THANK YOU FOR ATTENDING THE
FOURTH WORKING GROUP MEETING OF
BIOMARKERS AND NUTRITION FOR
DEVELOPMENT KNOWLEDGE INDICATING
DIETARY SUFFICIENCY OR BOND KIDS
PROJECT. I WOULD LIKE TO ONCE
AGAIN EXTEND THANKS TO THE
FEDERAL AND NON-FEDERAL MEMBERS
OF STEERING COMMITTEE OF THE
BONDS KIDS PROJECT WHO HELP
SHAPE THE MEETING SERIES AS WELL
AS ALL THE WORKING GROUP CHAIRS,
WORKING GROUP MEMBERS, WHO MADE
THIS PROJECT POSSIBLE. YOU PUT
IN COUNTLESS HOURS OF TIME ON
THIS PROJECT AND WHILE
CONTINUING YOUR DAY JOBS
IMMITTED THE CHALLENGES OF OUR
GLOBAL SITUATIONS. I WOULD LIKE
TO RECOGNIZE DR. DANIEL RAITEN
AS THE ORGANIZER OF THE BOND
KIDS PROJECT AND I WILL
INTRODUCE HIM AND YOU WILL HEAR
MORE ABOUT THE OVERALL PROJECT
FROM HIS PERSPECTIVE. I WOULD
LIKE TO PUT A THANK YOU TO MY
TEAM AT THE ACADEMY OF NUTRITION
AND DIETETICS AND FOR THIS
PARTICULAR WORK GROUP DR. MARY
RASNA FOR TREMENDOUS SUPPORT AND
INPUT ON THIS PROJECT. SIMILARLY
I WOULD LIKE TO THANK JENNY
WILSON FOR HELPING US STAY
ORGANIZED AND ALL HER EFFORTS.
FINALLY I WANT TO THANK THE
NICHD CONTRACT TECHNICAL AV
TEAMS FOR WORKING WITH US BEHIND
THE SCENES TO MAKE THESE
DISCUSSIONS AVAILABLE TO THE
PUBLIC AND THERE WILL BE
RECORDINGS THAT WILL BE MADE
AVAILABLE AFTER TODAY'S
WORKSHOP. THESE SERIES OF
WORKING MEETINGS ARE CULMINATION
OF HOURS OF PREPARATION AND
DISCUSSIONS AND AS DAN WILL
EXPLAIN ARE MEANT TO TAKE A DEEP
DIVE INTO EXAMINING THE ISSUES
OF NUTRITIONAL NEEDS AND
ASSESSMENT SCHOOL AGE CHILDREN CHILDREN.
THE PREVIOUS THREE BOND
KIDS WORKING GROUP MEETINGS HAVE
BEEN FANTASTIC. AND HUGE SUCCESS
AND WE ARE REALLY EXCITED FOR
TODAY'S AS WELL. IT IS MY
PLEASURE TO DR. DEUCE DR. DAN
RAITEN ORGANIZER OF THE BOND
KIDS PROJECTED. I WILL PUT UP
YOUR SLIDES NOW.
>> THANK YOU. I'M GOING OFF
SCRIPT A LITTLE AND MAKE A QUICK
JUST ACKNOWLEDGMENT OF THE
CHALLENGES BEING FACED BY THE
FAMILIES AND CHILDREN IN THE
UKRAINE AND HOPE THAT EFFORTS
LIKE THIS AND COMMUNITIES THAT
ARE INVOLVED IN BOND KIDS AND
OTHER ACTIVITIES WILL HELP FIND
SOLUTIONS NOW AND IN THE FUTURE.
TO HELP THOSE THAT COMMUNITY.
WELCOME BACK TO THOSE THAT
JOINED US WITH THE PREVIOUS
WORKSHOPS AND FOR THOSE THAT ARE
NEW TO BOND KIDS PROCESS WE ARE
GOING TO GIVE A LITTLE
INTRODUCTION AND OVERVIEW. SO
THANKS TO PATIENCE OF THOSE WHO
HAVE SEEN THIS BEFORE AND LET'S
MOVE FORWARD, WE'RE GOING TO
FOCUS ON HERE IS EXPLAINING WHY
WE CAME UP WITH THE NAME AND
WHAT OUR GOALS AND AS OPERATIONS
ARE OF THIS PROJECT. THIS
PROJECT WAS INITIATED THROUGH AS
A RESULT OF INQUIRIES AND
CONVERSATIONS WE HAD WITH OUR
PARTNERS HERE, ABOUT THE NEED TO
COME UP WITH A WAY TO ASSESS THE
IMPACT OF SOME OF THE TREMENDOUS
ACTIVITIES GOING ON AROUND THE
WORLD BEING LED BY THE WORLD
FOOD PROGRAM AND OTHERS. TO
ADDRESS THIS NUTRITIONAL NEEDS
TO SCHOOL AGE CHILDREN FROM 5 TO
19. THIS PARTICULAR PROJECT IS
FOCUSED ON HOW DO WE ASSESS THE
IMPACT OF THOSE PROGRAMS RATHER
THAN MONITORING EVALUATION. THIS
CARTOON REPRESENTS A PARADIGM WE
USE LEADERSHIP OF JIM BREMMER
UNABLE TO BE HERE WITH US TODAY
BUT HERE IN SPIRIT AND IT'S
UNDER HIS LEADERSHIP WE ARE ABLE
TO DO THESE PROJECTS, OUR INTENT
AS AN EXTRAMURAL RESEARCH
PROGRAM NIH IS TO SUPPORT
RESEARCH AND OUR CONSTITUENCIES
AND THE RESEARCH COMMUNITY. WE
ALSO RECOGNIZE THE NEED THAT TO
TAKE THAT INFORMATION AND
EVIDENCE GENERATED FROM THAT
RESEARCH AND TRANSLATE THAT INTO
MEANINGFUL AND EFFECTIVE
PROGRAMS TO SERVE FAMILIES AND
CHILDREN. NEXT SLIDE PLEASE. SO
THIS IS JUST A BRIEF ASPIRATIONS
OF THE BOND KIDS IS TO PROVIDE
SUPPORT FOR ALL THOSE AGENCIES
AND ORGANIZATIONS THAT ARE
ACTIVELY ENGAGED IN PROVIDING
NUTRITIONAL SUPPORT TO SCHOOL
AGE CHILDREN THROUGH SCHOOL MEAL
PROGRAMS AND OTHER EFFORTS. WE
HOPE TO ENGAGE ACADEMIC AND
CIVIL SOCIETY, TO FOSTER A
COLLABORATIVE EFFORT TO GENERATE
BETTER IDEA ABOUT WHAT EVIDENCE
WE HAVE AND WHAT EVIDENCE WE
NEED. JUST THE LAST THING THERE
TO BE CLEAR ABOUT WHAT THIS IS
NOT, WE ARE NOT TRYING TO
DEVELOP RECOMMENDATIONS, NOT
TRYING TO DEVELOP GUIDELINES, WE
ARE NOT DEVELOPING PROGRAMS WE
ARE SUPPORTING THOSE THAT DO DO. WE
-- OUR INTENT IS TO DEVELOP THE
EVIDENCE BASE. SO JUST BRIEFLY,
FOR THOSE WHO MAY BE FAMILIAR
WITH THE BOND PROJECT, FOR THOSE
THAT ARE NOT FAMILIAR WITH THE
BOND PROJECT, THE BOND PROJECT
STARTED BIOMARKSERS OF NUTRITION
FOR DEVELOPMENT AND THE D IS
DENNEDOR INTENDED TO BE TALKING
ABOUT HUMAN DEVELOPMENT, ALSO
TALKING ABOUT IMPACT OF
NUTRITION ON COUNTRY
DEVELOPMENTED, COMMUNITY
DEVELOPMENT, SCHOOL DEVELOPMENT,
ALL OF THE ENVIRONMENT IMPACTED
BY NUTRITION. THE BOND PROJECT
WAS STARTED IN 2010 AS
COLLABORATION WITH BILL AND
MELINDA GATES FOUNDATION AND
SEVERAL ENTITIES AT NIH
INCLUDING THE OFFICE OF DIETARY
SUPPLEMENTS AND OFFICE VISUAL
NUTRITION RESEARCH COORDINATION
NUTRITION RESEARCH. SO THE BOND
PROJECT IS ESSENTIALLY INTENDED
TO DEVELOP A PROCESS BY WHICH WE
CAN HARMONIZE DISCOVERY
SELECTION AND DEPLOYMENT OF
ASSESS METHODOLOGIES TO ASSESS
ASPECTS OF NUTRITION, COVERING
ALL THE ACTIVITIES OF THE GLOBAL
FOOD AND NUTRITION ENTERPRISE.
WE RECOGNIZE THAT ENTERPRISE HAS
MULTIPLE COMMUNITIES. AND THE
BOND PROJECT IS INTENDED THIS
PROJECT INTENDED TO SUPPORT THE
EFFORTS OF RESEARCHERS, CLINICAL
RESEARCHERS, LAB, BENCH
SCIENTIST, THOSE WORKING IN
CLINICAL SETTINGS. LIKE ALISON
AND HER COMMUNITY, MEDICAL
COMMUNITY, THOSE PROVIDING CARE,
THOSE THAT ARE DEVELOPING
PROGRAMS CREATING DEPLOYING
IMPLEMENTING PROGRAMS AND
MONITORING AND EVALUATING
PROGRAMS AND FUNDLY THOSE END
USERS THAT ARE -- FINALLY THE
END USERS USING DATA GENERATED
THROUGHOUT THE SYSTEM TO MAKE
POLICY. SO THE SECOND PART OF
THE TITLE IS KNOWLEDGE
INDICATING DIETARY SUFFICIENCY
AND THE TRADITIONAL VIEW OF THAT
IS MEASURING AND SEEING WHAT
FOOD YOU PROVIDE AND WHETHER OR
NOT THE SUBJECTS ARE EATING IT.
WE ARE TAKING A MUCH MORE
EXPANSIVE VIEW OF KNOWLEDGE
INDICATING DIETARY SUFFICIENCY
TO RECOGNIZE THAT NUTRITIONAL
SUFFICIENCY, AND NUTRITIONAL
STATUS REALLY IS ECOLOGICAL
CONCEPT AND BY ECOLOGY WE
REFERRING TO INTERACTION WITH
COMPLEX BIOLOGICAL SYSTEM IN
THIS CASE SCHOOL AGE CHILD AND
THEIR ENVIRONMENTS. SO WE HAVE
DESIGNED A PROJECT TO TRY TO
DEAL WITH THAT WHOLE ECOLOGY.
NEXT SLIDE. THIS IS OUR
REPRESENTATION OF OUR VIEW OF
THE HOLISTIC VIEW OF THE
ENVIRONMENT RECOGNIZING THAT IT
IS MORE THAN JUST PHYSICAL
ENVIRONMENT, IT IS HOME, SCHOOL
ENVIRONMENT, IT IS THE HEALTH
CONTEXT, IT IS ALL THESE THINGS.
THAT NEED TO BE CONSIDERED. A
CRITICAL PIECE OF THAT
ENVIRONMENT IS THE FOOD SYSTEM,
THE FOOD SYSTEM TENDS TO BE
INTENDED TO BY SEVERAL
COMMUNITIES BUT NUTRITION
COMMUNITY NEEDS TO BE AND IS
VERY MUCH PART OF THIS. SO THE
FOOD SYSTEM COVERS ALL THINGS
FROM PRODUCTION TO CONSUMPTION
TO MARKETING AND TO IMPACT,
THESE ARE COMPONENTS OF THE FOOD
SYSTEM THAT NEED TO BE
CONSIDERED AS WE HAVE SEEN IN
THE IN THE CASE OF COVID THE
IMPACT OF ENVIRONMENT, THINGS
LIKE PANDEMIC DISEASE HAVE
TREMENDOUS IMPLICATIONS FOR THE
FOOD SYSTEM. AND WHEN THE FOOD
SYSTEM IS NOT RIGHT, IT HAS
NEGATIVE FEEDBACK LOOP ON THE
PEOPLE THAT WE TRYING TO IN THIS
CASE SCHOOL AGE CHILDREN. NEXT
SLIDE. SO WHEN YOU PUT IT
TOGETHER THIS IS THE ECOLOGY WE
ARE TALKING ABOUT SO ALL THESE
COMPONENTS NEEDS TO BE
CONSIDERED WHEN YOU ARE
ADDRESSING THE NUTRITIONAL
STATUS OF THE SCHOOL AGE CHILD.
OR ANY MEMBER OF THE POPULATION.
TALKING NUTRITIONAL STATUS, IT
IS A BIOLOGICAL CONSTRUCT, IT IS
ABOUT ECOLOGY, NEED TO CONSIDER
ALL THESE THINGS TO BE ABLE TO
BE MORE PRECISE WHAT WE ARE
TALKING ABOUT AND MORE PRECISE
NOT JUST SENRY PART BUT
PROGRAMS. USED. NEXT SLIDE. SO
PUTTING THIS ALL TOGETHER THE
BOND KIDS PROJECT IS OBJECTIVE
IS TO TAKE ECOLOGICAL APPROACH
TO ADDRESS NUTRITIONAL NEEDS OF
SCHOOL AGE CHILDREN AND
IMPLICATIONS OF THOSE NEEDS AND
PROGRAMS TO ADDRESS THE NEEDS ON
GROWTH AND DEVELOPMENT. THE
PROJECT IS DESIGNED -- INTENDED
TO BE AT LEAST TWO PHASES. THIS
IS FIRST PHASE. THAT WE ARE
TALKING ABOUT, PHASE 1, THIS IS
AGAIN, GENERATING EVIDENCE
SEEING WHAT WE KNOW, WHAT WE
DON'T KNOW. WHAT WE GENERATE IN
THIS PROJECT HOPEFULLY WILL BE
USED PHASE 2 BY GROUPS LIKE THE
ONE LED BY DON THAT YOU WILL
HEAR LATER ON RESEARCH
CONSORTIUM AS WELL AS THE
COMMUNITIES INVOLVED WITH THE
BOND KIDS PROJECT. THIS IS A
REPRESENTATION OF STRUCTURE OF
THE BOND KIDS PROJECT. I WANT TO
MAKE ALISON TO THANK ALL THE
MEMBERS OF THE SECRETARY YAHT
AND REINFORCE THAT. I WANT TO
MAKE REALLY ACKNOWLEDGE THE
REALITY THAT THIS PROJECT
DOESN'T HAPPEN WITHOUT THE TEAM.
THEY I HAVE BEEN YOU KNOW HAVE
BEEN OUR PARTNERS THROUGHOUT
THIS AND CRITICAL AND ESSENTIAL
TO THE SUCCESS OF THESE
PROGRAMS. THE OTHER PIECE IS THE
SCIENTIFIC STEERING COMMITTEE
WHO YOU HEARD FROM THE FIRST
WORK SHOP WORKING GROUP ONE YOU
HAD PRECEDED BY A PANEL
CONVERSATION WITH REPRESENTATION
FROM MANY OF THE AGENCIES
REPRESENTED IN OUR SCIENTIFIC
STEERING COMMITTEE. WE FELT VERY
STRONGLY THAT AS NOTED THE BOND
PROJECT IS INTENDED TO HARMONIZE
IF YOU DON'T HAVE ALL THE
PLAYERS ON BOARD AND SIGNED ON
AND INVEST MISDEMEANOR THE
PROJECT AND OUTCOME, YOUR
CHANCES OF BEING ABLE TO
HARMONIZE ARE SLIM AND NONE. SO
WE ARE GRATEFUL FOR THE
SCIENTIFIC STEERING COMMITTEE
AND TODAY WE WILL HEAR FROM LAST
OF FOUR WORKING GROUPS WHO ARE
DOING THE HARD WORK. THIS IS
JUST A CARTOON REPRESENTING THE
CONTINUUM OF CONTENT THAT WE ARE
COVERING THE BOND KIDS PROJECT.
ON THE LEFT SIDE IS THE WORKING
GROUP THAT NUTRITIONAL STATUS
AND INTERACTION WITH VARIOUS
FUNCTIONAL DOMAINS ALL
SUPERIMPOSE OVER TOP OF THAT IS
IMPACT OF ENVIRONMENT WHICH
AFFECTS ALL THOSE THINGS AND HOW
WE UNDERSTAND THE INTERSECTION
BETWEEN THE ENVIRONMENT AND THE
BIOLOGY IS THE CHALLENGE OF THE
BOND KIDS PROJECT. WORKING GROUP
3 IS YOU HEARD FROM LAST WEEK IS
FOCUSED ON ASSESSMENT HOW TO PUT
THESE TOGETHER IN SOME SORT OF
MEANINGFUL WAY AND TODAY WE WILL
HEAR FROM THE TRANSLATION
IMPLEMENTATION GROUP LED BY DR.
KRISTINA CAMPOS AND DON BUNDY
AND WITH THAT THANK YOU AND I
WILL TURN THE MEETING OVER TO
DR. ECONOMOSS. I'M CHRIS
EXCELLENT SERIES OVER THE PAST
MONTH. AND AS YOU HEARD, I'M
CO-CHAIRING THIS WORKING GROUP
AND HAVE BEEN HONORED TO DO THAT
WITH DON BONDY SO BEFORE I
DELIVER REMARKS AND SLIDES I
WANT TO TURN IT OVER TO DON TO
SAY A FEW WORDS.
>> THANK YOU VERY MUCH, IT'S A
PLEASURE TO WORK WITH YOU AND
DON AND THE TEAM AT NIH. I THINK
THIS IS A TERRIFIC OPPORTUNITY
THAT NOW LIES BEFORE US. THIS
IS A IS A BEING OF A PROCESS,
NOT THE END THOUGH THE END OF
FOUR WORKSHOPS THIS MARCH SO
VERY EXCITED WHERE WE GO NEXT
AFTER THIS. THANK YOU, CHRIS.
>> GREAT, THANK YOU. BEFORE WE
FORMALLY KICK OFF THE AGENDA, I
WANT TO THANK THE NIH AND DAN
RAITEN AND MEMBERS OF THIS
WORKING GROUP MANY WHOM YOU ARE
HEAR FROM TODAY, IT'S BEEN A
PLEASURE WORKING WITH YOU AND
BEING THE LAST GROUP WE TRIED TO
TAKE INTO CONSIDERATION
EVERYTHING WE HEARD IN THE LAST
FEW WEEKS AND PUT THIS TOGETHER
TO HOPEFULLY COMMUNICATE PRETTY
EXCITING VISION FOR TRANSLATION
AND IMPLEMENTATION. SO DURING
THIS FOURTH WORKSHOP WHICH IS
FOCUSED ON TRANSLATION AND
IMPLEMENTATION WE HAVE THE GOAL
OF BRINGING THE WORK OF BOND
KIDS TOGETHER AND TO COMMUNICATE
THE FULL COMPLEXITY OF WHAT IT
TAKES TO DELIVER AND ASSESS
CHILDHOOD NUTRITION PROGRAMS
WORLDWIDE. TO BEGIN I WANT TO
SHARE THE MODEL DEVELOPED BY
WORKING GROUP IF WE CAN PULL UP
THE SLIDE, CENTERS ON CHILD
HEALTH AND DEMONSTRATES THE
CONTEXT WITHIN WHICH CHILD
NUTRITION IS ACHIEVED. THERE ARE
CHALLENGES TO ASSESSING THE
SOURCES OF NUTRITION AND THEIR
IMPACT. WE HOPE THIS MODEL GIVES
AN APPRECIATION OF THE VARIABLES
UP AND DOWN THE DECISION TRAIN
TO HAVE INTEGRATED APPROACH TO
NUTRITIONAL ASSESSMENT. WE HEARD
PREVIOUSLY WHAT TO ASSESS AND
HOW TO ASSESS IT AND TODAY WE
WILL DISCUSS THE NEED TO DEVELOP
THE SUPPORT AND THE
INFRASTRUCTURE TO DO IT. WHEN
YOU LOOK AT THIS MODEL I WANTED
YOU TO CONSIDER THREE THINGS,
THE FIRST IS THERE ARE MULTIPLE
LAYERS SURROUNDING A CHILD,
SECOND THERE ARE IMPLEMENTATION
FACTORS THAT NEED TO BE
CONSIDERED TO MAKE THIS WHOLE
COMPLEX SYSTEM WORK WORK. THIRD,
THERE ARE THREE KEY
DEVELOPMENTAL STAGES THAT NEED
TO BE CONSIDERED IN PLANNING,
IMPLEMENTATION, AND ASSESSMENT.
SO JUST TO QUICKLY WALK YOU
THROUGH THIS MODEL WHICH WE
CONSIDER A DRAFT AND HOPE A LOT
OF INPUT WE GET TODAY AND FUTURE
DISCUSSION WITH THE OTHER
WORKING GROUPS WILL FURTHER
DEVELOP THIS MODEL. SO AS YOU
CAN SEE IN THE CENTER WE HAVE
CHILD FOCUS HEALTH AND
NUTRITIONAL STATUS. THE LAYER
SURROUNDING THEM FOR PURPOSES OF
BOND KIDS, IS THE ACTUAL FOOD
FOR THE MECHANISM OF DELIVERY.
THEY ARE GETTING MEALS, GETTING
PACKAGE FOODS, SNACKS,
SUPPLEMENTATION, FORTIFICATION,
LOCAL INDIGENOUS AND ALSO
NUTRITION SENSITIVE PACKAGED
FOOD. SURROUNDING THAT IS THE
ENVIRONMENT WHICH YOU HEARD
ABOUT A COUPLE OF WEEKS AGO.
CHILDREN RECEIVE THESE FOODS IN
DIFFERENT SETTINGS IN THE
SCHOOL, WHICH WE ARE VERY
FOCUSED ON WE HEAR A LOT ABOUT
TODAY, FROM HOSPITALS AND
CLINICS AND THE COMMUNITY AT
LARGE, SUMMER PROGRAMS, AFTER
SCHOOL PROGRAMS, SOMETIMES IN
THE WORKPLACE, DEPENDING UPON
WHERE A CHILD IS, AFTER THE AGE
OF 15 OR 16, WITHIN THEIR
HOUSEHOLD WITH THEIR FAMILY, AND
THEN THERE ARE CHILDREN ACROSS
THE GLOBAL IN EXCEPTIONAL
ENVIRONMENTS FOR EXAMPLE, FOSTER
CARE, ORPHAN AGES REFUGEE CAMPS
SO MANY DIFFERENT ENVIRONMENTS
WITHIN WHICH WE DELIVER FOOD.
THE LAST REPRESENT IT IS LARGER
SYSTEMS THAT IMPACT ALL OF THIS,
THE ENERGY AND EFFECTIVENESS OF
THE FOOD ITSELF AND DELIVERY OF
FOOD INCLUDING POLICY, FOOD
SYSTEMS AND AGRICULTURE AS DAN
MENTIONED, DIFFERENT
GOVERNMENTS, THE HEALTH OF
DIFFERENT COUNTRY, EDUCATION
SYSTEM, MARKETING, SOCIAL
PROTECTION, FOOD DESERTS, FOOD
SAFETY, SO ON. WHAT OUR GROUP
FOCUSED ON IS WHAT YOU CAN SEE
ON THE RIGHT WHICH WE CALL
IMPLEMENTATION INDICATORS. THE
KINDS OF THINGS YOU WILL HEAR
ABOUT TODAY REALLY REPRESENT THE
IMPORTANT INDICATORS WITHIN EACH
OF THESE SYSTEMS. SO STARTING
AGAIN AT THE CENTER WE HAVE
EFFECTIVENESS. ARE THESE
PROGRAMS EFFECTIVE? CAN WE
ACTUALLY MEASURE AND ASSESS
WHETHER OR NOT NUTRITION IS
BEING DELIVERED AND WE ARE
PROMOTING THE HEALTH OF
CHILDREN. THE NEXT LAYER OUT YOU
SEE THE ACTUAL INDICATORS AROUND
THE FOOD ITSELF. COST, THE
QUALITY OF THE FOOD, THE
STABILITY OF A SHELF LIFE OF THE
FOOD AND SUSTAINABILITY OF THE
FOOD ITSELF SPEAKING DIRECTLY TO
FOOD SYSTEM HERE. THE NEXT LEVEL
OUT SHOWS THINGS WITHIN THESE
ENVIRONMENTS THAT WE NEED TO
TAKE INTO CONSIDERATION LIKE
EQUITY, REACH, WITH FIDELITY OF
THE PROGRAM, FOR PEOPLE TO
ACTUALLY IMPLEMENT THE AND
POLICY INFRASTRUCTURE AND HOW
THINGS ARE ACTUALLY DISTRIBUTED,
AND WHETHER THAT'S EQUITABLE.
LAST BUT NOT LEAST THE OUTER
LAYER SOME OF THE INDICATORS
INCLUDE POLITICAL WILL, ECONOMIC
LANDSCAPE AND CONDITIONS OR
CONTACTS FOR SCALE AND
SUSTAINABILITY AT THESE
PROGRAMS. AND THE ONE AT THE
BOTTOM WE HAVE DEVELOPED SIMPLY
THESE THREE DEVELOPMENTAL STAGES
10 TO 13 AND 14 TO 19. AS YOU
KNOW EACH YEAR ACTUALLY MATTERS.
WE HAVE ALSO DEVELOPED SOME
OVERARCHING PRINCIPLES WE
CONSIDER A DRAFT AND WE WANT
INPUT TODAY THAT WE BELIEVE ARE
INTEGRAL TO THE IMPLEMENTATION
AND TRANSLATION FRAMEWORK. THESE
INCLUDE THE FACT THAT
INTERVENTION DESIGN MUST BE
PURPOSEFULLY TARGETED FOR
DIFFERENT DEVELOPMENTAL STAGE,
ALL REQUIRES TRANSDISCIPLINARY
SCIENCE AND I THINK BETWEEN ALL
FOUR WORKING GROUPS YOU HAVE
HEARD MANY DIFFERENT PEOPLE
SPEAK FROM DISCIPLINES THAT ARE
EXTREMELY IMPORTANT TO MAKE ALL
THIS WORK. AND TRANSDISCIPLINARY
SCIENCE FOSTERS COLLABORATION
AND CONSIDERS BIOLOGY, ECOLOGY
AND IMPLEMENTATION SCIENCE.
AMONG OTHERS. WE ALSO BELIEVE
EQUITABLE ENGAGEMENT OF DIVERSE
STAKEHOLDERS FOSTERS INCLUSION,
DEVELOPS RELATIONSHIPS, BUILDS
BUY IN AND CO-CREATES CONTEXT
SPECIFIC CUSTOMIZATION OF
INTERVENTIONS. NEXT A RANGE OF
CONTEXTUAL DRIVERS INCLUDING
SOCIAL POLITICAL RACIAL
HISTORICAL AND ECONOMIC IMPACT
NUTRITION PROGRAMMING AND ALL
NEEDS TO BE CONSIDERED. NEXT
POLICIES INTERVENTIONS AND
PROCEDURES DEVELOPED IN ONE
SETTING, MAY NOT BE APPLICABLE
TO ANOTHER. AND THIS REALLY
SPEAKS TO BOTH INTERNAL AND
EXTERNAL VALIDITY AND WHEN WE
DEVELOP THE EVIDENCE HOW WE NEED
TO CONSIDER TRANSLATION OF IT.
LAST BUT NOT LEAST BUILDING FOR
SUSTAINABILITY INCLUDES ECONOMIC
AND FINANCIAL ANALYSES
APPROPRIATE FIT WITHIN EXISTING
SYSTEMS AND FLEXIBLE ADAPTATION.
SO ALL THESE ARE REALLY
IMPORTANT MAKE THIS FRAMEWORK
COME ALIVE SO THE WAY THAT WILL
RUN NEXT COUPLE OF HOURS IS
FIRST HEAR FROM WORKING GROUP
MEMBERS WHO WILL BRING THE
FRAMEWORK TO LIFE AND THEN WE
WILL HAVE A LITTLE BIT OF TIME
FOR CLARIFICATION WITH THE
SPEAKERS THEN WE HAVE FOUR
INVITED SPEAKER WHOSE WILL
DISCUSS WHAT WE DO IN PRACTICE
AND HOW WE SHOULD THINK ABOUT
BRINGING PHASE 2 OF THE BOND
KIDS WORK TO LIFE. WITHOUT
FURTHER ADIEU I WOULD LIKE TO
INTRODUCE OUR FIRST SPEAKER WHO
IS WORKING GROUP MEMBER, DEANNA
FROM UT HEALTH SCHOOL OF PUBLIC
HEALTH, WHO WILL TALK ABOUT
IMPLEMENTATION AND TRANSLATION
FRAME WORKS AND APPLICATION.
WELCOME, DEANNA.
>> THANKS, CHRIS. GOOD MORNING
AND THANKS TO Y'ALL FOR JOINING
US. I'M REALLY HONORED TO BE
PART OF THIS GROUP. MY JOB THIS
MORNING IS TO GIVE AN EXAMPLE TO
GIVE OVERVIEW OF IMPLEMENTATION
AND TRANSLATION AND INCLUDING
DEFINITIONS, CURRENT FRAMEWORK
AND CONCEPTING CONCEPTS INCLUDING POTENTIA L
MODELS AND POTENTIAL NEW
DIRECTIONS THAT INFORM OUR WORK.
FOR THIS PRESENTATION I WILL
REFER TO WHAT IS TRANSLATED AS
AN INNOVATION OR INTERVENTION
BECAUSE THAT IS HOW IT IS
REFERRED TO A LOT OF TIMES IN
THE LITERATURE. SO NEXT SLIDE.
WHAT IS IMPLEMENTATION AND
TRANSLATION? WE KNOW THAT IT
CREATES AN AVERAGE OF ABOUT 17
YEARS TO TAKE AN INTERVENTION
FROM BENCH TO BEDSIDE TO
COMMUNITY. THE TRANSLATIONAL
RESEARCH FRAMEWORK DEVELOP BY
BEGIN SIMILAR PROJECT TO OURS,
ILLUSTRATES THIS PROCESS AS T 1
TO T 5 TRANSLATION WHICH
PROCEEDS ARE FROM DISCOVERY TO
HUMAN HEALTH, IMPLICATIONS TO
CLINICAL AND PUBLIC HEALTH
IMPLICATIONS, TO IMPLEMENTATION
TO IMPACT. SO ANOTHER WAY OF
LACKING AT THAT CONTINUUM.
MOVEMENT OF EVIDENCE BASED
PRACTICES ISN'T SPONTANEOUS. BUT
IT REQUIRES EFFORT. THE ULTIMATE
GOAL IS PUBLIC HEALTH IMPACT OR
POPULATION HEALTH IMPACT. THIS
IS A SOCIAL PROCESS INTERTWINE
WITH CONTEXTUAL FACTORS.
TRANSLATIONAL SCIENCE
ACCELERATES THIS PROCESS. WHILE
IMPLEMENTATION SCIENCE STUDIES
METHODS TO INCREASE THE ADOPTION
IMPLEMENTATION AND MAINTENANCE
OF EVIDENCE BASED POLICIES,
PROGRAMS, PRACTICES AND
GUIDELINES.S. NEXT SLIDE PLEASE.
THIS SLIDE LISTS COMMON MODELS
OR FRAME WORKS USED IN
IMPLEMENTATION SCIENCE, THEY ARE
THE BASIS FOR SOME NUTRITION
FOCUS FRAME WORKS. AS WELL AS
OUR WORK HERE. DIFFUSION
INNOVATION IS AN OLDER THEORY
WITH SEVERAL CONCEPTS RELATED TO
OUR WORK. FIRST THERE'S
DIFFERENT KINDS OF ADOPTERS, AND
THEY RANGE FROM INNOVATORS AND
EARLY ADOPTERS TO -- SO
SOMETHING TO CONSIDER. DIFFUSION
OF INNOVATION HIGHLIGHTS
ADOPTION PROCEDURE THAT BEGINS
WITH KNOWLEDGE AND PERSUASION
AND GOES THROUGH IMPLEMENTATION
AND CONFIRMATION. DIFFUSION
INNOVATION ALSO TAKES INTO
ACCOUNT THE CHARACTERISTICS OF
THE INNOVATION OR INTERVENTION
SUCH AS RELATIVE ADVANTAGE
COMPARED TO WHAT WAS DONE
PREVIOUSLY, COMPLEXITY OF THE
INNOVATION AND COMPATIBILITY
WITH THE CONTEXT INTO WHICH IT
IS PLACED. REAIM IS AN ACRONYM
FOR REACH EFFECTIVENESS ADOPTION
IMPLEMENTATION, AND MAINTENANCE
IS ONE OF THE MOST USED
FRAMEWORKS IN IMPLEMENTATION
SCIENCE. REACH IS THE NUMBER OR
PROPORTION OF PEOPLE THE
INNOVATION REACHES. WHILE
ADOPTION IS THE NUMBER OR
PROPORTION OF SETTINGS OR
IMPLEMENTATION AGENTS WILLING TO
DELIVER INNOVATION OR
INTERVENTION. EFFECTIVENESS
LOOKS AT IMPACT ON OUTCOMES
WHILE IMPLEMENTATION LOOKS AT
CONSIDERS THE FIDELITY TO AN
INTERVENTION PROTOCOL OR
CONSISTENCY OF DELIVERY.
FINALLY, MAINTENANCE IS
SUSTAINABILITY. CEPR PROVIDES A
SYSTEMS OR YENNED FRAMEWORK FOR
IMPLEMENTATION OF RESEARCH
FINDINGS INTO PRACTICE THROUGH
FIVE DOMAINSS. THE FIGURE HERE
ILLUSTRATES THIS THROUGH
NUTRITION LENS. SO DOMAIN 1
LOOKS AT CHARACTERISTICS OF THE
INNOVATION, DOMAIN 2 LOOKS AT
THE ENTERSETTING YOU SAW IN OUR
MODEL, DOMAIN 3 LOOKS AT THE
OUTER SETTING OR EXTERNAL
ENVIRONMENT. THERE IS PLASTICITY
BETWEEN THESE TWO. DOMAIN 4
LOOKS AT INDIVIDUALS IMPLEMENT
EFFECTED BY THE INTERVENTION.
AND THEN DOMAIN 5 ACTUALLY
COVERS THE IMPLEMENTATION
PROCESSES. THE SOCIETY FOR
IMPLEMENTATION SCIENCE AND
NUTRITION, AND INTERNATIONAL
ORGANIZATION HAS DEVELOPED AN
INTEGRATED FRAMEWORK FOR
IMPLEMENTATION SCIENCE. WHICH
INCLUDES SEVERAL CONCEPTS THAT
ARE RELEVANT TO OUR WORK HERE IN
BOND KIDS. THE FIRST PART IS
CONTEXTUAL KNOWLEDGE AND
EXPERIENCE. THIS REFERS TO THE
KNOWLEDGE AND EXPERIENCE OF
PLANNERS IMPLEMENTERS AND OTHERS
THAT KNOW ABOUT THE CONTEXT.
THIS IS A FACTOR THAT'S OFTEN
TAKEN FOR GRANTED SO WE HAVE
INCLUDED THAT IN OUR MODEL.
CONTEXTUAL IMPLEMENTATION
RESEARCH INVOLVES FORMATIVE
RESEARCH THAT EXPANDS ON THE
GLOBAL KNOWLEDGE AND EXPERIENCE.
AND SO THIS INCLUDES THINGS LIKE
RAPID ASSESSMENTS, PROCESS
EVALUATION, AND MONITORING AND
SURVEILLANCE AND HOW WE RESPOND
TO THAT. FROM THE ROLL OUT OF AN
INTERVENTION. GLOBAL KNOWLEDGE
AND EXPERIENCE REFERS TO
RESEARCH KNOWLEDGE BUT ALSO
PRACTICERS ON THE GROUND.
THROUGH THESE THREE COMPONENTS
IN IMPLEMENTATION SCIENCE WE
TAKE THE FRAMEWORKS, GUIDELINES
AND TOOLS AND MAKE THEM MORE
ACCESSIBLE THROUGH CAPACITY
BUILDING, TECHNICAL ASSISTANCE,
AND KNOWLEDGE BROKERING AND
COACHING. SARLA ET AL CONDUCTED
MARETIVE REVIEW OF
IMPLEMENTATION SCIENCE FRAME
WORKS. FRAME WORKS MODELS AND
VARIES AND THEN CONDUCTED AD
QUALITATIVE THEMATIC ANALYSES
USED TO DEVELOP THIS MODEL FOR
EVALUATING NUTRITION
INTERVENTION IN A REAL WORLD
SETTING. SO DOMAIN 1 INCLUDES
EFFECTIVE INTERVENTIONS OR
INNOVATIONS TO BE TRANSLATED
INTO PRACTICE. AND THAT'S WHAT
WE ARE GETTING THROUGH OTHER
WORK GROUPS IN BOND KIDS.
DOMAIN 2 IS SCALING UP WHICH
FOCUSES ON THE IMPLEMENTATION
PROCESS, WITH FIDELITY. ONE
UNIQUE ASPECT OF THIS MODEL IS
THAT IT INCLUDES A COURSE
CORRECTION DURING IMPLEMENTATION
AS YOU CAN SEE BELOW THAT IS
FROM THE DATA THAT YOU GET FROM
RAPID ASSESSMENT AND HOW YOU CAN
CHANGE COURSE. THE OTHER THING
ABOUT THIS MODEL IS THAT IT IS
ITERATIVE SO YOU CAN SEE
BIRECOLLECTIONAL ERRORS ON IT.
THE LAST DOMAIN FOCUSES ON
SUSTAINABILITY WHICH WILL BE
DESCRIBED A LITTLE LATER. SO
HOW CAN WE MOVE IMPLEMENTATION
SCIENCE FORWARD IN BOND KIDS?
ONE THING LOOKING AT THE
PREVIOUS MODELS THAT I
PRESENTED, THERE IS A FEW THINGS
THAT ARE MISSING THAT ARE
ESPECIALLY RELEVANT TO OUR WORK
HERE. ONE IS THE CHILD FOCUS.
AND THAT INCLUDES AN EMPHASIS ON
DEVELOPMENTAL STAGES, IMPACT IN
TERMS OF HEALTH AND NUTRITIONAL
STATUS AND OTHER CONTEXTUAL
FACTORS IN A VERY SPECIFIC TO
CHILDREN SO THEY MIGHT BE IN THE
MODEL BUT THEY ARE NOT
NECESSARILY EXPLICIT. THE
SECOND CONCEPT OFTEN MISSING IS
NOT EXPLICIT IN THESE MODELS IS
HEALTH EQUITY. IT IS NOT OFTEN
PRESENTED AS A SPECIFIC PART OF
THE FRAME WORKS IN THE MODEL
FROM OUR RECENT PAPER IN ANNUAL
REVIEW OF PUBLIC HEALTH, HEALTH
EQUITY WAS AN OVERARCHING
CONCEPT. AFTER ARRIVING AT A
FRAMEWORK THE NEXT STEP IS PLAN
AND SELECT IMPLEMENTATION
STRATEGIES. THAT CAN BE DONE
WITH A THEORY BASED SYSTEMATIC
PROCESS SUCH AS IMPLEMENTATION
MAPPING. THIS CAN FURTHER ENSURE
EVIDENCE BASE TRANSITION FROM
BENCH TO BED TO COMMUNITY. FOR
BOND KIDS. THANK YOU VERY MUCH.
>> THANK YOU, DEANNA, THAT WAS
EXCELLENT. I WAS REMINDED TO
SHARE WITH THE AUDIENCE THAT
EVERYONE WITHIN WORKING GROUP 4
IS DOING RESEARCH IN COMMUNITIES
AND SCHOOLS AND REALLY IN THE
WORLD -- REAL WORLD SO TO SPEAK
AND TRANSLATING THIS. SO OUR
DISCUSSION WERE QUITE ROBUST IN
TERMS OF HAVING THE EXPERIENCE
PUTTING THESE FRAME WORKS TO
WORK AND ALSO SEEING THE MANY
CHALLENGES AND COMPLEXITY WHICH
LEADS ME TO INTRODUCE THE NEXT
SPEAKER TOM ROBINSON FROM
STANFORD UNIVERSITY WHO WILL
TALK PRAGMATIC SYSTEMS
APPROACHES. WELCOME, TOM.
>> THANK YOU, CHRIS. MY ROLE IS
TO STIMULATE INTEREST IN
APPLYING MORE SYSTEMS THINKING
TO OUR INTERVENTION DESIGN. AND
EVALUATION AND ASSESSMENT. AS
YOU HAVE HEARD ALREADY FROM DR.
RAITEN AND THE COMMENTS HE MADE
AND DR. ECONOMOS AND DR. HOLZIER
THIS SYSTEMS PERSPECTIVE IS A
LARGE PART OF OUR DISCUSSIONS
AND HOW WE THINK WE WANT TO LOOK
AT THESE AT THE PROBLEMS OF
NUTRITION. THE -- IF YOU WEREN'T
ALREADY A BELIEVER THAT THE
WORLD IS RUN OR OCCURS THROUGH
COMPLEX SYSTEMS, AND THE
PANDEMIC HAS SURELY HELPED MAKE
YOU AWARE OF THAT, AND INCREASE
THE IMPORTANCE OF IT, SEEING HOW
SARS COV-2 PANDEMIC HAS SHOWED
HOW INTERCONNECTED EVERYTHING IN
OUR WORLD IS IS. THAT A INFECTION,
THAT PROBABLY STARTED IN A
MARKET IN WUHAN CHINA, SPREAD
ACROSS THE WORLD HAS LED TO MORE
THAN 6 MILLION DEATHS THAT HAVE
BEEN REPORTED. REACHED EVERY
CORNER OF THE WORLD INCLUDING
INDIGENOUS ON POPULATIONS,
AFFECTED OUR SUPPLY CHAINS AND
OUR ECONOMY AND CREATED
WIDESPREAD FOOD INSECURITY IN
PLACES. THIS IS A JUST THE CAUSE
OF A VIRUS, THE ACTION OF A
VIRUS THAT LED TO ALL THESE
DISPARATE OUTCOMES AND CHANGED
ALL OF OUR LIVES SO MUCH, IT WAS
A RESULT OF BILLIONS AND
BILLIONS OF DECISIONS AND
ACTIONS THAT OCCURRED THAT ALL
INTERACTED WITH EACH OTHER,S TO
LEAD TO THIS SPECIFIC OUTCOME,
SPECIFIC OUTCOMES IN OUR LIVES
AND AS WE HAVE SEEN THIS
TREMENDOUS DIFFERENCES ACROSS
COUNTRIES, REGIONS WITHIN
COUNTRIES EVEN NEIGHBORHOODS
WITHIN REGION, WITHIN
COMMUNITIES, IN THE OUTCOMES
BASED UPON ALL THOSE
INTERACTIONS HAVE PLAYED OUT.
DESPITE THIS UNDERSTANDING AND
INTUITIVE UNDERSTANDING OF
SYSTEMS, AND THE BELIEF THAT WE
ALL UNDERSTAND HOW IMPORTANT
THEY ARE, FROM A COMMON SENSE
POINT OF VIEW, THEY HAVE NOT
NECESSARILY THIS TYPE OF
THINKING HAS NOT NECESSARILY
CHANGED MANY OF THE PUBLIC
HEALTH AND NUTRITION
INTERVENTIONS THAT HAVE BEEN
CREATED. NEXT SLIDE PLEASE.
STILL MOST INTERVENTIONS THAT
ARE CREATED ARE PROGRAMS ARE
VERY MANY IN REDUCTIONISTIC IN
HOW THEY ARE DONE, DESPITE
UNDERSTANDING AND ACKNOWLEDGING
THIS BROADER SYSTEMS OR
ECOLOGIES AS DR. RAITEN
MENTIONED. AND SO THEY ARE
GENERALLY THIS TIERED APPROACH
TO INTERVENTION IS APPLIED TO A
POPULATION OR PERSON AND IT
LEADS TO OUTCOMES. THERE IS
MUCH MORE AWARENESS OF
MULTI-LEVEL INFLUENCES ON
OUTCOMES, AND NUTRITION AND THIS
IS JUST ONE EXAMPLE OF THOUSANDS
THAT EXIST, ONE THAT A COLLEAGUE
AND I PUT TOGETHER, OF THE
CONCENTRIC CIRCLES THAT YOU SAW
SIMILAR TO THE MODEL DR.
ECONOMOS PUT UP IN A BETWEEN
PERSON PERSPECTIVE WE HAVE
EVERYTHING FROM GLOBAL SOCIETY
DOWN TO THE INDIVIDUAL, WITH THE
INDIVIDUAL BEHAVIORS, IN THE
CENTER AND THEN FROM A WITHIN
PERSON PERSPECTIVE EVERYTHING
FROM THE INTACT PERSON DOWN TO
THE MOLECULAR LEVEL. HOWEVER,
THESE MULTI-LEVEL INTERVENTIONS
STILL ARE VERY OFTEN
REDUCTIONISTIC IN THEIR APPROACH
TO LOOKING AT EACH LEVEL AND
TRYING TO HIT EACH LEVEL BUT NOT
ADDRESSING THE INTERACTIONS
BETWEEN THESE LEVELS OR THE
COMPONENTS OF THESE LEVELS. AND
THAT'S WHERE WE ARE TRYING TO
PUSH THIS FORWARD. NEXT SLIDE
PLEASE. THIS MAY BE FAMILIAR TO
MANY OF YOU, THIS IS THE OBESITY
SYSTEMS MAP, PUT TOGETHER BY THE
FOR SIGHT GROUP IN THE UNITED
KINGDOM AND THIS WAS IN APPROACH
TO THE SYSTEMS THAT INFLUENCE
OBESITY, HERE. THIS IS MORE HOW
YOU WOULD DISPLAY COMPLEX SYSTEM
YOU CAN SEE THERE ARE MANY
INTERACTIONS HERE, THIS OF
COURSE IS THE TOP LEVEL MODEL,
IT IS MUCH MORE COMPLEX THAN
THIS BECAUSE YOU CAN DRILL DOWN
ANY OF THESE AND SEE TREMENDOUS
NUMBER OF HYPOTHESIZE OR SOME
CASES DEMONSTRATED INTERACTIONS
THAT OCCUR TO LEAD TO GAINS IN
WEIGHT FOR EXAMPLE. AND SO THIS
IS MORE OF THE WAY THAT WE START
THINKING. SO HOW DO YOU APPLY
SOMETHING LIKE THIS TO
INTERVENTION DESIGN AND
EVALUATION? ONE INSTEAD OF
TRYING TO PREDICT HOW THINGS
WILL OCCUR AND UNDERSTANDING TO
TRY TO DRAW PATHWAYS, THINKING
ABOUT WHAT ARE THE
CHARACTERISTICS, WHAT ARE THE
FEATURES OF A COMPLEX SYSTEM,
THAT CAN BE USED IN DESIGNING
YOUR INTERVENTION OR YOUR
ASSESSMENT. ONE IS THAT A
COMPLEX SYSTEM TENDS TO BE
HOLISTIC, WHOLE, EVERYTHING IS
CONNECTED, YOU HAVE TO LOOK
BROADER THAN ANY SINGLE LEVEL.
YOU HAVE TO LOOK AT A ALL OF
THEM TOGETHER, OR YOU MISS OUT
ON ALL THOSE, IT TENDS TO BE
COMPLEX SYSTEMS TEND TO BE
DYNAMIC AND THEY CHANGE OVER AND
SO THESE CONNECTIONS AND THESE
MAY CHANGE OVER TIME AND -- OVER
TIME. THE INTERACTIONS THAT I
TALK ABOUT ARE A KEY FEATURE IN
THAT EVERYTHING IS RELATED TO
EVERYTHING ELSE, SOME OF THESE
REX TREATMENTLY HIGH ORDER
INTERACTIONS SO IT IS NOT JUST
ONE THING ONE FACTOR MORE THAN
ANOTHER BUT MAY BE A TENTH ORDER
INTERACTION OR 20TH ORDER
INTERACTION. IT ALSO LEADS TO
OPPORTUNITIES FOR FEEDBACK
LOOPS, TIPPING POINTS, FEATURES
LIKE THAT, WHERE SOMETHING
ACTUALLY MODIFIES THE -- YOUR
EXPOSURE TO DIFFERENT COMPONENTS
OFFER AN INTERVENTION OR
DIFFERENT COMPONENTS IN THAT
SURROUNDING ECOLOGY, AND
ACTUALLY LEADS TO THESE
NON-LINEAR CHANGES THAT OCCUR,
IF YOU THINK ABOUT YOUR
EXPERIENCE IN DOING NUTRITIONAL
INTERVENTIONS, THIS IS HOW
CHANGE OCCURS, THE FACT THAT WE
GENERALLY THINK OF THINGS AS THE
SMOOTH LINEAR CHANGES THAT OCCUR
OVER TIME THAT YOU GRADUALLY
WORK YOUR WAY UP OVER A SLOPE
FROM A TO B IN FACT THAT IS NOT
HOW CHANGE USUALLY OCCURS IN ANY
SETTING, CHANGES THAT OCCURS IN
THESE NON-LINEAR BURSTS OF
CHANGE THAT OCCUR AT ONE POINT
OR ANOTHER IN DIFFERENT FROM --
FOR DIFFERENT PEOPLE. THEN ALSO
THE IDEA THAT YOU HAVE TO -- WE
HAVE TO ACCEPT THE IDEA MULTIPLE
CAUSAL PATHWAYS EVEN THOUGH WE
MAY DRAW SIMPLE CIRCLES AND
SQUARES AND ARROWS THAT IN
GENERAL THERE ARE DIFFERENT
PATHWAYS TO GET O THE SAME
POINT. SO YOU HAVE TO TAKE THAT
AS A GIVEN AS OPPOSED TO FEEL
THAT IS A SOURCE OF NOISE. NEXT
SLIDE PLEASE. SO HOW WOULD YOU
START DOING THAT, FOR EXAMPLE,
YOU START WITH YOUR THEORY OF
CHANGE, POPULATION OR THE
INDIVIDUAL LEVEL, THAT LEADS TO
YOUR KEY INTERVENTION ACTIVITIES
OR COMPONENTS THAT YOU MAY MAP
ON TO, THESE ARE THE
INTERVENTION COMPONENTS THAT YOU
THINK ARE MOST IMPORTANT IN
CHANGING BEHAVIOR, IMPROVING
NUTRITION. AND THEN STARTING
WITH THOSE YOU HAVE TO BUILD A
MODEL OF INTERVENTION. AND PLANS
FOR INTERVENTIONAL VARIATIONS IN
HOW PEOPLE OR HOW POPULATIONS
WILL RECEIVE THESE
INTERVENTIONS, IN TIMING AND THE
ORDER OF INTERVENTIONS, IN
EXPOSURE TO THE INTERVENTIONS
AND TENSION THEY PLAY TO THEM IN
THEIR RETENTION OR ADHERENCE TO
INTERVENTION COMPONENTS TO MARE
THEIR MOTIVATION, ALL THINGS
THAT ALTER EVEN IF YOU ARE DOING
SOMETHING AT THE POPULATION
LEVEL, THESE ARE DIFFERENT FOR
EVERY INDIVIDUAL. YOU ALSO PLAN
FOR CONTEXTUAL INDIVIDUAL
CHANGES OVER TIME. SOMETHING
HAPPENS TO A FAMILY, TO A
COMMUNITY, THAT TOTALLY CHANGES
THE SYSTEM AROUND IT, AND THESE
INTERACTIONS AN SOMETHING THAT
WAS EFFECTIVE ONE DAY MAY BE
INEFFECTIVE BECAUSE OF CHANGE
THAT OCCURRED IN THE CONTEXT. IN
DOING THIS HOW TO ADAPT TO ALL
OF THESE VARIATIONS THAT OCCUR,
FOR EXAMPLE IN OUR INTERVENTION
WE THINK ABOUT REPETITION OR
REDUNDANCY AND REINFORCEMENT
OPPORTUNITIES FOR MASTERY IN
DIFFERENT ASPECTS OF OUR
INTERVENTION SO THAT IF SOMEONE
MISSES IT AT WINOR ONE POINT OR
WRONG TIMING AT ONE POINT IT
BECOMES THE RIGHT TIMING IN
ANOTHER POINT AND THAT
ENTERRECOLLECTION IS THERE FOR
THEM TO TAKE ADVANTAGE OF THE
LIGHT TIME TOR FOR THAT. CREATING
OPPORTUNITIES FOR INTERACTION OR
WHAT I THINK OF AS CATALYSTS AND
THEN HOW DO YOU MAKE THOSE
INTERVENTIONS, OCCUR MORE OFTEN
IN A HIGHER FREQUENCY AND THEN
FINALLY ASSUMEK AS I SAID BEFORE
THE MULTIPLE CAUSAL PATHWAYS IS
BUILD THAT INTO DESIGN OF
INTERVENTIONS, AND CAN BE IN THE
DESIGN OF EVALUATIONS. SO NEXT
SLIDE. SO THIS IS A SIMPLE
SIMPLIFIED EXAMPLE HOW I GO BACK
TO SORT OF PHYSICAL CHEMISTRY,
AND IF ALL THESE ARE PEOPLE, IN
A SPACE, IN IN A COMMUNITY, AND
YOU ARE TRYING TO GET THEM TO
INTERACT WITH INTERVENTION, OR
NEXT SLIDE, SO THAT THE -- IN
THIS CASE SO THE PURPOSE BILL OR
THE DARK BLUE DOTS MAY BE YOUR
BASIC INTERVENTION OR YOUR
PRIMARY INTERVENTION COMPONENT,
FOR EXAMPLE IN THIS CASE A
FAMILY BASED INTERVENTION. THEN
YOU ADD IN MAYBE A SCHOOL
COMPONENT THAT WOULD BE THE
BLACK BOXES. THERE ARE MORE
OPPORTUNITIES FOR THESE
INDIVIDUALS TO BUMP INTO YOUR
INTERVENTION, INTERACT WITH IT
IN THIS WAY AND THIS GETS AT A
LEVEL ASPECT OF THINGS IS THAT
YOU IF YOU DON'T GET IT AT HOME
AND THE HOME INTERVENTION IS
COMING FROM THE SCHOOL SETTING.
THEN YOU ADD THESE -- ANOTHER
CATALYST FOR EXAMPLE, THIS WILL
BE THE STARS ADDED, THAT WHEN
THOSE INTERACT WITH THE PERSON,
AND ONE OF YOUR INTERVENTIONS,
THAT LEADS TO I WOULD LIKE
PERHAPS POLICY CHANGE SCHOOL
ENVIRONMENT TO MAKE SCHOOL LUNCH
FREE FOR EVERYBODY. NEXT SLIDE.
THEN YOU MAY ADD ANOTHER
MS. PERDUE: BASION, YOU CHARGE
THE SYSTEM WITH SOMETHING LIKE
MAYBE ANOTHER POLICY, MAYBE
CONNECTING TO OR INTERACTIONS
WERE DATA ARE SHARED BETWEEN
DIFFERENT COMPONENTS OF
INTERVENTION. YOU LIGHT A FIRE
TO MAKE THOSE INTERACTIONS OCCUR
MORE FREQUENCY AS WELL. SO IF WE
GO TO THAT HOW WOULD YOU --
>> CAN YOU START TO WRAP UP
PLEASE.
>> YEP. SORRY. FOR EVALUATION OF
COURSE THE OUTCOME EVALUATION
BUT ALSO IN SYSTEMS LOOKING AT
WHO WHAT WHERE WHEN HOW AND WHY.
Z WHAT DOESN'T WORK TRY AND
LEARNING FOR THE NEXT LEVEL OF
NEXT INTERVENTIONS YOU DEVELOP.
SO THIS IS MY SUMMARY. IS THAT I
THINK IT IS IMPORTANT THAT WE
EMBRACE COMPLEXITY AND APPLY
SYSTEMS THINKING TO OUR WORK. WE
ASSUME MULTIPLE CAUSAL PATHWAYS,
WE ASSUME IDIOSYNCRASY, EVERY
INDIVIDUAL EXPERIENCES UNIQUE
INTERVENTION, EVEN IF DELIVERED
AT THE POPULATION LEVEL IT IS
UNIQUE FOR EVERYONE. WE DON'T
KNOW YET IF THIS APPROACH
ACTUALLY ADDS VALUE. IN TERMS OF
EFFECTIVENESS BUT THERE'S --
THAT IT WILL, MODELING
SIMULATIONS ARE USEFUL BUT I
BELIEVE MORE SO IN EVALUATION
PREDICTING THE FUTURE,
REPLICATION, WE HAVE TO THINK
MORE ABOUT REPLICATING
INTERVENTION MODELS RATHER THAN
SPECIFIC INTERVENTIONS AS YOU
HAVE HEARD, CONTEXT MATTERS SO
MUCH AND WE ARE GETTING TO HOW
YOU GET TO PRECISION PUBLIC
HEALTH TO MAXIMIZE INCREASING
INCLUSIVENESS BY PROVIDING
OPPORTUNITIES FOR THE RIGHT
INTERVENTION TO REACH THE RIGHT
PEOPLE RIGHT TIME AND PLACE IN
THE RIGHT WAY AND COMBINATION.
>> THANK YOU SO MUCH, TOM, THAT
WAS EXCELLENT AND I THINK REALLY
DEMONSTRATED AND VISUALLY
DISPLAYED FOR EVERYONE HOW
COMPLEX THIS WILL REALLY BE AS
WE START TO THINK ABOUT GIVING
ALL CHILDREN THE SAME EVIDENCE
BASED NUTRITION STRATEGIES. AND
ASSESSING APPROPRIATELY. SO OUR
NEXT SPEAKERS, THERE ARE TWO,
WILL SPEAK ABOUT INSTITUTIONAL
MONITORING AND EVALUATION OF
NUTRITION PROGRAMS AND I WOULD
LIKE TO WELCOME DIANE DEBERNARDO
AND H HE WILY MOREFIELD FROM USDA.
>> HE WILL H LOW, EVERYBODY. I
WILL OVER THIS BRIEFLY AND THEN
SHARE IN MORE DETAIL. THE
MCGOVERN DOLE INTERNATIONAL FOOD
FOR EDUCATION AND CHILD
NUTRITION PROGRAM IS THE LARGEST
SCHOOL FEEDING PROGRAM
ADMINISTERED BY USDA
INTERNATIONAL FOOD ASSISTANCE
DIVISION, AUTHORIZED IN 2002 BY
THE -- LAUNCHED IN 2003, AND
RECENTLY IN 2018 WE WERE GIVEN
THE ABILITY TO USE UP TO 10% OF
THE PROJECT FUNDS FOR LOCAL
REGIONAL FOOD AID PROCUREMENT.
THREE MAIN OBJECTIVES, SO IT IS
ALSO AN EDUCATION PROGRAM AND
THE STATED NUTRITION OBJECTIVE
IS CURRENTLY INCREASE USE OF
HEALTH NUTRITION AND DIETARY
PRACTICES. BUT WE ALSO STRIVE TO
MAKE IT LOCALLY AND NATIONALLY
OWNED IN ORDER FOR THE PROGRAM
TO GRADUATE AND HAVE
SUSTAINABILITY, THE ANNUAL
BUDGETS HAS COME TO BE
APPROXIMATELY 222 MILLION AND WE
ISSUE UP TO BIDDING PROCESS,
THIS IS A COMMODITIES DRIVEN
PROGRAM, WE EXPORT COMMODITIES
TO EACH OF THE COUNTRIES
COMMODITIES BECOME BULK OF THE
-- AND COMPLIMENTED BY LOCAL
FOOD. NEXT SLIDE PLEASE. FISCAL
YEAR 2021, 31 MILLION -- 31
COUNTRIES BENEFITING 2.1 SCHOOL
AGE CHILDREN. THE WAY WE
DETERMINE CURRENTLY VIRTUALLY NO
DATA FOR OLDER CHILDREN AS WE
KNOW. WE USE UNIVERSAL INDICES,
WE TOUCH BASE WITH OUR POST, OUR
AGRICULTURE ATTACHES AND STAFF.
WE REACH OUT TO PARTNERS, GATHER
INFORMATION THAT WAY WE HOLD
CALLS AND LOOK AT STANDARDS
SURVEYS AND OTHER DATA LIKE THE
DEMOGRAPHIC HEALTH SURVEYS AND
WE ALSO COORDINATE WITH
LEADERSHIP WITHIN USDA FOR OTHER
CONSIDERATIONS BECAUSE WE ARE
AGENCY THAT HANDLES OTHER ISSUES
BESIDES HUMANITARIAN AID AND
INTERNATIONAL DEVELOPMENT. NEXT
SLIDE PLEASE. THE MAJOR
COMPONENTS FOR THE NUTRITION
MCGOVERN DOLE, THE RATION I
WOULD SAY IS A HALLMARK OF IT
AND WE REQUIRE THAT THE RATION
REACH 30%, 25%, 30% WITH FOOD
COMPONENTS THAT IS FROM THE
COMMODITIES WE EXPORT OR FROM
LOCALLY SOURCED FOODS. NUTRITION
EDUCATION CAN BE THROUGH THE
CURRICULUM AND CLASSROOM OR
SOCIAL BEHAVIOR CHANGE
ACTIVITIES ANSWER REACHES THE
STUDENTS IN THE SCHOOLS BUT ALSO
VERY OFTEN THE COMMUNITY
SURROUNDING THE SCHOOLS, WE ALSO
TRAIN DIFFERENT STAFF IN
NUTRITION AND THAT CAN BE THE
SCHOOL STAFF, IT CAN BE
COMMUNITY HEALTH WORKERS, ALL
KINDS OF STAFF, IT DEPENDS ON
THE PROGRAMS. WE USUALLY HAVE
SOME SORT OF SCHOOL GARDEN
COMPONENT AND THAT CAN BE PURELY
FOR EDUCATION OR COULD BE LIKE A
FARM THAT ACTUALLY HELPS SOURCE
FOODS FOR THE SCHOOLS. THEN AS I
MENTION THE LOCAL AND REGIONAL
FOOD AID PROCUREMENT. WE/IT CAN
BE STABLES BUT WE ENCOURAGE IT
TO BE VEGETABLES, ANIMAL SOURCE
FOODS, FORTIFIED CROPS SO FORTH
SO THE AIM IS NOT ONLY TO
EVENTUALLY TRANSITION THE
PROGRAM TO LOCAL OWNERSHIP BUT
ALSO TO MAKE THE RATION MORE
NUTRIENT DENSE. NEXT SLIDE
PLEASE. WITH THIS I'LL HAND IT
OVER TO MY COLLEAGUE, ELLIE.
>> THANK YOU SO MUCH, DIANE AND
TO EVERYONE FOR THE OPPORTUNITY
TO BE HERE TODAY AND THE TEAM
LEAD SUPPORTING HUMAN EVALUATION
FOR USDA INTERNATIONAL FOOD
PROGRAMS, MY ROLE IS TO BRIEFLY
GO OVER HOW WE ADDRESS NUTRITION
IN THE COMPONENTS OF THE FOR THE
FEDERAL PROGRAM.
. THE WAYS WE DO THAT ARE
THROUGH THE ARTICULATION OF
DESIRED RESULTS IN PROGRAMS
RESULTS FRAMEWORK WHICH IS HERE
AND STANDARD INDICATORS,
INDIVIDUAL PROJECTS TRACK
RELATED TO NUTRITION AND
IDENTIFICATION OF RESEARCH
PRIORITY IS THE NUTRITION. SO
FIRST ON THIS RESULTS FRAMEWORK
YOU ARE SEEING HERE STRATEGIC
OBJECTIVE TWO, SO 1. THE FIRST
STRATEGIC OBJECTIVE IS LITERACY
BUT THERE IS NO HIERARCHY FOR
THE PROGRAM, THEY ARE BOTH
EQUALLY IMPORTANT STRATEGIC
OBJECTIVES. HIGHLIGHT A COUPLE
OF THINGS HERE, IMPLEMENTERS AND
SPECIAL RECOGNIZE PROGRESSION
HERE NUTRITION AND OTHER HEALTH
AND HEALTH RELATED TOPICS AND
IMPROVED KNOWLEDGE WILL LEAD TO
WITH ALL THE ACTIVITY THAT
SUPPORTS THAT TRAINING,
PRACTICAL SKILLS, ITSELF, TO
INCREASE USE OF HEALTH NUTRITION
AND DIETARY PRACTICES. SO IT IS
REALLY THE RESULTS FRAMEWORK
REFLECTS ESSENTIALLY A SHORT
MEDIUM TERM DESIRED RESULTS FROM
M AN A PERSPECTIVE. WE RECOGNIZE
THAT THIS RESULTS FRAMEWORK
DOESN'T SAY THAT LONGER TERM
RESULTS IMPROVE NUTRITIONAL
STATUS OF SCHOOL AGE CHILDREN,
THAT IS REFLECTIVE OF THE
GOVERNMENTAL PROGRAM, A VERY
PRACTICAL LEVEL A SCHOOL FEEDED
PROGRAM, IT SHOULD HAVE A
POSITIVE, CHANGE CERTAINLY HAVE
A POSITIVE IMPACT ON CHILDREN
NUTRITIONAL STATUS BUT WE REACH
CHILDREN WHEN THEY ARE IN SCHOOL
TYPICALLY WITH ONE MEAL DURING
THE SCHOOL DAY, JUST ON THE
SCHOOL DAYS DURING THE SCHOOL
YEAR. AND SO DIANE WAS SOLELY
NUTRITIONAL NOT NECESSARILY A
TYPICAL NUTRITION PROGRAM, IT IS
REALLY HOLISTICALLY ADDRESSING
EDUCATIONAL OUTCOMES THROUGH
SCHOOL FEEDING AND MANY RELATED
ACTIVITIES. SO AGAIN I THINK
YOU CAN SEE THAT IN OUR RESULTS
FRAMEWORK THERE. SO ANOTHER WAY
TO ADDRESS NUTRITION IS STANDARD
INDICATORS, MCGOVERN DOLE
PROJECTS ALL REPORT ON STANDARD
INDICATORS RELEVANT TO PLANNED
ACTIVITIES AND THEN THERE IS A
VARIETY OF ACTIVITIES THAT MAY
BE CARRYING OUT AS I MENTIONED
RELATED TO NUTRITION. THIS IS A
TABLE OF FY 20 DATA TO GIVE YOU
A FLAVOR. THESE ARE MOSTLY
OUTPUTS, I WILL ACKNOWLEDGE BUT
YOU CAN SEE THERE ARE A VARIETY
OF OUTPUTS THAT REFLECTS
DIVERSITY OF WAYS IN WHICH
PROJECTS COULD BE ADDRESSING
NUTRITION. REALLY THESE ARE I
THINK STEPPING STONES, OUTPUTS
AND MEDIUM TERM OUTCOMES,
STEPPING STONES TOWARDS AGAIN
THAT HIGHER LEVEL DESIRED RESULT
OF ACTUAL IMPROVED NUTRITIONAL
STATUS, HARD TO MEASURE IN
SCHOOL AGE CHILDREN: WE DO
REACH SOMETIMES PRE-SCHOOL AGE
PREGNANT WOMEN, THERE IS A
POLICY INDICATOR, REALLY
PROJECTS CAN WORK ON A VARIETY
OF LEVELS. SHORT ON TIME SO
NEXT SLIDE. A QUICK OVERVIEW. I
DO WANT TO HIGH LIGHT HERE, I
THINK THIS IS IMPORTANT, THESE
ARE TWO TYPES OF INDICATORS THAT
DO TRY TO GET AT THAT HIGHER
LEVEL, EXPERIMENT THE FIRST
SLIDE THIS IS IMPORTANT TO SHARE
HERE, IT WAS RETIRED IN 2015 BUT
WE DID USE A MAD INDICATOR, SURE
EVERYONE ON THE CALL IS FAMILIAR
WITH THAT, MINIMUM ACCEPTABLE
DIET INDICATORS THAT COMBINED
DIETARY DIVERSITY WITH FREQUENCY
OF MEALS. LONG STORY SHORT,
THERE IS NOTHING WRONG WITH
INDICATOR, THAT IS A GREAT
INDICATOR, WHY WE USE THE -- WE
WERE USING IT AS A PROXY FOR
SCHOOL AGE CHILDREN AND AGAIN IT
IS AN IMPORTANT PRACTICAL
EXAMPLE BECAUSE WE USE IT FOR A
FEW YEARS, AND BOTH INTERNAL
CONVERSATIONS AND REFLECTIONS
FROM IMPLEMENTERS, SHOW US IT
WASN'T FUNCTIONING AS A GOOD
PROXY FOR US IN OUR PROGRAM. SO
WE DID RETIRE IT. THERE WERE
QUESTIONS ON WHETHER IT WAS
VALID FOR THE SCHOOL AGE
CHILDREN THAT WE WERE -- THAT WE
WERE MEASURING, CONSIDERING IT
WAS DESIGNED FOR YOUNGER
CHILDREN. AND PROBABLY DIFFERENT
INTERVENTIONS. IT IS ALSO
DIFFICULT, RELATIVELY DIFFICULT
TO COLLECT AND YOU HAVE TO
CONSIDER ON THE GROUND WHETHER
THE TIME, POTENTIAL COST
INVESTED IN COLLECTING SOMETHING
IS OUTWEIGHING OR NOT THE USE OF
THAT DATA. SO WE DID RETIRE AND
WE ARE SEARCHING FOR BETTER
INDICATORS METRIC MEASURES, IN
THE SENSE THAT WE ARE -- NEWER
PROJECTS THE USE OF THOSE
MEASURES. COUPLE OF YEARS WILL
BE WELL-POSITIONED TO HAVE
GOTTEN SOME DATA BACK FROM
SEVERAL PROJECTS FUNDED IN FY
21, FY 22 WHO USED THESE
MEASURES ON THE GROUND AND WILL
LEARN AT USDAND THEY WILL HAVE
LEARNED HOW FEASIBLE ARE THOSE
MEASURES IN THE CONTEXT AND
MCGOVERN DOLE SPECIFICALLY AND
WHAT IS THE DATA SHOWING ARE WE
SEEING DIFFERENCESNA CORRELATE
WITH OR CAN BE ATTRIBUTED TO THE
PROJECT INTERVENTIONS. NEXT
SLIDE PLEASE. FINALLY THIS IS
ANOTHER WAY WE ARE ADDRESSING
NUTRITION OR SYSTEMS, IN 2016
THE MCGOVERN DOLE PROGRAM
DEVELOPED AN AGENDA, SOME MAY
HAVE PARTICIPATED DIRECTLY IN
WORKSHOPS MULTI-STAKEHOLDER
WORKSHOPS TO DEVELOP THIS. WHAT
YOU ARE SEEING ARE QUESTIONS
THAT AT THE TIME WERE NOT
ANSWERED WITH RIGOROUS EVIDENCE
BASE THAT WAS AVAILABLE SO THESE
WERE WHAT MANY DIVERSE
STAKEHOLDERS RESEARCHERS
ACADEMICS IMPLEMENTERS USDA
AGREED WERE NOT FULLY ANSWERED
BUT SHOULD BE ANSWERED, BECAUSE
THEY WOULD BENEFIT SCHOOL
FEEDING PROGRAMS MCGOVERN DOLE
SPECIFICALLY BUT MORE BROADLY
OTHERS WORKING IN THE SECTOR.
ALONG THE WAY WE HAVE BEGUN TO
ADDRESS THESE AT USDA WITH
CENTRALLY MANAGED CONTRACTS WITH
PROJECT LEVEL WORK, I SUSPECT
THAT EVEN THOUGH IN OTHER
SECTORS ALSO I'M SURE OTHERS ARE
WORKED ON THESE QUESTIONS, SURE
RESEARCH HAS BEEN PRODUCED THAT
HELPS ANSWER THESE, I SUSPECT
SOME OF THEM ARE STILL
UNANSWERED AND STILL WOULD
BENEFIT FROM A MORE RIGOROUS
EVIDENCE BASE AND CERTAINLY
BENEFIT FROM MCGOVERN DOLE
PROGRAM TO HAVE THESE ANSWERED.
RESOURCE AVAILABLE, HERE I WANT
TO EMPHASIZE THE TAKE AWAY FROM
THAT VERY BRIEF TOUR THROUGH
MNE, WE HAVE ELEMENTS IN PLACE
THAT ALLOW MCGOVERN DOLE
PROJECTS TO DESIGN IMPLEMENT
ACTIVITIES THAT ADDRESS
NUTRITION, WE ARE TRACKING
STEPPINGSTONES TOWARDS IMPROVE
NUTRITIONAL STATUS IN SCHOOL AGE
CHILDREN BUT CERTAINLY BENEFIT
FROM SCHOOL AGE CHILDREN
INDICATOR OF NUTRITIONAL STATUS.
I SEE MR. BUNDY, THANKS VERY
MUCH. ALL DONE.
>> THANK YOU SO MUCH, APPRECIATE
THAT COMPREHENSIVE OVERVIEW AND
AGAIN SHOWING THE COMPLEXITY OF
WHAT THIS REALLY TAKES. I WANT
TO WELCOME OUR NEXT SPEAKER,
OMAR DARY WHO WILL SPEAK THE
GLOBAL PERSPECTIVE AND TALK
ABOUT BEYOND SCHOOL FOOD,
UNDERSTANDING OUTCOMES AND
PROGRAMS AND OMAR IS FROM USAID.
WELCOME.
>> THANK YOU, CHRISTINE. HELLO
EVERYONE. WHEN I HAVE -- A
CHALLENGE IN A SHORT PERIOD OF
TIME TO MAKE SIMPLE A VERY
COMPLICATED WORK. TOM ROBINSON
WAS ALREADY EXPLAINING ALL THESE
SYSTEMS, NOW THE CHALLENGES HOW
CAN WE TRANSFER THE SAME TYPE OF
UNDERSTANDING TO THE PROGRAM. I
WILL TRY TO DO IN A FEW SLIDES.
NEXT SLIDE PLEASE. WHEN THIS IS
RECOGNIZE AS A WAY TO SAY THE
SAME THING LIKE HAS BEEN TELLING
US SEVERAL DAYS. I TOOK IT FROM
THE MODEL ABOUT THE CLEAR
INITIATIVE. FOR EARLY CHILD
DEVELOPMENT BUT SAYING THE SAME
THING. IN NUTRITION IS ONLY ONE
CONTRIBUTING FOR HAVING THE
HUMAN DEVELOPMENT. THE HEALTH
SAFETY LEARNING RELATIONSHIPS.
THAT IS ACROSS THE -- FROM THE
PREGNANT TO THE -- AND EVERYONE
IS RELATED WE HAVE ALL THE
FACTORS THAT ARE RELATED
EXTERNAL ENVIRONMENT. INTERNAL
ENVIRONMENT IS INSIDE EACH ONE
OF US. WHAT WE WANTED IS THAT
THE HUMAN INDIVIDUAL AS WELL AS
SOCIETY TO SURVIVE, TO THRIVE,
TO TRANSFORM. THAT MEANS THAT WE
CAN TRANSFORM OURSELVES BUT ALSO
OUR FAMILIES. THAT IS WHAT WE
WANTED TO DO. WITH ALL THE WORK
WE DO IN THE FOOD SCHOOL
SYSTEMS. WE STILL NEED TO LOOK
FOR THIS INDICATOR, THAT WE JUST
HAVE FROM OUR COLLEAGUES FROM
USDA. THEY ARE LOOKING FOR
INDICATORS OF -- INDICATORS OF
THE COGNITIVE DEVELOPMENT THOSE
ARE HIGH LEVEL INDICATOR BECAUSE
THAT IS OUR GOAL. REACHING
DEVELOP O. THE HUMAN BEING, THE
PHYSICAL COGNITIVE AND EMOTIONAL
OUTCOMES WHICH IS ON TOP OF THIS
FEATURE. THOSE ARE A LOT OF
DIFFERENT TYPE OF INPUTS, THE A,
THE B AS WELL AS THE NUTRITION
WE HAVE A SERIES OF INDICATORS
WITH NUTRITIONAL STATUS STARTING
FROM THE TOP, THE NUTRIENT
BIOEFFICACY, THOSE ARE
BIOLOGICAL SYSTEMS WORKING AS
HOMEOSTASIS WITH THE INTERNAL
AND EXTERNAL ECOLOGIES. WE HAVE
BIOMARKERS FOR DOING THOSE. SO
SOMETHING LIKE THAT WE CAN TAKE
-- LOOKING AT (INDISCERNIBLE) WE
COME DOWN WE HAVE BIOMARKERS OF
SYSTEMS, THAT IS THE NUTRIENT
BIOEFFICACY, THE INTERACTIONS
WITH THE DISEASE, WITH PAIR
SITES AND GENETICS AND WE HAVE
INDICATORS OF -- WHICH ARE THOSE
BIOMARKERS OF INTAKE. THESE ARE
BIOMARKERS OF (INAUDIBLE) BUT
ANYWAY WE HAVE EVERYTHING THERE
BUT WITH THESE INTERACTIONS THE
DIET CONTINUES BEING IMPORTANT.
IF WHICH DON'T HAVE THE DIET AND
KNEW TRENTS PROVIDED BY IT WE
DON'T HAVE INTERACTIONS THAT I I
SHOW IN THIS GRAPH. THE DIET
PROVIDE THE INTAKE AND THE
NATURE OF THE DIET IS THE
BIOAVAILABILITY OF THE NUTRIENTS
WHICH IS NOT THE SAME AS
ABSORPTION. ABSORPTION QUESTION
PENDS ON HUMAN METABOLISM
STATUS, SOMETHING LIKE THE IRON
ABSORPTION. IF WE ARE INFECTED
WE CANNOT ABSORB THE
BIOAVAILABILITY OF THE DIET IS
GOOD. WE NEED TO (INAUDIBLE) IN
ORDER TO UNDERSTAND WE TRYING TO
HAVE EVALUATION OF THE FOOD --
TYPE OF INTERVENTIONS, ONE SIZE
DID NOT -- THAT IS WHY IT IS SO
IMPORTANT TO KNOW EACH
ENVIRONMENT GENETIC PARAMETERS
ON MORTALITY. YOU CAN HAVE IN
THE RIGHT PART OF THE -- SEVERAL
COUNTRIES EACH ONE OF THESE
COLORS IS CHILD IN THOSE
COUNTRIES. 46% IS -- BECAUSE
THAT IS A VERY DRAMATIC SIMPLE
PARAMETER, EVERYONE THINKS THAT
BECAUSE THE POPULATION IS GOING
TO BE NUTRITION DEFICIENCIES IN
EVERYTHING, BUT THE -- FOR OTHER
MEASUREMENT, (INAUDIBLE) IS 45%,
AND THE WORK IS NOT TOO HIGH.
AND OTHER INDIANA KAY TORRS OF
MORTALITY, MATERNAL MORTALITY.
MY COLLEAGUES AT USDA, THEY DRAW
THE MINIMAL ADEQUATE DIVERSITY
INDICATOR FOR KIDS, BUT I PUT
MANY MY GRAPH ANYWAY AND SHOWED
THAT DESPITE -- IN THE GUATEMALA
LIGHT BLUE COLOR IS NOT AS BAD.
WHICH MEANS THAT PROBABLY THE --
INDICATOR TO PREDICT (INAUDIBLE)
MATERNAL MORTALITY IN THAT
COUNTRY. BUT THAT IS NOT
SECRETION. WE HAVE SEVERAL YEARS
ONGOING SYSTEM OF MACRO NUTRIENT
DEFICIENCIES AND THESE THE
SUMMARY PRESENT THERE HAD. IT'S
ALMOST NOT (INAUDIBLE)
POPULATION. IRON AND ZINC
DEFICIENCIES USING BIOMARKERS
ARE THERE BUT NOT SEVERE. THAT
IS NOT VITAMIN A D OR FOLATE
DEFICIENCIES. VITAMIN B 12
SOMETHING THERE WHICH MINE THIS
IS NOT SUFFICIENT TO LOOK VERY
SIMPLE INDICATORS THAT WE ARE
USING BECAUSE OF SIMPLE -- NOT
SIMPLE TO MEASURE. WE NEED TO
LOOK SOMETHING MORE BECAUSE
SOMETHING IS HIDDEN THAT WE
CANNOT LOOK AT, IF YOU PRESS --
MOBLE. WE ALSO HAVE SOME
ANALYSIS OF THE NUTRIENT INTAKE,
BUT IS SHOWING THE SAME THING
THE BLUE COLUMNS ARE THE
(INAUDIBLE) POPULATION AND THE
YELLOW ONE ARE -- VERY POOR HAS
MORE INADEQUACY. T YOU CAN SEE
IN THE INDIVIDUAL THEY DON'T
HAVE DEFICIENCIES FOR
EVERYTHING, THESE INCLUDE MOST
INDICATOR B 12, FOLATEB 12
AFFECTS EVERYONE, IRON ZINC AND
CALCIUM, ONLY A FEW. DESPITE
THAT ONE OF THE VERY NICE
INTERVENTIONS TO PUT BECAUSE
THIS IS EASY TO -- MORE --
WITHOUT REALLY LOOKING THAT WHAT
WE REALLY -- DEFICIENCIES IN THE
POPULATION. YOU CAN READ THE
BOTTOM OF THE GRAPH HERE YOU CAN
SEE VITAMIN A F FOLATE AND THAT
MEANS THAT IS BECAUSE NATIONAL
PROGRAM OF FOOD FORTIFICATION
THAT WORK -- CAN YOU PRESS --
SHOW YOU SOMETHING HERE.
FORTIFIED SUGAR AND FORTIFIED
FLOUR, THE COMPLIANCE OF THE
FORTIFICATION IN YEAR 2017 WAS
LIKE 10%, THAT WAS VARIABLE ON
THE NOT BECOME COMPLIANCE OF
STANDARD BUT 100%. THE FLOUR
CONTAINS IRON FOLATE ACID, B 1,
B 2 AND NIACIN. VITAMIN A IN
SOME PARTS IN THE INDUSTRIALIZED
WORLD WE DON'T WANT SUGAR AS WAY
TO HAVE DOING THINGS BUT ONE OF
THE ONLY FEW FOODS WE CAN
TRANSFER SOMETHING BECAUSE OF
THAT VITAMIN DEFICIENCY, 1981,
85. WHICH WHITE BREAD IS THERE,
FOOD FLOUR, SOMETHING LIKE
COMPLIMENTARY FOOD, THE SALT IS
WITH IODIDE. THIS IS ALSO A
SOURCE OF KNEW TRENTS.
NUTRIENT. THESE FOODS ARE HAVING
IN THE POPULATION. IT EXPLAINS
WHY DESPITE THE POPULATION,
HAVING THE PERFECT DIET DOES NOT
HAVE MANY FOOD DEFICIENCIES.
THIS IS MY FINAL SLIDE, THE
SCALABILITY BECAUSE WE ARE NOW
MOVING TO -- NEEDS TO BE A
PROGRAM THAT IS SAFE, IF WE
ALREADY HAVE SUFFICIENT SUPPLY
OF NUTRIENTS WE DON'T NEED TO
SUPPLY THOSE IN ADDITIONAL
INTERVENTIONS. THAT IS NOT ONLY
SAFETY, CONTAMINATION OF THE
FOODS BUT SAFETY TO KEEP BALANCE
OF THE DIET. NEEDS TO BE
EFFECTIVE. EFFICACY OF BROADER
DOMAIN TO BE EFFECTIVE. WE NEED
TO BE OF THE REAL CONDITIONS,
THAT LINK TO BECAUSE AND
POPULATION OF THE QUALITY TO
MAINTAIN. WHAT WE WANT IS REALLY
TO MOVE THE BIOINDICATORS AND IF
DOING THAT LOOKING INTO THE --
WHICH IS ONLY A SMALL PORTION OF
WHATEVER IS GOING TO INFLUENCE
THE POPULATION. WE HAVE THE
DIET, WE NEED TO KNOW BASICS OF
THE DIET IN THE COMMUNITY, IN
ORDER TO FIND WHICH IS THE TYPE
OF FOODS OR INTERVENTION WE NEED
TO DO IN THIS, TO COMPLIMENT
WHATEVER IS IN THE COMMUNITY.
THERE ARE SEVERAL INTERVENTIONS
TRYING TO DO IN ADDITION TO THE
NORMAL FOODS. WE CAN DO FOOD
SUPPLEMENTS LIKE THE SCHOOL
COOKING THAT IS FORTIFIED. WE
CAN HAVE SPECIFIC FORTIFIED FOOD
FOR THE SCHOOL SYSTEM, EVEN USE
SUPPLEMENT WHICH IS VERY
ATTRACTIVE. ALL OF THEM WHAT
THEY ARE DOING IS PUTTING MORE
IN THE INTAKE OF THE DIET BUT
EVERYTHING IS IN THE SAME
DIRECTION. WE DON'T KNOW WHAT IS
HAPPENING WITH COMBINATION OF
ALL OF THEM. THAT IS WHY WE NEED
REALLY TO LOOK EVERYTHING
REGARDING WHAT ARE THE SYSTEMS
WORKING AND WHAT INTERVENTIONS,
IN ORDER TO UNDERSTAND WHAT ARE
WORKING WHAT IS FEASIBLE AND HOW
TO KEEP THEM AND FINALLY THE
IMPACT WE WANTED TO DO, WE NEED
TO FIND THE NEED. IF YOU DON'T
HAVE THE NEED THERE IS NO
INTERVENTION. WE NEED TO LOOK AT
THE ADDITIONAL BIOEFFICACY OF
WHAT OUR INTERVENTIONS, AND
ESPECIALLY THE COVERAGE, WE WANT
FOR THE IMPORTANT PARAMETERS
THAT WE NEED TO HAVE. THANK YOU
EVERYONE FOR YOUR ATTENTION.
>> THANK YOU, O OMAMAR. EXCELLENT
ILLUSTRATION HOW MULTIPLE
PROGRAMS WORK SIMULTANEOUSLY AND
IN TERMS OF ASSESSMENT AND ALSO
TO REALLY FIGURE OUT WHICH ONES
TO FOCUS ON WHICH CONTEXT. SO
THANK YOU SO MUCH. THAT WAS HELP
HELPFUL. TRILLIONS OUR NEXT
SPEAKERS WILL TALK BUILDING
SUSTAINABILITY AND RESILIENCY
AND I WOULD LIKE TO WELCOME
RACHEL NOVOTNY UNIVERSITY OF
HAWAII AND JULIANA COHEN,
MERRIMACK COLLEGE.
>> THANK YOU, JULIANA ANDRY
SPEAKING TO SUSTAINABILITY AND
NUTRITION PROGRAMS DIRECTED
TOWARDS CHILDREN. WE ARE USING A
SOCIAL HE CAN LOGIC MULTILEVEL
MULTI-COMPONENT FRAMEWORK NOR
THE PRESENTATION. THAT IS HOW
INDIVIDUALS PARTNERS
ORGANIZATIONS AND POLICIES WORK
TOGETHER, SHOWN HERE DEPICTING
KEY POINTS FROM EXISTING
SYSTEMATIC REVIEW, EXAMINING THE
SUSTAINABILITY OF PUBLIC HEALTH
INTERVENTIONS. I WILL BE
REFERENCING LESSONS LEARNED IN
THE HEALTHY LIVING RANDOMIZE
TRIAL OR CHILL IN JURISDICTIONS
OF THE PACIFIC WHICH ARE LISTED
AT THE BOTTOM OF THE SLIDE.
DECREASE LEVEL OF CHILD
OVERWEIGHT OBESITY AND IN THOSE
COMMUNITIES AND WE ARE FINDING
THE EFFECT OF THE INTERVENTION
INCREASE ACROSS TIME. AT THE
INNER LEVEL OF THE MODEL IS THE
CHILD, THE TARGET OF THE
NUTRITION PROGRAMS. . CHILDREN
ARE THE FUTURE FOR
SUSTAINABILITY AND RESILIENCY IN
CHILDREN NUTRITION HEALTH AND
WELL BEING, BOTH SYMBOLICALLY
AND PRACTICALLY CHILDREN ARE
EASY RALLYING POINT WITH
COMMUNITIES TO FOCUS ON A VISION
OF CHILDREN WELL BEING.
INVOLVING PEOPLE WHO CARE ABOUT
AND FOR CHILDREN AND THE
CHILDREN THEMSELVES ESPECIALLY
THOSE THAT ARE NATURAL ROLE
MODELS, PROVIDES MOTIVATION AND
VIEW TOWARD SUSTAINABILITY AND
RESILIENCY. IN PLANNING
PRIORITIZE PARTNERSHIPS THAT
WILL BE THERE, TO SUSTAIN THE
PROGRAM WHEN THE INTERVENTION IS
OVER. PARTNERS FROM DIFFERENT
LEVELS OF SOCIAL ECOLOGICAL
FRAMEWORK AND DIFFERENT SETTING
OR SECTORS IDENTIFIED IN THE
LITERATURE AND COMMUNITY AS
INFLUENCING NUTRITION AND HEALTH
OF CHILDREN. IDENTIFY
PASSIONATE LOCAL LEADERS WORKING
IN THIS ARENA, FOCUS ON
SUPPORTING THEM TO DO MORE, SEEK
INDIGENOUS LEADERS AND SEEK TO
UNDERSTAND LOCAL INDIGENOUS WAYS
AS FRAME WORKS FOR WORKING AND
TALKING ABOUT CHILD WELL BEING.
WE DEVELOPED A COLLABORATION
READINESS TOOL SHOWN HERE TO
GUIDE THINKING ABOUT WILLINGNESS
TO COLLABORATE CAPACITY TO
CHANGE AND WORKING TOGETHER.
IDENTIFY A BACKBONE ORGANIZATION
THAT WILL COORDINATE PEOPLE AND
MANAGE PEOPLE IN SHORT AND LONG
TERM. WE AT THE UNIVERSIT OF
HAWAII LAND GRANT COLLEGE WITH
RESEARCH TRAINING AND OUTREACH
MISSION PLAY THE ROLE FOR CHILL
AND WE WORK WITH LAND GRANT
COLLEGE PARTNERS ACROSS THE
REGION. NOTE IN THE FIGURE THAT
THE CHILDREN -- IN THE TRIAL
SCHOOLS WERE PRIMARY PARTNERS
THOUGH OTHER GROUPS CONTRIBUTED
TO PROGRAM ACTIVITIES WHICH LED
TO DECREASE COMMUNITY LEVEL OF
CHILD OVERWEIGHT AN OBESITY.
BUILDING DEGREE SEEKING TRAINING
SETS UP A PROGRAM FOR
SUSTAINABILITY AND RESILIENCY
WITH FUTURE LEADERS WHO BOTH
CARRY ON AND INNOVATE. IDENTIFY
RESOURCES AN PROGRAMS TO
INNOVATE AND STRUCTURE SUCH AS
DATA CENTER THAT PROVIDES
ONGOING CONNECTION INFORMATION
AS WELL AS SMALL REVENUE STREAM. STREAM.
USE POLICY TO CREATE SUSTAINABLE
CHANGE AT ALL LEVEL, THIS IS A
COST EFFECTIVE APPROACH, SEEK
CHANGES IN EXISTING PROGRAMS AND
BUILD DATA SYSTEMS TO PROVIDE
ONGOING DATA TO SUPPORT POLICY
CHANGES BUILDING RELATIONSHIPS
FOR CHANGE ALLOWS RESPONSIVENESS
AND RESILIENCY MANY THE FACE OF
NATURAL DISASTERS SUCH AS
TYPHOONS IN THE PACIFIC AND
COVID OF COURSE. WE END WE MANY
CHARS TO CONSIDER AT EACH LEVEL
RELATED TO SUSTAINABILITY AND
RESILIENCY OF A PROGRAM. THE
JURISDICTION LEVEL COSTS OF
BASIC NEEDS ESPECIALLY FOOD FUEL
AND HOUSING, COMMUNITY LEVEL
PARENT CAREGIVER HOUSEHOLD,
INDIVIDUAL CHILDREN SOCIAL
NETWORKS AND THE INDIVIDUAL
LEVEL IN ADDITION TO MEASURES
PUT FORTH BY OTHER WORKING
GROUPS I WOULD LIKE TO HIGHLIGHT
THE VALUE OF SOME DIET ACTIVITY
RECORDS WORKING WITH POPULATIONS
UNDER STUDY TO LEARN ABOUT WHAT
IS ACTUALLY BEING CONSUMED ABOUT
DAILY ACTIVITIES. NONE OF THE
CHILDREN JURISDICTIONS ARE
NATIONAL MONITORING SYSTEMS OR N
HAYNES. SO THIS FOUNDATIONAL
WORK ON FOOD INTAKE AND ACTIVITY
IS VITAL TORR ACTIVITY PROGRAM
AND POLICY PLANNING. ALSO LIKE
TO HIGHLIGHT VISUAL ASSESSMENT
ACCORDING TO BURKE AS COST
EFFECTIVE WAY TO MEASURE
POPULATION LEVEL METABOLIC
CHANGES ASSOCIATED WITH OBESITY
FOR SURVEILLANCE, AND AS A
SCREENER FOR REFERRALS AND WE
FOUND SENTENCETIVE TO COMMUNITY
CHANGE IN TRIAL. SO THANK YOU,
VERY MUCH.
>> THANK YOU SO MUCH, INCREDIBLY
IMPORTANT TO BUILD FOR
SUSTAINABILITY. LAST WE HAVE TWO
SPEAKERS THAT ARE GOING TO TALK
ABOUT EQUITY. WE HAVE ANGELA
ODOMS YOUNG FROM CORNELL
UNIVERSITY AND BIBI GIYOSE FROM
NEPAD. FIRST ANGELA WILL TALK
ABOUT THE DOMESTIC CONTEXT AND
THEN BIBI WILL TALK ABOUT
INTERNATIONAL CONTEXT. AND I
WANT TO EMPHASIZE THAT OUR
WORKING GROUP TALKED EQUITY
EVERY STEP OF THE WAY AND WE
BELIEVE THAT IT NEEDS TO BE
INFUSED INTO ALL THIS WORK. AND
WE ARE HAPPY THAT THEY ARE BOTH
ENDING THE SERIES OF SPEAKERS
FROM THE INTERNAL WORKING GROUP.
WITH A ROBUST DISCUSSION AROUND
EQUITY. SO THANK YOU AND
WELCOME, ANGELA AND BIBI.
>> THANKS SO MUCH, CHRIS. IT
REALLY IS A PLEASURE TO BE ABLE
AND INVITED TO SPEAK ON THE
PANEL AS WELL AS THE PART OF THE
WORKING GROUP I HAVE BEEN
CHARGED TO TALK ABOUT EQUITY
MANY THE CONTEXT OF SCALE
PROGRAMS. NEXT SLIDE PLEASE.
SO SCHOOL MEAL PROGRAMS FOODS
SERVED IN SCHOOL ARE RELEVANT
WHEN WE THINK ABOUT PROMOTING
EQUITY AND EXTENSIVE BODY OF
LITERATURE, INDICATES THAT
YOUNGER INDIVIDUALS LOW INCOME
POPULATIONS, BLACK INDIGENOUS
PEOPLE OF COLOR, IN THE U.S. ARE
SIGNIFICANTLY AT RISK FOR HAVING
POOR DIETARY INTAKE AS WELL AS
INCREASE CONSUMPTION OF PROCESS
FOODS. SO FEDERAL PROGRAMS LIKE
THE NATURAL SCHOOL LUNCH
PROGRAMS, SCHOOL BREAKS FROM
FAST PROGRAMS SUMMER MEALS ARE
DESIGNED TO REDUCE FOOD
INSECURITY AND PROMOTE HEALTHY
EATING. STUDIES SHOW
PARTICIPANTS OF THESE PROGRAMS
HAVE HEALTHIER LUNCHES THAN
NON-PARTICIPANTS, WHO ALSO
RECENT STUDY HIGHLIGHTED FOODS
AND SCHOOL LUNCH PROGRAM HAS
IMPROVED OVER TIME AND THEY
PROVIDE THE BEST DIET QUALITY OF
MAJOR U.S. FOOD SOURCES COMPARED
TO OTHER SETTINGS. I WANT TO
FOCUS ON THIS IDEA OF OTHER
SETTINGS. BECAUSE IF WE LOOK AT
PARTICIPANTS, THIS IS FROM --
THOUGH THE LUNCHES, WE SEE
LIMITED DISPARITIES ACROSS
SCHOOLS WHEN IT COMES TO OVERALL
NUTRITIONAL QUALITY OF LUNCHES
SERVED. NOT BY SOCIOECONOMIC
STATUS OR RACE ETHNICITY, BUT
YOU SEE IMPACT OF THOSE MEALS
DIFFER ON OVERALL DIETARY
QUALITY SO LOOK AT LOW INCOME AS
COMPARED TO HIGHER INCOME OR
BLACK INDIGENOUS PEOPLE OF
COLOR, STUDENTS THAT ARE
PARTICIPATING, YOU DON'T SEE
THAT BENEFIT STRETCH OVER THE 24
HOUR PERIOD. AS YOU DO FOR
HIGHER INCOME GROUPS AND WHITE
STUDENTS. SO THE QUESTION IS, IS
WHEN WE THINK ABOUT IMPACT AND
EQUITABLE IMPACT, OF LUNCHES, DO
WE NEED MORE TO ACCOUNT FOR SOME
OF THOSE INEQUITABLE IMPACTS
THAT EXIST OUTSIDE OR HOW DO WE
IMPROVE BROADER CONTEXT OUTSIDE
SCHOOL FOODS. SO WHEN WE THINK
ABOUT SOME OF THOSE QUESTIONS
AND ALSO THE MODELS THAT DAN AND
CHRIS PRESENTED, AND OTHER
SPEAKERS, THERE IS THREE KEY
QUESTIONS QUESTIONS ABOUT
EQUITY. HOW DO WE UNDERSTAND THE
IMPACT OUTCOMES OF THESE
PROGRAMS FOR POPULATIONS. JUST
BECAUSE WE HAVE EQUITABLE ACCESS
DOESN'T MEAN IMPACT. DO WE NEED
INTERVENTIONS TO REALLY CLOSE
THOSE GAPS. HOW DO WE MEASURE
IF WE ARE CLOSING THOSE GAPS, SO
A LOT IS FOCUSED ON LOW INCOME
POPULATIONS BUT WHEN WE THINK
ABOUT BLACK INDIGENOUS PEEP OF
COLOR AND OTHER RACIALIZED
MINORITY GROUPS, RACIALIZED OR
MINORITIZE GROUPS AS SOME REFER
TO IN THE U.S., ARE WE SEEING
THOSE GAPS CLOSE AND CAN WE
MEASURE ACROSS THESE MULTIPLE
CONTEXT WHEN WE THINK ABOUT
IMPLEMENTATION ASSESSING
OUTCOMES AND I HAVE JUST A FEW
CONSIDERATIONS FOR THAT. SO SO
PART IS WE HAVE TO TAKE A
HISTORICAL PERSPECTIVE. EQUITY
HAS ALWAYS BEEN A KEY FOCUS WHEN
WE LOOK AT USDA PROGRAMS OVERALL
AND CHILD NUTRITION PROGRAMS
SPECIFICALLY TO REALLY BUFFER
THAT DISPROPORTIONATE IMPACT OF
POVERTY, ON DIETARY INTAKE AS
WELL AS PROMOTE NUTRITIOUS
AGRICULTURAL COMMODITIES. HAS
SOME INEQUITABLE IMPACT WHEN WE
THINK ABOUT WHO IS IN THAT PART
THAT CAN BENEFIT FROM WHAT IS
CONSUMED. NEXT SLIDE PLEASE. P
WE THINK ABOUT THE SOCIAL
STRUCTURAL DETERMINANTS OF
HEALTH, REALLY EVEN IN THE
CONTEXT OF WHEN THESE PROGRAMS
WERE CONCEIVED, WE HAVE PARALLEL
REALITIES. SO IF WE FOR EXAMPLE
LOOK AT THE HISTORICAL TIME
LINES OF THE DEPRESSION IN BLACK
AMERICANS, IF YOU LOOK WHEN THE
SCHOOL LUNCH PROGRAM WAS CON
RECEIVERRED IT WAS IN CONTEXT OF
WHAT WE KNOW AS SEPARATE BUT
EQUAL EDUCATION. A LOT OF IMPACT
OF SLAVERY AND JIM CROW RACIAL
INEQUITY WE HAVE SEEN AT ITS
HEIGHT IN 2020 AND 2021, STILL
HAVE IMPACT TODAY WHEN WE LOOK
AT WHERE ARE YOUTH REPRESENTED
WHAT CONTEXT. ARE THEY IN
SCHOOLS, IN OTHER SETTINGS. HOW
DO WE MEASURE THOSE ENVIRONMENTS
SO THIS IDEA OF LIVING UNDER
EFFECT OF O STRUCTURAL RACISM
COMES REALLY IMPORTANT WHEN WE
THINK ABOUT PROGRAM
IMPLEMENTATION. AND ASSESSMENT.
WE MAY HAVE UNIVERSAL GOALS AND
OUTCOMES BUT DO WE NEED MORE
TARGET UNIVERSALISM WHEN WE
THINK INTERVENTIONS. WHEN WE
LOOK AT INDIGENOUS COMMUNITIES,
THIS LAYERING OF HISTORICAL
TRAUMA, DURING THE TIME OF THESE
-- SOME OF THESE PROGRAMS WERE
CONCEPTUALIZED, WE HAD EXTENSIVE
LAND DISPOSSESSION, WITHIN
INDIGENOUS COMMUNITIES EROSION
OF TRADITIONAL FOOD SYSTEMS, AS
WELL AS CONTEXT OF EDUCATIONAL
SYSTEM, INDIGENOUS CHILDREN
PLACED IN BOARDING SCHOOLS,
REMOVED FROM THEIR HOMES. HOW
THESE FACTORS PLAY A ROLE IN OUR
ABILITY TO LOOK AT IMPACT. DO WE
HAVE EQUITABLE IMPACTS BECAUSE
WE MIGHT BE MORE TALK EQUITY NOT
EQUALITY TO CLOSE GAPS NOT JUST
IMPROVE THE DIETS OF CHILDREN
THAT ARE PARTICULARLY
PARTICIPATING IN THESE PROGRAMS
COMPARED THOSE THAT DO NOT
PARTICIPATE. SO A LOT OF THESE
HISTORIC FACTORS HAVE MANIFEST
IN SUBSEQUENT INEQUITIES AND
WEALTH SO WE SEE FOR EXAM
EXAMPLE, IN 2019, THE MEDIAN
WEALTH DISPARITY BETWEEN BLACK
HOUSEHOLDS AND WHITE IN THE
UNITED STATES, 25,000 MEDIAN
INCOME, BLACK HOUSEHOLDS
COMPARED TO 190,000 FOR WHITE
HOUSEHOLDS THIS GAP INCREASES
WITH AGE. WE SEE A SIMILAR
DISPARITY IN WEALTH OF -- AND
EARNINGS IN INDIGENOUS
COMMUNITIES IN LATINX
COMMUNITIES. PART OF THIS IS WE
THINK ABOUT OVERALL IMPACT WHAT
IS HAPPENING WITHIN THOSE
CONTEXT. NOT JUST WITHIN THE
INTERVENTION AND HOW CAN
INTERVENTIONS BE TAILORED TO
CLOSE GAPS TALKING EQUITY. WE
SEE THIS IN FOOD INSECURITY,
ACTUALLY WHERE FOOD INSECURITY
IN 2020 REMAIN STABLE IN THE
U.S. OVERALL. WE SEE INCREASE IN
POPULATIONS, THIS U.S. FOOD
INSECURITY BY RACE AND ETHNICITY
AND OF COURSE THESE DIFFERENCES
HAVE PERSISTED OVER MANY YEARS.
WHERE YOU SEE SOME YEARS, THE
GAPS CLOSE AND THEY WIDEN AND WE
SEE THAT BASED ON ECONOMIC
SOCIAL IMPACT OF COVID HEALTH
IMPACT OF COVID, IN ADDITION TO
THIS WIDENING WITH FOOD
INSECURITY WIDENING IN LIFE
EXPECTANCY THAT EXISTS BY RACE. RACE.
WHEN WE TALK HISTORIC AND SOCIAL
IMPACTS WE SEE A DIFFERENTIAL
OUTSIDE OF SCHOOL MEALS, IN
COMMUNITIES, AS BEEN SEVERAL
STUDIES THAT LOOKED AT
ENVIRONMENTS AROUND SCHOOLS SO
IN OUR BOND MODEL AS WE TALK
ABOUT CONTEXT, AND
NEIGHBORHOODS, SO BLACK NEXT TO
INDIGENOUS YOUTH ARE MORE LIKELY
TO LIVE -- TO ATTEND SCHOOLS AND
LIVE IN IMMUNITIES THAT HAVE
FOUR OR MORE OBESE FOOD
PROJECTS, AND DENSITY OF THESE
ESTABLISHMENTS AND LESS CONTROL
SO LESS LOCAL CONTROL. SO A LOT
OF EXTERNAL INFLUENCE VERSUS THE
IDEA OF INTERNAL CONTROL. WITHIN
COMMUNITIES IN SCHOOLS. THE
USDA HAD A STRONG FOCUS
PARTICULARLY RECENTLY, ON
PRIORITIZING EQUITY IN EVERY
STEP, TO ACHIEVE NUTRITION
INSECURITY. SO WHAT IS THE
POTENTIAL FOR THIS KEY QUESTION
WHEN WE LOOK AT IMPLEMENTATION,
WHAT INTERVENTIONS ARE NEEDED,
HOW WE ASSESS IMPACT OF
INTERVENTIONS ACROSS CONTEXT. SO
STRENGTHENING AND SUPPORTING
NATIVE AMERICAN TRIBAL SCHOOL
FOOD PROGRAMS IS AN EXAMPLE OF
THAT. USDA IS CENTERING ON, AND
LOOKING HOW TO CENTER MORE
INDIGENOUS FOODS AND FOOD
SOVEREIGNTY, WITHIN CONTEXT OF
INTERVENTION AND IN ADDITION TO
THE BROADER THOUGHT OF JUST NOT
HAVING ONE SIZE FITS ALL. WE
NEED TO APPLY CULTURAL
RESILIENCE FRAMEWORK OR LENS
THAT LOOKS AT CONCEPT OF
STRUCTURAL VIOLENCE, LOOK AT HOW
INTERVENTIONS ADDRESS THIS
DISINVESTMENT, I MAY BE RUNNING
OUT OF TIME, LOOKING AT HOW
RACIAL POVERTY AND LONG TERM
UNEMPLOYMENT, SO EQUITABLE
OPPORTUNITIES AND PEOPLE IN
PLACE, AND THEN MY LAST SLIDE.
SO WE HAVE TO THINK ABOUT THIS
BROADER CONTEXT OF WHERE FOOD IS
SERVED, HOW MARKETED SO THINGS
LIKE WHAT HAPPENS ON WEEKEND WEEKEND. OR
SUMMER MEALS SO I WILL STOP
THERE AND TURN IT OVER. THANK
YOU.
>> THANK YOU VERY MUCH AND
THANKS -- (INAUDIBLE) INTENSE
INFORMATION. SO I THINK THE MOST
IMPORTANT THING IS IS THIS LAST
THREE WEEKS INCLUDING TODAY, WE
LOOK AT THE WHAT AND THEN THE
NEXT QUESTION IS SO WHAT, WE ARE
AT A POINT NOW SAYING NOW WHAT
AND THIS IS WHERE TRANSLATION
SCIENCE BECOMES VERY IMPORTANT.
SO LET ME MAKE A LITTLE --
(INAUDIBLE) SLIDES AND NOT
SHOWING ANY COMPLICATED SLIDES,
MY POINT IS IN AND OF
THEMSELVES, A BIT OF GUIDANCE
AROUND KEY MESSAGE WE CAN BE
MOVING FORWARD AS WE ARE LOOK AT
TO ADDRESSING EQUITY FROM AS
ANGELA SAID DOMESTIC PERSPECTIVE
AND ALSO FROM INTERNAL
PERSPECTIVE. WE MUST LOOK AT
MULTI-PACKTORAL LENS. SCHOOL
MEALS SCHOOL HEALTH AND
NUTRITION. IS VERY COMPLEX. WE
NEED TO BE LOOKING AT EQUITY
AROUND DIFFERENT CONSIDERATIONS
FROM PRODUCTION TO THE CONSUMER
AND FOOD ENVIRONMENTS. IN THIS
REGARD THIS REMAINS VERY
IMPORTANT AGRICULTURE TRADING
MARKETS, PROCESSING HEALTH,
EDUCATION, AND OF COURSE
NUTRITION. THIS --
UNDERSTANDING THE BIOMARKERS FOR
INTAKE NUTRITION AND THEN
GOVERNANCE KEY IN HOW WE
UNDERSTAND HOW FEED PROGRAMS ARE
RUN, (INAUDIBLE) PROBLEMS
POLICIES FOR ACTION. AND
PROTECTION. THE SECOND POINT I
WOULD LIKE TO MAKE IS THAT THERE
IS NEED TO ENSURE SOCIAL AND
POLICIES AND PROGRAMS ARE FAIR
AND JUST ESPECIALLY TO INCLUDE
THE MARGINALIZED POPULATIONS. TO
GIVE THEM A VOICE FOR THEM TO BE
ABLE AND GIVE THEM FOOD TO -- TO
IMPLEMENT PROGRAMS THAT ARE
CONTEXTUALIZED FOR THEIR
ENVIRONMENTS, CREATE EQUITABLE
AND PLAIN SIMILAR LEVEL PLAYING
FIELD. WE NEED TO STRIVE AS
GLOBAL NORTH AND SOUTH TO HAVE
SIMILAR OPPORTUNITIES TO PLAN
TOK AND SUCCEED. WE NEED
FINANCING FOR SMALL TO MEDIUM
ENTERPRISES, FINANCING FOR SMALL
FARMERS, OPINIONSING ESPECIALLY
FOR FEMALE FARMERS WHO BY DESIGN
HAVE BEEN THE MOST MY-- IF YOU
LOOK AT (INAUDIBLE) THERE'S SO
MUCH INEQUITY, AFRICA REMAINS
THE CONTINENT WITH HIGHEST ONE
OF THE HIGHEST LEVELS OF
DIFFERENT FORMS OF MALNUTRITION.
IF LIVING IN EQUITABLE WORLD WE
WOULDN'T BE TALKING ABOUT THIS
IN THE 21ST CENTURY SO WE NEED
TO LOOK AT RESEARCH. WHO DESIGN
IT IS RESEARCH, THE RESEARCH
EQUITABLE, IN THE SENSE OF IF
YOU UNDERSTAND THE PROBLEMS AND
-- TALKING ABOUT THIS, -- ON THE
GROUND YOU KNOW WHAT WORKS FOR
YOU. YOU KNOW WHAT YOU REALLY
NEED. BECAUSE SOMETIMES WE TEND
TO -- SOLUTIONS FROM ELSEWHERE,
THINKING GOING TO WORK IN THAT
PARTICULAR ECOSYSTEM, WHEN THEY
DON'T WORK WE STAND BACK AND SAY
WHAT HAPPENED? IS SOMETHING
HAPPENED BECAUSE WE DIDN'T
CONSIDER WHERE THE RUBBER HITS
THE TARMAC. WHERE IT REALLY
MATTERS. THIN WE HAVE TO LOOK IN
TERMS OF EQUITY, CAPACITY AND
SKILL DEVELOPMENT, ARE WE
DEVELOPING CAPACITY
IMPLEMENTATION POLICY DESIGN, TO
MAKE SURE THAT WE HAVE
SUSTAINABILITY SYSTEM GOING
FORWARD. SO THAT THE PEOPLE ON
THE GROUND CAN BE ABLE TO
IMPLEMENT THAT AND THEN MOVE
AWAY FROM THE PROJECT TO A
SUSTAINABLE PROGRAM DESIGN AND
IMPLEMENTATION. AND LAST BUT
NOT LEAST, AS (INAUDIBLE) NOTED
THE QUALITY OF MEALS ARE WE
GIVING THE SCHOOL KIDS MEALS
THAT ARE NUTRITIOUS, THAT WILL
SUSTAIN THEM, AN HELP THEM
DEVELOP? IN AN EQUITABLE FASHION
WHETHER IT IS IN A LOW MEDIUM
INCOME COUNTRY OR RICH COUNTRY.
SO WILL IS NEED, THAT IS MY
FOURTH POINT, THERE'S NEED TO
FOR THEM TO SEE THE CONTEXTUAL
SOLUTIONS, SO YOU SEE IF YOU
DON'T CONTEXTUALIZE YOUR PROGRAM
AND SOLUTION (INAUDIBLE) HAS TO
BE COMING OR HAS TO BE AIMING AS
THE CONTRIBUTION TO WEALTH, THE
MARKET FOR OUR GROWTH AND
OBJECTIVES AND BENEFIT SHOULD
CONSIDER INCLUDING PROPERTY
REDUCTION, HUMAN CAPITAL
DEVELOPMENT, SOCIOECONOMIC
DEVELOPMENT AND OVERALL
DEVELOPMENT BECAUSE YOU CANNOT
RUN (INAUDIBLE) SO BEYOND A
THOUSAND DATES, TO THE NEXT
7,000 DATES, WHAT CAN WE DO
DIFFERENT IN AN EQUITABLE
MANNER. EQUITY IS CRITICAL FOR
ENSURING THAT NO ONE (INAUDIBLE)
ENSURING NO ONE IS LEFT BEHIND,
FOR SYSTEMATIC INEQUALITIES AND
INEQUITIES IN OUR SYSTEMS. SO
TRANSLATION IS ABOUT ACTION,
ACTION, ACTION, MORE ACTION. IN
EQUITABLE WAY TO ENSURE BEST
NUTRITION, BEST HEALTH E BEST
EDUCATION AND BEST PRODUCTIVITY.
WITH GOOD NUTRITION YOU END UP
WITH THE BEST PRODUCTIVITY AND
CONTRIBUTION TO A BETTER
SOCIETY. SO ALL THIS VERY
IMPORTANT TENANTS OF (INAUDIBLE)
AND WHAT -- INTENDS TO ACHIEVE
BY INCLUDING THE FOOD
ENVIRONMENT, AND ENSURING THAT
EVERYBODY GETS WHAT THEY REALLY
-- AT A VERY -- FROM AN EARLY
AGE INTO THE ADULT YEARS. SO I'M
GOING TO BE ASKING FOR ONE
MINUTE TO WATCH THE CLOSING,
MAKE ONE SMALL INTERVENTION.
THANK YOU VERY MUCH.
>> THANK YOU SO MUCH, ANGELA AN
BIBI. WE HAVE CENTERED THIS IN
OUR DISCUSSIONS AND OUR WORK AND
I HOPE THAT EVERYONE TOOK ALL OF
YOUR COMMENTS AND THINKING HOW
BOND KIDS CAN BE WITH THE BEST
EQUITY IN MINE. WE HAVE FIVE
MINUTES FOR SOME GROUP
DISCUSSION AND THEN YES GOIN TAKE TEN
MINUTE BREAK AN RECONVENE WITH
OUR INVITED SPEAKERS. SO I WILL
HAND TO YOU IF YOU HAVE A
QUESTION.
>> I'M LOOKING FOR A HAND UP IN
THE TEAM. OR IN THE OTHER
TEAMS.
>> SHE IS GETTING HER HEADSET
ON.
>> WRESTLING WITH HER
MICROPHONE.
>> HOW DOES THAT WORK?
>> HI, CONNIE. GREAT.
>> SO MY REACTION IS I THOUGHT
BIOLOGY WAS COMPLEX BUT THEN I
HAVE BEEN LISTENING TO THESE
OTHER WORKSHOPS AND I'M SORT OF
OVERWHELMED. I GUESS I WOULD
LIKE A LITTLE BIT OF
CONVERSATION ABOUT SEEMS LIKE
ALL OUR WORKING GROUPS HAVE
WORKED REALLY HARD AT EXPOSING
THE COMPLEXITY AND ALL THE
FACTORS THAT NEED TO BE
CONSIDERED I AM OF THE MIND
MAYBE THE WORK IS NOT THAT
HELPFUL UNTIL WE FUNNEL THOUGH
REPORT CAN GO THROUGH THE
DIFFERENT SYSTEMS THAT NEED TO
BE CONSIDERED AND REMINDERS
ABOUT WHO MIGHT GET LEFT OUT OR
WHATEVER. I THINK IN IN ORDER
FOR PROGRAM TO EVALUATE
EFFECTIVENESS, WE HAVE TO HELP
FUNNEL AND SAY HERE IS THE TOP
PRIORITIESPRIORITIES. I ENVISION AND WE
NEED TO TALK ABOUT THIS IN
FUTURE WORKING GROUP MEETINGS,
CAN WE SEE COMING UP WITH TABLES
THAT SORT OF OUTLINE HERE IS
YOUR TOP PRIORITY, MAYBE YOU
HAVE THIS OTHER CIRCUMSTANCES
AND CONSIDER THESE ADDITIONAL
ONES. BUT I THINK OUR NEXT BIG
EFFORT NEEDS TO BE FUNNELING.
>> I COULDN'T AGREE MORE, AND I
THINK WE ARE PICTURING A VISUAL
THAT HAS THE BASIC FOUNDATION
AND THEN BUILDING ON THAT WHICH
WILL BE CONTEXT SPECIFIC AND
DEVELOPMENTALLY SPECIFIC BUT
GIVING GUIDANCE, TO BUILD OUT AS
APPROPRIATE WHERE RESOURCES ARE
THERE, WHERE MANDATE IS THERE
BASED ON THE PARTICULAR
INTERVENTION BEING DONE AND
OUTCOME EXPECTED. I LIKE THAT
THOUGHT A LOT. IT WILL BE A
COMPLEX TABLE BUT I STILL THINK
IT WILL BE HELPFUL. APPRECIATE
THAT COMMENT.
>> CHRIS CAN I SUGGEST WE GO TO
-- THAT WE SKIP DEANNA BECAUSE
WE ARE GOING TO HAVE OUR GROUP
DISCUSSION AT THE END.
>> EXACTLY.
>> SO I'M GOING TO SUGGEST WE
JUST HEAR FROM MAUREEN AND THAT
CAN TAKE US TO OUR BREAK.
>> THEN MARIANNEELLE AND DEANNA
WILL WEIGH IN WORKING GROUP.
PERFECT.
>> EXACTLY.
>> THANK YOU VERY MUCH. I WILL
BE QUICK, SUCCINCT. I LOVE THE
TALKS. THEY WERE REALLY VERY
HELPFUL AND I THOUGHT CERTAINLY
EXTENDED FROM THE WORK WE DID IN
OUR ENVIRONMENTAL GROUP AND SO I
THOUGHT THERE WAS CONSISTENCY IN
THAT. THE CHALLENGE AND IS HOW
TOBLY THIS TOGETHER AND BRING IT
IN A WAY THAT HELPFUL
OPERATIONAL AND ENABLE US US TO
MOVE FORWARD. WHAT THIS REMIND
US, THERE'S NO MAGIC BULLET.
THERE'S NO QUICK ONE SIZE FITS
ALL SOLUTION. HOW CAN WE
MARSHALL WHAT WE KNOW AND SORT
OUT WHAT TO MEASURE, NOT ONLY
FROM THE CHILD PERSPECTIVE BUT
FROM SOME OF THE OTHER
INTERACTIONS AND ENVIRONMENTS
THAT WE KNOW INFLUENCE KIDS. THE
EXAMPLES THAT YOU GAVE RECENT
ONE ON SCHOOL MEAL, RACHEL
TALKED FROM THEIR PROJECT AND
HOW, YOU EVEN HAVE A DISPARITY
IN THAT. IN TERMS OF HOW THINGS
BENCH SO IT IS GREAT, I THINK WE
WILL NEED WORK AT THE END OF
THIS TO PUT THIS TOGETHER. SO
THANK YOU, VERY MUCH
>> I THINK MAUREEN SUMMARIZED MY
THOUGHTS SO I WANTED TO ADD IN
MANY WAYS THIS IS THE SESSION,
THIS IS WHERE THE RUBBER HITS
THE ROAD AS THEY SAY. THE
QUESTION I HAD WHILE WE HAVE
KNOWN FOR I DON'T KNOW DECADES
HOW CRITICAL CONTEXT IS, IS
THERE AN OPPORTUNITY, PEOPLE ON
THE GROUND ARE LOOKING FOR
SOLUTIONS AN DON'T HAVE A MAGIC
SOLUTION, BUT RATHER THAN
BRINGING OUR HAND ARE THERE
TOOLS, ARE ARE THERE APPROACHES
THAT CAN BE USED HAVING WORKED
IN CHILD DEVELOPMENT, HAVING --
TO MEASURE CHILD DEVELOPMENT
HAVE MOVED FORWARD. SO I THINK
THAT'S SOMETHING WHICH I HOPE
COMES OUT OF IT BECAUSE WHILE I
AGREE YOU WANT FROM THE GROUND
UP WHEN PEOPLE -- THERE'S SO
MUCH DISPARITY, THIS IS NOT ON
TOP OF THEIR LIST, AND WE HAVE
TO -- THINGS THAT FACILITATE AND
AGREE WITH CONNIE.
>> CHALLENGE US TO DO THAT. IT
WOULD BE INCREDIBLY USEFUL.
PLEASE DAN.
>> SO LET ME JUST QUICKLY MAKE A
COMMENT. I THINK ALL THE WORKING
GROUPS ARE DOING A GREAT JOB. IT
IS COMPLEX, IT IS DAUNTING, WE
SHOULDN'T BE DAUNTED BY IT. THE
FIRST THREE WORKING GROUPS ARE
INTENDED TO FOCUS OUR ATTENTION
ON CHILD. WHAT IT IS WE MOW
ABOUT BIOLOGY, WHAT WE KNOW
ABOUT THE IMPLICATIONS OF THE
ENVIRONMENT ON THOSE DOMAINS OF
INTEREST IN TERMS OF FUNCTION WE
MIGHT BE INTERESTED IN
MEASURING. WORK GROUP IS GOING
TO DEVELOP SOME SORT OF SUITE, A
MODEL SOME SORT OF APPROACH TO
PUTTING THOSE TWO THINGS
TOGETHER. THIS GROUP HERE HAS
COVERED ALL THE ISSUES THAT WILL
NEED TO BE CONSIDERED, ONCE WE
HAVE COMPILE THE RESULTS OF
WORKING GROUPS ONE THROUGH
THREE, WHAT ARE THE ISSUES THAT
NEED TO BE CONSIDERED FOR
IMPLEMENTATION TRANSLATION WHICH
IS AS CHRIS HIGHLIGHTED WHAT
PHASE 2 IS GOING TO BE ABOUT. SO
I WOULDN'T GET OVERLY DISTRACTD
BY THE COMPLEXITY. IT IS
COMPLEX. BUT EACH OF YOU YOUR
WORKING GROUPS HAVE BEEN DOING
WHAT YOU NEED TO BE DOING TO
HIGHLIGHT WHAT IT IS WE NEED TO
BE THINKING ABOUT. TO MEASURE
THE IMPACT OF THESE PROGRAMS ON
CHILD HEALTH AND DEVELOPMENT. SO
PLEASE DON'T GET DISTRACTED BY
THE COMPLEXITY. OWN IT. BUT WE
CAN MOVE -- WE WILL MOVE FORWARD
WITH THIS. AND ALSO I WANT TO
HIGHLIGHT THE NEED -- THE FACT
THAT AS I MENTION IN MY
PRESENTATION, THERE NEEDS TO BE
A BALANCE BETWEEN RESEARCH AND
TRANSLATION. THAT IS NOT A
LINEAR RELATIONSHIP, IT IS A
CIRCULAR ONE. SO WILL IS A
CONSTANT FEEDBACK LOOP. WE NEED
TO HAVE A RESEARCH PRIORITIES
THAT WE CAN LAY OUT. TO
HIGHLIGHT WHAT WE NEED TO BE
DOING, BECAUSE IT IS OBVIOUSLY
THINGS THAT WE NEED TO BE DOING.
WHAT WE CAN DO WE SHOULD MYLIGHT
AS WELL. THESE WERE HIGHLIGHTED,
WITH DUE CONSIDERATION TO ALL
THE THINGS THAN WERE HIGHLIGHTED
IN THE PRESENTATION THIS
MORNING. I WOULD FINISH BY
SAYING WE HAVE GONE THROUGH THIS
WITH THE BEGIN PROJECT. THIS IS
A COMPLEX ISSUE. SCHOOL AGE
CHILDREN IN THE IMPACT NUTRITION
SCHOOL AGE CHILDREN. BUT THE
ISSUE OF INFANT FEEDING AND
BREAST FEEDING AND LACTATION,
AND THE CONTEXTUAL ISSUES THAT
IMPACT ON THAT, IS EQUALLY
DAUNTING BUT THOSE -- WE ARE
ABLE TO PULL THAT TOGETHER IN A
MEANINGFUL WAY. AND I THINK WE
CAN DO THAT HERE. PLEASE DON'T
BE DISTRACTED. YOU GUYS ARE
DOING A GREAT JOB. WE WILL MOVE
FORWARD WITH THIS AND IT WILL BE
GREAT. THANK YOU.
>> THANKS FOR THE WORDS OF
ENCOURAGEMENT, DAN. WE HAVE A
SHORT BREAK PLANNED. WE'LL ASK
EVERYONE TO RECONVENE TAKE TEN
MINUTES? OR STICK WITH THE FIVE?
>> I THINK WE NEED TO STICK WITH
FIVE.
>> OKAY. SET YOUR TIMERS. PLEASE
COME BACK IN FIVE MINUTES. AND
WE'LL BEGIN WITH OUR SPEAKERS.
THANK YOU TO EVERYONE O WHO
SPOKE THIS MORNING, THE WORKING
GROUP MEMBERS. SEE YOU SOON.
>> WELCOME BACK, EVERYBODY. WE
WILL TALK WITH OUR SERIES OF
FOUR TALKS FROM INVITED SPEAKERS
WE ARE EXCITED ABOUT AND SO
APPRECIATIVE EVERYONE WAS
WILLING TO MAKE THE TIME TO BE
HERE TODAY. SO I'M GOING TO
START BY INTRODUCING DONNA
MARTIN WHO IS FROM THE BURKE
COUNTY BOARD EVENINGCATION. AND
ALSO WAS -- EDUCATION. PAST
PRESIDENT OF ACADEMY OF
NUTRITION AN DIETETICS. SHE
WILL TALK TRANSLATION AND
IMPLEMENTATION CONSIDERATIONS
FOR SCHOOL FOOD PROGRAMS IN THE
UNITED STATES. WELCOME, DONNA.
>> THANK YOU FOR THE OPPORTUNITY
TO SPEAK TODAY ABOUT THE LOWER
SCHOOL MEAL TRANSLATING
IMPLEMENTING IMPACT OF PROGRAMS
AND INTERVENTIONS TARGETING
NUTRITIONAL NEEDS OF CHILDREN.
SCHOOL MEALS ARE THE ULTIMATE
SAFETY NET FOR CHILDREN IN FOOD
INSECURITY AND EXCELLENT WAY TO
ENSURE CHILDREN LEARN TO EAT
HEALTHY. SO SCHOOL NUTRITION
PROGRAMS PROVIDE CRITICAL SYSTEM
OF SUPPORT FOR MILLIONS OF
AMERICANS WHEN AT SCHOOL OR
OTHER SUPERVISED CHILD CARE
SETTINGS. NATIONAL SCHOOL LUNCH
PROGRAM WAS ESTABLISHED IN THE
RICHARD BE RUSSELL NATIONAL
NUTRITION ACT SIGNED INTO LAW BY
PRESIDENT HARRY TRUMAN IN 1946.
THE NATIONAL SCHOOL LUNCH
PROGRAM IS LARGEST OF THE
PROGRAMS AND FEDERALLY ASSISTED
PROGRAM THAT OPERATES IN PUBLIC
AND NON-PROFIT SCHOOLS
7.1 MILLION CHILDREN PARTICIPATE
IN NATIONAL SCHOOL LUNCH PROGRAM
IN ITS FIRST YEAR. IT REACHES 30
MILLION CHILDREN EVERY DAY. AND
PROVIDES NUTRITIONALLY BALANCED
LOW COST OR NO COST LUNCHES TO
CHILDREN EACH SCHOOL DAY. THE
SCHOOL BREAKFAST PROGRAM STARTED
IN 1966 AS PILOT PROJECT AND
MADE PERMANENT ENTITLEMENT
PROGRAM BY CONGRESS IN 1975.
SLOWLY BUT STEADILY GROWN OVER
THE YEARS SERVING NEARLY A HALF
A MILLION CHILDREN IN 1970, AND
NOW REACHING CLOSE TO 15 MILLION
CHILDREN A DAY. THE CHILD
DEVELOP CARE FOOD PROGRAM IS
FEDERAL MANDATE THAT PROVIDES
REIMBURSEMENTS FOR NUTRITIOUS
MEALS TO ELIGIBLE CHILDREN FOR
CARE AND PARTICIPATING CHILD
CARE CENTERS AND DAY CARE
CENTERS. CONTRIBUTES TO THE
WELTNESS AND HEALTH APPROXIMATE
AND GROWTH OF YOUNG CHILDREN IN
THE UNITED STATES BY SERVING
NEARLY 4 MILLION CHILDREN DAILY.
THE CENTER FOOD SERVICE PROGRAM
ALSO KNOWN AS THE SUMMER MEALS
PROGRAM WAS ESTABLISHED IN
CHILDREN TO ENSURE CHILDREN
CONTINUE TO RECEIVE NUTRITIOUS
MEALS WHEN SCHOOL IS NOT IN
SESSION. WHEN SCHOOL IS OUT IS
SUMMER FOOD PROGRAM PROVIDES
MEALS TO KIDS AND TEENS IN LOW
INCOME AREAS. THOUGH QUITE A
FEW CHILDREN WITH SUMMER FOOD
SERVICE PROGRAM BECAUSE OF THE
PANDEMIC, PREPANDEMIC WE WERE
SERVING A FRACTION OF THE
CHILDREN TO RECEIVE SCHOOL MEALS
IN THE SCHOOL YEAR. THE FDA FARM
TO SCHOOL GRANT FINDS STATE
REGIONAL ORGANIZATIONS AS THEY
INITIATE EXPAND AND
INSTITUTIONALIZE FARM TO SCHOOL
METHODS. ON AN ANNUAL BASIS
AWARDS COMPETITIVE FARM TO
SCHOOL GRANTS THAT SUPPORT
PLANNING, DEVELOPING AND
IMPLEMENTING FARM TO SCHOOL
PROGRAMS. BEGINNING IN THE 21,
22 SCHOOL YEAR FARM TO SCHOOL
GRANT PROGRAM WILL BE SUPPORTING
176 GRANTS SERVING 6,800
SCHOOLS, MORE THAN 1.4 MILLION
STUDENTS OF THE VEGETABLE
PROGRAM IS A FEDERALLY ASSISTIVE
PROGRAM PROVIDING FRESH FRUIT AN
VEGETABLES TO CHILDREN WITH
ELIGIBLE ELEMENTARY SCHOOLS IN
THE SKOL DAY. THE GOAL OF THE
THE VEGETABLE PROGRAM IS
INTRODUCE CHILDREN TO FRESH
FRUITS AND VEGETABLES TO INCLUDE
NEW DIFFERENT VARIETIES AND
INCREASE ACCEPTANCE AS FUNCTION
OF FOOD. UNPROCESSED PRODUCE
AMONG CHILDREN. THE FRUIT AND
VEGETABLE ENCOURAGES HEALTHIER
SCHOOL ENVIRONMENT BY PROMOTING
EDUCATION, OVER THE LAST YEARS
FDA HAS INVESTED NEARLY 200
MILLION A YEAR IN FUNDING IN
THIS PROGRAM. NUTRITION
PROVIDED INFRASTRUCTURE THAT CAN
BE MOBILIZED TO IMPROVE
CHILDREN'S DIET AND HELP ON
NATIONAL SCALE WHY ALSO
IMPROVING SCHOOL ATTENDANCE,
TEST SCORES AND EDUCATIONAL
ATTAINMENT. THERE IS EVIDENCE
SOCIAL AND ECONOMIC BENEFIT OF
THE SCHOOL NUTRITION PROGRAMS
THAT EXTEND IN THE LOCAL
COMMUNITIES INCLUDING
IMPROVEMENTS IN THE DIET OF
OTHER FAMILY MEMBERS. HEALTHIER
OPTIONS IN GROCERY STORES
ECONOMIC STIMULUS TO
COMMUNITIES, STAGE CUSTOMERS FOR
AMERICAN AGRICULTURE, JOB
CREATION, AND POVERTY REDUCTION.
IN LIGHT OF THE PANDEMIC, THE
OBESITY AND FOOD INSECURITY
SHOULD BE THE OUTMOST IN PERSONS
SCHOOL MEALS ARE BEST DEFENSE
AGAINST THIS. GENERALLY EVERY
FIVE YEARS UNITED STATES
CONGRESS PASSES LEGISLATION THAT
REAUTHORIZES THE EXISTING
CHILDHOOD PROGRAM, THE LAST YEAR
AUTHORIZATION HELP KIDS ACT WAS
PASS MISDEMEANOR 2010.
CONSEQUENTLY THESE PROGRAMS HAVE
NOT BEEN UPDATED IN A DECADE.
THOUGH THE CURRENT LAW, FREE
KIDS ACT OF 2010 EXPIRED ON
SEPTEMBER 30 OF 2015, THE
PROGRAMS CONTINUE TO OPERATE BUT
NEED UPDATES. THE HE WILL THY
-- ENACTED IN WIDESPREAD PUBLIC
CONCERN BY AUTHORIZING CHANGES
IN THE SCHOOL NUTRITION PROGRAM.
THESE CHANGES RANGE FROM
CREATING NEW SCHOOL LUNCH
BREAKFAST AND COMPETITIVE FOOD
NUTRITION STANDARDS, THAT ALIE
WITH THE LATEST NUTRITION
SCIENCE. TO ELEVATE STATUS OF
SCHOOL NUTRITION ARE
PROFESSIONALS MANY RBN REQUIRING
CONTINUING EDUCATION. THE NEW
MEAL PATTERNS INCLUDE MINIMUM
AND MAXIMUM POWER LEVELS,
REQUIREMENTS OF FULL MEALS MUST
INCHRUD A FRUIT OR VEGETABLE ON
THE TRAY BUT SPECIFIC VEGETABLE
SUB GROUPS INCLUDED WHEN MENUS
ARE PLANNED AND 100% SERVE 51%
WHOLE GRAIN RICH. THE HEALTHY
HUNGER FREE KIDS ACT PROVIDED
GRANT MONEY TO STRENGTHEN
INITIATIVINGS IMPROVE
TRANSPARENCY, OVERSIGHT, AND
TECHNICAL ASSISTANCE, TO SCHOOLS
FOR WELLNESS POM SHY DEVELOPMENT
SPECIFICALLY RELATED TO
NUTRITION EDUCATION AND
PROMOTION OF FOOD, AND BEVERAGE
MARKETING TO CHILDREN. AND
EXPANDED AFTER SCHOOL MEALS TO
ALL STATES. WHAT HAPPENED SINCE
THE LAST AUTHORIZATION?
ACCORDING TO TUFTS UNIVERSITY
STUDY THAT FOLLOWED DIETARY
TRENDS OVER 15 YEAR PERIOD
BETWEEN 2003 AND 2018 PERCENTAGE
OF CORE NUTRITIONAL QUALITY FOOD
CONSUMED AT SCHOOL SUCCESSFULLY
REDUCE 55.6% TO 24.4%. THIS
DRASTIC IMPROVEMENT TOOK PLACE
MOSTLY AFTER THE 2010 HEALTHY
HUNGER FREE KIDS ACT.
SIMULTANEOUSLY OCCURRING WITH
THE PASSAGE OF THIS ACT,
NUTRITION QUALITY WAS MEASURED
USING MULTIPLE SCALES INCLUDING
USDA HEALTHY EATING INDEX WHICH
SCORES A PERSON DIET USING NINE
ADVOCACY COMPONENTS, TOTAL FRUIT
WHOLE FRUIT TOTAL VEGETABLES,
WHOLE GRAIN, DAIRY, TOTAL
PROTEIN, PLANT PROTEINS AND
PATTY ACIDS. AND FOR MODERATION
REFINED GRAINS SODIUM ADDED
SUGAR AND SATURATED FAT. AS A
RESULT, SCHOOLS ARE THE
HEALTHIEST PLACE TO EAT. THEY
ARE THE HEALTHIEST PLACE TO EAT
FOR CHILDREN DEMONSTRATING
SCHOOL NUTRITION MEAL. IT SHOWS
YOU HOW A SINGLE POLICY PASSED
BY CONGRESS CAN DRAMATICALLY
IMPROVE THE NUTRITION OF
MILLIONS OF CHILDREN. AMEND THE
RESULT RESEARCHERS ALSO FOUND
THE INCREASE IN HEALTHY EATING
SCHOOLS, EQUALLY IMPACTED ALL
ETHNICITIES INCLUDED IN THIS
STUDY. TALK ABOUT EQUITY. IN
2019 USDA PUBLISHED A STUDY THAT
FOUND LEVELS OF -- WERE REDUCED
OR UNCHANGED AS A RESULT OF
IMPLEMENTATION OF HEALTHY --
IMPROVEMENT ACT SO DON'T BELIEVE
ALL THE VIDEOS YOU SAW WITH KIDS
STARVING. THE STUDY FOUND THAT
SCHOOLS IMPLEMENTED THE
(INAUDIBLE) OPTION THAT PLACED
PLATE WEIGHTS SIGNIFICANTLY
LOWER SCHOOLS THAT DID NOT OFFER
THAT OPTION. ALSO SIGNIFICANT
ASSOCIATION BETWEEN THE TIMING
OF LUNCH PERIODS AND PLATED
WEIGHT. PERCENT OF PLATE WEIGHT
LOWER LUNCH PERIODS THAT STARTED
AFTER 12 P.M. OVERALL PLATE
WEIGHT HIGHEST FOR VEGETABLE,
FOLLOWED BY (INAUDIBLE) 29%,
FRUIT 26% AND GRAIN AND BREAD,
20% AND ENTREES AND MEAT WERE
THE LOWEST 16 AND 14%
RESPECTIVELY. ALSO STATISTICALLY
SIGNIFICANT ASSOCIATION BETWEEN
STUDENTS PARTICIPATION IN
NATIONAL SCHOOL LUNCH PROGRAM
AND NUTRITIONAL QUALITY MEASURED
BY HEALTHY INDEX. RATES OF
STUDENT PARTICIPATION
SIGNIFICANTLY HIGHER SCHOOLS
WITH HIGHER ATI SCORES. THE
THIRD HIGHEST QUARTILE, THE TOP
HALF, OF THE DISTRIBUTION
COMPARED TO THE LOWER QUARTILE.
IN DECEMBER 2018 USDA PUBLISHED
A RULE THAT MADE CHANGES TO THE
ORIGINALLY ESTABLISHED NUTRITION
STANDARDS. THIS WILL
PERMANENTLY ALLOW FLAVORED LOW
FAST MILK IN THE NATIONAL SCHOOL
LUNCH SCHOOL BREAKFAST MILK
PROGRAM AND -- PROGRAM LOWER
MINIMUM PERCENTAGE OF GRAIN
ELIMINATING THE THIRD TARGET ALL
TOGETHER. IN 2020, THE FEDERAL
COURT VAC THIS DOWN LEAVING WITH
THE ORIGINAL NUTRITION
STANDARDS. DUE TO COVID-19
PANDEMIC USDA ISSUED PANDEMIC
FLEXIBILITIES RANGING FROM
FLEXIBILITY MEAL PATTERN AND --
CHILD NUTRITION PROGRAMS. THESE
FLEXIBILITY SUPPORTED SAFELY AND
SOCIAL DISTANCING MEASURES
DURING THE PANDEMIC SHOULD BE
CONSIDERED EXTENDED PERMANENTLY
BUT RIGHT NOW THE ABILITY FOR
USDA TO EXTEND HAS NOT PASSED
CONGRESS LEAVING SCHOOL
NUTRITION PROGRAMS AND
JEOPARDIZING SCHOOL ABILITY TO
FEED CHILDREN. SO WHAT ARE THE
PRIORITIES FOR THE NEXT CHILD
NUTRITION RE-AUTHORIZATION? WE
ARE SUPPORTING INCREASE FUNDS TO
ENSURE THAT STRONG COMPREHENSIVE
AND CULTURALLY APPROPRIATE
NUTRITIONAL PROMOTION IS
INCLUDED IN AUTHORIZATION AND
THEN PROVIDED FOR ALL NUTRITION
PROGRAMS. WE WANT THEM TO
PROVIDE ADEQUATE FUNDS TO HELP
ALL STATES FROM STATE LEVEL
LEADERSHIP INFRASTRUCTURE FOR
COMPREHENSIVE NUTRITIONAL
PROMOTION LED BY QUALIFIED
PROFESSIONALS IN EVERY STATE
DEVELOPING NUTRITION EDUCATION,
AND PROMOTION PLAN TO PROMOTE
COORDINATE AND PROVIDE NUTRITION
EDUCATION TO ALL CHILDREN
NUTRITION PROGRAMS. WE WANT THEM
TO GIVE PERMANENT AUTHORITY TO
USDA TO PROVIDE WAIVERS AND
FLEXIBILITIES DURING THE PLANNED
EMERGENCY SUPPORT EVIDENCE BASE
MEAL NUTRITION STANDING THAT
ALIGN WITH LATEST DIETARY
GUIDELINES FOR AMERICANS AND
UPDATED AS NECESSARY ON AN
ESTABLISHED TIME LINE, PROVIDE
ADEQUATE FUNDING TO FROM PROVIDE
TRAINING TECHNICAL ASSISTANCE TO
SUPPORT MAINTENANCE AND
ATTAINMENT OF NUTRITION
STANDARDS AS WELL AS SKILLS
NECESSARY TO RUN SUCCESSFUL
PROGRAM. INCREASE FUNDING
MECHANISMS FOR UPDATED
INFRASTRUCTURE AND EQUIPMENT TO
SCHOOL KITCHENS. ENSURE EQUAL
EQUITABLE SCHOOL MEALS BY
SUPPORTING HEALTHY SCHOOL MEALS
TOKER ALL COMMUNITY ELIGIBILITY
POSITION. INCREASE RESEARCH THAT
PROVIDE EVIDENCE BASE
IMPROVEMENT FOR COMPREHENSIVE
CULTURALLY APPROPRIATE
NATIONWIDE NUTRITION EDUCATION
AND PROMOTION THAT APPROACHES
AND FOSTERS HEALTHY BEHAVIORS
EDUCATIONAL ATTAINMENT, AND
LIFELINE -- LIFE LONG FOR ALL
CHILDREN. PARTICIPATION IN
MEALS PROGRAM. INCREASE THE
FUNDING FOR THE FARM TO SCHOOL
GRANT AND FRESH FRUIT VEGETABLE
PROGRAM SO THAT MORE SCHOOLS
HAVE THE OPPORTUNITY TO
PARTICIPATE. SO WHAT ARE THE
LIMITATIONS OF THE NUTRITION
PROGRAM RIGHT NOW? THE HUGE ONE
IS THE SCHOOLS DO NOT HAVE
KITCHENS, OR HAVE OLD KITCHENS
AND THEY NEED NEW EQUIPMENT. THE
UPDATED -- AND THEY DON'T HAVE
KITCHEN. WE NEED KITCHENS TO
OPERATE (INAUDIBLE) THAT'S NOT
FUNDING TO NUTRITION EDUCATION,
IN SCHOOL, WE NEED HEALTHY
SCHOOL MEALS FOR ALL, THERE ARE
SERIOUS LABOR SHORTAGES, WE NEED
TO INCREASE FUNDING, BECAUSE
PANDEMIC HAS INCREASED FOOD AND
SUPPLY CHAIN ISSUES WE NEED
PERMANENT WAIVER AND WE NEED
MORE RESEARCH TO SUPPORT
BREAKFAST IN THE CLASSROOM AND
ADEQUATE TIME FOR KIDS TO EAT.
THANK YOU SO MUCH.
>> THANK YOU, DONNA, THAT WAS
TERRIFIC. THANK YOU FOR
HIGHLIGHTING ALL THOSE ELEMENTS
WHICH ARE PART OF THE
IMPLEMENTATION INDICATORS, WE
TALKED ABOUT. OUR NEXT SPEAKER
IS FRANCIS ZOTOR UNIVERSITY OF
HEALTH ALLIED SCIENCES IN GHANA.
FRANCIS WILL SPEAK ON NUTRITION,
TRANSITION, AND THE NEED FOR
NUTRITION INDICATORS IN AFRICA.
WELCOME, FRANCIS.
>> THANK YOU SO MUCH KRISTINA
AND THANK YOU DAN FOR HOSTING
THIS EVENT. AS KRISTINA SAID,
(INAUDIBLE) HAS COME ALIVE. IN
NUTRITION, FIRST THOUSAND DAYS
BUT DO NOT KNOW DIFFERENCES
BEING MADE ON THE FIRST 7,000
(INAUDIBLE) TO THE NEXT SLIDE
PLEASE. NOW WE KNOW THAT OUR
CHILDREN ARE OUR FUTURE AND
INFORM (INAUDIBLE) OF THE
NATION. WE ALSO KNOW --
INDICATED CAN ACHIEVE THE FULL
POTENTIAL. NEXT SLIDE PLEASE.
IF I TAKE IT BACK TO THIS
(INAUDIBLE) WE FIND NUTRITION IS
ABOUT THE INVESTMENT IN CHILDREN
AND -- IMPROVE THE LANGUAGE THAT
WE CAN OBTAIN EDUCATIONALLY. NOW
LOOK AT THE INTERRELATIONSHIP
BETWEEN EDUCATION AND NUTRITION
AND HEALTH IN EFFECTIVE
(INDISCERNIBLE)
LET ME PUT THIS INTO CONTEXT.
AFRICA IS MADE UP OF 55
COUNTRIES. AND (INDISCERNIBLE)
MOST LIKELY ZONES ALSO TELL US
COMMUNITIES, WHERE DIFFERENCES
IN A COMPLEXITY AND GREAT
CONTINENT WHERE -- ORIGINAL
COMMUNITIES CHALLENGES
DIFFERENTLY BASED ON THE -- THAT
WE HAVE PARTICULARLY AS AFRICA,
REALIZE STEPPING UP AN EFFECTIVE
SCHOOL HEALTH AND NUTRITION IS
COMMITMENT TO LEARN -- AND
CONTRIBUTE IN THE FUTURE OF
BLACK COMMUNITIES AN COUNTRIES.
NEXT SLIDE PLEASE. WE KNOW
STATISTICS THAT ONE IN FIVE
COUNTRIES -- FIVE PLACES ARE
FACING HUNGER. 282 MILLION
PEOPLE ARE UNDERNOURISHED.
(INDISCERNIBLE) COMPARED TO
INEQUITIES OF 46 MILLION. WHAT
ARE REASONS, THERE ARE SEVERAL
REASONS. FOOD INSECURITY DUE TO
CONFLICTS -- POOR MATERNAL --
ETHNICITY BUT -- HAVE SHIFTED
SIGNIFICANTLY FROM NUTRIENT RICH
TRADITIONAL DIET HIGH IN FIBER
AND LOW IN FAT TO NOW HIGH
PROCESSED ENERGY DENSE SALTY
FATTY AND SWEET CONVENIENCE
FOODS AND SNACKS TERMED WESTERN
DIETS. WE ALSO SEE THE TREND
AND TRANSFORMATION OF HEALTHY
INDIGENOUS PRODUCED FOODS SNACKS
AND BEVERAGES IN TERTIARY
PROCESSED FOODS RICH IN SUGARS,
FATS, UNHEALTHY SYNTHETIC FOOD
ADDITIVES. THIS IS NOW
(INAUDIBLE) NEXT SLIDE PLEASE.
SO THE AFRICAN SCENARIO, NOT
ONLY -- ACROSS AFRICA AND THAT
IS AFFECTING OUR POPULATION. SO
GOING BACK TO INTERACTION
BETWEEN FOOD INSECURITY AND
HUMAN HEALTH AND NUTRITIONAL
RISK, IT COULD BE (INAUDIBLE)
INFLUENCES ARE IMPACT WITH MUCH
MORE FOOD INSECURITY WHEN THIS
HAPPENS WE HAVE (INAUDIBLE)
DEFICITS, WE HAVE MINIMAL
INFLUENCES AND LONG TERM
CLINICAL OUTCOMES AND THIS DOES
HAVE GREAT EFFECT ON THE -- SO
WHAT I WILL TALK ABOUT IS
PREVIOUS SLIDE, SOMETHING ABOUT
THE CONTINENTAL NUTRITION
ACCOUNTABILITY SCORE CARD. THIS
IS THE MEASURE OF THE PROGRESS
OF THE -- AFRICAN ENVIRONMENT
ADVOCACY TOOL FOR CHALLENGE OF
(INAUDIBLE) SO GO TO THE NEXT
SLIDE, YOU CAN SEE DIFFERENT
PATHS, YOU CAN SEE THE TROPICS
IS -- THE MARGIN OF MALNUTRITION
THE SLIDE GIVES YOU AN IDEA OF
THE 20 INDICATORS WHICH SHOW
STATUS OF NUTRITION
(INDISCERNIBLE) IT GIVES AN IDEA
WHERE WE ARE AT. AND EFFORT
BEING MADE, NUTRITION TARGETS,
SO WHAT IT TELLS YOU IN AFRICA
EFFORTS WILL BEING MADE TO
ADDRESS THE CHALLENGE, I DRAW AN
EXAMPLE FROM WEST AFRICA, WE SEE
PARTICULARLY IN WEST AFRICA, 16
COUNTRIES, THERE ARE ONLY --
POLICIES, AND EDUCATION. ARE
FACING CHALLENGES, CANADA, THE
OTHER (INDISCERNIBLE) 55
COUNTRIES THAT (INAUDIBLE) TO
ADDRESS THIS CHALLENGE. NEXT
SLIDE. TO MAKE UP EFFORTS MADE
TOWARD SCHOOL NUTRITION WITH THE
HELP OF AUDA NEPAD, PARTICULARLY
THE AFRICAN UNION IS -- WHO ARE
IN THE FOREFRONT OF DRIVING
EDUCATION AGENDA AND (INAUDIBLE)
AND TO BRING BACK TO THE DINNER
TABLE AFRICAN -- PROGRAM THAT
IMPROVES THE (INAUDIBLE) ALSO
HAVE FULL ENVIRONMENT THE FOOD
ENVIRONMENT PLANNING
MODIFICATION, ENVIRONMENT OF --
WHICH IS (INAUDIBLE) IMPROVING
HEALTH WITH NUTRITION -- THERE
IS -- SUPPLY CHAINS, PROCUREMENT
OF POLICIES FOR SCHOOL MEALS.
THIS IS THE RECOMMENDATION --
SOCIETY, AND FOOD SYSTEM
DIALOGUE LED BY (INAUDIBLE). SO
WHAT ARE THE SHORT TERM
PRACTICAL AND PRAGMATIC
APPROACHES? IT IS A FACTNA THIS
AFRICA NOT ALL COUNTRIES HAVE
NATIONAL UPDATED BASELINE. SO
UNDER AFRICAN SOCIETY WE TRY TO
BUILD THIS -- TO DEVELOP
CAPACITY AND SKILLS ACROSS
AFRICA TO STRENGTHEN
OPPORTUNITIES. TO DO THIS WE
COLLECT DATA ANALYZE DATA AND
INTERPRET DATA. I CAN TELL YOU
THIS -- 17 COUNTRIES NOT GIVING
THE KNOWLEDGE AND PROGRAMS
INVOLVE 65 PEOPLE IN OUR SLIDE
HERE TO LOOK AT THE DATA THAT
WAS COLLECTED. THERE WAS A POINT
TOO -- BY COUNTRY SET UP TO
ABDUCT POLICIES AND STRATEGIES
TO NATIONAL CONTEXT AND
DATABASE. THIS CONTEXT IS --
NATIONAL POLITICAL DATA, WHAT --
NEXT SLIDE PLEASE. SO IN THE
(INAUDIBLE) CONSOLIDATING THE
EFFORTS UNDER THE AEGIS OF THE
AFRICAN NUTRITION SOCIETY AND
PARTNER, WANT TO LOOK AT THE
TOOLS, INDICATORS TO MONITOR
INSTRUMENTS THAT ARE DEVELOPED
AND TESTED. NOW SHORT TERM AND
MID LONG TERM GOALS, WHAT WE ARE
HOPING TO DO, AGAIN, WITH THE
AFRICAN (INAUDIBLE) IS TO
FACILITATE AND STRENGTHEN THE
NORTH SOUTH AND SOUTH SOUTH
COLLABORATIONS FOR RESEARCH AND
CAPACITY BUILDING AROUND HEALTH
AND NUTRITION OF A SCHOOL IS THAT THERE
ARE REALITIES AND
PARTICULARITIES MANY THE AFRICAN
CONTEXT IN THE DESIGN AND
IMPLEMENTATION OF INTERVENTIONS. INTERVEN TIONS.
WE WANT TO BUILD EXISTING
SUCCESSFUL INITIATIVES AN
PROGRAM, SUCH A AS SCALING UP
NUTRITION PROGRAMS, APPLIED IN
50 COUNTRIES, AFRICAN
DEVELOPMENT STRATEGY, PREVENTION
IN THE GUIDANCE FOR PROGRAMS.
WE ALSO WANT TO HOME GROWN
SCHOOL FEEDING AND SCHOOL
GARDENS ARE ALREADY ONGOING
ACTIVITIES, IN SEVERAL
COUNTRIES, GHANA, NIGERIA,
KENYA, RWANDA, TANZANIA, TO LOOK
AT EFFICIENCY IN THIS
REPLICATED. NEXT SLIDE. MY
(INAUDIBLE) TO GOVERNMENTS
SHOULD SERIOUSLY CONSIDER OUR
POLICIES AND PROGRAMS AND PAY
ATTENTION TO NUTRITION
TRANSITION WHICH IS HERE TO US,
LEVEL, ADVOCACY EFFORTS TO
ADDRESS THE TRIPLE BURDEN OF
DISEASE AND MALNUTRITION. THAT
IS A PROBLEM. WE HAVE TO SET UP
GOVERNMENTS TO LOOK UP PUBLIC
EVENTS TO ADDRESS THE --
CONFRONTING THIS AND BRING THIS
WE ARE SAYING THAT -- WHEN WE
ARE FACING AN EPIDEMIC.
SHORTAGES OF -- BECAUSE OF
PANDEMIC, WHAT THE PANDEMIC DOES
-- IS INTERESTED IN OR WHEN THE
PROBLEM OF EPIDEMIC, AFRICA,
SHOULD ALREADY -- AND I'M GLAD
THAT WE HAVE A LOT OF
(INAUDIBLE) THERE ARE A HUNDRED
DATA TO ADDRESS NUTRITION
CHALLENGES. I'M ALSO GLAD TO SEE
AFRICA NUTRITION ACTION IS
WAKING UP TO -- NUTRITION
SOCIETY TO -- WAKE THEM UP TO
THESE INITIATIVES. TOGETHER WE
CAN FORM APPROACH TO (INAUDIBLE)
(INDISCERNIBLE)
THE DATA THAT IS THE SOLE
PURPOSE. THANK YOU, VERY MUCH
FOR YOUR TIME.
>> THANK YOU SO MUCH, THAT WAS
TERRIFIC. AND I THINK CONSISTENT
WITH A LOT OF WHAT WE HAVE BEEN
HEARING REALLY APPRECIATE YOUR
REMARKS. OUR NEXT SPEAKER IS
FROM THE ROCKEFELLER FOUNDATION
WHO WILL TALK ABOUT FOOD
INCONSISTENCIES IN LOW AND
MIDDLE FIRST QUARTER COUNTRIES.
>> THANK YOU VERY MUCH, GOOD
MORNING, GOOD AFTERNOON AND GOOD
EVENING FROM NAIROBI, IT IS A
PLEASURE TO JOIN SUCH A
DISTINGUISHED AND IMPORTANT
GROUP. MY PRESENTATION WILL
REALLY COME MORE FROM
PRACTITIONER PERSPECTIVE SO I
WILL WALK YOU THROUGH THE
JOURNEY THAT BROUGHT US TOWARDS
TRYING TO THINK ABOUT MEAL AND
DIET QUALITY, TAKING MORE OF A
FOOD AND DIET BASED APPROACH.
LET ME SHARE MY SCREEN HERE. AND
SLIDE SHOW. SO FOR US THE
STARTING POINT WAS AN INITIATIVE
THAT WE CALL THE POWER OF
PROCUREMENT FOR NUTRITION. PP 4N
WHICH IS ABOUT INTENTIONALLY
LEVERAGING INSTITUTIONAL FOOD
PROCUREMENT AS A LEVER TOWARDS
IMPROVE DIETS BUT ALSO FOR MORE
SUSTAINABILITY ENVIRONMENT
TOWARDS GREATER EQUITY IN THE
PRODUCTION DISTRIBUTION
CONSUMPTION OF FOOD. SO WITH
THIS WE HAD SAY A DUAL GOAL OF
SAY IMMEDIATE IMPACT FOR
BENEFICIARIES AND SCHOOL FOOD IS
THE INSTITUTIO INSTITUTIONAL FOOD CHANNEL
PAR EXCELLENCE BUT AT THE SAME
TIME WE WANTED TO SOW THE SEEDS
FOR A VIBRANT MARKET FOR
NUTRITIOUS FOODS. SO USING THAT
Z A LEVERAGE POINT, ENTRY POINT
TOWARDS ALSO GROWING THE MARKET
FOR NUTRITIOUS FOODS, IN THE
DIFFERENT COUNTRIES. THIS
SOMETHING THAT WE STARTED DOING
IN THE AFRICAN PARTNERSHIP WITH
THE WORLD FOOD PROGRAM AND I WAS
BECOMING THE FOCUS OF A GLOBAL
PARTNERSHIP BETWEEN OUR TWO
INSTITUTIONS TOGETHER OF COURSE
WITH THE MULTITUDE OF LOCAL
PARTNERS IN DIFFERENT COUNTRIES
WE RAN INTO THE CHALLENGE OF HOW
TO MEASURE THIS. SO THEY DID --
THIS IS NOT EXHAUSTIVE, THERE'S
MORE COMPLEXITY BEHIND HERE BUT
THE IDEA BUZZ TO ILLUSTRATE HOW
STARTING WITH THE MEAL WE COULD
SORT OF TRY TO BUILD INTO THE
IDEA OF MEAL QUALITY, LEADING TO
MENU QUALITY AND THEN TO DIET
QUALITY. KNOWING THAT THERE IS
OF COURSE MANY GAPS AND LEAPS
FROM ONE TO THE OTHER BUT AT
LEAST IN THE LEVEL OF THE SCHOOL
WE HAVE REASONABLE DATA AND AS
WE WILL DISCUSS LATER THERE
MAYBE AN OPPORTUNITY TO
EXTRAPOLATE TO MENU QUALITY
METRIC AND THEN DIET QUALITY.
WHICH BY THE WAY IS OF COURSE
VERY EFFERVESCENT FEEL WITH
INTERESTING METRICS EMERGING
TRYING TO MEASURE THE QUALITY IN
A MORE COMPREHENSIVE MANNER. SO
THAT WAS OUR STARTING POINT. WE
JUST COULDN'T FIND A METRIC FOR
US WAS SATISFACTORY IN TERMS OF
MEASURING QUALITY AND
IMPROVEMENTS IN MEALS AND
INSTITUTIONAL SETS. IN THINKING
ABOUT HOW TO DO THAT, I MEAN,
THERE IS ONE CAN THINK OF SAY
THESE THREE STEPS OF A LADDER.
THERE'S NUTRIENT CONTENT
ADEQUACY LEVEL IN EACH MEAL THAT
ONE CAN EXPLORE. THERE IS THE
ELEMENT OF DIVERSITY IN THE DIET
BUT ALSO APPLIES TO MEAL, MEAL
MORE DIVERSE ENTERIC SIN LICK
SUPERIOR TO ONE THAT IS MADE UP
OF ONE FOOD GROUP. THEN LAYERING
UP TO HEALTHINESS WHERE YOU LOOK
NOT ONLY WHAT IS ON THE POSITIVE
SIDE OF THE EQUATION
CONTRIBUTING TO ADDRESS IN
NUTRITION BUT ALSO TRYING TO
ADDRESS THE GROWING RISK OF
OVERWEIGHT OBESITY AND CDs SO
SOMETHING THAT BALANCES TWO
SIDES OF THE EQUATION IN TERMS
OF CONTRIBUTING TO THE
HEALTHNESS OF MEAL AND DIET. SO
WE STARTED WITH JUST
ARTICULATING THE DESIGN
PRINCIPLES FOR SUCH A METRIC FOR
MEAL MENU QUALITY. SO JUST TO
TOUCH ON A FEW BRIEF HERE, WE
WANTED TO BE RESPONSIVE AND
SENSITIVE TO EXTENT THAT EVEN
SMALL CHANGES IN A MEAL OR A
MENU WOULD BE REFLECTED IN ANY
IMPROVED SCORE. SOMETHING THAT
WOULD BE CULTURALLY APPROPRIATE,
SO SAY A GLOBAL FRAMEWORK BUT
ALSO INTERPRETABLE AND
CONTEXTUALIZED TO A DEGREE. IT
SHOULD BE SIMPLE, IT SHOULD BE
INTEGRATABLE. IT SHOULD BE LOW
COST AND LOW BURDEN IN TERMS OF
DATA COLLECTION COLLECTION. COMPREHENSIVE
IN THE SENSE OF BRINGING FACT
DOORING IN BOTH SIDES OF THE
HEALTH EQUATION AND WITH SOME
FOUNDATION THAT WOULD BE
SCIENTIFICALLY ROBUST AND
VALIDATED. SO THOSE ARE THE
IDEAS IN THE BEGINNING, THE
DEVELOPMENT IN FIRST ITERATION
OF GLOBAL MEAL AND MENU QUALITY
SCORE ORIGIN QS. FOUNDATION WE
TOOK WAS ONE OF THE TWO -- WHAT
I WOULD CONSIDER ONE OF THE TWO
BEST EMERGING DIET QUALITY
METRICS WHICH IS THE GLOBAL DIET
QUALITY SCORE, IT IS A METRIC
AND FRAMEWORK THAT IS BEING
DEVELOPED BY HARVARD AND INTAKE
RESEARCHERS HAS A SCALE FROM 0
TO 49. IT HAS THIS SCALES TO SAY
DIVIDE CONSUMPTION OF DIFFERENT
FOOD GROUPS INTO TEAR TILES.
WITH INTERESTING, CERTAIN FOOD
GROUPS ARE GOOD UP TO CERTAIN
POINT BUT FROM CERTAIN THRESHOLD
UPWARD, THEY CAN HAVE A
DETRIMENTAL IMPACT ON HEALTH.
THIS HAS BEEN VALIDATED BOTH
NON-PREGNANT NON-LACTATING WOMEN
AGAINST UNDERNUTRITION AND RISK
AGAINST DATA SETS OF VARIOUS
COUNTRIES AND GEOGRAPHIES. THE
CONSUMPTION LABELS CAN BE
APPLIED TO OTHER ADULTS AND AGE
GROUPS. FOR US WE USE THE IDEA
OF SCALING THE CONSUMPTION LEVEL
TO SUPPORT CHILDREN, BY THE
DAILY CALORIC REQUIREMENTS SO
USING DEATH AS STARTING POINT TO
BRING TO SCALE FOR CHILDREN
POPULATIONS. SO THAT IS THE
GDQS. WE WANT TO DEVELOP
SOMETHING THAT SAY HAD SOME
FAITHFULNESS OR CONSISTENCY
PRINCIPLES OF GDQS. SOME OF THEM
FAVORABLE SO SOME RIGHT OFF THE
BAT IS BENEFIT OF PRECISE
QUANTITIES. AS OPPOSED TO HAVING
TO RELY ON DIETARY RECALLS.
ANOTHER ONE WHICH WAS THOUGHT
IMPORTANT BECAUSE OF
UNDERNUTRITION CHALLENGE IN LOW
AND MIDDLE INCOME COUNTRIES WAS
TO FACTORY FORTIFICATION AS
CONTRIBUTING TO THE POSITIVE
SIDE OF THE SCORE. WE HAD THE
THINK OF THIS AS A MEALS
CONTRIBUTION TO A HEALTHY DIET
BUT OF COURSE A MEAL WON'T
NECESSARILY REFLECT THE QUALITY
OR HEALTHNESS OF THE OVERALL
DIET. THEN IN TERMS OF
INTERPRETABILITY, WE FELT THAT
INSTEAD OF SCALES FROM 0 TO 49
IT WOULD BE INTERESTING TO
NORMALIZE 0 TO 100 OR 1 TO 100
SCALE TO JUST MAKE IT EASIER TO
INTERPRET FOR THE GENERAL PUBLIC
AND GENERAL STAKEHOLDERS. IN
TERMS OF DATA COLLECTION, OFTEN
TIMES THERE ARE PROCUREMENT
SYSTEMS UNDERLYING THE SCHOOL
FEEDING, WHEN THOSE ARE NOT
AVAILABLE WE CAN RELY ON A
SIMPLE TOOL TO COLLECT DATA
WHICH IS ESSENTIALLY CAPTURES
THE ITEMS, WEIGHT IN KILOGRAMS
AND NUMBER OF PUPILS SERVED
WHICH IS SOMETHING MANY SCHOOLS
DO ON REGULAR BASIS, HOW MANY
KIDS ARE IN SCHOOL TODAY SO THAT
CAN GIVE YOU THE BASIS TO
CALCULATE THE SCORE. WITH
PILOTED THIS METRIC IN A JOINT
ROCKEFELLER PILOT IN RWANDA
WHERE SAY THE MAIN CHANGE
INTRODUCE WAS REPLACING REFINED
MAZE FLOUR WITH FORTIFIED WHOLE
GRAIN FLOUR AMONG 14,000 KIDS IN
IN 18 SCHOOLS IN SOUTHERN
RWANDA. THAT MAY SEEM LIKE A
SIMPLE CHANGE BUT WHEN YOU LOOK
AT THESE PLACE, THEY ARE FAIRLY
REFLECTIVE OF TYPICAL MEALS YOU
HAVE, THIS SEMISOLID MEAL PLUS +
A LITTLE BIT OF BEANS, SO THAT
IS STARCH COMPONENT WHICH IS
CURRENTLY EATEN TYPICALLY IN
REFINED FOR, IF YOU REPLACE WITH
WHOLE GRAINS AND FORTIFY THERE
IS A SIGNIFICANT GAIN. THERE IS
OCCASIONAL ADDITION OF FRESH
FRUITS AND VEGETABLES WE WANT
TOTURE THAT AS WELL. THEN WE
WERE ABLE TO TRACK THIS METRIC
ON DAILY BASIS GO DOWN TO THAT
LEVEL. THIS IS AGAIN
ILLUSTRATIVE TO SHOW HOW THESE
FLUCTUATIONS AND IMPROVEMENTS IN
MEAL QUALITY CAPTURED BY SUCH A
METRIC THAT ENABLES YOU TO
MONITOR AGAINST TIME, GEOGRAPHY,
MANY METRICS AND DIMENSIONS. SO
WE OVERALL ARE FINDING WAS THAT
THIS IS A PROMISING METRIC THAT
HAS POTENTIAL. THIS -- THE GDQS
BECAUSE OF THE RICHNESS OF THE
FOOD GROUPS AND SAY INTRINSIC
SCIENTIFIC ROBUSTNESS PROVIDES A
GOOD FOUNDATION. AND THIS
SOMETHING THAT WE ARE NOW
ENGAGING WITH THE WORLD FOOD
PROGRAM, TO TAKE TO IT THE NEXT
LEVEL. AND TO DESCRIBE A LITTLE
BIT OF THE NEXT LEVEL, WE WANT
TO -- THIS IS NOT EXHAUSTIVE
LIST BUT SOME OF THE IMPORTANT
POINTS, WE WANT TO MAKE THIS
METRIC MORE SENSITIVE TO MEAL
COMPOSITION CHANGES WHICH MAY
APPLY POTENTIALLY LETTING GO OF
THOSE SCALES AND ADOPTING LINEAR
PROGRESSION AND SCORES THESE
QUANTITIES OF FOOD GROUPS WE
WANT TO EXTEND THE CURRENT
VERSION IS FOCUSED JUST ON MEALS
BUT WE WANT TO TAKE IT TO THE
NEXT STEP, THE MENU QUALITY.
HEAVY SIT POINT ALLOCATION FOR
FORTIFICATION, MORE SENSITIVE TO
CONTEXTUALIZED DEFICIENCIES IS,
REFINE SKILL AND INTERPRETATION
OF THE SCORE, EXTRAPOLATE DIET
QUALITY THROUGH SOME TARGETED
DATA COLLECTION PERHAPS AT THE
HOUSEHOLD LEVEL WHICH ENABLE
ADDING THAT TO THE MEAL TO
EXTRAPOLATE TO DIET QUALITY FOR
THESE POPULATIONS. ADAPT THE
DATA COLLECTION ALREADY
DEVELOPED WHICH IS LIKE AN APP
TO MAKE DATA COLLECTION SIMPLER
IN ENVIRONMENTS WHERE WILL IS
FEASIBLE. INTEGRATE INTO BROADER
FOOD SCORE NETWORK AND SHARE
WITH THE SCIENTIFIC COMMUNITY
THROUGH PEER REVIEWED
PUBLICATION. AND ENGAGE ON THE
COMMUNITY OF PRACTICE TYPE OF
EFFORT. FOR INSTITUTIONAL MEAL
QUALITY WITHIN THE SCOPE OF THE
SCHOOL MEAL COALITION AND THIS
EFFORT HERE. SO THANK YOU VERY
MUCH. I LOOK FORWARD TO
DISCUSSION. THANK YOU.
>> THANK YOU SO MUCH, AND THAT
WAS PERFECT TRANSITION TO OUR
LAST SPEAKER WHO IS CARMEN FROM
THE WORLD FOOD PROGRAM. AND BOOK
ENDING THIS ENTIRE SERIES FOR
US, CARMEN WILL BE SPEAKING
ABOUT THE SCHOOL MEALS
COALITION.
>> THANK YOU, KRISTINA AND DAWN,
APOLOGIZE FOR NOT PUTTING MY
CAMERA ON BUT I AM CONCERNED
ABOUT MY QUALITY OF WIFI. LET ME
KNOW IF YOU CAN HEAR ME.
>> WE CAN HEAR YOUR AND YOUR
SLIDES ARE UP.
>> GREAT. THANK YOU. SO THANK
YOU VERY MUCH. I WANT TO START
SAYING HOW INTERESTING AND
REALLY RICH THIS WHOLE SESSION
HAS BEEN. THANK YOU FOR THIS
OPPORTUNITY TO SPEAK TO THIS
GROUP. I GUESS MY JOB AT THE
MOMENT AS LAST SPEAKER IS
PROBABLY TO ZOOM OUT THERE HAS
BEEN A LOT OF DISCUSSION
THROUGHOUT THIS WHOLE SESSION
AROUND MEALS PROGRAMS IN THE
U.S., FOR MARGINALIZED MINORITY
GROUPS. MEALS AND NUTRITIONAL
LANDSCAPE FOR SCHOOL AGE
CHILDREN IN AFRICA, I REALLY
THINK ROCKEFELLAR FOUNDATION FOR
SHOWCASING THE WORK WE HAVE BEEN
DOING WITH THEM IN RWANDA AND
NOW THINKING ABOUT EXPANDING
THAT WORK FURTHER. BUT I THINK
WHAT MIGHT BE INTERESTING AT
THIS MOMENT IS ZOOMING OUT AND
REALLY MY JOB IS TO PRESENT WHAT
THIS LANDSCAPE OF SCHOOL MEALS
LOOKED LIKE AROUND THE WORLD. SO
THE FIRST THING THAT I WILL SAY
IS THAT UP UNTIL VERY RECENTLY,
WE DIDN'T HAVE AS GLOBAL
COMMUNITY A WAY TO MEASURE THE
SCALE OF THESE PROGRAMS
WORLDWIDE. IN A WAY WHAT THE
U.S. WAS DOING WHAT BRAZIL WAS
DOING WHAT CHINA WAS DOING WHAT
THE WORLD FOOD PROGRAM WAS
LOOKING AT IN AFRICA WERE
DISCRETE PIECES OF WORK THAT
WEREN'T CONNECTED. IN 2013 WFP
PUT OUT THE FIRST PUBLICATION
THAT QUANTIFIED THE NUMBER OF
CHILDREN RECEIVING MEALS IN
SCHOOL A DAY AND UPDATED THAT IN
2020 THANKS TO UPDATED SURVEY
FIGURES WE HAD. THE NUMBERS ARE
EXTRAORDINARY SO GO TO THE FIRST
SLIDE AND YOU WILL SEE WHAT WE
HAVE BEEN TALKING ABOUT IN THIS
CONVERSATION IS THE LARGEST
ASSISTANCE PROGRAM COVERING
CHILDREN IN THE WORLD. CURRENT
ESTIMATES PRE-PANDEMIC ARE 388
MILLION CHILDREN WERE RECEIVED
MEALS IN SCHOOL IN ONE SHAPE OR
FORM OR ANOTHER IN EVERY COUNTRY
OF THE WORLD, SOME ARE STILL IN
GRAY BECAUSE WE DON'T HAVE DATA
BUT YOU CAN SEE THE
PRESENTATIONS IF WE ZOOM OUT AND
PUT IN CONTEXT, ALMOST EVERY
COUNTRY IS WRESTLING WITH THE
SAME QUESTIONS WE HEARD FROM THE
U.S. FROM OUR COLLEAGUES IN
AFRICA, AND OTHERS, THE QUESTION
AROUND HOW DO WE ENSURE CHILDREN
DURING THEIR SCHOOL PERIOD
REALLY BEING PROVIDED WITH THE
RIGHT FOOD, THAT IS CONTEXT
SPECIFIC, THAT IS ALSO
ADDRESSING NUTRITIONAL PROBLEMS
WE SEE IN THE DIFFERENT CONTEXT
AND THAT IS INTEGRATED MORE WE
SEE INTEGRATED WITH BROADER
HEALTH NUTRITION INTERVENTIONS
AS WE SAW MANY PRESENTATIONS
FORTIFICATION, SUPPLEMENTATION
SOME CASES COMBINING WITH
DEWORMING VACCINATION AND OTHER
THINGS I MENTION THAT BECAUSE
THE LEVEL OF INTEGRATION WITH
OTHERS WILL HELP IN ADDITION
INTERVENTIONS HAVE IMPACT ON
NUTRITIONAL STATUS FROM DIET
ITSELF OF THE CHILDREN. SO THIS
IS WHERE WE WERE PRE-PANDEMIC.
FROM COMPARING TO 2013 BEHAD
SEEN A MASSIVE EXPANSION IN
SCALE AND COVERAGE. OVER LAST
DECADE, NOT COUNTING THE LAST
COUPLE OF YEARS, THIS IS A
PROGRAM THAT HAD REALLY EXPENDED
PARTICULARLY IN AFRICA. WE
QUANTIFIED AND ANALYZE TRENDS
BETWEEN 2013 AND 2020, AFRICA
NEARLY DOUBLED THE COVERAGE OF
THE NUMBER OF KIDS THAT WERE
RECEIVING MEALS IN SCHOOLS, NOW
UP TO ABOUT 65 MILLION CHILDREN.
SO A SIGNIFICANT PUSH, HUGE
AMOUNTS OF DOMESTIC FUNDING
DEVOTED TO THIS. AND JUST BEFORE
THE PANDEMIC THIS WAS A REALLY
ROSY PICTURE IN TERMS OF OUR
ABILITY TO EXPAND ACCESS TO
THESE PROGRAMS. THIS IS THE
PICTURE A YEAR AGO, PUBLISHED
THESE NUMBERS VERY EARLY ON IN
THE PANDEMIC IN THE MONTH OF MAY
OF 2020. OUR CONCERN AT THE
MOMENT WAS THAT ESSENTIALLY THE
WHOLE PLATFORM, THE WHOLE SAFETY
NET COLLAPSED WORLDWIDE TOGETHER
WITH THE CLOSURE OF SCHOOLS. WE
HAVE BEEN MONITORING HOW THIS
PANORAMA HAS CHANGED AND IN MOST
OF THE HIGH INCOME COUNTRIES
EVEN IN MIDDLE INCOME COUNTRIES
THE PICTURE HAS IMPROVED
SOMEWHAT. BUT WE STILL ARE
CONCERNED WITH THE LACK OF
ACCESS TO SCHOOL MEALS AND ALSO
TO EDUCATION FOR CHILDREN IN LOW
INCOME COUNTRIES WE CURRENTLY
ESTIMATE SOMETHING LIKE 150
MILLION CHILDREN ARE STILL NOT
RECEIVING THE MEALS THEY WERE
RECEIVING BEFORE SO RESTORING
ACCESS HAS BECOME AN IMPORTANT
FACTOR. I HAVE TO SAY ADDED TO
THIS OF COURSE IS A NEW
DIMENSION YOU MIGHT BE AWARE OF
WHICH IS THE LOOMING HUNGER AND
FOOD PRICE CRISIS COMING OUT OF
THE UKRAINE WAR AND YOU PROBABLY
HAVE SEEN IN THE NEWS RECENTLY,
REALLY THE ALARM OF WORLD FOOD
PROGRAM AND OTHER AGENCIES ON
THIS IMPENDING LACK OF
AVAILABILITY CERTAIN STAPLES AND
ALSO THE ISSUE OF RISING FOOD
PRICES, ALL AROUND THE WORLD.
THIS IS OBVIOUSLY IMPACTING
CHILDREN AND IT IS IMPACTING
THEIR HEALTH AND THEIR NUTRITION
STATUS AND ALSO THEIR ABILITY TO
GO TO SCHOOL. SO COMBINED THE
COVID PANDEMIC PLUS THIS NEW
FOOD CRISIS, WE ARE VERY
CONCERNED ABOUT HOW CHILDREN ARE
FAIRING. SO ONE OF THE COMMENTS
THAT I WANTED TO MAKE AS WE
CLOSE IS THAT THE WORK OF THIS
GROUP, THE WORK OF KIDS IN THIS
PARTICULAR PROJECT IS I THINK
MORE IMPORTANT THAN EVER. WE DO
NOT HAVE MEASURES TO TRY TO
UNDERSTAND HOW IS THIS AFFECTED
CHILDREN OF THE SCHOOL AGE AN
ADOLESCENCE. WE CAN MEASURE WHAT
IS HAPPENING WITH CHILDREN UNDER
FIVE MORE EASILY THERE ARE NOW
MEASURES BEING PUBLISHED ALL
AROUND IN TERMS OF HOW
UNDERWEIGHT AND ISSUES RELATED
TO PREGNANT AND LACTATING WOMEN,
ET CETERA, TO TRY AND MEASURE
THE IMPACT OF THESE CRISES, WE
HAVE NO COMMONLY USED INDICATOR
OR SET OF INDICATORS TO LET US
UNDERSTAND HOW THIS IS IMPACTING
THE SET OF -- THE AGE GROUP THAT
WE ARE TALKING ABOUT HERE. SO MY
SECOND COMMENT IS HOW IMPORTANT
IT IS THAT THE WORK OF THIS
GROUP IS TRANSLATED AS SOON AS
POSSIBLE INTO WORKABLE
INDICATORS SO WE CAN START
TRACKING. IN THE CONTEXT OF
THIS, IN THE CONTEXT OF THE
PANDEMIC, AND REALLY THE CRISIS
THAT ENSUED, LAST YEAR IN THE
FOOD SYSTEM SUMMIT NUMBER OF
COUNTRIES STARTED TO LOOK AT
THIS ISSUE AND REALLY DECIDED TO
DO SOMETHING ABOUT IT. LED BY
FINLAND AND FRANCE WHO HAVE
REALLY TAKEN ON THE BANNER OF
LOOKING AT THIS ISSUE NOT JUST
AS GOING BACK TO WHERE WE WERE
BUT HOW DO WE USE THE EXPANSION
AND RESTORATION OF SCHOOL MEALS
PROGRAMS TO TRANSFORM FOOD
SYSTEMS CHILDREN RELATIONSHIP TO
FOOD, THEIR NUTRITION, AND ALSO
OTHER ELEMENTS OF SOCIAL
PROTECTION AND EDUCATION. SO IN
THE CONTEXT OF THE FOOD SYSTEM
SUMMIT, THE SCHOOL MEALS
COALITION WAS CREATED. WE CAN
GO TO THE NEXT SLIDE. COUNTRIES
DECIDED IT WAS GOING TO HAVE A
BROAD GOAL,S THIS WAS ENSURING
THAT EVERY CHILD HAS OPPORTUNITY
TO RECEIVE HEALTHY NUTRITIOUS
SCHOOL MEAL BY 20306789 FROM
THAT GOAL THIS APPLIES TO ALL
INCOME LEVELS SO COUNTRIES FROM
RANGING FROM THE U.S. AND
FINLAND TO COUNTRIES LIKE SOME
OF THOSE THAT WE DISCUSSED TODAY
WHAT -- HAITI, RWANDA, MALAWI,
ET CETERA. THIS IS IMPORTANT
ACROSS THE BOARD, NOT JUST ABOUT
LOW INCOME COUNTRIES AFRICAN
COUNTRIES OR VULNERABLE KIDS IN
THOSE COUNTRIES, THE
RECOMMENDATION IN ADDITION WE
ARE TALKING ABOUT B
VULNERABILITY ACROSS INCOME
LEVELS IN COUNTRIES. AND THEN
THREE OBJECTIVES SET AS PART OF
THE COALITION AS IT WAS CREATED.
ONE THAT SPEAKS TO WHAT I WAS
TALKING ABOUT THE RESTORATION OF
WHAT WE HAD BEFORE PANDEMIC HIT
ENSURING ALL THE CHILDREN THAT
WERE RECEIVING THOSE MEALS GO
BAG TO RECEIVING THEM. AND
SUBSEQUENT GENERATIONS OF
COURSE. THE SECOND OBJECTIVE IS
REALLY FOCUSED ON LOW INCOME
COUNTRIES, THAT WAS AND IS THIS
RECOGNITION THAT EVEN THOUGH THE
PROGRAMS ARE WIDESPREAD AS YOU
SAW IN THE FIRST MAP THE LEVELS
OF COVERAGE AND LOW INCOME
COUNTRIES ARE SIMPLY
UNACCEPTABLE. WHILE HIGH INCOME
COUNTRIES COVERAGE OF SCHOOL
MEALS RANGES BETWEEN 80 AND 100%
OF VULNERABLE CHILDREN IN MIDDLE
INCOME COUNTRIES THAT FIGURE IS
AROUND 60 TO 70%, THE DROP IS
HUGE IN LOW INCOME COUNTRIES WE
ONLY SEE FIGURE OF ABOUT 20,
25%. . SO REALLY THE NEED TO
LOOK AT THIS ISSUE AND EXPAND
ACCESS IN MOST VULNERABLE
CHILDREN AND MOST VULNERABLE
COUNTRIES IS AN ISSUE AND WE
HAVE WITH THE EMPIRICAL COLLEGE
QUANTIFIED THAT WE WOULD BE
LOOKING AT LOOKING AT 73 MILLION
CHILDREN LIVING IN EXTREME
POVERTY AND 60 COUNTRIES MOST OF
THEM LOW INCOME, SOME LOW MIDDLE
INCOME THAT NEED THE SUPPORT
URGENTLY, O SO THAT WOULD BE THE
TARGET OF YOUR COALITION. THE
THIRD OBJECTIVE APPLIES ACROSS
THE BOARD. AND WE HAVE SEEN AND
WE ARE HAPPY TO START TO SEE
COUNTRIES WITHIN THE COALITION
FOR EXAMPLE FINLAND, FRANCE, AND
SOME OTHER COUNTRIES AS WELL,
LOOKING AT HOW THESE PROGRAMS
CAN BE IMPROVED, MUCH OF THE
CONVERSATION TODAY CENTERED
AROUND ISSUE OF IMPROVING THE
QUALITY OF THE MEALS AND THE
MENUS, HOW AS WAS MENTIONED WE
CAN MAKE TWEAKS IN WHAT CHILDREN
ARE RECEIVING TO HAVE IMPACT OF
THEIR NUTRITIONAL STATUS AND
AVAILABILITY. BUT ALSO HOW THESE
BE EFFECT CANNED TO MORE
SUSTAINABILITY VALUE CHAINS HOW
WE CONNECT TO LOCAL AGRICULTURAL
PRODUCTION PROVIDE OPPORTUNITIES
FOR JOB CREATION. VALUE CREATION
LOCALLY. AND COMMUNITY SUPPORT.
ALSO THE INTEGRATION AS I WAS
MENTIONING EARLIER WITH OTHER
SCHOOL HEALTH NUTRITION --
COMPONENTS NUTRITION AN
EDUCATION, WATER AND SANITATION
IS AN IMPORTANT ISSUE IN MANY
COUNTRY, VACCINATIONS ET CETERA,
HOW DO WE TRULY DELIVER ON THE
PROMISE OF THESE PROGRAMS AS
PLATFORMS, FOR CHILD SUPPORT, IN
THE FORM OF NUTRITION, SOCIAL
PROTECTION, EDUCATION,
AGRICULTURE, ET CETERA. AS THE
MOMENT AS I SPEAK THE COALITION
HAS 62 MEMBER COUNTRIES, AND 64
PARTNER ORGANIZATIONS WHEN IT
WAS LAUNCHED, IT WAS THE MOST
IMPORTANT HOME VISIBLE
INITIATIVE COMING OUT AND HAS
CONTINUED TO GROW SINCE THEN
CREATING A MOMENTUM AND
IMPRESSIVE MOMENTUM OF
COMMITMENT FROM GOVERNMENT
LEADERS AROUND THIS ISSUE. LET'S
MOVE FORWARD. ONE OF THE THINGS
WE DISCUSSED IN THE CONTEXT OF
THE COALITION WAS THAT IF WE
REALLY WERE LOOKING AT HELPING
GOVERNMENTS, INCREASE THE
QUALITY SUSTAINABILITY OF THEIR
PROGRAMMING THERE WERE SOME
BOTTLENECKS THAT NEEDED TO BE
ADDRESSED, SO FIVE GLOBAL
INITIATIVES WERE ANNOUNCED AS
PART OF THE COALITION, AND THREE
OF THEM ARE NOW UP AND RUNNING
THE TWO THAT REMAIN ARE GO TO BE
CONSOLIDATED THIS YEAR. THE
FIRST ONE, RESEARCH CONSORTIUM
REPRESENTED HERE BY PROFESSOR
DONALD BUNDY IS CONSOLIDATED
INITIATIVE AND WE SEE THE WORK
OF KIDS AS BEING DIRECT
CONTRIBUTION TO THE WORK OF THE
COALITION AND THE RESEARCH
CONSORTIUM. AS DON CAN EXPLAIN
BETTER THAN MYSELF, THIS IS AN
INDEPENDENT INITIATIVE WHICH IS
NETWORK OF ACADEMIC INSTITUTIONS
SPECIFICALLY DEVOTEDDED TO
RESEARCH HA IS ABOUT PROVIDING
DECISION MAKERS IN COUNTRIES
WITH BETTER INFORMATION TO ENACT
AND IMPLEMENT POLICY SO VERY
OPERATIONAL APPROACH HERE, TO
RESEARCH AROUND THIS AREA. THE
SECOND ONE IS SUSTAINABLE
FINANCING TASK FORCE,ING THIS
LED BY GLOBAL EDUCATION
COMMISSION. WHICH IS LED BY
GORDON BROWN, DEVOTEDDED TO THE
ISSUE AND -- DEVOTED TO THE
ISSUE, THE STABILITY OF THE
PROGRAMS PARTICULARLY THE
FINANCING OF SCHOOL MEALS AND
FINDING MORE SUSTAINABLE
SOLUTIONS PARTICULARLY LOW
INCOME COUNTRIES TO SUSTAIN
THESE PROGRAMS IN A PROPER WAY
THROUGHOUT SCHOOL YEAR AND
THROUGHOUT MANY YEARS. THIS
CONTINUES TO BE PROBABLY ONE OF
THE BIGGEST BOTTLE NEXT FOR THE
IMPLEMENTATION OF THE PROGRAMS
BUT ALSO TO THE STABILITY OF
THIS PLATFORM THAT LATER CAN OR
CANNOT DELIVER ON OUTCOMES WE
HAVE BEEN DISCUSSING. THIRD IS
DATA MONITOR INITIATIVE. ONE OF
THE MAJOR CONVERSATIONS NOW WITH
PARTNERS IS HOW DO WE AGREE ON A
SET OF INDICATORS THAT WILL BE
CONSIDERED CORE INDICATORS TO
MEASURE THIS AREA OF WORK
GLOBALLY. HOW DO WE MEASURE THEM
IN DIFFERENT CONTINENTS AND
DIFFERENT COUNTRIES AND HOW DO
WE ESTABLISH A GLOBALLY
RECOGNIZED DATABASE THAT CAN BE
CONSULTED AND CAN BE GLOBAL
PUBLIC, SO THIS IS THE THIRD
INITIATIVE LED BY WFP WITH THE
HELP OF MANY PARTNERS AND
ELEMENTS WE WOULD LIKE TO BRING
NOW IS WORK OF THIS GROUP BUT
ALSO OF THE WHOLE PROJECT
HOPEFULLY CAN BE INCORPORATED
LATER ON AS PART OF THE STEERING
COMMITTEE OF THIS DATA AND
MONITORING INITIATIVE FOR THE
GLOBAL COMMUNITY. THE OTHER TWO
ARE ABOUT PUTTING THIS IN
PRACTICE BOTH HELPING COUNTRIES
CONNECT AS A PEER TO PEER
COMMUNITY OF BEST PRACTICE LED
BY GERMANY AND WORKING AROUND
COMMUNICATIONS AND ADVOCACY WITH
THE VARIOUS PARTNERS. I WANT TO
ALSO MENTION AS PART OF THIS
GLOBAL CONVERSATION ON THE
COALITION OF COURSE THE WORLD
FOOD PROGRAM WE ARE A SEPARATE
PERIOD OF COALITION BUT WE ARE
ALSO ONE IMPORTANT STAKEHOLDER
IN THIS CONVERSATION BECAUSE WE
IMPLEMENT MANY OF THE PROGRAMS
WE HAVE BEEN DISCUSSING IN LOW
INCOME COUNTRIES HERE YOU HAVE
OUR REACH, WE ARE THE LARGEST
SUPPORTER OF SCHOOL MEALS ACROSS
THE WORLD. WE WORK IN 73, 74
COUNTRIES AND OUR COVERAGE
FLUCTUATES ANYWHERE BETWEEN 15
TO 17 MILLION CHILDREN, A LOT OF
THIS WITH SUPPORT OF USDA, SO
SOME OF THE PRESENTATIONS YOU
SAW EARLIER TODAY OF COURSE CUT
ACROSS OUR WORK. AND SO WE DO
ASIDE FROM THE SUPPORT WE
PROVIDE GLOBALLY THROUGH THE
COALITION WE HAVE A STEAK BUT
ALSO REALLY IMPORTANT PLATFORM
TO IMPLEMENT SOLUTIONS THAT
HOPEFULLY WILL BE COMING OUT
THROUGH THIS WORK. ONE OF THE
THINGS WE HAVE DONE IN THE LAST
COUPLE OF YEARS WHICH WAS
MISSING FROM OUR PROGRAMMING
TOOL KIT IS THINKING ABOUT A
THEORY OF CHANGE FOR OUR
PROGRAMMING AND FOR SCHOOL MEALS
IN GENERAL. LET ME SHOW YOU
WHERE WE ARE WITH THE THEORY OF
CHANGE. I WON'T GO THROUGH IT
SPECIFICALLY. TO THE NEXT SLIDE.
CONNECTIONS ARE MULTIPLE. HERE
YOU GO. YOU CAN GO THROUGH THE
NEXT ONE, IF YOU LOOK AT OUR
IMPACT, ON THE RIGHT HAND SIDE,
WE ARE LOOKING AT VARIOUS SDGs
THAT THESE PROGRAMS REALLY
RELATE TO, AND REALLY LOOKING AT
OPPORTUNITY -- DELIVERING
SUPPORT SO THAT CHILDREN CAN
HAVE THE OPPORTUNITY TO ACHIEVE
THEIR FULL POTENTIAL BUT ALSO
THE CONNECTION TO LIVELIHOOD AND
SUPPORT INCOME LEVELS AND GENDER
DIMENSIONS HERE. YOU CAN SEE
SOME OF THE ITEMS WE ARE
TARGETING INCLUDING OUTCOMES
RELATED TO EDUCATION, TO
LEARNING TO INCOME GENERATING
OPPORTUNITIES AND ELEMENTS
RELATED TO ALSO STABILITY AND
CAPACITY OF GOVERNMENT
INSTITUTIONS TO IMPLEMENT THESE
PROGRAMS. THEN YOU CAN GIVE IT
ANOTHER CLICK AND THIS COMPLEX
WEB WILL COME UP, I WON'T REALLY
DEVOTE A LOT OF TIME TO THIS BUT
AS MANY OF THE SPEAKERS HAVE
SAID TODAY, THIS IS A COMPLEX
ECOSYSTEM, FOR US THE THEORY OF
CHANGE IS VERY MUCH GENERIC
BLUEPRINT. HOW THIS IS
IMPLEMENTED IN PARTICULAR
COUNTRIES VARIES. AND SOME OF
THE OUTCOMES THAT WE CAN EXPECT
VARY. MOVE FORWARD PLEASE. ONE
OF THE THINGS THAT I WANTED TO
SAY FOR THIS GROUP IS THAT IF WE
LOOK AT THE PATHWAY THAT IS
ABOUT SCHOOL HEALTH AND
INCREASED ACCESS AND ALSO ON THE
OUTCOME SIDE OF THE NUTRITION
PATHWAY, HERE IS WHERE HOW WE
SEE THIS EVOLVING INCLUDING THE
PROVISION OF FOOD, HOW THIS HAS
IMPACT ON DIET SHORT TERM
HUNGER. IF YOU CLICK ONE MORE
TIME YOU WILL SEE WHERE WE HAVE
GAPS MANY TERMS OF INDICATORS
AND ABLE TO MEASURE AND NOT ABLE
TO MEASURE AT THE MOMENT. THIS
IS -- AS WE HAVE SEEN MANY MANY
PRESENTATIONS TODAY THIS IS NOT
JUST OUR PROBLEM, IT IS A
GENERAL PROBLEM. THE SQUARES YOU
SEE HERE IN RED ARE WHERE WE
DON'T HAVE INDICATOR AT ALL, AND
ORANGE BOXES WHERE WE HAVE SOME
MEASURES THAT ARE CONSIDERED AT
LEAST INADEQUATE OR REALLY
CURRENTLY IN DEVELOPMENT PHASE,
THE WORK OF THIS GROUP WE HOPE
CAN HELP FILL IN THE BANK AND
GIVE INDICATOR AND MEASURES TO
BE ABLE TO MOVE FORWARD ON THIS
AGENDA. LAST SLIDE. AS A
CONTRIBUTION HERE IN TERMS HOF
WE SEE THIS BEING APPLICABLE TO
BROADLY THE CONTEXT ONE SHORT
TERM IDEA IS HOW CAN CAN WE PIE
WILL THE SOME OF THE MEASURES
AND INDICATORS COMING OUT OF
THIS GROUP, AS FIRST INSTANCE IN
VARIOUS SETTINGS. THIS IS
SOMETHING WE CAN DO QUICKLY.
WITH DIFFERENT PARTNERS AND AS
YOU HAVE SEEN FROM ROCKEFELLAR
WE ARE DEVELOPING THAT. MEDIUM
TERM AN UPDATE OF THIS IN
CONTEXT OF SCHOOL MEALS
COALITION AND HOW TO INFLUENCE
GOVERNANCE, IN UP TAKING THIS
ISSUE. AND THEN REALLY IN THE
LONG TERM IMPORTANT CONTRIBUTION
OF THIS WORK WOULD BE HOW DO WE
LOOK AT THIS IN THE CONTEXT OF
THE NEXT ITERATION OF GLOBAL
GOALS AND HOW DO WE ENSURE NO
GAP NEXT TIME HOW WE MEASURE
CONDITIONS, WELL BEING OF
CHILDREN OF THE AGE GROUP IN THE
NEXT ITERATION OF THE GLOBAL
GOALS AS WE MOVE FORWARD. THANK
YOU SO MUCH, DON AND KRISTINA,
PLEA -- DAN AN KRISTINA,
PLEASURE TO BE WITH YOU TODAY.
>> THANK YOU SO MUCH, CARMEN,
GREAT WAY TO END. WOW, WHAT
AMAZING GROUP OF PRESENTATIONS
FROM EVERYONE SO MUCH
INFORMATION. AND ECHOING WHAT
SOME HAVE SAID, THIS IS COMPLEX
BUT SHOULDN'T BE AFRAID, WE
SHOULD FEEL OPTIMISTIC ABOUT THE
BRAIN TRUST ON THE CALL RIGHT
NOW AND WHAT WE CAN ESTABLISH
MOVING FORWARD. WE HAVE JUST
ABOUT 15 MINUTES WHICH IS
TERRIFIC. TO OPEN UP FOR
DISCUSSION AND DON AND I WOULD
LOVE TO HEAR FROM ANYONE WHO
WOULD LIKE TO MAKE A COMMENT OR
ASK A QUESTION. WE HAVE MANY
SPEAKERS ON THE CALL STILL.
>> I KNOW EARLIER DEE
>> AND MARIONELLA HAD THEIR
HANDS UP SO GREAT TIME TO JUMP
IN NOW:
>> I CAN GO AHEAD AND COMMENT ON
WHEN CONNIE TALKED ABOUT THE
IMPLEMENTATION AND TRANSLATING
IT, THAT IS ONE OF THE TENANTS
OF TRANSLATION SCIENCE OR
IMPLEMENTATION SCIENCE. YOU HAVE
TO HAVE A PACKAGE OR INNOVATION
TO DISSEMINATE. SO GETTING THAT
TOGETHER, THE YOU HAVE A PACKAGE
IT COULD BE THAT THINGS ARE NOT
THE SAME IN THAT PACKAGE, FOR
SCHOOL FOOD -- SCHOOL HEALTH
PROGRAM YOU MIGHT HAVE A FOOD
SERVICE COMPONENT, YOU MIGHT
HAVE A PE COMPONENT. YOU MIGHT
HAVE A FAMILY COMPONENT. BUT
THEY HAVE TO BE SIMILAR ENOUGH
TO EVALUATE CONTEXTUAL FACTORS.
JUST SOMETHING TO CONSIDER.
>> SEE DON WITH HIS HAND UP. --
DAN WITH HIS HAND UP.
>> THAT IS GREAT. QUICK QUESTION
FOR DR. MALANI, THANK YOU FOR
THE PRESENTATION. THE DIET
QUALITY SCORE YOU ARE WORKING
ON, AND MOST OF WHAT YOU
PRESENTED WAS PRE-FOOD CENTRIC.
IN YOUR DIET QUALITY SCORE YOU
MENTIONED RELIANCE ON THE WORK
BEEN DONE IN HARVARD SO ASSUMING
THAT'S FOCUSED ON IN HCDs.
WHAT ABOUT OTHER ISSUES THAT ARE
FACED BY THE 7,000 DAYS. CAN WE
BUILD INTO THIS EQUATION MODEL
THINGS THAT ARE REFLECTION OF
THINGS MORE PREVALENT REAL TIME
THIS THINGS WE HAVE BEEN TALKING
ABOUT. ENTERRICK DISEASE, OTHER
INFECTIONS. COVID, HOW CAN WE
BUILD RESILIENT FRAMEWORK THAT
CAN BE APPLIED TO 7,000 DAYS,
WHICH IS ONE OF THE GOALS HERE.
>> THANK YOU FOR THE QUESTION
AND GENEROSITY OF THE DOCTOR.
THOSE ARE GOOD QUESTIONS.ED THE
GLOBAL DIET QUALITY SCORE,
THAT'S THE WORK OF LED BY WALTER
WILLET AND INTAKE TEAM. MY
UNDERSTANDING, IT DOES ACCOUNT
FOR WHAT IS A HEALTHY DIET, NOT
JUST NCDs BUT SAY JUST
NUTRIENT ADEQUACY IS IMPLICIT
THERE. THAT WAS PART OF THE
VALIDATION EXERCISE THEY DID. IN
OUR OBJECTIVE WAS MODEST, IN THE
SENSE OF STARTING WITH THE MEAL
AND SEEING HOW IT CAN BUILD UP
TOWARDS MENU AND DIET. BUT THOSE
ARE CERTAINLY QUESTIONS THAT I
THINK ARE PART OF THE RESEARCH
AGENDA. SO THIS IS NOT THOUGH WE
WANT TO MEASURE DIET QUALITY FOR
SCHOOL CHILDREN AND ENTIRE
POPULATION. WE WERE TRYING TO
WORK OUR WAY FROM THE OTHER
DIRECTION. STARTING WITH THE
MEAL AND THEN GROWING UP TO
THOSE OTHER LEVELS OF SKILL.
THANKS.
>> NUTRITION, PERHAPS CON CAN
SPEAK TO THIS AND SOME MEMBERS
WORK GROUP. KNEW PRESENTATION IS
A BIOLOGICAL VARIABLE THAT IS
CONTROLLED BY THE CONTEXT. SO
NOT JUST MATTER OF WHAT GOES IN
OUR MOUTH QUALITY OF FOOD IS
IMPORTANT BUT THE CONTEXT THE
KIDS ARE LIVING IN IS IMPORTANT.
PARTICULARLY HEALTH CONTEXT. SO
HOPEFULLY WE CAN CAPTURE THIS
HERE. BUT WE NEED TO FIGURE OUT
A WAY TO BUILD IN THAT CONTEXT,
IT IS EVALUATION OF THESE
PROGRAMS.
>> GREAT POINT. I SEE A LITTLE
BIT OF SAY TROUGH OFF OR
BALANCING ACT BETWEEN SOMETHING
THAT CAN BE GLOBALLY MEANINGFUL
WHILE REFLECTING COUNTRIES SO
THANKS GOOD POINT.
>> THE OTHER POINT IS -- PLAY AS
ROLE BUT THERE ARE OTHER ISSUES,
SO TAKING US BACK TO THIS BIT
COMPLEXITY, QUESTION. AND I
REALIZE I CUT OFF MARIONEL LOOKA
WHO WAS GOING TMARE --MARIONELLA SO HOPEFU LLY YOU CAN
COME BACK NOW AND TALK TO US,
THANK YOU.
>> THANK YOU VERY MUCH FOR THESE
GREAT PRESENTATIONS. I JUST
WANTED TO MAKE SOME COMMENTS AND
I TOOK A LOT OF NOTES ACROSS THE
FOUR WORKSHOPS. TODAY I WANT TO
HIGHLIGHT WE ARE CHANGING
CRITICAL POINTS THAT IN THE PAST
WERE DIFFICULT TO HIGHLIGHT AND
PUT ON THE SPOT LIGHT.
SUGGESTING POLITICAL INFLUENCE
THAT WE CAN GET INTO DETERMINED
SITUATION. THAT IS REALLY
IMPORTANT. WE WERE KIND OF
AFRAID IN THE PAST JUST TO
MENTION THERE WAS A POLITICAL
INFLUENCE.INFLUENCE. WE ARE NOW REGAINING
THE STRENGTH TO SAY OKAY, IF
THERE IS NO POLITICAL WILL
THEREFORE WE CANNOT EXPECT
ANYTHING GOING INTO ACTION AT
LEAST IN A COUPLE OF SCENARIOS
AND ENVIRONMENTS. THAT IS REALLY
IMPORTANT. DEFINITELY WE ARE
NOW TALKING ABOUT HOW COMPLEX
ARE THE CHALLENGES THAT WE ARE
FACING IN EVERY ONE OF THE
DIMENSION WE HAVE BEEN
DISCUSSING IN TO THESE SERIES OF
WORKSHOPS. ONE THING -- WE CAN
GO LATER IN TO OUR GROUP
DISCUSSION GO INTO DEEPER
DISCUSSION OF THIS. IT IS CLEAR
TO ME RIGHT NOW THE DIFFERENCES
ON THE VALUES ON HEALTH AND FOOD
AND NUTRITION BETWEEN THE GLOBAL
AND IF WE CAN SAY THE GLOBAL
NORTH WHEN YOU ARE TAKING THE N
VALUE AS SOMETHING VERY
DIFFERENT, AND YOU PUT ALL THE
VALUE ON THE HEALTH CARE VERSUS
PRESERVING YOUR HEALTH AND
TAKING CARE OF YOUR HEALTH AND
HAVING A GROUP NUTRITION. SO
WITHIN THIS FRAMEWORK IT IS
INTERESTING TO THINK ABOUT N
VALUE, BECAUSE THAT WILL MAKE
TRANSLATE THE ACTIONS. IF WE CAN
EXPECT PEOPLE TO VALUE THEIR
HEALTH VALUE THEIR NUTRITION, IF
WE START AS EARLY AS DURING
SCHOOL AGE TO HAVE THAT VALUE WE
WILL MAKE HUGE DIFFERENCE ALONG
THE WAY. AND MANY MORE DETAILS I
WILL LEAVE TO OUR GROUP
DISCUSSION. THANK YOU VERY
MUCH. FOR ALL THESE FANTASTIC
WORK.
>> THANK YOU, MAI,ANELLA. MARIANELLA.
>> IT IS REALLY IMPORTANT, IT IS
ABOUT THE DIFFERENCE IN
PERCEPTION OF THE ROLE OF FOOD
IN OUR LIVES. I SEE PROFESSOR
ZOTOR HAS HIS HAND UP SO MAYBE
SEGUE WHAT HE'S GOING TO SHARE.
>> I WANT TO MAKE A PASSIONATE
PLEA, LOT OF AFRICANS THAT
BRINGS (INAUDIBLE) BECAUSE WE
DON'T HAVE THE TOOLS TO WORK
WITH. BUT I WANT TO ALSO ASSURE
THEM AND MAKE PASSIONATE APPEAL,
SOME THINKING OUTSIDE THE BOX.
THERE IS A COMMUNITY OF
PRACTICE, -- CONDITION THE GOAL,
WE ARE BUILDING RESILIENCE IN
THE -- SOCIAL POLITICAL
DEVELOPMENT. SO THAT OUTCOME AND
OUTPUT ARE ACTIVITIES, OBVIOUSLY
BETTER LIVED THAN -- PATIENT
SOCIETY TO ACTUALLY THIS. WE
WANT TO MAKE IMPACT -- HOPING
THAT WILL COME AND -- SO YOU CAN
SEE CONTINENT. THANK YOU VERY
MUCH.
>> THANK YOU. ARE THERE ANY --
WE HAVE THREE MINUTES LEFT. ANY
OTHER COMMENTS FROM THE GROUP?
IF NOT I THINK I'M GOING TO GIVE
DON AND DAN LAST WORD, WHOEVER
WANTS TO TAKE IT.
>> I WILL TAKE ONE WORD WHICH IS
TO SAY --
>> BIBI DID THROW HER HAND UP.
>> GO, BIBI.
>> THANK YOU VERY MUCH JUST
BEFORE THE CLOSING ONE MINUTE, --
WE HAVE BEEN FEW OF US ARE
MULLING OVER HOW DO WE GET THE
-- PROJECT IN GLOBALLY AND
DIFFERENT PLACES OF THE WORLD.
SO MIGHT BE GREATEST USE BENEFIT
IF WE CAN HAVE WORKSHOP IN
DIFFERENT BRIDGES, SO WE KNOW
PETITIONERS UNDERSTAND WHAT IT
IS ABOUT. AND HOW THEY CAN BE
BETTER FIT. SO THAT IS MY
REQUEST TO SAY YOU KNOW,
(INAUDIBLE) CURRENTLY BUT I
THINK IMPORTANT FOR INTERVIEW SO
AWARE IT IS EMBEDDED IN THE
PROCESSES, THANK YOU.
>> THANK YOU, BIBI. LINDSEY JUST
PUT HER HAND UP.
>> I WANT TO MAKE A PLEA THAT IN
ALL OF THIS COMPLEXITY WHAT OMAR
POINTED OUT IS ABSOLUTELY RIGHT,
IT MATCHES OF COURSE THE
CHILDREN HAVE ACCESS TO SCHOOL
MEALS BUT THEY THE BOTTOM LINE
IS WHAT IS ON THAT PLATE. I
BELIEVE THAT THE GLOBAL
DIVERSITY SCORE IS IMPORTANT, IT
IS REALLY PRACTICAL TOOL BUT I
WOULD LIKE TO SEE MORE WORK
LINKING THAT TO ACTUALLY THE
NUTRIENT MICRONUTRIENTS INTAKES
OF CHILDREN, WE NEED HARMONIZE
INFORMATION ON CHILDREN NUTRIENT
REQUIREMENTS, THAT IS AVAILABLE,
WE NEED SOFTWARE TO MODEL THE
IMPACT OF FORTIFICATION ON THE
CHANGE IN MICRONUTRIENT INTAKES.
AND THAT IS AVAILABLE I JUST
DON'T WANT TO EVERYBODY TO STOP
A DIET DIVERSITY BECAUSE
PERSONALLY I FOUND MANY TIMES
THAT REALLY DOESN'T MEASURE VERY
WELL WHAT IS GOING ON IN TERMS
OF MICRONUTRIENT INTAKES AND
STATUS OF CHILDREN. SO I'M
MAKING A PLEA FOR ADDITIONAL
WORK. IN ADDITION TO THE
WONDERFUL WORK THAT IS GOING ON
>> THANK YOU, LINDSEY. WE ARE
RIGHT AT THE HOUR. DON, DAN, ANY
LAST WORDS?
>> I'M GOING TO SAY ONE THING
THAT BOND KIDS HAS DONE IS MADE
IT CLEAR WE SHOULD BE PAYING
ATTENTION TO SCHOOL ADOLESCENTS,
IN TERMS OF NUTRITION NUTRITION. KEY
PIECE. IT IS CLEARER HOW TO
MOVE FORWARD, YOU SEE THE
COMPLEXITY NOW WE FUNNEL IT DOWN
AS CONNIE SAID. THAT'S OUR WAY
FORWARD.
>> I WANT TO THANK EVERYBODY,
THANKS TO THE CHAIRS CHRIS AND
DON FOR PLAYING TOGETHER AND
YOUR WHOLE TEAM PUTTING TOGETHER
A WONDERFUL WEBINAR. WE HAVE
LOTS OF WORK TO DO. BUT WE HAVE
A GREAT TEAM TO DO IT. WE HAVE
TWO GOALS, WE HEARD ABOUT FRAME
WORKS BUT THERE IS ACTUALLY TWO
FRAME WORKS TALKING ABOUT HERE.
IN BOND KIDS ONE IS RESILIENT
FRAMEWORK THAT CAN PULL TOGETHER
ALL THE INFORMATION THAT WAS
COVERED BY WORKING GROUP ONE AND
TWO, INTO A RESILIENT RESPONSE
TO MEANS OF 7,000 DAYS IN
CONTEXT OF SPECIFIC SETTINGS AN
WORKING GROUP 4 ALL THOSE
FACTORS TO CONSIDER MANY THE
APPLICATION OF THAT FLAME WORK
IN DIFFERENT CONTEXT SPECIFIC
SETS. SO I THINK WE HAVE DONE A
LOT LOVE WORK. MORE TO DO ON
THIS PROJECT. HAPPY TO ANSWER
ANY QUESTIONS. ONLINE BOTH NICHD
TEAM AND THE AMD TEAM ARE HERE
TO SUPPORT YOU AND PROVIDE THE
INFORMATION YOU NEED MOVING
FORWARD. THANKS TO EVERYBODY
THAT LISTENED IN. WE ARE HERE
FOR YOU AND WE ARE GOING TO GET
SOMETHING OUT. AND WE ARE
INSPIRED BY THE WORK THAT'S
BEING DONE BY YOU. THANK YOU AND
HAVE A GREAT DAY.
>> THANKS, EVERYONE.