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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

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Dear All,

It is such an opportunity, that I (we) can contribute to the change we desire in our societies as far as poverty and malnutrition are concerned; and this time through focusing on Social Protection.

Firstly, on my side, the ideal benefits of Social Protection measures are always outstanding and execellent on paper. It is the execution of some of these programs that is usually not appropriate. The developing world for so long has and is still (to a large extent) dependant on the developed world as regards social protection interventions. Some countries however have had it upon themselves to

The point here is CORRUPTION in some developing yet most vulnerable countries! It is viral and rapidly eating up all intervention systems today.

You will agree with me that the beneficiaries often times are not involved in the planning as well as monitoring and evaluting hence low sense of ownership as they do not have a say when resources are being swindled away in favour of the non beneficiaries for selfish purposes. Unfortunately, reports have always indicated achievements/success, challenges and recommendations not paying heed to the issues at the roots that hinder hitting targets; chronic inhibitors such as the scam of corruption.

It is therefore my humble request that the policy makers strongly consider the issue of corruption and misuse of resources in the process of desiging, formulating and implementing social protection programs.

Secondly, it is important to acknowledge the Nutrition forcused social protection interventions all around the globe. It is however key that there is a need to strongly consider the sustainability of these programs without compromising the well being of the beneficiaries.

The FAO's Protection to Production project in countries such as Kenya has taken a step to assess not only the quantitative results (food secutrity key indicators inclusive) but also the qualitative results that grantee sustainability of the interventions with continous and generation benefits. See: http://www.fao.org/economic/ptop/programmes/kenya/en/  Individual countries, even with their own local intervention strategies should aim at the long term outcomes. Failure to do this easily nutures a poor culture of dependency in societies were social protection measures are percieved as handouts even in times of no emergencies.

Thanks to Nyasha Tirivayi and the ICN2 Secretariat for the opportunity. I look forward to further discussion.

Regards,

Christine Namukasa

Nutritionist and Head of Research at Hunger Fighters Uganda

Alessandro Romeo

FAO
Italy

Dear members,

In the last decade, cash transfer programmes have become popular components of poverty reduction strategies in Sub Saharan African countries. Along with well-established benefits such as a reduction in food insecurity and increased school enrolment, recent research has found these programmes are also effective in promoting on-farm activities and investments in agricultural assets. In addition, some cash transfer interventions have proven effective in improving nutritional status of children living in beneficiary households. In the context of FAO-led From Protection to Production (PtoP) project , we use data from the Mchinji Social Cash Transfer pilot programme (Malawi) to assess if the programme had an impact on child nutritional status and to what extent this impact can be linked to increases in agricultural production by beneficiary households. 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. Full results will be submitted to the Journal of Development Economics.

I am from Georgia/Caucasus. For us is very important  participate to preparatory technical meeting which is to be held 13-15 November 2013, and to ICN2 at FAO Headquarters, in Rome, 19-21 November 2014.

We work for development on themes to improve nutrition throughout the lifecycle, focusing on the poorest and most vulnerable households, and on women, infants and young children, recognizing the nutrition transition and its consequences.

I am delighted to see this discussion of Social Protection to Protect and Promote Nutrition. It has been very good, but there is a point that deserves more attention: the rural women/girls and young  children, vulnerable and emergency contexts. However, when you look at existing data for Georgia/Caucasus and the developing world in general, malnutrition seems to be on the increase although this is not true in some countries. Typically, this challenge is viewed as a structural problem, It is everyone's desire that malnutrition should be booted out of humanity. Only 10% of the rural women /girls and children of Georgia  has adequate social security coverage, and more than 90% has none. These  are exposed to risks in the workplace and benefit from inadequate or non-existent health care and social security. This coverage regards a wide range of possibilities: minimum income in case of need, medical care, sickness, old age and disability, unemployment, accidents at work, maternity leave, family responsibility, and death. There will nesessarely be many activities designed to improve their social protection.

It is very interesting and positive that various international organizations join forces and knowledge to deal with synergy a global problem such as nutrition. I believe that this conference (ICN2) will draw new ideas and policies for the developing countries.

Thank you,

Marine Solomonishvili

President of International Foundation LEA &

Network of ethnic/religious minority women/girls (NGO)

19 Nishnianidze str,Tbilisi0105,Georgia

 

Esam Eldin B. M. Kabbashi

Ministry of Science and Communications
Sudan

Dear Secretariat

I proposed for the policy makers the design on Social protection to protect and promote nutrition to consider the different environment, cultures, gender and age and the economic capacities of the different social groups. These will be infiltrated with some elaboration in the project formulation. That is, the environment may dictate the nutritional pattern of its dwellers specially for a great deal of the African that live in forests and deserts with a spreading illiteracy. However, for the mundane societies the image may look the same in the end results i.e. the malnutrition here is in taking unnecessary amounts of foods that may result in obesity, hyperinsulinaemia and probable diabetes together  with hypertension and the long series of disorders including heart and vascular diseases. The formulation of the project may include and amalgamate the scientific findings with the social nutritional activities as much as possible. However, a main part of the formulation must include the mandate of healthy water and how it could save a lot for the communities in protecting them from an extensive list of water transmitted diseases. The formulation may also consider a part in the importance of using healthy additives in preserved food with a tendency to the natural ones. 

However, the implementation of all the array of healthy nutrition may include the efficient ways of convincing the different groups of population with what mentioned considering the psychological, social, cultural and educational aspects of the targets. However, it is worth to mention that the awareness of the healthy nutritional pattern may need a continuous activation e.g. the well educated eat more and more sugars than the needed together with drinking less and less amounts of  water than the needed. Accept my kind regards please.

Dr. Esam Eldin B. M. Kabbashi

Food Research Centre, Ministry of Science and Communications, Khartoum.

Let us now, once and for all, stop talking about safety nets! This is what leads to mere tinkering within the system. The ongoing casino capitalism with its global restructuring, creates the problems, and food and nutrition professionals are supposed to pick up the pieces? Just so that poor and marginalised people do not revolt? Who is cheating whom here? We need to stop victimising poor people and them throwing them bread-crumbs. What about changing the system that makes safety nets for poor people necessary to begin with?

Claudio, PHM

Dear forum members,

I would like to share with you one example of social protection scheme and how it has contributed to the promotion of nutrition in my country, Rwanda. In Rwanda, there are several forms of social protection schemes including health insurance (this has improved health care in Rwanda dramatically), the Vision 2020 Umurenge Programme (VUP), one cow per poor family, among others. My contribution to the present discussion will focus on one cow per poor family which is linked to the third question of this topic.

Under the name of Girinka programme, it was initiated by the President of Rwanda, Paul Kagame in 2006. The programme targets poor households and enable them to own an improved dairy cow. In principle, first, a poor family (inclusion criteria have been established) receives a cow free of charge. Second, when the initial cow reproduces, the first female calf is given to a neighbor who passes on a female calf to another neighbor, and so on.

Beneficiaries of “one cow per poor family” report a daily milk consumption of five litres. Additionally, their neighbors who have not benefited from the scheme report that their children (<5 years) now have milk regularly (see www.ifad.org, Report no. 2434-rw). Furthermore, the manure can be used for crop fertilization and biogas. Malnutrition is also being addressed through school feeding programs as result of one cow per poor family.

Of course, many challenges remain, but the government is committed to improving nutrition through multisectoral approaches.  To end my contribution, I would like to add that income or in-kind transfer is necessary but not sufficient to improve nutrition. I would also like to support Mr. NGOUAMBE Nestor’s contribution by saying that women must be given opportunity to have control over resources, given their recognized role in improving nutritional status of their families.

The Food and Agriculture Organization and World Bank have produced an introductory (free!) e-learning course on social safety nets. The course provides an overview of safety net programmes and how they are used and customized for different contexts to reduce poverty and build food security. It also includes training materials which you can customize to suit your own needs. Available in English, French, and Spanish at:

http://www.foodsec.org/dl

Regarding Nyasha Tirivayi’s question, “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? Over 3 years?”:

While there has been a recent push back from the polar view that there is no catch up after the 1000 day period, the evidence marshaled is not programmatic; there still is little evidence that programs at scale are as effective after that period as they are during the 1000 days.  This is particular true for food transfer programs which have shown that supplements during weaning have larger impact than those receive subsequently. See, Lutter CK, Mora JO, Habicht JP, Rasmussen KM, Robson DS, Herrera MG. Age-specific responsiveness of weight and length to nutritional supplementation. Am J Clin Nutr. 1990. 51(3):359-64 as well as Schroeder, Dirk, Reynaldo Martorell, Juan Rivera, Marie T. Ruel and Jean-Pierre Habicht.  1995. Age Differences in the Impact of Nutritional Supplementation on Growth. Journal of Nutrition 125: 1051S-1059S.  There is also some evidence that attempting to address stunting after a child’s second birthday increases the chance of subsequent obesity or heightens the risk of chronic diseases in adulthood.

On the other hand, there is a wealth of information on the potential to close the gap in cognitive and socio-emotional skills attendant to stunting in the post 1000 day period as referenced in the 3rd Lancet article launched June 6 and linked with this discussion.  While one will always desire more costing studies, investing in preventing stunting in the first 1000 days makes sound economic sense while the resources available for programs aimed at children somewhat older would be better spent on other aspects of child development, perhaps directing particular attention to those children who for a variety of reasons, did not avoid stunting during the critical early years.  Such prioritization may be made on a criterion of efficiency of investments as well as an objective of equity in subsequent educational opportunities.    

Regarding the question: “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?”

Wasting is a transitory measure; most children either succumb to the risks of severe acute malnutrition or gain enough so that they are no long classified as severely malnourished. Fortunately, there have been major strides in both identifying children in this critical situation and in implementing cost effective programs to reach these children.  While these are excellent programs, they are not social protection activities (except, perhaps, when family emergency response is coupled with age specific emergency measures in, for example, drought or hurricane relief).  Targeting other more predictable social protection endeavors to poor families with children in the most vulnerable age bracket will likely simultaneously address stunting and underweight; I cannot think of a social protection instrument that, once the age of the target  population is considered, can distinguish its impact on stunting relative to that on underweight.

The more difficult choice is determining the share of available resources that address the consumption needs to other population groups be they slightly older children or even elderly.  There are equity reasons to address the needs of such groups.  However, with limited resources there are likely tradeoffs on these two dimensions.  For example, programs targeted to the elderly have (at best) only indirect nutritional impact compared to allocating similar funds to children.  Conversely, prioritizing funds towards programs linked to investment in health have a recognizable investment potential but may exclude those that cannot take up opportunities for child investments.  Thus, while consideration of the potential for social protection to impact nutrition is important, it does not eliminate the need to balance between the twin priorities of equity and efficiency.

La vulgarisation et le conseil agricole joue un rôle prépondérant dans l'accompagnement des femmes pour la sécurité alimentaire de leurs familles.

Il est reconnu à la femme le rôle de moteur de la sécurité alimentaire des familles populations "pauvres". Elles sont chargées de la production et de la préparation des repas au sein des familles. Cependant, elles n'ont pas toujours accès aux services ruraux qui facilitent leur  tâches. Les discriminations faites à leur encontre contribuent à maintenir la plupart des pays dans une situation stagnante d'insécurité alimentaire.

Au Cameroun, depuis 2002, les nouveaux dispositif d'appui-conseil impliquent davantage des femmes et prennent progressivement en compte leurs besoins. D'une façon global, les femmes bénéficient déjà des formations sur:

- Le diagnostic de la sécurité alimentaire du ménage: il s'agit de voir la fréquence de repas consommé par jours par chaque membre du ménage, observé la fréquence d'utilisation des stocks vivriers, les prévisions en terme de production.

- L'inventaire des besoins alimentaires des membres de la famille: il s'agit de d'estimer  approximativement les quantités et qualités d'aliments que chaque individu du ménage peut consommer durant l'année. Ce qui permet à l'exploitation de définir son projet de production en fonction de ces besoins. Par exemple, il s'agit d'apporter les réponses aux questions telles que, quelles sont les besoins en céréales de ma famille, les quantités actuellement produites suffiront-elles pour combler ces besoins? Si non quelles quantités supplémentaires doit-je produire pour combler ces besoins. si oui quelles quantités doit-je espérer vendre?

Selon une étude réalisée entre 2011-2012, environ 60% des femmes affirment avoir participé aux programmes d'appui conseil et estiment que leur capacité de diagnostic et de gestion des stocks est améliorée. Les femmes valorisent leurs connaissances locales dans la transformation des denrées alimentaires en adoptant aussi les innovations telles que les semences améliorées et les équipement modernes de transformation des produits (maïs, manioc etc).

Mais ont constate que le faible niveau de scolarisation des femmes est un frein à l'appropriation de la démarche. Elles ont aussi des difficultés à participer aux programme dans la mesure où les considérations traditionnelles et coutumière leur interdisent de parler devant les hommes et aussi d'hériter des terres qu'elles peuvent mettre en valeur au profit de la population.

Malgré ces obstacles, les femmes sont le moteurs de la sécurité alimentaire des ménages ruraux. Elles savent valoriser leur potentiel pour la production et la transformation. Elles passent la majeure partie de leur temps à réfléchir pour le bien être des enfants et la famille.

Il serait donc important que des mesures soient prises pour renforcer leur capacités et réduire les considérations qui limitent leur accès aux services de vulgarisation et conseil agricole.