Some practical recommendations, from a personal point of view, on how governance and aid choices and approaches may improve the prospects of lives, living conditions and opportunities of all in a society into and for their future:
A person’s resilience starts from conception. A pregnant mother needs to have access to vital nutrients, foods and care in a healthy environment and for her baby to be shielded from malnutrition and debilitating illnesses during the first years of life. Malnutrition permanently undermines a person’s, its community and country’s resilience and any potential to develop and thrive in a highly dynamic, changing world.
Several Sahel countries have some of the world’s highest infant and maternal mortality rates and they lack the basic governance foundations available and accessible for notably the sizeable and growing non-resilient part of its population. For them there is no equity.
Malnutrition represents a particularly high burden for the West Africa Sahel region. Of the estimated 74 million people living in its 6 main countries from Senegal to Chad (not counting Northern Nigeria, which harbours a malnourished population of similar scale), an estimated 5.0 million children under the age of 5 are chronically malnourished. This is well over a third of the 13.7 million <5’s estimated living in the Sahel this year. Another 830,000 children in this age group, most of them between 6 and 36 months old, are expected to become Severely Acutely Malnourished (SAM), malnutrition’s worst condition, in 2013. A child untreated for SAM has a 50% chance to survive.
These children and their mothers are at risk of adverse and often permanent consequences for their lives and prospects, because of their (early) stage in life and personal development. And they are at increased risk of becoming affected by socio-economic and food-security shocks, especially when already living strenuous livelihoods conditions. When looking at both aspects at the same time, one finds a very high correlation (studies show rates of 60% to even 80%) between the risk of becoming malnourished and of being raised in an ultra-poor family.
Vulnerability analyses are mostly taken from a food-security perspective (considering the latter risk-aspects, linked to food price-shocks, climatic shocks etc.). However, risk concepts that consider the persons in a specific category - in a stage of conception, birth and first vital growth - are far less widespread in vulnerability analyses. Considering the very strong link between malnutrition and socio-economic factors, for the effective prevention of under-nutrition, both approaches to risk are of vital importance and entirely complementary.
Prevention of malnutrition is therefore both an important and very concrete - in view of the 100,000’s of young children that require treatment every year, for a condition that is perfectly preventable - way forward to reduce the risks and levels of future food security crises in the Sahel as a whole, so intricately linked to the very high levels of malnutrition in the Sahel.
Preventative social protection measures such as safety nets will need to target the poorest households and persons as a priority. At the same time, all persons in the risk category (the <5’s and pregnant and breastfeeding women) will require actual - affordable, without financial, geographic and other such barriers - access to a minimum acceptable package of nutrition, health, immunisation and other associated curative and preventative care, the basic package of acceptable quality basic services. In sum: good governance.
The sense of urgency to make a basic package of essential basic services available so as to shield future generations from permanent personal disability and therefore from lack of their and their society’s resilience is striking, notably in the context of such high population growth.
Practical recommendations (non exhaustive) for immediate concurrent actions to improve the resilience of current and future populations therefore include:
* A common diagnosis with governance and development stakeholders, supported and informed by quality multi-sector evidence and expertise, to confirm, agree upon and own priority actions and policies, to be maintained for some considerable time to come, allowing for beneficial outcomes to take shape and supported by predictable realistic budgets;
* This includes a questioning of potential poor governance choices and practice too - which is complicated of course, and not entirely within the comfort zone of diplomacy and development cooperation perhaps, but necessary to reach actual progress towards more equity in real terms for those persons and populations most at risk of and affected by non-resilience;
* Measures to mobilise and scale-up the support of governance capacity at national and in particular decentralised levels (region, district, community) to help improve coverage of basic governance measures accessible by the least/non-resilient persons and to boost future good governance;
* Provision of the package of services and measures to allow for a comprehensive implementation of the 1,000-Day initiative and the treatment of Acute Malnutrition by national services and their development partners;
* Health user fee exemption for the population under the age of 5 and pregnant and breastfeeding women;
* Reliable supply of acceptable and controlled quality (reproductive) health, nutrition, wash, education, agriculture, livestock and other basic services inputs up to community level;
* Notably regarding reproductive health inputs, the principle of at least providing women and families until the most remote areas in a country with a choice to access these inputs appears to encounter serious and ill-justified opposition, based on untested hypotheses. Practice proves otherwise, no matter how religious and traditional an area may be perceived;
* Accessible minimum quality education, notably for girls until the age of 16;
* Targeted seasonal social transfers linked to nutrition and health outcomes using socio-economic criteria and approaches (such as on the basis of HEA) focusing on the Very Poor and Poor parts of the population. More sophisticated social protection schemes may be informed and developed on the basis of such practise when feasible;
* Accurate data collection and the transparent management of multi-sector early warning analysis and forecasting of food and nutrition security by a multi-actor governance-practitioner platform on local, national and regional levels;
* Maintain adequate quality emergency response capacities (that is: not to upscale attention to resilience at the detriment of emergency response) to help address the high (permanent) emergency needs until eventually hopefully the beneficial outcomes and impact of better “pro-resilience” governance and aid may become apparent.
Hope this is helpful for the discussion; of course these are personal views.
Kind regards from Dakar, Jan
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These discussions are led by the Food and Agriculture Organization of the United Nations (FAO), the International Fund for Agricultural Development (IFAD) and the World Food Programme (WFP)
and facilitated by the Global Forum on Food Security and Nutrition (FSN Forum)