Intervention Co-creation to Improve Community-based Food Production and Household Nutrition in Small Island Developing States (ICoFaN)

联合国五分之一的成员是小岛屿发展中国家（SIDS）： 38个国家，人口总数为6100万。其中大多数是贫穷国家，有资格获得官方发展援助，超过四分之一是“最不发达”国家。它们的营养不良负担沉重，包括育龄妇女超重和肥胖以及贫血，另外一些国家，如海地，儿童发育迟缓的负担也很重。在过去30年里，小岛屿发展中国家的营养不良问题因越来越依赖粮食进口而加剧，而这些粮食大多数营养质量较低。小岛屿发展中国家政府已承诺增加当地营养食品的生产和消费，作为增加粮食安全和主权以及解决与营养不良有关的发病率和死亡率的沉重负担的一种方式。这项建议旨在增加证据基础和研究能力，以支持这些政策承诺。这项建议以南太平洋和西印度群岛大学在斐济和圣文森特和格林纳丁斯这两个小岛屿发展中国家合作开展的发展工作为基础。通过这项工作，制定了评估方法并收集了试点数据。此外，还与斐济的农村一体化和企业发展基金会和SVG的里士满谷学院这两个当地非常成熟的非政府组织建立了关系。在这项提议中，我们将与这两个非政府组织共同创建基于社区的干预措施，以改善当地的粮食生产和消费，并评估其对家庭营养和家庭支出的影响。将采用定量入户调查、定性深度小组访谈和照片语音等混合方法。这些干预措施的设计将以初步工作为依据，这些初步工作确定并评估了有关这些地区目前膳食摄入量的现有证据，以及当地生产的食品的营养价值。该设计还将通过“绘制”斐济和SVG的食物系统来提供信息。这将通过让整个食品价值链的利益攸关方参与包括研讨会在内的参与性进程来实现，在研讨会上，将得出导致营养不良负担的因素及其之间的关系。此外，除了在斐济和SVG充分发展和试验干预措施外，还将在海地开展新的工作。在海地，现有的饮食和营养证据也将被整理和评估，利益相关者将参与绘制粮食系统。将在海地尼普斯地区收集试点数据，包括关于家庭营养和增加家庭和小农粮食生产作为改善营养手段的机会的数据。这项工作将为准备进一步推出和评估的干预措施的设计提供信息。

One in five members of the United Nations are small island developing states (SIDS): 38 countries with a combined population of 61 million. The majority of these are poor, eligible for official development assistance, and over a quarter are 'least developed' countries. They have high burdens of malnutrition, including overweight and obesity alongside anaemia in women of reproductive age, and additionally some, such as Haiti, also have high burdens of childhood stunting. Over the past 3 decades malnutrition in SIDS has been exacerbated by an increasing reliance on food imports, the majority of which are of low nutritional quality. SIDS Governments have committed to increasing the local production and consumption of nutritious food as a way of increasing food security and sovereignty and addressing the high burden of malnutrition related morbidity and mortality. This proposal is intended to add to the evidence base and research capacity to support these policy commitments. The proposal builds on development work undertaken in partnership with the Universities of the South Pacific and West Indies in two SIDS: Fiji and St Vincent and the Grenadines (SVG) respectively. Through this work evaluation methods were developed and pilot data collected. In addition, relationships were established with two local and very well established NGOs, the Foundation for Rural Integration and Enterprise Development (FRIEND) in Fiji and Richmond Vale Academy in SVG. In this proposal we will co-create community based interventions to improve local food production and consumption with these two NGOs and evaluate their impacts on household nutrition and household expenditures. Mixed methods will be used, including quantitative household surveys, qualitative in-depth group interviews and photo voice. The design of the interventions will be informed by preliminary work that identifies and appraises available evidence on current dietary intakes in those settings, and the nutritional value of locally produced foods. The design will also be informed by 'mapping' the food systems in Fiji and SVG. This will be done by engaging stakeholders from across the food value chain in a participatory process, including a workshop, in which the factors, and the relationships between them, contributing to the burdens of malnutrition will be drawn. In addition, to the full development and testing of interventions in Fiji and SVG, new work will be undertaken in Haiti. In Haiti available dietary and nutritional evidence will also be collated and appraised, and stakeholders engaged in mapping the food system. Pilot data will be collected in the Nippes region of Haiti, including on household nutrition and the opportunities for increasing household and small holder food production as a means to improving nutrition. This work will inform the design of an intervention ready for further roll out and evaluation.