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10h00 Badminton Hall Monday Haddad

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11/30/2012

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Transforming Africa’s Nutrition Landscape

Lawrence Haddad
Institute of Development Studies UK

Outline
• Slow progress in reducing stunting in Africa • What is needed to accelerate progress? • We need to Transform
– Thinking – Political commitment – Financial Resources – Leadership – Capacity – Communication

% stunting 50 45 40 35 30 25 20 15 10 5 0

Slow Progress in Africa: Prevalence and trends of stunting among pre-school children, 1990-2020

1990

2000

2010

2020

Asia

Sub-Saharan Africa

Prevalence and Trends of Stunting Among Pre-School Children, 1990-2020. De Onis, M., M. Blossner and E. Borghi. Public Health Nutrition. 2011.

Transform thinking

Our assumptions about nutrition are not in line with reality
Immediate Immediate

Immediate

Underlying

Underlying

Underlying

Fundamental

Fundamental

Fundamental

Assumptions

Reality

Aspiration

Transforming commitment and accountability to nutrition reduction

Which aid donors are committed to reducing hunger?
Country Denmark Finland Belgium Ireland Norway France United Kingdom Australia Netherlands Spain Germany South Korea Japan Canada Greece Sweden Italy USA Government expenditure rank 3 6 9 5 2 11 14 16 10 4 12 23 8 13 21 7 22 18 Policies and programmes rank 4 9 7 11 15 6 3 2 8 14 10 1 17 13 5 19 12 18 HRCI (1 is best) 1 2 3 3 5 5 5 8 8 8 11 12 13 14 14 14 17 18
7

Source: IDS – at hrcindex.org

Who is committed to nutrition reduction in Africa?
Outcomes Ethiopia Madagascar Niger
Fair

Burkina Faso Burundi Kenya Mali

Sound

Tanzania Ghana Mozambique Uganda Zambia

Malawi

Commitments

Emerging

Nigeria

Egypt South Africa Cameroon Angola
Fair Sound

Democratic Republic of Congo
Frail

Frail

Cote d’Ivoire Sudan
Emerging

Save the Children UK 2012

Citizen Feedback: Can they improve nutrition interventions? Randomised control trial of community-based monitoring of public primary health care providers in Uganda • Citizen report cards reduced child mortality by 33 per cent • The study documents large increases in utilisation and improved health outcomes
Björkman, M and Svensson, J. (2009) 'Power to the People: Evidence from a Randomized Field Experiment on Community Based Monitoring in Uganda’, The Quarterly Journal of Economics, Vol 124: 2, pp 735–69
9

Access to Nutrition Index | Hom e

ATNI: Which private sector actors are improving nutrition ?

04/ 03/ 2012 11:19

Improving nutrition for all.
The Access to Nutrition Index is a groundbreaking initiative that rates food and beverage companies' performance in providing nutritious products to consumers.

The Access to Nutrition Index is currently being developed. Sign up to stay informed or Discover more about the Index.
Supported by:

10

More Dynamic Nutrition Mapping with Mobile Technology
Govt of Malawi, Unicef Malawi and Columbia University

http://www.sipa.columbia.edu/academics/concentrations/epd/documents/UNICEFFinalReport_2009.pdf

11

Kenya CMAM implementation

Transform financial resources

ODA to basic nutrition is tiny

Scaling Up Nutrition: What will it cost? S. Horton, M. Shekar, C. McDonald, A. Mahal and J.K. Brooks. 2010. World Bank.

14

ODA to basic nutrition compared to related sectors

Large resource flows to Indirect interventions which can be made nutrition sensitive
Aid For Nutrition: Can investments to scale up nutrition actions be accurately tracked? ACF. 2012.
15

Transformative leadership

Nutrition leadership—who is building it?

17

Transforming the way we think about capacity

Programme Assessment Guide: A structured way of scaling up proven interventions

Pelletier, D., Corsi, A., Hoey, L., Houston, R., Faillace, S. Program Assessment Guide. August 2010, A2Z Project, AED, Washington, DC.

Nutrition Diagnostics: getting the commitment to doing the right things
Growth diagnostics: from economics to nutrition

Source: Doing Growth Diagnostics in Practice: A ‘Mindbook’ Ricardo Hausmann, Bailey Klinger, Rodrigo Wagner CID Working Paper No. 177 September 2008. Harvard University.

20

Transforming the way we communicate about nutrition

Do (economics) blogs change anything?
1. Do they affect the dissemination of economics research? (Yes.) 2. Do they affect the reputation of their creators? (Yes.) 3. Do they change attitudes of readers or lead to their increased knowledge? (Yes.) 4. Do they influence policy? (Don't know, probably yes)
David McKenzie and Berk Ozler. The Impact of Economic Blogs. 2011. World Bank

22

Blogs on malnutrition: any African ones?
• Global Food for Thought • The Hunger and Undernutrition Blog by Humanitas Global Development • The Global Forum on Food Security hosted by FAO. • Save the Children Blogs showcases views of individual staff members. • 1000 Days is a partnership of the US State Dept, GAIN, InterAction • You are what you eat by Jessica Fanzo • Action Against Hunger Blog. Has good frontline accounts. • Scaling Up Nutrition Does not have its own blog, but lists a few blog articles • Development Horizons from IDS • Transform Nutrition from IFPRI and partners • UNSCN has 2 electronic discussion platforms (on nutrition and climate change; on nutrition and noncommunicable diseases) and is hosting a third one, the Agriculture-Nutrition Community of Practice.
23

Conclusions
• Stunting reduction in Africa is much too slow • Getting stunting reduction is about building commitment • As researchers we can contribute to this • We need to problematise commitment, resources, capacity and communication for nutrition • We need to transform the way we think about nutrition to transform nutrition status

Thank you!

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