Rolf Klemm
Datos Biográficos
| ID | 4509553 |
|---|---|
| NOMBRE | Rolf Klemm |
| NOMBRES | Rolf |
| APELLIDO | Klemm |
| FIRMA | KLEMM R |
| AFILIACIONES | Helen Keller International |
| ORCID | 0000-0002-8423-1943 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 19 |
| TOTAL DE CITAS | 3 |
| TOTAL COMO AUTOR | 19 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2009 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2024 |
| ÍNDICE H | 1 |
Impact of Suaahara , an integrated nutrition programme, on maternal and child nutrition at scale in Nepal
Suaahara was an innovative, complex, multi-sectoral, large-scale, nutrition programme in Nepal to increase exposure to nutrition-related information and services, improve nutrition-related knowledge and practices among pregnant women and mothers of infants and young children, and improve their nutrition. This study evaluated the effectiveness of Suaahara to improve nutrition and nutrition-related practices by comparing changes over 10 years betwe…
Engaging men in maternal, infant and young child nutrition in rural Tanzania
There is growing recognition that engaging men in maternal, infant and young child nutrition (MIYCN) interventions can benefit child health and disrupt harmful gender norms. We conducted a cluster-randomized controlled trial in Tanzania, which engaged men and women in behaviour change via mobile messaging (short message service [SMS]) and traditional interpersonal communication (IPC), separately and in combination. Here, we evaluate intervention …
Between the city and the farm
Objective: Artisanal and small-scale mining (ASM) is a widespread livelihood in low- and middle-income countries; however, many in ASM communities face high levels of poverty and malnutrition. The food environments in ASM communities have non-agricultural rural characteristics that differ from those in urban and agricultural rural areas examined in much existing food environment literature. Design: We examine these complex external and personal f…
Assessing the challenges to women’s access and implementation of text messages for nutrition behaviour change in rural Tanzania
Objective: This process evaluation aimed to understand factors affecting the implementation of a government-sponsored short message service (SMS) programme for delivering nutrition information to rural populations, including message access, acceptability and putting messages into action. Design: The study was nested within a larger randomised controlled trial. Cross-sectional data collection included structured surveys and in-depth interviews. Da…
Refocusing vitamin A supplementation programmes to reach the most vulnerable
WHO recommends vitamin A supplementation (VAS) programmes for children 6–59 months where vitamin A deficiency is a public health problem. However, resources for VAS are falling short of current needs and programme coverage is suffering. The authors present the case for considering the options for shifting efforts and resources from a generalised approach, to prioritising resources to reach populations with continued high child mortality rates and…
Thinness and fecundability
Undernutrition may affect fecundability, but few studies have quantified this relationship. In rural Bangladesh, where newlywed couples face strong pressures to become pregnant, we assessed fecundability, estimated by time to pregnancy (TTP), and its association with preconceptional thinness among nulligravid, newlywed female adolescents. During 2001-2002, 5,516 newlywed women aged 12-19 years participated in a home-based, 5-weekly surveillance s…
Household food insecurity is associated with low dietary diversity among pregnant and lactating women in rural Malawi
Objective To examine the association between household food insecurity and dietary diversity in the past 24h (dietary diversity score (DDS, range: 0–9); minimum dietary diversity (MDD, consumption of three or more food groups); consumption of nine separate food groups) among pregnant and lactating women in rural Malawi. Design Cross-sectional study. Setting Two rural districts in Central Malawi. Subjects Pregnant ( n 589) and lactating ( n 641) w…
Implementing small‐scale poultry‐for‐nutrition projects
This paper examines Helen Keller International's model for nutrition-sensitive poultry production using a programme implemented in four diverse African contexts-three rural and one urban. Consecutive cross-sectional surveys conducted every 5 months among ~15% of participating households show that despite project-provided training and inputs, there was only limited uptake of many "best practices." Few households constructed improved henhouses; vac…
Improving maternal, infant and young child nutrition in Nepal via peer mobilization
Objective To evaluate the impact of a peer facilitator (PF) approach for improving mothers’ knowledge and practices relating to maternal and child nutrition. Design A quasi-experimental design nested within a large-scale integrated nutrition programme, Suaahara , in Nepal. Suaahara interventions were implemented in all study sites, but peer facilitators were used in only half of the study sites. Setting Rural, disadvantaged villages in three dist…
Suaahara in Nepal
The burden of undernutrition in South Asia is greater than anywhere else. Policies and programmatic efforts increasingly address health and non-health determinants of undernutrition. In Nepal, one large-scale integrated nutrition program, Suaahara, aimed to reduce undernutrition among women and children in the 1,000-day period, while simultaneously addressing inequities. In this study, we use household-level process evaluation data (N = 480) to a…
Individual, household, and community level risk factors of stunting in children younger than 5 years
Despite substantial reductions in recent years in Nepal, stunting prevalence in children younger than 5 years remains high and represents a leading public health concern. To identify factors contributing to the stunting burden, we report multilevel risk factors associated with stunting in 4,853 children aged 6-59 months in a nationally and agroecologically representative random sample from the first year of the Policy and Science for Health, Agri…
Experiences and lessons learned for planning and supply of micronutrient powders interventions
Realistic planning for a nutrition intervention is a critical component of implementation, yet effective approaches have been poorly documented. Under the auspices of "The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance," 3 working groups were formed to summarize experiences and lessons across countries regarding micronutrient powders (MNP) interventions for young children. This paper focuses on programmatic experienc…
Risk of Depressive Symptoms Associated with Morbidity in Postpartum Women in Rural Bangladesh
Determinants of successful vitamin A supplementation coverage among children aged 6–59 months in thirteen sub-Saharan African countries
Objective Vitamin A supplementation (VAS) for children aged 6–59 months occurs regularly in most sub-Saharan African countries. The present study aimed to explore child, household and delivery platform factors associated with VAS coverage and identify barriers to compliance in thirteen African countries. Design We pooled data ( n ~60 000) from forty-four household coverage surveys and used bivariate and multivariable regression analyses to assess…
Availability of emergency obstetric care (EmOC) among public and private health facilities in rural northwest Bangladesh
Although EmOC availability and readiness was higher among the surveyed seven most commonly visited private clinics, public facilities appeared to be more affordable for C-section and more geographically accessible. Strategies to retain anesthesiologists and surgeons, such as non-financial incentives, are needed to improve EmOC provision in the public sector. Centralized blood banks are recommended to streamline safe blood acquisition for obstetri…
Preferred Delivery Method and Acceptability of Wheat-Soy Blend (WSB++) as a Daily Complementary Food Supplement in Northwest Bangladesh
Fortified blended foods (FBFs) are widely used to prevent undernutrition in early childhood in food-insecure settings. We field tested enhanced Wheat Soy Blend (WSB++)-a FBF fortified with micronutrients, milk powder, sugar, and oil-in preparation for a complementary food supplement (CFS) trial in rural northwestern Bangladesh. Formative work was conducted to determine the optimal delivery method (cooked vs. not) for this CFS, to examine mothers'…
Low‐birthweight rates higher among B angladeshi neonates measured during active birth surveillance compared to national survey data
Birth size is an important gauge of fetal and neonatal health. Birth size measurements were collected within 72 h of life for 16 290 live born, singleton infants in rural Bangladesh from 2004 to 2007. Gestational age was calculated based on the date of last menstrual period. Newborns were classified as small-for-gestational age (SGA) based on a birthweight below the 10th percentile for gestational age, using three sets of US reference data. Birth…
Epidemiology of tornado destruction in rural northern Bangladesh
The epidemiology of tornado-related disasters in the developing world is poorly understood. An August 2005 post-tornado cohort study in rural Bangladesh identified elevated levels of death and injury among the elderly (≥ 60 years of age) (adjusted odds ratio (AOR) = 8.9 (95 per cent confidence interval (CI): 3.9-20.2) and AOR = 1.6 (95 per cent CI: 1.4-1.8), respectively), as compared to 15-24 year-olds, and among those outdoors versus indoors du…
Difference in ponderal growth and body composition among pregnant vs. never-pregnant adolescents varies by birth outcomes
Recently, we showed that following pregnancy and 6 months of lactation, adolescents cease linear growth and have reduced fat and lean mass in rural Bangladesh. Here, we examined whether these changes varied by pregnancy outcomes such as fetal loss, low birthweight (LBW) and neonatal mortality. Anthropometric measurements were taken among 12-19-year-old primigravidae (n = 229) in early pregnancy and at 6 months post-partum. Never-pregnant adolesce…
Epidemiology of tornado destruction in rural northern Bangladesh
The epidemiology of tornado-related disasters in the developing world is poorly understood. An August 2005 post-tornado cohort study in rural Bangladesh identified elevated levels of death and injury among the elderly (≥ 60 years of age) (adjusted odds ratio (AOR) = 8.9 (95 per cent confidence interval (CI): 3.9-20.2) and AOR = 1.6 (95 per cent CI: 1.4-1.8), respectively), as compared to 15-24 year-olds, and among those outdoors versus indoors du…
Difference in ponderal growth and body composition among pregnant vs. never-pregnant adolescents varies by birth outcomes
Recently, we showed that following pregnancy and 6 months of lactation, adolescents cease linear growth and have reduced fat and lean mass in rural Bangladesh. Here, we examined whether these changes varied by pregnancy outcomes such as fetal loss, low birthweight (LBW) and neonatal mortality. Anthropometric measurements were taken among 12-19-year-old primigravidae (n = 229) in early pregnancy and at 6 months post-partum. Never-pregnant adolesce…
Epidemiology of tornado destruction in rural northern Bangladesh
The epidemiology of tornado-related disasters in the developing world is poorly understood. An August 2005 post-tornado cohort study in rural Bangladesh identified elevated levels of death and injury among the elderly (≥ 60 years of age) (adjusted odds ratio (AOR) = 8.9 (95 per cent confidence interval (CI): 3.9-20.2) and AOR = 1.6 (95 per cent CI: 1.4-1.8), respectively), as compared to 15-24 year-olds, and among those outdoors versus indoors du…
Low‐birthweight rates higher among B angladeshi neonates measured during active birth surveillance compared to national survey data
Birth size is an important gauge of fetal and neonatal health. Birth size measurements were collected within 72 h of life for 16 290 live born, singleton infants in rural Bangladesh from 2004 to 2007. Gestational age was calculated based on the date of last menstrual period. Newborns were classified as small-for-gestational age (SGA) based on a birthweight below the 10th percentile for gestational age, using three sets of US reference data. Birth…
Availability of emergency obstetric care (EmOC) among public and private health facilities in rural northwest Bangladesh
Although EmOC availability and readiness was higher among the surveyed seven most commonly visited private clinics, public facilities appeared to be more affordable for C-section and more geographically accessible. Strategies to retain anesthesiologists and surgeons, such as non-financial incentives, are needed to improve EmOC provision in the public sector. Centralized blood banks are recommended to streamline safe blood acquisition for obstetri…
Preferred Delivery Method and Acceptability of Wheat-Soy Blend (WSB++) as a Daily Complementary Food Supplement in Northwest Bangladesh
Fortified blended foods (FBFs) are widely used to prevent undernutrition in early childhood in food-insecure settings. We field tested enhanced Wheat Soy Blend (WSB++)-a FBF fortified with micronutrients, milk powder, sugar, and oil-in preparation for a complementary food supplement (CFS) trial in rural northwestern Bangladesh. Formative work was conducted to determine the optimal delivery method (cooked vs. not) for this CFS, to examine mothers'…
Suaahara in Nepal
The burden of undernutrition in South Asia is greater than anywhere else. Policies and programmatic efforts increasingly address health and non-health determinants of undernutrition. In Nepal, one large-scale integrated nutrition program, Suaahara, aimed to reduce undernutrition among women and children in the 1,000-day period, while simultaneously addressing inequities. In this study, we use household-level process evaluation data (N = 480) to a…
Individual, household, and community level risk factors of stunting in children younger than 5 years
Despite substantial reductions in recent years in Nepal, stunting prevalence in children younger than 5 years remains high and represents a leading public health concern. To identify factors contributing to the stunting burden, we report multilevel risk factors associated with stunting in 4,853 children aged 6-59 months in a nationally and agroecologically representative random sample from the first year of the Policy and Science for Health, Agri…
Experiences and lessons learned for planning and supply of micronutrient powders interventions
Realistic planning for a nutrition intervention is a critical component of implementation, yet effective approaches have been poorly documented. Under the auspices of "The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance," 3 working groups were formed to summarize experiences and lessons across countries regarding micronutrient powders (MNP) interventions for young children. This paper focuses on programmatic experienc…
Risk of Depressive Symptoms Associated with Morbidity in Postpartum Women in Rural Bangladesh
Determinants of successful vitamin A supplementation coverage among children aged 6–59 months in thirteen sub-Saharan African countries
Objective Vitamin A supplementation (VAS) for children aged 6–59 months occurs regularly in most sub-Saharan African countries. The present study aimed to explore child, household and delivery platform factors associated with VAS coverage and identify barriers to compliance in thirteen African countries. Design We pooled data ( n ~60 000) from forty-four household coverage surveys and used bivariate and multivariable regression analyses to assess…
Implementing small‐scale poultry‐for‐nutrition projects
This paper examines Helen Keller International's model for nutrition-sensitive poultry production using a programme implemented in four diverse African contexts-three rural and one urban. Consecutive cross-sectional surveys conducted every 5 months among ~15% of participating households show that despite project-provided training and inputs, there was only limited uptake of many "best practices." Few households constructed improved henhouses; vac…
Improving maternal, infant and young child nutrition in Nepal via peer mobilization
Objective To evaluate the impact of a peer facilitator (PF) approach for improving mothers’ knowledge and practices relating to maternal and child nutrition. Design A quasi-experimental design nested within a large-scale integrated nutrition programme, Suaahara , in Nepal. Suaahara interventions were implemented in all study sites, but peer facilitators were used in only half of the study sites. Setting Rural, disadvantaged villages in three dist…
Household food insecurity is associated with low dietary diversity among pregnant and lactating women in rural Malawi
Objective To examine the association between household food insecurity and dietary diversity in the past 24h (dietary diversity score (DDS, range: 0–9); minimum dietary diversity (MDD, consumption of three or more food groups); consumption of nine separate food groups) among pregnant and lactating women in rural Malawi. Design Cross-sectional study. Setting Two rural districts in Central Malawi. Subjects Pregnant ( n 589) and lactating ( n 641) w…
Refocusing vitamin A supplementation programmes to reach the most vulnerable
WHO recommends vitamin A supplementation (VAS) programmes for children 6–59 months where vitamin A deficiency is a public health problem. However, resources for VAS are falling short of current needs and programme coverage is suffering. The authors present the case for considering the options for shifting efforts and resources from a generalised approach, to prioritising resources to reach populations with continued high child mortality rates and…
Thinness and fecundability
Undernutrition may affect fecundability, but few studies have quantified this relationship. In rural Bangladesh, where newlywed couples face strong pressures to become pregnant, we assessed fecundability, estimated by time to pregnancy (TTP), and its association with preconceptional thinness among nulligravid, newlywed female adolescents. During 2001-2002, 5,516 newlywed women aged 12-19 years participated in a home-based, 5-weekly surveillance s…
Between the city and the farm
Objective: Artisanal and small-scale mining (ASM) is a widespread livelihood in low- and middle-income countries; however, many in ASM communities face high levels of poverty and malnutrition. The food environments in ASM communities have non-agricultural rural characteristics that differ from those in urban and agricultural rural areas examined in much existing food environment literature. Design: We examine these complex external and personal f…
Assessing the challenges to women’s access and implementation of text messages for nutrition behaviour change in rural Tanzania
Objective: This process evaluation aimed to understand factors affecting the implementation of a government-sponsored short message service (SMS) programme for delivering nutrition information to rural populations, including message access, acceptability and putting messages into action. Design: The study was nested within a larger randomised controlled trial. Cross-sectional data collection included structured surveys and in-depth interviews. Da…
Engaging men in maternal, infant and young child nutrition in rural Tanzania
There is growing recognition that engaging men in maternal, infant and young child nutrition (MIYCN) interventions can benefit child health and disrupt harmful gender norms. We conducted a cluster-randomized controlled trial in Tanzania, which engaged men and women in behaviour change via mobile messaging (short message service [SMS]) and traditional interpersonal communication (IPC), separately and in combination. Here, we evaluate intervention …
Impact of Suaahara , an integrated nutrition programme, on maternal and child nutrition at scale in Nepal
Suaahara was an innovative, complex, multi-sectoral, large-scale, nutrition programme in Nepal to increase exposure to nutrition-related information and services, improve nutrition-related knowledge and practices among pregnant women and mothers of infants and young children, and improve their nutrition. This study evaluated the effectiveness of Suaahara to improve nutrition and nutrition-related practices by comparing changes over 10 years betwe…
Medicine (18 obras) · Child Nutrition and Water Access (14 obras) · Environmental health (12 obras) · Nursing (9 obras) · Global Maternal and Child Health (7 obras) · Population (7 obras) · Demography (6 obras) · Demography (6 obras) · Geography (6 obras) · Psychological intervention (6 obras)