{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:49:52Z","timestamp":1777639792125,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2007,3,1]],"date-time":"2007-03-01T00:00:00Z","timestamp":1172707200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Food Nutr Bull"],"published-print":{"date-parts":[[2007,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Two large-scale studies, the National Surveillance System (NSS) Pilot Study (2003\u20132004) and the National Risk and Vulnerability Assessment (NRVA) 2003, were conducted by government, United Nations, and nongovernmental organizations in Afghanistan, as part of wider efforts characterizing Afghan livelihoods in relation to particular outcomes of interest: vulnerability to poverty, food insecurity, and malnutrition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To present the data from these two surveys with nutrition as the key outcome of interest, and to further construct the understanding of the underlying causes of malnutrition, thus providing public health practitioners and other sector specialists with insight into how a variety of sectoral programs can impact nutritional outcomes in Afghanistan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The NSS gathered information on livelihoods, food security, and nutrition from 20 to 40 randomly selected households in each of 26 purposively selected sentinel sites (representative of livelihood zones) during November\u2013December 2003 and May\u2013June 2004. The NRVA gathered information nationally from households selected with a two-stage sampling (based on livelihood zone and then socioeconomic group) during July\u2013September 2004.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Acute malnutrition is below emergency levels for children under five. The level of chronic malnutrition in children under five indicates a problem of public health importance. Dietary diversity in Afghanistan is not as low as expected but still shows room for improvement, particularly in remote areas and with respect to food groups associated with adequate micronutrient intake. The findings also suggest that in addition to lack of adequate household food intake, recurrent illness and suboptimal infant and young child feeding and hygiene practices contribute to poor nutritional outcomes in this age group. The survey also found poor access to health care, markets, and water for household use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Improving nutritional status requires a multipronged approach, directly targeting malnutrition, coupled with economic growth, household livelihood security, social protection, access to public health services, and water and sanitation. Nutrition policy, programming, and monitoring need to reflect the immediate and underlying causes of malnutrition. Future research needs to be designed to quantify the relative contribution of underlying causes of poor nutrition, allowing practitioners to prioritize responses aimed at improving nutritional outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/156482650702800101","type":"journal-article","created":{"date-parts":[[2015,11,25]],"date-time":"2015-11-25T16:05:38Z","timestamp":1448467538000},"page":"3-17","source":"Crossref","is-referenced-by-count":22,"title":["Nutritional Status in Postconflict Afghanistan: Evidence from the National Surveillance System Pilot and National Risk and Vulnerability Assessment"],"prefix":"10.1177","volume":"28","author":[{"given":"Wendy A.","family":"Johnecheck","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane E.","family":"Holland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2007,3,1]]},"reference":[{"key":"bibr1-156482650702800101","volume-title":"National risk and vulnerability assessment 2003: A stakeholder-generated methodology","author":"Pinney A","year":"2004"},{"key":"bibr2-156482650702800101","volume-title":"Light footprints at the crossroads: Learning from responses to food insecurity in Afghanistan?","author":"Johnecheck W","year":"2006"},{"key":"bibr3-156482650702800101","volume-title":"Predicting childhood stunting and wasting in the transitional Islamic State of Afghanistan with 2003\u20132004 National Surveillance System Data","author":"Kaplan Ramage A","year":"2004"},{"key":"bibr4-156482650702800101","volume-title":"U.S. Department of Agriculture. Food Composition Tables for the Near East","author":"Food and Agriculture Organization","year":"1982"},{"key":"bibr5-156482650702800101","volume-title":"Report on findings from the 2003 National Risk and Vulnerability Assessment (NRVA) in rural Afghanistan","author":"World Food Programme, Ministry of Rural Rehabilitation and Development","year":"2004"},{"key":"bibr6-156482650702800101","unstructured":"USAID Famine Early Warning System Network, Ministry of Rural Rehabilitation and Development, Ministry of Agriculture and Animal Husbandry, Ministry of Health, World Food Programme, Food and Agriculture Organization. What are rural Afghans eating: Insights from the NRVA 2003. Available at: http:\/\/mrrd.gov.af\/vau\/NRVA%2003%20Downloads\/AFSN%20Bulletin%20April%2004.pdf. Accessed 17 December 2006."},{"key":"bibr7-156482650702800101","volume-title":"Dietary diversity as a household food security indicator","author":"Hoddinott J","year":"2002"},{"key":"bibr8-156482650702800101","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.21.2723"},{"key":"bibr9-156482650702800101","volume-title":"Nutrition anthropometric survey summary report, Sang Charak, Sar-e-Pul Province","author":"Action Contre la Faim","year":"2002"},{"key":"bibr10-156482650702800101","doi-asserted-by":"crossref","DOI":"10.1596\/8522","volume-title":"Afghanistan poverty, vulnerability and social protection: An initial assessment. Human Development Unit. Report No. 29694-AF","author":"World Bank","year":"2005"},{"key":"bibr11-156482650702800101","volume-title":"Tchachnyak Province: National Surveillance System","author":"Ministry of Rural Rehabilitation and Development, Ministry of Agriculture and Animal Husbandry, Ministry of Health, Save the Children\u2013US","year":"2004"},{"key":"bibr12-156482650702800101","volume-title":"Afghanistan in crisis?","author":"Dufour C","year":"2005"},{"key":"bibr13-156482650702800101","volume-title":"Summary Report of the National Nutrition Survey Afghanistan, 2004","author":"Ministry of Public Health of the Islamic Republic of Afghanistan, UNICEF, Centers for Disease Control and Prevention, National Institution for Research on Food and Nutrition, Tufts University","year":"2005"},{"key":"bibr14-156482650702800101","volume-title":"Nutrition and Mortality Survey, Panjsheer Valley\u2013Shamali Plains, March\u2013April 2002","author":"Action Contre la Faim","year":"2002"},{"key":"bibr15-156482650702800101","volume-title":"Nutritional Anthropometric Survey, children under 5 years old, Mazar e Sharif, Afghanistan. August 2002","author":"Action Contre la Faim","year":"2002"},{"key":"bibr16-156482650702800101","volume-title":"Malnutrition and Mortality in Kohistan District, Afghanistan, April 4\u201310 2001. Pakistan\/Afghanistan Field Office","author":"Save the Children\u2013US, Centers for Disease Control and Prevention","year":"2001"},{"key":"bibr17-156482650702800101","volume-title":"Nutrition and Health Survey, Maslakh IDPs Camp, Herat, Afghanistan, April 2002","author":"UNICEF","year":"2002"},{"key":"bibr18-156482650702800101","volume-title":"Nutritional Anthropometric Screening of Returnee Children under 5 at Pul E Charki Encashment Centre, July. 2003","author":"Action Contre la Faim","year":"2003"},{"key":"bibr19-156482650702800101","volume-title":"Public Nutrition Department. Public Nutrition Policy and Strategy 2003\u20132006","author":"Ministry of Public Health of the Islamic Republic of Afghanistan","year":"2003"},{"key":"bibr20-156482650702800101","volume-title":"Nutrition and Mortality Survey, Kabul City, Afghanistan, March 2001","author":"Action Contre la Faim","year":"2001"},{"key":"bibr21-156482650702800101","volume-title":"Nutrition and Mortality Survey in Panjsheer Valley, March 2001","author":"Action Contre la Faim","year":"2001"},{"key":"bibr22-156482650702800101","volume-title":"Nutritional Anthropometric Survey, Afghanistan. Southern Kapisa. Children under 5 years. August 2003","author":"Action Contre la Faim","year":"2003"},{"key":"bibr23-156482650702800101","volume-title":"Progress of provinces: Multiple Indicator Cluster Survey","author":"Central Statistical Office of the Islamic Republic of Afghanistan (CSO)\/UNICEF","year":"2003"},{"key":"bibr24-156482650702800101","volume-title":"Re-thinking rural livelihoods in Afghanistan","author":"Grace J","year":"2004"},{"key":"bibr25-156482650702800101","unstructured":"Pain A. Livelihoods under stress in Faryab Province. Save the Children\u2013US, 2001. Available at: www.areu.org.af\/index.php?option=com_docman&Itemid=&task=doc_download&gid=319. Accessed 17 December 2006."},{"key":"bibr26-156482650702800101","volume-title":"Breastfeeding and weaning beliefs and practices in parts of northern Afghanistan (Andkhoy, Khancharbagh, Qaramqul, and Qurghan districts, Jawsjan Province)","author":"Save the Children\u2013US","year":"2003"},{"key":"bibr27-156482650702800101","volume-title":"Anthropometric nutrition survey, Mazar City, Afghanistan. March 2002","author":"Action Contre la Faim","year":"2002"},{"key":"bibr28-156482650702800101","volume-title":"Nutrition Report in Andkhoy District","author":"Save the Children\u2013US","year":"2003"}],"container-title":["Food and Nutrition Bulletin"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/156482650702800101","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/156482650702800101","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:14:32Z","timestamp":1777443272000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/156482650702800101"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,3]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2007,3]]}},"alternative-id":["10.1177\/156482650702800101"],"URL":"https:\/\/doi.org\/10.1177\/156482650702800101","relation":{},"ISSN":["0379-5721","1564-8265"],"issn-type":[{"value":"0379-5721","type":"print"},{"value":"1564-8265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,3]]}}}