Nutitiion experts and advocates offered observations on and support for the US Agency for International Development’s new multisectoral nutrition strategy at a meeting held on Capital Hill in Washington, DC September 17.
USAID Administrator Rajiv Shah gave a brief overview of the strategy, which aims to reduce chronic malnutrition (which leads to stunting) by 20 percent in the countries where the nutrition strategy will be implemented. The focus will be on childen (and their mothers) in the first 1000 days of life, when the impact of malnutrition is most severe. A very important part of the strategy is that it involves multiple sectors, such as agriculture and health, in order to have a significant impact on chronic malnutrition. Shah reminded the audience, which filled a House Appropriations commitee hearing room, that Congressional implementing legislation needed to be passed in order for the program to be implemented most effectively. This legislation has not yet been introduced in either the House or Senate.
John Hoddinott of the International Food Policy Research Institute reviewed key impacts of malnutrition in the first 1000 days of life, which causes permanent cognitive impairment and deficiencies in motor skills, reducing skills necessary later in life for the labor market.
Tim Evans of the World Bank observed that institutions such as the World Bank, USAID and country governments tended to “stovepipe” programs, which means that sectors such as health and agriculture usually operate only within their own spheres and it is difficult to have them work collaboratively. Nor are pronising programs scaled up to sufficient size to make a real impact. One way in which the World Bank has addressed these concerns, he said, is by designing programs that focus on results, giving as an example a Bank program in the poor northeast section of Argentina, which in order to reduce the number of children with neonatal problems including low birth weights, gave money to low-income mothers so that they could obtain good health care and nutrition. In addition the program insured that these health and nutrition services would be available.
Joanne Carter of Results, a major advocacy group supporting reducing malnutrition, observed that other recent initiatives such as the Child Survival Call to Action were pointing in the same direction, and would also work to reduce child deaths and harm due to malnutrition She emphasized the need to increase funding for programs to reduce child deaths and harm–“we need to do more with more.”
Richard Greene of USAID observed that less progress had been made in reducing childhood malnutrition than in other problems. For example immunization rates in developing countries have been boosted significantly, reducing deaths from childhood diseases such as measles. He laid part of the blame to the need for sectors such as health and agriculture to work collaboratively, which has not been easy to accomplish. He outlines some of what USAID was planning to do over the next 10 years to have sectors work together to make measurable reductions in child malnutrition. Greene now works in the Bureau for Food Security, the USAID bureau that handles food aid, but has spend most of his career at USAID in the USAID health bureau, so it was interesting to see this example of cross-bureau collaboration.
William Garvelink of the International Medical Corps emphasized the need to combine nutrition interventions with interventions in other sectors such as agriculture to make a strong reduction in child malnutrition. He also pointed out the need to locate malnutrition reduction initiatives properly within developing country governments (not, say, in some obscure department of nutrition in the health ministry), or they would be ineffectual.
Lane Vanderslice is the editor of Hunger Notes