CI: 1.1–9.1) were significantly associated with severe acute malnutrition treatment coverage. The findings highlight that severe acute malnutrition treatment coverage in both pastoralist and agrarian settings of Ethiopia remains critically low. Stronger implementation of active screening and treatment services recommended by Ethiopian national guidelines, together with social protection measures for the poorest households, may improve treatment coverage.

Formative research in Ethiopia and Bangladesh: Strengthening household survey measures of maternal micronutrient supplementation in low- and middle-income countries

Background As countries transition from implementing iron folic acid (IFA) to multiple micronutrient supplements (MMS) for pregnant women, they need accurate data on who is being reached with these interventions. The aim of our formative research in Ethiopia and Bangladesh was to design updated household survey questions, response options, and visual aids to measure coverage of prenatal micronutrient supplements. Methods In phase I, we landscaped health providers and retailers to identify prenatal micronutrient products available in each country and interviewed currently pregnant women (CPW) and recently delivered women (RDW) about how they differentiated among micronutrient products. In phase II, we used these findings to draft survey questions and visual aids. In phase III, we iteratively tested and refined the draft tools through cognitive interviews with women. Results We had 73 participants in Ethiopia and 132 in Bangladesh, encompassing CPW, RDW, healthcare workers, and retailers. Women in both contexts distinguished among micronutrient products based on colour, shape, packaging, and perceived purpose. In cognitive tests, women generally understood the English term ‘iron’ as a catch-all term for any iron-containing supplement. Women did not recognise any specific term for multivitamins or MMS. Shorter recalls of seven days or one month for adherence were feasible for respondents. Conclusions It is challenging for the measurement community to identify terms and images that help women distinguish between supplement types. The final set of survey questions developed as part of this research is comprehensible and can be feasibly adapted and used in multi-topic surveys in MMS contexts, but requires validation.

Feasibility and readiness for scaling‐up multiple micronutrient supplements in Nepal: A qualitative study using the expandnet scaling‐up framework

Micronutrient deficiencies in pregnancy remain a critical public health issue in Nepal, where iron–folic acid (IFA) supplementation alone has not fully addressed maternal and neonatal risks. Multiple micronutrient supplements (MMS) promise broader nutritional benefits; however, real‐world guidance for their effective and equitable integration into routine maternal care is lacking. A qualitative study, guided by the ExpandNet scaling‐up framework, was conducted from February to March 2025, including 28 focus group discussions with antenatal care (ANC) providers and female community health volunteers (FCHVs) and 40 key informant interviews with policymakers at different levels of the health system. Data was analyzed thematically to identify perceived facilitators and barriers to MMS adoption, institutionalization, and scale‐up, and equitable implementation. Stakeholders viewed MMS as offering clear advantages over IFA, citing broader micronutrient coverage and fewer side effects that could improve adherence. However, they identified several system‐level requirements for successful scale‐up, including formal policy integration, sustainable financing, strengthened procurement and supply chains, and adequate storage capacity at facilities. FCHVs and ANC providers emphasized the need for clearer role definitions, improved training, and manageable counseling workloads. Persistent community‐level barriers—such as concerns about tablet size, misconceptions about fetal growth, and low trust in free medicines—were seen as risks to equitable uptake. Respondents highlighted community engagement, culturally tailored counseling, and consistent support for FCHVs and ANC providers as essential to ensuring effective and equitable MMS adoption. Stakeholders in Nepal view MMS as a promising strategy to improve maternal and newborn nutrition, but its potential depends on strong policy commitment, adequate and sustainable financing, and community‐centered implementation. Addressing product‐related concerns, strengthening counseling and trust in public services, and ensuring uninterrupted supply chains are essential to MMS scale‐up, including translating its introduction into equitable and meaningful gains in maternal and child nutrition.

Exposure to social and behavior change interventions directly and indirectly improved health and nutrition-related awareness, knowledge, and practices among male household heads and grandmothers in Nepal

Background Adult family members often share household tasks and decision-making, including those related to health and nutrition. Beyond the important role of mothers, grandparents and fathers also often play key contributing roles for maternal and child nutrition and health. Objectives This study aimed to investigate whether exposure of male household heads (HHs) and grandmothers to social behavior change communication (SBCC) platforms was associated with ideal nutrition and health practices in their households and the mediating role of awareness and knowledge for this linkage. We also aimed to investigate whether key sociodemographic factors moderated these mediated paths. Methods We used data from the endline survey (2022) of Suaahara’s quasi-experimental impact evaluation. Our samples were limited to households with a child <2 that included male HHs (n = 982) and grandmothers (n = 817). Structural equation models, accounting for community-level clustering, were used to examine the mediation paths for male HHs and grandmothers separately. All models were adjusted for household wealth and caste/ethnicity, child age, and respondent (male HHs or grandmothers) age and education. Stratified models examined potential moderating factors: wealth (relatively poorer 40% compared with wealthier 60%), caste/ethnicity (upper compared with lower), and household structure (nuclear compared with joint). Results Greater exposure to SBCC was associated with greater awareness and, in turn, knowledge, and ultimately, maternal and child health and nutrition practices. Approximately 30% and 40% of the total association was mediated through this indirect path among male HHs and grandmothers, respectively. The indirect path through greater awareness and knowledge was stronger among male HHs from lower (compared with upper) caste/ethnic groups and nuclear (compared with joint) households, as well as wealthier (compared with poorer) grandmothers. Conclusions Family member engagement in SBCC interventions is an important mechanism for improving health and nutrition practices.

Gestational weight gain and maternal immediate perinatal and postpartum outcomes in low and middle income countries: Individual participant data meta-analyses

Objective To estimate the associations between gestational weight gain and maternal immediate perinatal and postpartum outcomes by pooling data from low and middle income countries. Design Individual participant data meta-analyses. Data sources PubMed, Embase, Web of Science, and Cochrane Library, based on three searches (Search 1: all prospective studies published from January 2000 to May 2021; Search 2: randomized controlled trials of balanced energy and protein supplementation published until June 2021; Search 3: randomized controlled trials of anti-infectious agents published until August 2021). Eligibility criteria for selecting studies Prospective studies (randomised controlled trials or observational cohort studies) with measured maternal weight during pregnancy and data available on maternal height, based in populations from low and middle income countries with no underlying conditions. Results The analyses included 156 300 women from 61 studies and 23 countries, with most participants based in South Asia (n=78 454, 50.2%) and sub-Saharan Africa (n=36 327, 23.2%). Compared with women with adequate (90-125%) gestational weight gain, women with excessive (>125%) gestational weight gain had a higher risk of caesarean delivery (risk ratio 1.10, 95% confidence interval 1.06 to 1.13, τ2=0.000) and emergency caesarean delivery (risk ratio 1.22, 1.03 to 1.43, τ2=0.000). Women with moderately (70% to <90%) or severely inadequate (<70%) versus adequate gestational weight gain had lower risks for caesarean delivery (risk ratio in women with moderately inadequate gestational weight gain 0.88, 95% confidence interval 0.84 to 0.92, τ2=0.004; risk ratio in women with severely inadequate gestational weight gain 0.82, 0.77 to 0.88, τ2=0.010) and emergency caesarean delivery (risk ratio in moderately inadequate gestational weight gain 0.82, 0.71 to 0.95, τ2=0.004; risk ratio in severely inadequate gestational weight gain 0.73, 0.56 to 0.96, τ2=0.103). Excessive versus adequate gestational weight gain was associated with higher postpartum weight retained at any time point (mean difference 2.00 kg, 95% confidence interval 1.49 to 2.50, τ2=1.317), whereas moderately and severely inadequate gestational weight gain were associated with lower retained weight compared with adequate gestational weight gain. Similar trends were found for postpartum body mass index. Severely inadequate gestational weight gain was associated with lower systolic and diastolic blood pressure at any time point post partum than adequate gestational weight gain. No associations were observed for other outcomes including postpartum depressive symptoms or breastfeeding. Evidence indicating an interaction between gestational weight gain and body mass index before pregnancy was found when examining the risk of caesarean delivery and postpartum weight retention, body mass index, and systolic blood pressure as outcomes. Conclusions These findings support the association between suboptimal gestational weight gain and adverse maternal outcomes in the immediate perinatal and postpartum periods. Further research examining the consequences of suboptimal gestational weight gain in low and middle income countries would be valuable to inform potential strategies to improve long term maternal health.

Urbanicity and the diets and nutritional status of adolescents and their mothers in Vietnam

Background Urbanization catalyzes significant shifts in diets worldwide, yet its impact on adolescent diets and nutrition is poorly understood. Objectives We examined the association between urbanicity and diets and nutritional status among Vietnamese adolescents and their mothers. Methods We assessed diets using a multipass 24-h recall (15% repeated) and collected anthropometric data from 2861 adolescents and their mothers (n = 2664) in rural, peri-urban and urban areas. We calculated the Global Diet Quality Score (GDQS: total 0–49; healthy: 0–32; unhealthy: 0–17) and risk categories. We estimated usual intakes (National Cancer Institute’s method) and the mean probability of adequacy (MPA) for 11 micronutrients. We compared outcomes across areas using regression models adjusted for school-level clustering. Results GDQS healthy was higher in the urban area (adolescents 7.5, mothers 9.5) than in the rural area (6.6 and 7.7). GDQS unhealthy was comparable across areas (∼11 in adolescents and mothers). Adolescent and maternal diets in the rural area were most likely to fall in the GDQS high-risk category for nutrient inadequacy and non-communicable diseases(23% and 11%). MPA was low across all areas for both adolescents and mothers (≤40%). The prevalence of overweight/obesity was highest in urban areas among adolescents (29%) and similar across areas among mothers (15%–19%). Conclusions Urbanicity was positively associated with healthier diets due to greater healthy food consumption, but also with higher risks of adolescent overweight/obesity. Differences by study area, however, were small and diet healthiness was low across all settings. Innovative school and food environment interventions and policies are needed to promote greater consumption of healthy foods and limit unhealthy food intake among Vietnamese adolescents and their mothers, and to prevent and control rising overweight/obesity.

Perceived challenges and solutions to adopting healthy diets among women and children: A photovoice study in urban Ethiopia

Ethiopia has one of the highest rates of undernutrition among children under five (U5) and women of reproductive age (WRA) globally, alongside rising overweight/obesity, particularly in urban areas. Poor diet is a shared driver of multiple forms of malnutrition. We used a participatory photography (Photovoice) approach to explore the lived experiences of WRA and their children U5 in adopting healthy diets across lower- and higher- socio-economic status (SES) groups in Addis Ababa. Women took photographs illustrating challenges to healthy diets, and five focus groups (n = 31 women) were conducted to discuss challenges and solutions, with separate sessions held for different SES groups. A hybrid thematic analysis, combining deductive and inductive approaches, identified themes/subthemes, with comparisons across SES groups. Financial and physical barriers to accessing healthy foods, time constraints and perceived poor food safety were major contributors to poor diets. In lower SES groups, women also reported limited knowledge about healthy diets, inadequate family support and poor home food environments. In higher SES groups, unhealthy food preferences coupled with easy access to and aggressive promotion of unhealthy foods were key challenges. Proposed government-level solutions included job creation, nutrition education, affordable healthy food, investment in household infrastructure, expanded childcare and restrictions on unhealthy food availability and promotion. Societal-level solutions included gender equality, strengthened community-based loan schemes and support for urban agriculture. These findings highlight that women recognise their needs and who should support them, and emphasise the importance of including women’s voices in decision-making processes. Findings also underscore the need for integrated interventions targeting individual, food environment and socio-economic drivers to improve diets among women and children in urban Ethiopia.

Women’s experiences of the food environment and their association with fruit and vegetable intake: Insights from northern Tanzania

This analysis examined associations between factors in the food environment and fruit and vegetable (F&V) intake among women living in rural Northern Tanzania. We used cross-sectional data from 2597 women and 1275 food sources. Women’s self-reported factors included buying frequency, sources, availability, and convenience. We also measured women’s access to F&V sources using geospatial measures of distance and time from home to the reported typical sources. Data from a 30-day F&V food frequency questionnaire were used to calculate two scores that captured intake frequency and variety. We conducted a descriptive analysis of indicators of women’s experience and tested their associations with the scores using multivariable and Poisson regression models, controlling for covariates. On average, 5% and 35% of women reported buying F&V daily, respectively. Fruit was mostly bought from markets: F: 80%, V: 40%. Two-thirds of respondents perceived F&V as available (F: 65%, V: 60%). Median (IQR) distance and time to fruit sources were 9 km (2,19), 39 min (19,78), and to vegetable sources were 3 km (1,10), 32 min (8-69). Compared to women who reported making daily purchases of F&V, those who purchased weekly or monthly reported lower frequency and variety of F&V intake. Women’s perceptions that F&V were less available and at a longer distance were associated with lower frequency and variety of vegetable intake.Buying frequency, perceived availability, and distance to markets were associated with women’s frequency and variety of F&V intake, underscoring the need to consider these and other factors in food environments to increase F&V intake.

Food is always close by: An assessment of the healthiness of the adolescent home and school food environments in northern Vietnam

Background Adolescents are vulnerable to rapidly evolving food environments. Urbanization is widely thought to contribute to less healthy food environments, and school food environments are often considered less healthy than those at home. These associations, however, have not been quantified. Objective Assess differences in adolescent food environments in Northern Vietnam by setting (home vs school) and area (rural town, peri-urban or urban). Methods We collected cross-sectional data on adolescents (n=3,005) and surveyed all outlets (n=6,194) that sold food or beverages around adolescents’ homes and schools (n=13) in three sites that differed in urbanicity. We calculated distances from home and school to the nearest outlet selling select food groups and measured outlet density and diversity of foods offered (within 100-meter radius). We analyzed differences by urbanicity and by home/school environment using regression models, accounting for clustering at commune level. Results Both unhealthy food groups (UFG) (e.g., sugar-sweetened beverages, sweets), and healthy food groups (HFG) (e.g., fruits, nuts/seeds) were closer to adolescents’ home in the urban (∼21-50 m) than the peri-urban area (∼75-200 m) and rural town (∼155-270 m). Fruits and vegetables were consistently further away than UFG across all areas in home environments, although still close by (∼ 50-270 m). Urban adolescents were exposed to the greatest density and diversity of both HFG and UFG close to home and school. There were no differences in healthiness of home and school food environments. Conclusions Unhealthy foods were more accessible (in distance) and available (in density) than fruits and vegetables across all settings, but differences were small and food was always close by. Diversity of HFG and UFG was the greatest in urban areas. Healthy foods should be promoted and made the preferred choice through nudging interventions at point-of-purchase, combined with restrictions on the marketing and availability of unhealthy foods.

US funding cuts offer a rare chance to remodel Global North–Global South research collaboration