of Health), and system levels (for example, on wages, career prospects, and certification) if nutrition-specific interventions are to be scaled up, nutrition-sensitive programs developed,3 and an enabling environment created (Sodjinou et al. 2014).
• Collect data on the resource-use intensity of nutrition pro- grams. This issue will become increasingly pressing in the post-2015 era, but few data exist. What is the intensity of resource use in nutrition interventions, and which approach- es are most environmentally sustainable?
WAYS FORWARD IN FILLING SOME OF THE GAPS
The report has already highlighted ways forward for filling financial tracking gaps (Panel 7.1), SAM coverage gaps (Pan- el 5.1), and capacity gaps for using existing data (Panel 8.5). Table 9.3 summarizes some ways forward in nine further areas: measuring natural resource use in nutrition, costing nutrition ac- tions, developing food consumption indicators, using experien- tial assessments of severe hunger, assessing capacity, measuring
low birth weight, reporting on adult obesity, self-reporting on SUN institutional transformations, and collecting data on vita- mins and minerals. The detailed pieces of work behind each row in Table 9.3 are provided in Technical Notes 4–12.
This report refrains from further prioritizing the data gaps to be filled. More detailed decisions about data priorities should probably be made in various international, regional, national, and subnational forums and involve users and producers of such data. Criteria for such decisions should be appropriate to the context, but should include questions such as the following: Does filling the gap have the potential to stimulate and guide action that reduces malnutrition faster? Is it feasible to fill the gap? Is there is demand for the gap to be filled?
The final priorities will no doubt reflect a combination of technical, capacity, and political considerations. Just as informa- tion is power, power shapes information: the data selected for collection, how they are used, and the conclusions framed are all influenced by who is using them.
TABLE 9.3 SOME KEY POINTS FROM TECHNICAL NOTES 4–12 ON WAYS FORWARD IN FILLING SOME DATA GAPS Data gap
Way forward Natural resource use Costs of nutrition actions Food security Severity of food insecurity
Explore and test innovative scientific methods, pilot studies, metrics, and good practices to link human and natural resource outcomes. (Technical Note 4)
Develop standardized guidance on what constitutes nutrition-sensitive action. Address how to include nongovernmental costs. Develop tools to help prioritize and sequence actions. (Technical Note 5)
Invest in setting up, maintaining, and validating a worldwide data collection system that allows incorporation of standard measures of key food security indicators, including simple food access indicators measured at household and individual levels, into existing survey platforms. Escalate the amount of nationally representative survey data on food consumption, collected through standardized methods. (Technical Note 6)
Rather than measuring the consequences of food insecurity in terms of what people eat (analysis of food consumption data), measure the severity of food insecurity by asking people directly about their food-related behaviors in the face of restricted access to food. Though food insecurity cannot be directly observed, its extent can be inferred from the lived experiences of food-insecure people themselves. (Technical Note 7)
Implementation capacity
Because capacity is the combination of many interrelated factors at individual, organizational, and systemic levels, a systemic assessment of capacity gaps is needed. A thorough capacity gap analysis would provide the basis for developing a comprehensive framework to strengthen the implementation and scale-up of nutrition interventions. Several authors have provided clear indications to guide the measurement of capacity gaps for nutrition in a systematic manner. However, there have been few attempts to link these proposed frameworks to concrete case studies in countries or regions with a high burden of malnutrition. (Technical Note 8)
Measuring low birth weight Adult obesity
Institutional transformation Vitamins and minerals Analyze current methods to adjust for collection inconsistencies and reporting, and explore alternative methods (ongoing). (Technical Note 9)
Achieve a consensus on the pros and cons of using different adult obesity data sources, with a recommendation on which to use in future Global Nutrition Reports and elsewhere. (Technical Note 10)
The SUN indicator on institutional transformation (described in Chapter 7) raised awareness about the significant gaps in implementation of actions around common results and in the alignment and tracking of investments for nutrition. Future such exercises can be a way of prioritizing and stimulating change. (Technical Note 11)
Allocate resources for countries where there are no data and where there is interest in conducting surveys. Collect more nationally repre- sentative survey data on multiple micronutrient biomarkers, using standardized methods. Develop field-friendly devices that allow a quick and low-cost assessment of multiple biomarkers in small blood samples. Integrate micronutrient biomarkers into national health information systems. Standardize coverage definitions, collect coverage data, and collate them in a global database to track the progress of micronutri- ent interventions. (Technical Note 12)
Source: Authors.
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