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Addressing Undernutrition in the Context of Urbanisation in Low- and Middle-income Countries

Urbanisation presents a set of challenges and opportunities for tackling undernutrition in low- and middle-income countries where the United Kingdom’s Department for International Development (DFID) works. This evidence review considers the scale of urbanisation in these countries, appraises what works in urban settings and how this context differs from the rural context with regard to nutrition programming, and identifies the main evidence gaps.

This report gives contextual information describing the projected increase in urbanisation and urban nutrition statistics, as well as urban-specific diet and food security considerations.

The literature on programming is described in the following areas:

  • Strengthening policy and planning
  • Nutrition-specific programming
  • Nutrition-sensitive health programming
  • Nutrition-sensitive agriculture programming
  • Equity and resilience
  • Physical environment

Priority research activities to address identified gaps include:

  • Mapping existing programmes, policies and bodies that support resilient urban food security.
  • Developing and testing a toolkit for urban vulnerability assessment, and applying this toolkit in varied urban contexts to develop an understanding of how to identify slow onset urban emergencies.
  • Exploring (a) differences in nutrition-specific programme approaches for urban/peri-urban versus rural areas and (b) features of effective nutrition interventions in urban/peri-urban settings.
  • Testing the effectiveness of integration models for nutrition-sensitive health, agriculture and water, sanitation and hygiene (WASH) programming.
  • Exploring equity dynamics, and specifically the interplay between gender, poverty and undernutrition in urban areas.
  • Exploring the source of food prepared by street vendors and how this affects others’ livelihoods.
  • Undertaking WASH programme evaluations which incorporate nutrition outcome indicators.

A technical brief summarising this report is also available.