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The end of the year is approaching and, with it, finalizing the strategies, the action plans and the yearly reviewsAlmost two years after defining the ACF-IN 2015 strategy, it is legitimate to raise the question, How does ACF research contribute to improving the fight against undernutrition and to improving humanitarian practices in emergency contexts?. Since its foundation, and strongly restated in its 2015 international strategy, ACF considers research to be strategic for its operations. Improving the quality of its programs, through the definition of rigorous operational and technical tools and recommendations, is indeed at the heart of ACFs development. As a consequence, ACF Research has been designed to remain strongly tied to the missions needs: research starts first and foremost in the field, when the existing practices and knowledge reach their limits in addressing the needs of the most vulnerable populations. This specificity places ACF in an interesting position in the international scientific community, as ACF is strongly linked to field issues, and also in the humanitarian spheres, as the existence of a research sector testifies the organizations will for professionalism and quality. Research brings credibility and visibility. This newsletter aims at presenting the current ACF research activities, highlighting how they relate with the ACF-International 2015 strategic priorities, and illustrating how they directly address operational questions. Implementing research projects in humanitarian conditions is a real challenge, one that each team faces daily with rigor and professionalism. Admirable work has been developed in-house, notably thanks to strong collaborative work between the field and the headquarters. This is vital for the successful implementation of research projects and we wish to thank all the teams involved in research for their work. Looking forward to many more fruitful research collaborations in 2012! Today, as Nutrition Security is being placed at the top of many international agendas, including those of scientific communities, the definition and implementation of innovative, evidence-based and prospective approaches and positioning are more than ever strategic for ACF. Improving the analysis of causes of undernutrition in different contexts, improving the impact of our technical The Research Department approach on nutrition, defining innovative and context-adapted multi- This Newsletter was prepared in Paris sectoral approaches to prevent with the participation of all undernutrition, are examples of our headquarters and missions. main challenges in research. Thanks to all for your contributions.

ZOOM ON the Research Department QUESTIONS ASKED TO FOCUS ON RESEARCH PROJECTS (contribution to the 2015 ACF-IN Strategy) o o o Pillar 1: Increase ACFS impact on acute malnutrition, curatively and preventively Pillar 2: Respond to and prevent humanitarian crises, address vulnerability and reinforce longer term population resilience to crises Pillar 3: Further develop partnerships with local, national and international stakeholders to increase the number of beneficiaries and promote sustainability WHAT HAPPENED? Publications, surveys, reports, meetings, fora FOCUS on a NEW publication: Zero Hunger NEWS on ACF research tools WHATS NEXT? 2012 CONFERENCES 27 28 30 31 32 33 19 5 2 4

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Zoom onthe Research Department

They worked for you in 2011

Freddy Houngbe Research Project Manager Ready-to Use Food Project Chad

Audrey Papucci Research Officer MAMOUT project Paris

Alejandro Vargas Technical Coordinator Peru

Adrienne Daudet Cash Transfer Research Officer Mauritania

Ccile Salpteur Nutrition Research Officer Paris

Julien Chalimbaud Nutritional Causal Analysis Research Officer Paris

Caroline Sidi Research Management Officer Paris

Benjamin Guesdon Nutrition Research Officer Paris Jimena Peroni FS & Nutrition Coordinator Fresh Food Voucher project Bolivia

Myriam AtAssa Senior Research Advisor Paris

Brigit Olagivel Nutritionist Fresh Food Voucher project Bolivia

Ricardo Bado Research Project Manager Peru

Julie Aubriot Right to Water Research Officer Paris/ South Africa

Cristian Le Picard Research Project Manager Antibiotics Project CAR

Ankur Singh Chauhan Research Officer India

Facely Camara Research Project Manager Nutrition and Pastoralism Chad

Damien Pereyra Nutrition Epidemiologist Paris

and all the students and wonderful operational and technical people involved daily in research activities We thank them all!!
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Research News Bites

Adrienne DAUDET was recruited this summer for one month to support the Mauritania mission in the definition of a research protocol aiming at measuring the impact of a multi-annual cash transfer project on malnutrition. Limitations in the methodology have impeded the validation of the implementation of the project. The recommendations put forth, in accordance with the IRD, will be taken into account in future related projects. Some ACF-Spain scientific collaborations: - ACF-Spain signed a Memorum of Understanding with Cdiz University for technical support in methodology design and later for data analysis. - ACF-Spain is entering a third year agreement with the University of Alcal, for a WASH expert graduate. - Signed an agreement with the same university for a Doctoral thesis on Water poverty index in Colombia. ACF-France will sign a long-term partnership with IRD, Institut de Recherche et Development.

Key Figures
- Approximately 25 research projects / year, - Students who did great jobs on the different topics in all the technical sectors, 2 PhD Theses starting soon: - in collaboration with Ghent University (Ghent, Belgium) and Agroparistech (Paris) - Audrey Papucci, - with the University of Science and Technology Beijing (USTB) - Recruitment process still on-going

Research in India, a new focus for ACF

We are glad to welcome Ankur Singh Chauhan, Nutrition Research Officer since July 2011, in the ACF India mission. nd Ranked 2 in the world by the World Bank, in 2009, for the number of children suffering from undernutrition (World Bank Report on Malnutrition in India, 2009), India, and therefore also the ACF mission, faces considerable challenges. Moreover, as the context in India requires implementation of evidence-based interventions, research has been a strategic axis of the ACF India mission. We wish Ankur and all the India team good collaborations, both with field practitioners and Indian scientific organisations. Ankur (left) with Puranti Prajapat (middle) and Gayatri Gochar (right), 2 community Health Workers. This picture was taken in August 2011 Karvari Village, about 30 km from Baran, in Rajasthan (India), where a Community-based Management of Acute Malnutrition program should soon be implemented.

M At-Assa/India 2011

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Dr. Miltos Ladikas
Senior Research Fellow, Centre for Professional Ethics, University of Lancashire, UK Member of the International Scientific Council, ACF-France
The International Scientific Council of ACF brings together field experts and international scientists who are renowned for their work in the areas of nutrition, health, food security & livelihoods, advocacy, water, sanitation and hygiene. Its role consists of assisting ACF in responding in the best possible way to different problems which its volunteers are faced with in the field. ACF established the Scientific Nutrition Advisory Committee in 1994, focusing primarily on nutrition issues. In 2006, this committee evolved into the International Scientific Council, with a wider focus, now including all areas of ACFs technical field of expertise.

Questions & Answers

The ISC meets at least once a year and currently is made up of 5 members: Nutrition and Health: -Dr. Andrew Tomkins, Institute of Child Health, London, UK -Dr. Hlne Delisle, Universit de Montral, Canada Food Security and Livelihoods: Dr Alain Leplaideur, Agropolis International, Montpellier Water, Sanitation, Hygiene: Dr. Pierre Ribstein, Universit Pierre & Marie Curie, Paris Ethics: Dr Miltos Ladikas, a member since 2008

What is your professional background? My background is in Social Psychology with a focus on public perceptions of new technologies, science and development, and research ethics. My work relates to a wide spectrum of ethics-related topics (including science policy, technology assessment, access to medicines and benefit sharing) and covers Europe, Asia (China, India, Mongolia) and Africa (South Africa, Kenya, Uganda). Im an ethics advisor to the European Commission and the European Research Council and Im also vice-Chair of the local University Health Ethics Committee. Why did you accept to be a member of ACFs International Scientific Council? I felt honoured to be asked to join the ISC and I felt obliged to use my knowledge and networks for the benefit of an organisation that supports helpless people. I was also impressed by the quality and dedication of the ACF staff that I met at the time. What has been your experience so far with the ISC? The ISC is made up with very good and dedicated scientists. One feels lucky to work with them. The role of the ISC in the organisation is quite general and covers a wide spectrum of activities in the limited time of two meetings per annum. There is space for improvement and for a better focus but I believe ISC has already achieved a significant upgrading of research activities in the organisation. What do you see is the role of research in humanitarian NGOs such as ACF? Research in humanitarian organisations should be seen as a systematic way of gathering and disseminating facts, and substantiating claims.

M At-Assa

The needs in the field are huge, the stakes are extremely high, the opinions of dedicated people can be very strong and funders need to separate the worthy from the worthless. In relevant discussions, any unsubstantiated claim is seen as an invalid claim. Research can provide substance to claims and turn them into facts (that is also much appreciated by funders). According to you, what are the important challenges in the area of ethics in research in the humanitarian sector? The single most important challenge is awarenessraising and standardization of research ethics in the sector. Humanitarian organisations work in extreme conditions with the best possible intentions but good intentions do not necessarily translate into good research. There is an urgent need to raise staff awareness on the issues of quality and ethics in research. At the same time we need to understand the special circumstances in which such research is undertaken and accordingly re-align research ethics to better fit the sector. What message would you like to communicate to the ACF teams that are in the field? Ive visited the ACF teams in the field once (in Myanmar) and Ive been deeply impressed by the people I met. My message to them and all field teams is: Your dedication to your work and persistence in such difficult conditions are nothing less than heroic. Regardless of the reasons for your choices and your opinions for your work, you are role models for countless people back home.
Interviewed by Caroline Sidi, October 10th, 2011

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ACF Researchs overall objective is to actively contribute to ACFs global strategy. This part of the newsletter highlights our on-going research activities, each activity contributing to the achievement of the different pillars of the ACFs 2015 Strategy.

Comparison of the efficacy of 3 nutritional products in the treatment of Moderate Acute Malnutrition among children 6-59 months enrolled in ACF Supplementary Feeding Programmes and living in Northern Rakhine State, Myanmar, in 2009
Ccile Salpteur - HIV & Nutrition Research Advisor, ACF-France In the current context of the international debate on how to manage Moderate Acute Malnutrition (MAM) through innovative approaches, ACF-France decided to carry out a research project to test different nutritional products. Plumpydoz (PD), SupplementaryPlumpy (SP) and a locally made food ration enriched in micronutrients, called CTL, were used as a diet in the treatment of MAM within ACFs Supplementary Feeding Programmes (SFP) in Buthidaung and Maungdaw districts, in Northern Rakhine State in Myanmar. It was hypothesized that PD as well as SP would be as effective CTL. A scientific consultant, Dr Laura Rossi, developed the research protocol with Myanmar and HQ nutrition teams. Ethical considerations were taken into account by following ACFs SFP treatment protocols as well as using the Non Respondent Protocol to avoid any harm to children enrolled in the project. A family food ration was planned in case of need as the families were mainly food insecure in these districts. Oral consent was obtained from families whose MAM children were randomly selected to be included within one of the three study arms. Children between 6 to 59 months were enrolled in SFPs if they fit the admission criteria i.e. Weight for Height (WH) <1.5 Z-score (based on WHO 2006 references) and/or 110 mm < MUAC 115 mm. Among these children enrolled in a SFP, a sample of 1156 children was randomly assigned to each of the 3 groups. The quantity of PD was 46 g per day for one arm, 1 sachet of SP per day for the second arm and 343 g per day of the local ration CTL for the third arm. Data were analysed for 1055 children. Discharge from a SFP was obtained if WH -1 zscore for 2 consecutive weightings. Study participation lasted 12 weeks (3 months). Children came on a weekly basis for routine monitoring and anthropometry. A follow up visit was organized 6 months after discharge from a SFP. Results are currently being re-analyzed with new statistical methods. A scientific article, summarizing results and recommendations, is being written for publication in 2012.

A.Rozet/M. Grossiord

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Masters thesis on the Success Factors of the Alternative Treatment of Severe Acute Malnutrition, as implemented in 2009 in Myanmar
Ccile Salpteur - HIV & Nutrition Research Advisor, ACF-France Due to operational constraints in the field (an increase in number of beneficiaries while at the same time Plumpynut procurement becoming problematic) an alternative treatment of Severe Acute Malnutrition (SAM) was implemented in 2009, in the Outpatient Therapeutic Programme (OTP) in Northern Rakhine State in Myanmar. The OTP using the SAM alternative treatment showed good performance when using less Plumpynut at the end of the treatment. It is noteworthy that these positive results are obtained in a particular context and programme framework that can be as significant as changes in the diet. Hence, to replicate this alternative treatment of SAM in other countries, a deeper analysis was required to identify potential key factors to consider and to build a feasibility grid to assess favourable contexts. For this reason, Naomi Cosgrove, a Public Health Nutrition Masters student from Sheffield University, UK, conducted this spring a qualitative research study to identify the key success factors of this alternative treatment project and to envision its replication in other contexts. Semi-guided interviews by Skype or face-to-face were organised with former Programme Managers and Coordinators from Myanmar in 2009. Results will be presented in an article recently submitted to the magazine Field Exchange (pending acceptance). This protocol will be tested in another context in 2012. Confirmation of these positive results could be an important contribution to the improvement of the treatment of Severe Acute Malnutrition.

Efficacy of the systematic antibiotic treatment for uncomplicated Severe Acute Malnutrition: a randomized control trial in preparation
Benjamin Guesdon - Nutrition Research Advisor, ACF-France The systematic antibiotic treatment for uncomplicated Severe Acute Malnutrition (SAM) children has been called into question for several years by both the scientific and the humanitarian organisations. Notably, questions were raised with regards to resistance and negative side effects of this antibiotic therapy for uncomplicated SAM children. The main question is: are routine antibiotics essential for children with Severe Acute Malnutrition and without complications? As was recently underlined by WHO, this treatment needs to be carefully reviewed in the light of robust randomized control trials. With the support of ACF headquarters in Paris, ACF-Central African Republic has decided to address this issue through an operational research project, in collaboration with the Hpitaux Universitaires de Genve and the Complexe Pdiatrique de Bangui (hospital in CAR for SAM children with complications). The protocol has been designed as a double-blinded randomized control trial aiming at comparing the therapeutic success, nutritional recovery and complications occurring during the treatment of uncomplicated SAM children following three different antibiotics strategies (standard amoxicillin, cefdinir or a third generation cephalosporin, and a placebo). Uncomplicated SAM children, aged 6 to 59 months, will be included in the study at their first visit and admission at three outpatient therapeutic program (OTP) centres in Bangui (centres de sant Saint-Joseph, Amis d'Afrique Boy Rabe, et Saint-Jacques), starting November 2011. In order to minimize the risks and to guarantee a benefit for each participant, all the children will be followed by a dedicated and trained medical staff. They will get a follow-up check-up two days after admission, then every two to three days during the first two weeks of treatment, and finally on a weekly basis, until the end of the treatment.

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This way, any complications will be treated quickly, and the staff will be able to regularly assess the children outcomes. In accordance with the WHO Manille statement (1981) the study protocol has already been carefully reviewed by an independent ethical committee (CPP Ile-de-France XI). It will also be submitted for approval by the MoH scientific committee in CAR before the start of the inclusion. An external scientific peer-review committee has been set up to include a panel of experts: Andr Briend (ex-WHO), Muriel Vray (Institut Pasteur, Paris), Marco Kerac (UCL, London) and Mark Manary (Washington University). Christian Le Picard-Goos has been recruited as research project manager. This project is proof of ACFs willingness to improve the quality of treatment used for undernourished children, by playing an active role in the field and being in the forefront of operational research destined to bring new knowledge to international recommendations.

C. Le Picard / Gobongo, CAR

What future for severely acute malnourished children? A research initiative aiming at defining the consequences of severe acute malnutrition on the survival and development of the infant
Ccile Bizouerne - Senior Mental Health and Care Practices Advisor, ACF-France ACF today treats children who are severely malnourished and considers them cured once they reach a weight/height ratio of 85%. The child is followed for three months following discharge. However, a current review of the literature clearly indicates dramatic mid-term and long-term consequences in child development throughout childhood and persisting at least into adolescence, for children who have suffered child undernutrition. Few studies exist and there is an obvious lack of data on the future of children once they leave therapeutic centres. This raises the question of what are the mid-term and long-term impacts of ACF nutritional programs and whether activities promoting child development and parental guidance should be added. In order to answer this operational question, a research proposal is being written by Patricia Kariger, a child development specialist. The main objective of this study will be to follow a cohort of children over a span of 2 years in order to evaluate their survival and their development following treatment from an episode of severe acute malnutrition. The mid-term impact of the ACF programmes on the survival, the growth and development of children will be measured. Results from this study should allow ACF to evaluate the short-term and long-term impact of medical-nutritional treatments on child survival and development and as a consequence to improve the management of severe acute malnutrition, specifically in terms of monitoring after discharge from a nutritional program and use of activities promoting child development. The methodology implemented will additionally lead to a reflection on the tools for measuring child development and on the mother-child relationship for populations of children affected by severe acute malnutrition.

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Scaling-up Nutrition, an interesting example of a research initiative dedicated to advocacy purposes: Aid for Nutrition - How Much Should Be Invested?
Sandra Mutuma - Senior Nutrition Advisor, ACF-UK The Lancet Series (2008) on maternal and child undernutrition estimates the number of children under 5 years affected by acute malnutrition at 55 million; over a third of these children, an estimated 19 million, suffer from severe acute malnutrition. Without treatment these children are at imminent risk of dying and of never achieving their full growth potential. Although effective solutions are known, tested and available, the funding to implement these solutions at scale to treat and prevent Undernutrition, particularly severe acute malnutrition is inadequate. Funding tends to be abundant for acute malnutrition in emergency contexts, however, millions of children are dying needlessly each day, two every minute, from severe malnutrition in the absence of any disaster at any one point in time. There is a wide gap between what is being spent on nutrition and what is required. Typically, funding levels have remained stable and inadequate, varying between $185 to $511 per year between 2004 and 2007, what is available is not being spent on the right things and is not spent as efficiently as it could be and data collection and reporting can be better. The World Bank has estimated that $12.5 billion per annum needs to be invested to scale up the nutrition package (Lancet Series, 2008) in the high burden and small countries with the highest prevalence of malnutrition. This project is within the framework of ACF-INs AMAI (acute malnutrition advocacy initiative) to increase resources for the treatment and prevention of acute malnutrition and is a follow-up to the AMAI Monitoring Baseline Final Report which identified several gaps in research that are the basis for the proposed research. Aims of the research project: To understand the level of funding required to successfully scale up nutrition interventions in the countries with the highest levels of undernutrition Ensure that nutrition policies and strategies are supported by sustainable and adequate implementation budgets in the relevant sectors Optimise aid effectiveness and the impact of investment by linking and balancing treatment and prevention strategies for Undernutrition

Objectives: 1. Estimate overall aid to different sectors as reported to the OECD by DAC member countries between 20002009 2. To evaluate trends and priorities in major donor commitments and disbursements to direct and indirect nutrition interventions from 2000-2009 within and between sectors as reported to the OECD 3. Identify and assess trends and gaps in funding for the evidence-based direct nutrition interventions to prevent and treat undernutrition 4. Assess investment in nutrition interventions by donors to countries with high levels of undernutrition 5. Estimate how much should be invested by key donors to accelerate achievement of the MDGs (millennium development goals) and rid the world of the scourge of malnutrition 6. Advocate for transparency and accountability in the use of resources to facilitate the investment in nutrition interventions at scale

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2. Addressing the underlying causes of acute malnutrition: a major emphasis for ACF research
Contributing to the scientific improvement of the treatment of acute malnutrition is a key axis for ACF research, yet finding innovative context-adapted and sustainable preventive approaches of acute malnutrition also represents a crucial scientific challenge today. The causes of undernutrition, defined in the Unicef conceptual framework of undernutrition, need to be well understood in order to define appropriate operational strategies in a given area. Given the strategic importance today to improve the treatment and prevention of undernutrition, the research department strives towards improving the way ACF analyses the causes of undernutrition.

Nutrition Causal Analysis

Julien Chalimbaud - NCA Research Officer, ACF-France Action contre la Faim bases all its interventions and needs analysis on the nutrition causal analysis adapted from the Unicef conceptual model of malnutrition, which identifies immediate, underlying and basic causes. However, many ACF missions have currently expressed their need to develop a comprehensive understanding of the causes of undernutrition in a specific context in order to develop an appropriate strategy of intervention (e.g. Chad, Bangladesh, South Sudan, Nepal, Pakistan, India). The different analysis methodologies developed up to now have not allowed the assessment of the contribution of each underlying factor that influence nutritional status. Today, there is a need for a standard methodology within ACF and within many organisations on NCA. The Nutritional Causal Analysis (NCA) project can provide a unique and innovative tool to identify and quantify the linkages between ACF interventions and nutrition outcomes. Such a tool does not yet exist and is greatly needed, not only by ACF. During the course of the first phase of the project, started in August 2010, several donors and other agencies also expressed an interest in this approach. The NCA methodology was initially defined with ACFs scientific partners: Helen Young and Jennifer Coates (TUFTS University), Yves Martin Prevel (IRD), Kate Ogden (WFP) and Susanne Jaspers (independent consultant). In phase 1, the method was tested in Zimbabwe and Bangladesh... Among the different analyses tested, one emerged as potentially the most interesting for ACF: the path analysis; traditionally used in psychology studies, and especially adapted to test casual pathways. In addition, a first version guideline was drafted and tested (on-going). A scientific workshop reviewing the results and a scientific research article are planned by the end of 2011. The initial objective of the research project was to produce a methodology to quantify causes of malnutrition and easy to handle by field workers. However, the selection process of the most appropriate quantitative approach is still ongoing, and field workers still need specific training to follow the full guidelines. The main challenge met so far, is finding the optimal balance between a necessary large body of information to collect and the feasibility of such a study to be replicable.

ACF / Bangladesh

Therefore, a multi-layer approach is proposed for phase 2 of the project, which should start end 2011 and has a general goal to further develop, simplify and roll out the NCA methodology. Specific objectives, to be attained over the next two years, are: 1. Improve the operational guidelines based on a simplified methodology, mainly qualitative, that can be easily handled by field workers. 2. Explore and simplify the still complex quantitative analytical part: o focus on the selected method validated by workshop in 2011 o work by sector on pathways to undernutrition o work by sector on standardised indicators that can be used in an NCA o validate the NCA quantitative methodology to be included in a second version of the guidelines Moreover, the research study will aim to roll out the NCA tools by 2013. Results from the NCA project, aiming at better understanding the causes of malnutrition, will undoubtedly improve targeting of ACF interventions and increase the quality of our interventions towards preventing malnutrition.

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3. Preventing acute malnutrition

In 2010-2011, a strong and effective collaboration was achieved between the research and operational departments. Both at the field and headquarters level, ACF staff was mobilized in the implementation of a considerable research project in the difficult context of Abch, in Chad. It is important to highlight in particular the crucial role and involvement of the ACF staff based in Abch and NDjamena as a key success factor of this project. ACF scientific partner, Lieven Huybregts, Ghent University, also played a key part in this story. This project was a very good example of operational-scientific collaboration, resulting in an innovative research project for ACF. It is a first milestone in ACFs research axis prevention of acute malnutrition, and sets the course for a new research project soon to be launched in 2012 on the same theme.

Prevention of acute malnutrition among children 6-36 months during the hunger gap using Food for Training, and with or without RUF, in Chad in 2010
Ccile Salpteur - HIV & Nutrition Research Advisor, ACF-France To respond to the nutritional crisis expected for the 2010 Hunger gap in Chad, ACFs Chad mission considered several preventative options such as a blanket distribution of RUF, or Cash for Work or Food for Work. No evidence of the comparative effectiveness of these interventions existed at the time. Thus, there was a need for an evidence-based intervention, comparing the efficacy of these preventive interventions in order to identify the best operational strategy and to be able to replicate positive interventions in other contexts. In partnership with the University of Ghent, Belgium, and with the fulltime scientific expertise of Dr Lieven Huybregts, a research project was implemented in Abch, east of Chad funded with ACF-France research-dedicated funds (except the WFP food rations). Freddy Houngbe was the ACF Research Project Officer based in Chad; Raphal Brechard, a Food For Training (FFT) Programme Manager, Marine Mejri, a WASH Programme Manager and Armelle Sacher, a communication specialist, completed the team in the field.

A beneficiary tasting Plumpydoz

F.Houngbe/A. Sacher

Armelle Sacher being interviewed by the local radio of Ouadda province

F.Houngbe/A. Sacher

Prior to the start of the project, the acceptability of Plumpydoz (PD) was tested on a small group of healthy children and their parents and a preliminary Food For Training launched, where most vulnerable families of 7 quarters of Abch were enrolled and received a WFP food ration, on condition they would attend Hygiene and Sanitation sessions. From this control group, an intervention group was randomly selected to receive 46g of RUF (Plumpydoz ) on a daily basis, in addition to WFP food ration. Over a period of 5 months, consenting families and children 6-36 months in both groups, visited distribution sites on a monthly basis, and included measurements and surveying. A total of 1038 children were considered in the analyses. /

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A food survey based on a 24h-recall method on a subsample of children documented the childrens intake in energy, proteins, lipids & carbohydrates. At the beginning and end of the 5-month intervention, anaemia in children was assessed. In parallel, a baseline survey documenting the socio-economic status of families in both groups was conducted to check the comparability between families in the control group (FFT alone) and those in the intervention group (FFT + PD), and a SMART nutrition anthropometrical survey implemented. Despite difficult field conditions (sandstorm, insecurity, heat...), the operational teams based in Abch managed to successfully implement the research project. Results provided useful insight regarding the impact of Plumpydoz in the prevention of acute malnutrition. A scientific article, summarizing results and recommendations, is being written for future publication.

Haemoglobin measurement
F.Houngbe/A. Sacher

This study adds to the body of evidence on the use of RUF in a preventative approach; more studies are needed to confirm the efficacy of such products in a food-only based approach to fighting undernutrition. For this reason, ACFs Scientific and Technical Department has decided to continue work in this domain and has initiated a new research project aiming at comparing the efficacy of different multi-sectoral approaches in the prevention of acute malnutrition (cf. next article). In addition, a complementary cost-effectiveness study is planned to be conducted in 2012.

A distribution site

F.Houngbe/A. Sacher

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Implementing the recommendations of the RUF Chad project for more research: alternative approaches to nutritional products to prevent acute malnutrition among children under 2 years of age
Audrey Papucci - MAMOut project Research Officer, ACF-France Following the recent research project in Chad, this operational research project also aiming at preventing acute malnutrition will be implemented in the field in spring 2012, for at least 18 months. This MAMOut project aims to compare different preventive strategies in a non-emergency context with a high level of acute malnutrition. The hypothesis is that context-adapted and alternative approaches to products are as efficient as and more cost-effective than classical approaches based on products. Thus, an approach based on the distribution of a nutritional product will be compared to two other approaches: one based on family support of households considered at-risk, and the other involving nutritional safety nets. The operational objective of this project is to identify a sustainable and efficient strategy to prevent acute malnutrition, which will also be adapted to the need of the population and be easy to replicate after its adoption by the community. This research will be done in partnership with the University of Ghent, Agroparistech (France) and hopefully local universities. Up to date, field needs have already been recorded, and the selection of the country is in process. A proposal deposit has been submitted to the Ministry of Research in order to obtain 1 a CIFRE grant for co-funding. Audrey Papucci, soon starting her PhD on this topic, is the research manager of this research project.
Convention Industrielle de Formation par la REcherche. Research funding for doctoral students managed by the French Ministry of Research

ACF is part of an international research initiative called Moderate Malnutrition Study (MMS), led by ENN (Emergency Nutrition Network) and Save the Children-UK. The aim of this project is to define aapproaches to the prevention and treatment of moderate malnutrition in emergencies.
ACF pays attention to coordinate its research activities with this on-going international study. Contact: Benjamin Guesdon (

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4. Diagnosis, surveys and surveillance

First evaluation of a nomadic populations nutritional status through an appropriate survey method in Chad
Benjamin Guesdon - Nutrition Research Advisor, ACF-France This pilot project in Chad is the final one, following two previous studies in Mali and Ethiopia, before larger scale dissemination. Funded by ECHO and ACF, it took place from May to June 2011. The objective was to test a new anthropometric nutrition assessment in nomadic pastoralist population, the Pastoralist Survey Method (PSM), defined in 2008 by ACF in collaboration with Anne-Marie Mayer and Marc Myatt (consultants at the time). This method is tailored to the particular living conditions and body shape of nomadic pastoralist communities. It consists of a qualitative and quantitative phase to measure acute malnutrition and it was used to assess the nutritional status of children from 6-59 months. The target population in Chad was the Gorane nomadic pastoralists, whose nutritional status has never been properly assessed. The acute malnutrition prevalence found was extremely high, 12.7% measured with MUAC, revealing a critical need for sustained efforts and increased intervention. The PSM is described in a recent ALNAP publication and an abstract of this study was submitted for the World Nutrition Rio conference in 2012. Further reading:
B. Guesdon

Pastoralist Survey Method

The importance of having accurate and valid information from nutrition anthropometric surveys in pastoralist populations has been a major issue to all partners involved in Humanitarian Action. One of the challenges of carrying out nutrition surveys amongst nomadic pastoralists is that populations are scattered, mobile, migrating and of unknown & changing community size. The other challenge is that pastoralists tend to have a particular body shape with longer legs and shorter trunk compared to settled populations; this makes the usual case definition for malnutrition (weight for height) biased. The pastoralist survey method is innovative because it uses both a new sampling method and an appropriate case definition for malnutrition in pastoralist populations (Mid Upper Arm Circumference (MUAC) <115mm and/or bi-lateral pitting oedema). Whilst designed for assessment of malnutrition, the sampling method could be used for a range of other assessments which could be done at the same time, such as vaccination coverage, animal health assessments, and water and sanitation surveys for example.

Taking MUAC measurements

B. Guesdon

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Capitalising on ACF nutrition data to create new exploitable databases

Damien Pereyra Junior Nutrition Epidemiologist, ACF-France One of the 2011 Action Plans of the ACF-France HealthNutrition and the Research services was to build a comprehensive database using data collected from the field nutrition programme. Data from 2005 to 2011 was collected in 9 missions: Bangladesh, Burundi, Haiti, Liberia, Myanmar, Central African Republic, Somalia, Sudan and Chad. Around 70 excel sheets containing the nutritional records of the beneficiaries and their evolution in ACF direct or integrated intervention, were standardized in order to build a unique Therapeutic Feeding Programme Database (TFP-DB). ACFs Technical and Research Departments shared the latter with the Health and Nutrition Tracking Service (HNTS) Expert Reference Group, which is developing a project for establishing a more reliable method of estimating the expected number of malnourished children that could be admitted in a TFP at the beginning of an emergency. In order to find this number, Claudine Prudhon and Nancy Dale, from the University of Tampere (Finland), proposed an empiric approach that will allow the development of a conversion factor from the SAM prevalence nutrition surveyed results. In the summer of 2010, another database was set up, gathering individual data and anthropometrical measures from 423 surveys in 25 countries that had been conducted since 2001 by the nutrition teams of ACFIN. This Nutrition Survey Database (NS-DB) contains the data of almost 370,000 measured children. Our team also shared this NS-DB with the International Emergency and Refugee Health Branch of the Centre for Disease Control NCEH/CDC. Their aim is to explore the design effect and a new plausibility test for the SMART/ENA software in order to improve the quality of surveys. In 2010, ACF recruited a Nutrition Epidemiologist (Damien Pereyra) to be in charge of the nutritional databases, to build the TFP-DB and then to conduct the analysis, together with the Nutrition Research team, in order to answer important questions coming from the field and participate in the development of new information for all the humanitarian nutrition community.

Study of body shape and relationship with MUAC in the Pilipino population
Elisa Dominguez - Senior Nutrition Advisor, ACF-Spain MUAC measurements have been used worldwide for identification, referral and admission of severely malnourished children aged 6-59 months to nutrition programmes. It is a quick, easy and cheap alternative to weight-for-height measurements and has recently been 1,2 endorsed by the World Health Organisation (WHO). In some populations, however, large differences have been observed between prevalence of acute malnutrition measured by weight-for-height versus MUAC. In line with this, three surveys carried out by Action contre la Faim (ACF) in the Philippines found a big discrepancy between the two. This raises a number of questions: what causes such a big difference between MUAC and weight-forheight based prevalences in some populations and not in others, what are the programmatic implications, and which is the better indicator for measuring acute malnutrition in the Philippines? To build more evidence to help decide which indicator would be better in our area of intervention in the Philippines, we have decided to include the body shape measurement through the Cormic index. The Cormic index, which is sitting height to standing height ratio, is the most common bi-variate index of shape. Cormic index has been used as a valid means to study body size as has been observed in many populations. There is a racial or ethnic variation in the mean Cormic index. For the European and IndoMediterranean population, it is about 52% (0.52). Africans have proportionally longer legs in general with Cormic index value around 51% (0.51). Asians and far Eastern populations have proportionally shorter legs with Cormic index of 53-54%. Currently, a SMART survey is ongoing in Lanao del Sur in the Philippines and sitting height has been included as standard measurement. Cormic index will be calculated and correlation between Cormic index (body shape) and MUAC, by age and sex will be studied. Preliminary results will be ready by the end of the year.

1 UN Standing Committee on Nutrition. Task Force on Assessment, Monitoring and Evaluation. Fact Sheets on Food and Nutrition Security Indicators/Measures: Mid-Upper Arm Circumference (MUAC). 2 Myatt M., Khara T. and S. Collins. A review of methods to detect severely malnourished children in the community for their admission into community based therapeutic Care programmes. 2005.

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5. Preventing undernutrition
Several research projects on the prevention of nutritional deficiencies were implemented in 2011, including fruitful collaborations between the ACF Nutrition & Health and Food Security & Livelihoods teams.

Analysis of micronutrient interventions in Bangladesh refugee camps

Benjamin Guesdon - Nutrition Research Advisor, ACF-France Since 2008, ACF has been implementing different nutritional interventions of treatment and prevention of vitamin A/retinol deficiencies and anaemia in the camps of Kutupalong and Nyapara, in the Cox Bazaar region of Bangladesh, where micronutrient deficiencies are highly prevalent, besides acute malnutrition. A Public Health Nutrition Masters thesis, undertaken by Megan Grover at Sheffield University, UK, aimed at analysing the relevance and safety of these different micronutrient interventions run by ACF. In addition, the risk of toxicity associated with the impressive variety of Vitamin A supplements distributed was also investigated. The impact of the current micronutrient powder distributed to correct anaemia (Pushtika), has been diminished due to non-compliance issues. Plumpydoz has been evaluated in a cohort study run by ACF in 2010 to see if it can induce a change in haemoglobin levels in children 6 35 months of age. These results were compared with those obtained one year earlier in another cohort of children supplemented with Pushtika. Both Pushtika and Plumpydoz distributions are associated with increased haemoglobin levels from baseline to after intervention (p<0.001), and thus decreased anaemia prevalence. Their effects are impacted by differing camp and programme conditions. Yet, the analysis indicates that neither supplement was more effective than the other in changing haemoglobin levels (NYP: p=0.232; KTP: p=0.790). Plumpydoz could nevertheless be a useful alternative to Pushtika as it contains added kilocalories. Estimated daily retinol intakes suggest a risk of deficiency for some groups, and a risk of toxicity for others, which call for a better adequacy between interventions and nutritional recommendations. In calculating vitamin A status and deciphering micronutrient supplements efficacy, the primary conclusion is that a more precise assessment of the nutritional practices and needs should be done in order to target interventions and prevent risk of vitamins and minerals deficiencies/toxicities. These results highlight the drawbacks of micronutrient supplementation and the need for long-term food-based strategies.

ACF / Bangladesh

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Measuring Impact of Low Input Gardens (LIG) on HIV affected communities in Chipinge district, Eastern Zimbabwe, in 2010
Ccile Salpteur - HIV & Nutrition Research Advisor, ACF-France In 2010, the Zimbabwe mission of ACF assessed the nutritional impact of Low Input Gardens (LIG) that had been implemented for 3 years in the context of a EuropAid programme in Chipinge district. A retrospective crosssectional research project was undertaken from August 2010 to July 2011. The research protocol was managed by nutrition & food security and HIV scientific experts, and was authorised by the Ethical Committee of the University of Antwerp (Belgium). The LIGs aimed at improving the nutritional status of communities affected by HIV, and to help them create some income through teaching gardening methods in organic agriculture, conservation farming, nutrition, food preparation and preservation. Each LIG also had a well and latrines. Indicators used were Quality of Life score for People Living with HIV, Household Dietary Diversity Score, Food Consumption Score, Household Food Insecurity Access Scale, a one-to-one interview, Body Mass Index and MUAC. There were 281 HIV positive persons in the intervention group (LIG beneficiaries) and 238 in the control group (non LIG beneficiaries). The results and conclusions have been submitted for presentation at the international HIV/AIDS conference ICASA, to be held in December 2011 in AddisAbaba, and for publication as a scientific article.

ACF / Zimbabwe

Aligning Food Security and Nutrition

Julien Morel - Food Assistance and Social Protection Advisor, ACF-France The Food Security and Livelihoods (FSL) department published in July 2011 a manual entitled Maximising the Nutritional Impact of Food Security and Livelihoods Interventions A manual for field workers. This manual provides operational guidance to field workers on how to align FSL interventions with nutrition, promoting the systematic use of a nutrition lens at each step of the project cycle and a close collaboration between sectors. It also emphasizes the need to dispel the myth that economic growth and agricultural development in particular equals automatically improved nutritional status. Finally, the document provides practical guidance for FSL approaches and activities such as agricultural and livestock interventions, food aid, income generating activities and cash-based interventions. Following the release of the manual, FSL coordinators were trained and worked on practical implementation of the recommendations of the manual during a 2-day session at the last ACF FSL workshop in Kenya. The development of a 2-day training tool kit in order to ensure an extensive roll out to ACF missions and partners is in process. The complete manual with appendices can be downloaded from the ACF website: Related to this theme, ACF is involved in an Agricultural Research DevelopmentNGO consortium. Through this platform, ACF presented comments on the CGIAR Research Program 4: Agriculture for Improved Nutrition and Health. The ACF Research Department will further study this important and strategic research axis.

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Ethno-nutrition: Assessing the nutritional value of wild foods

Hlne Deret - Senior FSL Advisor, ACF-France A significant proportion of foods have been progressively neglected in spite of modern and improved agricultural practices, thereby narrowing the base of global food security and diversity. The general objective of this project is, in collaboration with Bioversity International, to improve the knowledge of ACF-IN to better design food diversification interventions in the context of undernutrition prevention. Specifically, it will lead to drafting of a technical summary based on existing documentation and other agencies experiences, as well as to proposing an ACF-IN strategy and research plan in terms of ethno-nutrition. Adrienne Daudet has been recruited to work on this project.

Reduction of Iron deficiencies in Guaranies families by improving access to nutritious food and diet diversity through Fresh Food Vouchers (Chaco, Bolivia)
Jimena Peroni and Brigit Olagivel, ACF-Bolivia Contact: Julien Jacob - FSL Technical Advisor, ACF-Spain High rates of stunting and anaemia in children under 2 in Chaco, Bolivia, found in a SMART survey in May 2011, revealed the need to improve diet diversity and practices through Fresh Food Vouchers (equivalent to 22 to 36 USD per household, depending on size and household composition), community workshops and Health & Nutrition gardens. The aim was to improve economic access to micronutrient-rich fresh food. A longitudinal study to measure the impact of these interventions measured capillary haemoglobin and IDDS in children under 5 and found a reduction of severe and moderate anaemia; this was not significant probably due to small sample and length of study. Haemoglobin increased in 63.4% and decreased in 32.2%. IDDS increased (average of 2.1 points) showing an important impact on diet diversity (particularly, vitamin A-rich foods and iron-rich foods). Final evaluation showed a high degree of satisfaction among beneficiaries. Fresh food vouchers had a short term impact by increasing access and consumption of micronutrients, with a significant impact in haemoglobin levels, even if reduction of anaemia was not significant. Medium and longer term impact is reached with awareness and recognition of the nutritious value of local food.

Source : Bioversity International

Biofortification is one of ACF-Spains research axes for which they have implemented several field projects in Latin America, addressing both agricultural (validation of optimized production) and nutritional (impact on improved nutritional content) aspects of biofortification.

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Impact in the linear growth and haemoglobin levels of fortified nutritional supplementation versus nutrition supplementation on rural populations of Sierra Central in Peru
Ricardo Bado and Alejandro Vargas, ACF-Peru Contact: Elisa Dominguez, Senior Nutrition Advisor, ACF-Spain In Peru, despite overall national improvements in decreasing stunting and anaemia, local figures reveal that this progress has been unequal. To address the shortcomings of the traditional modalities the use of RUTF-LNS (Lipid-based supplements), has been suggested. ACF, with the Centro Nacional de Alimentacin y Nutricin (Per), the University of Cdiz (Spain) and the University of Waterloo (Canada) have design a study to evaluate the impact on linear growth and levels of haemoglobin after consumption of LNS-Nutributter in children between 6 and 12 months compared to national strategies of food supplementation in rural areas of Sierra central in Peru. The sample consists of 349 children from 6 to 11 months in 21 health centres of 5 districts located in the Department of Hunuco. Each centre was randomly assigned to a modality of treatment (porridge, Sprinkles and LNS). Length of research will be 18 months; the protocol is concluded and has been approved by the Ethical committee in Peru. Currently, the research is pending registration at the National Institute of Health in Peru.

The PUR project: combining water purification and therapeutic treatment for treating SAM
Nick Radin - Senior WASH Advisor, ACF-USA The PUR project is a nutrition-based field research trial where a water treatment product known as PUR will be distributed to severely malnourished cases admitted in the ambulatory therapeutic program, for the duration of their treatment. The treatment follows the national protocol in DRC, PCIMA, and includes RUTF (Plumpynut ) and medical treatment. The hypothesis is that the children receiving PUR tablets will consume safe water, making them less likely to become sick and therefore improving their rate of weight gain during the treatment period, and consequently increasing the cured rate. A trial run will include 2 groups: a control group (therapeutic treatment only) and an intervention group (therapeutic treatment + PUR). The trial will take place in Bandundu Province (southwest DRC), using participants from ACF-supported OTP sites. The PUR project had been delayed due to a lack of funding visibility for Nutrition programs in DRC, and also due to the risk of insecurity during the national elections (scheduled for 28th November 2011). A recently signed contract has provided the nutrition funding visibility that will ensure a suitable sample size for the duration of the PUR field trial; however the risk of political violence linked to the elections means that the start date has been postponed to January 2012. This trial, expected to last 8 months, is funded by Procter and Gamble, while UNICEF funds the therapeutic program from which the trial participants will be selected.

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Evaluation in Mental Health and care practices in emergencies
Ccile Bizouerne - Senior Mental Health and Care Practices Advisor, ACF-France Mental health is a sector in which evaluation is complex. Specific indicators recognized at an international level and transposable to different cultural contexts do not exist, whether for emergency situations or in the case of more normal psychological care. However, the need to be able to evaluate and collect psychological data in the intervention sites, and to evaluate the mental health of individuals in order to decide whether or not there is a need for psychological care no longer needs to be proven. This research project aims to define a mental health evaluation tool for ACF, at the collective level during exploratory missions and at the individual level for programmes already in place. Practical tools will be defined. This study is currently on-going and on a good track, with the collaboration of a consultant, Laura McDonalds. A first field test of the evaluation method, initially planned in Haiti, was conducted in the Central African Republic.

M At-Assa / Myanmar 2009

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2. Increase ACF support to the most vulnerable and affected populations, during protracted crisis, post-crisis and rehabilitation contexts
Cholera in the watershed of Lake Chad: Intervention strategy for the ACF-Chad mission.
Joachim Peeters WASH Technical Advisor, ACF-France With more than 85 000 cases recorded this year and 2466 deaths, Central Africa is facing a major cholera epidemic. One of the main hot spots is Lake Chads watershed, sharing borders with Cameroon, Nigeria and Niger. The response of ACF, which began in September 2010, aims to prevent and respond early and is structured around three strategic axes. The first one aims at containing the early outbreaks through the rapid placement of mobile teams. Activities in this phase depend on high-quality epidemiologic surveillance, due to ACF working closely with the Integral Service of Epidemiologic Surveillance of Chads Ministry of Health and health authorities of the affected area, and include decontamination of homes, raising awareness in the area, and distribution of tailored hygiene kits. A second axis is a strategy of operational partnerships with local health delegations and local NGOs and research partnerships with on-site laboratories for a project to study the biological, social, cultural and environmental aspects and assess their impact on the emergence and development of the epidemic. A consultant epidemiologist from the CDC (Centers for Disease Control) assists with the analysis of epidemiological data. The third axis includes the establishment and support for crossborder coordination through six cross-border platforms. Support of the Spain and New York ACF missions in the coordination of cross-border platforms will also be important. By 2012, the ACF-Chad mission is moving towards the dual strategy of "shield" and "punch" to fight cholera, which is recommended particularly by Unicef. The shield is characterized by sustainable WASH interventions and the punch is a response to an epidemic phase after the confirmation of the first cases. To do this, ACF will conduct an assessment in risk areas in order to identify avenues for medium to long-term interventions to help mitigate the spread of the disease during an epidemic. The mission will continue as needed via emergency interventions of the mobile teams with a blanket strategy in response to the evolution of the epidemic; and is seeking funding for a project to strengthen the capacity of the MPH for the preparation, national and trans-border surveillance and early response in most at-risk areas identified.
Source : ACF

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Comparative study of traditional and modern geophysical exploration methods in order to improve the capacity of ACF: India, Liberia and soon, CAR.
Jean Lapgue - Senior WASH Advisor, ACF-France A new operational research project of geophysics aims to conduct a comparative study between traditional and modern methods of geophysical exploration in a context of fractured bedrock, in Central African Republic. This research will allow the development of recommendations to improve the effectiveness and efficiency of geophysical exploration; improving the success rate of drilling in the CAR, and providing the foundation for a technical capacity building project in terms of geophysical exploration of the ANEA1, ACFs operational partner in CAR and of the ACF-CAR mission. The study will contribute to the development of the geophysical support project for ACF missions, in terms of knowledge (internal capitalization) and means, initiated by Johan Hoareaus thesis on the coupling RMP-TDEM-SYSCAL (ACF India, IRD, CERFISE, NITK, IISC) from 2006 to 2010 and continued in Liberia in 2011 (ACF, Cranfield University). The expected results will lead to operational recommendations aimed at: (1) improving the success rate of drilling holes built by ACF and ANEA and its partners - gain in time and in Two operational outputs: ACF Manual INTERNATIONAL: Use of SYSCAL as part of geophysical exploration missions (2010) ACF Manual INTERNATIONAL : Use of TEM-Fast as part of geophysical exploration missions (2010) efficiency, allowing for future projects the planning of a larger number of wells to be constructed, with an optimized timetable and budget, (2) strengthen the technical capacity of ANEA and strengthen the operational partnership ACF - ANEA, and (3) build ACFCARs capacity in applied geophysics. This project is parallel to a project funded by the European Union (Provide water), that includes material and theoretical capacity building for ANEA in the field of truck-mounted drilling rigs This project is a continuation of the research initiated in 2006 on the Geophysics expertise of ACF and the transfer of skills and equipment to our partners (SYSCAL to NITK, India; RMP to the research foundation 2ie, Burkina Faso).
Agence Nationale pour lEau et lAssainissement agence gouvernementale dpendant de la DGH. National Agency for Water and Sanitation, government agency belonging to the DGH (Direction Gnrale de lHydraulique).

Ground water resources monitoring in northern Uganda

Youcef Hammache - Senior Technical Advisor, ACF-USA With the increased demand for water due to rising population demographics and a perceived reduction of water resource recharge due to drought and climate change, the ACF Uganda WASH department raised questions about the environmental sustainability and impact linked to ACFs work. Key questions were: What is the groundwater recharge of the rate? What is the hydraulic potential of the exploited aquifers? How does ACF ensure sustainable water resource management? How is the changing context affecting the available water resources (factors include climate change, population movement, deforestation, agricultural practices)? Are any of these factors impacting water quality? Since 2008, a multi-year project is being implemented by ACF, in collaboration with the University of Avignon, to monitor the available groundwater resources in Northern Uganda. A similar type of approach is being duplicated in Karamoja since July 1st, 2011 with the University of Avignon and IUCN (the International Union for Conservation of Nature) partnerships. The objectives are: To monitor the groundwater quality during different hydrological seasons To identify any potential contamination risks from population concentrations, lack of basic sanitation infrastructure and environmental land use, and finally To provide a guideline for a sustainable exploration of groundwater resources within the investigated regions according to various evolution scenarios relating to population movements and groundwater recharge.

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Cash transfer and voucher programming in humanitarian response: the Cash Learning Partnership (CaLP)
Silke Pietzsch - Senior Food Security Advisor, ACF-USA ACF, along with four other organisations, is part of the Cash Learning Partnership (CaLP), which focuses on capacity building for humanitarian practitioners to implement cash transfer programs. Evidence building and learning are part of the overall objective of the CaLP. The CaLP works in four focus countries; Niger, Zimbabwe, Kenya and Philippines, and has had two short-term emergency support focal points, Pakistan and Ivory Coast. In 2011, the CaLP commissioned several research projects. The research looked into market analysis tools (EMMA, MIFIRA, etc.) and their applicability in the various emergency response contexts, cash transfer programmes in urban areas, scale and coverage in large disasters, and innovation and technology supporting the transfer of cash to disaster affected populations. ACF has received a sub-grant from the CaLP for evidence building, guidance materials and training and briefing sessions. This fund is administered by an internal ACF cash working group, comprising members of the Paris, Madrid and New York HQ Food Security and Livelihood teams. To find out more about the CaLP go to:
Source : CaLP

Guidance on food and nutrition security in urban crisis contexts

Julien Morel Senior Food Assistance and Policy Advisor, ACF-France ACF Food Security & Livelihoods sector is working on a partnership with WFP, FAO, Oxfam and Concern, with the aim to develop and pilot guidance to identify Food and Nutrition Security (FNS) needs and to inform response to crisis in urban and peri-urban areas. The guidance will cover assessments, targeting, monitoring and contingency planning methodologies and tools adapted to urban contexts. The project builds on the fact that nearly all the currently available tools and methodologies for FNS assessment and response analysis were developed and piloted in rural settings. There is an urgent need to research and document the appropriateness of these approaches in urban contexts, define which ones need to be adapted and which specific urban methodologies need to be designed. The project is planned to last for 2 years, including piloting of the tools in 3 different cities. A brief presentation of the project can be found at: Os_Guidance.pdf

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Sustainable sanitation for vulnerable peri-urban population: operational research study in Mongolia
Jean Lapgue, Senior WASH Advisor, ACF-France Approximately one third of the urban population in Mongolia still lives in Gers (yurts), where poverty is generally concentrated and the issue of hygiene and sanitation, in particular in Ulaan Baatars Ger areas is an emerging problem. Since 2009, ACF in Mongolia has implemented an operational research program that aims at experimenting sustainable water, sanitation and hygiene options for peri-urban yurt areas of Ulaan Baatar. Still, these techniques need to be further explored and scientifically documented. Thus, in continued partnership with the Centre for Sustainable Environmental Sanitation, University of Science and Technology Beijing (USTB), China, ACF is carrying on this important operational research project and extending it with a focus on the human excreta management chain in the urban context. The main objectives are to review ACF's practices and policies in place, identify and analyse opportunities and constraints for integrated programmes, to recommend practical steps for implementing integrated sanitation approaches and improve ACF WASH emergency programmes as well as rehabilitation and predevelopment approaches in the urban context. One PhD and six Master students will contribute to this project until 2014.

Ger area

Source : unknown

Rural urban linkages and impact on undernutrition

Morwenna Sullivan - Policy Advisor, ACF-UK There is no longer a clear cut distinction between rural and urban livelihoods; they are interconnected on many levels. Recognising that this rural-urban gap no longer exists, and that households often have one foot in the rural economy and another in the urban economy, implies that ACF needs to understand the system as a whole rather than focussing exclusively on the rural sector. It is clear that rural urban linkages and interactions play an increasingly significant role in local economies and in the livelihoods of a large number of people. Understanding the increasing spatial and occupational complexity of livelihoods is key if we want to ensure that activities intended to tackle the underlying causes of undernutrition are relevant to todays household. The research originally intended to examine the impact of rural urban linkages on undernutrition at the household level, to ascertain what these linkages mean and how they can contribute to addressing the underlying causes of undernutrition. However, following preliminary enquiry with experts on this subject and initial work on methodology, it was decided it would be impossible to cover all the potential causes of undernutrition in such a short time frame, with limited budget. As a result, the main research question was amended to include coping ability instead; the idea being that households with stronger rural urban links are better able to cope with shocks. The research examined four types of flows: people, goods, cash and information. The aim was to find out what type of links are most important for coping ability and further to determine the causal chain leading from stronger linkages to improved food security, dietary diversity and nutrition for under 5s. By finding answers to these questions, it should then be possible to assess how ACF can strengthen rural urban linkages for positive nutrition outcomes. Where are we now? We have completed one case study in Zimbabwe, and are in the process of writing up results. The second case study, in Conakry, Guinea is now underway. We expect to have draft reports available by the end of November.

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The right to water and social movements

Jean Lapgue - Senior WASH Advisor, ACF-France

The operational research project (Laboratory Techniques, Territories and Societies LATTS, CNRS, AFD), comes to an end in 2011: after finalizing the drafting of a publication in connection with the AFD (Agence Franaise du Dveloppement) on "Activism uses of the right to water and social policy in South Africa", Julie Aubriot will defend her thesis by the end of December 2011, after four years of collaboration with ACF. We thank her and wish to congratulate the quality of the work rendered, in a moving and always questioning humanitarian sector. In addition, her work will open the door to new and emerging thoughts on the future interest of "the rights-based approach", becoming a leverage increasingly used by many organizations of the growing civil society. The departure of Julie and the passionate debate initiated by this research will however, undoubtedly leave its mark as well as new paths within ACF: in March 2011, this research project allowed to identify 10 principles and five key actions to implement for use in operationalizing the right to water at the service of the activities in the sector "Water, Sanitation and Hygiene." One of them highlights the interest of raising awareness in the population about their right to a larger participatory and community approach and allowing for greater sustainability of WASH interventions in the most vulnerable populations. In addition, ACF-Spain is now working on the operationalization of the right to food. They have endorsed the Campaign Right to Food ( and have drafted a briefing paper on the right to food and ACF.

Since the beginning of this research project, and its premise, namely the work of Julie Aubriot on the right to water in emergencies for the WASH Cluster, the International Institutional Framework has progressed, with recognition in July 2010 of the United Nations, and in September 2010 of the World Council of Human Rights. This recognition, underlined by UNESCO at the th conference on the political process of the 6 World Water Forum (WWF) in Stockholm, August 2011, was in particular driven by the WWF in Istanbul (March 2010) where ACF coordinated the platform on the right to water. These developments, at both international level and at domestic policy level, show the accurate visionary approach of ACF on this topic. Finally, the positions taken by ACF in 2010, if they have unfortunately distanced ACF from the international debate, they have, in return, allowed Julie Aubriot to found an NGO (Waterlex) that is now a reference in the field and is a leading player in the WWF. Julie Aubriot is also currently employed by the World Water Council to th prepare the political positioning during the 6 WWF of March 2012. For information on right to food and ACF-Spains activities, contact Amador Gomez (

Scientific publications and communications linked to the research project "Right to water" Being edited - "Impacts of the trial Mazibuko, to a redefinition of the water service in Johannesburg? Effects of the use of rights activism and impact on access to water for urban poor - AFD Resort to the courts as a way of mobilizing new social movements in South Africa? The example of 'water wars in Soweto'. Aubriot Julie, LATTS, , ACF 2010

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3. Building long term resilience in populations most vulnerable to disasters

GIS: Pastoral Surveillance System
Frdric Ham - Disaster Risk Management and GIS Senior Advisor, ACF-Spain Participation in the CRAM (Crop and Rangeland Monitoring) Conference organised by the JRC (Joint Research Center), 26 - 30 September 2011, in Nairobi. Presented the ACF Pastoral Surveillance System. Two partnerships with universities emerging as new players: o Complutense University of Madrid for mounting a project for developing an information system and decision tool for managing disasters and human logistics. o University of Avignon + INRA for mounting a project related to the improved monitoring of biomass by remote sensing. One article published describing the pastoral surveillance system submitted to the United Nations International Strategy for Disaster Reduction (UNISDR): One horn of the cow: an innovative GIS-based surveillance and early warning system in pastoral areas of Sahel . Frdric Ham, Thierry Mtais, Patricia Hoorelbeke, Erwann Fillol, Amador Gomez and Philippe Crahay; Action contre la Faim International.

Biomass anomaly, rainy season 2009. West African

Source: ACF International and VITO

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How Climate Change is going to impact undernutrition: a research issue?

Sandrine Roussy - Disaster Risk Management Officer, ACF-France This question has been raised at the international level by Action contre la Faim, which has been one of the first NGOs to demonstrate the need to consider undernutrition in climate change issues (ACF initiated the publication of Climate Change and Nutrition Security in 2010, SCN). This question is currently being addressed by the SUNRAY consortium, Sustainable Nutrition Research for Africa in the Years to come, a consortium with which ACF has close links, and whose aim is to identify research needs on malnutrition in Africa. ACF, represented by Philippe Crahay (Former ACF France Climate Change and Disasters Officer), participated in 2011, in the SUNRAY sub-group working specifically on climate change issues; a group led by Christina Tirado, from the University of California-Los Angeles School of Public Health, Los Angeles, CA, U.S.A. The main conclusion and recommendations are the following: Research gaps: Whereas there is an understanding of some causal pathways leading to undernutrition, no single study analyzes the impacts and threats of climate change in Africa in a cross-sectoral manner. Some sectoral issues that shape nutrition security are overlooked, so is their interplay with undernutrition in the context of climate change. Consistent prediction models are missing regarding undernutrition in a changing climate context in Africa. Very few nutrition surveillance systems monitor climate-related factors in Africa e.g.; climate-related seasonality and increased undernutrition caseload as a consequence of climaterelated shocks.

Research needs on climate change, food and nutrition security and associated responses in Africa: Several areas of basic and applied research are suggested to better understand and address the impacts and threats of climate change on food and nutrition security in Africa: - Analyse food and nutrition security in a multisectoral, comprehensive manner, - study specific overlooked sectoral issues and their interplay with undernutrition/ nutrition security in the context of climate change, - provide consistent prediction model and data of undernutrition (wasting), - monitor the interplay between climate-related hazards (i.e. climate-related shocks, seasonality and trends) and food and nutrition security, and develop tailored early warning systems, - identify effective adaptation actions for food and nutrition security under a changing climate, - analyse and monitor the synergy opportunities and the threats of climate change mitigation measures on food and nutrition security, - identify and suggest how to strengthen institutional capacity and the policy framework. To know more about the report: Climate Change and Nutrition in Africa Focus on Sub-Saharan Africa, 2011, contact Sandrine Roussy.

More on the SUNRAY project:

Internal contact: Myriam Ait-Assa, ACF-France ( EXPECTED OUTCOME: the new nutrition research agenda will be translated into a strategic framework for decision makers. A roadmap document will summarize research opportunities, threats, strengths and gaps as well as resource requirements and linkages between African and Northern institutions COUNTRIES: Benin - South Africa - Tanzania Uganda - Mozambique Rwanda - Togo Launch: January 2011 and will run until December 2012. ter_01_english.pdf

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Evaluation of the impact and sustainability of ACF 15-year water supply interventions in Northern Rakhine State, Myanmar
Simon Potier, Masters thesis, Cranfield University Jean Lapgue - Senior WASH Advisor, ACF-France In Northern Rakhine State (NRS), Myanmar, the population faces extreme oppression from the authorities, resulting in a dramatic humanitarian situation. With 800 HPs installed in the past 15 years, ACF has been the main contributor in improving water supply situation. For the future of ACF and the WASH community, learning from ACF experience is an invaluable opportunity. The study is about analysing impact and sustainability of ACF water supply interventions on the population of NRS. Particularly, can the sustainability of water facilities be reached in such a non-enabling environment? With 57% of the HPs still being used, ACF extensively improved the drinking water coverage, reaching 18% of the population. ACF has shifted the good water source paradigm among the population from surface to groundwater; although it is rarely practiced, as safe water remains a secondary priority. It has also significantly improved the living conditions by providing water all year long, closer and of better quality. Lastly, sustainability mainly relies on presence of leadership and on community cohesion, which are factors undermined by the political framework. As a result, sustainability is very unlikely to be met in NRS in this context, if it is not accompanied by a strong continuous support from community-external organisations. Working on partnership with local organisations and implementing better management systems, which could be based on traditional social structures, are ways to increase this limited sustainability. Nonferrous water taste is also a crucial factor of HP use, implying the use of alternative technical solutions where it is not met. The study is to be finished by the end of September, before integrating the recommendations into the up-coming ACF proposal for the next 3 years in NRS.

M At-Assa / Myanmar 2009

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ACF participation in key scientific meetings
World Conference on Humanitarian Studies, Boston, 2 - 5 June 2011
Myriam Ait-Assa, ACF-France (

The Second World Conference on Humanitarian Studies (WCHS) took place 2 - 5 June 2011 in Boston. It was organized by the International Humanitarian Studies Associational (IHSA) and hosted by Tufts University, Medford, USA (in collaboration with Harvard University, Columbia University and the Social Science Research Council). Saul Guerrero (Action Against Hunger - UK) made a presentation on Measuring and maximizing efficacy, effectiveness, and coverage of nutritional rehabilitation programs and Mira Cuturilo (ACF-Canada) on SMART (Standardized Monitoring and Assessment of Relief and Transitions). The conference was a new step in gathering the scientific community around the understanding of the dynamics of societies in crisis, the resultant greater use of evidence based humanitarian programming and an increased professional approach to humanitarian work. Summaries of the panel presentations are available on request.

EC Joint Research Center conference on: Scientific Support for Food Security and Global Governance, Brussels, 28 September 2011
Myriam Ait-Assa, ACF-France (

The main objective of the conference was to examine from a scientific perspective the need to increase availability and access to food globally in a sustainable way. The conference identified and debated key questions relating to food security, with a specific focus on how science, technology and innovation can contribute to food for all. It also had a policy dimension as food security will remain high on the political agenda for the foreseeable future. This was a very interesting conference highlighting the importance of having Food at the top of the agendas of the international research institutions in the 20 coming years.

Nota Bene: Linked to this theme, ACF has an operational position. G20 SUMMIT, Call for Action: What the G20 should do to fight hunger and undernutrition?
Elise Rodriguez - Advocacy Officer, ACF-UK On September 15 , ACFIN, in coalition with Oxfam, Care International, World Vision and Helen Keller International, released a set of recommendations and expectations in the fields of food security and nutrition towards political decision-makers of the G20 Summit and the public. Building around the valuable contribution of the UK Hunger Alliance Tackling the high food price challenge: five recommendations from the UK Hunger Alliance to G20 Members (June, 2011), ACF and partners brought together expertise and knowledge to draft 7 recommendations highly relevant to the G20 agenda and outcomes of G20 meetings between June and September 2011. The main outcomes are the position paper, the publication of an advert in Le Monde, New York Times and Financial Times, and a website ( to disseminate and gather support from other organizations. In terms of advocacy, activities included a lobby letter sent to ten G20 countries plus the OECD and participation in meetings with French delegation and in G20 Sherpas and civil society meeting where we put forward our requests to 7 countries and the OECD. The recommendations include the full disbursement of previous funding commitments and continuity in providing financial support, and increased support for the development of nutrition sensitive policies with the inclusion of nutrition outcomes as indicators of success, as well as reinforcement of social protection, particularly safety nets. In relation to the G20 agenda, the FeedinG20 coalition called for transparent regulation of financial markets as a crucial step to address food price volatility; supporting the implementation of a cost-effective system of food reserves that goes beyond emergencies; and promoting coherence in the governance of food security and strengthening response mechanisms to agricultural markets information systems. Finally, we expressed our concern regarding the lack of any concrete commitment in the G20 for climate change mitigation and adaptation.

International Scientific Council Meeting

The bi-annual meeting of ACFs International Scientific Council took place on the 27 and 28 October, in Paris. This meeting focused on three main topics: discussion on a current scientific controversial issue, prevention of acute undernutrition; the Ethical guidelines for research and the ACF Research Strategy definition.
th th

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Other key scientific meetings attended in 2011:

3rd LIDC Seminar series: "What works in international development?" London International Development Center, 1st Forum DEFIS SUD, Paris, France URD (Urgence, Rhabilitation, Dveloppement) Conference: "La ville face aux crises" Paris, France 20th Scientific Day Epicentre/MSF, Paris, France, 35th WEDC international conference, UK, World water week, Stockholm, Sweden ILSI Europe: International symposium on health benefits of foods: from emerging science to innovative products, Prague, Czech Republic, WSSCC Global Forum on Sanitation and Hygiene, Mumbai, India Combatting Malnutrition through Sustainable Interventions: EU-ASEAN Relations as a Key Driver, Brussels, CMAM Conference: Scaling up Community Management of Acute Malnutrition and Scaling up Nutrition (SUN), Addis Ababa, Ethiopia,

Action contre la Faim: establishing links with the Food and Health European Research
Contact: Myriam Ait-Assa, ACF-France (

ACFs linkages with the European Scientific Community

Action contre la Faim participated several times in the French Groupe de Travail National (national work group) whose aim is to contribute to the definition of the European Commission Research Directorates orientations for Research. This participation highly contributed in 2011 to the funding of the SUNRAY project (cf article in previous section on research projects). ACFs Research Department has also established connections with European Commissions experts working in the field of Nutrition, Food and Water research.

ACF involvement in the European Forum on Agricultural Research for Development

Action contre la Faim is part of the European Forum on Agricultural Research for Development, EFARD. Founded in 1997 in Montpellier, EFARDs mission is to follow the principles of the Global Forum on Agricultural Research (GFAR), and contribute to its Global Plan of Action. More information:

Action contre la Faims Contribution to the FAHRE research project

ACF was invited to attend a conference of the FAHRE (Food and Health Research in Europe) consortium in February 2011 and to review their final report in October 2011. FAHRE aims to investigate how to improve the coordination of food and health research in Europe.
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FOCUS on one NEW Publication

ZERO HUNGER. Transforming evidence-based success into effective change
Morwenna Sullivan - Policy Advisor, ACFUK The Zero Hunger Project aimed at understanding why and how some countries have managed to reduce undernutrition, while others have not. The project began September 2010 and the publications were finalised and launched June 2011. Phase 1 reviewed the experience of five case study countries Brazil, Peru, Mozambique, Malawi and Bangladesh which have had relative success at bringing down rates of undernutrition to derive lessons and examples of good practice. Phase 2 examined the extent to which six success factors are relevant in Niger. Phase 3 highlights the relevance and potential of regional institutions and mechanisms to reduce hunger and malnutrition in West Africa. Key messages Undernutrition is not just an emergency issue; addressing it is clearly linked to poverty reduction. Fighting undernutrition must be put at the centre of the political agenda. Civil society participation in governance must be promoted. decision-making and

Tackling undernutrition requires a multi-phase and multisectoral approach. Existing nutrition institutions must be reinforced and strengthened in order to ensure effective institutionalised coordination. Continued, sustained financial support is a prerequisite for the success on the fight against undernutrition.

To download the publications: Zero Hunger Phase 1: Undernutrition: What Works Zero Hunger Phase 2: Undernutrition: Lessons from Niger Zero Hunger Phase 3: Achieving Regional Integration: The key to success for the fight against hunger in West Africa Zero Hunger: Transforming evidence-based success into effective change. An overview of the three phase Zero Hunger series

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News on ACF Research Tools

Caroline Sidi, Research Management Officer, ACF-France (

The improvement of ACF Scientific Knowledge Management is a priority for the Research Department. Caroline Sidi is in charge of the ACF scientific library. Please, do not hesitate to share and send your scientific articles to!

Myriam Ait-Assa, ACF-France (

Stphanie Andriamparany conducted a 4 months internship within the Research Department on Research positioning in NGOs: study and comparison . People from IRC-US/UK; Merlin, Micronutrient Initiative, MSF-Suisse, Epicentre, CRASH, Concern Worldwide, Oxfam-US, Save the Children-UK, SMRU have been interviewed. A report is available in French and will be translated in English. It appears that ACF is not badly positioned in terms of research organisations and investment compared to other NGOs. Results will be shared soon within ACF.


Myriam Ait-Assa, ACF France, (

A revision of the research organisation was done in 2010 by Myriam Ait-Assa, in collaboration with Laurence de Junneman, former Quality Manager. It led to the revision of the Research Guidelines. Caroline Sidi is in charge of the revision of the Tool Kit for research (description of research project management procedures, tools and check-lists). A draft already exists and will be shared with the teams (

Myriam Ait-Assa and Miltos Ladikas worked together on the first draft of the Ethical Guidelines for research. A new draft is being written following comments from the International Scientific Council members during the ISC meeting in October 2011.

M At-Assa / Myanmar

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Publications, surveys, reports, meetings, fora
Next key conferences:
o COP17, 28 November - 9 December, 2011, Durban, South Africa. ACF, together with the World Food Programme (WFP), UN Standing Committee on Nutrition (UNSCN) and the Public Health Institute (PHI), is organizing and facilitating a side-event on Nutrition and Climate Change: Making the Connection to Enhance Livelihood Resilience, Health and Women's Empowerment. Cash & Risk in Humanitarian operations, 5-6 December, 2011, Copenhagen, Denmark. The conference will be attended by Senior Food Security Technical Advisors from ACF-France and AAHUS; together they will be leading two of the workshops. 16 International Conference on AIDS and STIs in Africa (ICASA), 4-8 December, Addis Ababa, Ethiopia. An abstract has been submitted in collaboration with MDM (Medecin du Monde) for a potential presentation of the results from the recently conducted research project on the impact of Low Input Gardens (LIG) on HIV affected communities in Chipinge district, Eastern Zimbabwe. International Scientific Symposium on the Measurement of Food Deprivation and Undernutrition, FAO, 17-19 January, 2012 Rome, Italy. Abstracts have been submitted from ACF-France and ACFSpain. An abstract presenting the work on the impact of Low Input Gardens (LIG) on HIV affected communities in Chipinge district, Eastern Zimbabwe, and another abstract presenting the work on diet diversity and fresh food vouchers in Bolivia have already been accepted. World Nutrition Rio 2012, 27-30 April 2012, Rio de Janeiro, Brazil. A total of ten abstracts from the whole ACF network have been submitted on Nutrition and Food Security, all related to the projects detailed in this newsletter.

Some 2012 planned ACF Publications:

o Scientific publications on the Ready-to-Use Food project in Chad, and Climate Change and DRM issues have been submitted. New ones will be submitted in 2012. o Publication of Julie Aubriots PhD on: Right(s) to water and social movements. African examples.

We thank our scientific partners for their collaborations in 2011:

AgroParisTech, France IRD, France Tufts University, US Universit de Ghent, Belgium Center for Disease Control and Prevention (CDC), US London School of Hygiene and Tropical Medicine, UK National Institute of Research and Food Nutrition, Italy University of Sheffield, UK Universit de Montreal, Canada University College of London, UK University of Alcal, Spain Hpitaux de Genve, Switzerland CNRS/LATTS (Ecole des Mines), France University of Beijing, China Cranfield University, UK University of Zimbabwe, Zimbabwe CIRAD, France IDS, UK University of California, Davis, US Universit Paris 6, France 2iE, Burkina Faso UCLAN, UK Agropolis International, France Cdiz University, Spain Institute of Child Health, UK ..

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Date City, Country Conference Organiser or host Internet link International Scientific Symposium on Food & Nutrition Security Information: From valid measurement to effective decision-making 49th Annual National Conference of Indian Academy of Pediatrics: PEDICON 2012 Urban Food Security in Africa: Multidisciplinary Perspectives, Global Dimensions One Health Summit 2012 One Health - One Planet - One Future Risks and Opportunities

17-19 Jan

Rome, Italy


18-22 Jan 18 Feb 19-23 Feb

Gurgaon, India Oxford, UK Davos, Switzerland

Indian Academy of Pediatrics Oxford Food security Forum, Oxford University Global Risk Forum Davos

22 Feb 28-29 Feb 1-3 Mar 12-17 Mar 20-21 Mar

Brussels, Belgium New Delhi, India Paris, France Marseille, France London, UK Wageningen, The Netherlands Yale, New Haven, USA

The European Food Security Conference - Better Forum Europe farming for a sustainable European food suppply 3rd International Conference on M4D - Mobile Communication for Development 1st International conference on nutrition and growth 6th World Water Forum CIWEM'S 2012 CONFERENCE Water & Environment: Green Revolution: Are we there yet?

Kenes International Chartered Institution of Water and Environmental Management (CIWEM)

1-4 April 21-22 April 23-27 April 27-30 April 11-13 May 13-18 May JUNE 22-27 July 26-31 Aug

Agriculture in an Urbanizing Society: International Wageningen Univeristy and Conference on Multifunctional Agriculture and UrbanResearch Centre Rural Relations 9th Global Health & Innovation Conference Unite For Sight aids_conference.php

World Federation of Public Health Addis Ababa, 13th World Congress on Public Health Associations / Ethiopian Public Ethiopia Health Association World Public Health Nutrition Rio de Janeiro, Brazil World Nutrition Rio2012 Association / ABRASCO Resilient Cities 2012: 3rd World Congress on Cities ICLEI - Local Governments for Bonn, Germany and Adaptation to Climate Change Sustainability IWA World Congress on Water, Climate and Energy International Water Association Dublin, Ireland 2012 (IWA) Paris, France 21me journe scientifique Epicentre/MSF Epicentre /MSF Washington, USA XIX International AIDS Conference Sidaction Stockholm International Water Institute

Stockholm, Sweden World water week: water and global food security

4th International disaster and risk conference 26-30 Aug Davos, Switzerland IDRC Davos 2012:"Integrative Risk Management in a Global Risk Forum Davos Changing World-Pathways to a Resilient Society" Nutrition Society of South Africa (NSSA)/ 30 Sept - 04 Bloemfontein, South 5th African Nutrition Epidemiology Congress: Association for Dietetics in South Oct Africa Transforming the nutrition landscape in Africa Africa (ADSA) / Africa Nutrition Society (ANS) 4th world congress of Pediatric Gastroenterology, 14-18 Nov Taipei, Taiwan Hepatology and Nutrition 3-7 Dec New Delhi, India World Breastfeeding Conference 2012


R4D: Research4Development is the portal to DFID (Department for International Development) centrally funded research. It provides up-to-date information on DFID's current research portfolio. Farming First: a coalition of multi-stakeholder organisations, promotes programmes and activities to further sustainable agricultural development worldwide.

For further information or comments about this newsletter, please contact Myriam Ait-Assa: Action contre la Faim International /// Newsletter N /// December 2011 13 33