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With research staff from more than 70 countries, and offices across the globe, IFPRI provides research-based policy solutions to sustainably reduce poverty and end hunger and malnutrition in developing countries.

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Danielle Resnick

Danielle Resnick is a Senior Research Fellow in the Markets, Trade, and Institutions Unit and a Non-Resident Fellow in the Global Economy and Development Program at the Brookings Institution. Her research focuses on the political economy of agricultural policy and food systems, governance, and democratization, drawing on extensive fieldwork and policy engagement across Africa and South Asia.

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Nutrition, Diets, and Health

Rebecca Brander

Research Fellow

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Rebecca Brander

Bio

Rebecca Brander is a Research Fellow with the Nutrition, Diets, and Health Unit, and is based at IFPRI-Nairobi.

Nutrition, Diets, and Health

Publications

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Journal Article

Effect of azithromycin on post-discharge growth in Kenyan children

2025
Atlas, Hannah E; Mogeni, Polycarp; Shawon, Riffat Ara; Tickell, Kirkby D; Bunyige, Lucy; Monchari, Irene; Oongo, Susan; Diakhate, Mame M; Brander, Rebecca L.; Liru, Meshack
…more Bogonko, George; Nduati, Ruth; Richardson, Barbra A; John-Stewart, Grace; Walson, Judd L; Singa, Benson O; Pavlinac, Patricia B; McGrath, Christine J
Details

Effect of azithromycin on post-discharge growth in Kenyan children

Introduction: Children discharged following hospitalisation for acute illnesses in low- and middle-income settings are at increased risk of poor growth, particularly linear growth faltering. We aimed to determine the effect of azithromycin administered at hospital discharge on post-discharge growth. Methods: Using data from the Toto Bora Trial (NCT02414399), a double-blind, placebo-controlled randomised trial of a 5-day course of azithromycin in Kenyan children aged 1–59 months, we assessed differences in mean monthly change in growth (height-for-age z-score (HAZ), weight-for-height z-score (WHZ), weight-for-age z-score (WAZ)) in the 6 months following hospital discharge. Results: This analysis included 1276 children who survived to 6 months post-discharge (640 randomised to azithromycin and 636 to placebo). At discharge, 285 (22%) of children were stunted, 64 (5%) were wasted and 156 (12%) were underweight. There was no difference in 6-month post-discharge growth (mean difference: HAZ, 0.010 (95% CI −0.005 to 0.025); WAZ, 0.003 (95% CI −0.013 to 0.019); WHZ, −0.003 (95% CI −0.025, 0.019)) between treatment groups. Further, no differences in mean monthly change in HAZ, WAZ or WHZ were observed between randomisation groups when stratified by age, nutritional status at discharge or discharge diagnosis. Mean monthly change in HAZ declined among all children in the 6 months post-discharge, irrespective of the treatment group (azithromycin group: −0.038 (95% CI −0.049 to –0.028); placebo group: −0.048 (95% CI −0.059 to –0.038). Mean monthly change in WAZ did not differ significantly by treatment group (0.025 (95% CI 0.013 to 0.037) in the azithromycin group and 0.022 (95% CI 0.011 to 0.033) in placebo (p=0.688)). Monthly WAZ and WHZ gains were similar in both groups, with greater weight gains among older children (6–11, 12–23, 24–59 months). Conclusion: We did not observe statistically significant improvements in post-discharge growth among children receiving azithromycin at hospital discharge.

Year published

2025

Authors

Atlas, Hannah E; Mogeni, Polycarp; Shawon, Riffat Ara; Tickell, Kirkby D; Bunyige, Lucy; Monchari, Irene; Oongo, Susan; Diakhate, Mame M; Brander, Rebecca L.; Liru, Meshack; Bogonko, George; Nduati, Ruth; Richardson, Barbra A; John-Stewart, Grace; Walson, Judd L; Singa, Benson O; Pavlinac, Patricia B; McGrath, Christine J

Citation

Atlas, Hannah E.; Mogeni, Polycarp; Shawon, Riffat Ara; Tickell, Kirkby D.; Bunyige, Lucy; et al. 2025. Effect of azithromycin on post-discharge growth in Kenyan children. BMJ Global Health 10(11): e020294. https://doi.org/10.1136/bmjgh-2025-020294

Country/Region

Kenya

Keywords

Africa; Sub-saharan Africa; Eastern Africa; Antibiotics; Children; Child Growth; Health; Hospitals

Language

English

Access/Licence

Open AccessCC-BY-NC-4.0

Links

https://doi.org/10.1136/bmjgh-2025-020294 Source record

Record type

Journal Article

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Journal Article

Preventing relapse from wasting: the role of sociodemographic, child feeding, and health care determinants and of wasting prevention interventions in Burkina Faso and Mali

2025Brander, Rebecca L.; Touré, Mariama; Becquey, Elodie; Ruel, Marie T.; Leroy, Jef L.; Huybregts, Lieven
Details

Preventing relapse from wasting: the role of sociodemographic, child feeding, and health care determinants and of wasting prevention interventions in Burkina Faso and Mali

Background Relapse among children treated for wasting is a major concern. We estimated the frequency and determinants of relapse to wasting in two populations exposed to PROMIS, an integrated wasting prevention and screening program. Methods Using longitudinal data from PROMIS trials in Burkina Faso and Mali, we calculated the incidence rate and period prevalence of relapse to wasting within 6 months in children who had ≥1 wasting episode ending when they were ≥6 months old for which they were treated and recovered (NBurkina Faso=247; NMali=220). We used backward elimination to select a multivariable model of sociodemographic, nutrition- and health-related determinants of relapse. We also evaluated if prevention interventions (behavior change communication (BCC) and/or small quantity lipid-based nutrient supplements (SQ-LNS) were associated with relapse, adjusting for confounders and trial arm. Results Relapse incidence was 2.6 per child-year in Burkina Faso (N=291 episodes) and 1.6 per child-year in Mali (N=300 episodes). In both countries, being fed the recommended food frequency or iron-rich foods after recovering from wasting was associated with lower risk of relapse. In Mali, longer wasting episodes, lack of minimally diverse diet consumption, and several caregiver/household characteristics were associated with lower risk of relapse. In both countries, receipt of BCC after recovery from wasting was associated with lower risk of relapse (Incidence rate ratio [IRR]Burkina Faso = 0.51 [95% confidence interval [CI] = 0.30, 0.86]; IRRMali = 0.26 [95% CI = 0.11, 0.65]), as was receipt of SQ-LNS (IRRBurkina Faso = 0.33 [95% CI = 0.16, 0.70]; (IRRMali = 0.43 [95% CI = 0.19, 0.94]), after adjustments. Conclusion Children being discharged from wasting treatment are a well-defined vulnerable population who stand to benefit from targeted post-discharge preventive interventions. BCC that includes advice on optimal infant and young child feeding practices and SQ-LNS may help prevent wasting relapse in at-risk children.

Year published

2025

Authors

Brander, Rebecca L.; Touré, Mariama; Becquey, Elodie; Ruel, Marie T.; Leroy, Jef L.; Huybregts, Lieven

Citation

Brander, Rebecca L.; Toure, Mariama; Becquey, Elodie; Ruel, Marie T.; Leroy, Jef L.; and Huybregts, Lieven. 2025. Preventing relapse from wasting: the role of sociodemographic, child feeding, and health care determinants and of wasting prevention interventions in Burkina Faso and Mali. Journal of Nutrition 155(9): 2945-2954. https://doi.org/10.1016/j.tjnut.2025.06.019

Country/Region

Burkina Faso; Mali

Keywords

Africa; Western Africa; Northern Africa; Sub-saharan Africa; Child Feeding; Nutrition; Recuperation; Wasting Disease (nutritional Disorder)

Language

English

Access/Licence

Open AccessCC-BY-4.0

Links

https://doi.org/10.1016/j.tjnut.2025.06.019 Source record

Project

Sustainable Healthy Diets

Record type

Journal Article

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Journal Article

Perspective: Growth monitoring and promotion as an opportunity to improve early childhood development

2025Larson, Leila M.; Frongillo, Edward A.; Akter, Fahmida; Wooten, Shelbie; Brander, Rebecca L.; Ruel, Marie T.; Leroy, Jef L.
Details

Perspective: Growth monitoring and promotion as an opportunity to improve early childhood development

Growth monitoring and promotion (GMP) visits provide a frequent contact point with caregivers which can be an opportunity for the promotion of early child development (ECD). Using a combination of quantitative analyses of longitudinal and cross-sectional data and a review of the literature, we investigated whether the GMP platform could improve ECD by identifying children at risk of poor development and delivering responsive parenting education to caregivers of young children. Cross-sectional and lagged regression analyses and area under the receiver operating characteristic curves (AUCs) indicated that growth indices were not accurate predictors of concurrent and later child development. Rather, validated tools, such as the Ages and Stages Questionnaire or the Survey of Well-being of Young Children, could be utilized during GMP visits to screen individual children for suboptimal development. Through a review of published literature on ECD interventions, we identified 10 light-touch ECD interventions which could feasibly be implemented during GMP visits, but only half have been evaluated for their effectiveness. Our findings demonstrate that, while growth indices cannot accurately identify children at risk of suboptimal development, the GMP platform could offer an opportunity to screen children for suboptimal development and to deliver ECD interventions. Further evidence on the implementation and effectiveness of light-touch parenting programs, however, is required.

Year published

2025

Authors

Larson, Leila M.; Frongillo, Edward A.; Akter, Fahmida; Wooten, Shelbie; Brander, Rebecca L.; Ruel, Marie T.; Leroy, Jef L.

Citation

Larson, Leila M.; Frongillo, Edward A.; Akter, Fahmida; Wooten, Shelbie; Brander, Rebecca L.; et al. 2025. Perspective: Growth monitoring and promotion as an opportunity to improve early childhood development. Advances in Nutrition 16(8): 100470. https://doi.org/10.1016/j.advnut.2025.100470

Keywords

Child Growth; Child Development; Monitoring

Language

English

Access/Licence

Open AccessCC-BY-4.0

Links

https://doi.org/10.1016/j.advnut.2025.100470 Source record

Record type

Journal Article

Blogs

Growth monitoring and promotion as an opportunity to improve early childhood development
Research Post
 | 
November 13, 2025

Growth monitoring and promotion as an opportunity to improve early childhood development

By Leila M. Larson, Edward A. Frongillo, Rebecca Brander, Marie Ruel, and Jef L. Leroy

Leveraging a widespread practice.

Screening for early childhood obesity: What can we learn from growth monitoring data?
Research Post
 | 
October 22, 2025

Screening for early childhood obesity: What can we learn from growth monitoring data?

By Morgan Boncyk, Jef L. Leroy, Rebecca Brander, Leila M. Larson, Marie Ruel, and Edward A. Frongillo

Focusing on risks for children under 5.

Rethinking growth monitoring and promotion in low- and middle-income countries
Research Post
 | 
March 05, 2025

Rethinking growth monitoring and promotion in low- and middle-income countries

By Jef L. Leroy, Rebecca Brander, Edward A. Frongillo, Leila M. Larson, Marie Ruel, and Rasmi Avula

A study raises questions about a standard practice.

View all Blogs

Events

Beyond Treatment: Integrated Strategies to Prevent Child Wasting and post-treatment Relapse
IFPRI Program/Country Event

 | 

April 1, 2026, 9:00 – 10:30 am

Beyond Treatment: Integrated Strategies to Prevent Child Wasting and post-treatment Relapse

Child wasting affects an estimated 42 million children at any given time, but over a year, between 240 and 295 million episodes of wasting occur.  Wasting, including severe wasting, is associated with approximately 850,000 child deaths annually and have livelong consequences for child health and development. Although effective outpatient treatment protocols exist, coverage remains below 30% […]

23rd International Congress of Nutrition (ICN)
IFPRI at External Event

 | 

August 24 to 29, 2025

23rd International Congress of Nutrition (ICN)

IFPRI is participating in the 23rd International Congress of Nutrition (ICN), hosted by the International Union of Nutritional Sciences (IUNS) on August 24-29 in Paris, France.  The theme of this year’s congress is “Sustainable Food for Global Health,” bringing together experts to discuss evidence and innovations in nutrition, sustainability, food science, and public health. IFPRI […]

News

July 31, 2025 | Press Release

New study finds behavior change communication and nutrition supplements can help prevent relapse from child wasting

The study, published in The Journal of Nutrition, used longitudinal data from two cluster-randomized trials in Burkina Faso and Mali, the PROMIS project.