![[Feedback]](/icons/banner/feedbackACT.gif){kind=icon}
![[For Subscribers]](/icons/banner/subscriberACT.gif){kind=icon}
![[Archive]](/icons/banner/archiveACT.gif){kind=icon}
![[Search]](/icons/banner/searchACT.gif){kind=icon}
![[Contents]](/icons/banner/tocACT.gif){kind=icon}
|
|
|
|
|
||
4 Center for Evaluation Research and Surveys, National Institute of Public Health, Col. Santa María Ahuacatitlán, CP 62508, Cuernavaca, Morelos, Mexico and 5 Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853
* To whom correspondence should be addressed. E-mail: jleroy{at}correo.insp.mx.
 |
ABSTRACT |
|---|
 TOP ABSTRACT LITERATURE CITED |
|---|
Improving the delivery and utilization of health and nutrition programs depends on the behaviors of policy makers, program planners and implementers, markets, and civil society and front-line health providers but also on the behaviors of households and individuals and the support they receive from their families and communities (see Fig. 1 for examples of key actors at the different stages between program design and health impact). Research focused on delivery and utilization of programs and services can shed light on these processes and build an evidence base to inform decisions about the best options for delivering key interventions. The kind of research needed requires perspectives from disciplines as wide ranging as organizational behavior, household economics, anthropology, and policy sciences, to name a few.
|
The knowledge to fully unleash the potential of existing and newly designed efficacious nutrition interventions will only come from concerted efforts at studying factors that influence delivery and utilization of these interventions in a variety of contexts. Therefore, the symposium aimed to 1) explore our knowledge of factors that affect the delivery and utilization of nutrition interventions; 2) demonstrate conceptual and methodological approaches for studying factors influencing program delivery and utilization; and 3) highlight questions that call for further investigation in the coming years. In these proceedings, 6 articles are presented that illuminate a variety of issues and research questions pertaining to program research on delivery and utilization. Marsh et al. (11) present a comprehensive framework for program design, planning, and evaluation. Menon et al. (12) discuss the importance of assessing organizational roles in the context of a program evaluation in Haiti. Leroy et al. (13) review the enrollment and utilization of Oportunidades, Mexico's conditional cash transfer program. Winch et al. (14) present research on the community response to the introduction of zinc and combination therapy in southern Mali. Finally, Garrett (15) comments on the symposium presentations and proposes an agenda for future research on program delivery and utilization.
|
FOOTNOTES |
|---|
2 Author disclosures: J. L. Leroy and P. Menon, no conflicts of interest.
3 Supported by the American Society for Nutrition; Mainstreaming Nutrition Initiative.
|
LITERATURE CITED |
|---|
|
TOPABSTRACTLITERATURE CITED |
|---|
1. Pelletier DL, Frongillo EA Jr, Habicht JP. Epidemiologic evidence for a potentiating effect of malnutrition on child mortality. Am J Public Health. 1993;83:1130–3.
2. Fishman SM, Caulfield LE, de Onis M, Blossner M, Hyder AA, Mullany L, Black RE. Childhood and maternal underweight. In: Ezzati M, Lopez AD, Rodgers A, Murray CJL, editors. Comparative quantification of health risks: the global and regional burden of disease attributable to selected major risk factors. Geneva: World Health Organization; 2004. p. 39–161.
3. Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS. How many child deaths can we prevent this year? Lancet. 2003;362:65–71.[Medline]
4. Walker SP, Wachs TD, Gardner JM, Lozoff B, Wasserman GA, Pollitt E, Carter JA. Child development: risk factors for adverse outcomes in developing countries. Lancet. 2007;369:145–57.[Medline]
5. Shekar M, Heaver R, Lee Y-K. World Bank. Repositioning nutrition as central to development: a strategy for large scale action. Washington, DC: World Bank; 2006.
6. Bryce J, el Arifeen S, Pariyo G, Lanata C, Gwatkin D, Habicht JP. Reducing child mortality: can public health deliver? Lancet. 2003;362:159–64.[Medline]
7. Victora CG, Wagstaff A, Schellenberg JA, Gwatkin D, Claeson M, Habicht JP. Applying an equity lens to child health and mortality: more of the same is not enough. Lancet. 2003;362:233–41.[Medline]
8. Leroy JL, Habicht JP, Pelto G, Bertozzi SM. Current priorities in health research funding and lack of impact on the number of child deaths per year. Am J Public Health. 2007;97:219–23.
9. Woolf SH, Johnson RE. The break-even point: when medical advances are less important than improving the fidelity with which they are delivered. Ann Fam Med. 2005;3:545–52.
10. Bennett S. What is health policy and systems research and why does it matter? Briefing note 1. Geneva: Alliance for Health Policy and Systems Research, World Health Organization; June 2007.
11. Marsh DR, Alegre JC, Waltensperger KZ. A results framework serves both program design and delivery science. J Nutr. 2008;138:630–3.
12. Menon P, Mbuya M, Habicht JP, Pelto G, Loechl CU, Ruel MT. Assessing supervisory and motivational factors in the context of a program evaluation in rural Haiti. J Nutr. 2008;138:634–7.
13. Leroy JL, Vermandere H, Neufeld LM, Bertozzi SM. Improving enrollment and utilization of the Oportunidades program in Mexico could increase its effectiveness. J Nutr. 2008;138:638–41.
14. Winch PJ, Doumbia S, Kanté M, Malé AD, Swedberg E, Gilroy KE, Ellis AA, Cissé G, Sidibé B. Differential community response to introduction of zinc for childhood diarrhea and combination therapy for malaria in southern Mali. J Nutr. 2008;138:642–5.
15. Garrett JL. Improving results for nutrition: a commentary on an agenda and the need for implementation research. J Nutr. 2008;138:646–50.
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
