Would you take your grandmother into a London night club and expect her to like it? (Rosling, part 2)

This somewhat eye catching blog headline was offered by Klaus von Grebmer at IFPRI in response to my Rosling? Eh... post a couple of days ago.


Klaus used to be the Director of Communications at IFPRI and knows a thing or two about this topic.  Apart from the fact that I wouldn't be going to London nightclubs these days, let alone taking my grandmother (yes, Duncan Green is right, I can be grumpy), his point is that Hans Rosling is communicating to people who are not researchers.


Klaus writes:

"I think that Hans' presentation addresses a totally different audience. The TED audience is usually not attended by researchers and by people that know as much about population growth as the Pope knows about yodeling. Agreed, Lant does only take 2 minutes, but - contrary to Hans -what he says will not stick in the minds of non-researchers."


My colleague David O'Brien at IDRC (IDS Alum and one of our Board members) said:

"Don't forget what education psychologists tell us: we all learn and absorb messages differently. Some, and I guess you are in this camp, like the talking heads!! Others are more visual learners. Put your kids in front of the Rosling and Lant presentations and ask them the next day what each person said."

So first my grandmother, then the Pope, and now my kids have been brought into the debate.  

But I think I conceded the different audience point in the previous blog--although not easily.

For example, the Pritchett video is directed to non researchers.  It says simply that aid is not as effective as it could be because we take models that work in one place and blindly assume they can be transplanted elsewhere.  Trees transferred without their roots.  Pretty visual even without the image.  Function follows Form, when Form should follow Function.  I think that is pretty simple, profound and memorable.

A post I wrote a year or two back on Heath and Heath's "Made to Stick" is all about this topic, about how researchers can hear the music of the research in their heads and they often assume the music is blaring out to everyone, when of course they are the only listeners.  This makes the art of communication vital if evidence is to contribute to change.  And we all have to improve in this domain. 

Another domain in which I have been asked to up my game is controversy.  I am too sedate (see Simon in comments on previous post).  In general I like to think I don't shy away from controversy when I feel I am on solid ground (e.g. the MVP debate--see letter published in Lancet yesterday).  But controversy to pump up the stats?  Not for me.   But I will see if I can be more edgy within the evidence limits I set for myself.  

As always, thanks for the feedback.  It's ironic that this post created so much buzz when the one on the 2 Hoddinott papers took 10 times as much time to write and is much more important--just goes to show how much work I have to do to improve my own communication!

Hans Rosling? Eh..

OK, I admit it, I am constantly bemused by the bouquets and applause that rain down on Professor Hans Rosling, the medical researcher and public speaker (left).

Jealousy you say?  No, really, I am genuinely bemused.

The latest video to hit our screens takes 10 minutes to show us that fertility rates are falling all over the world--at all income levels and for all religions.  It shouldn't take 10 minutes.

Yes, the moving bubbles are a nice innovation, but I have to admit I find them distracting at times.

Yes, Prof. Rosling is an engaging speaker, and there are certainly plenty of terrible presenters in the ranks of the research world, but there are plenty of good ones too.

Have you ever seen Lant Pritchett present? See how beautifully he communicates a complex and profound idea in less than 2 minutes.


Perhaps Prof. Rosling is best appreciated by those who are not researchers?

In any case, I have a touch of the Larry David (right) when it comes to Prof. Rosling, and I thought I better 'fess up.

Am I the only one? What am I missing?

New Results from John Hoddinott on the Productive Safety Net Programme in Ethiopia, and on Cost Benefit Ratios in Nutrition

John Hoddinott is one of those researchers who is very modest and self effacing, but whose work is quoted by nearly everyone in the poverty, food and nutrition field. He has a habit of delivering cutting edge methods to questions we all want the answers to.

I have just read two of John's most recent papers (although he would be the first to note the co-authors and the fact that he is not even the first author on one of them).

The first paper addresses the effectiveness of Ethiopia's Productive Safety Net Programme and the second paper is an update of the Copenhagen Consensus paper series on the cost-benefit ratios of nutrition interventions.

The PSNP

The Productive Safety Net Programme (PSNP) is one of the largest public works, household asset building, food basket, cash transfer programmes in Africa, with more than 7 million people participating since operations began in 2006. It is targeted at chronically food insecure households (defined as three or more months of unmet food needs per year in each of the last 3 years).

Unlike some of the earlier impact evaluations (this one uses the most recent data from 2010), this one cannot use non-participants as the control group, basically because with the programme running for 6 years, the number of households who are eligible for it but have not received it has diminished. This is a good thing, but it means there is no control group in the sense of households untouched by the programme.

So the authors use the difference between 1 and 5 years of participation as their treatment and control groups. They use propensity score matching create a comparison group for those who received 1 year and those who received 5 years of PSNP. In general propensity score matching involves matching participants and non participants on their propensity score (their estimated probability of being a participant--thus allowing lots of matching variables to be combined in one composite) to create two groups that are similar except for their participation (I'm making it sound more straightforward than it is).

What do they find? I will restrict my description to the largest component of the PSNP, the public works. The authors find that it is only after 5 years of participation in the PSNP that the impacts on food security really kick in (see Figure 4.3).

If the average food gap is around 3-3.5 months per year, 5 years participation in the PSNP public works project reduces the gap by just over one month, or about one third of the food gap.

Is one third a big impact for the resources expended? It's hard to say without seeing the cost data, but the really important finding is that the impact seems to be increasing at an increasing rate the longer participation continues. 

Too often in development donors and governments give up because the short term impacts are underwhelming. So the government and donors deserve credit for taking the medium term view with the programme (and with the evaluation).

The Copenhagen Consensus

The second paper is an expansion and update of benefit cost ratios for direct and indirect nutrition interventions as part of the Copenhagen Consensus series of papers.

Findings:

• yield increases and reduced yield variability, are put through the IFPRI IMPACT model to translate into underweight rates (using the Smith-Haddad 2000 elasticities) and they generate benefit:cost ratios of 16-50.
• interventions that improve access to market information via sms technologies give benefit:cost ratios of 8 (the authors project this ratio to rise as costs of sms technology decrease and the returns improve from the sms technology application to higher value crops)
• updates on a range of micronutrient interventions: the new estimates give iron supplementation a lower benefit to cost ratio than those from previous Copenhagen Consensus papers (8-24 compared to 82-140)
• first ever benefit:cost ratios for bundled interventions that reduce infant stunting (relating to the health of mothers, care behaviours, health of infants, quantity and quality of child diet). Under the most conservative assumptions they consider (which are indeed very strict), the benefit:cost ratio of such interventions is 15. If the most conservative assumptions are relaxed the benefit: cost ratio ranges between 23.8 and 138.6. In the country with the largest number of undernourished children in the world, India, these benefit:cost ratios lie between 44 and 138.6.

There are lots of caveats to these estimates, and they will--and should--be put through the mill, but they are probably the best we can do at this stage. 

Interesting things to note

• the fairly large agriculture benefit:cost (BC) ratios, although my guess is that these are probably the most fragile given the cross-country modelling they are premised on
• the downgrading of iron supplementation BC ratios
• the high BC ratios for the bundled interventions (mostly direct interventions)
• the scope for increases in the BC ratios for sms technology in agriculture (and probably even bigger ratios if they were applied to health and nutrition information asymmetries)

You can see how foundational and useful these papers are.  Keep up the good work John.

DFID in India: Money Can't Buy Me Love (but TA can)

A new report from the Independent Commission for Aid Impact ("the independent body responsible for scrutinising UK aid") evaluates DFID"s support for Health and Education in India.

The report gives DFID a Green-Amber rating overall (Green-Amber means the programme is performing well, but some improvements should be made).

The report makes 4 recommendations:

1. Monitor benefits of UK aid more fully. This means focus more on the impacts of the quality of services (as well as access) and focus on the impacts of the knowledge and relationships it shares and develops.
2. Clarify the DFID strategy in India beyond 2014-15. Uncertainty here will place gains at risk and may result in various initiatives being placed on hold by state governments.
3. Increase further the contribution it makes to technical assistance (TA) in India, because this is where it adds most value
4. DFID's new anti-corruption strategy should have stronger ties with local law enforcement and establish a whistle-blower hotline.

DFID in India works differently from DFID in Africa. It's budget, while large in absolute terms, is but a drop in the bucket in India, even in the 3 poorest states where it concentrates its work. In India, DFID seeks to add value through the know how that it can help to nurture and support (I've seen first hand how competent the Bihar Technical Assistance Support team is). I'm pretty sure this is how most African DFID offices will operate in 5-10 years time.

But Recommendation 1 is not going to be straightforward to implement. The impact of relationships and knowledge sharing is difficult to assess. Those of us in research constantly grapple with the challenges and perils of trying to assess the impact of relationships, research and research uptake (impact vs influence, attribution vs contribution, immediate vs lagged, intent vs action etc. see here for an example).

And Recommendations 1 and 3 seem rather at odds with each other. Recommendation 3 says do more TA work, while Recommendation 1 says find better ways of assessing the impact of TA work (the assumption being that we know what good TA looks like before we assess it).

Recommendation 2 on DFID's strategy in India post 2014-15 is a tricky one for the Government. Aid to India continues to be a political hot potato in the UK, and since it would be difficult to just terminate UK aid to a country with about 40% of the world's poor, UK aid in India will probably slowly decline. If that is the case, better to take the pain sooner rather than later when the decision will run up against the 2015 UK general election.

The final Recommendation on a "Global Whistle Blowing System" seems sensible, and it is surprising that DFID does not already have such a system given its increased spend, fewer staff and the more fragile contexts it now works in.

A final note, I found the ICAI report very useful, but I do wonder how it is any different to an International Development Select Committee report/analysis--perhaps it is just the frequency of the reports that makes ICAI different, or the fact that they are not undertaken by researchers working for MPs.

DFID in India is a fascinating test case of how the currency of aid is surely switching from money to know how.

Africa's First HDR on Food Security Fails to "Put the Last First"

Today UNDP released its first ever Human Development Report for Africa, entitled "Towards a Food Secure Future".

I have a lot of time for Human Development Reports.  I think they offer a nice counterpoint to World Development Reports, and the regional reports really offer a chance for regional voices to be heard and for national politics to come into the picture. And the topic of food security is one that I very deeply care about.

There is much to like about the Report. It offers a more nuanced position on agriculture, income generation and nutrition; on empowerment, accountability, commitment, and resilience. I like the language of nutrition as a bridge from agriculture to human development.

But it is depressing to see the the last chapter in a good report (yet again) be about "Empowerment for Justice, Gender Equity and Food for Everyone".

It should be the first chapter, not the last. It should set the stage for everything else in the Report.

It should show us how food insecurity comes about because of the choices made by those with power, the interplay of competing interests, and the way the existing rules of the game are set up. In other words, politics.  The scope for doing this in a regional report is surely greater than in a more generic global one.

We should then have an agenda for what can be done to change the dynamic and the outcomes. What are the ways, methods and strategies in which voice, accountability and transparency can be promoted in the spheres of policy, technology, spending, training, communicating and framing.

And where are the actors, champions, alliances, movements and networks that need support to do this? How can their rights to speak out and be heard be promoted?

People, power and politics should come first in fight against hunger, not last.

Non Communicable Disease = Not Currently Development?

As part of a Development Studies Association New Ideas initiative, Hayley McGregor and Linda Waldman, two Fellows at IDS,  hosted a workshop on non-communicable disease (somewhat  clunkily called NCDs by all).

I chaired a session on nutrition with two excellent presenters, Venkat Narayan from the Rollins School at Emory University and Andres Mejia Acosta a Fellow at IDS.

NCDs are what they say they are--diseases that are not communicable.  This is includes cardio vascular disease, some cancers, diabetes, some neurological conditions and mental health.

This is what we know (see slides from one of yesterday's speakers, Richard Smith, Director of United Health Chronic Disease Initiative):

• the fundamental drivers of NCDs are increasing: urbanisation, ageing, consumption of processed foods, inequality
• the global burden of disease will shift rapidly from infectious disease to NCDs in the next 10-15 years, even in the poorer countries (the above graphic on the website is from the Bangladesh Matlab nutrition surveillance sites -the red shows the % of deaths caused by non communicable disease--growing very rapidly)
• NCDs rates are not related to income levels, and for some NCDs are higher in the poorest groups
• we don't have effective interventions or policies and we don't have good evidence on what works

Why is this a development issue?

1. Because it is a very bad byproduct of the dominant development pathway
2. Because it threatens to close off future development pathways by overburdening health systems, workforce productivity, and taking away resources from communicable diseases.
3. Because it profoundly affects wellbeing and the quality of life for very long periods of life.

Why is attention on NCDs so fitful? Apparently only 3% of global health resources (public and private) are allocated to NCDs (from Rachel Nugent) and it is certainly difficult to get aid agencies (and apparently Foundations) thinking about it.

The neglect is possibly because:

1. the "narrative" around NCDs is fragmented (undernutrition has its 1000 days), what does over nutrition have?
2. it is not seen as development, rather as a disease of affluence or lifestyle choice--but this is clearly not the case as the data presented by Richard Smith yesterday show
3. the limited range of cost-effective interventions, backed up by rigorous evidence, is not reassuring enough for policymakers--we need more research
4. civil society is not organised around these issues--on the one hand we have the MDG type NGOs and on the other hand the non-development NGOs concerned with single issue NCDs
5. NCDs are not in the MDGs--will they get into the next round?

In the nutrition domain, the NCD field seems about 20 years behind the undernutrition world. The worrying thing is that we do not have 20 years to wait--the NCD elephant in the room is charging--fast.

Are we Letting the 0.7% Target Become a Distraction?

If anyone had any faint hope that legislation to enshrine the UK's commitment to the 0.7% ODA target would make it into the Queen's speech (and therefore into Parliament's business in the next year) the UK local elections last week put paid to that.  

The Conservative Party did poorly in those elections, and this did not exactly help Andrew Mitchell's efforts to make good on his promises.  The non-appearance of the 0.7 Bill in the Queen's speech was widely trailed and so the critics were well primed. 

But are we too obsessed with the 0.7?  Yes, it is a clear and meaningful commitment, but it is ironic that many of us are saying on the one hand that DFID cannot handle its increasing spend, in more fragile contexts, while demonstrating impact, with fewer staff and, on the other hand, that it should rapidly increase its spend.  

Personally, I am content with a steady, measured increase in the quantity of aid. What I want to see is an improvement in the quality of aid.  And that includes wanting to see DFID play more of an influencing role on places like the World Bank and the IMF to get them thinking more seriously about the quality of growth.  

But perhaps even more importantly I want to see a greater contribution from the whole of the UK Government to global development--what are other ministries doing on climate, trade, security, diplomacy, tax havens, intellectual property and the like?  

CGD has led the way on this with their Commitment to Development Index and in the coming months Matthew Lockwood and I will be doing some more in depth work on the extent of the UK's whole of government approach to development. I will report on this as things progress.   

ODA is 1% of UK government expenditure.  Let's not forget about the other 99% and what it could do for global development.  

MVP Impacts? New Paper in The Lancet

A new paper from the Millennium Villages (MV) Project team (pdf) was released today in the Lancet. The paper's conclusion?


"An integrated multisector approach for addressing the MDGs can lead to rapid improvement in child survival in rural sub-Saharan Africa."

Is this impact?

The paper introduces comparison villages in year 3, so MV sites can be contrasted with these comparison sites. This is a move in the right direction, but because the comparison sites are introduced so late on in the project we don't really know how comparable they are and they rely on recall data. 

The assessment of the comparability of these villages (on observable characteristics) is based on 3 sets of data:

(a) village level infrastructure at year 0, but recorded at year 3 for the comparison villages (I think, but the paper is not clear). These are relatively fixed features of villages and for the features that vary over time should be able to be derived from recall

(b) household characteristics at year 3 (collected in year 3 for both sets of villages)

(c) household characteristics at year 0, collected at year 0 for the MV villages, but at year 3 for the comparison villages. This is more problematic--it is is difficult, but not impossible, to construct accurate recall data at the household level over a 3 year period

The mean values of the three sets of variables are pretty comparable across the two sets of villages--in both time periods--so that is somewhat reassuring, but the comparison sites are not control sites (for one thing, we cannot say that the unobservable characteristics have been equally allocated between the two). But it is progress.

The crux of the paper are the results in Table 2. This table makes three sets of comparisons on outcome variables:

(1) for 17 outcome variables, the changes within MV sites between years 0 and 3 are assessed. In 13 out of 17 comparisons, there has been a statistically significant improvement (5%) in the outcome indicator. This could be due to the MV or to some other effect. So the results are neither here nor there. What we are really interested in is the comparison of improvements in MV sites with improvements (or otherwise) in the comparison sites

(2) the second set of comparisons is between the MV sites in year 3 and the comparison sites in year 3.  For these comparisons to isolate impact, the MV and comparison villages need to be comparable at year 0 in observable AND unobservable characteristics. We don't know whether the latter holds and we only have a partial and somewhat fragile perspective on the comparability of the former. Of the 12 comparisons of outcomes between year 3 in MV and year 3 in comparison sites, 3 are substantially improved at 5% significance levels (bednet use, malaria prevalence and access to improved sanitation) 

(3) the third and final comparison is a "kind of" difference-in-difference comparison: what is the difference in the change in MV sites between years 0 and 3 the change in comparison sites between years 0 and 3?  It is "kind of" because the sites were not randomly allocated between MV and comparison at year 0, and the year 0 data for comparisons sites are  collected in year 3. Of the 6 outcome comparisons made here, 2 are substantial improvements that are significant at the 5% level (skilled birth attendance which increased by 24.7 percentage points in MV and by 12.7 percentage points in comparison sites; and mortality rate in children younger than 5 years of age (deaths per 1000 births): in MV sites this number decreased by 24.6 and in the comparison sites it actually increased by 5.9).

So?

• 5 of the 18 outcome comparisons between MV and comparison sites show significant improvements.  This does not seem like a very high number. Why so few?
• But some outcomes are more important than others, and a big outcome is the decline in child deaths, and this was in one of the "kind of" difference-in-difference comparisons.
• If we find the cost data credible, is this a good enough return for a more than quadrupling ($27 to $116 per person per year) of spending over the three years on these multi sector interventions? I have no idea--it would have been really helpful if, for example, the child mortality numbers had been converted into cost per death averted so we could benchmark against other interventions.
• The more interesting comparisons will be the changes in outcome variables between year 6 (say) and year 3 between the MV and comparison sites, because although the nonrandom allocation of sites problem remains, at  least the observations in years 3 and 6 in MV and comparison sites will not be based on 3 year recalls.
• The key thing remains sustainability--is there life beyond proof of concept or is the MV doomed to the start-up "valley of death"? To assess this it would be good to have a better sense of what is in and what is out when the cost data were assembled.

Impact? Getting warmer, but more work to do.

Sustainability? This needs some serious research. 

Verdict on MVs? Still out.

Severe Acute Malnutrition: Neglect Upon Neglect? Or an Opportunity to Mobilise Communities Against Malnutrition Writ Large?

2 May 2012 – UN NEWS CENTRE.  “At least one million children are at risk of dying of malnutrition in the central-western part of Africa’s Sahel region due to a drought crisis, the United Nations Children’s Fund said today, adding that more resources are urgently needed to help those in need. ‘We estimate that in 2012 there will be over a million children suffering from severe acute malnutrition – what’s important to know is that malnutrition can kill,’ UNICEF’s Director of Emergency Programmes, Louis-Georges Arsenault, said in a news release.”

It is ironic that this most media-visible form of malnutrition (severe acute malnutrition or SAM) is also the most under-researched form.  Don’t get me wrong, there is a lot we know:

• SAM is when a child's weight for height is more than 3 standard deviations below median WHO growth curves (by way of comparison, moderate malnutrition is between 2 and 3 standard deviations below the WHO curves) OR mid upper arm circumference (thinness of arm) less that 115m (about 4 inches) OR severe oedema (excessive build up of fluids)
• SAM affects 20 million children worldwide (about 180 million suffer from moderate + acute malnutrition), usually as a consequence of famine or armed conflict
• Children with severe wasting (SAM) are twice as likely to die as kids with moderate wasting
• Conventional treatment of SAM has been on an inpatient basis (recovery and rehabilitation), followed by discharge and follow up
• Given sufficient resources this model works well in reducing mortality, but of course SAM is unlikely to occur in places that have good health facilities
• So Community Management of Acute Malnutrition (CMAM) has become the new conventional wisdom.
• CMAM is (a) early detection of SAM in a community setting, (b) nutritional treatment with ready-to-use therapeutic food (RUTF) and (c) medical treatment in a clinic for the most serious cases
• RUTF has increased the effectiveness of CMAM quite significantly (it is an oil based nutrient dense paste which requires no refrigeration and simple packaging), but its use makes many countries nervous (especially India) as it is seen as a potential Trojan Horse for food industry influence
• Expert and systematic reviews conclude that while there is limited experimental evidence of CMAM’s effectiveness and cost effectiveness (Bachmann, Picot) there is substantial body of non-experimental evidence that it can achieve outcomes as good as those at inpatient clinics, but at much lower cost (at about 1/5th of the cost per person treated).
• The cost of CMAM in terms of per disability adjusted life year (DALY) averted is estimated to be $42-493 in Malawi and $50 in Zambia. These numbers compare favourably with the costs of purchasing DALYs through other proven health interventions such as salt iodisation and iron fortification.          

There are a number of unanswered research questions:

What types of CMAM are best for each context? The evaluations so far have tended to be versus inpatient treatment, but what about different governance/incentives around different types of CMAM?

How sustainable is CMAM? Can it be embedded successfully in existing health systems? Do CMAM resources get captured by the most powerful community players?

Can RUTF be produced at lower cost, with greater local acceptance, but the same or enhanced efficacy? What public guidelines are needed to ensure businesses act in the public good?

What intervention methods are most effective for children less than 6 months of age? There is no evidence.

Finally, can CMAM be a mechanism for sensitizing communities and politicians to the less visible chronic forms of malnutrition? Or will it draw attention from the more widespread, still devastating, but less dramatic forms of malnutrition?

Is SAM the most neglected manifestation of the neglected issue of malnutrition? And might CMAM be an entry point for making all forms of malnutrition harder to neglect?

The technical issues here are critical, but the strategic and political ones are equally vital.

Recommended Reading and Links

• Steve Collins et. al. 2006. Lancet (pdf). This is a seminal review from the guru
• Bachmann 2010. Expert Reviews (pdf). On cost-effectiveness of CMAM + the Zambia study
• Wilford et. al. 2011. Health Policy and Planning—Malawi case study (pdf) 
• Gera 2010. Indian Pediatrics (pdf). A global review with thoughts on applicability to India (hardly any studies there despite high levels of SAM)
• Picot. 2012. Systematic Review of all SAM treatments, but no cost data (pdf). 

Nutrition: Noteworthy and New

It's only halfway through the week, but the nutrition stuff is stacking up.

Research Papers

An interesting new paper (here is the working paper version) from the Review of Economics and Statistics (one of the harder to get into journals) by Luis Braido, Pedro Olinto and Helena Perrone, who explore (random enough) accidental exclusions of families from the Bolsa Alimentacao (or BA, one of the CCT programmes in Brazil). BA is targeted to women, so the random enough accidental exclusion generates a natural experiment: households in BA for whom resources are transferred to the senior woman in the household versus BA eligible households who (unfortunately) receive no transfer. The authors ideally need an experiment that randomly allocates who receive the cash transfer, men or women. But they do not have this, they have female income transfers versus no income transfer. 

So they look at different household sub groups to see if the differences in impact on food expenditure between female income and no income vary for different household groups: (1) households with no adult males, (2) households with male and female adults but where the eligible female has an additional source of income she can lay claim to and (3) households with male and female adults but where the transfer is the only source of income to the eligible woman.

They find the (female income--no income) impact differential on food expenditures does not vary by household group and conclude that BA does not give an extra boost to food security and diet quality via the female income effect. An interesting paper and somewhat against the orthodoxy. A good reminder, as Micheal Lipton often says, that we researchers should always be testing our priors rather than peddling them.

Blogs/articles/speeches

Here is an interesting new blog from Robert Chambers (Sanitation and Hygiene: Undernutrition’s Blind Spot) arguing that Fecal Related Infections have been overlooked in the fight against undernutrition. He may just be right.

A speech from Tony Lake, UNICEF Executive Director, to the G8, arguing that the other 4 members (Germany, Italy, Japan and Russia) need to join up to the Scaling Up Nutrition movement. A nice piece from the new Chair of the SUN Lead Group.  

An interesting piece on the Reuters wire from Megan Rowling "How do you count the world's hungry people?" documenting the challenges of assessing hunger (personally I think 1 billion might be too low given the comparisons with household survey data in Africa--see my Save UK powerpoints referred to below).

A short policy brief from IDS on Nutrition Governance: Can It Help Accelerate Undernutrition Reduction? (by Andres Mejia Acostsa, Jessica Fanzo (WFP) and me. Summarises a six-country study and comes up with some key features on an enabling environment for nutrition status promotion. An interesting and different take on nutrition governance, even if I do say so.
 
People/Meetings

I started the week at Save the Children UK with their impressive new team of Nuria Molina, Director of Policy and Research and David McNair, Head of Growth and Livelihoods. I was presenting with John Beddington, the UK's Chief Scientist, on some of the Foresight work from last year, updated with some more recent work.  My powerpoints are here. Save UK reaffirmed their leadership on undernutrition issues, and we had a useful discussion of some of the research gaps and some of the strategic footholds they may create/identify over the coming 18 months in their nutrition work.

Yesterday IDS had a visit from Bruce Cogill, one of the authors of the famous Lancet series on nutrition from 2008 and now the head of nutrition and biodiversity at Bioversity International, one of the 16 CGIAR international agricultural research centers (you can see him in action here). Bruce is developing an interesting programme of work around biodiversity, resilience, dietary quality and nutrition. Worth keeping track of (Bruce and the work).

Opportunities

We have 3 PhD scholarships available to work with the IDS team on the Transform Nutrition Research Programme Consortium. Check it out. You even get to have me boss you around...

Robert Chambers: Blogger, Poet and Provocateur

Robert Chambers, IDS Associate and all round inspiration has just released a book, Provocations for Development.  The book is a collection of short pieces over the past  30 or so years, only one of which has appeared in one of Robert's books before.

The book is great--Robert designed it so you could dip in and out with ease, and he has achieved this.

So, for example, I read with interest about his word content dissection of the Paris declaration on Aid Effectiveness (please don't do this on one of my papers Robert), his views on mobile phones (and why he keeps taking photos of his knees), the six blind spots of deprivation (e.g. the poverty of time), the story of Chapter 11 in the World Bank's Development Report of 2000/1 (very pertinent with all the talk of Voices of the Poor 2) and the participation of children in shaping our futures (children will astonish us if only the adults would let them).

I also realised Robert was a blogger before any of us were (he just did his first formal one here, but as you can see from the book he has been doing them since the 70s).

He is also a poet. There are loads of poems in the book. One verse "Empowerment means having voice; You enjoy the right of choice; You are free in every way; To run your country as we say". And this is one of the less raucous ones.

But he is above all a provocateur, someone who can make you think about things that are outside your comfort zone.

I found his final entry in the book to be the most provocative.

When posed the question, "what would it take to eliminate poverty in the world?" Robert starts making his wish list of policy outcomes and other things... then he stops and says, yes, but this is just a wish list, and it is mostly a list of things others should do. What about us, the non-poor, the better off, the wealthy, the powerful? He then lays out 3 areas in which he is continuously learning to do better: around power and wealth, social relations and personal behaviours. It is a fascinating list.

So Robert has now gotten me to think about my own list--which is the kind of thing the book does. And he knows where I live.