09 February 2015

Odisha’s Open Spaces for Nutrition Innovation

Last week we held a Global Nutrition Report roundtable in Odisha’s state capital, Bhubaneswar.  We had a great line up of speakers from Odisha and Delhi.  The state’s Chief Minister, Naveen Patnaik, as well as the Minister of Women, Children and Development, Usha Devi, were in attendance at the end of the day to hear the result of the day’s deliberations.  About 140 participants from government, civil society and research were present.

We were in Odisha because it has high rates of stunting from the 2005-6 NFHS-3 survey at just over 40% and because it is home to one of the Independent Expert Group, Arti Ahuja, Principal Secretary for Health and Welfare.

My 4 takeaways from the day’s conversation
1. Odisha is a state that is very open to innovation and experimentation in nutrition and health, with a genuine desire to improve delivery and outcomes.  There was ample evidence of lots of pilots and evaluations (e.g. social audits, nutrition focused malaria programmes and different incentives for nutrition and health frontline workers to work as a cohesive unit) underpinned by strong collaborations between government, NGOs and researchers.  This is the kind of leadership we need -- and the tone is set at the top.  The Chief Minister was clearly massively busy—he had been in parliament all day--and was going from our meeting to chair a Cabinet meeting.  He could easily have not attended and saved himself a precious hour, but he resisted and was with us.

2. The flip side risk of being an open space for experimentation and innovation is the temptation to overelaborate and generate a glittering but threadbare patchwork of lovely pilots that are incapable of being scaled up. There was no evidence of that happening, but it is a risk to monitor closely.

3. The nutrition community really need to engage with powerful development processes.  Whether working in malaria prevention, house construction, school feeding, employment legislation, women’s land rights or disaster prevention and resilience promotion, a nutrition lens may lead to design changes that can enhance nutrition status (e.g. mesh windows in mud huts, roads that enhance access to food markets).  In addition, there is a need to anticipate and plan for cuts in social sector spending that seem to be on their way from central government in Delhi.

4. Finally I stressed that leadership for nutrition needs to come from wherever people were situated.  That leadership would be characterized by taking risks to get things moving even when there was some potential personal cost, questioning lazy assumptions, forming alliances, making yourself accountable and never forgetting to be outraged by malnutrition.

Participants had clearly reflected on the Global Nutrition Report.  As well as lots of plaudits, there were criticisms: where was the rights based paradigm?  Where were the warnings that a lack of data should not be an excuse for doing nothing?  Where was the subnational data that is most useful for policymakers and programme implementers?  All valid critiques, and ones which we will try to address in 2015.
Overall I was impressed with how cutting edge much of the thinking and work being done in Odisha seemed to be, and how warm and generous the Oriya participants were.


Unknown said...

Thanks for your valuable assessment of nutrition programme and policy in Odisha. I wish to understand why there is no mention of wasting which is as high as 18% according to current status with many high burden district which fall in Odisha. Government is complacent on doing a rapid survey and having a plan to scale up innovative approaches which have been demonstrated. Valid International and DFID have a proven track record. It is time the government get roll out plans and actively engages in the process. We can actually set up some demonstration sites to begin with.
I was extremely happy to interact with you during the release function of GNR on the 4 Feb in New Delhi. Raj Bhandari MD , Mumbai

Lawrence Haddad said...

Raj, I agree that wasting is not being talked about enough in India, including by me. It is a real puzzle (is it infection?). I don't know about the plans you wish to scale up but I suggest ask DFID to contact the Odisha WCD. Best