I would beg to jump in on these last days to share a little bit of my experiences in a Food Transfer Based Program designed to cushion producers from asset loss and guarantee food consumption. I thank the moderator and those who have contributed the wealth of experience already shared.
What are the main issues for policy-makers to consider in the design, formulation and implementation of nutrition-enhancing social protection measures?
Nutrition experts will agree with me that even when food is available consumption patterns, intra-house household food allocation, preparation methods and storage have an impact on how the available food can impact nutrition. Food supply, voucher systems and cash transfers assumed to impact nutrition without accompanying behavior change are unlikely to achieve the changes that need to be attained in reducing under nutrition in many developing countries.
In Ethiopia the Productive Safety Net Program is designed to prevent the loss of productive asset loss at the same time smoothing consumption. This program has made admirable steps in addressing both of these aspects and resulted in great enhancements in productivity of land and quality of natural resources.
Commendable as this may be questions linger over how improved production, incomes, protected assets and even direct food transfers have resulted in nutritional impacts. Studies on how this have come together point to a number of areas of considerations:
1. Clear Linkages with the National Nutrition Program. Where there has been a clear connection between food transfers and Therapeutic Feeding Programs, the Health Extension System and other health and nutrition promotion activities, positive changes are noted.
2. Determination of non-food causes of under-nutrition: Water health and sanitation and health care are the other key determinants of nutritional outcomes besides food security. any program aiming to have an impact on the nutrition will need to interrogate these other determinants and ensure that there is a clear link. Examples from Ethiopia include food for work activities that promote clean water provision, construction and connection to health posts for safety net beneficiaries.
3. Transfer Values, Timing, Targeting and Delivery. Transfer programs often address overall situations eg population level 50% lack of food 3 months a year. It is however the case that households have different gaps and needs. Designs that bring this on board are paramount to ensure that enough transfers are received by all. There is initial good progress in this approach in the variable wage rate and transfers in Ethiopia's PSNP. On the same note, targeting, delivery will need closer consideration to reduce time and effort it takes in collecting transfers in themselves.
What are the key institutional and governance challenges to the delivery of cross-sectoral and comprehensive social protection policies that protect and promote nutrition of the most vulnerable?
1. Institutional - Governments often plan resources under one ministry, line, bureau and department and the bureaucracies then set out to achieve their individual targets almost in competition. This package of the household in compartments eg. economic development differentiated from health or education is a regular pitfall. Growth indicators that don't connect health, education, income etc into one target that each player targets often leads to successes in one being drained by an unmatched focus in the other.
2. Related to above , the delivery of the programs happens at district and lower levels. well written and intended programs with potential for good impact are often watered down as they go through the hierarchy. The fault could be juggled across the layers but often times a district province, village responsible has on his plate political tasks, security etc., and yet needs to ensure success of an ambitious.
In your experience, what are key best-practices and lessons-learned in fostering cross-sectoral linkages to enhance malnutrition and poverty reduction through social protection
when social protection programs sit in a core government department and or ministry with a steering committee of major players, clear synergies and efficiencies are created. Packaging is as important as the contents, good programs can be watered down by sitting in the wrong line department based on political goodwill and perceptions on importance of the department.
Thanks all and looking forward to final recommendations from the conclusions of this thought provoking discussion about a very real and current development agenda.
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