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02.06.2013 - 27.06.2013

Social protection to protect and promote nutrition

The Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) in cooperation with IFAD, IFPRI, UNESCO, UNICEF, World Bank, WTO, WFP and the High Level Task Force on the Global Food Security Crisis (HLTF), are jointly organizing the Second International Conference on Nutrition (ICN2) at FAO Headquarters, Rome from 19 to 21 November 2014. The ICN2 will be a high-level ministerial conference which will seek to propose a flexible policy framework to adequately address the major nutrition challenges of the next decades. It will also seek to identify priorities for international cooperation on nutrition in the near and medium-term. As part of the preparatory process for the conference, a technical meeting is to be held at FAO Headquarters 13-15 November 2013. More information is available at: http://www.fao.org/food/nutritional-policies-strategies/icn2/en

To feed into and inform this meeting, a series of on-line discussions are scheduled to be held on selected thematic areas. This online discussion “Social protection to protect and promote nutrition”, promoted by IFPRI, ODI, IPC-UNDP, UNICEF, WFP and the World Bank as part of the ICN2 Social Protection and Nutrition Task Force, aims to explore how the most disadvantaged and nutritionally vulnerable groups of society - low income, resource poor, food insecure, economically marginalized and socially excluded (especially women and children) -  can be protected by an inclusive development process through the design and implementation of nutrition-enhancing social policies and social protection interventions. In this regard, please consult the Concept Note on “social protection to protect and promote nutrition”.

The outcome of this online discussion will be used to enrich the discussions at the preparatory technical meeting on 13-15 November 2013 and thereby feed into and inform the main high level ICN2 event in 2014.

We would like to invite you to comment upon and further develop this Concept Note as well as to share your experiences and views on this thematic area by responding to the following questions:

  • What are the main issues for policy-makers to consider in the design, formulation and implementation of nutrition-enhancing social protection measures?
  • 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?
  • 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?

Recent documents and fora that highlight the importance of these synergies include:

We look forward to your contributions.

Nyasha Tirivayi
Social Protection Specialist
On behalf of the ICN2 Secretariat

This discussion is now closed. Please contact fsn-moderator@fao.org for any further information.

Nyasha Tirivayi facilitator of the discussion, FAO, Italy
24.06.2013
Nyasha

Thank you for the 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 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?

Here were some of your answers

Challenges

1.       In the long run, it might not be sustainable to rely upon the public sector, the donor community, international/national NGOs for financing, interest and technical assistance.

2.       Poor  cross-sectoral coordination of multiple stakeholders leading to turf battles and inefficiency e.g. the Uganda Nutrition Action Plan has faced this challenge, especially poor coordination between ministries and private sector.

3.       Conflicting ideologies among ministries.

4.       Lack of legislation to support nutrition-sensitive social protection policies elicits less attention and accountability from the government.

5.       Lack of political will.

6.       Top-down exclusive approach that does not recognize the role of the claim holders or intended beneficiaries.

7.       Implementing judicious targeting is a challenge.

8.      Lack of awareness and knowledge of how integrating nutrition interventions into social protection schemes promotes human development.

9.       Choosing the evidence based nutrition interventions.

10.   Inadequate training of community workers.

11.    Choosing the appropriate indicators for monitoring and evaluation.

12.    Maintaining the nutrition focus in social protection policies during crises or emergencies.

Possible solutions to challenges

1.       Involve decisive government/ministerial stakeholders  e.g. ministry of finance, vice-presidency specifically the highest organs of government involved in policy making. 

2.       Obtain buy in from all government ministries e.g. in Nepal the Multi‐Sectoral Nutrition Plan was endorsed by the Cabinet with a common results framework where all ministries have agreed on a set of essential nutrition-­‐specific and nutrition sensitive interventions.

3.       There should be clear roles and responsibility and the institution responsible for oversight should be clearly stated.

4.       Multisectoriality should be set out from the beginning by thinking beyond Health and Agriculture sectors.

5.       Specify target age of beneficiaries e.g. more effective to scale up or strengthen essential nutrition interventions for  the 1000 days of life

5.       Ensure interventions and policies are sensitive to local contexts. For example providing cash to women where gender based domestic violence is prevalent might be problematic

6.       Targeting should be realistic and context specific. E.g.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. In Djibouti the social protection/nutrition program implemented in response to the food price crisis and high unemployment rates, targets poor families with a member  in the first 1,000 days of life to ensure the foundation of solid human capital. 

7.       There should be more private sector engagement in the institutional and governance structures of nutrition sensitive social protection policies. This would lessen the reliance on the public sector and on Civil Society.

8.      Promote and bottom up, inclusive approach where the claim holders/intended beneficiaries are involved e.g. Brazil’s Zero Hunger programme’s integral stakeholders are local social councils

9.       Promote  a  human rights/right to food approach where  both claim holders and duty bearers are aware of the rights and claim holders are mobilized to demand their rights.

Souraya Hassan UNICEF, Burundi
24.06.2013
Souraya

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

 

 

 

Peter Steele Independent Consultant Agricultural Engineer, Italy
24.06.2013
Peter Steele

Encouraging the private sector

It was encouraging to read the contribution of Christine Namukasa of Hunger Fighters Uganda (HF-UG) with her reference to the role of the private sector within national efforts to promote nutrition and to provide some measure of social protection to local people. Unfortunately, Ms Namukasa does not describe the extent of this role apart from reference to ‘pipeline’, ‘synergies’ and ‘partnerships with CSOs and government’. The logical place to find this information would be on the HF-UG web pages, but I couldn’t encourage their search engine to shift into gear. The site listed the usual selection of UN agencies, international NGOs and others as partners; no reference to private sector partners.

This is, of course, no critique of HF-UG – it is sufficient to have raised the issue (for the role of the private sector) – but it would have been interesting and perhaps of value to learn of what the private sector in Uganda may be doing to promote social protection, and particularly of small-scale, grass-roots, community-based, etc. interventions, that have proven of value in Uganda that could then be tried elsewhere. A successful private sector provides that measure of economic security long-term that comes from making a profit.

Others may have a similar contribution to make and this leads neatly into my contribution; the risks of relying upon the public sector, the donor community, international/national NGOs and others with non-profit objectives that depend ultimately upon the goodwill of external funds, effort, intellect and interest.

The model for community self-interest with the most fundamental of community functions – child care, nurturing and security – was described earlier in the first contribution by George Kent of Hawaii; check out the model, it contains the child at centre within seven nested circles of security. After ‘family’ and ‘community’ the assumption is one wherein the public sector should take responsibility; there is neither reference to the private sector nor to the risks of dependency that comes from reliance upon others. If either the family or the community is sufficiently capable of becoming financially/economically self-sufficient, then clearly that those children will be more secure as they grow and, importantly, they become more capable – more self reliant citizens - as they, in turn, shift into adulthood.

There is only so much that can be covered in a few words, but the thesis here is one of focus upon the self-reliance of family and/or community; teaching/encouraging people to rely upon their own resources/effort/intellect/etc. and to shift away from dependency upon others and, particularly, from the dubious/irregular decision-making of sometimes distant central governments. For all the best will in the world – public sector people are not always the most appropriate source of social development/investment expertise.

(You only have to look at a handful of key countries across the MENA region and selected national food/energy social support programmes that have routinely provided subsidized prices of staples across the country in an effort to placate their mainly urban populations – to the detriment of real farm prices, rural poverty, import dependency and more; to appreciate the risks of inadequate planning. Many governments in the region continue to pay off their citizens in state-supported interventions to ensure civil stability – and more so since the impact of the Arab Spring on the region.)

On much the same tack, the private sector is not some benign benefactor comfortably allocating a proportion of company funds for social responsibility spending – leastways not on small-scale, and rarely in the low-income countries. Too many of the SMEs involved are working close to margins that simply cover cost plus – but, crucially, keeping workers and family intact and in-food. Workers and family are, typically, one-and-the-same; it’s this thing about starting up a business and people being required to ‘work twice as hard for half the income’.

Private enterprise and markets are no panacea for future well-being, but provide opportunities for shifting away from traditions of ‘government provides all’; government used to try to provide all, but has rapidly stepped back within the complexity required of modern national management. We are no longer in a post-colonial world of newly independent states with all that this implied for ‘old models’ of donor/development assistance from others. Middle income people are a feature of all new countries, responsible for the wealth that is being created on the basis of intellectual creativity, sensible investments and market risks.[1] You sometimes have to look hard to find those old models – sure they exist – but they are rapidly disappearing within the modern images of urban development, shifts in agro-technologies and determined people that you meet everywhere.

The key is one of education, confidence, self-appreciation and the development of a ‘can-do’ society.  Check out and invest in the young in your community.

Peter Steele
Agricultural Engineer
Rome

[1] More information. Access your favourite search engine with ‘private sector’, ‘social responsibilities’ and similar key words. USAID, for example, at: http://www.usaid.gov/news-information/fact-sheets/more-3-billion-private-sector-investment-new-alliance-food-security-and describes global, regional and national partnerships with >US$3B investment funds in the pipeline. And, if any of those companies are local to where you are, check them out for the opportunities that may arise for partnerships, provision of services, contracts and more.

 

Christine Namukasa Hunger Fighters Uganda, Uganda
20.06.2013
Christine

Dear Colleagues,

In response to the question at hand:

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?

Today, in the country, the Civil Society fraternity focusing on Food and Nutrition Security and poverty for the Vulnerable has grown larger and stronger. The private sector is also in the pipeline and it is synergically playing its role together with the CSOs and government as compared to a decade ago.

With the Uganda Nutrition Action Plan that was lauched in 2011, it would be ideal that Food and Nutrition security efforts take a better direction. The plan, under objective 3, indicates outstanding interventions based on the strategy of Promoting social protection to improve nutrition for the vulnerable. These and more in this plan are ultimately the directions to take to strengthen a muti-sector and multi-institutional collaboration towards a common goal.

However, the UNAP has not taken course due to the uncoordinated institutional structures among the key players inclusive of ministries and the private sector wing. For example, the Council could not operate without the Bill! This precisely is one of the reasons as to why Nutrition is been given less priority by the government. However it is important to acknowledge its efforts to reduce poverty levels under the National Development Plan which addresses food insecurity for all citiznes.

With the joining of the SUN movement (http://scalingupnutrition.org/), it is indicated in the final Uganda Summary report that stakeholders have been seen to tremendously reconsider to undertake their roles under the UNAP and other national obligations.

I think therefore that there has to be institutions specifically meant to spearhead the coordination, planning and implementation of the relevant Nutrition interventions as well as actively involving the government/line ministries for all countries. The effort of the CSOs can't go unnoticed. I strongly support it.

Whether the Nutrition department is under Health sector or Agriculure, Nutrition and Food Security social protection systems should be emphasised and given priority with specific resource allocations. An outstanding case in point is in Nepal where the Multi‐Sectoral Nutrition Plan that was endorsed by the Cabinet with a common results framework where all ministries have agreed on a set of essential nutrition-­‐specific and nutrition sensitive interventions.

Thank you once again for this opportunity. I hope that the above is part of what will inform the next course of action.

Christine Namukasa

Nutritionist and Head of Research Department

Hunger Fighters Uganda

 

Marie Chantal Messier World Bank , United States of America
20.06.2013

Some of the challenges in making social protection programs nutrition sensitive are: efficient cross-sectoral coordination and collaboration (i.e. how to minimise turf battles), high level support and understanding of how integration of nutrition interventions into social protection schemes contribute to human development, judicious targeting, choice of evidence based nutrition interventions, adequate training of community workers and choice of appropriate indicators for monitoring and evaluation. 

Other concerns are how to build up on and capitalize on social protections schemes during crisis and emergencies to protect and promote e nutritional status of the most vulnerables. The World Bank has developped a Toolkit in which this topic is discussed and concrete exemples on how countries in Latin America have done this. 

Toolkit on How to Protect and Promote the Nutrition of Mothers and Children in Crisis

In Djibouti the social protection cum nutrition program has become one of the flagship programs of the government. First preoccupied by the food price crisis and high unemployment rates, the government has put in place an innovative programs that focuses on prioritizing poor families with a member  in the first 1,000 days of life to ensure the foundation of solid human capital. The objectives of the Social Safety Net Project for Djibouti are to: (a) support the provision of short-term employment opportunities in community-based labor-intensive works for the poor and vulnerable; and (b) support the improvement of nutrition practices among participating households focusing on pre-school children and pregnant or lactating women through a community based peer-support and care taker empowerment approach. . 

World Bank. 2012. Djibouti - Social Safety Net Project : emergency project paper. Washington D.C. - The Worldbank.

Thank you, 

Marie Chantal

Dr. Claudio Schuftan PHM, Viet Nam
19.06.2013
Claudio

Please find the answers to Nyasha's questions in italics below:

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? Your contributions can cover all instititutional and governance issues you know to affect the delivery of cross-sectoral nutrition enhancing social protection policies.

Both serious institutional and governance can be put under the same umbrella of political constraints at the decision making level which are still very much top-down. Attempts at cross-sectoral have historically failed since there is the ideological underpinning of elites running state affairs. This will cotinue to fail unless a  counterpower is achieved through active empowerment and mobilization of claim holders.

e.g. who are the stakeholders: claim holders and duty bearers rather...
power balance: absolutely the key
intersectoral conflicts, intersectoral coordination, decentralization: all these play a role, but secondary to power issues
and community participation absolutely the key
institutional capacity, financial capacity, roles and responsibilities for oversight holding the state and private sector accountable
legislative accountability, inclusiveness, rights based approach absolutely the key.

1.        In discussing this question, please provide examples and case studies of successful or failed cross sectoral social protection policies that promote nutrition: would I be exaggerating if ratio success:failure in this is >50:1?  reasons why your examples succeeded or failed political as per above.

For example in the concept note Brazil's Zero Hunger programme is given as a successful example of a national and multisectoral social protection system promoting nutrition: the political thrust in Brazil is undeniable!. Another example given is the Bangladesh Rural Advancement Committee (BRAC)’s Challenging the Frontiers of Poverty Reduction in Bangladesh: I declare my ignorance about this one

2.       Please recommend possible solutions to the institutional and governance challenges that you identify from your experiences, examples/case studies or literature. A massive human rights/right to food learning cum empowerment effort is needed both for claim holders and duty bearers followed by social mobilization of the former to demand their rights.

I'll be glad to elaborate if challenged.
Claudio

Nyasha Tirivayi facilitator of the discussion, FAO, Italy
17.06.2013
Nyasha

Dear Participants

This week we move on to the second question for our discussion. 

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?

Your contributions can cover all instititutional and governance issues you know to affect the delivery of cross-sectoral nutrition enhancing social protection policies   

e.g. who are the stakeholders, power balance, intersectoral conflicts, intersectoral coordination, decentralization and community participation, institutional capacity, financial capacity, roles and responsibilities for oversight, legislative accountability, inclusiveness, rights based approach etc.

1.        In discussing this question, please provide examples and case studies of successful or failed cross sectoral social protection policies that promote nutrition…Give reasons why your examples succeeded or failed.

For example in the concept note Brazil's Zero Hunger programme is given as a successful example of a national and multisectoral social protection system promoting nutrition. Another example given is the Bangladesh Rural Advancement Committee (BRAC)’s Challenging the Frontiers of Poverty Reduction in Bangladesh. 

2.       Please recommend possible solutions to the institutional and governance challenges that you identify from your experiences, examples/case studies or literature.

Nyasha Tirivayi facilitator of the discussion, FAO, Italy
17.06.2013
Nyasha

Dear participants

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

  • Include clear nutrition goals and actions in the programs.
  • Consider the different environment, cultures, gender and age and the economic capacities of the different social groups.
  • Complementary?
  • Promote access to clean water and reduce the incidence of water borne diseases as they adversely affect nutrition.
  • Linking the transfer to health and/or education conditions may increase the nutrition impact of social protection programs.
  • Extension and agricultural advice plays an important role in supporting women to food security for their families. Would be useful complementary intervention to nutrition enhancing social protection
  • Obesity
  • Also address the other side of malnutrition i.e. obesity and the consumption of sugars, additives and other non-nutritious foods
  • Consider reforming the food price system in developed and middle-income countries by increasing the retail prices of food to prevent over eating and reduce overweight/obesity outcomes. Can be achieved by increasing taxes of retail food prices and ploughing back the revenues into social protection systems for the poorest.
  • Re-designing school feeding programmes to take into account the growing risk of obesity.
  • Eliminate corruption and misuse of resources in the process of designing, formulating and implementing social protection programs.
  • Take into account the sustainability of these programs without compromising the well being of the beneficiaries. This can be achieved through favoring asset holding, income generation and social justice for the beneficiaries.
  • During administration of cash transfers, use electronic means of delivery such as cash withdrawal cards or telephone money transfer systems so as to minimize risks of rent-seeking behaviour in the administration.
  • Avoid mistiming social protection interventions such that they divert labour away from food production activities e.g. public works… or food aid which can discourage local food production and trade
  • Targeting
  • Increase social security coverage especially for women e.g. only 10% of the rural women /girls and children of Georgia  have adequate social security coverage, and more than 90% have none.
  • Experience from CCT in Latin America suggests that positive nutrition outcomes may be greater when the social safety transfers cash and a fortified food for groups with high nutrient needs (pregnant and lactating women and young children).
  • While targeting young children is critical, other population groups have consumption needs e.g. older children and the elderly. And for equity reasons they need to be addressed. But with few resources available, there is need to balance between the twin priorities of equity and efficiency.

Questions to the contributors: Summary of Answers

  1. Studies have shown that the first 1000 days of life are a crucial window for preventing irreversible undernutrition like stunting. Yet other research rebuts this position by showing that catch-up growth is still possible even after the first 1000 days of life. From your experiences, who should we target when implementing nutrition enhancing social protection measures? Under 3 years or over?

    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.

  1. Should we only always give cash or food transfers to women?

    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).

  1. Should we only always target the poorest? Rural households? Or should we consider universal social protection schemes?

    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.

  1. Recent research shows that stunting has far reaching consequences even affecting income earning capacities in adulthood and on a national scale leading to two –three percent losses in GDP (Bhutta, Sachdev et al. 2008). In that case, should we prioritize eliminating stunting over wasting or underweight? Or we should not prioritize one over the other?

    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.

  1. What are some of the lessons you have learned, best practices concerning social protection measures implemented to enhance food security and nutrition? E.g. cash transfers
  • Rwanda. Girinka “one cow per family” programme. A livestock transfer programme, where a poor family receives a cow for free on condition they give the first female calf (cow offspring) to their neighbor. Programme increased milk supply and consumption to beneficiaries and non-beneficiaries.
  • Ethiopia. The successful integration of Infant and Young Child Feeding practices into  PSNP has been done through behavioural communication change approach, addressing social norms and via community based delivery.
  • Ethiopia. Fresh food vouchers programme where vouchers are exchanged for locally sourced fruits and vegetables and eggs. Programme successfully improved dietary diversity and promoted the consumption of fruits and vegetables.
  • Malawi. Mchinji Social cash Transfer scheme. At the household level, the analysis shows a substantial impact on household food and non-food expenditure as well as a shift in the consumption preferences towards better nutrients. At the individual level, we find children of age 0-5 residing in beneficiary households being, on average, taller compared to the control group, which translates into a significant reduction in the stunting rate among children. Further, we find that the programme positively affected food consumption out of own production and that children living in families experiencing a shift toward home production of foods, such as meat and fish, dairy products and pulses benefitted more in terms of nutritional outcomes.
Mr. Yesake Demeke Andeyhun Stellenbosch University, South Africa
17.06.2013
Yesake Demeke

Dear FSN Forum,

to respond to the question of debate: what are the main issues for policy-makers to consider in the design, formulation and implementation of nutrition-enhancing social protection measures?, please find below an article adapted from my unpublished Master’s thesis on Africa’s food availability, accessibility and utilization analysis.

With kind regards

Yesake D. Andeyhun

Msc (Agric) Agricultural Economics (final year student)
Stellenbosch University
South Africa
 

Social protection to protect and promote nutrition: a case for the poorest rural households

While the poor in most of Sub Saharan Africa (SSA) are largely susceptible to food production, accessibility and utilization shocks coupled with the high level of prevalence of poverty and their high income share expenditure on food, the importance of social protection and safety nets is extremely important. The main essence of safety nets is provision of equity and efficiency (Alderman, Hoddinott 2007).

In this regard social protection can be defined as: “A specific set of actions to address the vulnerability of people’s life through social insurance, offering protection against risk and adversity throughout life; through social assistance, offering payments and in kind transfers to support and enable the poor; and through inclusion efforts that enhance the capability of the marginalized to access social insurance and assistance” (European communities, 2010; cited in(Devereux 2012).

According to Devereux (2012), this definition has three components: social assistance (protection against poverty); social insurance (protection against vulnerability); and social injustice and exclusion (social risks such as discrimination or abuse).  He argued that food security can be enhanced through social protection by income stabilization, raising income and promoting social justice. Income stabilization can be maintained by agricultural insurance, offering temporary employment on public work programmes, giving food aid or cash transfers to targeted individuals, through provision of employment guarantee and managing food supplies through strategic grain reserves (Devereux 2012).

Effective social protection interventions can raise income and create asset especially in rural Africa through promotion of small scale farmers, off farmers and land less poor(Alderman, Hoddinott 2007, Devereux 2012). While there is a positive synergy between agricultural promotions and social protection; impact of social protection when effectively implemented in promoting agricultural growth and poverty reduction is vital (Devereux 2012). Carefully designed social protection schemes can reduce seasonal hunger; increase farm income (which allows better nutrition and stabilize agricultural yield), also through weather indexed insurance it promotes farmers risk taking behaviors; such as adopting high yield varieties and so on(Devereux 2012, Ethiopian Government 2009).

It can also be effectively designed to include agricultural input subsidies, inputs for work and input trade fairs; also interventions that enhance public works projects which construct roads that link markets and reduce transaction costs are effective(Ethiopian Government 2009). In this regard social protection should be well designed that public work must not attract farm labor in a way it compromises farming or food aid should not discourage local production and trade; and also cash transfers should not be introduced where markets are so weak which might lead to inflation (Devereux 2012, Ethiopian Government 2009).

The social justice aspect of social protection can be implemented by examining and tackling the main social and political causes of marginalization and exclusion of the poor and vulnerable groups (Devereux 2012). Accordingly, addressing of these fundamental issues is effective and sustainable even more than dealing with technical issues such as input subsidy and food aid. For that, he identified rights based approaches, which are permanent programs such as those implemented by government rather than external donor projects; hence it is based on rights and social contract. Although sometimes it is exposed to local elites and powerful groups in the village, community based targeting is also effective in identifying more vulnerable communities. Social audits are another mechanism for effective implementation of rights based approach and enhancing improved service delivery and good governance (Devereux 2012).

The effectiveness of social protection in rural Africa in poverty reduction, food security and better nutrition, has been demonstrated in Productive Safety Net Programme (PSNP) of Ethiopia (Ethiopian Government 2009). The programme launched in 2005 at larger scale with estimated budget of 500 million USD comprising around one million participants, selected based on geographic and community targeting (Gilligan, Hoddinott et al. 2009). And as of April 2009, around 56,895 households have been graduated from the programme up on sizable improvements on asset holding and food availability (Ethiopian Government 2009). It mostly uses public work scheme paying beneficiaries 10birr/day[1] or 3 kilograms of cereals for work on labour intensive projects of building community assets during January and June of each year so that it doesn’t interfere with peak farming season(Ethiopian Government 2009). While a small proportion of beneficiaries (elderly or disabled) get direct support, the program has been complemented by agricultural productivity enhancement services; such as access to credit, extension services, technology transfer and irrigation and water harvesting schemes(Gilligan, Hoddinott et al. 2009).

In conclusion social protection schemes should be designed in more sustainable manner to address the poorest and vulnerable groups, favoring asset holding, income generation and social justice. Theoretically this approach is also supported by Sen’s capability approach, in which the main focus should be on building capacity and addressing the root causes of vulnerability. Experience has showed that, non-targeted direct cash transfer and food aid increased dependency and deteriorated realization of local capability. In this regard the experience of Ethiopian Productive Safety Net Programme (PSNP), which enhanced large scale poverty reduction and food security through better nutritional intervention, is one of the best models to be adopted in the rest of rural poor regions.

References

ALDERMAN, H. and HODDINOTT, J., 2007. Growth-promoting social safety nets. International Food Policy Research Institute.

DEVEREUX, S., 2012. Social Protection for Enhanced Food
Security in Sub-Saharan Africa.
WP 2012-010. Brighton, UK: UNDP Regional Bureau for Africa.

ETHIOPIAN GOVERNMENT, 2009. Food Security Programme 2010-2014: Productive Safety Net. Ministry of Agriculture and Rural Development.

GILLIGAN, D., HODDINOTT, J., KUMAR, N. and TAFFESSE, A., 2009. Can Social Protection work in Africa? Evidence on the impact of Ethiopia’s Productive Safety Net Programme on food security, assets and incentives. Evidence on the Impact of Ethiopia’s Productive Safety Net Programme on Food Security, Assets and Incentives (August 18, 2009), .


[1] It was initially 6 birr/day and it grew to 10birr/day in 2010  (note that 1USD=17.5 birr, in current value)

 

Andrew MacMillan Formerly FAO, Italy
17.06.2013
Andrew

Friends,

I am fully convinced of the essential role that social protection must play in reducing hunger and improving nutrition amongst people whose food consumption options are curtailed by their inability to buy adequate food. The evidence seems to point quite convincingly to the particular advantages of targeted family-focussed cash transfers, with predictable monthly amounts being transferred, where possible, through adult women household members. Such transfers will provide greater eating choices to participating families, and their nutritional impact may be increased through links with nutrition education and possibly supplementation programmes for pregnant and nursing mothers and their youngest children. The biggest challenge is to reach the very poorest families as well as individuals – those living “outside the system” -  and to bring them on board. To minimize risks of institutional capacity constraints, such programmes should be nationwide in scope with a single register of participants and kept very simple, with a minimum of attached conditionalities. Wherever feasible transfers should be made electronically through cash withdrawal cards or telephone money transfer systems so as to minimise risks of rent-seeking behaviour in the administration of transfers.

Having said this (in perhaps rather too dogmatic terms !), I would suggest that we need to start to look at such social protection programmes as part of a broader process of food pricing system reform, at least in developed and middle-income countries. Part of the impact would be nutritional (less over-eating, and resulting overweight/obesity outcomes), but the aim should be to also to capture other important potential social, financial and environmental benefits.

In the most general terms, we are seeing a price squeeze all along the food chain (except at the level of major retailers who, through their immense purchasing power are able to protect their margins) which has a lot of bad effects. It contributes to a general impoverishment in rural areas, with low incomes for small-scale farmers and an absence of incentives for them to invest in raising production; appalling conditions of work for farm labourers and people working in food assembly, processing and distribution; and a pervasive under-provision  of rural infrastructure and services. One consequence is rural-urban migration on a massive scale. Relatively low food prices for consumers encourage food wastage and over-consumption and, most importantly, mean that we are failing to pay for the environmental costs of our food production and distribution (natural resources degradation and greenhouse gas emissions), effectively passing the bill for this onto future generations.

People who buy fair trade food have recognized the multiple social, environmental and behavioural benefits of paying more for their food and demonstrate that quite small retail price rises, if passed back through the system responsibly, can create a whole range  set of good effects. They represent, however, a very small fraction of the world’s buyers of food who are happy to see the continuation of low price regimes, accepting the argument that prices have to be kept down to reduce the threat of food deprivation for low-income families. In fact, given that the highest concentration of poverty, hunger and other forms of malnutrition are concentrated in rural areas, a rise in food prices, reflected in higher producer prices, could have a hugely beneficial impact on the rural poor and obviate part of the need for extended social protection systems. The inflationary impact of rising food retail prices would also be relatively limited, given that , at least in developed countries, the proportion of household expenditure applied to food is quite modest.

I am simply suggesting that, if dependable social protection measures, based on regular cash transfers (with the transfer amount indexed to food price inflation) are put in place, this opens very important opportunities for an upwards movement of food prices for high and middle income consumers and a consequent correction of many of the “wrong signals” created by present policies. To the extent that a part of the price rise would come from increased taxation on food – especially “high footprint food” – the resultant income could be ploughed back into social protection for the poor and into accelerating the shift towards food production systems that are truly sustainable from  environmental, economic and social perspectives.

I very much hope that the CFS will look at the connections between social protection and nutrition in this broader context of overall food pricing policies.

Some further thought is given to food pricing issues in the second edition of “How to End Hunger in Times of Crises” by Trueba and MacMillan, available from Amazon and www.fast-print.net/bookshop.

Andrew MacMillan