Re: Social protection to protect and promote nutrition

Souraya Hassan UNICEF, Burundi

Dear all,

It is very interesting to read this discussion of Social Protection to Protect and Promote Nutrition as this is a crucial issue for the majority of developing countries. Indeed, Nutrition must be approached as central dimension to Development (World Bank, 2006) and then must be considered like long term investment which has huge implications on the quality of human capital (productivity, schooling performance, etc.). 

In this perspective, the Govt of Burundi and UNICEF Country Office undertook jointly in 2012 a Situation Analysis on Child Malnutrition. One of the innovative aspects of this research work was to provide estimated of cost of malnutrition to raise awareness of all stakeholders starting from national authorities. It is useful here to mention that nearly two thirds (58%) of Burundi’s children are chronically malnourished, which means their physical growth and intellectual development risk being seriously impaired, potentially leading to a negative impact on the long-term progress of the country.

Capitalizing on the UNICEF Burundi and other UN and international organizations (WB for instance) collaborative experience so far, it is crucial for policy makers to consider certain points when thinking about designing/implementing nutrition sensitive social protection measures:

  1. Involving decisive national stakeholders such as the ministry of finance, the vice-presidency of the Republic according to the country configuration with a high level policy department that usually ensures coordination and oversees the implementation of Poverty Reduction Strategy Plan  
  2. this implies the fact that it is fundamental from the beginning to think beyond Health and Agriculture sectors and cultivate the multisectoriality of the nutrition and then social protection issues
  3. in terms of interventions, it is decisive to organize and implement at scale or strengthen essential nutrition interventions during the 1000 days of the window of opportunity (i.e. from pregnancy up to 2 years). This is supported by several studies such as Hoddinott and al (Effect of a nutrition intervention during early childhood on economic productivity in Guatemalan adults, The Lancet, 2008) paper that showed in Guatemala that early nutrition was associated with reduced stunting prevalence, better school performance, substantial increases in wage rates.
  4. this window of opportunity of 1000 days could be even enlarged up to 5 years via small ‘improvements in living standards (that) can increase a child’s chances of catching up from stunting or malnutrition in the early years. In particular, investments in sanitation and water appear to have large payoffs." as showed by Outes & Porter (2012) in rural Ethiopia.
  1. Develop Social Safety nets and social cash transfers that are crucial to help poor families to ensure an adequate nutritious diet for their children. In Burundi case, data indicated that those in the poorest wealth quintiles are severely disadvantaged and children born in such families run an elevated risk of stunting and other forms of malnutrition. It is imperative that poor families, and in particular, poor women, have access to credit to start up micro- businesses.
  • Either cash or in kind, the final decision should be taken according to the context. Indeed, where gender-based domestic violence is already prominent (such as in Burundi), it could be sensitive to provide cash for the women (even if they are the back bone of the family and society). In such circumstances, we should consider in-kind.
  • Targeting question is also context specific question; in Burundi with 81% of population living below 1.25 USD a day, targeting the poor would not help; in this case, malnutrition could be a proxy for targeting.

Best regards