全球粮食安全与营养论坛 (FSN论坛)

意见征集

关于征集健全粮食系统投资范例和良好实践的通知

The Committee on World Food Security invites you to share experiences and examples to help identify lessons learned and good practices on investments promoting healthy food systems, including those implemented through south-south and triangular exchanges.

Taking stock of existing country-level experiences and lessons learnt on how to improve nutrition is a powerful way to stimulate stakeholders to adopt, adapt and scale up proven and effective practices that are both country- and context- specific.

The results of this exercise will inform CFS policy development work on nutrition to align CFS efforts to foster global policy convergence with identified gaps, country needs and realities, and contribute effectively to the UN Decade of Action on Nutrition.

A selection of the submitted experiences and examples will be compiled in a background document for discussion in the CFS 44th Plenary meeting (CFS44) in Rome on 10 October 2017. 

In the selection process, we will consider diversity in terms of geography, actors and perspectives, food systems, investments and nutrition issues addressed. We will also consider the lessons learnt in terms of their relevance for policy making, the evidence of how nutrition outcomes changed or are expected to change alongside the extent to which the examples present lessons (positive and negative) that could inform future investments.  Examples jointly submitted by stakeholders are encouraged.

To make your contributions as relevant as possible, we would like to invite you to focus on:

  • Food systems: describe the food system your example belongs to, the nutrition challenges and  inter-linkages and complementarities among the system’s components;
  • Nutrition: describe how the example addresses nutrition issues in the context of the food system considered;
  • Investments: describe the investments and their objectives, as well as their intended and unintended outcomes, on nutrition in particular;
  • Inclusiveness: describe to which extent the investment considered was developed through a multi-stakeholder and participatory approach;
  • Learning: describe the lessons (positive and negative) that can be learned from your case and whether these could be replicable in contexts having the same/similar characteristics and how gaps, obstacles and any other adverse conditions were addressed;
  • Diversity: describe the geographic scope and the different stakeholders involved in your example;
  • South-south or triangular collaboration: If applicable, describe whether the example has benefitted from a south-south or triangular cooperation approach.

The deadline for submissions is 19 May 2017.

Please use the submission form to share your examples and experiences.

You can download it here: 
http://bit.ly/2nAitb1

You can upload the completed form below or send it via email to [email protected].

For more information on CFS’ engagement in advancing nutrition please see: http://www.fao.org/3/a-mr186e

The Committee on World Food Security (CFS) is the foremost inclusive international and intergovernmental platform for all stakeholders to work together to ensure food security and nutrition for all. The Committee reports to the UN General Assembly and to FAO Conference. With a membership of 135 countries and using a multi-stakeholder, inclusive approach, CFS develops and endorses evidence-based policy recommendations and guidance on a wide range of food security and nutrition topics. CFS holds an annual plenary session every October in FAO, Rome. 

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Food and Nutrition Department

Ministry of Health
Chile

Proponent

Food and Nutrition Department

Date/Timeframe and location

Chile

Main responsible entity

Ministry of Health

Nutrition context

In the last decades, the nutrition situation in Chile has shifted with the prevention and control of prevalence of undernutrition and increase of overweight and obesity. Modern diets have been incorporated to daily diets and traditional foods have been replaced gradually. Currently, cardiovascular diseases are the first cause of death and one of the main morbidities among adults while risk factors for chronic diseases, such as sedentarism, inadequate diet (high calories, sugar, fat and sodium and low nutrients), tobacco and alcohol consumption, have also increased.

The prevalence of overweight and obesity in Chile is:

  • Obesity in children under 6 years old 11,4%
  • Overweight in children under 6 years old 23,7%
  • Obesity in adults over 15 years old 25%
  • Overweight in adults over 15 years old 40%

Key characteristics of the food system(s) considered

Chile’s food system is undergoing structural changes (Transitional). As urbanisation increases, food commodities are increasingly sourced from complex supply and value chains driven by large retailers and processors. While productivity enhancement is still a priority, the government targets investments that shape the transformation of the food system. Chile has demonstrated the ability to invest in and implement strong supply side interventions as well as demand side interventions. Chile experienced a nutritional transition that contributed to currently 40% of adults and an increasing number of children and adolescents in the country present overweight or obesity.

Annual sales per capita in 2013 of ultraprocessed foods in Chile were 201,9 kg, becoming the second market of these foods after Mexico in Latin-America and Caribbean region.  59,8% growth of ultraprocessed foods in Chile from 2000 to 2013.   

Key characteristics of the investment made

The national strategy includes an approach based in social health determinants and health in all policies in order to change food environments.

Laws and regulations for food labeling:

In 2012, the Chilean government approved a Law of Nutritional Composition of Food and Advertising (Ley 20.606). In June 2015, the Chilean authority approved the regulatory norms required for the law’s implementation (Diario Oficial No 41.193) which came into effect on 27 June 2016. The regulatory norms define progressive limits for calories (275 calories/100g or 70 calories/100ml), saturated fat (4g/100g or 3g/100ml), sugar (10g/100g or 5g/100ml) and sodium (400mg/100g or 100mg/100ml) content considered “high” in food and beverages. All food that presents addition of sugars, sodium or sat fatty acids and exceeds these limits must have a front-of-package black and white warning message inside a stop sign that reads “HIGH IN” followed by CALORIES, SATURATED FAT, CALORIES or SUGAR OR SODIUM, as well as “Ministry of Health”. A warning message will be added to products that exceeds the limit (eg a product high in fat and sugar will have two stop signs). The regulatory norms provide specifications for the size, font and placement of the warning message on products. The limits for calories, saturated fat, sugar and sodium will be implemented using an incremental approach, reaching the defined limits by 1 July 2018 (see "O – Offer healthy food and set standards in public institutions and other specific settings" and “R – Restrict food advertising and other forms of commercial promotion” for details of the law's school food and advertising restrictions).

Taxation: Since October 2014, Chile applies 18% ad valorem tax to sugary drinks that contain more than 6,25g of sugar per 100ml. Sugary drinks with less than 6,25g of sugar per 100ml are taxed with 10%. Sugary drinks are defined as non-alcoholic drinks with added sweeteners and include energy drinks and waters.

Agreements: In 2011 the Chilean government agreed a voluntary target with bakers to reduce salt content of bread to 400mg/100g. Today the average reduction reaches 480mg/100g

Programmes:

  • Healthy Strategies, Municipalities, Communes and Communities: This strategy aims to install stable structural conditions over times that support the change of lifestyles through the development of healthy environments for the population. In this context, the challenge for governments is to bring about the behavioral change of society and individuals towards healthier lifestyles that will reduce the prevalence of these risk factors. In this area, policy-making at the territorial level considers the living conditions of people and communities, which must respond to the various realities, taking into account their culture, local history, resources, capacities and strengths of the people, as well as the Various forms of linkage characteristics of each community.
  • healthy Life: this program contributes to reducing the incidence of risk factors for developing diabetes mellitus and arterial hypertension through an intervention in eating habits and physical fitness for children, adolescents, adults and postpartum women.

Key actors and stakeholders involved (including through south-south/triangular exchanges, if any)

Chilean government: Ministry of Health, Ministry of Economy, Ministry of Finance, Ministry of Agriculture, National Consumer Service, National Television Council, Chile University, parliament, National Institute of Food technology (INTA).

Key changes (intended and unintended) as a result of the investment/s

Key changes Law 20.606:

  • Mandatory use of warning signs in food with addition that exceed the limits stablished by the Ministry of Health.
  • Prohibition of sale in schools of foods that exceed the limits established by the Ministry of Health
  • Prohibition of advertising of foods that exceed the limits established by the Ministry of Health

*Six months after the entry into force of Law 20.606:

  • Execution of more than 2,100 inspections, with a compliance of 64, 4%. In addition, the percentage of defaults tended to decrease over time
  • Broad compliance in television advertising, finding only 2 pieces with suspected breaches since the entry into force
  • The food industry, through SOFOFA, reported a 18% reformulation of its products.
  • The perception of Chileans is positive regarding the measures implemented by the regulation, declaring between 74.4% and 92.4% of cases as "good" or "very good" each of the regulations.

Challenges faced

  • Modern lifestyle, difficulties to organize time to cook at home.
  • Difficult to address adult population with health messages
  • Coordination with different sectors
  • The social value given to sugary drinks and “high in” snacks
  • The role and interests of the food industry
  • Technical difficulties associated to the inspection of advertisement in internet and cable tv.

Lessons/Key messages

  • The need to understand food patterns as a social habit, modeled by social determinants
  • Integrated work between ministries and other sectors to change laws and benefit health
  • The change of food environments as a key goal for  public health

Taryn Barclay

Cargill
United States of America

Dear FSN Forum,

Please find enclosed two case study submissions from Cargill in response to the open call for examples and good practices on investments for healthy food systems.

Thank you!

Taryn

Director, Corporate Responsibility and Partnerships

Cargill

Helping the world thrive

Proponent

Cargill and CARE – Nourishing the Future in Central America

Date/Timeframe and location

In partnership with international humanitarian organization CARE, Cargill launched the Nutriendo el Futuro (Nourishing the Future) program in 2008. Nourishing the Future started in Honduras and expanded to reach 11 municipalities: three in Guatemala, three in Honduras and five in Nicaragua, over an eight year period until 2016. With the new phase until 2019 we will be working with 18 municipalities.

Main responsible entity

Cargill and CARE - Cargill has been partnering with CARE, a leading humanitarian organization fighting global poverty, for more than 50 years to improve food and nutrition security by strengthening rural communities.

Nutrition context

Cargill and CARE have worked to improve nutrition and the livelihoods of communities in eight countries globally – including Guatemala, Honduras and Nicaragua, since 2008. Called The Nourishing the Future program, the collaboration in Central America has included a strong focus on improving nutrition education and providing access to more diverse diets.

In Central America, the partnership has reached more than 277,000 people, including assistance for 100,000 farmers and nutrition education for 130,000 children, parents and teachers.

Key characteristics of the food system(s) considered

Despite increased economic growth in the region, 13% of the population in Central America is malnourished and 48% of the population live below $1.25/day. Guatemala alone experiences 48% stunting and nearly 16% undernourishment.

The collaboration focused on improving nutrition in rural agricultural communities where poverty and malnutrition are often most acute. Within the communities; schools, households and farms were targeted for specific interventions, including social and behavior change communication in schools, cooking demonstrations, community and school gardens, and training in healthy nutrition practices for school children, teachers and community leaders. Cargill also addressed the lack of infrastructure in many of the schools by building kitchens. This provides a clean, secure space for preparing the meals. Cargill also supplements the meals with protein products. 

Cargill also worked with local farmers to improve agricultural production through training in good agronomic practices across seven value chains, including maize, red beans, sorghum, green beans, blackberries and peas.  The focus of these efforts was to increase productivity for farmers and provide access to markets to increase local food security and nutrition.

Key characteristics of the investment made

Cargill has invested more than $6 million in the Nourishing the Future program since it began in 2008. In 2016, Cargill renewed its global commitment to CARE for three years. The additional funding for Central America – more than $3 million – will continue the work in Honduras, Guatemala, Nicaragua and also expand to Costa Rica.

Key actors and stakeholders involved (including through south-south/triangular exchanges, if any)

The Cargill-CARE Central America collaboration melds Cargill’s expertise in food and agriculture with CARE’s decades of success in community-led rural development, helping communities to take a leading role in identifying problems and developing sustainable solutions. This is public-private partnership that prioritizes community-led solutions. Local and central Government has taken the Nourishing the Future project to adapt actions into their own social development agendas. Cargill volunteers are strengthening the impact with school infrastructure such as Cargill Kitchens.

Key changes (intended and unintended) as a result of the investment/s

Early results of the project demonstrated a positive impact on local nutrition and stronger regional food system.  Households in Guatemala and Honduras more than doubled their incomes as a result of the project with incomes increasing by 22.5% in Nicaragua. Families in all three countries diversified their diets. The dietary diversity scores for all three countries went up 16 to 45 percent in the last three years. Analysis of the last years shows families in the program saw a decrease in the number of months they were food insecure. Guatemala families dropped from five months to two, a 60 percent improvement. Honduras and Nicaragua showed improvements of 19 percent and 13 percent, respectively. Larger companies that export products like green beans don’t work with small individual producers, and maneuvering the market to find a reliable middleman can be overwhelming. Nourishing the Future enabled 50 female producers to connect, form cooperatives and share the costs of connecting to larger buyers with their combined harvest. A recent CARE study, which looked at women’s empowerment among participants, saw big gains in all three countries. In Honduras, the empowerment index was up 21 percent. The index measures how empowered women feel to financially provide for their family and how much control they have at home to make purchasing decisions.

Challenges faced

While the partnership is seeing measurable success in raising incomes of families, improving nutrition and food security, challenges remain.  One of the most acute challenges is the impact of climate change on local farmers. Farmers are increasingly facing drought, flooding and other challenges due to short- and long-term climate impacts. Moving forward, Cargill aims to create a more focused connection with its businesses and to set strong benchmarks on improving climate resilience. This resilience will help families adapt and stabilize incomes.

Lessons/Key messages

Further information can be found here:

https://www.cargill.com/story/eight-years-of-progress

---------

Proponent

Cargill

Date/Timeframe and location

2004- present/Brazil

Main responsible entity

Fundação Cargill (The Cargill Brazil Foundation)

Nutrition context

Projeto de Grão em Grão (Grain by Grain project)

One of the key pillars of The Cargill Foundation’s work in Brazil is to help improve access to safe, healthy, sustainable and affordable food for communities where Cargill operates in the country. In 2004, the Grain by Grain project was established to improve nutrition education and ensure access to fresh produce for schools.

The Grain by Grain project provided education on concepts ranging from proper food hygiene, post-harvest handling of vegetables, and vegetable garden production techniques. Schools were provided with all the resources to establish vegetable gardens, including seeds, tools, compost. The harvested products were then used as part of the school lunch, making the meals more nutritious and tasty. Teachers and canteen staff also attended training courses on safe food practices and nutritional techniques. The project also incorporated food safety training for families. The project was initially developed in support of the National Zero Hunger Program in Brazil.

Since 2004, the gardens were developed on school premises, but the learning from program was that this created additional requirements for the schools in terms of maintenance, staff time, and management of the gardens. Also many of the schools were in rural communities where there was existing agricultural production taking place. So in 2015 a strategic decision was taken to transition the supply of fresh produce from the schools to local small-scale family farms. This was also a way to strengthen the relationship of Cargill and the communities and create new markets for the local farmers. The Grain by Grain project started two pilot initiatives engaging small-scale family farms, in the Brazilian cities of Santarém and São José do Rio Pardo.

The main idea was to train the farmers in more sustainable techniques and guide them to diversify their production. With a larger and better quality production they started to organize themselves in trading groups to sell to the community, including to public schools through the federal incentive programs and the national school food program.

Key characteristics of the food system(s) considered

The project aimed to address two issues in the food system: 1) The lack of sufficient nutritious fresh foods for school meals, a key vehicle for improving dietary diversity and nutrition for children and young people; and 2) The lack of market access for local produce farmers.

Key characteristics of the investment made

The Cargill Foundation has contributed BRL 13.255.000 (over US$4 million) since the beginning of the project as well as providing technical expertise, employee volunteers, and creating new connections for schools, farmers and the final consumers.

Key actors and stakeholders involved (including through south-south/triangular exchanges, if any)

This public-private partnership engages local and global experts including Cargill employees, schools, local government, teachers, canteen staff, parents, farmers and general consumers. It is however very locally owned and managed, with local producers and schools connecting to ensure the schools have a continuous supply of fresh produce for their feeding programs.

Key changes (intended and unintended) as a result of the investment/s

As a result of the project, farmer participants on average have tripled their incomes while cutting pesticide use by 90 percent. On a typical year, for instance 2014, the project was present in 10 cities and 95 schools and benefited 41,000 students and 1,800 teachers.

Listen to farmers talk about their success - https://www.cargill.com/story/empowering-vegetable-farmers-in-brazil-grain-by-grain

Challenges faced

While the program has seen measurable improvements in local nutrition and stronger food systems, there are still a number of challenges. The program has reduced the administrative burden for the schools but there is still a requirement to manage this initiative with the producers and school staff, which some schools are under-resourced to do. There are still schools that have their own gardens and have to invest in its maintenance and management.

Increasing the adoption of the healthy meals is a challenge and therefore continued education on the nutritional value is ongoing. Productivity and incomes have increased for the local producers, but there are still further improvements to be made to increasing farmers’ knowledge of good agricultural practices and participation in the market. There is also further opportunity to have more producers connected to the federal incentive programs PAA (Food acquisition program) and PNAE (National School Food Program).

The Cargill Foundation will continue to work through these challenges in collaboration with the farmers, schools and local authorities as the long term ambition is to expand the pilot to other communities where Grain by Grain is operating.

Lessons/Key messages

The project has resulted in several key insights that will help scale the impact and further strengthen the food system.  This includes continued education on nutrition and diverse diets in order to both stimulate the demand for fresh produce in the community and to build increased adoption of healthy meals at the schools.

 

 

 

 

Dear Organizers,

HarvestPlus is pleased to submit the attached entry/contribution in response to the recent CFS call for examples and good practices on investments for healthy food systems.

Thank you very much.

Regards,

Adewale Oparinde, Research Fellow

HarvestPlus I Better Crops * Better Nutrition

c/o IFPRI 1201 Eye, NW, Washington, DC 20005

O: +1.202.627.4690 I M: 202.492.7324

Good day,

on behalf of the World Foundation for Prosperity and Autonomy, please find below the template of the nutrition project and a concepts expalining the background of the project.

Thank you.

S Gershuny for World Foundation for Prosperity and Autonomy

ValDavid Quebec Canada J0T 2N0

Proponent

World Foundation for Prosperity and Autonomy

Date/Timeframe and location

2007-2009   Lesotho (district Teyateyaneng)

Main responsible entity

Local affiliated organization:  Canadian Centre for Prosperity and Autonomy Lesotho

Nutrition context

The organization focused on the nutritional status of young children considered underweight for their height and in particular with respect to a protein intake which would allow adequate growth and immune system development.  Many children, already having lacked this protein in childhood are identified as  'stunted' in their later childhood and teen years.

Pregnant and nursing women were to be included in the project work in the intention of improving transmission of nutrients from mothers to children during pregnancy and breastfeeding.

According to a basic project carried out by an organization 'Leaf for Life' in Central America an extract of leaves (ex. Alfalfa leaves) with a certain protein content could be used effectively as food supplement for the young children in a meal of carbohydrate (rice or sorghum..).

Our project in the village of TY invited several local women to pick leaves of local plants, others to carry out the leaf extraction and drying of the supplement.

An agreement through the Ministry of Health would allow children attending Mother and Child Health clinics to receive supplement initially  for a six month period.

A second aspect of the project included the initiation of small agricultural businesses by families living around the area of the 'extraction' workshop, as a sustainable response to providing increased income to the families, group marketing strategies and the use of various soil protection and recovery techniques. (Please request our Concept note for further details)

Key characteristics of the food system(s) considered

The basic food system of Basotho people consists of a cereal made from maize meal ('papa') with a chopped and boiled vegetable known as 'moroho' which is called 'spinach' and is mainly made from leaves of swiss chard.  Without an addition of a meat or meat substitute source, which many cannot afford, complete protein and various vitamins and minerals can be lacking.   

Key characteristics of the investment made

Funds from a Canadian Rotary Club allowed for training of the group of women and initial payment of salaries.

Current efforts by our international organization to provide the local organization with further funds would include micro finance funds for the rural families, improved equipment for the leaf extraction process, salaries for project managers in each of the country's ten districts, funds for periodic travel for monitoring and distance communication of the international organization.

 

CONCEPT NOTE

Cooperatives and Associations for Plant Production, Extraction and Transformation

Based on research carried out by the British organization,”Find your Feet” and the U.S. “Leaf for Life” which showed that a protein-rich extract from alfalfa leaves, had the capacity to eliminate symptoms of acute malnutrition in a relatively short time period,  we have developed a programme for the production and distribution of a protein-rich leaf extract supplement for young children and pregnant women produced from leaves of  plants indigenous to the country.

Associated with this programme, an agriculture development activity involving at least sixty farm families, living in the area surrounding the extraction workshop, will assume an objective of increasing household income and financial security, enabling these rural people to purchase foods not grown and other commodities required.

Following a community stakeholders gathering, families interested in participating will contract to supply the workshop with a certain quantity of  (selected indigenous and grown plant leaves from one third of their field or garden).

On another third of their land, they will grow maize, a staple food plant usually grown as a mono crop, intercropped with beans and pumpkins or squashes from non-treated seeds for a potential organic market. The final third will be planted with organic herbs (to be packaged) or vegetables again for an organic market.

Area coordinators (local women), who will receive appropriate training at the beginning of the project work, will be enabled to encourage the farmers and gardeners to plant certain leguminous trees around their gardens or fields (to increase water retention and put minerals into the soil), utilize drip irrigation equipment, save seeds and sell them, find ways of transforming cultivated vegetables to innovative products for market, conduct group consultation sessions about marketing and report to the NGO consultant about achievements and any particular challenges encountered.   Negotiation by the consultant with a local bank for the coordination of a small micro-finance fund will allow start-up of each farm household with untreated seeds, compost, fencing, etc.  With the assistance of the area coordinator and assistants, farmers will write a brief description, expected costs and revenues paper about their proposed agriculture project to be approved by the NGO projects committee, in addition to attending a basic training session before receiving initial funds.

The leaf extraction workshop, under the guidance of the area coordinator, will hire four to six local women to receive leaves from the farmer families, produce the leaf protein concentrate using basic equipment, distribute to up to five hundred children and pregnant women in their locality, and offer (nutrition and agriculture) education workshops to the parents of children and pregnant women receiving supplement.

An initial baseline survey of the nutritional/health status of children and pregnant women to receive supplement, as well as a household income survey of participating farmer households, undertaken by the consultant from the organization 'World Foundation for Prosperity and Autonomy', will be followed up after each six months of the programme and a comprehensive report shared with implicated stakeholders.

As the small agricultural projects begin to prosper, farmer contributions to a common fund will allow the initiation of community support projects (according to a system referenced in the book “Foundations for World Unity” ) for  vulnerable members like orphans, elderly and the sick decided upon by the participating farmers.



 

Dear Mr, Mrs,

On behalf of Mr Crispim Moreira, FAO´s Representative of Bolivia, I am pleased to send to you a contribution of good practices on investments for healthy food systems that FAO is implementing in the southern and central area of the rural area of Bolivia.

Best Regards

Sergio Laguna Bretel

Asociado de Programas

Representación de la FAO en Bolivia

 

Proponente

Representación FAO Bolivia

Fecha/plazos y ubicación

2015-2017, Municipios de Tupiza y Villazon del departamento de Potosí, y los municipios de Pojo y Pocona del  departamento de Cochabamba.

Principal entidad responsable

FAO Bolivia

Contexto nutricional

La desnutrición crónica en el menor de cinco años continúa siendo uno de los problemas de salud no resueltos en Bolivia con una prevalencia del 18.1%, dos de cada 10 niños menores de 5 años padece de desnutrición crónica. Sin embargo la desnutrición crónica afecta al 25.6% de los niños menores de 5 años. Asimismo seis de cada diez niños entre 6 meses y 5 años de edad padecen de anemia, siendo este el problema de deficiencia nutricional con más prevalencia en el país. (Encuesta de Evaluación de Salud y Nutrición, 2012).

Los niños con desnutrición tienen mayor probabilidad de contraer enfermedades, por lo que a menudo se incorporan tardíamente al sistema educativo y registran un mayor ausentismo escolar.

Asimismo, el déficit de micronutrientes tiene un impacto directo en la reducción de sus habilidades intelectuales y capacidad de aprendizaje; desventajas que en el largo plazo dan como resultado personas adultas que no tienen condiciones de desplegar su máximo potencial intelectual, físico y por ende productivo, desacelerando el progreso económico y afectando de manera irreversible su desarrollo humano.

Principales características del (de los) sistema(s) alimentario(s) considerado(s)

En Bolivia, actualmente se están realizando esfuerzos significativos para mejorar la seguridad y soberanía alimentaria enfocados al logro de un estado nutricional y de salud adecuado, sobre todo de la población de mayor vulnerabilidad, lo que significa reducir en primera instancia los porcentajes de desnutrición infantil expresada en la talla baja y anemia, y avanzar hacia la preservación de una alimentación adecuada de bolivianos y bolivianas en todo su ciclo de vida para evitar las enfermedades crónicas no transmisibles desde una perspectiva integral y de respuesta a múltiples determinantes.

Esto se encuentra respaldado en la normativa actual como la Constitución Política del

Estado que en el artículo 16 constitucionaliza el derecho a la alimentación adecuada, las Leyes 144 “Revolución Productiva Comunitaria Agropecuaria”, 300 “Ley de Madre Tierra”, 338 “Ley de las Organizaciones Económicas Campesinas, Indígenas y Originarias (OECAS) y de las Organizaciones Económicas Comunitarias (OECOM)”, 3525 “Promoción de la Producción Ecológica”, 622 “Alimentación Complementaria Escolar”.

A un nivel más programático la Seguridad y Soberanía Alimentaria está reflejada en los pilares 6 y 8 de la Agenda Patriótica al 2025, la Política de Alimentación y Nutrición (PAN) que contempla programas nacionales como el Programa Multisectorial

Desnutrición Cero (PMDC), el Programa Nacional de Alimentación Complementaria Escolar (PNACE) y el Programa Nacional de Agricultura Familiar Campesina Comunitaria Sostenible (PRONAGRIFSC).

Estos esfuerzos están siendo articulados de manera multisectorial del Consejo Nacional de Alimentación y Nutrición (CONAN).

Características clave de la inversión realizada

La desnutrición deriva de muchas causas. Tiene que ver con la disponibilidad y acceso a alimentos suficientes para cubrir el requerimiento diario de energía, sin embargo, cubrir este requerimiento energético no se traduce necesariamente en una buena nutrición.

Alcanzar una nutrición adecuada depende del balance del consumo de energía y de micro y macro nutrientes, así como de otros factores inherentes a la pobreza, prácticas de alimentación y nutrición, cuidado de los niños, acceso a servicios de salud y de saneamiento, entre otros. Por lo tanto, la seguridad alimentaria y la nutrición no solo se refieren al acceso y disponibilidad de alimentos, sino también a la calidad de estos y a las condiciones de salud y educación de las familias.

En este contexto el proyecto abordó el problema de la malnutrición desde un enfoque multisectorial como condición necesaria para lograr traducir el aumento de la disponibilidad de alimentos locales en una mejor nutrición, así como impulsar sistemas de producción y consumo local que sean ambiental y socialmente sostenibles, promoviendo la creación o fortalecimiento de espacios de diálogo.

Por esta razón el enfoque  que se implementó en el desarrollo de la experiencia fue de “Territorialización de políticas públicas” y “Sistemas agroalimentarios sostenibles, resilientes e inclusivos”, lo que permitió que las políticas nacionales lleguen al nivel local (articulación vertical) y en el nivel local se articule la producción agroecológica y diversificada de alimentos con el consumo primero de las mismas familias, la transformación, y la comercialización de excedentes a las entidades gubernamentales a través de las compras públicas (articulación horizontal).

Principales actores y partes implicadas involucradas (incluyendo a través de intercambios Sur-Sur y triangulares, si procede)

Ministerio de Desarrollo Rural y Tierras-MDRyT,

Ministerio de Salud-MS y Ministerio de Educación-ME

Servicio Departamental de Salud Cochabamba y Potosí

Gobierno Autónomos Municipales de Villazon, Tupiza, Pocona y Pojo

Organizaciones de Mujeres Campesinas Indígenas Bartolina Sisa

Centrales de Trabajadores Campesinos

FAO, ONUDI y UNICEF

Principales cambios (previstos y no previstos) como resultado de la(s) inversión(es)

El principal cambio se alcanzó en la articulación a nivel local del área de desarrollo productivo y desarrollo humano, como producto de la incidencia en los espacios de diálogo conformados por representantes de la sociedad civil, instancias técnicas y autoridades locales, lo que ha permitido a nivel local:

  • 1149 familias se capaciten producción agroecológica organizados en 56 Escuelas de Campo, en las que se ha transversalizado la educación alimentaria nutricional y la gestión de riesgos.
  • Los sistemas productivos locales integren una mayor de diversidad de cultivo de hortalizas, así como la crianza de cuyes, el cultivo de peces carpa y la crianza de gallinas de postura, incrementando la diversidad y disponibilidad de alimentos ricos en micronutrientes y proteína de origen animal.
  • Se ha fortalecido las cuatro redes de salud con la capacitación de aproximadamente 120 profesionales, para que brinden atención a familias con niñas y niños menores de 5 años principalmente, las mismas que han implementado cuatro Unidades de Nutrición Integral-UNI, especializadas en la atención de niñas y niños menores de 5 años, esta acción estratégica se concretó con la participación activa de la Unidad de Nutrición del Ministerio de Salud, los Servicios Departamentales de Salud de Potosí y Cochabamba, las Redes de Salud y los Gobiernos Municipales.
  • Los municipios han implementado  una estrategia de Educación Alimentaria Nutricional a través de sus redes de salud y UNI.

En una articulación estratégica los municipios han incorporados a sus compras públicas de alimentos productos alimenticios locales de 7 organizaciones de productores por un valor de aproximadamente $us 116.000, de las cuales 3 son exclusivamente de mujeres. Estos productos son dirigidos a los Centros de Atención de niños menores de 5 años y la alimentación complementaria escolar.

Dificultades encontradas

La principal dificultad fue la articulación sectorial en el nivel local, los municipios cuentan dentro de sus estructuras con las áreas de desarrollo productivo y desarrollo humano, las cuales de manera natural no coordinan sus acciones. Se fomenta la producción pero no se orienta la misma al consumo primero de las familias, a la provisión de programas municipales de atención de menores de 5 años, alimentación escolar u otros. Por otro lado el sector de salud presta servicios en comunidades rurales pero sus acciones no están se vinculan al apoyo que se brinda a la producción de alimentos.

La falta de sensibilización y conocimiento de autoridades locales sobre la problemática nutricional de los niños, sus efectos en la salud y desarrollo integral, se convierte en una limitante para la toma de decisiones y acciones que promuevan un abordaje integral y multisectorial de la problemática.

Lecciones/mensajes clave

La promoción de espacios de diálogo entre la sociedad civil y autoridades locales se convierten clave para establecer acciones concretas en los tomadores de decisión.

Esta experiencia piloto se convierte en un modelo para la articulación multisectorial en el nivel local que permite la territorialización de políticas públicas en base a sistemas agroalimentarios sostenibles, resilientes e inclusivos. 

 

 

Proponent

Dutch Ministry of Health, Welfare and Sports



Date/Timeframe and location

2014 - 2020



Main responsible entity

National Agreement to Improve Product Composition 2014-2020

The purpose of the National Agreement To Improve Product Composition is to reduce the salt, unsaturated fat and calorie content (sugar and fat) of products. This will result in a healthier range of products.

The agreement has been signed by the following parties:

  • Dutch Food Retail Organisation (CBL)
  • Federation of the Dutch Food Industry (FNLI)
  • Royal Dutch Hotel and Catering Association (KHN)
  • Dutch Catering Association (Veneca)
  • Minister of Health, Welfare and Sport (VWS)

In the National Agreement To Improve Product Composition these parties state how they will jointly, each on the basis of their own responsibility, set about achieving the objectives up to and including 2020. The scope of the agreement aims in particular at salt, saturated fat and calories (sugar and fat), although it also has the wider ambition of making the range of products as a whole healthier.



Nutrition context

In the National Agreement To Improve Product Composition these parties state how they will jointly, each on the basis of their own responsibility, set about achieving the objectives up to and including 2020. The scope of the agreement aims in particular at salt, saturated fat and calories (sugar and fat), although it also has the wider ambition of making the range of products as a whole healthier.

On 27th of January the Dutch ministry of Health, Welfare and Sports and the ministry of Economic affairs organized the Dutch Food Summit. The outcome was a declaration, where all present parties agreed upon a declaration to work on healthier food options. See attached declaration.



Key characteristics of the food system(s) considered

The purpose of this Agreement is to reduce the salt2, unsaturated fat and calorie (sugar and (saturated) fat3) content in products. This will result in a healthier range of products4.

In this Agreement the parties:

  • Central Bureau for the Food Trade (CBL)
  • Dutch Federation for the Food Industry (FNLI)
  •  Royal Dutch Hotel and Catering Association (KHN)
  • Dutch Catering Association (Veneca)
  • Minister of Health, Welfare and Sport (VWS)

state how they will set about achieving this together over the next few years, each of them on the basis of their own responsibility.



Key characteristics of the investment made

THE SIGNATORY PARTIES AGREE THE FOLLOWING JOINT AMBITIONS

 To reduce the salt content in the range of products so that it is easier for consumers to consume a maximum of 6 grams of salt per day. Consumers who eat good food in accordance with the National Dietary Guidelines can comply with the consumption of a maximum of 6 grams per day by 2020 at the latest.

 To reduce the saturated fat content in the range of products so that it is easier for consumers to consume a maximum of 10 energy% saturated fats per day. To achieve this by 2020.

 To make it easier for consumers to consume less energy. To achieve this by 2020 by, wherever possible, reducing both the energy density of products via a reduction in sugar and/or (saturated) fat and/or reducing portion sizes as well as continuing to promote fruit and vegetables.

In achieving the ambitions:

 The prioritising of the product categories is based on their relevance for public health: their contribution to consumption and improvements that can be (technologically) achieved.

 Products that are intended for children are given high priority.

Key actors and stakeholders involved (including through south-south/triangular exchanges, if any)

In this Agreement the parties:

-  Central Bureau for the Food Trade (CBL)

-  Dutch Federation for the Food Industry (FNLI)

-  Royal Dutch Hotel and Catering Association (KHN)

-  Dutch Catering Association (Veneca)

-  Minister of Health, Welfare and Sport (VWS)

state how they will set about achieving this together over the next few years, each of them on the basis of their own responsibility.



Key changes (intended and unintended) as a result of the investment/s

  • Less salt, saturated fats and sugars in food products.

Challenges faced

  • Technological challenges.
  • Consumer behaviour

Lessons/Key messages

  • The approach /agreement has to be part of an international (EU wide, worldwide) challenge to produce and offer healthier products to consumers.

 

Proponent

Global Alliance for Improved Nutrition



Date/Timeframe and location

January 2016 to June 2017 – 3 Districts of Sofala Province, Mozambique



Main responsible entity

GAIN



Nutrition Context

Mozambique is one of the poorest countries in the world where one third of the population is chronically food-insecure, and the average life expectancy is 50.  Nearly 30% of the population has a staple-based diet with limited access to a diversity of foods that are able to provide a full range of nutrients, including micronutrients, needed for optimal health, and physical and mental development.  The prevalence of vitamin A and iron deficiencies in children under five are also very high, at 69% and 74% respectively; 1 in every 2 children under five do not achieve their potential physical, cognitive or mental and development. Less than a third of children consume more than four food groups a day, with only 13% of children 6-23 months being fed according to Infant and Young Children Feeding (IYCF) practices.

Malnutrition, including micronutrient deficiencies is a major impediment to socioeconomic development that contributes to a vicious cycle of underdevelopment and has long-ranging effects on health, learning ability, and productivity. It also leads to high social and public costs, reduced work capacity in populations due to high rates of illness and disability, and tragic loss of human potential.



Key characteristics of the food system(s) considered

The Cost of the Diet Study conducted in different regions of Mozambique (WFP 2010) showed that 80% of the households could not cover the minimum cost of a (nutritious) diet. Providing nutrient rich complementary foods to children 6-23 months is challenging for low income households who do not have access to micronutrient rich food, both in terms of availability and affordability. The study also showed that by distributing free sachets of micronutrient powders, containing 15 essential vitamins and minerals to be mixed into the food of children 6-24 months, it would be possible to make the diet of the child more affordable (i.e. reduce the minimum cost of the diet of the child by 68%).

Given iron-deficiency anemia is a serious public health concern for children under 5 in Mozambique, the Ministry of Health (MISAU) decided to adopt home fortification with micronutrient powders as a preventative measure.

Projects in Mozambique that provide free distribution of MNPs are only available to around one sixth of the population, are hard to sustain in the long run, and the costs of extending schemes nationally exceeds available budgets.  While MNPs are seen as an effective solution to improve micronutrient intake, distributing them for free through the health system alone is seen as a burden on the health providers in terms of managing storage and distribution of a product which is time consuming and costly.



Key characteristics of the investment made

The project set out to test a hybrid MNP distribution model with two elements – (a) using vouchers redeemed via commercial retail outlets to handle distribution and reduce pressure on the health system. This opens up the possibility of subsidized and targeted distribution; and (b) explore the development of building a market for commercial sales of MNPs. It was implemented the Sofala province includes the delivery of vouchers to caregivers of children 6-23 months through the public health system, both in health facilities (through either health facility staff or dedicated promoters) and communities (through community activists).  Each voucher – which can either be a paper or an electronic (on-demand voucher requested through short messaging service (SMS)) – allows caregivers redeem 3 boxes of 20 MNP sachets at small retail  outlets that sell fast moving goods, registered with PSI as “Troca Aki”.  These outlets are registered through PSI’s electronic data platform managed called “Movercado” which provides real-time tracking data of which vouchers are redeemed by caregivers.

This mechanism was selected for this project such that the voucher system could alleviate pressure on the government supply chain system for health supplies and medicines delivered directly through MISAU health centers, and to promote the market-based channel and decrease the burden on the public sector, which does not have funds to provide MNPs for the entire country.



Key actors and stakeholders involved (including through south-south/triangular exchanges, if any)

GAIN was responsible for coordinating and overseeing the overall project design and implementation. GAIN partnered with Population Services International (PSI), Save the Children (SCI) and the District Health Authorities to conduct the implementation. GAIN also partnered with the MISAU and the Provincial Health Directorate of Sofala Province for strategic alignment and direction with national policies and priorities



Key changes (intended and unintended) as a result of the investment/s

The intended outcome of the project would be to improve the accessibility (availability and affordability) of MNPs for caregivers with children 6-23 months as well as their knowledge of optimal infant and young child feeding practices. The intention behind this would be improved message coverage of MNPs (caregivers who had heard of MNPs), improved contact coverage (caregivers who have tried feeding MNPs to their child) and improved effective use (continuous use of MNPs according to dosage recommendations) in order to have an impact on nutritional status.

Through the project 2,000,000 sachets of MNPs were distributed to caregivers in a period of 15 months in 3 districts. Preliminary results from an evaluation indicate that the majority of caregivers (>60%) have heard about the scheme, while 35% have used MNPs.



Challenges faced

  • The initial project design intended for MNPs to be sold using vouchers through the “troca aki” posts. However, due to a change in policy set by MISAU requiring MNPs to be distributed free to children 6-24 months the project model had to be adapted. Thus the project concentrated on testing distribution via non health service infrastructure
  • MNPs are currently classified as a medicine in Mozambique, which meant it was not possible to conduct social marketing activities to create demand for the product, which was necessary for a new product category and behaviour.
  • All interpersonal communication material and radio spots on the general product category of MNPs underwent thorough reviews and discussion by stakeholders, causing some delay in implementation.
  • Access to MNPs for caregivers was dependent on the supply through Troca Akis, however many of them experienced stock outs due to slow demand providing a disincentive for Troca Aki owners to re-stock.
  • Community reach of caregivers was dependent on the community volunteer cadre (activistas), however the dropout rate of activistas was higher than 50%, and during the rainy season, most active activistas would be working  in their fields;
  • Overall the movercado platform worked very well in terms of reporting number of doses of MNPs distributed. Unfortunately the Electronic voucher was used infrequently because most of the caregivers did not own mobile phone. This meant that the project had to rely mainly on paper vouchers which made the process for data collection more cumbersome and expensive;
  • The low use of the electronic voucher also meant that the monitoring of paper voucher distribution to caregivers was dependent on registry books filled in by activistas and at the health centers. This led to many problems in terms of data quality and reporting

Lessons/Key messages

  • Use of the commercial platform (channels) providing MNPs can increase the reach of the product, and provides an opportunity to cover costs for future sustainability, and encourages more continuous use from the perspective of the consumer
  • Social marketing is crucial for new product category like MNPs to build the trust of the “consumer” and increase demand for the product. The use of mass media and social media can reinforce face-to face communication such as counselling at the health center and in the communities – this should be opted for in future programs;
  • Relying on registry books managed by the National Health System to monitor any intervention program should be avoided as it is not reliable and there can be serious issues with data quality. Instead, using a platform such movercado to monitor any intervention program is extremely useful and efficient at generating real-time, accurate data
  • To move towards the use of the Movercado type of system, and overcome the inefficiencies of using a paper voucher, more thought/analysis has to be given on how to rely on electronic vouchers to register any transactions;
  • Community activists have the potential to reach many more beneficiaries and the issue of lack of motivation and high dropout rates could perhaps be overcome if a proportion of the margin generated from the sale of the product is reverted to them as an incentive to perform well as part of the program.
  • The results are feeding directly into a policy review process of the national strategy on MNPs to make it more sustainable and MNPs more widely available, which is being led by the Minister of Health.

 

Dear all,

Please accept the attached template describing a food systems-oriented partnership between Government of Pakistan, WFP and private sector that focused on improving local production of nutrient-dense foods for treating and preventing undernutrition. This work includes elements of supply (working with agro-processors) as well as demand (partnership with retailers and linkage with national safety net programme).

Thanks,

Quinn Marshall, on behalf of WFP Nutrition Division

Proponent

World Food Programme



Date/Timeframe and location

2008 until current



Main responsible entity

Government of Pakistan



Nutrition context

Pakistan’s nutrition context includes a mix of different outcomes and trends. While on the one hand child underweight decreased from 2001 to 2011, stunting and wasting increased over this same time period. Current rates are 45% and 10.5% respectively (Global Nutrition Report 2016). The 1,000 day period from conception to 2nd birthday, as well as adolescence, have been identified as periods of high risk. Maternal undernutrition plays a role, with low birthweight experienced by a quarter of newborns and 18% of women of reproductive age underweight (body mass index less than 18.5). Exclusive breastfeeding for the first 6 months is low (13%) and the quality of home available foods given as complementary foods to children 6-23 months is also poor. In addition to these significant challenges in reducing undernutrition, Pakistan is experiencing a growing double burden of malnutrition, with overweight and obesity on the rise, particularly among women in urban areas.

The Pakistan Ministry of Planning, Development & Reform and WFP recently carried out a Fill the Nutrient Gap assessment, which found that 67% of Pakistani households are unable meet minimum nutrient requirements with their income. In addition to unaffordability of nutritious food, there is limited availability of fruits and vegetables for the poor.



Key characteristics of the food system(s) considered

Pakistan is characterized by the Global Nutrition Report (2015) as having an “emerging” food system. These systems are noted for more reliance on staple crops (dietary diversity is low) and lower agricultural productivity, in addition to a lack of production diversity and fewer nutrient-dense options for consumption. Pakistan is more urban than many other South Asian countries, meaning that more households rely on food purchases from the market to meet nutrition needs. In this context, the lack of availability and access to affordable, nutrient-dense foods in local markets was a key gap recognized by WFP, the government and partners.

At the same time, agri-business and food processing industries are regarded as mature in Pakistan. Manufacturing companies have production capacity, including the necessary equipment and knowledge of production processes, to produce a variety of processed foods. The key for this project has been how to harness this production capacity to address the nutrition needs highlighted above, particularly related to acute and chronic malnutrition.



Key characteristics of the investment made

The Government has prioritized use of ready-to-use lipid based nutrient supplements (LNS) as an appropriate response to address malnutrition, especially in crises. WFP, working together with private sector food manufacturing companies in Pakistan, sought to develop a chickpea-based version of LNS, which was more adapted to local tastes. Through the course of the assistance, WFP also aimed to support companies to enhance their capacity to produce LNS, including by engaging in R&D and designing, developing and testing of the chickpea-based recipe. WFP did not provide financial investment to the food manufacturers. The investments made in new production lines were taken on by the food manufacturers themselves. These companies were also aware of the potentially limited demand and relatively low financial returns that would be associated with a producing a nutritious food that is used in humanitarian programming, but senior management was committed to a long-term partnership. Future efforts are now being invested in means of commercializing the foods with the Scaling Up Nutrition (SUN) Movement, including by working with retailers and who can stock them in their stores, as well as with government, who may provide access to the foods via social protection programmes that are targeted to the poor.



Key actors and stakeholders involved (including through south-south/triangular exchanges, if any)

  • WFP
  • Private sector food manufacturing companies
  • Government of Pakistan
  • SUN Movement

Key changes (intended and unintended) as a result of the investment/s

  • Through the collaboration between WFP and private sector manufacturers, a nutrient supplement was developed that meets international standards for stability, quality and safety, as well as nutrient requirements for energy and micronutrients. Additionally, the product is adapted to local tastes and preferences.
  • Local production capacity of lipid-based nutrient supplements increased substantially, from 100 metric tons per year in 2009 to over 10,000 metric tons per year in 2013.
  • Through these efforts, there is better availability of nutrient-dense fortified foods that can be used to address several types of undernutrition that Pakistan faces, and easily integrated into humanitarian programmes which respond to crises, ensuring access for the most vulnerable, food insecure populations.

Challenges faced

Though the private sector manufacturers partnered with WFP knowing that demand was likely to fluctuate and returns were likely to be low, this does not mean that issues of sustainability do not need to be considered. Continued production at the necessary scale will rely on enhanced demand creation for the nutrient supplements. For this reason, WFP is now partnering with retailers to increase access to and awareness of the product among consumers in the open market. Additionally, the Fill the Nutrient Gap exercise that WFP conducted with the government enabled them to identify the national social protection programme (known as the Benazir Income Support Programme), as one of the most cost-effective entry points for improving nutrition in the short term and preventing another stunted generation. Efforts are now underway to pilot an approach in Southern Punjab whereby the unconditional cash transfers provided as part of the programme is complemented by a nutritional supplement for pregnant and lactating women, as well as children 6-23 months old.



Lessons/Key messages

  • Fortified complementary foods, including lipid-based nutrient supplements, are an effective tool for addressing multiple forms of undernutrition among key vulnerable groups within the 1,000 days.
  • Pakistan has shown that local private sector food manufacturers are capable of adapting their production processes to increase availability of these foods. Private sector partnership has been a key success factor, but realistic expectations have to be set on the returns and demand that will be available.
  • While humanitarian programmes can procure these foods for use in responding to shocks, long term sustainability will depend on generating more demand through market-based approaches, as well as utilizing social protection programmes that are capable of enabling better access among poor households on a large scale.











     

 

 

 

The International Dairy Federation is thankfull for the oppourtunity to participate to this e-consultation. Please find our contribution below.

We stay at your disposal if you would need more information.

Kind regards,

Laurence Rycken

Proponent

The International Dairy Federation represents the global dairy sector covering over 75% of global milk production and engages all stakeholders of the dairy chain in primary production, milk processing and related research and innovation. Collectively, this is an enormous amount of knowledge, resources and networks.



Date/Timeframe and location

Continuous and worldwide



Main responsible entity



Nutrition context


Livestock is vital for ensuring food and nutrition security and to achieving the sustainable developments goals.

Good nutrition is important for people of all ages. During childhood, good nutrition promotes normal growth and development. In the longer term, it is believed that establishing healthy eating habits in childhood can help to reduce the development of chronic diseases such as diabetes, heart disease and some cancers. Promoting a healthy diet to children can help them form healthy habits that extend into later life. Micronutrient deficiencies arising from poor-quality diets remain widely prevalent. Milk is rich in bio-available nutrients and an efficient vehicle for delivering several critical micronutrients and improving growth of young children.

As school feeding programs provide valuable settings to promote access to healthy, diversified diets. IDF with its large member basis provided the ideal platform to conduct together with the FAO the largest global review to date of school milk programme implementation, administration, promotion and nutritional importance.

The survey held in 2014 gives an in-depth look at 60 different school milk programmes in the Americas, Asia, Africa, Oceania and Europe. 140 million children were reached with these programs, with around 57% of those receiving it at least 5 days per week.  In 58% of the programmes, children were provided with free milk. In 27% it was provided to them subsidised. Comparison with a survey carried out in 1998 by FAO shows that milk and dairy foods are still as popular as ever and are widely recognised as essential to healthy eating. The survey provides much more detailed information on these school milk schemes and provides guidance for those who are implementing or considering implementing such programmes (http://store.fil-idf.org/product/the-contribution-of-school-milk-programmes-to-the-nutrition-of-children-worldwide/) .

Beyond ensuring access to milk and dairy foods in schools, many of our members deliver nutrition education programs to foster healthy food and physical activity habits.  Through the dairy nutrition initiative IDF collects exemplary practices of effective education programs from around the world.  The initiative has collected examples from around several countries, reaching different age groups, engaging multiple partnerships but with the same goal to connect children with the source of their foods and educate them about healthy lifestyles.



Key characteristics of the food system(s) considered

(Re)-connect the youth with the source of their foods and educate them about healthy lifestyles



Key characteristics of the investment made

School feeding programmes can have a positive influence on food choices and can be funded and supported in a number of different ways.



Key actors and stakeholders involved (including through south-south/triangular exchanges, if any)

Considering all data compiled many programmes were organized through a collaboration of different organizations. Some key actors were dairies, government, communities and schools. But also parents and teachers can be the initiators of the programs.



Key changes (intended and unintended) as a result of the investment/s

The impact of school milk programmes, in terms of number of children reached, varied significantly from country to country. Of all the countries responding, a total of 139 977 649 children were benefiting from school milk, an average of 54%.         But variation are huge amongst different countries, the US for example is able to reach 80%, however there are countries were only 20% or less of the children were receiving school milk.



Challenges faced

The biggest challenge identified in the survey was the funding of the programmes.

Other challenges included an expectation that school milk programmes should be free or highly subsidized; the administrative and resourcing burden for school staff; and competition from other foods.



Lessons/Key messages

These programs are at the nexus of agriculture, nutrition and education.  Aligning resources and funding through public-private partnerships will not only improve reach and impact, it will also ensure the target audience receives a consistent message at critical touch points.