haddad 0800 thursday african nutrition congress

7/31/2019 Haddad 0800 Thursday African Nutrition Congress

1/27

Recent Developments in Food and

Nutrition Policies in Developing

Countries: Relevance for Africa

Lawrence Haddad

Institute of Development StudiesUK

Lawrence Haddad, Institute ofDevelopment Studies

1


2/27

Outline

Why nutrition sensitive policies are vital

How can the following be more nutritionsensitive? Evidence

Agriculture

Womens Empowerment

Social Protection

Water and Sanitation The need for data on nutrition sensitive

financial flows


2


3/27

Share (%) of reduction inchild underweight

attributed to underlying

variables, 197095 (63

developing countries)

19.3

26.1

43

11.6

Health Environment

National Food Availability

Female Education

Women's Status

Smith and Haddad 2000.

IFPRI Research Report.

3Lawrence Haddad, Institute ofDevelopment Studies

Nutrition Sensitive Policies are Crucial for

Undernutrition Reduction


4/27

4

DirectNutrition

Interventions

Driven by:Leadership,

Ideas,

Institutions,

Incentives

Effective nutrition

action requires

coherence and critical

massfrom all sectors



5/27

5

DirectNutrition

Interventions

Agriculture

Focus onpoverty

reduction,

Gender


Ideas,

Institutions,

Incentives

Effective nutrition

action requires





6/27

6

DirectNutrition

Interventions

Agriculture

Focus onpoverty

reduction,

Gender

Social

ProtectionFocus on

health

conditionalities


Ideas,

Institutions,

Incentives

Effective nutrition

action requires





7/27

7

DirectNutrition

Interventions

Agriculture

Focus onpoverty

reduction,

Gender

Social

ProtectionFocus on

health

conditionalities

Womens

empowermentBalance of

upstream and

downstream

empowerment


Ideas,

Institutions,

Incentives

Effective nutrition

action requires





8/27

8

DirectNutrition

Interventions

Agriculture

Focus onpoverty

reduction,

Gender

Social

ProtectionFocus on

health

conditionalities

Womens


upstream and

downstream

empowermentWater and

Sanitation

Focus on

nutrition status

outcomes


Ideas,

Institutions,

Incentives

Effective nutrition

action requires





9/27

9

DirectNutrition

Interventions

Agriculture

Focus onpoverty

reduction,

Gender

Social

ProtectionFocus on

health

conditionalities

Womens


upstream and

downstream


Sanitation

Focus on

nutrition status

outcomes

Health systems

View nutrition as

lower in

hierarchyembed

direct nutrition

programmes

Education

Keep girls in

secondary

school to delay

age at firstpregnancy


Ideas,

Institutions,

Incentives

Effective nutrition

action requires





10/27

10

DirectNutrition

Interventions

Agriculture

Focus onpoverty

reduction,

Gender

Social

ProtectionFocus on

health

conditionalities

Womens


upstream and

downstream


Sanitation

Focus on

nutrition status

outcomes


Ideas,

Institutions,

Incentives

Effective nutrition

action requires





11/27

Agriculture


11


12/27

Pathways through which changes in agriculture

affect health and nutrition

1. Improved household Income

2. Lower consumer food prices

3. New foods into diet

4. Changes in processing

5. Changes in agricultural work patterns

6. Labor devoted to agricultural production

7. Changes in power within the household

J. Hoddinott. 2011. 2020 Conference Paper 2 Agriculture, Health, and Nutrition: Toward

Conceptualizing the Linkages 12


13/27

Table 3.5 Impact of interventions on nutritional status of children

Study Stunting (height-for-age)

Underweight(weight-for-age)

Wasting (weight-for-height)

Aiga et al. (2002) n.s ** n.sFaber et al. (2002) n.s n.s n.s.Hoorweg et al. (2000) ** ** **Makhotla and Hendriks (2004) n.s. n.s. n.s.Low et al. (2007) n.s. ** **Olney et al. (2009) n.s. n.s. n.sSchipani et al. (2002) n.s. n.s. n.s.Shmidt and Vorster (1995) n.s. n.s. n.s.

Note: in the second column, n.s. is not statistically significant, * is statistically significant atthe 10% level, ** is significant at the 5% level, *** is significant at the 1% level

The nutrition impact of agricultural interventions that

are designed to have an impact on nutrition

Masset E, Haddad L, Cornelius A and Isaza-Castro J (2011), A systematic review of agricultural interventions that aim to

improve nutritional status of children. London: EPPI-Centre, Institute of Education, University of London.



14/27

Source: Peterman, Behrman and Quisumbing, 2010. IFPRI Discussion Paper 975

Number of studies

Women famers are disadvantaged

in access to inputs



15/27

Social Protection


15


16/27

HLPE, 2012. Social protection forfood security. A report by the

High Level Panel of Experts on

Food Security and Nutrition of

the Committee on World Food

Security, Rome 2012.

Social protection at

a glance



17/27

HLPE, 2012. Social protection for food security. A report by the High Level Panel of Experts on Food Security and Nutrition of the

Committee on World Food Security, Rome 2012.

Safety Nets: an important part of the response to the food price crisis



18/27

0.32

0.41

0.23

0.02

0.13

0

0.16

0.01 0.01

-0.02

0.02

-0.02

-0.11

-0.19

-0.04

Impact of various Latin American

conditional cash transfers on

child height for age z score

For Honduras, S=Supply side interventions, D=demand side and C=control

Age in months

J. L. Leroy, M. Ruel, E. Verhofstadt (2009) The impact of conditional cash

transfer programmes. In Journal of Development Effectiveness 1 (2).

Mexico, Nicaragua and Colombia

have the largest cash transfers

Difference in difference

results, except for Brazil

(Bolsa Alimentacao)



19/27

Womens Empowerment


19


20/27

Impact of womens

status on child

underweight rates

Source: Smith et. al. 2003, IFPRI Research Report 131

20

Proportion of under

5 children who are

underweight

Womens decision making power



21/27

So, where to target womens empowerment

efforts for nutrition?

Nutrition

Determinant

Eradicate

discrimination

Positive promote catch up

in womens status

Basic Voting rights Quotas in governance and

decision making fora

Underlying Equalise access to

farm inputs

Target social protection to

women

Immediate Equal access tofortified foods

Nutrition programmestargeted to young girls

No one size fits all answer -- depends on context,

programmes and evidence



22/27

Water, Sanitation and Hygiene


22


23/27

Figure 19b: Comparison ofrigorous studies (Esrey et al., 1991 and current review)

0.5

0.6

0.7

0.8

0.9

Multiple Hygiene Sanitation Water

supply

Water

quality

Intervention

Rela

tiverisk

Esrey

Current

Note: a risk ratio of 1 = no effect on diarrhea rates;

lower scores represent stronger effects

Water, Sanitation And Hygiene: Interventions And Diarrhoea;A Systematic

Review and Meta-analysis. Lorna Fewtrell and John M. Colford, Jr. July 2004.World Bank.

Impact of water, sanitation and hygiene interventions



24/27

BRAZIL

Relative

contribution (%) to

the decline in childstunting between

1996 and 2007

Income

22,5%

Maternal

Schooling

24,6%

HealthCare

10,4%

Other Factors

36,7%

Source: Monteiro et al (2009). Causes for the decline in child

undernutrition in Brazil, 1996-2007. Revi Sade Pb, 43 (1): 35-43. 24Lawrence Haddad, Institute of

Development Studies

But which sector to focus on?

We need studies like this for

African countries to guide efforts


25/27

Financial Resource Flows


25


26/27

Aid For Nutrition: Can investments to scale up nutrition actions be accurately tracked? ACF.

2012.

Direct and Indirect

spend on nutrition

as % of ODA is tiny



27/27

Conclusions

Nutrition sensitive policies have much largerbudgets than nutrition specific programmes

If they can become nutrition sensitive their

potential is enormous agriculture, social protection, womens

empowerment, water and sanitation

But it is not easy: technical, political, financial

challenges Key task is to start auditing the nutrition

sensitivity of different policies


27

haddad 0800 thursday african nutrition congress

Documents