Raising Nutrition Awareness

› Workshop for FDOV/SDGP advisors

› Utrecht, 28 October 2019 The Netherlands Working Group on international Nutrition, represented by Herbert Smorenburg

Arine Valstar Marijke de Graaf

› Who is who?

› Today’s workshop

– Context of our assignment

– Why Nutrition?

– Framework for Nutrition Improvement

– Application to three types of FDOV/SDGP projects

– Coffee break

Introduction

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– Example project

– Indicators and M&E tools for nutrition

– Next steps

– End (13.00)

› Marijke de Graaf, ICCO

› Nutritionist, who worked for UNICEF in Latin America and Asia, and is now responsible for ICCO’s food and nutrition security (FNS) policy

› Provides guidance on design, planning, implementation and monitoring of FNS programs

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› Herbert Smorenburg, Partnering with Purpose BV

› Helps partnerships to become more effective and efficient to contribute to a better world

› Provides advice, in-company training, lectures, mentoring/coaching of individuals and interim-management of organisations and collaborations

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Levels of nutrition skill

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Know

Knows how

Shows how

Does

Knows about

Heard of

Miller’s pyramid

Levels of nutrition skill

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Know

Knows how

Shows how

Does

Knows about

Heard of

Miller’s pyramid

Nutritionists

Advisors and

project owners

• 1 in 3 people worldwide are malnourished

• Leading cause of poor health

• Unhealthy diets pose a greater risk to morbidity and mortality than does unsafe sex, and alcohol, drug, and tobacco use combined.

• 6 of the top 10 risk factors are diet related

• Enormous economic and human capital costs

Why Nutrition?

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Sources: see Reference slide

Occupational risks

High total cholesterol

Tobacco

Alcohol and drug use

High body mass index

High fasting plasma glucose

Air pollution

High systolic blood pressure

Dietary risks

Child and maternal malnutrition

The Global Burden of Disease:

6 of the top 10 Risk Factors for are Diet Related

DALYs

Different forms of malnutrition co-exist

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• Childhood stunting

• height for age < -2 std dev.

• Anaemia and other micronutrient deficiency related disorders

• Overweight and Obesity (risk factor for non-communicable diseases)

• Body Mass Index > 25 kg/m2

End hunger, achieve food security and improved nutrition and promote sustainable agriculture

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Targets (Nutrition focused)

2.1 By 2030, end hunger and ensure access by all people, in particular the poor and people in vulnerable situations, including infants, to safe, nutritious and sufficient food all year round

2.2 By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons

2.3 …

Indicators

2.1.1 Prevalence of undernourishment

2.1.2 Prevalence of moderate or severe food insecurity in the population, based on the Food Insecurity Experience Scale (FIES)

2.2.1 Prevalence of stunting (height for age <-2 standard deviation from the median of the World Health Organization (WHO) Child Growth Standards) among children under 5 years of age

2.2.2 Prevalence of malnutrition (weight for height >+2 or <-2 standard deviation from the median of the WHO Child Growth Standards) among children under 5 years of age, by type (wasting and overweight)

Improving nutrition can have a powerful and positive multiplier effect across multiple aspects of development, including poverty, environmental sustainability, and peace and stability.

“Nutrition is one of the best drivers of development: it sparks a virtuous cycle of socioeconomic improvements, such as increasing access to education and employment.”

Kofi Annan, 2018

Nutrition as driver of development

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Simplified Framework for Nutrition Improvement

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Sources: see References slide

› Reflect on one of the listed project(s)

› Identify where in this framework your project may contribute

› Write keyword on a post-it

› Present to group

How does your project contribute to nutrition?

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Project name Programme Country Outcome 1

Outcome 2 Outcome 3

RiceTechCambodia: Adding value to the organic rice sector in Cambodia leading to inclusive growth

SDGP Cambodia increased income

South Senegal Rice on the Rise

SDGP Senegal increased income

increased resilience

increased local and national food security

Sugar and Steam - Sustainable Intensification of Agro-Forestry Production Systems

SDGP Indonesia increased income

increased income for women

Development of sustainable bean value chains for smallholders to increase food security in Zimbabwe

FDOV Zimbabwe increased access to dry beans

Inclusive milk supply chain development to increase food security

FDOV Bhutan increased availability

fortified milk at schools (?)

She Sells Shea-35,000 women entrepeneurs making a living

FDOV Burkina faso increased women entrepreneurship

increased income

increased nutrition

Source: based on aiddata.rvo.nl

Overview SDGP portfolio

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Project name

Programme Country Outcome 1 Outcome 2 Outcome 3

Agroforestry interventions for uphill food and income security and downhill tea plantation protection

SDGP Rwanda increased income access to nutritious foods

Circular Coffee from Peru: creating value across the chain SDGP Peru increased food security

East: Africa, Tanzania: a Farmers’ Roadmap of Expanding Successful Horticulture (EAT: FRESH)

SDGP Tanzania, united republic of

high quality, high value vegetables

EcoCajou - Cashew processing in Northern Côte d’Ivoire SDGP Côte d'ivoire fair working conditions

Fish Farming Value Chain Development Project in Burundi SDGP Burundi new fishfarmers Going Bananas - Restoring Livelihoods of Conflict Affected Farmers in Cotabato

SDGP Philippines (the) increased income increased nutritional value and food security

Increased Maize Value Chain Efficiency in Rwanda SDGP Rwanda less aflatoxin increased income

Increased potato value chain efficiency in Great Lakes Region SDGP Rwanda increased productivity

LEAP2 Bridging the digital Gap SDGP Kenya increased income increased income for women and youth

Lions oignons: Improving the onion value chain in Senegal based on the Dutch three-pillar approach

SDGP Senegal improved local productivity small holder farmers

MasterPeas, Myanmar Pulses for agricultural growth, higher incomes and nutrition

SDGP Myanmar increased income improved access to pulses

RiceTechCambodia: Adding value to the organic rice sector in Cambodia leading to inclusive growth

SDGP Cambodia increased income

South Senegal Rice on the Rise SDGP Senegal increased income increased resilience increased local and national food security

Sugar and Steam - Sustainable Intensification of Agro-Forestry Production Systems

SDGP Indonesia increased income increased income for women

SupporTing EnVironmentally sound stevia production for improved Income in Madagascar

SDGP Madagascar increased income

Sustainable and Accessible Fish for All SDGP Myanmar increased income promotion of fish to consumers

Sustainable Food and Nutrition Security and Transforming Smallholders’ Livelihood in Madhya Pradesh, India

SDGP India reduce malnutrition in rural groups

improved access to healthy and diverse food

improved income

Transforming Nigeria’s Vegetable Markets SDGP Nigeria increased productivity domestic vegetables

improved dietary balance of rural households

Source: based on aiddata.rvo.nl

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Project name

Programme Country Outcome 1 Outcome 2 Outcome 3

Dairy Farm Equipment, Ethiopia FDOV Ethiopia increased income increased access to milk & milk products

Development of a sustainable dairy sector in Vietnam FDOV Viet nam increased affordability increased quality

Development of sustainable bean value chains for smallholders to increase food security in Zimbabwe

FDOV Zimbabwe increased access to dry beans

Development of sustainable dairy villages in Indonesia FDOV Indonesia increased access / affordability increased quality

Fair Planet five year plan for Ethiopia FDOV Ethiopia increased yield high value vegetables

Farming crickets for food and business FDOV Kenya, Uganda increased availability increased consumption

Food for all Project in Kenya (F4APK) FDOV Kenya increased production of bananas, vegetables and high value products like milk and French beans

Food Security through improved resilience of small scale producers

FDOV Kenya, Ethiopia improved productivity of crops for local markets

improved resilience

Food security via vertical integration of a new Kenyan pot chain FDOV Kenya increased productivity of potatoes

FoodTechAfrica FDOV Kenya increased production of fish

Going Nuts FDOV Malawi less aflatoxin

Inclusive milk supply chain development to increase food security FDOV Bhutan increased availability fortified milk at schools (?) Market Access & Food Security for Nicaraguan coffee & cocoa farmers

FDOV Nicaragua increased food security nutrition education changing eating habits

PPP Macadamia Value Chain Enhancement FDOV Malawi increased income smallholders

She Sells Shea-35,000 women entrepeneurs making a living FDOV Burkina faso increased women entrepreneurship

increased income increased nutrition

Sustainable and affordable poultry for all FDOV Myanmar increased affordability

Overview FDOV portfolio

Source: based on aiddata.rvo.nl

FDOV/SDGP: three clusters of pathways that may lead to nutrition improvement

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Income

Improved diet

Access

Income

› Impact depends on – Intra-household dynamics (inclusion of women)

– Awareness and attitudes

– Food access

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Relevant interventions Indicators and M&E

Women Empowerment Gender disaggregated data for reach interventions Women’s Empowerment in Agriculture Index (WEAI)

Nutrition education and Social and Behaviour Change Communication

Nutrition and food safety-related knowledge and attitudes (KAP) survey

Food access interventions Household food insecurity scale (HFIAS) and Months of Adequate Household Food Provisioning (MAHFP)

Access to a specific food crop

› Impact depends on:

– nutritional value

– dietary gap

– affordability and accessibility to target group throughout the year

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Relevant interventions Indicators and M&E

All mentioned for income + • Nutritional relevance of crop • Accessibility to vulnerable groups (BoP, children,

women,…) • Uptake of improved post-harvest and processing practices • Increased demand for, purchase and/or consumption of

nutritious crop • Food frequency questionnaire

In case of nutrient dense crops: • Adequate post-harvest handling and processing • Promotion of own consumption

In case of staple or non-food crops: • Alongside homestead food production

Improved diet

› Meaning: a diet that is diverse, healthy and adequate. The diet should:

– cover all nutritional needs: energy, proteins, micronutrients , essential fats, fibre and water

– be suitable for the age of the targeted group

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Relevant interventions Indicators and M&E

All mentioned for income and access + • Minimum Acceptable Diet (MAD) for 6-24 months old infants and children

• Minimum Dietary Diversity (MDD-W) for women of reproductive age

Participatory appraisal of dietary habits (involve people in assessing their own food and nutrition situation and identifying the causes of food and nutrition problems according to their perceptions)

Cooking / food processing demonstrations

An alternative perspective: Workforce nutrition

› Workforce nutrition programmes

– Organised by employer

– Part of the solution to malnutrition

– Important for business returns and, ultimately, on GDP

– Most suitable where employer can organise interventions at the workplace and make these accessible to the entire workforce

› Interventions

– Healthy food at work

– Nutrition education

– Nutrition-focused health checks

– Breastfeeding support

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Source: GAIN, Workforce Nutrition evidence briefs, 2019 https://nutritionconnect.org/resource-center/workforce-nutrition-evidence-briefs

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Example: Vegetables for All (AIM FDOV)

A closer look at Indicators and M&E tools

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› All information available on NWGN website https://the-nwgn.org/information/tools-methods/

› Invitation to all project owners by RVO: w/c 28 Oct.

› We will organise:

– a 1 hr webinar to explain the essentials (Nov)

– a 3 hr workshop in NL, similar to today’s workshop (Nov)

– consultation sessions where we are available to project teams (Nov)

› We hope that this will result in increased nutrition awareness in FDOV & SDGP projects and lead to tangible and measurable contributions towards improved nutrition.

What’s next?

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› Don’t forget to fill out the evaluation survey

› For further information and questions don’t hesitate to contact us:

– Herbert Smorenburg

– Email: Herbert.Smorenburg@gmail.com

– Tel: +31627011363

– Skype: Herbert_Smorenburg

Questions / recommendations

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References

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› Why Nutrition?

Sources: Development Initiatives, 2018 Global Nutrition Report: Shining a light to spur action on nutrition. Bristol, UK, 2018. Institute for Health Metrics and Evaluation (IHME), University of Washington. GBD Compare Data Visualization. Seattle, USA, 2018. Available from http://vizhub.healthdata.org/gbd-compare. (Accessed 26 August 2019) Global Panel on Agriculture and Food Systems for Nutrition. Cost of malnutrition, https://glopan.org/cost-of-malnutrition

Herforth, A. & Ballard, T. 2016. Nutrition indicators in agriculture projects: current measurements, priorities and gaps. Global Food Security. Available at: https://www.sciencedirect.com/science/article/pii/S2211912415300109

(accessed 26 August 2019)

› Simplified Framework for Nutrition Improvement

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Photo: GSGarrett Images