Today a new report from IDS-UNICEF (written by me, Nick Nisbett, Inka Barnett and Elsa Valli) on the reasons for the rapid declines in stunting in Maharashtra between 2006 and 2012.
Report is here. Video is here. Powerpoints are here.
We used three approaches to tell the story: a review of reports and studies; primary stakeholder interviews and a comparison of two the surveys from 2006 and 2012.
We found improvements in stunting were across the board in all groups. There were many improvements in determinants at many levels and in many sectors, but they were not amazingly large--they were just wide-ranging.
The conclusions were that if stunting cannot decline in Maharashtra where lots of things were moving in the right direction then stunting will not decline anywhere.
On the other hand there were still things that did not improve much--food security, sanitation, and PDS leakage. So Maharashtra is not such a perfect scenario that these results cannot be replicated elsewhere (and probably are in many Indian states).
Finally we noted that these declines took 10 years of public commitment and quiet hard work from governments, civil society and researchers --all working together.
Undernutrition can come down quickly, it just takes a lot of people working together with a strong and enduring focus.
05 August 2014
01 August 2014
Nutrition for the Next Generation: what the US - Africa Summit should really focus on
“Investing in the Next Generation” is the powerful theme for
next week’s US-Africa Summit in Washington DC.
It’s a big moment. Convened by Barack Obama and spanning three days with around 50 heads of state, a range of African and US businesses leaders, civil society, youth leaders and politicians. No doubt there will be plenty of announcements, handshakes, deals, pledges and rhetoric.
It’s a big moment. Convened by Barack Obama and spanning three days with around 50 heads of state, a range of African and US businesses leaders, civil society, youth leaders and politicians. No doubt there will be plenty of announcements, handshakes, deals, pledges and rhetoric.
I hope that one issue has the attention it deserves. Good
nutrition is one of the best investments political leaders can make in the next
generation. If you want your countries’ kids to maximise their potential in
life and to supercharge your demographic dividend, you should invest in child nutrition
in the womb and in their early years. The right nutrition at the right time
will not only give your children a head
start in life, it will slow down the onset of non-communicable diseases that
are now dominating health burdens throughout the world—diabetes, hypertension,
coronary heart disease and obesity. Well-nourished
mothers are more likely to give birth to well-nourished babies. This is an investment in the next generation,
and the next: the investment returns are remarkable.
Ten years ago, these points were not well known. Now there
is widespread recognition that sustainable economic growth and child growth are
inextricably linked. I have written about the economic impact of
undernutrition, which may cost African countries on average 11% of GDP[1]. Given the enormous potential GDP win, you
would think all government leaders and economic planners would have their eyes
on their undernutrition rates and make massive budget allocations to fix the
problem. But the data is not available.
Can you imagine running an economy with data that is 5-10
years out of date? Week in week out,
Ministers of Finance and political leaders sweat the decimal points over
inflation rates, interest rates, employment rates and the rate of GDP
growth. Up to date data is critical to
make informed economic course corrections and to prevent or recover from
crises. But up to date nutrition rates or data on nutrition spend? Not so.
There are many initiatives to try to fill these data
gaps.
The Global
Nutrition Report, an initiative of a wide range of stakeholders from
national governments, the UN, civil society and donors, is attempting to bring
all of the data together and make it widely available and easy to use. The idea is to help measure progress,
strengthen accountability and reduce malnutrition faster. The Report will be launched in November at
the Second International Conference on Nutrition in Rome. We are working hard
on a first draft, but some things are already clear:
- Few countries have the data to even tell if they are on target for more than 3 of the 6 World Health Assembly nutrition goals.
- Hardly any data is available on what governments actually spend on nutrition.
- The 70 or so nutrition relevant indicators the Report has collected (on outcomes, programmes, determinants and inputs) are not consistently available.
This is not the fault of the
organisations tasked with collecting these data—they are doing heroic things on
modest budgets. They want the data to be
good quality, relevant, timely and used.
But too often, organisational decisions on budget allocations assume
that data collection can be done on the cheap, when even low quality data is
expensive to collect. Many organisations also think that data collection does
not bring enough direct benefits. Even worse, some think that the data is not
valuable enough, assuming wrongly that we will not be able to respond effectively
to what the data is telling us.
We would not think that way in
economics. Constructing household income is a devilishly difficult thing to do
with a huge number of challenging assumptions about prices, consumption
baskets, the costing of in-kind consumption, self-reporting accuracy etc. For child growth you have to collect age,
weight and height. Easier said than
done, but just like you can train an economist to measure prices per common
unit of weight or volume, you can train for collection of good nutrition data. In economics we would invest in surveys,
enumerators, supervisors, data processors, data checking routines, analysts and
smart ways to communicate the data. Governments would then tell us how they were
going to react. Conversations and debate
would ensue. Action would be demanded.
Economics matter to
politicians. But politicians should care
as much about child growth as they do about economic growth because they are
inextricably linked. We need a data revolution in nutrition and we need it
now. Without investments in good data
for nutrition, we are less likely to have good nutrition. And that really is bad for the economy.
I hope that during the three days
of talks at the US-Africa Summit, the leaders are not content to settle for the
world as it is. They should have the courage to remake the world as it should
be. Invest in good nutrition for the next generation.
(Note, this article first appeared on the Devex website)
(Note, this article first appeared on the Devex website)
[1] Child Growth=Sustainable Economic Growth: Why we
should invest in Nutrition, Haddad 2013, [include weblink]
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