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>>WELCOME TO THE THIRD
AND

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FINAL WEBINAR IN THE LESSONS

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LEARNED FROM GLOBAL FOOD AND

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NUTRITION INSECURITY WEBINAR

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SERIES.

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MY NAME IS SUSAN VORKOPER, AND

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I'M WITH THE NIH FOGARTY

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INTERNATIONAL CENTER.

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>>AND I'M BRAMARAMBA
WOWTHA.

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THIS IS BUILT ON THE INVESTMENTS

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THAT U.S. GOVERNMENT IS MAKING

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IN FOOD NUTRITION INSECURITY

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BOTH AT HOME AS WE SAW DURING

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THE WHITE HOUSE CONFERENCE ON

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FOOD NUTRITION AND HUNGER AND

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ABROAD WITH THE RECENT PASSAGE

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OF GLOBAL MALNUTRITION ACT.

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THIS HIGHLIGHTS INNOVATIVE

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RESEARCH PROJECTS ON NUTRITION

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AND FOOD INSECURITY AND HEALTH

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OUTCOMES IN GLOBAL SETTINGS AND

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IDENTIFIES LESSONS LEARNED AND

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OPPORTUNITIES FOR ADAPTATION IN

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U.S. AND OTHER CONTEXTS.

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OUR FIRST WEBINAR PROVIDED AN

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OVERVIEW OF THE IMPACTS OF FOOD

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AND NUTRITION INSECURITY ACROSS

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THE WORLD IN VARIOUS AGE GROUPS

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AND SETTINGS, INCLUDING THE

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CONNECTION TO CHRONIC AND

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INFECTIOUS DISEASES, AS WELL AS

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SPECIFIC EXAMPLES OF

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INTERVENTION RESEARCH THAT

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PRESENT OPPORTUNITIES FOR

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TRANSLATIONS AND ADAPTATIONS.

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DURING OUR SECOND WEBINAR, WE

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LOOKED AT THE ROLE THAT THE HOME

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NEIGHBORHOOD AND COMMUNITY FOOD

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ENVIRONMENTS PLAY IN FOOD

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INSECURITY AND PROVIDES EXAMPLES

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OF EFFECTIVE FOOD ENVIRONMENT

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AND FOOD SYSTEM EXHIBIT VENGSESS

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ACROSS MULTIPLE REGIONS.

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THIS THIRD AND FINAL WEBINAR

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TODAY FOCUSES ON IMPLEMENTATION

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SCIENCE TO ADDRESS FOOD AND

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NUTRITION INSECURITY.

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AS YOU KNOW, IT IS A FIELD OF

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RESEARCH THAT ADDRESSES

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CHALLENGES AT THE INTERSECTION

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OF RESEARCH AND PRACTICE AND

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AIMS TO UNDERSTAND FACTORS THAT

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INFLUENCE IMPLEMENTATION OF

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PROVEN INTERVENTIONS IN REAL

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WORLD SETTINGS.

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IN TODAY'S WEBINAR, WE WILL

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EXPLORE THE IMPLEMENTATION

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SCIENCE METHODS AND APPROACHES

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USED IN FOOD AND NUTRITION

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INSECURITY RESEARCH AND PROVIDE

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EXAMPLES OF GLOBAL FOOD

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INSECURITY INNOVATION THAT HAS

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BEEN ADAPTED ACROSS SETTINGS.

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AND WE WILL END WITH A DYNAMIC

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DISCUSSION ON HOW IMPLEMENTATION

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SCIENCE CAN CONTRIBUTE TO

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LONG-TERM SUSTAINABILITY OF FOOD

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AND NUTRITION SECURITY

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INNOVATIONS.

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SUSAN?

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>>SO THIS WEBINAR SERIES
IS

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MADE POSSIBLE THROUGH

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PARTNERSHIPS WITH NIH'S OFFICE

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OF DISEASE PREVENTION, OFFICE OF

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NUTRITION RESEARCH, THE NATIONAL

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CANCER INSTITUTE, THE NATIONAL

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HEART, LUNG, BLOOD AND SLEEP

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INSTITUTE AND THE NATIONAL

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INSTITUTE FOR CHILD HEALTH AND

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HUMAN DEVELOPMENT, AS WELL AS

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USAAD AND CDC, TO DEVELOP THIS

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THREE-PART SERIES.

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WE WELCOME QUESTIONS FROM THE

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AUDIENCE TO ASK QUESTIONS, CLICK

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ON THE "SEND LIVE FEEDBACK"

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BUTTON DIRECTLY BELOW THIS

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VIDEO.

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I'LL INTRODUCE YOU TO OUR FIRST

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SPEAKER AND THE LEAD FOR THIS

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WEBINAR, PROFESSOR AND DIRECTOR

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OF GLOBAL HEALTH INITIATIVES AT

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THE UNIVERSITY OF SOUTH CAROLINA

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AND PRESENT OF THE SOCIETY FOR

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IMPLEMENTATION SCIENCE AND

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NUTRITION.

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ED?

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>>THANK YOU, SUSAN.

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SO I'M PLEASED TO BE WITH YOU

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THIS AFTERNOON TO DISCUSS

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IMPLEMENTATION SCIENCE IN

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NUTRITION.

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SO I'M GOING TO START WITH THE

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IDEA THAT IN ORDER TO TAKE

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STRATEGIC ACTIONS FOR IMPROVING

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NUTRITION AND HEALTH, IT'S

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USEFUL TO THINK ABOUT TOLEDO

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MAINS, ABOUT A BIOLOGICAL AND

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EPIDEMIOLOGICAL DOMAIN, A

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SOCIAL, POLITICAL AND POLICY

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DOMAIN AND IMPLEMENTATION.

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SO WE HAVE, IN NUTRITION, WELL

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OVER 100 YEARS NOW OF DEVELOPING

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THE SCIENCE, THE BIOLOGICAL

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SCIENCE OF NUTRITION, THE SOCIAL

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AND POLITICAL AND POLICY DOMAIN

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REALLY HAS STARTED BEING APPLIED

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AS A SCIENCE AND NUTRITION MUCH

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LATER, MAYBE OVER THE LAST 20 TO

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25 YEARS, AND IMPLEMENTATION

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SCIENCE AND NUTRITION IS NASCENT

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IN COMPARISON TO THESE.

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SO WHY IMPLEMENTATION SCIENCE?

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SPECIFIC INTERVENTIONS WE KNOW

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CAN BE EFFECTIVE AT LOW COST AND

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RELATIVELY CONTROLLED

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ENVIRONMENTS AND SHORT TERM

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STUDIES OR ON SMALL SCALES, BUT

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WHAT ABOUT AT LARGE SCALES, SO

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WE CAN REALLY IMPACT THE

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PUBLIC'S HEALTH, WE NEED TO HAVE

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STRONG AND RESPONSIVE SYSTEMS

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THAT IMPLEMENT THESE

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INTERVENTIONS THAT PROMOTE

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HEALTH AND WELL-BEING THROUGH

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SUSTAINABLE STRATEGIES THAT WORK

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ON A LARGE SCALE IN THE REAL

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WORLD, IN ORDER TO ADDRESS

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ISSUES LIKE MALNUTRITION AND

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POOR HEALTH IN ALL ITS FORMS,

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AND THE NEED TO WORK THROUGH

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MULTIPLE SYSTEMS SUCH AS

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AGRICULTURE, FOOD, EDUCATION,

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AND HEALTH.

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WE HAVE SOME PROVEN

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INTERVENTIONS, BUT THEIR

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EFFECTIVE IMPLEMENTATION IS

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REQUIRED IN ORDER TO REACH THE

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SUSTAINABLE DEVELOPMENT GOALS

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AND TO MEET NATIONAL COMMITMENTS

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FOR UNIVERSAL HEALTH COVERAGE

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AND OTHER NATIONAL GOALS IN ALL

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COUNTRIES INCLUDING THE U.S.

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SO WHAT'S THE NEED?

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ONE WAY TO THINK ABOUT THE NEED

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IS THAT WE HAVE TO FOCUS ON,

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REFOCUS ON IMPLEMENTATION

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INTERVENTIONS AND NOT JUST THE

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INTERVENTION IMPACTS OF

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IMPLEMENTATION, NOT JUST ON

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EVALUATION, BUT ON STUDY

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IMPLEMENTATION ITSELF.

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MORE STUDY OF IMPLEMENTATION

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WHERE IT'S THE MAIN OUTCOME OF

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THE STUDY IN TERMS OF

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FEASIBILITY, ADOPTION,

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ACCEPTANCE, QUALITY, EQUITY,

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EFFICIENCY, SCALE,

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SUSTAINABILITY, ET CETERA.

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, THAT WE CONSIDER DIFFERENT

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PHASES OF IMPLEMENTATION AND NOT

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JUST IMPLEMENTATION EXAMINATION

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THAT OCCURS NESTED WITHIN

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PROCESS OR LONG TIRM IMPACT

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EVALUATIONS, AND THAT WE

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DETERMINE WHAT EFFECTS

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IMPLEMENTATION QUALITY ACROSS

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MULTIPLE DOMAINS AND HOW TO

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IMPROVE THAT.

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SO SOME EXAMPLE QUESTIONS FOR

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IMPLEMENTATION SCIENCE, THESE

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WERE GENERATED BY A DISCUSSION

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COMING OUT OF THE -- AT THE END

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OF THE 12 YEARS OF THE ALIVE AND

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THRIE PROGRAM, AND THINKING

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ABOUT GOING ACROSS THE ENTIRE

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PORTFOLIO IN MANY COUNTRIES

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DURING THAT TIME THAT THE

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EVALUATION TEAM WAS THINKING

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ABOUT, OKAY, WHAT ARE THE BIG

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QUESTIONS THAT WE NEED TO

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ANSWER?

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SO WE CAME UP WITH QUESTIONS

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SUCH AS, HOW CAN PROGRAMMING BE

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INTEGRATED INTO AND STRENGTHEN

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EXISTING SYSTEMS AND PLATFORMS,

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HOW CAN DATA AND IMPLEMENTATION

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LEARNING BE USED TO IMPROVE

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IMPLEMENTATION QUALITY,

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COVERAGE, EQUITY OF SERVICES,

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AND WHO'S ACCOUNTABLE WHEN IT

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DOESN'T GO RIGHT?

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WHAT CONDITIONS AND STRATEGIES

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AND METHODS ARE NEEDED TO ENABLE

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COUNTRY-LEVEL SCALE-UP, HOW DOES

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ONE MOTIVATE INDIVIDUALS TO

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ADOPT AND SUSTAIN BEHAVIOR

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CHANGE, BEING PROMOTED BY

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INTERVENTIONS THAT WE BELIEVED

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WILL WORK?

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HOW CAN CAPACITIES,

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CAPABILITIES, MOTIVATION AND

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PERFORMANCE OF FRONTLINE WORKERS

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BE IMPROVED?

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AND HOW CAN PROGRAMS BE

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SUSTAINED AT MULTIPLE LEVELS,

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COMMUNITY, PROGRAM AND

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INSTITUTION?

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WE ORGANIZED TWO WORKSHOPS IN

219
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2019, ONE AT THE AMERICAN

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SOCIETY FOR NUTRITION MEETING

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AND ONE AT THE A & H ACADEMY

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WEEK, AND IT WAS STRIKING THAT

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THE WORKSHOP PARTICIPANTS IN

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BOTH WORKSHOPS IDENTIFIED SOME

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CHALLENGES THEY SAW WITH

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IMPLEMENTATION SCIENCE AS

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APPLIED TO NUTRITION.

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LITTLE AGREEMENT REGARDING

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DEFINITIONS, METHODS AND

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CURRICULA, THE GOVERNMENTS AND

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DONORS TYPICALLY FOCUS ON

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END-LINE RESULTS AND DON'T VALUE

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ACHIEVING IMPLEMENTATIONS AND

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OUT COME, THUS LIMITING FUNDING

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OPPORTUNITIES.

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OBVIOUSLY THAT'S CHANGING, WHICH

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IS WHY WE'RE HAVING THIS

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WEBINAR, AND WE'RE GRATEFUL FOR

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THAT.

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INFREQUENTLY BUILT INTO PROGRAMS

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AND STUDIES, BEING UNDERVALUED

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IN ACADEMIA, NOT WIDELY SHARED

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AND DISSEMINATED AT CONFERENCES.

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THAT'S ALSO CHANGING.

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THAT IT WAS CHALLENGING TO REACH

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AND ENGAGE WITH NUTRITION

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PRACTITIONERS, A LACK OF

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CONCEPTUAL COHESION AROUND

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IMPLEMENTATION AS AN OBJECT OF

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STUDY, AND THE TENDENCY TO

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DESCRIBE IMPLEMENTATION SCIENCE

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IN TERMS OF METHODS RATHER THAN

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STARTING WITH THE QUESTIONS

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ASKED, THE ISSUES RAISED AND THE

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CONTRIBUTIONS TO MAKE.

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AND SO ANDREA WARREN, WHO'S HERE

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ON THE CALL, IS A PANELIST, HOOE

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TOOK WHAT WE LEARNED FROM THESE

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WORKSHOPS AND TRIED TO FIND A

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PATH FORWARD.

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ONE OF THE THINGS THAT -- ONE OF

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THE WAYS IN WHICH WE THOUGHT IT

263
00:08:32,000 --> 00:08:34,480
WAS IMPORTANT TO GO FORWARD WAS

264
00:08:34,480 --> 00:08:38,640
TO RECOGNIZE THE IMPORTANCE OF

265
00:08:38,640 --> 00:08:40,480
BOTH DISCOVERY AND MISSION

266
00:08:40,480 --> 00:08:41,560
ORIENTATIONS, THAT

267
00:08:41,560 --> 00:08:42,560
IMPLEMENTATION SCIENCE HAS TO

268
00:08:42,560 --> 00:08:45,000
CREATE QUESTIONS, WHERE WE SEEK

269
00:08:45,000 --> 00:08:46,840
TO CREATE A RESERVOIR OF

270
00:08:46,840 --> 00:08:52,440
JEBIZEED KNOWLEDGENERALIZED -- E

271
00:08:52,440 --> 00:08:53,640
SEEKING TO CREATE KNOWLEDGE TO

272
00:08:53,640 --> 00:08:55,360
HELP ACCOMPLISH A VERY SPECIFIC

273
00:08:55,360 --> 00:08:56,800
OBJECTIVE IN FRONT OF US.

274
00:08:56,800 --> 00:08:58,400
SO THAT MEANS THAT

275
00:08:58,400 --> 00:08:59,320
IMPLEMENTATION SCIENCE QUESTION

276
00:08:59,320 --> 00:09:01,040
SHOULD BE INSPIRED BY THEIR

277
00:09:01,040 --> 00:09:03,120
USEFULNESS BUT NOT NECESSARILY

278
00:09:03,120 --> 00:09:04,880
LIMITED TO ONES THAT HAVE

279
00:09:04,880 --> 00:09:05,760
IMMEDIATE USE.

280
00:09:05,760 --> 00:09:07,840
WE ALSO FOUND THAT A LOT OF THE

281
00:09:07,840 --> 00:09:09,400
CONFUSION CAME ABOUT BECAUSE

282
00:09:09,400 --> 00:09:11,120
THERE WERE THREE DISTINCT

283
00:09:11,120 --> 00:09:15,240
PERSPECTIVES BEING DISCUSSED

284
00:09:15,240 --> 00:09:16,680
ABOUT IMPLEMENTATION SCIENCE AND

285
00:09:16,680 --> 00:09:17,880
NUTRITION AND OFTEN HAD PEOPLE

286
00:09:17,880 --> 00:09:19,000
TALKING PAST EACH OTHER.

287
00:09:19,000 --> 00:09:22,920
SO ONE OF THOSE PERSPECTIVE WAS

288
00:09:22,920 --> 00:09:24,480
A BIOMEDICAL ONE WHERE THE

289
00:09:24,480 --> 00:09:26,120
STARTING POINT IS THE NEED TO

290
00:09:26,120 --> 00:09:27,640
TRANSLATE BASIC BIOMEDICAL

291
00:09:27,640 --> 00:09:28,840
SCIENCE INTO PRACTICE, SOMETHING

292
00:09:28,840 --> 00:09:31,560
THAT'S VERY IMPORTANT TO DO, AND

293
00:09:31,560 --> 00:09:33,200
ITS PURPOSE IS TO IDENTIFY,

294
00:09:33,200 --> 00:09:34,640
UNDERSTAND AND DEVELOP

295
00:09:34,640 --> 00:09:37,240
STRATEGIES FOR OVERCOMING

296
00:09:37,240 --> 00:09:40,760
BARRIERS TO THE ADOPTION,

297
00:09:40,760 --> 00:09:42,000
ADAPTATION, INTEGRATION,

298
00:09:42,000 --> 00:09:43,720
SCALE-UP AND SUSTAINABILITY OF

299
00:09:43,720 --> 00:09:44,920
INTERVENTIONS, TOOLS, POLICIES

300
00:09:44,920 --> 00:09:47,560
AND GUIDELINES THAT WE BELIEVE

301
00:09:47,560 --> 00:09:48,200
WORK FROM THE INVESTIGATION

302
00:09:48,200 --> 00:09:52,120
THAT'S BEEN DONE, AND TO ALSO

303
00:09:52,120 --> 00:09:54,000
UNDERSTAND WHEN DO WE STOP

304
00:09:54,000 --> 00:09:55,640
IMPLEMENTING INTERVENTIONS THAT

305
00:09:55,640 --> 00:09:57,600
ARE INEFFECTIVE, UNPROVEN, LOW

306
00:09:57,600 --> 00:09:58,800
VALUE OR HARMFUL?

307
00:09:58,800 --> 00:10:00,000
DISTINCT FROM THAT WAS A PROGRAM

308
00:10:00,000 --> 00:10:02,120
OR POLICY PERSPECTIVE WHERE THE

309
00:10:02,120 --> 00:10:03,320
STARTING POINT WAS TO IMPROVE

310
00:10:03,320 --> 00:10:06,480
IMPLEMENTATION OF A PROGRAM OR

311
00:10:06,480 --> 00:10:08,360
POLICY WHICH WE FOUND

312
00:10:08,360 --> 00:10:09,960
DE-EMPHASIZES DISCOVERY-ORIENTED

313
00:10:09,960 --> 00:10:11,880
SCIENCE SINCE IT'S PRIMARILY

314
00:10:11,880 --> 00:10:12,600
MISSION-ORIENTED, SO HERE THE

315
00:10:12,600 --> 00:10:15,400
PURPOSE IS TO IDENTIFY AND

316
00:10:15,400 --> 00:10:16,840
ADDRESS IMPLEMENTATION

317
00:10:16,840 --> 00:10:18,240
BOTTLENECKS, IDENTIFY, EVALUATE

318
00:10:18,240 --> 00:10:20,880
AND SCALE UP IMPLEMENTATION

319
00:10:20,880 --> 00:10:22,320
INNOVATIONS AND ENHANCE THE

320
00:10:22,320 --> 00:10:23,440
UTILIZATION OF EXISTING

321
00:10:23,440 --> 00:10:25,160
KNOWLEDGE AND TOOLS AND

322
00:10:25,160 --> 00:10:26,920
FRAMEWORKS BASED ON THE EVOLVING

323
00:10:26,920 --> 00:10:27,480
SCIENCE.

324
00:10:27,480 --> 00:10:32,160
AND THEN FINALLY, HEALTH SYSTEMS

325
00:10:32,160 --> 00:10:33,640
PERSPECTIVE AS AT THE STARTING

326
00:10:33,640 --> 00:10:35,680
POINT UNDERSTANDING SYSTEM

327
00:10:35,680 --> 00:10:38,960
FUNCTIONING AND ALIGNMENT AND

328
00:10:38,960 --> 00:10:40,040
ARTICULATION WITHIN AND BETWEEN

329
00:10:40,040 --> 00:10:43,000
THE DIFFERENT SEMI  SYSTEMS THAE

330
00:10:43,000 --> 00:10:43,320
INVOLVED.

331
00:10:43,320 --> 00:10:45,080
SO HERE THE PURPOSE IS TO

332
00:10:45,080 --> 00:10:47,680
UNDERSTAND HOW HEALTH

333
00:10:47,680 --> 00:10:48,480
INTERVENTIONS WORK OUT THERE IN

334
00:10:48,480 --> 00:10:51,240
THE REAL WORLD IN REAL SYSTEMS,

335
00:10:51,240 --> 00:10:55,800
TO CAPTURE AND ANALYZE

336
00:10:55,800 --> 00:10:57,760
INFORMATION AND TO HELP

337
00:10:57,760 --> 00:10:58,880
ORGANIZATIONS DEVELOP CAPACITY

338
00:10:58,880 --> 00:11:01,160
TO LEARN FROM IMPLEMENTATION SO

339
00:11:01,160 --> 00:11:03,520
THERE'S AN ITERATIVE PROCESS OF

340
00:11:03,520 --> 00:11:04,440
KNOWLEDGE GENERATION AND USE.

341
00:11:04,440 --> 00:11:07,520
SO BASED ON ALL OF THIS, WE

342
00:11:07,520 --> 00:11:08,720
DEFINED IMPLEMENTATION SCIENCE

343
00:11:08,720 --> 00:11:10,760
AS A BODY OF SYSTEMATIZED

344
00:11:10,760 --> 00:11:12,400
KNOWLEDGE, THAT'S WHAT A SCIENCE

345
00:11:12,400 --> 00:11:14,480
IS, ABOUT HOW TO IMPROVE

346
00:11:14,480 --> 00:11:16,360
IMPLEMENTATION, AND THAT

347
00:11:16,360 --> 00:11:17,400
IMPLEMENTATION SCIENCE RESTS ON

348
00:11:17,400 --> 00:11:19,080
THREE PRINCIPLES.

349
00:11:19,080 --> 00:11:20,280
ONE IS THAT IT'S DISTINGUISHED

350
00:11:20,280 --> 00:11:21,720
BY ITS AIM TO LEARN ABOUT THE

351
00:11:21,720 --> 00:11:24,720
PROCESS OF IMPLEMENTATION, NOT

352
00:11:24,720 --> 00:11:25,640
NECESSARILY TO JUDGE WHETHER

353
00:11:25,640 --> 00:11:30,040
THERE'S BEEN IMPACT, THAT'S A

354
00:11:30,040 --> 00:11:32,440
VALUATION, BUT HERE TO FOCUS ON

355
00:11:32,440 --> 00:11:33,880
THE PROCESS OF IMPLEMENTATION,

356
00:11:33,880 --> 00:11:35,400
TO ADOPT METHODS THAT DERIVE

357
00:11:35,400 --> 00:11:37,920
FROM AND FIT WITH THE AIMS THAT

358
00:11:37,920 --> 00:11:40,120
HAVE BEEN ARTICULATED, AND TO

359
00:11:40,120 --> 00:11:41,440
RECOGNIZE THAT IMPLEMENTATION

360
00:11:41,440 --> 00:11:44,160
SCIENCE IS BUILT WITH TACIT AS

361
00:11:44,160 --> 00:11:45,840
WELL AS EXPERT KNOWLEDGE AND

362
00:11:45,840 --> 00:11:47,320
EXPERIENTIAL LEARNING FROM

363
00:11:47,320 --> 00:11:48,960
STAKEHOLDERS, SYSTEMS, PROVIDERS

364
00:11:48,960 --> 00:11:52,120
AND RECIPIENTS AS WELL AS

365
00:11:52,120 --> 00:11:52,440
SCIENTISTS.

366
00:11:52,440 --> 00:11:57,040
SO I WANTED TO GIVE AN EXAMPLE.

367
00:11:57,040 --> 00:11:58,480
TATIANA MARTINEZ LED THE

368
00:11:58,480 --> 00:12:00,000
DEVELOPMENT OF AN INTERVENTION

369
00:12:00,000 --> 00:12:02,640
IN COSTA RICA THAT HAD THE AIM

370
00:12:02,640 --> 00:12:07,520
TO BOTH REDUCE DISCOURAGEMENT IN

371
00:12:07,520 --> 00:12:09,840
FOOD INSECURITY BUT ALSO PREVENT

372
00:12:09,840 --> 00:12:10,720
EXCESS WEIGHT GAIN.

373
00:12:10,720 --> 00:12:15,120
SO THIS IS A CLUSTER RA RANDOMID

374
00:12:15,120 --> 00:12:16,080
DESIGN WHERE THERE WAS AN

375
00:12:16,080 --> 00:12:18,360
INTERVENTION ARM COMPARED TO --

376
00:12:18,360 --> 00:12:20,680
THAT WAS INTENSIVE COMPARED TO A

377
00:12:20,680 --> 00:12:21,920
NON-INTENSIVE ARM AND THEN A

378
00:12:21,920 --> 00:12:23,080
FOLLOW-UP WAS DONE SIX MONTHS

379
00:12:23,080 --> 00:12:23,960
LATER.

380
00:12:23,960 --> 00:12:25,480
THE EVALUATION SHOWED CLEARLY

381
00:12:25,480 --> 00:12:27,120
THAT THERE WAS A REDUCTION IN

382
00:12:27,120 --> 00:12:30,080
OVERWEIGHT MORE IN THE

383
00:12:30,080 --> 00:12:32,240
INTENTATIVE ARM, HOWEVER IT WAS

384
00:12:32,240 --> 00:12:33,120
MEASURED, THAT FOOD INSECURITY

385
00:12:33,120 --> 00:12:34,640
WAS REDUCED, THAT THERE WAS AN

386
00:12:34,640 --> 00:12:36,440
INCREASE IN PSYCHOLOGICAL

387
00:12:36,440 --> 00:12:37,480
EMPOWERMENT, AN INCREASE IN

388
00:12:37,480 --> 00:12:38,480
CONTRIBUTION TO HOUSEHOLD

389
00:12:38,480 --> 00:12:41,120
SUPPORT FROM WOMEN, THAT MORE

390
00:12:41,120 --> 00:12:43,960
WOMEN FOUND A JOB, MORE WOMEN

391
00:12:43,960 --> 00:12:45,720
USED THE EMPLOYABILITY AND

392
00:12:45,720 --> 00:12:48,680
WOMEN'S OFFICES IN THE CITY OF

393
00:12:48,680 --> 00:12:49,880
ALOALA, WHERE THE STUDY WAS

394
00:12:49,880 --> 00:12:52,720
DONE, AND THE WOMEN HAD GREATER

395
00:12:52,720 --> 00:12:53,920
FAVORABLE CHANGES IN FOOD

396
00:12:53,920 --> 00:12:55,160
CONSUMPTION IN THE INTENSIVE

397
00:12:55,160 --> 00:12:57,640
ARM.

398
00:12:57,640 --> 00:13:00,400
SO THE QUESTION IS, HOW DID THIS

399
00:13:00,400 --> 00:13:02,440
HAPPEN?

400
00:13:02,440 --> 00:13:05,400
TWO PREVIOUS STUDIES THAT WERE

401
00:13:05,400 --> 00:13:06,560
RANDOMIZED, ONE IN MEXICO AND

402
00:13:06,560 --> 00:13:09,440
ONE NA GUATEMALA, IN TRYING TO

403
00:13:09,440 --> 00:13:11,760
IMPROVE FOOD SECURITY, HAD

404
00:13:11,760 --> 00:13:12,960
ACTUALLY RESULTED IN AN INCREASE

405
00:13:12,960 --> 00:13:14,920
IN WEIGHT IN WOMEN SO THIS STUDY

406
00:13:14,920 --> 00:13:16,000
ACHIEVED THE OPPOSITE.

407
00:13:16,000 --> 00:13:17,680
SO IMPLEMENTATION SCIENCE WAS

408
00:13:17,680 --> 00:13:18,960
CRUCIAL HERE.

409
00:13:18,960 --> 00:13:21,600
THERE WAS PREVIOUS QUALITATIVE

410
00:13:21,600 --> 00:13:24,000
WORK THAT MARTINEZ LED WHICH

411
00:13:24,000 --> 00:13:25,640
SHOW THAT DISCOURAGEMENT IS WHAT

412
00:13:25,640 --> 00:13:27,800
LINKED FOOD INSECURITY AND

413
00:13:27,800 --> 00:13:34,840
EXCESS BODY WA WEIGHT AMONG COSA

414
00:13:34,840 --> 00:13:36,600
RICAN WOMEN, THAT FAMILY AND

415
00:13:36,600 --> 00:13:37,800
EXISTING GENDER NORMS

416
00:13:37,800 --> 00:13:40,320
CONTRIBUTED TO AND COMPOUND IN

417
00:13:40,320 --> 00:13:41,720
COEXISTENCE, THAT HOUSEHOLD

418
00:13:41,720 --> 00:13:42,480
RESPONSIBILITIES PREVENT WOMEN

419
00:13:42,480 --> 00:13:43,600
FOR ASSUMING OTHER OPPORTUNITIES

420
00:13:43,600 --> 00:13:45,960
IN SOCIETY AND OPPORTUNITIES FOR

421
00:13:45,960 --> 00:13:47,880
SELF-CARE, AND THESE TOGETHER

422
00:13:47,880 --> 00:13:49,960
AFFECTED WOMEN'S PHYSICAL AND

423
00:13:49,960 --> 00:13:51,760
MENTAL HEALTH THROUGH

424
00:13:51,760 --> 00:13:53,200
PSYCHOLOGICAL DISEMPOWERMENT AND

425
00:13:53,200 --> 00:13:53,560
DISCOURAGEMENT.

426
00:13:53,560 --> 00:13:55,080
SO SHE LED A GROUP, A

427
00:13:55,080 --> 00:13:56,360
PARTNERSHIP OF HER SCHOOL OF

428
00:13:56,360 --> 00:13:57,640
NUTRITION AT THE UNIVERSITY OF

429
00:13:57,640 --> 00:13:59,680
COSTA RICA, THE WOMEN'S OFFICE

430
00:13:59,680 --> 00:14:02,800
AND ALOWELA, WHICH IS THE SECOND

431
00:14:02,800 --> 00:14:06,200
CITY IN COSTA RICA, AN NGO

432
00:14:06,200 --> 00:14:08,840
FOCUSING ON WOMEN'S WELL-BEING,

433
00:14:08,840 --> 00:14:09,800
THE EMPLOYABILITY OFFICE AND THE

434
00:14:09,800 --> 00:14:11,360
UNIVERSITY OF SOUTH CAROLINA,

435
00:14:11,360 --> 00:14:13,440
AND CONDUCTED -- SHE AND HER

436
00:14:13,440 --> 00:14:14,440
COLLEAGUES CONDUCTED

437
00:14:14,440 --> 00:14:15,640
IMPLEMENTATION RESEARCH AT

438
00:14:15,640 --> 00:14:16,400
MULTIPLE LEVELS.

439
00:14:16,400 --> 00:14:18,320
SO THIS WAS AT THE WOMEN'S EAFL,

440
00:14:18,320 --> 00:14:19,680
THE HOUSEHOLD OR FAMILY LEVEL,

441
00:14:19,680 --> 00:14:21,520
THE HEALTH CENTER LEVEL, AND THE

442
00:14:21,520 --> 00:14:23,960
COMMUNITY LEVEL, USING A NUMBER

443
00:14:23,960 --> 00:14:27,160
OF DIFFERENT METHODS, DID

444
00:14:27,160 --> 00:14:30,520
EXTENSIVE TESTING OF

445
00:14:30,520 --> 00:14:31,800
IMPLEMENTATION COMPONENTS, AND

446
00:14:31,800 --> 00:14:33,000
GATHERED INFORMATION ABOUT THE

447
00:14:33,000 --> 00:14:33,880
IMPLEMENTATION THROUGHOUT THE

448
00:14:33,880 --> 00:14:34,760
INTERVENTION THAT COULD BE FED

449
00:14:34,760 --> 00:14:36,320
BACK TO IMPROVE THE

450
00:14:36,320 --> 00:14:39,680
IMPLEMENTATION AS IT WENT.

451
00:14:39,680 --> 00:14:41,840
I WAS IN COSTA RICA AT THE END

452
00:14:41,840 --> 00:14:43,240
OF SEPTEMBER AND ATTENDED ONE OF

453
00:14:43,240 --> 00:14:44,480
THE WOMEN'S GROUPS.

454
00:14:44,480 --> 00:14:48,760
THE PROGRAM IS NOW SUSTAINED

455
00:14:48,760 --> 00:14:52,600
OVER TIME BY THE WOMEN'S OFFICE,

456
00:14:52,600 --> 00:14:54,480
OVER THE LAST FOUR YEARS, AND

457
00:14:54,480 --> 00:14:55,960
THE WOMEN'S GROUP WAS JUST

458
00:14:55,960 --> 00:14:56,240
WONDERFUL.

459
00:14:56,240 --> 00:14:57,840
IT WAS JUST VERY INSPIRING TO

460
00:14:57,840 --> 00:15:00,320
HEAR WOMEN TALKING ABOUT HOW

461
00:15:00,320 --> 00:15:01,320
WHAT THEY WERE LEARNING THERE

462
00:15:01,320 --> 00:15:02,520
AND THE WAY IN WHICH THEY WERE

463
00:15:02,520 --> 00:15:03,880
ABLE TO SUPPORT EACH OTHER WAS

464
00:15:03,880 --> 00:15:06,560
ABLE TO OVERCOME THE ISSUES THAT

465
00:15:06,560 --> 00:15:10,520
HAD BEENLYING THEM TO

466
00:15:10,520 --> 00:15:12,600
DISSCOURGEMENT AND PREVENTING

467
00:15:12,600 --> 00:15:14,480
THEM FROM ACHIEVING FOOD

468
00:15:14,480 --> 00:15:15,680
SECURITY AND CONTROLLING WEIGHT.

469
00:15:15,680 --> 00:15:18,080
SO FINALLY, WE KNOW THAT THE

470
00:15:18,080 --> 00:15:19,640
BIOMEDICAL TRANSLATIONAL MODEL

471
00:15:19,640 --> 00:15:23,760
OF GETTING INFORMATION FROM THE

472
00:15:23,760 --> 00:15:25,080
LABORATORY, FROM BENCH SCIENCE

473
00:15:25,080 --> 00:15:26,440
OUT INTO COMMUNITIES TAKES 15 TO

474
00:15:26,440 --> 00:15:30,960
20 YEARS, AND THAT RESEARCH

475
00:15:30,960 --> 00:15:31,520
EFFORT IS CRUCIAL.

476
00:15:31,520 --> 00:15:33,080
BUT WE ALSO KNOW IF WE'RE GOING

477
00:15:33,080 --> 00:15:35,040
TO AFFECT PUBLIC HEALTH AND

478
00:15:35,040 --> 00:15:36,040
PUBLIC NUTRITION IN A SHORTER

479
00:15:36,040 --> 00:15:38,320
AMOUNT OF TIME, WE HAVE TO HAVE

480
00:15:38,320 --> 00:15:39,520
OTHER MODELS TO GO FORWARD.

481
00:15:39,520 --> 00:15:40,600
SO TODAY WE'RE GOING TO HEAR

482
00:15:40,600 --> 00:15:42,560
ABOUT TWO EXAMPLES.

483
00:15:42,560 --> 00:15:45,000
ONE FROM ESIAN IN MEXICO AND ONE

484
00:15:45,000 --> 00:15:47,600
FROM ALIVE & THRIVE,
INITIATIVES

485
00:15:47,600 --> 00:15:49,360
THAT DEMONSTRATE AN ALTERNATIVE

486
00:15:49,360 --> 00:15:51,000
MODEL FOR BEHAVIORAL

487
00:15:51,000 --> 00:15:52,120
INTERVENTIONS WHERE THEY BROUGHT

488
00:15:52,120 --> 00:15:53,840
TOGETHER BRIGHT, COMMITTED AND

489
00:15:53,840 --> 00:15:54,760
TALENTED PEOPLE OUTSIDE AND

490
00:15:54,760 --> 00:15:56,880
WITHIN THE COUNTRIES TO TRY TO

491
00:15:56,880 --> 00:15:57,880
MAKE A DIFFERENCE AT LARGE SCALE

492
00:15:57,880 --> 00:16:00,400
IN A RELATIVELY SHORT PERIOD OF

493
00:16:00,400 --> 00:16:01,920
TIME, WHERE THE INTENTION,

494
00:16:01,920 --> 00:16:03,040
COMMITMENT AND PLANNING TO DO

495
00:16:03,040 --> 00:16:05,320
THAT WAS THERE FROM THE OUTSIDE,

496
00:16:05,320 --> 00:16:07,840
AND IN BOTH OF THESE EXAMPLES,

497
00:16:07,840 --> 00:16:09,520
REQUIRED IMPLEMENTATION SCIENCE

498
00:16:09,520 --> 00:16:11,680
AND WE LOOK FORWARD TO HEARING

499
00:16:11,680 --> 00:16:13,880
MORE DETAILS ABOUT THAT FROM OUR

500
00:16:13,880 --> 00:16:15,280
NEXT TWO SPEAKERS.

501
00:16:15,280 --> 00:16:22,840
SO OUR NEXT PRESENTER IS

502
00:16:22,840 --> 00:16:23,840
ANNABELLE, DIRECTOR OF RESEARCH

503
00:16:23,840 --> 00:16:24,960
IN NUTRITION POLICIES AND

504
00:16:24,960 --> 00:16:26,240
PROGRAMS IN THE CENTER FOR

505
00:16:26,240 --> 00:16:28,000
RESEARCH AND NUTRITION AND

506
00:16:28,000 --> 00:16:29,440
HEALTH AT THE NATIONAL INSTITUTE

507
00:16:29,440 --> 00:16:31,680
OF PUBLIC HEALTH IN MEXICO.

508
00:16:31,680 --> 00:16:33,240
SO THANK YOU, ANNABELLE, FOR

509
00:16:33,240 --> 00:16:42,720
JOINING US TODAY.

510
00:16:42,720 --> 00:16:44,160
>>THANK YOU, ED.

511
00:16:44,160 --> 00:16:45,800
GOOD AFTERNOON, AND THANKS TO

512
00:16:45,800 --> 00:16:49,520
THE ORGANIZERS FOR INVITING ME

513
00:16:49,520 --> 00:16:50,520
TO SHARE OUR EXPERIENCE.

514
00:16:50,520 --> 00:16:55,320
TODAY I WILL PRESENT AN EXAMPLE

515
00:16:55,320 --> 00:16:57,280
AS ED SAID OF USING A

516
00:16:57,280 --> 00:16:58,240
COMPREHENSIVE RESEARCH APPROACH

517
00:16:58,240 --> 00:16:59,960
THAT WE APPLIED TO SUPPORT A

518
00:16:59,960 --> 00:17:06,040
LARGE SCALE PROGRAM IN MEXICO.

519
00:17:06,040 --> 00:17:14,120
CALLED ESIAN.

520
00:17:14,120 --> 00:17:15,960
SO THE ESIAN STRATEGY WAS ONE OF

521
00:17:15,960 --> 00:17:18,800
THE INNOVATIONS OF SEVERAL

522
00:17:18,800 --> 00:17:20,200
INNOVATION RESEARCH APPLIED TO

523
00:17:20,200 --> 00:17:20,960
THE HEALTH AND NUTRITIONAL

524
00:17:20,960 --> 00:17:25,480
COMPONENT OF A LARGE SCALE

525
00:17:25,480 --> 00:17:29,000
PROGRAM TO IMPROVE PUBLIC

526
00:17:29,000 --> 00:17:31,120
SERVICE UTILIZATION ACROSS THE

527
00:17:31,120 --> 00:17:34,880
HEALTH AND -- SECTORS IN

528
00:17:34,880 --> 00:17:35,440
NUTRITION.

529
00:17:35,440 --> 00:17:40,480
INITIALLY THE PROGRAM WAS CALLED

530
00:17:40,480 --> 00:17:42,760
PROGRESA, IN A LIMITED NUMBER OF

531
00:17:42,760 --> 00:17:43,960
AREAS IN 2002.

532
00:17:43,960 --> 00:17:49,120
THEN IT WAS EXPANDED, AND AT THE

533
00:17:49,120 --> 00:17:52,280
END, AFTER 20 YEARS OF

534
00:17:52,280 --> 00:17:53,920
IMPLEMENTATION, IT WAS SCALED UP

535
00:17:53,920 --> 00:17:56,120
TO MORE THAN 6.1 MILLION

536
00:17:56,120 --> 00:17:58,960
FAMILIES.

537
00:17:58,960 --> 00:18:01,200
WL PROSPERA, THE FAMILIES WERE

538
00:18:01,200 --> 00:18:04,840
PROVIDED WITH AN ECONOMIC

539
00:18:04,840 --> 00:18:06,160
INCENTIVE, TO BE USED FOR THE

540
00:18:06,160 --> 00:18:07,240
PREVENTION OF HEALTH SERVICES.

541
00:18:07,240 --> 00:18:09,280
AS FOR INSTANCE, WOMEN WERE

542
00:18:09,280 --> 00:18:13,480
REQUIRED TO REGULARLY ATTEND AND

543
00:18:13,480 --> 00:18:15,480
TAKE THEIR CHILD TOLL A REGULAR

544
00:18:15,480 --> 00:18:18,960
WELL CHILD CLINIC AS WELL AND

545
00:18:18,960 --> 00:18:20,280
OBTAIN HEALTH WORKSHOP.

546
00:18:20,280 --> 00:18:22,520
THE PROGRAM ALSO PROVIDED

547
00:18:22,520 --> 00:18:23,880
MULTIPLE MICRO NUTRIENT

548
00:18:23,880 --> 00:18:26,280
SUPPLEMENTS DURING THE PREGNANCY

549
00:18:26,280 --> 00:18:28,320
AND UP TO ONE YEAR OF POSTPARTUM

550
00:18:28,320 --> 00:18:31,560
AS WELL AS TWO CHILDREN FROM

551
00:18:31,560 --> 00:18:33,040
6 MONTHS TO 5 YEARS OF AGE.

552
00:18:33,040 --> 00:18:34,880
DURING THE 20 YEARS THAT WE HAD

553
00:18:34,880 --> 00:18:37,880
THE PROGRAM, SEVERAL DIFFERENT

554
00:18:37,880 --> 00:18:46,280
SUPPLEMENTS WERE PROVIDED.

555
00:18:46,280 --> 00:18:48,680
SO RIGOROUS EVALUATION SHOWED A

556
00:18:48,680 --> 00:18:50,240
POSITIVE IMPACT ON PATIENT

557
00:18:50,240 --> 00:18:56,480
OUTCOMES BUT ALSO SUBSTANTIAL

558
00:18:56,480 --> 00:19:00,320
GAPS IN ADDRESSING NUTRITION.

559
00:19:00,320 --> 00:19:04,760
NUTRITION PROGRAMS.

560
00:19:04,760 --> 00:19:06,080
FIRST WE HAVE A RESULT FROM

561
00:19:06,080 --> 00:19:07,840
URBAN AND RURAL AREAS FROM

562
00:19:07,840 --> 00:19:08,920
MEXICO.

563
00:19:08,920 --> 00:19:10,040
THEN WE'LL DEMONSTRATE THIS

564
00:19:10,040 --> 00:19:14,640
PROGRAM HAS POSITIVE IMPACT ON

565
00:19:14,640 --> 00:19:16,160
LINEAR GROWTH.

566
00:19:16,160 --> 00:19:18,480
CHILDREN FROM THE POOREST

567
00:19:18,480 --> 00:19:24,600
BENEFICIARIES GREW 1 CENTIMETER

568
00:19:24,600 --> 00:19:27,880
MORE THAN CHILDREN IN PAIR SON

569
00:19:27,880 --> 00:19:28,560
FAMILIES, ESPECIALLY IN THE

570
00:19:28,560 --> 00:19:31,680
FIRST MONTH OF LIFE, HOWEVER,

571
00:19:31,680 --> 00:19:32,760
WHETHER THIS IMPACT WAS ENOUGH

572
00:19:32,760 --> 00:19:35,160
OR SUFFICIENT GIVEN THE PROGRAM

573
00:19:35,160 --> 00:19:36,840
DESIGN AND INVESTMENT.

574
00:19:36,840 --> 00:19:38,600
AND ALSO IF THE IMPACT WAS LARGE

575
00:19:38,600 --> 00:19:39,880
ENOUGH TO ACCOMPLISH OR TO

576
00:19:39,880 --> 00:19:42,200
CONTRIBUTE TO THE ACHIEVEMENT OF

577
00:19:42,200 --> 00:19:44,160
THE PROGRAM'S FINAL GOALS THAT

578
00:19:44,160 --> 00:19:51,480
WAS IMPROVE THE HUMAN CAPITAL.

579
00:19:51,480 --> 00:19:55,960
SOs THERE WAS ALSO A 10%

580
00:19:55,960 --> 00:19:57,320
DECREASE IN THE PREVALENCE OF

581
00:19:57,320 --> 00:19:59,480
ANEMIA IN RURAL AREAS AND SOME

582
00:19:59,480 --> 00:20:00,880
EVIDENCE OF IMPACT IN A SMALL

583
00:20:00,880 --> 00:20:04,960
YOSUBSAMPLE OF CHILDREN IN RURAL

584
00:20:04,960 --> 00:20:06,760
AREAS, ESPECIALLY IN THOSE 6 TO

585
00:20:06,760 --> 00:20:07,760
36 MONTHS OF AGE.

586
00:20:07,760 --> 00:20:09,120
BUT DESPITE THIS POSITIVE

587
00:20:09,120 --> 00:20:12,040
IMPACT, A HIGH PREVALENCE OF

588
00:20:12,040 --> 00:20:15,880
MALNUTRITION PERSISTS IN THE

589
00:20:15,880 --> 00:20:16,440
POPULATION.

590
00:20:16,440 --> 00:20:17,720
THE SERVICE IMPROVED BUT THE

591
00:20:17,720 --> 00:20:20,600
QUALITY OF CARE WAS LUCKY.

592
00:20:20,600 --> 00:20:29,080
THE CONCEPTION OF THE --

593
00:20:29,080 --> 00:20:30,520
LACTATING WOMEN WAS IRREGULAR,

594
00:20:30,520 --> 00:20:33,720
BUT THE PATTERN OF THE YOUTH

595
00:20:33,720 --> 00:20:35,440
WOULD LIMIT IN FREQUENCY AND

596
00:20:35,440 --> 00:20:37,200
QUANTITY CONSUMED.

597
00:20:37,200 --> 00:20:38,400
THEN SUBSTANTIAL DIVERSITY OF

598
00:20:38,400 --> 00:20:39,960
THE PREVALENCE OF MALNUTRITION

599
00:20:39,960 --> 00:20:41,800
WAS DOCUMENTED OR MALNUTRITION

600
00:20:41,800 --> 00:20:43,640
IN THIS CASE UNDER NUTRITION

601
00:20:43,640 --> 00:20:45,840
SPECIFICALLY, AND WAS

602
00:20:45,840 --> 00:20:46,520
INCREASED -- THERE WAS AN

603
00:20:46,520 --> 00:20:50,160
INCREASE OF THE RISK OF

604
00:20:50,160 --> 00:20:52,200
OVERWEIGHT AND OBESITY AMONG

605
00:20:52,200 --> 00:20:54,480
WOMEN.

606
00:20:54,480 --> 00:20:57,320
SO THIS LEADS TO A SERIES OF

607
00:20:57,320 --> 00:20:59,720
ANALYSIS, THE EVALUATION OF THE

608
00:20:59,720 --> 00:21:01,480
DATA AND SEVERAL COMPLEMENTARY

609
00:21:01,480 --> 00:21:03,480
STUDIES TO EXPLORE IN DEPTH THE

610
00:21:03,480 --> 00:21:05,520
QUALITY OF IMPLEMENTATION AND

611
00:21:05,520 --> 00:21:07,920
THE ADEQUACY OF THE DESIGN FOR

612
00:21:07,920 --> 00:21:10,680
THE CONTEXT IN VARIOUS SUBGROUP

613
00:21:10,680 --> 00:21:12,440
OF THE IMPLEMENTATION, AND ALSO

614
00:21:12,440 --> 00:21:13,960
MEASURE OF THE INTERMEDIATE

615
00:21:13,960 --> 00:21:14,720
RESULTS.

616
00:21:14,720 --> 00:21:25,200
SO HERE WE HAVE THE STUDIES

617
00:21:25,720 --> 00:21:26,760
CONDUCTED.

618
00:21:26,760 --> 00:21:30,080
SO THE REVIEW OF THE PROGRAM

619
00:21:30,080 --> 00:21:32,080
IMPACT PATHWAY, WE HIGHLIGHT

620
00:21:32,080 --> 00:21:33,880
SEVERAL GAPS IN THE DESIGN OF

621
00:21:33,880 --> 00:21:36,480
THE PROGRAM FOR SOME GROUP OF

622
00:21:36,480 --> 00:21:37,920
POPULATION AND THE QUALITY OF

623
00:21:37,920 --> 00:21:41,400
THE IMPLEMENTATION.

624
00:21:41,400 --> 00:21:42,320
DESPITE THAT SUPPLEMENTS WERE

625
00:21:42,320 --> 00:21:45,480
HIGH IN QUALITY, THERE WERE VERY

626
00:21:45,480 --> 00:21:47,640
HIGH QUALITY -- AND WERE

627
00:21:47,640 --> 00:21:49,600
ACCEPTED BY THE POPULATION.

628
00:21:49,600 --> 00:21:51,920
THEIR USE, HOWEVER, WAS NOT

629
00:21:51,920 --> 00:21:52,560
ALIGNED WITH THEIR

630
00:21:52,560 --> 00:21:53,320
RECOMMENDATION.

631
00:21:53,320 --> 00:21:55,080
LIKELY BECAUSE OF SEVERAL

632
00:21:55,080 --> 00:21:58,480
FACTORS INCLUDING INADEQUATE

633
00:21:58,480 --> 00:22:00,640
PROMOTION, WHICH RELATES TO THE

634
00:22:00,640 --> 00:22:03,840
SECOND GAP THAT WAS IDENTIFIED

635
00:22:03,840 --> 00:22:05,280
THAT WAS POOR QUALITY OF THE

636
00:22:05,280 --> 00:22:07,760
DESIGN AND IMPLEMENTATION OF THE

637
00:22:07,760 --> 00:22:10,480
COMMUNICATION STRATEGY.

638
00:22:10,480 --> 00:22:12,720
AND ALSO WE HAD A COMMON DESIGN

639
00:22:12,720 --> 00:22:15,000
ACROSS REGIONS THAT THIS WAS NOT

640
00:22:15,000 --> 00:22:19,160
WELL TREATED TO THE SPECIFIC

641
00:22:19,160 --> 00:22:20,440
NEEDS OF SOME OF THE POPULATION

642
00:22:20,440 --> 00:22:29,320
AS WE WERE COMMENTING.

643
00:22:29,320 --> 00:22:31,520
SO THIS TRIGGERED ADDITIONAL

644
00:22:31,520 --> 00:22:35,960
STUDIES, ALSO TO IMPROVE THE

645
00:22:35,960 --> 00:22:36,960
COMMUNICATION COMPONENT THAT

646
00:22:36,960 --> 00:22:39,680
SEVERAL BARRIER LIMITATION WERE

647
00:22:39,680 --> 00:22:41,480
IDENTIFIED BEFORE AND TO EXPLORE

648
00:22:41,480 --> 00:22:43,520
THOSE FACTORS THAT MAY HAVE

649
00:22:43,520 --> 00:22:46,920
INFLUENCED THE PROGRAM

650
00:22:46,920 --> 00:22:48,880
ACCEPTANCE AND USE.

651
00:22:48,880 --> 00:22:50,520
ONE OF THESE STUDIED WAS AN

652
00:22:50,520 --> 00:22:53,800
EFFICACY STUDY THAT WE CONDUCTED

653
00:22:53,800 --> 00:22:56,880
IN CHILDREN, WOMEN AS WELL BUT

654
00:22:56,880 --> 00:22:57,760
PRESENTED RESULTS FROM CHILDREN

655
00:22:57,760 --> 00:22:59,400
AND WE USED THREE TYPES OF

656
00:22:59,400 --> 00:23:04,320
SUPPLEMENT WITH IDENTICAL --

657
00:23:04,320 --> 00:23:09,560
THAT WAS PROVIDED BY THE

658
00:23:09,560 --> 00:23:10,680
PROGRAM.

659
00:23:10,680 --> 00:23:13,240
THE RESULTS INDICATE THE MICRO

660
00:23:13,240 --> 00:23:16,120
NUTRIENT SUPPLEMENT WAS --

661
00:23:16,120 --> 00:23:17,000
COMPLEMENTARY FOOD WITH LOWER

662
00:23:17,000 --> 00:23:19,720
COST AND HIGHER POTENTIAL TO

663
00:23:19,720 --> 00:23:21,600
REACH THE TARGET POPULATION.

664
00:23:21,600 --> 00:23:23,240
AND ALSO THAT WE NEED AN

665
00:23:23,240 --> 00:23:24,960
INTEGRATED APPROACH AND A

666
00:23:24,960 --> 00:23:29,160
STRATEGY JUST FOCUSED ON A MICRO

667
00:23:29,160 --> 00:23:32,120
NUTRIENT SUPPLEMENTS.

668
00:23:32,120 --> 00:23:32,800
THOSE CONCRETE RECOMMENDATIONS

669
00:23:32,800 --> 00:23:37,800
WERE MADE TO THE PROGRAM'S

670
00:23:37,800 --> 00:23:41,040
IMPLEMENTERS TO FORMULATE A

671
00:23:41,040 --> 00:23:43,040
NUTRITION COMPONENT THROUGH THE

672
00:23:43,040 --> 00:23:44,120
STRATEGY WE ALREADY COMMENT AND

673
00:23:44,120 --> 00:23:46,320
NOW THE STRATEGY WAS FOCUSED ON

674
00:23:46,320 --> 00:23:48,800
THE 1,000 DAYS TO ADDRESS THE

675
00:23:48,800 --> 00:23:50,720
TREATMENT BURDEN OF

676
00:23:50,720 --> 00:23:52,680
MALNUTRITION, UNDERNUTRITION,

677
00:23:52,680 --> 00:23:55,400
MICRO DEFICIENCIES AND OBESITY

678
00:23:55,400 --> 00:23:57,560
TO INCORPORATE DOUBLE DUTY

679
00:23:57,560 --> 00:23:59,880
ACTIONS OF PROVEN EFFICACIES AND

680
00:23:59,880 --> 00:24:04,160
TO CHANGE IN A DIFFERENT FORMAT

681
00:24:04,160 --> 00:24:08,080
FOR RURAL AND URBAN GROUPS.

682
00:24:08,080 --> 00:24:09,520
FOR RURAL, WE CONTINUE TO

683
00:24:09,520 --> 00:24:11,360
PROVIDE THE FORTIFIED FOOD, AND

684
00:24:11,360 --> 00:24:13,440
THEN WE ADD MICRO NUTRIENT

685
00:24:13,440 --> 00:24:16,920
POWDERS, AND FOR CHILDREN IN --

686
00:24:16,920 --> 00:24:20,320
WE JUST PROVIDE POWDERS.

687
00:24:20,320 --> 00:24:25,760
FOR LACTATING WOMEN WE CHANGE

688
00:24:25,760 --> 00:24:26,800
TO -- WITH A SPECIFIC

689
00:24:26,800 --> 00:24:29,320
FORMULATION FOR MEXICO.

690
00:24:29,320 --> 00:24:31,800
SO AFTER THE ASSESSMENT OF ALL

691
00:24:31,800 --> 00:24:34,560
THE -- HERE WE HAVE THE PROGRAM

692
00:24:34,560 --> 00:24:36,520
THEORY OF A STRATEGY, BUT I WILL

693
00:24:36,520 --> 00:24:38,160
FOCUS MORE ON THE PROCESS.

694
00:24:38,160 --> 00:24:41,120
AFTER THE ASSESSMENT OF THE

695
00:24:41,120 --> 00:24:42,560
INFORMATION THAT WAS AVAILABLE

696
00:24:42,560 --> 00:24:44,640
FOR PREVIOUS STUDIES AND

697
00:24:44,640 --> 00:24:46,040
EVALUATION WE PRESENT BEFORE, WE

698
00:24:46,040 --> 00:24:47,360
CONDUCT FORMATIVE RESEARCH TO

699
00:24:47,360 --> 00:24:48,560
GUIDE THE DESIGN OF THE

700
00:24:48,560 --> 00:24:49,000
STRATEGY.

701
00:24:49,000 --> 00:24:50,520
TYPICAL INFORMATION FOR MATERNAL

702
00:24:50,520 --> 00:24:52,680
INFANT FEEDING AND SERVICES

703
00:24:52,680 --> 00:24:53,680
DELIVERED WAS COLLECTED, AND

704
00:24:53,680 --> 00:24:56,280
SOME KEY DECISIONS WERE TAKEN

705
00:24:56,280 --> 00:24:58,080
BASED ON THESE RESULTS.

706
00:24:58,080 --> 00:24:59,360
FIRST IT WAS NECESSARY TO

707
00:24:59,360 --> 00:25:01,040
INTEGRATE THE EVIDENCE-BASED

708
00:25:01,040 --> 00:25:02,760
NUTRITION INTERVENTION INTO THE

709
00:25:02,760 --> 00:25:04,840
PRIMARY HEALTHCARE SERVICES,

710
00:25:04,840 --> 00:25:07,160
INCLUDING FOR INSTANCE GROWTH

711
00:25:07,160 --> 00:25:08,160
MONITORING AND COUNSELING.

712
00:25:08,160 --> 00:25:13,280
WE NEED TO HAVE ACHIEVED FROM

713
00:25:13,280 --> 00:25:15,120
A -- APPROACH TO A PREVENTIVE

714
00:25:15,120 --> 00:25:16,880
APPROACH, WE NEED TO START

715
00:25:16,880 --> 00:25:18,960
UPDATING AND STANDARDIZING

716
00:25:18,960 --> 00:25:20,480
INFORMATION THAT HEALTH WORKERS

717
00:25:20,480 --> 00:25:21,520
PROVIDE, IMPROVE THEIR PRACTICE

718
00:25:21,520 --> 00:25:23,080
AND THE QUALITY OF THE

719
00:25:23,080 --> 00:25:24,640
INTERACTION THEY HAVE WITH THE

720
00:25:24,640 --> 00:25:28,280
MOTHERS.

721
00:25:28,280 --> 00:25:29,720
AND THEN IT WAS EVIDENT THAT WE

722
00:25:29,720 --> 00:25:34,480
NEED TO DEVELOP A BUSINESS

723
00:25:34,480 --> 00:25:36,240
STRATEGY TO APPROACH ALL THE

724
00:25:36,240 --> 00:25:37,440
BARRIERS WE IDENTIFIED, AND WE

725
00:25:37,440 --> 00:25:39,080
DID SO ASSIGNING DIFFERENT ROLES

726
00:25:39,080 --> 00:25:41,040
FOR DIFFERENT HEALTH WORKERS AND

727
00:25:41,040 --> 00:25:42,440
COMMUNITIES HEALTH VOLUNTEERS,

728
00:25:42,440 --> 00:25:45,200
AND DEVELOPING MATERIALS TO

729
00:25:45,200 --> 00:25:50,320
IMPROVE THEIR ACTIVITIES.

730
00:25:50,320 --> 00:25:53,800
ISO THE DEVELOPING STRATEGY IN

731
00:25:53,800 --> 00:25:55,360
FOUR STATES OF THE COUNTRY AND

732
00:25:55,360 --> 00:25:57,040
WAS EVALUATING WITH EXPERIMENTAL

733
00:25:57,040 --> 00:25:59,080
DESIGN USING MIXED METHOD

734
00:25:59,080 --> 00:26:01,200
APPROACH.

735
00:26:01,200 --> 00:26:02,800
IT SHOWED POSITIVE RESULTS IN

736
00:26:02,800 --> 00:26:04,120
DIFFERENT OUTCOMES, INCLUDING

737
00:26:04,120 --> 00:26:05,120
SIGNIFICANT DIFFERENCE IN

738
00:26:05,120 --> 00:26:08,280
COUNSELING OF BREASTFEEDING AND

739
00:26:08,280 --> 00:26:12,960
COMPLEMENTARY FEEDING, AND ALSO

740
00:26:12,960 --> 00:26:14,600
IN ANEMIA REDUCTION, ESPECIALLY

741
00:26:14,600 --> 00:26:16,360
IN RURAL AREAS AS WE SEE IN THE

742
00:26:16,360 --> 00:26:19,880
GRAPH.

743
00:26:19,880 --> 00:26:22,960
SO IN ADDITION, THIS PILOT STUDY

744
00:26:22,960 --> 00:26:25,120
WAS QUITE IMPORTANT TO HIGHLIGHT

745
00:26:25,120 --> 00:26:26,640
SEVERAL CHALLENGES THAT COULD

746
00:26:26,640 --> 00:26:28,080
AFFECT IMPLEMENTATION AT LARGE

747
00:26:28,080 --> 00:26:28,640
SCALE.

748
00:26:28,640 --> 00:26:30,680
AND SOME OF THE MOST RELEVANT

749
00:26:30,680 --> 00:26:36,600
WERE THE HIGH TURNOVER OF THE

750
00:26:36,600 --> 00:26:43,600
HEALTH PERNE PERSONNEL, ESPECIAY

751
00:26:43,600 --> 00:26:45,360
PHYSICIANS, THE -- OF TRAINING

752
00:26:45,360 --> 00:26:47,440
AND THE LACK OF ACCOUNTABILITY,

753
00:26:47,440 --> 00:26:50,600
THERE WAS NOT A MONITORING AND

754
00:26:50,600 --> 00:26:55,640
SUPERVISION SYSTEM, AND LACK OF

755
00:26:55,640 --> 00:26:56,960
VALIDATION OF THE COMMUNICATION

756
00:26:56,960 --> 00:26:57,280
MATERIAL.

757
00:26:57,280 --> 00:27:02,200
SO WE DID SEVERAL ADJUSTMENTS TO

758
00:27:02,200 --> 00:27:03,080
OVERCOME THIS PROBLEM, INCLUDING

759
00:27:03,080 --> 00:27:04,720
THE DEVELOPMENT OF A

760
00:27:04,720 --> 00:27:06,680
COMPUTER-BASED TRAINING SYSTEM

761
00:27:06,680 --> 00:27:09,440
ONLINE AND OFFLINE, AND

762
00:27:09,440 --> 00:27:10,400
MONITORING AND SUPERVISION

763
00:27:10,400 --> 00:27:12,280
SYSTEM.

764
00:27:12,280 --> 00:27:13,680
AND OF COURSE THE COMMUNICATION

765
00:27:13,680 --> 00:27:16,440
MATERIAL WERE VALIDATED AND WERE

766
00:27:16,440 --> 00:27:17,280
FORMULATED BEFORE THEY WERE

767
00:27:17,280 --> 00:27:17,760
SCALING UP.

768
00:27:17,760 --> 00:27:19,800
SO THE STRATEGY WAS SCALE UP AND

769
00:27:19,800 --> 00:27:23,120
THE TRAINING REACHED ALMOST

770
00:27:23,120 --> 00:27:24,840
200,000 PHYSICIAN AND NURSES

771
00:27:24,840 --> 00:27:29,440
THAT PROVIDE SERVICES TO THE

772
00:27:29,440 --> 00:27:29,760
POPULATION.

773
00:27:29,760 --> 00:27:31,200
THIS WAS INTEGRATED IN THE

774
00:27:31,200 --> 00:27:32,480
PRIMARY HEALTHCARE SERVICES, IT

775
00:27:32,480 --> 00:27:40,360
WAS ADOPTED INTO THREE OF THE

776
00:27:40,360 --> 00:27:41,680
CRITICAL HEALTH -- WORKFORCE AND

777
00:27:41,680 --> 00:27:42,000
FINANCING.

778
00:27:42,000 --> 00:27:44,960
AND THE KEY ASPECT THAT WE

779
00:27:44,960 --> 00:27:47,400
IDENTIFY FOR SCALE-UP AND AT A

780
00:27:47,400 --> 00:27:52,120
NATIONAL LEVEL AND TO ENSURE

781
00:27:52,120 --> 00:27:54,600
FUNDS FOR IMPLEMENTATION, AS

782
00:27:54,600 --> 00:27:57,680
MENTIONED, A SCALE-UP MINDSET

783
00:27:57,680 --> 00:27:59,600
FROM THE BEGINNING OF THE

784
00:27:59,600 --> 00:28:03,040
PROGRAM, AND WE WERE -- SCALING

785
00:28:03,040 --> 00:28:03,560
UP.

786
00:28:03,560 --> 00:28:05,640
THE IMPLEMENTATION RESEARCH WITH

787
00:28:05,640 --> 00:28:07,200
A MIXED METHOD APPROACH THROUGH

788
00:28:07,200 --> 00:28:09,240
THE LIFE OF THE PROGRAM YEN RATE

789
00:28:09,240 --> 00:28:10,600
EVIDENCE FOR THE SCALING UP AND

790
00:28:10,600 --> 00:28:11,760
FOR MAINTAINING THE PROGRAM

791
00:28:11,760 --> 00:28:13,880
THROUGH THE 20 YEARS.

792
00:28:13,880 --> 00:28:17,560
THE POLITICAL WILL MOMENTUM AND

793
00:28:17,560 --> 00:28:18,680
A SYSTEMATIC COORDINATION

794
00:28:18,680 --> 00:28:20,200
THROUGH A NATIONAL COORDINATION

795
00:28:20,200 --> 00:28:24,560
OF THE PROGRAM WAS ALSO A KEY

796
00:28:24,560 --> 00:28:26,880
ASPECT FOR SCALING UP.

797
00:28:26,880 --> 00:28:30,800
AND MOST IMPORTANT, THE ENABLING

798
00:28:30,800 --> 00:28:32,360
ENVIRONMENT FOR USE OF THE

799
00:28:32,360 --> 00:28:34,240
EVIDENCE FROM THE IMPLEMENTATION

800
00:28:34,240 --> 00:28:36,040
SCIENCE TO IMPROVE DESIGN AND

801
00:28:36,040 --> 00:28:37,360
IMPLEMENTATION THROUGH THE LIFE

802
00:28:37,360 --> 00:28:39,440
OF THE PROGRAM, TO ENSURE THE

803
00:28:39,440 --> 00:28:40,840
COMMITMENT FOR MOVING FROM THE

804
00:28:40,840 --> 00:28:44,280
PILOT STUDY AND FOR SCALING UP

805
00:28:44,280 --> 00:28:46,800
TO NATIONAL LEVEL, AND TO ENSURE

806
00:28:46,800 --> 00:28:48,440
THE FUND FOR DESIGNING

807
00:28:48,440 --> 00:28:50,520
IMPLEMENTATION AND EVALUATION,

808
00:28:50,520 --> 00:28:55,400
AND ALSO THE LOCAL

809
00:28:55,400 --> 00:29:00,200
MANUFACTURE -- AND DISTRIBUTION

810
00:29:00,200 --> 00:29:03,600
SYSTEM FOR THE MICRO NUTRIENT

811
00:29:03,600 --> 00:29:04,400
COMPONENT, SUPPLEMENTATION

812
00:29:04,400 --> 00:29:06,880
COMPONENT OF THE STRATEGY.

813
00:29:06,880 --> 00:29:09,520
THE MAIN STRENGTH THAT WE

814
00:29:09,520 --> 00:29:11,480
IDENTIFIED WAS FOR ONE SIDE THE

815
00:29:11,480 --> 00:29:12,240
LOCAL PRODUCTION OF THE

816
00:29:12,240 --> 00:29:13,800
SUPPLEMENT DUE TO THE HIGH

817
00:29:13,800 --> 00:29:17,920
DEMAND BECAUSE IT WAS

818
00:29:17,920 --> 00:29:19,480
INCORPORATED IN THE SOCIAL

819
00:29:19,480 --> 00:29:23,520
PROTECTION PROGRAM THROUGH THE

820
00:29:23,520 --> 00:29:24,720
HEALTH SYSTEM, SO IT WAS

821
00:29:24,720 --> 00:29:26,120
PROVIDING SUPPLEMENT TO MORE

822
00:29:26,120 --> 00:29:27,480
THAN 5 MILLION FAMILIES, AND

823
00:29:27,480 --> 00:29:28,880
THESE CONTRIBUTE TO THE

824
00:29:28,880 --> 00:29:29,640
APPROPRIATION BY THE GOVERNMENT

825
00:29:29,640 --> 00:29:31,520
AND ITS SUSTAINABILITY.

826
00:29:31,520 --> 00:29:34,000
SO THE LOCAL MANUFACTURING.

827
00:29:34,000 --> 00:29:37,000
THE GOVERNANCE SYSTEM WITH A

828
00:29:37,000 --> 00:29:38,840
CONSTANT INTERRELATION BETWEEN

829
00:29:38,840 --> 00:29:42,800
IMPLEMENTERS, EVALUATORS,

830
00:29:42,800 --> 00:29:43,840
FACILITATED CONTINUITY IN

831
00:29:43,840 --> 00:29:44,840
FUNDING, COMMITMENT TO

832
00:29:44,840 --> 00:29:49,560
EVALUATION AND CONTINUOUS

833
00:29:49,560 --> 00:29:50,240
EVIDENCE-BASED IMPROVEMENT OF

834
00:29:50,240 --> 00:29:51,640
THE PROGRAM.

835
00:29:51,640 --> 00:29:53,280
AND THE CONDITIONALITY WHICH

836
00:29:53,280 --> 00:30:00,720
INCREASED THE ACCESS TO

837
00:30:00,720 --> 00:30:02,680
HEALTH -- AND THIS LEADS TO THE

838
00:30:02,680 --> 00:30:04,440
LARGE IMPACT OF THE -- THE LARGE

839
00:30:04,440 --> 00:30:05,320
SCALE IMPACT OF THE PROGRAM.

840
00:30:05,320 --> 00:30:07,600
AMONG THE CHALLENGES, WELL, WE

841
00:30:07,600 --> 00:30:11,120
HAVE THAT FROM 2012 TO 2019, WE

842
00:30:11,120 --> 00:30:14,280
START TO SEE AN ACCEPTANCE OF

843
00:30:14,280 --> 00:30:15,600
THE IMPROVEMENT.

844
00:30:15,600 --> 00:30:18,560
WE DO NOT KNOW QUITE SURE WHY

845
00:30:18,560 --> 00:30:22,480
THIS WAS BECAUSE THE PROGRAM WAS

846
00:30:22,480 --> 00:30:24,320
DISCONTINUED, BUT THE EXPERTS

847
00:30:24,320 --> 00:30:26,520
AGREE THAT IT COULD BE TO THE

848
00:30:26,520 --> 00:30:30,680
SCALING UP PROCESS, IT WAS SUCH

849
00:30:30,680 --> 00:30:33,520
A BIGGING SCALE TO WHOLE FAMILY,

850
00:30:33,520 --> 00:30:39,000
THE COMPLEXITY OF -- FOUR KIND

851
00:30:39,000 --> 00:30:41,280
OF SUPPLEMENTS AND THE

852
00:30:41,280 --> 00:30:43,040
MONITORING OF SUPERVISION OF THE

853
00:30:43,040 --> 00:30:44,080
STRATEGY THAT MADE OPERATION

854
00:30:44,080 --> 00:30:44,680
MORE DIFFICULT.

855
00:30:44,680 --> 00:30:46,200
ALSO, WE CANNOT FORGET THAT

856
00:30:46,200 --> 00:30:49,160
CHANGES IN DIET PATTERNS WITH

857
00:30:49,160 --> 00:30:50,480
MARKED INSCREES IN THE

858
00:30:50,480 --> 00:30:52,760
CONSUMPTION OF OLDER PROCESSED

859
00:30:52,760 --> 00:30:55,040
FOOD IN THE COUNTRY OF LOW

860
00:30:55,040 --> 00:30:56,600
NUTRITIONAL QUALITY, AND MEXICO

861
00:30:56,600 --> 00:30:57,920
IS ONE OF THE COUNTRIES THAT

862
00:30:57,920 --> 00:31:01,440
HAVE THE BIGGEST ULTRA PR PROCED

863
00:31:01,440 --> 00:31:03,920
FOOD CONSUMPTION IN THE WORLD.

864
00:31:03,920 --> 00:31:05,120
SO TO FINISH, SOME OF THE

865
00:31:05,120 --> 00:31:07,520
LESSONS LEARNED WAS THAT, WELL,

866
00:31:07,520 --> 00:31:10,280
AS YOU KNOW INTEGRATIVE MATERNAL

867
00:31:10,280 --> 00:31:12,480
AND CHILD NUTRITION INTO PRIMARY

868
00:31:12,480 --> 00:31:16,760
HEALTHCARE SERVICES IS A COMPLEX

869
00:31:16,760 --> 00:31:18,600
TASK, BUT WHERE IMPLEMENTATION

870
00:31:18,600 --> 00:31:20,200
RESEARCH FACILITATE THE PROCESS

871
00:31:20,200 --> 00:31:24,040
AND ALLOW PROGRAMS INNOVATION

872
00:31:24,040 --> 00:31:25,720
AND THE SUSTAINABILITY OF THE

873
00:31:25,720 --> 00:31:27,560
PROGRAM.

874
00:31:27,560 --> 00:31:32,040
OH, THE ME SON WAS THAT WAS

875
00:31:32,040 --> 00:31:33,560
ALWAYS TRANSLATED AS YEN RATED

876
00:31:33,560 --> 00:31:34,400
INTO POLICY AND PROGRAM.

877
00:31:34,400 --> 00:31:35,640
FOR INSTANCE, THE EVIDENCE THAT

878
00:31:35,640 --> 00:31:37,840
WE GENERATE, WE PROPOSE TO TYPE

879
00:31:37,840 --> 00:31:40,120
OF SUPPLEMENTS BUT THE PROGRAM

880
00:31:40,120 --> 00:31:43,560
WANTS TO KEEP DIFFERENT

881
00:31:43,560 --> 00:31:45,480
FORMULATION OF SUPPLEMENTS, SO

882
00:31:45,480 --> 00:31:47,560
THIS COMPLICATES THE MANAGEMENT

883
00:31:47,560 --> 00:31:49,640
OF THE SUPPLEMENTS, AND THAT IN

884
00:31:49,640 --> 00:31:52,960
THE END, I'M MONITORING A

885
00:31:52,960 --> 00:31:54,880
SUPERVISION SYSTEM, BUT THIS WAS

886
00:31:54,880 --> 00:31:58,800
NOT IMPLEMENTED AS DESIGNED AND

887
00:31:58,800 --> 00:32:00,600
AS I SAID BEFORE, THIS MIGHT

888
00:32:00,600 --> 00:32:01,160
AFFECT THE RESULT OF THE

889
00:32:01,160 --> 00:32:05,080
PROGRAM.

890
00:32:05,080 --> 00:32:06,400
SO THANK YOU VERY MUCH FOR YOUR

891
00:32:06,400 --> 00:32:07,800
ATTENTION, AND NOW I WILL

892
00:32:07,800 --> 00:32:13,600
INTRODUCE OUR NEXT SPEAKER.

893
00:32:13,600 --> 00:32:17,440
SONI IS A RESEARCH FELLOW IN THE

894
00:32:17,440 --> 00:32:18,640
FOGARTY DIVISION OF THE

895
00:32:18,640 --> 00:32:19,840
INTERNATIONAL FOOD POLICY

896
00:32:19,840 --> 00:32:27,720
RESEARCH INSTITUTE.

897
00:32:27,720 --> 00:32:28,920
>>THANKS, ANNABELLE.

898
00:32:28,920 --> 00:32:39,280
>>HOLD ON ONE SECOND.

899
00:32:41,080 --> 00:32:42,680
>>GOOD AFTERNOON,
EVERYONE.

900
00:32:42,680 --> 00:32:44,120
I'LL BE PRESENTING ON A CASE

901
00:32:44,120 --> 00:32:46,120
STUDY OF IMPLEMENTATION SCIENCE

902
00:32:46,120 --> 00:32:47,520
APPLIED WITHIN A NUTRITION

903
00:32:47,520 --> 00:32:53,320
INTERVENTION STUDY IN ETHIOPIA.

904
00:32:53,320 --> 00:32:54,360
THE CASE I'LL BE PRESENTING ON

905
00:32:54,360 --> 00:32:57,600
IS BASED ON A LONG-TERM

906
00:32:57,600 --> 00:32:58,880
COLLABORATION THAT OUR TEAM HAS

907
00:32:58,880 --> 00:33:01,320
HAD WITH THE ALIVE & THRIVE
AS A

908
00:33:01,320 --> 00:33:02,280
RESEARCH PARTNER FOR OVER A

909
00:33:02,280 --> 00:33:03,400
DECADE.

910
00:33:03,400 --> 00:33:04,840
ALIVE & THRIVE IS A GLOBAL

911
00:33:04,840 --> 00:33:08,840
INITIATIVE TO SAVE LIVES,

912
00:33:08,840 --> 00:33:10,160
PREVENT ILLNESS AND ENSURE

913
00:33:10,160 --> 00:33:11,680
HEALTHY GROWTH OF MOTHERS,

914
00:33:11,680 --> 00:33:14,880
CHILDREN IN MULTIPLE COUNTRIES,

915
00:33:14,880 --> 00:33:19,360
WORKING TO STRENGTHEN DIVERSE

916
00:33:19,360 --> 00:33:20,120
SYSTEMS, PARTICULARLY APPLYING

917
00:33:20,120 --> 00:33:22,840
THE SOCIAL AND BEHAVIOR CHANGE

918
00:33:22,840 --> 00:33:25,240
FRAMEWORK AND POLICY ADVOCACY

919
00:33:25,240 --> 00:33:26,360
STRATEGIES.

920
00:33:26,360 --> 00:33:28,320
ALIVE & THRIVE HAS GONE
THROUGH

921
00:33:28,320 --> 00:33:29,400
SEVERAL PHASES AND GENERATIONS

922
00:33:29,400 --> 00:33:30,960
OF PROJECTS IN THE PAST 12

923
00:33:30,960 --> 00:33:32,000
YEARS, BUT AT THE FIRST PHASE OF

924
00:33:32,000 --> 00:33:34,440
THE WORK, WE CONDUCTED RESEARCH

925
00:33:34,440 --> 00:33:36,600
STUDIES TO EVALUATE LARGE SCALE

926
00:33:36,600 --> 00:33:38,960
INVENTIONS TO IMPROVE INFANT AND

927
00:33:38,960 --> 00:33:41,480
YOUNG CHILD FEEDING PRACTICES IN

928
00:33:41,480 --> 00:33:44,480
THREE COUNTRIES, INCLUDING EET

929
00:33:44,480 --> 00:33:46,360
ETHIOPIA, WHICH I'LL BE TALKING

930
00:33:46,360 --> 00:33:47,120
MOSTLY ABOUT TODAY.

931
00:33:47,120 --> 00:33:51,920
A RATIONALE FOR WORKING ON IYCF

932
00:33:51,920 --> 00:33:58,160
IN ETHIOPIA, IN 2011, ONLY HALF

933
00:33:58,160 --> 00:34:00,360
OF MOTHERS WITH INFANTS

934
00:34:00,360 --> 00:34:03,200
PRACTICED EARLY INITIATION OF

935
00:34:03,200 --> 00:34:06,400
BREASTFEEDING AND EXCLUSIVE

936
00:34:06,400 --> 00:34:07,800
BREASTFEEDING WHICH HAS NOW

937
00:34:07,800 --> 00:34:10,760
IMPROVED SIGNIFICANTLY TO 72%.

938
00:34:10,760 --> 00:34:12,840
LESS THAN HALF OF THE CHILDREN

939
00:34:12,840 --> 00:34:14,680
CONSUMED COMPLEMENTARY FOODS AT

940
00:34:14,680 --> 00:34:16,640
6 TO 8 MONTHS, AND ONLY 4% OF

941
00:34:16,640 --> 00:34:18,520
CHILDREN CONSUMED AT LEAST FOUR

942
00:34:18,520 --> 00:34:20,080
FOOD GROUPS, WHICH HAVE IMPROVED

943
00:34:20,080 --> 00:34:21,480
SINCE THEN BUT STILL REMAIN

944
00:34:21,480 --> 00:34:24,240
VERY, VERY LOW IN THE COUNTRY.

945
00:34:24,240 --> 00:34:29,960
IN 2011, 44% OF CHILDREN UNDER H

946
00:34:29,960 --> 00:34:31,800
RECENT DATA SHOW IS STILL ABOUT

947
00:34:31,800 --> 00:34:33,120
37% OR ABOUT ONE-THIRD OF

948
00:34:33,120 --> 00:34:34,040
CHILDREN OR MORE THAN ONE-THIRD

949
00:34:34,040 --> 00:34:36,840
OF CHILDREN.

950
00:34:36,840 --> 00:34:38,160
OUR OVERALL RESEARCH DESIGN IN

951
00:34:38,160 --> 00:34:40,200
EET COPE YA WAS A PRE/POST

952
00:34:40,200 --> 00:34:41,880
EVALUATION IN TWO PROGRAM AREAS.

953
00:34:41,880 --> 00:34:44,760
ONE IN THE SOUTH AND ONE IN THE

954
00:34:44,760 --> 00:34:47,040
NORTH.

955
00:34:47,040 --> 00:34:47,840
WITH TWO CROSS-SECTION SIGNAL

956
00:34:47,840 --> 00:34:53,000
SUSURVEYS, A BASELINE SURVEY IN

957
00:34:53,000 --> 00:34:54,280
2010 AND 2014.

958
00:34:54,280 --> 00:34:56,880
IN ETHIOPIA HE TIME OF OUR STUDY

959
00:34:56,880 --> 00:34:58,640
THE GOVERNMENT WAS OPPOSED TO

960
00:34:58,640 --> 00:34:59,640
RANDOMIZATION BUT SINCE THEN

961
00:34:59,640 --> 00:35:02,240
THEY'VE ALL BEEN CLUSTER

962
00:35:02,240 --> 00:35:03,440
RANDOMIZED CONTROL TRIALS.

963
00:35:03,440 --> 00:35:05,200
THE CORE INTERVENTIONS INCLUDED

964
00:35:05,200 --> 00:35:08,160
COUNSELING BY TWO ALL-FEMALE

965
00:35:08,160 --> 00:35:09,280
CADRES, HEALTH EXTENSION WORKERS

966
00:35:09,280 --> 00:35:11,000
WHO WORKED PRIMARILY AT THE

967
00:35:11,000 --> 00:35:12,320
LOCAL HEALTH POSTS, AND

968
00:35:12,320 --> 00:35:14,800
COMMUNITY VOLUNTEERS CALLED THE

969
00:35:14,800 --> 00:35:16,000
WOMEN'S DEVELOPMENT ARMY.

970
00:35:16,000 --> 00:35:18,240
THEY VEST ITED HOMES OF FAMILIES

971
00:35:18,240 --> 00:35:19,000
IN THEIR COMMUNITIES FOR HEALTH

972
00:35:19,000 --> 00:35:21,480
AND SANITATION SERVICES, AS WELL

973
00:35:21,480 --> 00:35:23,560
AS OTHER FUNCTIONS AND

974
00:35:23,560 --> 00:35:23,880
ACTIVITIES.

975
00:35:23,880 --> 00:35:25,520
COMMUNITY MEETINGS WERE HELD

976
00:35:25,520 --> 00:35:27,280
WITH MOTHERS AND FATHERS OF

977
00:35:27,280 --> 00:35:30,920
YOUNG CHILDREN AND TV AND RADIO

978
00:35:30,920 --> 00:35:33,400
SPOTS BLASTS IYCF MESSAGES.

979
00:35:33,400 --> 00:35:37,240
OUR PRIMARY STUDY OUTCOMES

980
00:35:37,240 --> 00:35:39,560
INCLUDED EIGHT WHO RECOMMENDED

981
00:35:39,560 --> 00:35:41,280
IYCF INDICATORS AMONG CHILDREN

982
00:35:41,280 --> 00:35:42,440
UNDER TWO YEARS AND STUNTING

983
00:35:42,440 --> 00:35:45,200
AMONG OLDER CHILDREN AGED 24 TO

984
00:35:45,200 --> 00:35:47,520
59 MONTHS, WHOSE NUTRITIONAL

985
00:35:47,520 --> 00:35:49,400
STATUS WAS EXPECTED TO HAVE

986
00:35:49,400 --> 00:35:50,600
BENEFITED FROM THE INTERVENTIONS

987
00:35:50,600 --> 00:35:57,520
TARGETED AT UNDER 2 YEARS OF

988
00:35:57,520 --> 00:35:58,280
AGE.

989
00:35:58,280 --> 00:35:59,400
FROM THE INCEPTION WE DEVELOPED

990
00:35:59,400 --> 00:36:01,360
A LEARNING AGENDA WITH ALIVE
&

991
00:36:01,360 --> 00:36:02,680
THRIVE THAT INCLUDED IMPACT

992
00:36:02,680 --> 00:36:04,400
EVALUATIONS AND STUDIES ON THE

993
00:36:04,400 --> 00:36:05,600
IMPLEMENTATION PROCESS.

994
00:36:05,600 --> 00:36:07,480
FORMATIVE RESEARCH AND

995
00:36:07,480 --> 00:36:08,640
STAKEHOLDER ENGAGEMENTS WERE

996
00:36:08,640 --> 00:36:10,000
DONE WITH THE ALIVE AND THRIVE

997
00:36:10,000 --> 00:36:11,960
TEAMS TO INFORM INTERVENTION

998
00:36:11,960 --> 00:36:16,320
DESIGN AT SCALE-UP, WHICH WAS A

999
00:36:16,320 --> 00:36:18,840
MAJOR PARTY FOR ALIVE &
THRIVE

1000
00:36:18,840 --> 00:36:19,600
IN THE START.

1001
00:36:19,600 --> 00:36:22,800
WE EMBEDDED IMPLEMENTATION

1002
00:36:22,800 --> 00:36:24,240
SCIENCE PRINCIPLES AND METHODS

1003
00:36:24,240 --> 00:36:27,400
IN RESEARCH WORK WHICH IS

1004
00:36:27,400 --> 00:36:29,120
DEMONSTRATED IN THE BOX,

1005
00:36:29,120 --> 00:36:31,960
INCLUDING DEVELOPING IMPACT

1006
00:36:31,960 --> 00:36:33,400
PATHWAYS OF HOW WE EXPECTED THE

1007
00:36:33,400 --> 00:36:34,480
INTERVENTIONS TO ACHIEVE IMPACT

1008
00:36:34,480 --> 00:36:36,480
IN EACH STUDY, WE COLLECTED DATA

1009
00:36:36,480 --> 00:36:41,360
MAPPED TO THESE PROGRAM IMPACT

1010
00:36:41,360 --> 00:36:43,760
PATHWAYS, WE LINKED PROCESS AND

1011
00:36:43,760 --> 00:36:45,560
IMPLEMENTATION STUDIES WITH

1012
00:36:45,560 --> 00:36:48,040
IMPLEMENTATION TIME LINES WHICH

1013
00:36:48,040 --> 00:36:50,120
INVOLVED EXAMINING MONITORING

1014
00:36:50,120 --> 00:36:51,880
DATA IN ROLLOUT, REACH AND

1015
00:36:51,880 --> 00:36:53,960
UPTAKE OF INTERVENTIONS AND WE

1016
00:36:53,960 --> 00:36:55,400
HAD CLOSE ENGAGEMENTS BETWEEN

1017
00:36:55,400 --> 00:36:56,680
OUR RESEARCH TEAM AND THE

1018
00:36:56,680 --> 00:36:57,680
PROGRAM IMPLEMENTATION AND

1019
00:36:57,680 --> 00:36:58,360
MANAGEMENT TEAMS.

1020
00:36:58,360 --> 00:37:00,120
ALSO IMPORTANTLY, THE PARTNERS

1021
00:37:00,120 --> 00:37:01,320
WERE COMMITTED TO DOCUMENTING

1022
00:37:01,320 --> 00:37:06,560
ALL OUR WORK IN VARIOUS FORMS,

1023
00:37:06,560 --> 00:37:07,880
PUBLISHING IN PEER REVIEWED

1024
00:37:07,880 --> 00:37:08,880
JOURNALS TO SHARE WITH THE

1025
00:37:08,880 --> 00:37:10,280
RESEARCH COMMUNITY AND A WIDER

1026
00:37:10,280 --> 00:37:11,640
AUDIENCE, AND TO DISSEMINATING

1027
00:37:11,640 --> 00:37:13,600
OUR FINDINGS WITH STAKEHOLDERS.

1028
00:37:13,600 --> 00:37:17,360
THIS APPROACH TO A LEARNING

1029
00:37:17,360 --> 00:37:18,640
AGENDA WAS PUBLISHED EARLY ON IN

1030
00:37:18,640 --> 00:37:22,040
THE PROGRAM.

1031
00:37:22,040 --> 00:37:23,800
THE ALIVE & THRIVE HAD A
STREA

1032
00:37:23,800 --> 00:37:25,840
TEE JIK FRAMEWORK, WHICH IS

1033
00:37:25,840 --> 00:37:27,400
APPLIED IN ALL OF ITS COUNTRY

1034
00:37:27,400 --> 00:37:28,160
PROGRAMS.

1035
00:37:28,160 --> 00:37:29,360
ITS CORE STRATEGIES ARE SHOWN

1036
00:37:29,360 --> 00:37:31,240
HERE IN THE DARK GREEN, WHICH

1037
00:37:31,240 --> 00:37:34,400
INCLUDED ADVOCACY, INTERPERSONAL

1038
00:37:34,400 --> 00:37:37,560
COMMUNICATION, AND COMMUNITY

1039
00:37:37,560 --> 00:37:38,560
MOBILIZATION, MASS COMMUNICATION

1040
00:37:38,560 --> 00:37:40,960
THROUGH TV, RADIO AND/OR

1041
00:37:40,960 --> 00:37:42,800
INTERNET IN CASE OF VIETNAM, AND

1042
00:37:42,800 --> 00:37:44,440
STRATEGIC USE OF DATA ALL TO

1043
00:37:44,440 --> 00:37:46,720
REINFORCE EXISTING DELIVERY

1044
00:37:46,720 --> 00:37:46,960
SYSTEMS.

1045
00:37:46,960 --> 00:37:48,160
THESE STRATEGIES WERE TARGETED

1046
00:37:48,160 --> 00:37:50,120
TO VARIOUS DECISION-MAKERS,

1047
00:37:50,120 --> 00:37:51,760
SERVICE PROVIDERS AND

1048
00:37:51,760 --> 00:37:53,520
BENEFICIARIES, AND THEY AIM TO

1049
00:37:53,520 --> 00:37:56,160
IMPROVE KNOWLEDGE AND SKILLS AND

1050
00:37:56,160 --> 00:37:57,240
THE ENABLING ENVIRONMENT IN

1051
00:37:57,240 --> 00:37:59,640
SUPPORT OF IMPROVED IYCF

1052
00:37:59,640 --> 00:38:00,120
PRACTICES.

1053
00:38:00,120 --> 00:38:03,280
AND IN EACH COUNTRY CONTEXT,

1054
00:38:03,280 --> 00:38:05,360
FORMATIVE RESEARCH WAS CONDUCTED

1055
00:38:05,360 --> 00:38:07,640
TO DESIGN SPECIFIC INTERVENTIONS

1056
00:38:07,640 --> 00:38:10,040
AND TO CONTEXTUALIZE TOOLS AND

1057
00:38:10,040 --> 00:38:10,280
MESSAGES.

1058
00:38:10,280 --> 00:38:12,880
IN THE CASE OF ETHIOPIA,

1059
00:38:12,880 --> 00:38:14,280
INTERVENTIONS FOCUSED ON SMALL,

1060
00:38:14,280 --> 00:38:15,960
DOABLE ACTIONS AND THEY CAME UP

1061
00:38:15,960 --> 00:38:18,040
WITH SEVEN EXCELLENT ACTIONS ON

1062
00:38:18,040 --> 00:38:20,000
IYCF PROMOTED BY THE HEALTH

1063
00:38:20,000 --> 00:38:20,760
EXTENSION WORKERS AND THE

1064
00:38:20,760 --> 00:38:22,520
COMMUNITY VOLUNTEERS, AS WELL AS

1065
00:38:22,520 --> 00:38:25,800
THROUGH THE TV AND RADIO SPOTS

1066
00:38:25,800 --> 00:38:26,800
REINFORCING THESE DIFFERENT

1067
00:38:26,800 --> 00:38:27,240
MESSAGES.

1068
00:38:27,240 --> 00:38:29,120
THIS STRATEGIC FRAMEWORK AND

1069
00:38:29,120 --> 00:38:30,600
APPROACH TO AN INTERVENTION

1070
00:38:30,600 --> 00:38:34,560
DESIGN WAS ALSO PUBLISHED BY OUR

1071
00:38:34,560 --> 00:38:39,920
ALIVE AND THRIVE PROGRAM TEAM.

1072
00:38:39,920 --> 00:38:43,960
AS MENTIONED EARLIER, WE'VE THEN

1073
00:38:43,960 --> 00:38:45,240
DEVELOPED PROGRAM PATHWAYS

1074
00:38:45,240 --> 00:38:47,280
TOGETHER WITH THE COUNTRY TEAM,

1075
00:38:47,280 --> 00:38:48,480
DURING IMPLEMENTATION, WE

1076
00:38:48,480 --> 00:38:49,440
COLLECTED DATA ALONG THESE

1077
00:38:49,440 --> 00:38:50,600
PATHWAYS TO BETTER UNDERSTAND

1078
00:38:50,600 --> 00:38:52,720
THE EXTENT OF IMPLEMENTATION AND

1079
00:38:52,720 --> 00:38:57,880
ANY GAPS IN THESE COMPONENTS.

1080
00:38:57,880 --> 00:38:59,400
WE USED PROGRAM MATERIALS AS A

1081
00:38:59,400 --> 00:39:01,160
WAY TO UNIQUELY TRACE PROGRAM

1082
00:39:01,160 --> 00:39:02,160
EXPOSURE AND REACH SINCE THE

1083
00:39:02,160 --> 00:39:03,440
INFORMATION ABOUT BREASTFEEDING

1084
00:39:03,440 --> 00:39:06,720
OR COMPLEMENTARY FEEDING IN

1085
00:39:06,720 --> 00:39:08,600
ITSELF WERE NOT NECESSARILY NEW

1086
00:39:08,600 --> 00:39:11,240
AND MAYBE RECEIVED FROM OTHER

1087
00:39:11,240 --> 00:39:11,440
SOURCES.

1088
00:39:11,440 --> 00:39:12,760
WE OBSERVED EXPOSURE AND RECEIPT

1089
00:39:12,760 --> 00:39:14,280
OF THE TOOLS WERE HIGH AMONG

1090
00:39:14,280 --> 00:39:15,920
HEALTH WORKERS AND SUPERVISORS,

1091
00:39:15,920 --> 00:39:17,680
BUT LESS AT THE COMMUNITY LEVEL

1092
00:39:17,680 --> 00:39:18,880
AMONG VOLUNTEERS AND THE

1093
00:39:18,880 --> 00:39:19,240
MOTHERS.

1094
00:39:19,240 --> 00:39:21,680
THEN WE ACTUALLY SHOWED THE

1095
00:39:21,680 --> 00:39:22,720
SEVEN EXCELLENT ACTIONS TOOL

1096
00:39:22,720 --> 00:39:27,000
WITH MESSAGES COVERED AND THE

1097
00:39:27,000 --> 00:39:27,880
IDENTIFIED GAPS WHERE THE

1098
00:39:27,880 --> 00:39:29,160
MESSAGES WERE NOT RECOGNIZED OR

1099
00:39:29,160 --> 00:39:30,600
NOT CORRECTLY UNDERSTOOD, SUCH

1100
00:39:30,600 --> 00:39:33,680
AS ON EBF OR EXCLUSIVE

1101
00:39:33,680 --> 00:39:34,880
BREASTFEEDING AND ABOUT FEEDING

1102
00:39:34,880 --> 00:39:40,440
DURING ILLNESS.

1103
00:39:40,440 --> 00:39:44,720
WE ALSO PUBLISHED THESE FINDINGS

1104
00:39:44,720 --> 00:39:45,600
AND FIDELITY.

1105
00:39:45,600 --> 00:39:47,240
AT END LINE OUR EVALUATION

1106
00:39:47,240 --> 00:39:48,560
RESULTS SHOW SIGNIFICANT

1107
00:39:48,560 --> 00:39:50,680
IMPROVEMENTS ACROSS ALL OF THE

1108
00:39:50,680 --> 00:39:52,280
IYCF PRACTICES IN THE

1109
00:39:52,280 --> 00:39:55,560
INTERVENTION AREAS, HOWEVER, WE

1110
00:39:55,560 --> 00:39:56,520
OBSERVED NO SIGNIFICANT

1111
00:39:56,520 --> 00:39:57,520
IMPROVEMENTS IN CHILD GROWTH.

1112
00:39:57,520 --> 00:39:59,400
SO ALONGSIDE THESE RESULTS, WE

1113
00:39:59,400 --> 00:40:01,520
ALSO CONDUCTED PLAUSIBILITY

1114
00:40:01,520 --> 00:40:03,600
ANALYSIS TO UNPACK OUR FINDINGS,

1115
00:40:03,600 --> 00:40:07,160
WHICH WE DETAILED IN AN ANALYSIS

1116
00:40:07,160 --> 00:40:08,080
PLAN.

1117
00:40:08,080 --> 00:40:11,360
WE TRACED THE CHANGES ALONG THE

1118
00:40:11,360 --> 00:40:13,440
PROGRAM PATHWAY AND USED

1119
00:40:13,440 --> 00:40:14,200
DOSE-RESPONSE ANALYSIS TO

1120
00:40:14,200 --> 00:40:16,960
FURTHER EXAMINE THE RELATIONSHIP

1121
00:40:16,960 --> 00:40:18,640
BETWEEN PROGRAM EXPOSURE AND

1122
00:40:18,640 --> 00:40:18,920
OUTCOMES.

1123
00:40:18,920 --> 00:40:22,440
TO YOUR RIGHT IS A TABLE ON THE

1124
00:40:22,440 --> 00:40:24,760
ASSOCIATION BETWEEN EXPOSURE

1125
00:40:24,760 --> 00:40:27,880
INTENSITY IN TERMS OF CONTACTS

1126
00:40:27,880 --> 00:40:30,560
AND RECALL OF KEY MESSAGES AND

1127
00:40:30,560 --> 00:40:30,840
OUTCOMES.

1128
00:40:30,840 --> 00:40:32,520
THERE WAS LOW EXPOSURE TO A

1129
00:40:32,520 --> 00:40:33,840
SINGLE INTERVENTION BUT EXPOSURE

1130
00:40:33,840 --> 00:40:35,280
TO MULTIPLE CHANNELS AT HEALTH

1131
00:40:35,280 --> 00:40:36,360
POSTS, IN THE COMMUNITY, THROUGH

1132
00:40:36,360 --> 00:40:43,240
MASS MEDIA, WITH ODDS OF

1133
00:40:43,240 --> 00:40:44,680
ACHIEVING HIGHER OUTCOMES.

1134
00:40:44,680 --> 00:40:46,640
THEN AFTER END LINE WE HELD

1135
00:40:46,640 --> 00:40:47,240
DISSEMINATION MEETINGS

1136
00:40:47,240 --> 00:40:48,600
PARTICULARLY WITH THE GOVERNMENT

1137
00:40:48,600 --> 00:40:49,760
OFFICIALS, PROGRAM IMPLEMENTERS

1138
00:40:49,760 --> 00:40:51,400
AND OTHER COUNTRY STAKEHOLDERS,

1139
00:40:51,400 --> 00:40:54,120
AND THE ALIVE AND THRIVE TEAM

1140
00:40:54,120 --> 00:40:55,800
CONTINUED TO DISSEMINATE AND

1141
00:40:55,800 --> 00:40:57,520
ADAPT THROUGH IYCF TOOLS AND

1142
00:40:57,520 --> 00:40:58,600
MATERIALS IN OTHER REGIONS.

1143
00:40:58,600 --> 00:41:01,360
FINDINGS FROM THIS STUDY LED TO

1144
00:41:01,360 --> 00:41:03,240
ANOTHER STUDY SPECIFICALLY

1145
00:41:03,240 --> 00:41:06,920
FOCUSED ON TACKLING KIELD CHILD

1146
00:41:06,920 --> 00:41:08,480
FEEDING DURING FASTING.

1147
00:41:08,480 --> 00:41:12,120
ALSO THE AGRICULTURAL SECTOR WAS

1148
00:41:12,120 --> 00:41:12,400
ENGAGED.

1149
00:41:12,400 --> 00:41:14,280
THEN WE EXPANDED TO OTHER TARGET

1150
00:41:14,280 --> 00:41:14,640
GROUPS.

1151
00:41:14,640 --> 00:41:16,280
WE RECENTLY CONDUCTED A

1152
00:41:16,280 --> 00:41:18,240
FEASIBILITY STUDY TO STRENGTHEN

1153
00:41:18,240 --> 00:41:20,400
MATERNAL NUTRITION INTERVENTIONS

1154
00:41:20,400 --> 00:41:22,000
DURING ANTENATAL CARE IN TWO

1155
00:41:22,000 --> 00:41:24,400
REGIONS IN THE COUNTRY.

1156
00:41:24,400 --> 00:41:26,040
AS WELL AS A FEEDABILITY STUDY

1157
00:41:26,040 --> 00:41:30,280
ON ADOLESCENT NUTRITION

1158
00:41:30,280 --> 00:41:31,160
INTERVENTIONS IN TWO REGIONS.

1159
00:41:31,160 --> 00:41:32,680
THE CYCLE HAS BEEN ON LEARNING

1160
00:41:32,680 --> 00:41:33,880
FROM IMPLEMENTATION RESEARCH ON

1161
00:41:33,880 --> 00:41:35,880
HOW TO STRENGTHEN NUTRITION

1162
00:41:35,880 --> 00:41:38,280
INTERVENTIONS THROUGH EXISTING

1163
00:41:38,280 --> 00:41:40,360
SYSTEMS, DOCUMENTING AND

1164
00:41:40,360 --> 00:41:41,560
DISSEMINATING ADAPTING AND

1165
00:41:41,560 --> 00:41:46,720
SCALING UP.

1166
00:41:46,720 --> 00:41:48,240
HERE I'VE TAKEN THIS NICE SLIDE

1167
00:41:48,240 --> 00:41:50,440
FROM OUR ALIVE AND THRIVE

1168
00:41:50,440 --> 00:41:51,560
COLLEAGUES TO SHARE THE GLOBAL

1169
00:41:51,560 --> 00:41:53,840
LEARNING AGENDA AS THIS WORK

1170
00:41:53,840 --> 00:41:55,800
GOES BEYOND JUST ETHIOPIA.

1171
00:41:55,800 --> 00:41:57,880
WE'VE PARTNERED ON

1172
00:41:57,880 --> 00:42:01,040
IMPLEMENTATION AND EVALUATION

1173
00:42:01,040 --> 00:42:03,280
RESEARCH, AS VIETNAM, BANGLADESH

1174
00:42:03,280 --> 00:42:05,480
AND ETHIOPIA, BROADER LEARNING

1175
00:42:05,480 --> 00:42:07,000
AGENDA TO BUILD A PROOF OF

1176
00:42:07,000 --> 00:42:09,520
CONCEPT OF LARGE SCALE SPCC

1177
00:42:09,520 --> 00:42:12,480
PROGRAM, ADAPTING TO NEW

1178
00:42:12,480 --> 00:42:13,920
CONTEXTS, DIFFERENT DELIVERY

1179
00:42:13,920 --> 00:42:15,320
PLATFORMS, VARIOUS SECTORS ON

1180
00:42:15,320 --> 00:42:17,320
NUTRITION TOPICS, THEN

1181
00:42:17,320 --> 00:42:18,400
REPLICATING A SCALING UP WITH

1182
00:42:18,400 --> 00:42:23,760
MORE PARTNERS AND COLLABORATORS.

1183
00:42:23,760 --> 00:42:25,760
FINALLY I'LL CLOSE WITH A FEW

1184
00:42:25,760 --> 00:42:26,200
TAKEAWAYS.

1185
00:42:26,200 --> 00:42:28,600
WE NEED TO GENERATE DATA FOR

1186
00:42:28,600 --> 00:42:29,240
DECISION-MAKING ALONG EVERY STEP

1187
00:42:29,240 --> 00:42:31,800
OF OUR INTERVENTION WORK.

1188
00:42:31,800 --> 00:42:33,200
FOCUS SHOULD BE ON COLLECTING

1189
00:42:33,200 --> 00:42:34,280
INFORMATION ABOUT WHAT WORKS BUT

1190
00:42:34,280 --> 00:42:36,160
ALSO WHAT DOES NOT WORK.

1191
00:42:36,160 --> 00:42:38,120
AND I THINK ANNABELLE ALSO

1192
00:42:38,120 --> 00:42:40,040
ILLUSTRATED ALL OF THIS.

1193
00:42:40,040 --> 00:42:41,080
ALONG THE WAY, THERE NEEDS TO BE

1194
00:42:41,080 --> 00:42:43,160
TOUCH POINTS FOR COMMUNICATING

1195
00:42:43,160 --> 00:42:44,600
FINDINGS WITH DIFFERENT

1196
00:42:44,600 --> 00:42:46,680
STAKEHOLDERS, AND LASTLY,

1197
00:42:46,680 --> 00:42:47,480
IMPLEMENTATION RESEARCH REQUIRES

1198
00:42:47,480 --> 00:42:48,520
DEDICATED FUNDING AND TRUE PARTS

1199
00:42:48,520 --> 00:42:51,840
NER SHIPS.

1200
00:42:51,840 --> 00:42:56,120
TTRUEPARTNERSHIPS.

1201
00:42:56,120 --> 00:42:57,320
THANKS FOR YOUR ATTENTION.

1202
00:42:57,320 --> 00:42:59,520
I CAN'T ACKNOWLEDGE ALL OF THEM

1203
00:42:59,520 --> 00:43:02,480
BY NAME BUT SOME KEY GROUPS

1204
00:43:02,480 --> 00:43:05,840
INCLUDE OUR TEAM, UNIVERSITY OF

1205
00:43:05,840 --> 00:43:09,920
SOUTH CAROLINA, ALIVE &
THRIVE

1206
00:43:09,920 --> 00:43:11,240
IN WASHINGTON, D.C. AND

1207
00:43:11,240 --> 00:43:12,440
ETHIOPIA, ALL OUR STUDY

1208
00:43:12,440 --> 00:43:13,880
PARTICIPANTS AND OF COURSE

1209
00:43:13,880 --> 00:43:15,280
FUNDING FOR OUR RESEARCH WORK

1210
00:43:15,280 --> 00:43:18,160
FROM THE BILL AND MELINDA GATES.

1211
00:43:18,160 --> 00:43:19,240
BACK TO YOU FOR THE PANEL

1212
00:43:19,240 --> 00:43:19,520
DISCUSSION.

1213
00:43:19,520 --> 00:43:21,520
>>THANK YOU SO MUCH,
SUNNY, ED

1214
00:43:21,520 --> 00:43:22,120
AND ANNABELLE.

1215
00:43:22,120 --> 00:43:24,760
I'M GOING TO ASK ALL OF YOU TO

1216
00:43:24,760 --> 00:43:26,480
KIND OF COME BACK AND GET OUR

1217
00:43:26,480 --> 00:43:27,160
DISCUSSION STARTED.

1218
00:43:27,160 --> 00:43:28,880
I ALSO WANT TO VERY MUCH WELCOME

1219
00:43:28,880 --> 00:43:30,200
ANDREA WARREN, THE NUTRITION

1220
00:43:30,200 --> 00:43:32,280
RESEARCH ADVISOR AT THE BUREAU

1221
00:43:32,280 --> 00:43:35,240
OF HUMAN YAIR TAN ASSISTANCE AT

1222
00:43:35,240 --> 00:43:39,400
USAID AND APRIL LOWE AT THE

1223
00:43:39,400 --> 00:43:40,040
NATIONAL CANCER INSTITUTE, WHO

1224
00:43:40,040 --> 00:43:41,840
WILL ALSO BE JOINING US.

1225
00:43:41,840 --> 00:43:45,120
SO I THINK BUILDING ON THE

1226
00:43:45,120 --> 00:43:46,320
PRESENTATIONS THAT WE JUST HEARD

1227
00:43:46,320 --> 00:43:50,080
AND I THINK ECHOING SOME OF THE

1228
00:43:50,080 --> 00:43:50,720
QUESTIONS THAT WE'RE HEARING

1229
00:43:50,720 --> 00:43:52,120
FROM BOTH THE AUDIENCE AND THAT

1230
00:43:52,120 --> 00:43:54,120
I THINK WE HEAR GENERALLY AROUND

1231
00:43:54,120 --> 00:43:54,760
IMPLEMENTATION SCIENCE, I'M

1232
00:43:54,760 --> 00:43:56,080
GOING TO OPEN US WITH A QUESTION

1233
00:43:56,080 --> 00:43:57,560
ABOUT HOW DO WE ACTUALLY

1234
00:43:57,560 --> 00:43:59,480
FACILITATE THE USE AND

1235
00:43:59,480 --> 00:44:00,640
APPLICATION OF IMPLEMENTATION

1236
00:44:00,640 --> 00:44:03,400
SCIENCE AND HOW CAN WE ENSURE

1237
00:44:03,400 --> 00:44:03,960
THAT IMPLEMENTATION SCIENCE

1238
00:44:03,960 --> 00:44:05,800
CONTRIBUTES TO LONGER-TERM

1239
00:44:05,800 --> 00:44:06,640
SUSTAINABILITY?

1240
00:44:06,640 --> 00:44:09,680
ANDREA, I'LL START WITH YOU.

1241
00:44:09,680 --> 00:44:12,200
>>THANKS, SUSAN.

1242
00:44:12,200 --> 00:44:13,400
GREAT.

1243
00:44:13,400 --> 00:44:15,360
SO YEAH, SO HOW CAN WE

1244
00:44:15,360 --> 00:44:16,800
FACILITATE THE USE AND

1245
00:44:16,800 --> 00:44:18,560
APPLICATION OF IMPLEMENTATION

1246
00:44:18,560 --> 00:44:19,000
SCIENCE?

1247
00:44:19,000 --> 00:44:24,240
IT'S A GREAT QUESTION.

1248
00:44:24,240 --> 00:44:26,200
SO US -- AID FUNDS BOTH RESEARCH

1249
00:44:26,200 --> 00:44:27,320
AND PROGRAMMING SO FOR THIS

1250
00:44:27,320 --> 00:44:28,200
QUESTION, I'LL SPEAK TO THE

1251
00:44:28,200 --> 00:44:30,160
PROGRAMMING SIDE.

1252
00:44:30,160 --> 00:44:32,480
AND I THINK AS ED NOTED, IT'S

1253
00:44:32,480 --> 00:44:35,640
REALLY IMPORTANT TO BE

1254
00:44:35,640 --> 00:44:37,440
INTENTIONAL ABOUT WEAVING

1255
00:44:37,440 --> 00:44:38,080
IMPLEMENTATION SCIENCE INTO

1256
00:44:38,080 --> 00:44:39,200
PROGRAM DESIGN FROM THE VERY

1257
00:44:39,200 --> 00:44:40,160
BEGINNING.

1258
00:44:40,160 --> 00:44:44,120
SO AS AN EXAMPLE OF THIS, MY

1259
00:44:44,120 --> 00:44:46,080
BUREAU, BUREAU FOR HUMANITARIAN

1260
00:44:46,080 --> 00:44:47,960
ASSISTANCE, FUNDS FIVE-YEAR

1261
00:44:47,960 --> 00:44:50,480
MULTI-SECTORAL RESILIENCE

1262
00:44:50,480 --> 00:44:50,920
PROGRAMMING.

1263
00:44:50,920 --> 00:44:53,080
THESE ARE CALLED RESILIENCE FOOD

1264
00:44:53,080 --> 00:44:55,200
SECURITY ACTIVITIES OR RIFSAs,

1265
00:44:55,200 --> 00:44:56,560
AND WITHIN THAT FIVE-YEAR

1266
00:44:56,560 --> 00:45:00,320
PROGRAM CYCLE, THE FIRST YEAR IS

1267
00:45:00,320 --> 00:45:02,880
USUALLY DEDICATED TO LEARNING,

1268
00:45:02,880 --> 00:45:04,320
SO IMPLEMENTING PARTNERS CAN USE

1269
00:45:04,320 --> 00:45:08,800
THIS TIME TO PILOT SPECIFIC

1270
00:45:08,800 --> 00:45:10,000
APPROACHES OR DO FORMATIVE

1271
00:45:10,000 --> 00:45:13,960
RESEARCH OR COMMUNITY

1272
00:45:13,960 --> 00:45:15,800
CONSULTATIONS TO BETTER

1273
00:45:15,800 --> 00:45:18,880
CONTEXTUALIZE THEIR INTERVENTION

1274
00:45:18,880 --> 00:45:21,720
MATERIALS OR APPROACHES OR THEIR

1275
00:45:21,720 --> 00:45:22,160
TARGETING.

1276
00:45:22,160 --> 00:45:23,760
WE CALL THIS THE REFINE AND

1277
00:45:23,760 --> 00:45:27,120
IMPLEMENT APPROACH, AND THE

1278
00:45:27,120 --> 00:45:28,960
INTENTION IS REALLY JUST TO HELP

1279
00:45:28,960 --> 00:45:30,520
IMPLEMENTING PARTNERS DESIGN

1280
00:45:30,520 --> 00:45:32,160
MORE SUSTAINABILITY AND RELEVANT

1281
00:45:32,160 --> 00:45:33,120
INTERVENTIONS.

1282
00:45:33,120 --> 00:45:35,760
SO FROM THE DONOR PERSPECTIVE,

1283
00:45:35,760 --> 00:45:38,760
THAT'S ONE WAY WE CAN AND DO

1284
00:45:38,760 --> 00:45:39,960
FACILITATE THE USE AND

1285
00:45:39,960 --> 00:45:44,200
APPLICATION OF IMPLEMENTATION

1286
00:45:44,200 --> 00:45:44,640
SCIENCE.

1287
00:45:44,640 --> 00:45:49,920
TO THE SECOND QUESTION ABOUT

1288
00:45:49,920 --> 00:45:51,240
SUSTAINABILITY, SO THAT'S A BIG

1289
00:45:51,240 --> 00:45:52,880
CONCEPT, SO I'LL JUST REFER HERE

1290
00:45:52,880 --> 00:45:55,280
TO SUSTAINABILITY IN TERMS OF

1291
00:45:55,280 --> 00:45:57,720
PROGRAM LONGEVITY.

1292
00:45:57,720 --> 00:45:59,680
I THINK AS ANNABELLE ILLUSTRATED

1293
00:45:59,680 --> 00:46:03,720
SO WELL, IT REALLY BENEFITS A

1294
00:46:03,720 --> 00:46:05,400
PROGRAM AND IT BENEFITS

1295
00:46:05,400 --> 00:46:07,040
DECISION-MAKERS TO HAVE A MORE

1296
00:46:07,040 --> 00:46:10,640
NUANCED UNDERSTANDING OF HOW AND

1297
00:46:10,640 --> 00:46:12,320
WHY A PROGRAM DOES AND DOESN'T

1298
00:46:12,320 --> 00:46:12,960
WORK.

1299
00:46:12,960 --> 00:46:15,920
SUNNY ALSO POINTED THAT OUT IN

1300
00:46:15,920 --> 00:46:18,120
HER EXAMPLE.

1301
00:46:18,120 --> 00:46:19,320
BUT IMPLEMENTATION SCIENCE, IT

1302
00:46:19,320 --> 00:46:22,040
REALLY JUST ALLOWS FOR SMARTER

1303
00:46:22,040 --> 00:46:23,920
ADAPTIVE MANAGEMENT AND COURSE

1304
00:46:23,920 --> 00:46:25,440
CORRECTION WHERE NEEDED AND,

1305
00:46:25,440 --> 00:46:27,560
WHEN DONE WELL, IT ALSO IMPROVES

1306
00:46:27,560 --> 00:46:29,200
BUY-IN AND UPTAKE BY

1307
00:46:29,200 --> 00:46:32,080
STAKEHOLDERS AT ALL LEVELS.

1308
00:46:32,080 --> 00:46:33,840
DONORS, IMPLEMENTERS AND

1309
00:46:33,840 --> 00:46:38,520
PARTICIPANTS, AT KEY POINTS IN

1310
00:46:38,520 --> 00:46:38,760
TIME.

1311
00:46:38,760 --> 00:46:40,280
SO I THINK I'LL LEAVE IT THERE,

1312
00:46:40,280 --> 00:46:44,360
AND MAYBE PASS IT OVER TO APRIL.

1313
00:46:44,360 --> 00:46:44,680
>>GREAT.

1314
00:46:44,680 --> 00:46:45,480
THANK YOU SO MUCH.

1315
00:46:45,480 --> 00:46:48,960
YOU KNOW, I AM JUST SO STRUCK BY

1316
00:46:48,960 --> 00:46:51,600
THESE EXAMPLES SHARED BY OUR

1317
00:46:51,600 --> 00:46:52,160
PANELISTS.

1318
00:46:52,160 --> 00:46:53,680
YOU KNOW, FOR ME, THERE ARE A

1319
00:46:53,680 --> 00:46:55,880
COUPLE OF KEY PIECES THAT I TOOK

1320
00:46:55,880 --> 00:46:59,640
AWAY IN TERMS OF IMPACT OF

1321
00:46:59,640 --> 00:47:00,520
IMPLEMENTATION SCIENCE AND ITS

1322
00:47:00,520 --> 00:47:01,680
POTENTIAL.

1323
00:47:01,680 --> 00:47:05,440
SO ONE IS WITH ANNABELLE'S

1324
00:47:05,440 --> 00:47:06,640
PRESENTATION, A REACH GOING FROM

1325
00:47:06,640 --> 00:47:10,040
A LIMITED NUMBER OF RURAL AREAS

1326
00:47:10,040 --> 00:47:14,200
TO 6.1 MILLION FAMILIES,

1327
00:47:14,200 --> 00:47:14,800
ULTIMATELY 26 MILLION PEOPLE,

1328
00:47:14,800 --> 00:47:16,520
THAT'S THE KIND OF PUBLIC HEALTH

1329
00:47:16,520 --> 00:47:19,680
IMPACT THAT WE WANT TO HAVE,

1330
00:47:19,680 --> 00:47:20,840
PARTICULARLY FOR SOMETHING SO

1331
00:47:20,840 --> 00:47:23,280
IMPORTANT AND SO IMPACTFUL

1332
00:47:23,280 --> 00:47:24,840
ACROSS THE LIFE COURSE OF CHIRP

1333
00:47:24,840 --> 00:47:28,680
AND FAMILIES WITH FOOD SECURITY.

1334
00:47:28,680 --> 00:47:30,200
SO THAT REACH IS IMPRESSIVE.

1335
00:47:30,200 --> 00:47:31,640
AND SOME OF THE KEY PIECES THAT

1336
00:47:31,640 --> 00:47:34,640
SHE MENTIONED AROUND POLITICAL

1337
00:47:34,640 --> 00:47:35,840
WILL, SOME OF THE CHALLENGES

1338
00:47:35,840 --> 00:47:37,360
AROUND THE EVIDENCE-BASE THAT

1339
00:47:37,360 --> 00:47:40,560
WAS DISCOVERED AND THAT

1340
00:47:40,560 --> 00:47:41,760
TRANSLATION PROCESS INTO POLICY,

1341
00:47:41,760 --> 00:47:43,200
THIS SEEMS TO ME A KEY

1342
00:47:43,200 --> 00:47:47,920
OPPORTUNITY FOR US AS A FIELD IN

1343
00:47:47,920 --> 00:47:49,400
FOOD SECURITY, NUTRITION,

1344
00:47:49,400 --> 00:47:50,800
BEHAVIOR CHANGE POLICY AND

1345
00:47:50,800 --> 00:47:51,640
IMPLEMENTATION SCIENCE, TO LOOK

1346
00:47:51,640 --> 00:47:53,760
AT EXAMPLES LIKE THIS, AND

1347
00:47:53,760 --> 00:47:57,040
REALLY LEARN ABOUT HOW OUR

1348
00:47:57,040 --> 00:47:58,600
EVIDENCE BASE CAN REALLY MOVE TO

1349
00:47:58,600 --> 00:48:00,000
BIGGER REACH AND BROADER IMPACT.

1350
00:48:00,000 --> 00:48:02,000
AND IT REMINDS ME TOO OF

1351
00:48:02,000 --> 00:48:05,280
THINKING NOT JUST ABOUT

1352
00:48:05,280 --> 00:48:06,000
IMPLEMENTATION PROCESSES BUT

1353
00:48:06,000 --> 00:48:08,480
ALSO HOW DO WE COMMUNICATE BACK

1354
00:48:08,480 --> 00:48:11,880
THE BENEFIT OF THESE EVIDENCE

1355
00:48:11,880 --> 00:48:13,280
BASE PROGRAMS OF THE PROCESSES

1356
00:48:13,280 --> 00:48:15,240
AND WORK TO CHANGE POLICY AND TO

1357
00:48:15,240 --> 00:48:17,160
HAVE THIS REACH.

1358
00:48:17,160 --> 00:48:20,680
SO SUNNY'S KEY EXAMPLE, I REALLY

1359
00:48:20,680 --> 00:48:23,240
THOUGHT WAS SUCH A FABULOUS ONE

1360
00:48:23,240 --> 00:48:28,160
IN REALLY SE DINING FOR YOUR

1361
00:48:28,160 --> 00:48:29,280
INTERVENTION -- DESIGNING WITH

1362
00:48:29,280 --> 00:48:30,360
IMPLEMENTATION IN MIND, AND

1363
00:48:30,360 --> 00:48:32,800
THINKING ABOUT THOSE KEY

1364
00:48:32,800 --> 00:48:34,320
MULTIPLE STAKEHOLDER PARTNER,

1365
00:48:34,320 --> 00:48:35,520
COMMUNITY PARTNERS AT EACH LEVEL

1366
00:48:35,520 --> 00:48:37,840
OF AN INTERVENTION, AND THE KEY

1367
00:48:37,840 --> 00:48:39,560
PIECE FOR ME THAT SEEMED TO COME

1368
00:48:39,560 --> 00:48:42,480
OUT OF THAT FOR LONG TERM

1369
00:48:42,480 --> 00:48:44,040
SUSTAINABILITY WAS AROUND

1370
00:48:44,040 --> 00:48:45,680
EMPOWERMENT OF COMMUNITY.

1371
00:48:45,680 --> 00:48:46,920
AND ONE OF THE WAYS IT SEEMED TO

1372
00:48:46,920 --> 00:48:48,720
ME THAT SUNNY WAS DOING THAT WAS

1373
00:48:48,720 --> 00:48:51,360
BY SHARING DATA BACK, AND GIVING

1374
00:48:51,360 --> 00:48:53,280
THE DATA BACK TO DECISION-MAKERS

1375
00:48:53,280 --> 00:48:55,240
SO THAT THEY'RE A PART OF THAT

1376
00:48:55,240 --> 00:48:56,760
PROCESS IN TERMS OF LEARNING

1377
00:48:56,760 --> 00:48:58,280
ABOUT WHAT WORKS AND HOW TO

1378
00:48:58,280 --> 00:48:59,520
PIVOT AND HOW TO MOVE FORWARD

1379
00:48:59,520 --> 00:49:00,840
FROM THERE.

1380
00:49:00,840 --> 00:49:02,680
SO WOULD LOVE TO HEAR MORE AT

1381
00:49:02,680 --> 00:49:04,800
ANOTHER POINT, TOO, ABOUT HOW

1382
00:49:04,800 --> 00:49:06,120
THAT DATA WAS COMMUNICATED BACK,

1383
00:49:06,120 --> 00:49:07,640
AND WHAT METRICS MIGHT BE USED

1384
00:49:07,640 --> 00:49:10,480
IN TERMS OF IDENTIFYING HOW THAT

1385
00:49:10,480 --> 00:49:12,680
REALLY CHANGES EMPOWERMENT,

1386
00:49:12,680 --> 00:49:14,800
TRUST, TO BUILD TOWARDS THOSE

1387
00:49:14,800 --> 00:49:17,080
LONG-TERM SUSTAINABILITY GOALS.

1388
00:49:17,080 --> 00:49:18,880
SO REALLY JUST SO EXCITED FOR

1389
00:49:18,880 --> 00:49:21,360
THOSE EXAMPLES AND I HOPE THAT

1390
00:49:21,360 --> 00:49:22,560
IN THE CHAT, I THINK WE WERE

1391
00:49:22,560 --> 00:49:24,440
GOING TO TRY TO SHARE SOMERMAN

1392
00:49:24,440 --> 00:49:30,080
SOMEMANUSCRIPTS OR PAPERS SO YOD

1393
00:49:30,080 --> 00:49:33,160
THE AUDIENCE CAN LOOK DEEPER

1394
00:49:33,160 --> 00:49:33,600
INTO EXAMPLES.

1395
00:49:33,600 --> 00:49:35,200
>>YES, WE'LL BE SHARING
STUFF

1396
00:49:35,200 --> 00:49:36,320
ON OUR WEBSITE THAT WE'RE

1397
00:49:36,320 --> 00:49:37,040
DEVELOPING.

1398
00:49:37,040 --> 00:49:38,520
WE'RE UNFORTUNATELY UNABLE TO

1399
00:49:38,520 --> 00:49:41,680
SHARE ON THE VIDEOCAST

1400
00:49:41,680 --> 00:49:42,040
CURRENTLY.

1401
00:49:42,040 --> 00:49:43,240
BUT I THINK YOUR POINT, APRIL,

1402
00:49:43,240 --> 00:49:45,880
IS REALLY GOOD, SO I ALSO REALLY

1403
00:49:45,880 --> 00:49:47,440
ECHO YOUR EXCITEMENT ABOUT THESE

1404
00:49:47,440 --> 00:49:47,720
EXAMPLES.

1405
00:49:47,720 --> 00:49:48,840
I'M GOING TO TURN IT OVER TO

1406
00:49:48,840 --> 00:49:49,320
SUNNY.

1407
00:49:49,320 --> 00:49:51,320
I THOUGHT YOUR POINT ABOUT --

1408
00:49:51,320 --> 00:49:52,360
EVEN AT THE VERY END ABOUT THE

1409
00:49:52,360 --> 00:49:54,360
TOUCH POINTS ABOUT WHEN IT IS

1410
00:49:54,360 --> 00:49:55,120
THAT YOU'RE GOING THROUGH AND

1411
00:49:55,120 --> 00:49:57,000
YOU'RE KIND OF CONNECTING WAS A

1412
00:49:57,000 --> 00:49:57,680
REALLY IMPORTANT POINT.

1413
00:49:57,680 --> 00:49:59,880
I MEAN, I THINK IT BUILDS ON

1414
00:49:59,880 --> 00:50:01,080
WHAT ANNABELLE ALSO HAD TO SAY

1415
00:50:01,080 --> 00:50:03,040
AND I'D LOVE TO HEAR FROM THEM

1416
00:50:03,040 --> 00:50:05,360
NEXT, BUT SUNNY, I'D LOVE TO GET

1417
00:50:05,360 --> 00:50:09,760
YOUR TAKE ON THIS.

1418
00:50:09,760 --> 00:50:10,840
>>ONE OF THE STRATEGIES
FOR

1419
00:50:10,840 --> 00:50:12,040
SURE THAT HAS BEEN BUILT INTO

1420
00:50:12,040 --> 00:50:13,360
THE ALIVE AND THRIVE WORK WAS

1421
00:50:13,360 --> 00:50:15,440
BECAUSE IT'S ABOUT SOCIAL AND

1422
00:50:15,440 --> 00:50:17,120
BEHAVIOR CHANGE, IS TO REALLY

1423
00:50:17,120 --> 00:50:19,400
ENGAGE FROM THE DESIGN WITH

1424
00:50:19,400 --> 00:50:21,520
ACTIVE PARTICIPATION FROM THE

1425
00:50:21,520 --> 00:50:22,480
STAKEHOLDERS TO UNDERSTAND

1426
00:50:22,480 --> 00:50:23,720
WHAT'S FEASIBLE TO INTEGRATE

1427
00:50:23,720 --> 00:50:27,320
INTO THEIR WORK SCHEDULE, FOR

1428
00:50:27,320 --> 00:50:29,000
INSTANCE, FOR HEALTH WORKERS TO

1429
00:50:29,000 --> 00:50:30,200
ADAPT MORE COUNSELING

1430
00:50:30,200 --> 00:50:31,160
INFORMATION, FOR INSTANCE, TO

1431
00:50:31,160 --> 00:50:32,600
DELIVER DURING THEIR HEALTH

1432
00:50:32,600 --> 00:50:35,520
CONTACTS, OR FOR COMMUNITY

1433
00:50:35,520 --> 00:50:36,480
WORKERS WHO ARE VOLUNTEERS

1434
00:50:36,480 --> 00:50:38,960
ACTUALLY DOING OTHER POLITICAL

1435
00:50:38,960 --> 00:50:40,560
ACTIVIST WORK IN VOTE,

1436
00:50:40,560 --> 00:50:42,080
PROMOTIONS AND OTHER THINGS THEY

1437
00:50:42,080 --> 00:50:43,600
CAN INTEGRATE INTO THEIR WORK TO

1438
00:50:43,600 --> 00:50:44,600
DELIVERING NUTRITION MESSAGING.

1439
00:50:44,600 --> 00:50:48,120
SO THERE'S A LOT OF ACTIVE

1440
00:50:48,120 --> 00:50:49,240
PARTICIPATION IN THE DESIGN, AND

1441
00:50:49,240 --> 00:50:51,000
THEN ALONG THE DIFFERENT

1442
00:50:51,000 --> 00:50:54,160
IMPLEMENTATION MOMENTS TO REALLY

1443
00:50:54,160 --> 00:50:56,000
SPEAK BACK TO THE DIFFERENT

1444
00:50:56,000 --> 00:50:58,680
LOCAL DECISION MAKERS ABOUT THE

1445
00:50:58,680 --> 00:51:01,680
PROGRESS OF THE PROGRAMMING AND

1446
00:51:01,680 --> 00:51:02,880
IMPACTS, I THINK IT'S REALLY

1447
00:51:02,880 --> 00:51:04,160
CRITICAL TO BUILD THAT IN, WHICH

1448
00:51:04,160 --> 00:51:06,160
I REFER TO AS THESE TOUCH POINTS

1449
00:51:06,160 --> 00:51:09,880
TO DIFFERENT STAKEHOLDERS, HAS

1450
00:51:09,880 --> 00:51:10,560
BEEN REALLY CRITICAL.

1451
00:51:10,560 --> 00:51:13,720
ON THE POINT OF SUSTAINABILITY,

1452
00:51:13,720 --> 00:51:14,560
I THINK SOME OF THE COMPONENTS

1453
00:51:14,560 --> 00:51:16,160
ARE, YOU NEED TO HAVE SOMEBODY

1454
00:51:16,160 --> 00:51:20,000
LIKE LASTING LEADERSHIP ADVOCACY

1455
00:51:20,000 --> 00:51:22,000
OR CHAMPIONING REALLY FOR THIS

1456
00:51:22,000 --> 00:51:23,400
WORK CAPACITY IN PARTICIPATION,

1457
00:51:23,400 --> 00:51:25,320
BUT THE OTHER COMPONENT, I ALSO

1458
00:51:25,320 --> 00:51:27,520
WAS THINKING ABOUT WAS WE DIDN'T

1459
00:51:27,520 --> 00:51:28,760
REPORT BACK A LOT ABOUT

1460
00:51:28,760 --> 00:51:29,960
FINANCING, AND I THINK ANNABELLE

1461
00:51:29,960 --> 00:51:32,040
AND I BOTH MENTIONED FUNDING,

1462
00:51:32,040 --> 00:51:35,600
FUNDING, FUNDING IN THESE POINTS

1463
00:51:35,600 --> 00:51:37,520
AT THE END, AND THIS HAS BEEN

1464
00:51:37,520 --> 00:51:40,880
RAISED BUT SOMETIMES EVEN AS

1465
00:51:40,880 --> 00:51:41,920
OPPORTUNITIES DO OPEN UP, IT'S

1466
00:51:41,920 --> 00:51:44,160
STILL A CHALLENGE TO GET SUPPORT

1467
00:51:44,160 --> 00:51:46,360
FOR IMPLEMENTATION RESEARCH AND

1468
00:51:46,360 --> 00:51:49,760
STUDIES ON PROGRAM MAINTENANCE

1469
00:51:49,760 --> 00:51:50,560
AND SUSTAINABILITY.

1470
00:51:50,560 --> 00:51:52,520
SO I THINK JUST DELIVERING BACK

1471
00:51:52,520 --> 00:51:55,800
THESE MESSAGES AND HOW TO APPLY

1472
00:51:55,800 --> 00:51:58,440
THIS INFORMATION TO ADVOCATE FOR

1473
00:51:58,440 --> 00:52:00,760
THESE RESOURCES AND SUPPORT IS

1474
00:52:00,760 --> 00:52:04,400
CRITICAL.

1475
00:52:04,400 --> 00:52:05,360
>>THANKS.

1476
00:52:05,360 --> 00:52:06,240
ANNABELLE OBVIOUSLY

1477
00:52:06,240 --> 00:52:06,880
SUSTAINABILITY IS SOMETHING THAT

1478
00:52:06,880 --> 00:52:08,240
YOU WERE THINKING OF AND HAVE

1479
00:52:08,240 --> 00:52:09,520
BEEN WORKING TOWARDS THROUGHOUT

1480
00:52:09,520 --> 00:52:10,080
YOUR RESEARCH.

1481
00:52:10,080 --> 00:52:10,880
>>YES.

1482
00:52:10,880 --> 00:52:13,080
AND I ACTUALLY WANT TO COMMENT

1483
00:52:13,080 --> 00:52:15,480
ON APRIL'S QUESTION OF HOW WE

1484
00:52:15,480 --> 00:52:18,560
COMMUNICATE IN OUR CASE, BECAUSE

1485
00:52:18,560 --> 00:52:20,200
IT WAS A FEDERAL PROGRAM, WE

1486
00:52:20,200 --> 00:52:21,880
HAVE A NATIONAL COORDINATION

1487
00:52:21,880 --> 00:52:26,040
WHERE DIFFERENT SECTORS SIT A

1488
00:52:26,040 --> 00:52:30,200
MONTHLY OR I THINK IT WAS

1489
00:52:30,200 --> 00:52:31,200
BI-MONTHLY TO DISCUSS ALL THE

1490
00:52:31,200 --> 00:52:31,800
ASPECT OF THE PROGRAM.

1491
00:52:31,800 --> 00:52:34,400
AND WE HAVE THESE CONTINUAL

1492
00:52:34,400 --> 00:52:36,040
INTERRELATION WITHIN THE

1493
00:52:36,040 --> 00:52:40,800
RESEARCHER WITH THE IMPL IMPLEMS

1494
00:52:40,800 --> 00:52:42,240
AND EXPLAIN IN ALL THESE

1495
00:52:42,240 --> 00:52:44,720
MEETINGS LIKE THE RESULTS OF THE

1496
00:52:44,720 --> 00:52:45,760
RESEARCH AND ALL THIS

1497
00:52:45,760 --> 00:52:47,720
INFORMATION THAT WAS KEY TO

1498
00:52:47,720 --> 00:52:52,640
DEVELOPING THE NEXT STUDIES AND

1499
00:52:52,640 --> 00:52:53,920
IMPROVING THE -- AND APPLYING

1500
00:52:53,920 --> 00:52:57,520
THE INNOVATION THAT WE WERE I'D

1501
00:52:57,520 --> 00:53:01,560
FAYINGIDENTIFYING FOR THE PROGR.

1502
00:53:01,560 --> 00:53:03,920
IT WAS THIS NATIONAL

1503
00:53:03,920 --> 00:53:05,920
COORDINATION THAT FACILITATE THE

1504
00:53:05,920 --> 00:53:07,320
PROCESS AND ALSO TWO IMPORTANT

1505
00:53:07,320 --> 00:53:07,760
POINTS.

1506
00:53:07,760 --> 00:53:11,200
ONE WAS THE MOMENTUM, LIKE WHEN

1507
00:53:11,200 --> 00:53:12,480
GOVERNMENT CHANGED, BECAUSE THE

1508
00:53:12,480 --> 00:53:14,680
PROGRAM WAS THROUGH FOUR

1509
00:53:14,680 --> 00:53:17,440
DIFFERENT GOVERNMENT PERIODS.

1510
00:53:17,440 --> 00:53:19,320
AND IN THE LAST -- WELL, IN TWO

1511
00:53:19,320 --> 00:53:21,640
PERIODS BEFORE, THE RESULT FOR

1512
00:53:21,640 --> 00:53:23,720
THE IMPLEMENTATION RESEARCH WERE

1513
00:53:23,720 --> 00:53:23,920
READY.

1514
00:53:23,920 --> 00:53:27,960
AND IN THIS TIME, ONE OF THE

1515
00:53:27,960 --> 00:53:29,000
GOVERNMENT CAME AND SAW THE

1516
00:53:29,000 --> 00:53:30,400
RESULT AND SAID OKAY, YES, WE

1517
00:53:30,400 --> 00:53:32,600
NEED TO APPLY IT AND WE NEED TO

1518
00:53:32,600 --> 00:53:34,000
GO TO A SCALE-UP.

1519
00:53:34,000 --> 00:53:37,160
SO THIS CHANGE WAS VERY FAVOR

1520
00:53:37,160 --> 00:53:38,680
FOR US FOR THE SCALING UP

1521
00:53:38,680 --> 00:53:45,960
PROCESS, AND OF COURSE WE HAVE A

1522
00:53:45,960 --> 00:53:47,160
WELL-KNOWN VOICE IN OUR RESEARCH

1523
00:53:47,160 --> 00:53:48,560
TEAM THAT THIS ALSO FACILITATE

1524
00:53:48,560 --> 00:53:53,520
THE PROCESS OF THE SCALING UP.

1525
00:53:53,520 --> 00:53:55,280
>>THAT'S A REALLY GOOD
POINT.

1526
00:53:55,280 --> 00:53:56,920
YOU KNOW, ED, I KNOW THAT THIS

1527
00:53:56,920 --> 00:54:00,160
IS SOMETHING THAT SUSAN HAS BEEN

1528
00:54:00,160 --> 00:54:01,040
REALLY THINKING ABOUT AT KIND OF

1529
00:54:01,040 --> 00:54:04,000
LIKE EVEN A SORT OF BROADER

1530
00:54:04,000 --> 00:54:04,200
SCALE.

1531
00:54:04,200 --> 00:54:05,400
PERHAPS YOU COULD SAY A LITTLE

1532
00:54:05,400 --> 00:54:09,080
MORE ABOUT THAT.

1533
00:54:09,080 --> 00:54:14,960
>>WELL, I THINK THAT
REALLY THE

1534
00:54:14,960 --> 00:54:17,680
CHALLENGE IS HELPING SORT OF

1535
00:54:17,680 --> 00:54:18,960
SPREAD THE WORD, I GUESS YOU

1536
00:54:18,960 --> 00:54:23,520
COULD SAY, TO DISSEMINATE THE

1537
00:54:23,520 --> 00:54:24,160
UNDERSTANDING OF THE IMPORTANCE

1538
00:54:24,160 --> 00:54:24,960
OF THIS.

1539
00:54:24,960 --> 00:54:27,320
I WAS STRUCK QUITE A NUMBER OF

1540
00:54:27,320 --> 00:54:30,720
YEARS AGO NOW, YOU MAY KNOW THAT

1541
00:54:30,720 --> 00:54:33,440
ABOUT 10 OR -- 10 OR 11 YEARS

1542
00:54:33,440 --> 00:54:35,880
AGO, IT WAS DISCOVERED THAT ZINC

1543
00:54:35,880 --> 00:54:36,640
SUPPLEMENTATION, WHEN

1544
00:54:36,640 --> 00:54:39,160
ADMINISTERED IN A TIMELY WAY TO

1545
00:54:39,160 --> 00:54:42,960
YOUNG CHI CHILDREN WHO HAD DIARA

1546
00:54:42,960 --> 00:54:44,440
WOULD SUBSTANTIALLY REDUCE THE

1547
00:54:44,440 --> 00:54:46,760
MORTALITY OR MORBIDITY.

1548
00:54:46,760 --> 00:54:47,760
I REMEMBER TALKING TO SOMEONE IN

1549
00:54:47,760 --> 00:54:50,280
ONE OF THE COUNTRIES I WAS

1550
00:54:50,280 --> 00:54:52,400
WORKING IN WHO WAS VERY

1551
00:54:52,400 --> 00:54:53,880
FRUSTRATED WHO SAID WELL, THIS

1552
00:54:53,880 --> 00:54:54,840
SHOULDING STRAIGHTFORWARD, YOU

1553
00:54:54,840 --> 00:54:56,160
MANUFACTURE THE PILLS, YOU GIVE

1554
00:54:56,160 --> 00:54:57,480
THEM TO THE CLINICS, THE NURSES

1555
00:54:57,480 --> 00:54:59,080
OR THE PRIMARY HEALTHCARE WORKER

1556
00:54:59,080 --> 00:55:00,240
GIVES TO THE CAREGIVER, THEY

1557
00:55:00,240 --> 00:55:02,600
GIVE TO THE CHILD, AND WE REDUCE

1558
00:55:02,600 --> 00:55:03,680
MORBIDITY AND IT'S NOT HAPPENING

1559
00:55:03,680 --> 00:55:05,680
AND WHY IS THAT?

1560
00:55:05,680 --> 00:55:07,480
THAT'S A PROBLEM OF

1561
00:55:07,480 --> 00:55:09,280
IMPLEMENTATION SCIENCE, IS

1562
00:55:09,280 --> 00:55:11,960
UNDERSTANDING WHAT ARE THOSE

1563
00:55:11,960 --> 00:55:13,160
PROCESSES THAT ARE INVOLVED AND

1564
00:55:13,160 --> 00:55:14,920
WHAT GETS IN THE WAY OF EVEN

1565
00:55:14,920 --> 00:55:16,560
SOMETHING THAT SEEMS ON THE FACE

1566
00:55:16,560 --> 00:55:18,000
OF IT AS SIMPLE AS THAT.

1567
00:55:18,000 --> 00:55:25,560
AND I THINK THAT JUST -- AGAIN,

1568
00:55:25,560 --> 00:55:27,720
JUST CONVEYING THE IMPORTANCE OF

1569
00:55:27,720 --> 00:55:31,280
THE KINDS OF PROCESSES THAT

1570
00:55:31,280 --> 00:55:32,720
SUNNY AND ANNABELLE WERE TALKING

1571
00:55:32,720 --> 00:55:36,440
ABOUT, AND WHY THOSE MATTER IN

1572
00:55:36,440 --> 00:55:38,440
TERMS OF WHETHER OR NOT THE

1573
00:55:38,440 --> 00:55:39,680
INTENDED BENEFICIARIES ACTUALLY

1574
00:55:39,680 --> 00:55:41,080
HAVE A BENEFIT GENERATED FOR

1575
00:55:41,080 --> 00:55:44,800
THEM.

1576
00:55:44,800 --> 00:55:48,000
>>YEAH.

1577
00:55:48,000 --> 00:55:51,720
I'M GOING TO FOCUS TO ANOTHER

1578
00:55:51,720 --> 00:55:53,160
QUESTION ONE THAT UNDERLIES THIS

1579
00:55:53,160 --> 00:55:55,040
ENTIRE WEBINAR SERIES WHICH IS

1580
00:55:55,040 --> 00:55:56,680
HOW WE KIND OF TRANSLATE OR

1581
00:55:56,680 --> 00:55:57,680
ADAPT DIFFERENT INTERVENTIONS

1582
00:55:57,680 --> 00:55:58,560
ACROSS SETTINGS?

1583
00:55:58,560 --> 00:55:59,960
YOU KNOW, I THINK THAT THAT'S

1584
00:55:59,960 --> 00:56:01,800
REALLY THE GOAL OF WHAT WE'RE

1585
00:56:01,800 --> 00:56:03,080
TRYING TO LEARN HERE FOR THIS

1586
00:56:03,080 --> 00:56:04,720
WHOLE WEBINAR SERIES, SO I THINK

1587
00:56:04,720 --> 00:56:06,440
EVEN WITH THIS LAST MOMENT, I

1588
00:56:06,440 --> 00:56:07,600
THINK IT WOULD BE WORTH

1589
00:56:07,600 --> 00:56:09,480
ADDRESSING.

1590
00:56:09,480 --> 00:56:11,440
ANNABELLE, DO YOU WANT TO TRY TO

1591
00:56:11,440 --> 00:56:12,280
ANSWER THAT ONE?

1592
00:56:12,280 --> 00:56:14,000
>>YES, I THINK THAT FOR
THESE

1593
00:56:14,000 --> 00:56:17,600
FORMATIVE RESEARCH IS KEY, AND

1594
00:56:17,600 --> 00:56:21,480
USING A MIXED METHOD APPROACH TO

1595
00:56:21,480 --> 00:56:23,800
IDENTIFY BARRIERS AND THEN TO

1596
00:56:23,800 --> 00:56:26,200
IDENTIFY ALSO THE WAY TO DEVELOP

1597
00:56:26,200 --> 00:56:28,440
OR TO ADAPT THE STRATEGIES TO

1598
00:56:28,440 --> 00:56:32,600
OVERCOME THESE BARRIERS AND

1599
00:56:32,600 --> 00:56:35,480
CONSIDERING THE NEIGHBORS IN

1600
00:56:35,480 --> 00:56:36,320
THESE DIFFERENT CONTEXT.

1601
00:56:36,320 --> 00:56:38,640
I THINK IN OUR EXPERIENCE, NOW

1602
00:56:38,640 --> 00:56:41,720
THAT THE IMPLEMENTATION RESEARCH

1603
00:56:41,720 --> 00:56:43,720
SCIENCE FIELD IS DEVELOPING, WE

1604
00:56:43,720 --> 00:56:45,200
HAVE BEEN -- I MEAN, WE HAVE

1605
00:56:45,200 --> 00:56:48,480
MORE THAN 20 YEARS IMPLEMENTING

1606
00:56:48,480 --> 00:56:52,040
FOFORMATIVE RESEARCH, INCLUDING

1607
00:56:52,040 --> 00:56:56,760
NOW ALL THESE -- THAT HAVE BEEN

1608
00:56:56,760 --> 00:56:58,000
DEVELOPING IN THE FIELD OF

1609
00:56:58,000 --> 00:56:58,840
IMPLEMENTATION AND FOR INSTANCE

1610
00:56:58,840 --> 00:57:03,160
IN THE LAST FORMATIVE RESEARCH

1611
00:57:03,160 --> 00:57:05,640
IN A SIMILAR STRATEGY WE ARE

1612
00:57:05,640 --> 00:57:09,320
DEVELOPING, WE APPLIED LIKE THE

1613
00:57:09,320 --> 00:57:12,160
FRAMEWORK FROM -- WHERE THEY --

1614
00:57:12,160 --> 00:57:14,920
IT'S AN ADAPTATION OF FRAMEWORK

1615
00:57:14,920 --> 00:57:16,920
FOR IMPLEMENTATION RESEARCH, BUT

1616
00:57:16,920 --> 00:57:19,760
NOW WE GO PREVIOUS TO THE

1617
00:57:19,760 --> 00:57:21,760
COMMUNITY WITH THE DIFFERENT

1618
00:57:21,760 --> 00:57:23,120
STAKEHOLDERS AND EXPLORE THESE

1619
00:57:23,120 --> 00:57:26,760
DOMAINS THAT WE KNOW THAT ARE

1620
00:57:26,760 --> 00:57:31,000
RELATED WITH THE SUCCESSFUL

1621
00:57:31,000 --> 00:57:31,920
IMPLEMENTATION, OR FOR INSTANCE,

1622
00:57:31,920 --> 00:57:36,440
ALSO INCLUDING THE

1623
00:57:36,440 --> 00:57:38,320
IMPLEMENTATION RESEARCH OUTCOMES

1624
00:57:38,320 --> 00:57:40,680
SUCH AS THE ONE THAT HAS BEEN

1625
00:57:40,680 --> 00:57:42,920
PUBLISHED BY PROCTOR, WHERE WE

1626
00:57:42,920 --> 00:57:45,920
IN ADVANCE GO WITH THE

1627
00:57:45,920 --> 00:57:49,600
STAKEHOLDERS AND SEE HOW IS THE

1628
00:57:49,600 --> 00:57:52,520
ADOPTION, THE APPROPRIATION, THE

1629
00:57:52,520 --> 00:57:54,160
FLEXIBILITY OF IMPLEMENTING

1630
00:57:54,160 --> 00:57:56,680
THESE NEW INNOVATION OR CHANGES

1631
00:57:56,680 --> 00:58:00,360
OR NEW STRATEGIES, SO I THINK

1632
00:58:00,360 --> 00:58:01,880
THAT THESE NOW MORE THAN EVER IS

1633
00:58:01,880 --> 00:58:04,640
REALLY IMPORTANT TO GO WITH A

1634
00:58:04,640 --> 00:58:07,560
VERY WELL FORMATIVE RESEARCH,

1635
00:58:07,560 --> 00:58:08,960
INFORMED BY THE IMPLEMENTATION

1636
00:58:08,960 --> 00:58:10,040
RESEARCH FRAMEWORK THAT WE HAVE

1637
00:58:10,040 --> 00:58:12,360
NOW THAT WE DIDN'T HAVE BEFORE,

1638
00:58:12,360 --> 00:58:14,280
AND TAKE ADVANTAGE OF THIS TO

1639
00:58:14,280 --> 00:58:16,360
DEVELOP BETTER INTERVENTION AND

1640
00:58:16,360 --> 00:58:18,520
TO ADAPT INTERVENTIONS THAT ARE

1641
00:58:18,520 --> 00:58:19,720
ALREADY IN PLACE TO THE

1642
00:58:19,720 --> 00:58:24,680
DIFFERENT CONTEXTS.

1643
00:58:24,680 --> 00:58:25,960
>>THANK YOU SO MUCH,
ANNABELLE,

1644
00:58:25,960 --> 00:58:27,800
AND REALLY TO ALL OF OUR

1645
00:58:27,800 --> 00:58:28,400
PANELISTS.

1646
00:58:28,400 --> 00:58:29,320
REALLY APPRECIATE YOU JOINING US

1647
00:58:29,320 --> 00:58:31,160
TODAY.

1648
00:58:31,160 --> 00:58:37,360
I NOW WANT TO PASS IT OVER TO

1649
00:58:37,360 --> 00:58:38,680
DR. RAFAEL PEREZ, SCIENTIFIC

1650
00:58:38,680 --> 00:58:41,640
CHAIR FOR THIS PROJECT, TO WRAP

1651
00:58:41,640 --> 00:58:44,040
UP THIS WEBINAR AND THIS SERIES

1652
00:58:44,040 --> 00:58:44,640
AS A WHOLE.

1653
00:58:44,640 --> 00:58:47,480
>>THANK YOU VERY MUCH,
SUSAN,

1654
00:58:47,480 --> 00:58:48,880
AND CONGRATULATIONS TO ALL THE

1655
00:58:48,880 --> 00:58:51,440
PRESENTERS AND ALL THE

1656
00:58:51,440 --> 00:58:52,800
DISCUSSANTS ON TODAY'S

1657
00:58:52,800 --> 00:58:54,760
OUTSTANDING WEBINAR FOCUSING ON

1658
00:58:54,760 --> 00:58:55,440
IMPLEMENTATION SCIENCE.

1659
00:58:55,440 --> 00:58:58,320
I WANT TO START BY THANKING

1660
00:58:58,320 --> 00:59:00,920
SUSAN ENORMOUSLY, NOT ONLY FOR

1661
00:59:00,920 --> 00:59:04,320
BEING THE DRIVING FORCE BEHIND

1662
00:59:04,320 --> 00:59:05,920
THESE WEBINARS, BUT ALSO FOR

1663
00:59:05,920 --> 00:59:09,200
SUGGESTING THE TOPIC TO BEGIN

1664
00:59:09,200 --> 00:59:09,760
WITH.

1665
00:59:09,760 --> 00:59:11,600
I THINK SHE PUT TOGETHER AN

1666
00:59:11,600 --> 00:59:12,680
INCREDIBLE GROUP OF FEDERAL

1667
00:59:12,680 --> 00:59:13,960
AGENCIES THAT, TOGETHER, COULD

1668
00:59:13,960 --> 00:59:17,680
HAVE A HUGE IMPACT ON ADVANCING

1669
00:59:17,680 --> 00:59:21,280
FOOD SECURITY POLICIES,

1670
00:59:21,280 --> 00:59:23,760
PROGRAMS, AS WELL AS

1671
00:59:23,760 --> 00:59:24,960
IMPLEMENTATION SCIENCE EFFORTS

1672
00:59:24,960 --> 00:59:26,520
GLOBALLY.

1673
00:59:26,520 --> 00:59:29,240
THERE IS NO DOUBT THAT THROUGH

1674
00:59:29,240 --> 00:59:30,640
THIS SERIES OF THREE WEBINARS,

1675
00:59:30,640 --> 00:59:35,760
WE HAVE LEARNED THAT STRENGTH,

1676
00:59:35,760 --> 00:59:37,160
THAT POWERFULNESS OF CROSS

1677
00:59:37,160 --> 00:59:38,360
BORDER COLLABORATIONS AND

1678
00:59:38,360 --> 00:59:41,480
SHARING OF LESSONS LEARNED TO

1679
00:59:41,480 --> 00:59:42,600
ADVANCE FOOD SECURITY.

1680
00:59:42,600 --> 00:59:46,200
IN THE FIRST WEBINAR, WE LEARNED

1681
00:59:46,200 --> 00:59:47,720
THAT THROUGH THIS EXTENSIVE

1682
00:59:47,720 --> 00:59:49,320
SHARING, THE WORLD HAS BEEN ABLE

1683
00:59:49,320 --> 00:59:51,920
TO REACH GLOBAL CONSENSUS ON THE

1684
00:59:51,920 --> 00:59:55,320
DEFINITION OF FOOD SECURITY, HOW

1685
00:59:55,320 --> 00:59:57,640
BOTH DIETARY QUALITY AND SAFETY

1686
00:59:57,640 --> 00:59:59,520
ARE VERY MUCH A PART OF THE

1687
00:59:59,520 --> 01:00:03,160
DEFINITION OF FOOD SECURITY, NOT

1688
01:00:03,160 --> 01:00:05,440
ONLY QUANTITY OF FOOD OR

1689
01:00:05,440 --> 01:00:07,560
CALORIES, AND IN ADDITION, THE

1690
01:00:07,560 --> 01:00:10,000
IMPORTANCE OF BOTH FOOD SECURITY

1691
01:00:10,000 --> 01:00:13,520
AND HEALTH SECURITY ON

1692
01:00:13,520 --> 01:00:17,320
DETERMINING NUTRITION SECURITY.

1693
01:00:17,320 --> 01:00:18,840
WITHOUT THIS CROSS BORDERS

1694
01:00:18,840 --> 01:00:20,640
SHARING OF KNOWLEDGE AND

1695
01:00:20,640 --> 01:00:21,840
FRAMEWORK, THESE WILL HAVE NEVER

1696
01:00:21,840 --> 01:00:22,760
HAPPENED.

1697
01:00:22,760 --> 01:00:25,560
SECONDLY, WE HAVE LEARNED

1698
01:00:25,560 --> 01:00:28,800
THROUGH THIS SERIES THAT REGIONS

1699
01:00:28,800 --> 01:00:30,080
LIKE LATIN AMERICA HAVE ACTUALLY

1700
01:00:30,080 --> 01:00:32,840
GENERATED AN ENORMOUS AMOUNT OF

1701
01:00:32,840 --> 01:00:38,680
KNOWLEDGE AS SHARED,

1702
01:00:38,680 --> 01:00:39,880
ILLUSTRATING HOW PROGRAM DESIGN,

1703
01:00:39,880 --> 01:00:43,040
HOW POLICIES AND ALSO HOW

1704
01:00:43,040 --> 01:00:45,440
REGULATIONS COMBINED WITH

1705
01:00:45,440 --> 01:00:47,040
NUTRITION EDUCATION AND

1706
01:00:47,040 --> 01:00:48,920
COUNSELING CAN INDEED HELP

1707
01:00:48,920 --> 01:00:51,120
PROMOTE HEALTHIER EATING

1708
01:00:51,120 --> 01:00:52,520
PATTERNS AND ACHIEVE BETTER

1709
01:00:52,520 --> 01:00:54,120
NUTRITION OUTCOMES.

1710
01:00:54,120 --> 01:00:56,080
BUT WE ALSO HAVE SHOWN THROUGH

1711
01:00:56,080 --> 01:00:58,720
THESE WEBINARS THAT THE LESSONS

1712
01:00:58,720 --> 01:01:01,400
LEARNED ACROSS THE GLOBE IS THAT

1713
01:01:01,400 --> 01:01:03,160
THESE WILL JUST NOT HAPPEN

1714
01:01:03,160 --> 01:01:08,080
WITHOUT MAJOR TRANSFORMATIONS OF

1715
01:01:08,080 --> 01:01:09,800
THE GLOBAL FOOD SYSTEMS THAT

1716
01:01:09,800 --> 01:01:11,160
SURROUND HUMAN BEINGS SINCE THE

1717
01:01:11,160 --> 01:01:13,080
DAY THEY ARE CONCEIVED.

1718
01:01:13,080 --> 01:01:15,680
THIS MAJOR TRANSFORMATIONS ARE

1719
01:01:15,680 --> 01:01:19,880
REALLY GOING TO REQUIRE MAJOR

1720
01:01:19,880 --> 01:01:22,000
IMPLEMENTATION SCIENCE THINKING

1721
01:01:22,000 --> 01:01:25,920
AND APPLICATIONS IN THE CONTEXT

1722
01:01:25,920 --> 01:01:27,560
OF COMPLEX ADAPTIVE SYSTEMS.

1723
01:01:27,560 --> 01:01:31,800
THERE IS VERY LITTLE DOUBT THAT

1724
01:01:31,800 --> 01:01:33,320
WITHOUT WITHOUT APPLYING THE

1725
01:01:33,320 --> 01:01:34,680
PRINCIPLES OF IMPLEMENTATION

1726
01:01:34,680 --> 01:01:37,280
SCIENCE THROUGH AN EQUITY LENS,

1727
01:01:37,280 --> 01:01:38,880
THAT THESE WILL JUST NOT HAPPEN.

1728
01:01:38,880 --> 01:01:41,600
AND LAST BUT NOT LEAST, I WANT

1729
01:01:41,600 --> 01:01:42,800
TO LEAVE YOU WITH PERHAPS WHAT

1730
01:01:42,800 --> 01:01:45,600
IS ONE OF THE MOST IMPORTANT

1731
01:01:45,600 --> 01:01:47,360
LESSONS THAT WE'RE STARTING TO

1732
01:01:47,360 --> 01:01:49,120
LEARN FROM COUNTRIES LIKE

1733
01:01:49,120 --> 01:01:54,960
BRAZIL, FROM COUNTRIES LIKE THE

1734
01:01:54,960 --> 01:01:57,280
U.S., THAT FOR INSECURITY,

1735
01:01:57,280 --> 01:01:58,040
MONITORING, EVALUATION IS NOT

1736
01:01:58,040 --> 01:01:59,800
JUST IMPORTANT FOR INDIVIDUAL

1737
01:01:59,800 --> 01:02:02,280
PROGRAMS OR ASSESSING INDIVIDUAL

1738
01:02:02,280 --> 01:02:04,240
POLICIES, BUT AT THE END OF THE

1739
01:02:04,240 --> 01:02:09,360
DAY, IT'S CRUCIAL FOR ADVANCING

1740
01:02:09,360 --> 01:02:11,280
FOOD SECURITY COHORT LENS.

1741
01:02:11,280 --> 01:02:12,720
SO THANK YOU VERY MUCH, AGAIN,

1742
01:02:12,720 --> 01:02:14,000
SUSAN FOR GIVING ME THE

1743
01:02:14,000 --> 01:02:15,880
PRIVILEGE, THE HONOR OF CHAIRING

1744
01:02:15,880 --> 01:02:18,000
THIS WEBINAR SERIES, AND MOVING

1745
01:02:18,000 --> 01:02:20,840
FORWARD, WE HOPE THAT THE

1746
01:02:20,840 --> 01:02:22,520
SPECIAL ISSUE THAT WILL BE

1747
01:02:22,520 --> 01:02:25,720
PUBLISHED NEXT YEAR VERY MUCH

1748
01:02:25,720 --> 01:02:28,360
INSPIRED BY THIS WEBINAR WILL

1749
01:02:28,360 --> 01:02:31,080
HELP MANY OF YOU TO CONTINUE

1750
01:02:31,080 --> 01:02:32,360
BUILDING COLLABORATIONS OR

1751
01:02:32,360 --> 01:02:34,680
STARTING NEW COLLABORATIONS

1752
01:02:34,680 --> 01:02:37,600
ACROSS BORDERS IN THE AREA OF

1753
01:02:37,600 --> 01:02:40,480
FOOD INSECURITY AND NUTRITION.

1754
01:02:40,480 --> 01:02:42,600
THANK YOU VERY, VERY MUCH,

1755
01:02:42,600 --> 01:02:44,000
AGAIN, TO ALL OUR WONDERFUL

1756
01:02:44,000 --> 01:02:54,200
AUDIENCE.