09 October 2014

The recent ENN meeting--helping break down the boundaries in nutrition

I was at the Emergency Nutrition Network (ENN) technical meeting in Oxford this week.  

The meeting was organized to fill a perceived gap – not enough technical meetings on nutrition to address problems we talk about a lot but never make time to grapple with.

The 100 or so participants were mostly from implementing agencies (not so many researchers).  

The issues addressed were quite practical:

* what does nutrition-sensitive WASH actually look like (still not terribly clear to me despite some great presentations)?

* What forms does multistakeholder coordination take (e.g. co-location of programmes, embedding of nutrition programmes in broader programmes, hybrid or integrated approaches) and when is which form the most appropriate? 

* What are some of the new innovations in cash transfer programming (vouchers, cash, direct bank account transfers, cash transfers in emergency situations)?

* What are some of the new global developments to be aware of (e.g. the ICN2, Sustainable Development Goals, the Global Nutrition Report, WHO/UNICEF’s new Global Monitoring Framework etc.)? 

* What are some of the disconnects that stop the nutrition community working as effectively as possible (e.g. bureaucratic imperatives that lead to competition for funding, wanting to brand individual work, very different languages, seemingly arbitrary divisions of responsibility – WFP leads on moderate acute malnutrition and UNICEF leads on severe acute malnutrition--duplication of effort: e.g. 10 different infant and young child feeding programmes going on in one district)?

* Was the initial humanitarian response in Syria too African-centric (i.e. too focused on acute malnutrition? Yes.)

I really enjoyed the meeting, which was very well organised.  It was great to interact with lots of very thoughtful people I usually do not get to talk to with, although it made me sad that there are so many nutrition professionals working behind a wafer thin but seemingly impenetrable wall from those working on more chronic forms of nutrition.  (One example: I bet not many of the latter camp know the definition of Global Acute Malnutrition—a key summary indicator for this community).

Somehow we need to get beyond the labels of “emergency” and “development”. 

First, poor development choices generate emergencies, and poor emergency responses can set back or propel development.  The boundaries are not substantive.   

Second, these labels do not describe what each community does.  “Chronic” does not equal development (stunting rates can be profoundly affected by shocks) and “acute” does not equal emergency (e.g. India has very high levels of wasting).  

Finally, stunting and wasting go hand in hand at the national level and perhaps at the individual level (for the Global Nutrition Report we could not find estimates for 50 plus surveys answering the question “what percent of stunted children are also wasted and vice versa?”). 

Perhaps we could just talk about "one nutrition".  Perhaps ENN could call itself the Enabling Nutrition Network! 


Tanya Green said...

Hi Lawrence got any suggestions about how to overcome the "gap" ? ... Tanya

The SUN Movement said...

Dear Lawrence, the SUN Movement has also shared an article on their website. See here http://scalingupnutrition.org/news/a-technical-meeting-on-nutrition-is-hosted-by-the-emergency-nutrition-network#.VETHvTKSzRE

Lawrence Haddad said...

Good challenge Tanya

Here is my list

1. Teach this material in a joined up way at university
2. Agencies to break down organisational barriers between the two sets of staff
3. Or if that is not possible, more exchange/cross-posts
4. Rethink the current UN division of labour
5. Special issues of high profile journals devoted to bridging the gap
6. Reports such as the Global Nutrition Report trying to bridge the gap
7. Research funding calls that incentivises more joint working
8. External funding that incentivises more collaboration

I think a lot of it starts with number 1.

Readers, what would be on your list?

amanda pearson said...

It is also informative to look at where developing countries locate nutrition within their ministries. For example, Ethiopia shifted fairly recently (2008) from approaching nutrition as an acute, emergency issue to programming for chronic undernutrition. Historically, Ethiopia focused on its citizens’ nutrition status during emergencies (famine) as part of the Disaster Management ministerial portfolio. I wonder how long it takes to change mindsets?