# A WHO global research priority agenda for wasting and nutritional oedema in infants and children under 5 years

## TL;DR

This paper outlines a global research agenda to address wasting and nutritional oedema in children under 5, focusing on prevention and intervention strategies.

## Contribution

The paper presents a prioritized list of research questions developed through a global consultation process for tackling wasting and nutritional oedema.

## Key findings

- A CHNRI process identified 10 priority research questions for each of four populations at risk of wasting and nutritional oedema.
- High agreement among experts was observed, with median scores of 89.9 for research priority and 83.4 for expert agreement.
- The agenda emphasizes delivery and effectiveness of interventions rather than discovery or development.

## Abstract

The guideline development process for the WHO guideline on prevention and management of wasting and nutritional oedema highlighted extensive evidence gaps. We, the WHO Steering Committee and methodologists for the 2023 WHO guideline, therefore aimed to develop a comprehensive global research priority agenda for wasting and nutritional oedema in infants and children. It has a timeframe up to 2030 aligning with the Sustainable Development Goals and Global Nutrition Targets related to wasting and nutritional oedema.

We used a Child Health and Nutrition Research Initiative (CHNRI) exercise to develop this research priority agenda for four populations and topics of interest: (1) infants less than 6 months of age at risk of poor growth and development; (2) infants and children 6–59 months of age with severe wasting and/or nutritional oedema; (3) infants and children 6–59 months of age with moderate wasting and (4) prevention of wasting and nutritional oedema. For this CHNRI process, we conducted two anonymous surveys, the first to ensure the list of research questions was comprehensive and clear, and the second to score research questions based on their answerability, effectiveness, deliverability and effects on equity.

63 people from 28 countries completed survey 1 and 50 people from 23 countries completed survey 2. We identified 10 priority research questions for each of the four populations and topics of interest, which had median research priority scores of 89.9 (IQR 2.8) and average expert agreement scores with a median of 83.4 (IQR 4.5) indicating high agreement. The research questions are largely focused on delivery and effectiveness of interventions for prevention and management of wasting and nutritional oedema rather than discovery or development.

This research priority agenda will guide researchers and research institutions, funders and others to address pressing research questions on wasting and nutritional oedema.