haddad 0800 thursday african nutrition congress
TRANSCRIPT
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Recent Developments in Food and
Nutrition Policies in Developing
Countries: Relevance for Africa
Lawrence Haddad
Institute of Development StudiesUK
Lawrence Haddad, Institute ofDevelopment Studies
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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
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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.
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Nutrition Sensitive Policies are Crucial for
Undernutrition Reduction
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DirectNutrition
Interventions
Driven by:Leadership,
Ideas,
Institutions,
Incentives
Effective nutrition
action requires
coherence and critical
massfrom all sectors
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DirectNutrition
Interventions
Agriculture
Focus onpoverty
reduction,
Gender
Driven by:Leadership,
Ideas,
Institutions,
Incentives
Effective nutrition
action requires
coherence and critical
massfrom all sectors
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DirectNutrition
Interventions
Agriculture
Focus onpoverty
reduction,
Gender
Social
ProtectionFocus on
health
conditionalities
Driven by:Leadership,
Ideas,
Institutions,
Incentives
Effective nutrition
action requires
coherence and critical
massfrom all sectors
Lawrence Haddad, Institute ofDevelopment Studies
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DirectNutrition
Interventions
Agriculture
Focus onpoverty
reduction,
Gender
Social
ProtectionFocus on
health
conditionalities
Womens
empowermentBalance of
upstream and
downstream
empowerment
Driven by:Leadership,
Ideas,
Institutions,
Incentives
Effective nutrition
action requires
coherence and critical
massfrom all sectors
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DirectNutrition
Interventions
Agriculture
Focus onpoverty
reduction,
Gender
Social
ProtectionFocus on
health
conditionalities
Womens
empowermentBalance of
upstream and
downstream
empowermentWater and
Sanitation
Focus on
nutrition status
outcomes
Driven by:Leadership,
Ideas,
Institutions,
Incentives
Effective nutrition
action requires
coherence and critical
massfrom all sectors
Lawrence Haddad, Institute ofDevelopment Studies
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DirectNutrition
Interventions
Agriculture
Focus onpoverty
reduction,
Gender
Social
ProtectionFocus on
health
conditionalities
Womens
empowermentBalance of
upstream and
downstream
empowermentWater and
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
Driven by:Leadership,
Ideas,
Institutions,
Incentives
Effective nutrition
action requires
coherence and critical
massfrom all sectors
Lawrence Haddad, Institute ofDevelopment Studies
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DirectNutrition
Interventions
Agriculture
Focus onpoverty
reduction,
Gender
Social
ProtectionFocus on
health
conditionalities
Womens
empowermentBalance of
upstream and
downstream
empowermentWater and
Sanitation
Focus on
nutrition status
outcomes
Driven by:Leadership,
Ideas,
Institutions,
Incentives
Effective nutrition
action requires
coherence and critical
massfrom all sectors
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Agriculture
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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
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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.
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Source: Peterman, Behrman and Quisumbing, 2010. IFPRI Discussion Paper 975
Number of studies
Women famers are disadvantaged
in access to inputs
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Social Protection
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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
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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
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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)
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Womens Empowerment
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Impact of womens
status on child
underweight rates
Source: Smith et. al. 2003, IFPRI Research Report 131
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Proportion of under
5 children who are
underweight
Womens decision making power
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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
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Water, Sanitation and Hygiene
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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
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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
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Financial Resource Flows
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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
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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
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