Taking action on malnutrition

A lack of sufficient nutrients in the diet is responsible for around 2.6 million deathsof children per year, the largest killer of children in the world. Those children that do survive will be stunted in their physical growth and mental development, which can not only cause health problems but will detrimentally impact their education and earning potential for the rest of their lives. This is a risk faced by some 165 million children across the world.

This year, high-level decision makers will come together on 8^th June for a Hunger summit, hosted by David Cameron, ahead of this year’s G8, and nutrition will likely be on the agenda. But what action can leaders, donors and people on the ground take to tackle undernutrition?

The Montpellier Panel, in their 2011 briefing paper on Scaling Up Nutrition, outlined the urgent need for children to receive adequate nutrition in the first 1000 days of their lives (from conception to 2 years old). It also detailed the measures the United Nations Scaling Up Nutrition (SUN) movement was taking globally to combat child undernutrition. The SUN movement works with partner countries (35 to date) to integrate nutrition into development plans across sectors such as health, education and agriculture.

In particular the SUN movement supports the following interventions and policies:

Specific Nutrition Interventions

• Support for exclusive breastfeeding up to 6 months of age and continued breastfeeding, together with appropriate and nutritious food, up to 2 years of age;
• Fortification of foods;
• Micronutrient supplementation; and
• Treatment of severe malnutrition.

Nutrition-Sensitive Approaches

• Agriculture: Making nutritious food more accessible to everyone, and supporting small farms as a source of income for women and families;
• Clean Water and Sanitation: Improving access to reduce infection and disease;
• Education and Employment: Making sure children have the energy that they need to learn and earn sufficient income as adults;
• Health Care: Improving access to services to ensure that women and children stay healthy;
• Support for Resilience: Establishing a stronger, healthier population and sustained prosperity to better endure emergencies and conflicts; and
• Women’s Empowerment: At the core of all efforts, women are empowered to be leaders in their families and communities, leading the way to a healthier and stronger world.

Recent interest has focused on the contribution of agriculture to ending hunger and malnutrition. Agriculture plays a crucial role in access to nutritious and diverse crops, affordable sources of foods and as an income source but the links between agriculture and nutrition are not always clear. Several recent reports have summarised how agricultural development can have positive outcomes for household nutrition.

In a World Bank report, released in April 2013, authors synthesise a series of guiding principles linking agriculture and nutrition from existing published guidance. These principles were grouped into four categories, namely:

• Planning for nutrition, such as incorporating explicit nutrition objectives into agricultural projects, programmes and policies; understanding the context to appreciate causes and constraints; measuring impact and working across sectors.
• Taking action, such as empowering women, managing natural resources and educating people about nutrition.
• Combining with other approaches, such as diversifying agricultural production, producing nutrient-rich crops, reducing post-harvest losses and increasing market access.
• Creating a supportive environment, such as advocating for nutrition, building local capacity and improving policy coherence and governance.

Similarly, a report and briefing paper launched recently, entitled Small scale, big impact: smallholder agriculture’s contribution to better nutrition, investigated the impact of smallholder agricultural development projects on nutrition and food security. Commissioned by the UK Hunger Alliance and produced by the Overseas Development Institute, the case studies reviewed showed that sustainable agricultural projects, such as promoting small-scale farming like home gardens and fish ponds, empowering women and complementing agricultural programmes with education, health services, and clean water and sanitation, can be beneficial for nutrition. As an example, “Child stunting was cut by 16% in three years under the rights-and-livelihoods based SHOUHARDO intervention in Bangladesh involving 400,000 households. This included the integration of home gardens, women’s empowerment, mother and child health, vitamin A supplements, awareness-raising on improved nutrition habits, immunisations, savings groups, and cash-for-work as a safety net.”

The report concludes with three ways that smallholder agriculture can have greater impact on nutrition:

• Empowering women farmers;
• Promoting home gardens and small-scale livestock and fish raising;
• Complementing agricultural programmes with education and awareness-raising on improving nutrition habits, health services, clean water and sanitation.

And three areas of recommendation for UK and G8 leaders:

• Scale up public support for small-scale environmentally sustainable agricultural systems
• Increase support for women small-scale producers
• Promote improved, more accountable and joined-up country-led nutrition and food security strategies and approaches

The June 8th Hunger Summit is an opportunity for the UK to show its commitment to nutrition and to encourage other leaders and donors to make tackling child malnutrition a global priority. Such a focus will also be important to ensure progress on nutrition is carried into the development agenda once the Millennium Development Goals expire in 2015.