23 April 2015

Needed: Nutrition Behaviour Change Communication for the Powerful

This week I was invited to give a keynote on the global nutrition situation in the context of a book launch on Development and Nutrition: The Role of Social Norms by the excellent Elaina La Ferrera and Annamaria Milazzo of Bocconi University with the support of the Fondazione Romeo and Enrica Invernizzi, one of the supporters of the Milan Expo 2015 which starts next month.

The book reviews norms around inheritance, intrahousehold resource allocation and beliefs around diet and nutrition. The authors report on some interesting issues such as what happens to diets when people move to different states or countries (sometimes good for nutrition, sometimes not) , the differences in nutrition status across religions controlling for all other factors (e.g. Hindus with stronger son preference compared to Muslims in India), the strengthening of inheritance rights for women (good for infant nutrition), the delineation of certain crops as being grown by women or men and the brake that puts on household food security. 

This is a fascinating review, but it tends to focus on norms that affect the household.  But these norms also affect powerful decision-makers in the public and private sectors. And these individuals are perhaps better positioned to change the norms. 
Consider the following social norms I commonly encounter in policy circles:

*Income growth will take care of nutrition status. It will take care about half of undernutrition—in the long term.  Kids don’t have the luxury of waiting.  Keynes said in the long run we are all dead, but for young children, they are more likely to die in the short run without adequate nutrition.

*Food security is the same as nutrition. Food security is one of the 3 legs of the nutrition table.  Care and health environments are the other 2.  Food security is necessary but not sufficient for good nutrition. 

*Children 0-2 grow differently in different countries.  The WHO growth standards study shows definitely that they do not.  After the age of 2 maybe, but until then, no.

*Women’s time is less valuable than men’s.  While women tend to have less access to resources, control and authority, asking them to do more things may be even more disempowering.  They need to have more control over the priceless commodity of time.  

All of these norms need to be challenged and updated.  As any good community behavior change communication initiatives will know, information and evidence are vital, but not nearly enough.
Engagement, mobilization, ownership and collective action are all vital for changing norms at the community and household levels. They are vital in policy circles too.   

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