Thank you for a lively and insightful discussion last week. Here is a summary of last week's contributions.
The guiding question for last week's discussion was: What are the main issues for policy-makers to consider in the design, formulation and implementation of nutrition-enhancing social protection measures?
Here were your contributions
Questions to the contributors: Summary of Answers
Near consensus that the critical window for targeting nutrition-sensitive social protection programmes for children under 3 years or within the first 1000 days of life and for pre-conception women and girls. Others noted that recent literature shows that there is catch up growth after the 1000 days period, though there is little evidence at scale up, these programs would be as effective as during the 1000 day period. Cost wise, targeting the first 1000 days of life would be more efficient than after. For instance food supplements have been shown to be more effective during weaning than after. Addressing stunting after second birthday may increase obesity and risk of chronic disease in adulthood. But, recent literature also shows there is potential to effectively improve cognitive and socio-eomotional skills after the first 1000 days of life.
Overall, there consensus is that when women are the recipients of the social transfers, there are nutrition and food security related benefits to the household, especially to children. Some contributors feel that cash transfers work better than food transfers. However, others point out that social transfers oftern have multiple objectives and gender targeting or non-gender targeting might fulfill an objective but not necessarily enhance nutrition. Targeting of the transfers might also depend on the household’s commitment to the diets of pregnant and lactating women and young children. If the commitment exists, the control of the transfer would be dependent more on the additional objectives of the social safety net programme (such as women’s empowerment, self-confidence, etc).
The poorest and most marginalized are the popular target group for the contributors. This was defined by one as those least able to access goods and services (which may be rural households, but this not a general rule as urban populations can be greatly affected by inequitable access or lack of quality services). However, others point out that it is very challenging to reach the poorest and most excluded as such to minimize the risks for low institutional capacity, would be better to have universal coverage.
One contributor would prioritize the elimination of stunting. Another urges caution and argues that since interventions would be context specific, it doesn’t seem appropriate to suggest prioritization of one over the other. They also argue that children with acute malnutrition are at immediate risk of mortality while the mortality for stunted children greater in absolute numbers. Social safety nets or transfers cited as nutrition sensitive interventions as they operate at scale and target the poorest (The 2013 Lancet Series -Ruel et al- Paper 2). Another contributor argues that wasting is transitory and usually addressed by non-social protection measures unlike stunting which is chronic. Social protection programs targated to poor families with children would likely address both stunting and underweight.
Links and resources:
Concept note on social protection and nutrition
Social Protection for Food Security HLPE Report
Improving Nutrition through multisectoral Approaches – Social Protection
Talking points on social protection and nutrition, Centre for Social Protection
Post-2015 Development Agenda - Joint Chairs and co-Leads Synthesis Report
TST Issues Brief: Food Security and Nutrition
Lancet article on maternal and child nutrition