31 July 2013

Nutrition in Zambia: On the Cusp? A Call for Abstracts

Zambia is the next in the IDS series of country-focused collections of papers on undernutrition.

The series has generated the IDS Bulletins on India (2009 and 2012), Pakistan (2013) and now Zambia (2014).

As with the others in the series, the Zambia collection highlights contributions from national researchers, practitioners and policymakers living in Zambia.

Zambia is a mineral-wealthy country in southern Africa, has one of the fastest declines in stunting rates (although still at 45% of all children under 5), has a moderate commitment to hunger and malnutrition reduction as measured by the HANCI index, and is a Scaling Up Nutrition early riser country, so the time is good for this collection.

The collection of short papers will help to do several things (a) strengthen the Zambian network of nutrition commentators, activists, analysts and strategists, (b) provide these professionals additional links to the international nutrition community, (c) generate new insights about the nature of undernutrition in Zambia, what to do about it and how to go about it, and (d) sustain and hopefully increase the momentum within Zambia for undernutrition reduction.

The co-editors of the collection are me, Dr. Cassim Massi the Executive Director of the National Food and Nutrition Commission (pictured above), Musonda Mofu, the Acting Deputy Executive Director of the Commission and Jody Harris, a researcher at IFPRI who is very familiar with Zambian nutrition.

We are now calling for abstracts in the following areas

  1. Determinants of stunting in Zambia
  2. Interventions and Approaches that are proven to work in reducing malnutrition in Zambia 
  3. Approaches to implementing the 1000 Day Programme
  4. What can be done to raise the profile of nutrition within the economic growth agenda?
  5. Policy, capacity, resource and evidence priorities 

Interested authors are asked to submit an abstract of no more than 200 words to j.harris@cgiar.org by September 1, 2013

Authors of selected abstracts will be contacted by the editors by September 15, 2013 and invited to submit a full paper (of no more than 4000 words in length) for consideration by November 30, 2013.

The edited book will be published in mid 2014. Submissions are particularly sought from Zambian authors.

30 July 2013

No, I have not been fired...

As you know, the position of Director of IDS is being advertised, for a July 2014 start.

And I am making a list of the reasons that make it to me, via friends and colleagues, about why I am leaving.

These are the three I hear most often.

1. He was fired.   Well, no surprising phone calls from my Board, although there is time...

2. He is going to be the new Executive Director of the World Food Programme.   They have an excellent ED in Ertharin Cousin who has only been in post a year, and in any case, that job sounds way too difficult

3. He is going to apply for the Head of Global Studies at the University of Sussex.  The University is wonderful, but the words "frying pan" and "fire" come to mind

I can tell I am going to have an interesting year.

The reason I am leaving now is that IDS' constitution limits Directors to a maximum of 10 years and 2014 will be, um, 10 years.

We sometimes call people in this position lame ducks or a busted flush.  I prefer (for obvious reasons) the analogy to the android played by Rutger Hauer in Bladerunner: the research director-machine raging against the dimming of the light.

Will keep you updated on any new oddities this final year at IDS throws up...

27 July 2013

IDS Transforming Nutrition Summer School 2013: Debates and Reflections

Well, that was intense, but fun. I'm talking about he the IDS Summer School on Transforming Nutrition. The 25 participants are shown above.  About half from high burden countries and half from donors and agencies.  We cycled through definitions, distribution, causes, consequence (all in Day 1), with interventions in Days 2 and 3 and building commitment and converting it into action on Days 3 and 4.  There were also 4 country working groups who worked on an real issue facing the participants in Ethiopia, Tanzania, Burkina Faso and Kyrgyzstan presented on Day 5.  We had some particularly interesting discussions on:

1.  The differences between the SUN nutrition specific interventions (based on Lancet 2008) and the Lancet 2013 nutrition specific interventions. We noted that:

  • Five interventions overlap completely (promotion of breastfeeding, complementary feeding, management of SAM, Vitamin A supplementation, salt iodisation).  
  • There are 6 in Lancet 2013 that are not in the SUN set (maternal balanced protein energy supplementation, maternal multiple micronutrient supplementation, Folic acid supplementation, management of MAM, preventative Zinc supplementation, Calcium supplementation). These reflect new evidence and new understandings about the importance of maternal nutrition. 
  • Finally, there were 6 "missing" interventions, i.e. in SUN 13 but not in Lancet 2013 (hand wash with soap, therapeutic zinc for diarrhoea management, Iron and Folic acid for pregnant women, multiple micronutrient powders for children, deworming and iron fortification of staple foods). Why are some of the interventions missing?  Each missing intervention has a different reason for omission: hand washing with soap promotion and therapeutic zinc for diarrhoea management are still fully endorsed by the Lancet authors, but for categorisation reasons (they are about disease control) they were not listed in the Lancet 2013 list. Iron and Folic supplementation is now subsumed by maternal multiple micronutrient supplementation. Iron fortification of staples listed as beyond scope of review. Multiple micronutrient powders for children and deworming--increasingly mixed views on the nutrition benefits of these.

2. The absence of evidence is not evidence of absence

In other words, (1) a finding of no statistical evidence in a randomised controlled trial must be taken in the context that often these trials do not have large enough sample sizes to detect real differences.  But also, maybe more importantly, (2) when a huge amount of non-experimental but highly plausible evidence suggests that one thing causes another it should not be ignored.  This discussion came up in the context of nutrition sensitive programmes.  Paper 3 in the Lancet by Ruel and Alderman is careful to make both of these points.   Nevertheless the paper was politely criticised by Per Pinstrup Andersen in his commentary paper in the same volume for ignoring other types of evidence (e.g. econometric evidence) that suggest highly plausible effects of agricultural programmes and policy on nutrition status.  What to do in the absence of definitive evidence that x causes y?  Doing something has risks but doing nothing does too. The translation of evidence into action is still more of an art than a science.

Relatedly I just read an interesting paper by Andrea Cornwall at the University of Sussex on how RCTs are set up to capture impact by intervention design, but not (1) impact due to interaction with other interventions and (2) impact by emergence--unimagined outcomes which are not easily discerned, but which emerge due to interactions with other interventions or with historical and cultural processes. I suggest you write to Andrea for a copy (a.cornwall@sussex.ac.uk).

3.  The role of the private sector.  We had a discussion that emphasised:

  • the need to unpack what we mean by the private sector: national or international? small, medium or large? which sectors? 
  • the need to map this onto different stages in the lifecycle of nutrition: which age groups should be regulated more closely? which interventions are most susceptible to private sector influence? where can the biggest positive contributions be potentially made?
  • the need to map different private sector roles: influence, delivery, innovation, finance
Only by doing this can we have a non-polarised discussion of the areas of private sector engagement that are likely to maximise the positive benefits and minimise the negative. Above all, the public nutrition sector needs to know where the bottlenecks are and which ones might be relaxed by private sector engagement.

4.  The orphan to an orphan? Sanitation  

We were enlivened by several interventions by Robert Chambers.  Robert has just published a paper in Economic and Political Weekly on open defecation in India and together with the emerging interest in environmental enteropathy (focally transmitted diseases that do not necessarily manifest as diarrhoea) we had a lively discussion about whether sanitation is a potentially big and quick win for nutrition.  A new systematic review is due out on this soon, I believe. 

5. Youth

One of our participants was a Youth Ambassador for one of the major INGOs. He reminded us that we were not doing enough to include youth in this conversation about nutrition---the nature of the problem, how to build commitment to doing something about it, what to do about it, and how to sustain that energy.  This has given us something important to think about. 


we heard this week that one of the Summer School Convenors, Prof. Anna Lartey, has just been appointed as Director of Nutrition at FAO.  This is a superb appointment by FAO--Anna is a smart researcher, a powerful speaker and an inspiring leader.  We look forward to supporting her in this exciting new development.  

We will run the course again next July.  Watch out for the ads later this year. 

21 July 2013

Sen, Dreze, Bhagwati, Dasgupta and Panagariya on India's "Arrested Development"

This month's Prospect magazine has an interesting interview with Amartya Sen, Nobel Prize winning economist, about his new book with Jean Dreze "An Uncertain Glory: India and Its Contradictions".  The book is reviewed by Partha Dasgupta, a famous economist working on economics and the environment, in tandem with another book just out by two other famous Indian economists, Jagdish Bhagwati and Arvind Panagariya called "Why growth matters: how economic growth in India reduced poverty".

In a nutshell:

  1. Dreze and Sen argue that the type of GDP growth India has generated has not led to sufficiently fast improvements health and education (the slow pace of reduction in undernutrition was their starting point).  This they argue is because the quality of growth is not high--not broad based, market governance stacked against poor etc.  They say that in a democracy, the population has to fight for these improvements and that the poor in India have been much too patient.  
  2. Politically, Bhagwati and Panagariya are far to the right of Dreze and Sen.  The former pair argue that getting GDP growth is essential to poverty reduction and to generating the kinds of revenues that can now be invested in health and education.  
  3. Dreze and Sen would counter this by saying GDP growth that does not raise health and education is denying itself a further source of sustainable growth--we know that improvements in health, nutrition and education further spur growth. 
  4. Dasgupta says they both are missing the point--the extrenalities generated by India's growth are eroding natural capital such as ecosystems, exacerbated by increasing population pressure and that this is a key trap that is preventing growth from generating improvements in human welfare. 

My view?  I have some sympathy with parts of all the views, but I come down most strongly on the side of Dreze and Sen.

India's growth is doing well in reducing poverty (Bhagwati and Panagariya), but this poverty reduction is not translating fast enough into education, health and nutrition reduction (Dreze and Sen).  This may be due to deep-rooted but misguided beliefs (e.g. Panagariya's vies on the inappropriateness of the global nutrition standards on height for under 2's, even though India was one of 6 countries that generated the standards!), discrimination (e.g. caste and gender--Dreze and Sen), environmental externalities (e.g. half of the Indian population defecates in the open--Dasgupta), poor management of public resources that are expended on health and education programmes (e.g. the ICDS programme which has highly variable performance--Dreze and Sen), a complacent government (where is the urgency on the issues?--Dreze and Sen) and a too-placid civil society (can Brazilian/Turkish/Egyptian riots be far away?).

The Indian Government's apparent complacency on these issues seems like a very dangerous stance to take.  As I have said before in the attached paper, they should be as obsessed with child growth as they are with economic growth.  If not they might be thrown out of office by an Indian electorate that sooner rather than later decides it just isn't going to take it any more.

14 July 2013

Why should you study for a PhD at IDS?

July in Brighton sees Summer Graduation for University of Sussex students and since IDS teaches several University courses, I was there to read out the IDS graduates’ names and to congratulate them on their achievements.

As usual, the Chancellor Sanjeev Bhaskar made some astute, wry and humorous comments. His key point: find something you love and learn from and then stick with it, and if you are not in that situation, don’t be afraid to change. Above all, never give up.

We had some great shouts from the audience, including “that’s my baby”, “that’s my sister”, and “halleluah”. We had babies on stage, a faked heart attack and some very good dance moves.  The Chancellor maintained his dignity throughout.

We also had a very nice speech from Prannoy Roy, receiving an Honorary Degree for his work in the media in India (he is the founder of NDTV). He also stressed the theme of never give up: he went through 7 professions before finding the one he loved.

The Winter Graduation is usually the more boisterous ceremony when all of our Master’s students arrive to receive their certificates, but the Summer one, dominated by the PhD graduates has a quiet joyfulness of a long road completed successfully.

And what a road. Completing a PhD is one of the most stressful things one can do—I certainly found it so. It can be quite a solitary endeavour, there is nowhere to hide and doing a sustained piece of work over 4 years is something that is even harder in our multi-media, multi-distraction, multi-opportunity world.

That is why we try hard to place our PhDs within a supportive and collaborative environment. PhDs at IDS are part of research teams and clusters, they are Members of IDS and they are vital to our thriving intellectual community. We are striving to do even better at embedding our PhDs in multi-year research programmes and creating events and publication opportunities for them to showcase their work.

They are a brilliant group of professionals and (dare I say it) conducting some of the most interesting research around.

We wish them well and we will hold them close.

If you want to find out more about applying for a PhD look here.

If you want to know what to expect as an IDS PhD, look here.

Why should you do a PhD at IDS? To contribute to the tradition of research that is people centric, embraces the political, takes on orthodox views and is at the intersection of academia, policy and practice. You will be like a kid in a candy store.

Come and join us.

05 July 2013

Egyptian Revolts: Behind the Narrative -- a Conversation with Mariz Tadros

One of our Fellows at IDS, Mariz Tadros, is an expert on political movements and is Egyptian. After reading the Western media, I was puzzled: why is there such relief that a democratically elected President has been ousted by the mob and the military?

These are the questions I posed, and Mariz's interesting answers are in green. Thanks Mariz.

Mariz, help me out. This is the standard narrative.
1.  Morsi was elected in a free and fair election. He won narrowly but decisively.

I am afraid it was neither free nor fair- he won by a slim margin (less than one percent) but there was evidence collected by independent sources (AlAhram Centre for Strategic and Political Studies for example) that fraud and voter rigging. These were not taken serious by the electoral commission because they were not independent.

2. He has governed at best incompetently, at worst, autocratically shutting down democratic institutions

Yes, absolutely, and the same precursors that existed before the January 22th Uprising were prevalent in this case as well, i.e. a military disenfranchised and feeling oppressed, worsening economic policies, the absence of any corporatist, inclusive system of governance and the monopolization of power on a macro and micro level in the hands of the Brothers, who basically treated their coming to power as a case of winning the war and distributing the booty (posts) between them. In fact we predicted that we will have another revolt and made this prediction public at least a month before the protests: See Egypt’s Unfinished Transition or Unfinished Revolution? Unruly Politics and Capturing the Pulses of the Street

3. A broad spectrum of citizens have called for him to step down 

Exactly -- the breadth of the citizenry surpassed that witnessed in the 25th of January revolution of 2011: Participation, Power and Social Change blog - Missing the pulse of Egypt's citizens

4. The military, funded by the US, have enforced this desire 

Yes, the combined forces of the youth movements who had called for the 30th June revolt, the religious leaders, the ultra radical Islamist Salafis all met with the military and agreed on a roadmap that would NOT involve the military heading Egypt, but the head of the Supreme Constitutional Court, until a new constitution is drawn and elections are held. See Mariz Tadros' article 'Opportunities and pitfalls in Egypt’s roadmap' on Open Democracy

However, it is important to remember that the military went AGAINST the desire of the US by responding to the people’s demand for intervention- and which now has meant that the American administration which has supported the Muslim Brotherhood since 9/11 has now threatened to cut aid to Egypt. This may in fact explain the extraordinary bias in the western media and think tanks towards unilateral support for the Muslim Brotherhood against the Egyptian citizenry. 

I am confused. It seems to me like all that has happened is that (a) the military has been empowered...

yes of course it has to a certain extent, but remember the military had lost many of its men in Sinai as a consequence of the growth of jihadi militant forces who were kidnapping army men and Morsi was just doing nothing about it

(b) any time any elected politician does anything unpopular she or he will be booted out by revolts...
well I think when elections are not free and fair in the first place, when constitutions are seen as illegitimate because they only represent the will of one political force in the country and when majoritarianism trumps inclusive democracy, then revolts may potentially occur over and over again.

and (c) political Islam has become even more radicalised.

The Muslim Brotherhood political project has been challenged by a significant proportion of the people, but the “Islamist project” per se has not- and there is a fear that the ultra radical Islamists will win any future election however, it is also true to say that a significant proportion of Egyptians have actually turned against those who speak in the name of Islam because they saw how political forces instrumentalize religion for their own ends- so it could go either way really.

Is this mobocracy (millions protesting, yes, but fewer millions than voted)...

no it was not just mobs but whole segments of the state turning against an undemocratic system- i.e. the judiciary, the police, the government employees, resignation of ministers, resignation of members of the shura so it cannot be described as a mobocracy

... democracy (this is how democracy works in countries that have not had it for a very long time)

this is one expression of an unfinished revolution- important to recall that other revolutions were also extended over long periods of time (i.e the French Revolution)

...or autocracy (by the military)?

in view of the fact that a roadmap collectively agreed upon by all parties (except the Brotherhood who refused to take part in the process), and the country is not actually run by the military, I see this as a case of the military playing the role of the midwife preventing the death of the baby (if civil war should occur) rather than the emergence of another military dictatorship.

And were all democratic avenues for getting rid of Morsi tried and exhausted (was the revolt the last possible option)?

yes, during the course of the year, he was asked to establish a technocratic government and he didn’t. On the 30th of June, the military proposed that President Morsi appease the crowds by calling for a referendum on  early presidential elections and he refused.

Appreciate your insights.

That’s what I am here for, please don’t hesitate to let me know if there is any further information needed.


02 July 2013

When is a policy product a public good? (Or, don't let VFM crush your double loop dreams)

This is a question that we have recently posed ourselves through some work with one of our development partners.

The analyses we are doing are grounded in specific policy processes, typically at the national or sub national levels and are intended to nudge those processes towards more informed decisions about how to reduce poverty and promote human development, and therefore contribute to the realisation of those ultimate goals. The policy products we are producing are things like public policy briefs, in person briefings, analysis papers, and knowledge sharing roundtables and other knowledge sharing platforms.

Public goods are things that the market does not provide which are non-excludable (everyone can consume them) and non-rivalrous (consumption by one individual does not have an impact on the consumption by others) and have positive externalities (the more they are used, assuming they are of good quality).
Can context-specific policy products be public goods? Well, they can pass the technical definition of public goods—if they are not behind a paywall then they are non-excludable and they are non-rivalrous in that they can be accessed by unlimited numbers of readers without diminishing anyone’s individual consumption.

But can these policy products pass a more meaningful definition of public good? That is, a public good that is useful outside of its context. For example, take a piece of analysis that, say, suggests norm setting around violence against women and girls in country x is shaped, in large part, by the attitudes towards alcoholism and therefore programmes to treat and prevent alcoholism. This analysis is available and non rivalrous but, assuming it is of good quality, how useful is it in other contexts? The internal validity of the analysis and conclusions might be high (this is a credible conclusion in this context at this time), but what of the external validity (does this have any relevance for other contexts and times?). Perhaps in other cultures it is the design of urban spaces that emerges as a contributing factor to violence against women and girls, or poor protection in schools. 

So how do we make specific policy analysis outputs attain more features of a useful public good? One way is by surveying multiple experiences in several contexts, looking for commonalities, differences and patterns.  This is helped if the analyses surveyed pass a quality standard and are surveyed in a transparent and systematic way (and there are many transparent and systematic ways of doing this). Vital to this is a balanced interpretation of the evidence assembled to determine which factors are identified most frequently and which experiences carry more weight?

But most important, I think, is to determine whether the results we assemble cause us to fundamentally rethink our general assumptions about why violence against women and girls happens and what public policy can do about it. Does the assembled evidence, say, point to a complete rethink about violence against women? Is it more about norm-setting while the manifestations are context specific? If it is about norm-setting, that is the widely useful public good and the context specific knowledge about how to reset those norms and how to deal with their current fallout, while a public good, is the new locally valid policy product.  

For many in the illegal drugs control movement a similar ah-ha moment happened when they began to realise that different types of drug control was having as much of a negative effect on development as the drugs themselves. It was time to rethink the term “drug control”. Or when the reproductive health community began to realise that sex was always portrayed as a negative risk factor rather than something that could be a positive force for better reproductive health. Or when the HIV/AIDS community recognised how fundamental inequalities of all kinds were to the spread of HIV.

I suppose this is a kind of double loop learning. Single loop learning involves trying different approaches based on a given set of assumptions about the nature of the problem. Double loop learning questions the assumptions more and then uses that analysis to be more creative in generating potential solutions. Study after study shows that most organisations don’t have time for single, let alone double loop learning (never mind triple loop). 

Under the intense VFM pressures of today’s fiscal climate, all of us are being pressured into more and more single loop learning. We should resist. Policy and analysis will be the better for it--as will VFM.