Research and Development Agenda
Despite progress, much work remains unfinished. Other chapters focus on research and development needs in relation to packaging services, scaling up, and ensuring sustainability. Here the focus is on research for strengthening the database for policy making.
Gaps in knowledge remain with respect to recognized strategies for intervention programs. Often information on intervention efficacy exists, yet little scientific literature on program effectiveness is available. Key gaps include the following:
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evaluation of the effectiveness of national iron fortification programs to reduce iron deficiency anemia
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implementation and evaluation of the effectiveness of iron supplementation programs for young children
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evaluation of the effect on child mortality of multifaceted programs to reduce child undernutrition
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evaluation of the effectiveness of programs based on the new guiding principles for reducing undernutrition and micronutrient malnutrition in young children
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implementation and evaluation of the effectiveness of food-based strategies to reduce micronutrient malnutrition
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implementation and evaluation of the effectiveness of early postnatal vitamin A supplementation to reduce infant mortality.
Costing studies should accompany the evaluations to allow estimates of cost-effectiveness for decision making.
Because of the logistical difficulties in developing fortification approaches in settings with little industry infrastructure, alternative fortification approaches are needed, such as micronutrient sprinkles or foodlets. In addition, operational research is needed to develop, implement, and evaluate programs to improve zinc status. Never has so much evidence been amassed on the consequences of a deficiency disorder without programmatic application. The challenge now is to develop and implement programs for preventing and treating zinc deficiency and to evaluate their effectiveness for child growth, health, and survival. The International Zinc Nutrition Consultative Group (2004) has laid out a research agenda with these aims in mind.
