Forum global sur la sécurité alimentaire et la nutrition (Forum FSN)

Concluding remarks

Dear Participants,

Thank you for sharing your experiences and insights on nutrition-sensitive social protection policies and programmes.  Your contributions reflected experiences from a diverse array of country contexts, including India, Togo, Ghana, Ethiopia and the Dominican Republic. Both the near universality of social protection programs and the numerous nutrition-related themes and principles highlighted (e.g.  the importance of the quality of service provided, nutrition education, contextually-specific approaches, etc.) paralleled topics explored during the recent two-day Global Forum on Nutrition-Sensitive Social Protection Programs in Moscow that coincided with this discussion.

In an effort to work towards building a shared understanding of what is being done by way of nutrition-sensitive social protection in countries around the world and the current challenges, the Forum brought together approximately 150 experts, technical practitioners and policymakers from over 20 countries—literally to the same table— to discuss and analyze case studies nutrition-sensitive social protection programs.

Clearly we are early in building a shared understanding of what we mean by nutrition-sensitive social protection and what works to improve nutrition outcomes, and there are more questions than answers. However, it is also evident from the comments, publications, and resources shared that interest and knowledge is growing.

In line with the ICN2 recommendations and as echoed during the Global Forum BRICS session, countries have shown firm commitment towards nutrition-sensitive social protection and need to work together to share good practices.

Together the online and in-person discussions culminate in a repository of experiences that can be drawn upon for lessons learned, best practices, and ideas about what works in specific country contexts. The final report from the Global Forum will be launched later this year, and combine feedback from both venues.

We encourage you to keep checking the resource section of this discussion for any updates.

Many thanks,

Lucy Basset and Ahmed Raza

About half of the deaths of children under the age of 5 in the country can be attributed to nurition related disorders. Besides the well known Mid Day Meal for schoolchildren, there are many other initiatives that seek to address nutritional security. India has a large dairy cooperative sector and many dairies are supplying small packets of flavoured milk to schoolchildren, mainly in tribal dominated areas. This helps to improve the nutritional status of children. Together with the Mid Day Meal such nutrition programs are also known to improve school attendance. 

Recently, the NDDB (National Dairy Development Board), through the NDDB Foundation for Nutrition has announced a 'Gift Milk Program'. This program a major initiative to provide 'A Glass of Milk to Every Child' to address nutrition among children across India by using its vast network of cooperatives. The program provide a transparent electronic platform to connect individuals and corporate as donors in the Initiative.

Way too late, but...

I facilitated a one and a half day session on household food security and nutrition during a summer school on sustainable mountain development at the end of June. Part of this was group work and one of the groups decided to work on a valley in the Peruvian Andes. Their diagnosis  (which caught me by surprise) was that the local economy was undermined by the Conditional Cash Transfer programme: people would stop buying locally and spent their cash in the local supermarket (which was doing great :-)). So no good for local farmers (who may have to apply sooner or later to the programme) and  no good for consumers (not sure shifting from local foods to supermarket food is necessarily the healthy choice).

This was clearly anecdotal. Has any research been carried out to look at the impact of social protection programmes on food practices and diets?

Florence

Although the deadline has passed, my quick comment, based on Rwanda's experience is that nutrition-sensitive social protection programmes are highly dynamic and require continuous and intense decision-making processes to ensure sustainability. Therefore, robust decision-support tools for such programmes are critical for successful management and decision-making.

For this reason, I am working on a proposal that seeks to  develop a decision-support tool that could be used in a nutrition-sensitive social protection programme while selecting beneficiaries and collecting food and nutrition security indicators to ensure positive impact of the programme on nutrition status of beneficiaries. I will use the Rwandan One Cow Per Poor Family Program as a case study.

Regards,

Theogene

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Théogène Dusingizimana

Assistant Lecturer

University of Rwanda

 

Dear FSN Forum members,

This UNICEF paper on cash transfers and child nutrition provides a comprehensive overview of the impacts of cash transfer programmes on child nutrition: while cash transfers have a positive role in increasing resources for food, health and care, the evidence is mixed with respect to whether these programmes positively impact growth-related outcomes among children.

This paper reinforces the message coming from the Bangladesh study that cash transfers alone are probably not enough to ensure improvements in child nutrition. If cash transfers are delivered along with interventions on nutrition education, behaviour communication, and supply side interventions that improve access and quality of health services there are greater chances to achieve impacts on child nutrition.

I look forward to hear the outcomes from the Moscow meeting last week, where nutrition-sensitive social protection programmes have been discussed and thanks to Lalita for sharing this paper.

Renata

Dear participants, 

It is great to see reference in the discussion to India’s Mid-Day Meal Scheme, which is the largest school feeding program in the world. Almost every country has a government-led program making it one of the most common nutrition-sensitive safety net tools globally. Adolescent girls may be reached through this intervention, and the nutritional status of the next generation may also be affected.

In Ghana, the Partnership for Child Development (PCD), has worked closely with the Ministries of Local Government, Health and Agriculture to promote the delivery of school feeding rations that provide 30% RDA of energy and key nutrients such as iron through locally produced, diverse foods. The linkages with local agriculture along with the provision of nutrition education and behavioural change communication can amplify the program’s social protection and nutrition benefits to the community. The recognition of school feeding as a social protection tool in Ghana is reflected in the recent reorganization placing the program in the Ministry of Social Protection.

Your question on M&E is intriguing and the comments from Matilde are insightful. While it is important to monitor the effectiveness on nutrition, this potential is very much contingent on the quality of implementation. Thus it is critical for M&E to include robust process indicators and appropriate targets, and these may be specific to the actual program. There is a strong need to support governments develop strong M&E systems that can enhance the delivery of effective programming. 

Meena Fernandes, Senior Research Advisor

Getrude Anase-Baiden, Ghana Programmes Manager

Partnership for Child Development, Imperial College London

Dear members,

I would like to follow up to Ellen’s post regarding the study on Bangladesh.

Social protection programs, if designed and implemented properly, can have significant impacts on food and nutrition security, agricultural productivity and rural development. Synergy between agriculture and social protection is considered necessary for reducing rural poverty and vulnerability.

As mentioned in the Bangladesh case, the Transfer Modality Research Initiative (TMRI), a joint effort between WFP, IFPRI and the Government of Bangladesh, showed that all social transfers’ modalities (food and cash) caused meaningful improvements in nearly all measures of consumption (i.e. expenditure on food and nonfood consumption, calorie intake, and diet quality). However, inclusion of nutrition behavior change communication (BCC) along with the transfers determined considerably larger improvements than transfer alone. In particular, cash transfers + nutrition BCC had a larger impact on diet quality (in terms of food consumption score) and was the only modality to significantly reduce child stunting. Moreover, nutrition BCC also had a positive impact on women empowerment and social status.

These outcomes provide useful lessons for policy attention and information on how to make the best use of social protection programmes to improve nutrition. The "Monitoring Report 2015 of the National Food Policy Plan of Action and the Country Investment Plan for Agriculture, Food Security and Nutrition" considered the results of the study particularly relevant for the implementation of the recent National Social Protection Strategy and recommended to use them to identify the types of social protection interventions to be implemented at country level.

I trust the meeting in Moscow will help in drawing up further evidence on the best social protection programmes and implementation modalities to improve food security and nutrition of the vulnerable populations for whom it is most intended.

Kind regards,

Lalita

Lalita Bhattacharjee, PhD

Nutritionist and Officer in Charge, Meeting the Undernutrition Challenge –MUCH

Food and Agriculture Organization of the United Nations

Bangladesh

Dear Members,

Just to share our thoughts and experience on the topic – mainly in West Africa where we are working:

The need to rigorously evaluate nutrition-sensitive social protection programs is pressing not only to accumulate evidence concerning the impact and cost-effectiveness of such programs but also for learning  i.e. to improve the design of future programs and to uncover impact pathways (i.e. to better understand what factors contribute to an impact). These learning aspects should be an integral part of any evaluation as they are essential for the successful scale up and replication of programs. Donors and program implementers should also be more aware that a meaningful impact evaluation implies its conception at the onset of a program and an interest in impact beyond primary indicators.

We are collaborating with IFPRI (International Food Policy Research Institute) on a large applied research program aiming to evaluate and strengthen social transfer programs which objective is to improve food and nutrition security in West Africa (see the one-pager concept note). We are using experimental or quasi-experimental methods, including randomized design and valid comparison groups where appropriate; we also use mixed methods (a combination of quantitative and qualitative data collection) to document if, why and how the impact is achieved (or not).

Impact and process evaluation of three cash transfer programs are underway in Mali and Togo: 

1. SNACK (Santé Nutritionnelle à Assise Communautaire à Kayes) project (WFP)
2. Jigiséméjiri (Malian Government and the World Bank)
3. Pilot cash transfer project in Kara and Savanes regions, north Togo (Togolese government, Unicef, World Bank)

Results are not available yet (endline survey to be conducted in 2016 and 2017) but we will certainly share these when the time comes. We do hope that our work will contribute to provide the evidence needed for rational choices concerning social transfer program design(s) adapted to specific contexts and to motivate governments to integrate such interventions into comprehensive national social protection policies.

Dr Mathilde Savy, on behalf of IRD/IFPRI teams

Dear all,

Thanks for all the interesting comments and contributions that have been posted over the past several days. I trust the conference is off to an excellent start and hope that all of you participating are enjoying the conversations and benefiting from the information exchange.

I really appreciate the resources that people have shared (i.e. FAO paper, Nutrition and Social Protection; Bangladesh study on CCT plus nutrition education; etc.), which provide some concrete ideas about how to design nutritionally-impactful social protection programs and what works. Similarly, the examples of nutrition-sensitive social protection programs in action (Ethiopia’s Productive Safety Net Program and India’s Integrated Child Development and mid-day meal schemes) give a flavor of different approaches to achieving improved nutrition in the context of social protection, as well as some of the challenges (human resources, ensuring budget availability, monitoring and accountability, etc.). 

It is interesting to see some common themes emerging in the comments. For example, several of you raise the importance of the quality, safety, and cultural appropriateness of food. While this can be addressed in part through nutrition education and training, commenters point out that complementary support and/or policies must be present to ensure sustained improvement. These could be things like land rights, and appropriate agricultural support like crop insurance, equipment, appropriate seed and livestock, and financial incentives as well as an adequate infrastructure. Several of you also emphasize the importance of supporting family farming as part of nutrition-sensitive social protection.

Another theme that comes out is that of institutional arrangements, roles, and responsibilities. Someone suggests that the state should play a role in monitoring NGO-provided services. Another questions how related ministries (e.g. health) will be motivated to monitor nutrition outcomes coming through social protection. The book, Working Multisectorally in Nutrition: Principles, Practices, and Case Studies, may provide some ideas on that topic.

I am curious to see what other examples of successful or promising nutrition-sensitive social protection endeavors people put forth after participating in the conference. It may be helpful to think of what can be achieved in different phases in a particular country, especially for those that do not have anything in place yet. What could be a feasible and valuable first step?

I look forward to hearing more from you in the coming days.

--Lucy Bassett

Dear participants,

I am pleased to share the newly released paper on “Nutrition and social protection”, which presents each social protection instrument and describes how its impact on nutrition can be enhanced. The paper is complete with case studies and analysis of major challenges and windows of opportunity.

Given its importance for improving food and nutrition security, FAO has made social protection one of its corporate priorities. Social protection is one of the pillars of FAO’s Strategic Objective “Reduce Rural Poverty”, and will be the central theme of this year’s World Food Day and of FAO’s flagship report on the State of Food and Agriculture 2015.

The paper Nutrition and social protection is the result of a collaborative effort between the FAO Nutrition Division and Social Protection Division. It is written for policy makers and project managers working on areas related to nutrition and social protection, and aims to provide practical and operational suggestions to enhance the nutritional impact of social protection policies and programmes.

Abstract:

This publication presents the linkages and synergies between social protection and nutrition in the food and agriculture sector and proposes recommendations for maximizing the nutritional impact of social protection programmes. The target audience includes professionals working in social protection who wish to know more about how nutrition relates to their work, as well as nutrition experts who wish to know how social protection can contribute to improving nutrition.

http://www.fao.org/3/a-i4819e.pdf