If, When and Whom to Marry: Young Women Choosing Their Best Future of Health

28796175381_0b954aa4ae_zIt is perhaps easy to envision what should constitute quality health care for all people. What about choice in what quality health care means per person, according to what one wants for their lives?

When a person reaches the age of adolescence, they become more aware of how their surroundings and choices affect their future. When that adolescent is entrenched in a patriarchal society, the set expectations for their future more so affects their current life and health. Examples include teen pregnancy as a result of early and child marriage, lack of access to age-appropriate sexual and reproductive health education, and young women dropping out of school.

The Hunger Project is working in Africa and South Asia to shift these patriarchal mindsets and empower youth – both young women and men – to make decisions about their health and future through the Her Choice Program.

Through a community-based mentoring approach, including peer mentors, the program mobilizes relevant community actors to build local ownership over ending child-marriage. Activities aim to foster empowerment among girls and young women to take control of decision-making, and sensitize the community to value such.

Girls and communities become increasingly aware of the negative [health] consequences of early, child and forced marriage, which allows girls and young women to better participate in society and apply newly gained knowledge from sexual and reproductive health rights (SRHR) into their life choices. “If, when and whom” to marry is the primary choice in focus.

Early, child and forced marriage pervades the cycle of poverty, especially for young women: dropping out of school, teen pregnancy, limited or no household decision making capacity, poor health of young mothers and newborns, lack of decisions around one’s sexual and reproductive preferences, and stagnated economic empowerment and income generation among women. The program aims to improve access to formal education for girls by supporting girl-friendly schools and access to youth-friendly SRHR services.

035Relevant community actors are key in helping shift the patriarchal social norms to ensure an enabling environment wherein girls can make their own life choices. Women’s “self-help” groups carry out trainings and education about financial services to improve economic security of girls and their families. This helps to decrease incentive for marrying off daughters and increase women’s independent economic empowerment. Relevant community actors also include traditional leaders and supportive groups of men of all ages to help transform social and traditional norms toward inclusion of women and girls in decision-making. Traditional leaders are especially crucial in helping enforce national policies around child marriage, in not approving or overseeing child marriages in their respective communities.

By imbedding youth-friendly SRHR leadership and program activities into communities, Her Choice is influencing sustainable results. They can continue building on local assets and train additional young leaders to continue fostering women’s choice in marriage.

Do you want to marry? If so, when would you want to marry? And to what kind of person would you like to be married? Do you want to finish school before you consider marriage? Do you want to finish school and pursue work more than you want to be married? The choices – at least in some way – affect health and economic security.

There are many ways we can degrade, stabilize or improve our own health. Everyday habits like washing your hands, drinking clean water, eating healthily, to more long-term choices like getting vaccinated. Young women have a right to choose their future of health, and that right includes choosing “if, when and whom” they should marry.

 

 

Gender & Governance in rural India, Ghana, and Ethiopia

In 2010, the International Food Policy Research Institute (IFPRI) and the World Bank (WB) conducted an analysis of agricultural extension and clean water access in rural areas in India, Ghana, and Ethiopia. The surveys were conducted in approximately 1,000 households in each country.

Access to agricultural extension varied across the three countries. There was reported moderate access in India and Ethiopia, and low access in Ghana. Agricultural extension services were reported as inconsistent in many areas and the quality of the service provided varied. Each country in the report had different apparent causes for the inadequate availability or poor quality of agricultural extension services. A common feature in every country was the gendered divide in access to agricultural extension services. Oftentimes, extension service workers did not talk to the women of the household and in some cases, there was a perception that women were not farmers and thus could not benefit from the extension services. Seemingly by default, the extension workers would speak only to the men of the household even if women were a part of the agricultural community in that region.

The IFPRI and WB report also investigated access to clean water in this study. India was reported to have high water access, Ghana had moderate access, and Ethiopia had low access to clean water. The decentralization of water access and maintenance in India most likely contributes to its high amount of clean water access. However, Ghana and Ethiopia do not report high disatisfaction rates even if water access is low. In addition to access, the survey also asked about maintenance and accountability to water systems. Regardless of rates of water access and happiness with water access, the share of households that reported dissatisfaction with their service (or lack thereof) to government officials or political representatives was low.

General recommendations for improving agricultural extension services and access to clean water address the gendered issues seen in every country. Some of suggestions are:

  • Looking at why rural services and solutions fail women: link gender-related efforts to general reform efforts and fix the perceptions that women are not farmers, or do not make agricultural decisions
  • There is a need to obtain gender-disaggregated data on access to services
  • Investigate the possibility of different kinds of community groups for services that are necessary for the entire population of the village or region: for instance, farmer-based organizations are good for targeting farmers but lack access to the entire population for promoting and ensuring clean water access=

IFPRI and the WB also recommended country-specific policy suggestions. There is an acknowledgement that agricultural extension services and clean water access are managed and maintained best by local actors. There have been efforts to decentralize these systems in all three countries, but there are recommendations to make the decentralization more effective.


India
To make decentralization as effective as possible, IFPRI recommends:

  • Creating structures to prevent elite capture of resources
  • Increasing gram panchayat administrative support
  • Making it easier for women to attend gram panchayat meetings

India has not hired new agricultural extension workers for more than a decade (in 2010) and capacity suffers because of this. Further recommendations include:

  • Hiring new extension workers as soon as possible will improve the quantity of farms an extension worker can visit and, hopefully with gender-sensitive training, can help bridge the gap between agricultural extension access between men and women
  • Re-establish the function of agricultural extension workers as a link between farmers and researchers.
  • Expanding extension workers roles even more- there is an opportunity for extension workers to organize inclusive farmer-based organizations and interest groups.

Suggestions for India’s clean water access focus mainly on making the water and sanitation systems more gender inclusive:

  • Getting more women involved in WASH committees
  • Including gender issues in WASH professionals’ training
  • Hiring more women
  • Focusing more on drainage

Ghana
Decentralization in Ghana has opportunities to be stronger. Some recommendations are gender focused:

  • Increasing the number of female district assembly members
  • Strengthening gender district focal points to ensure gender is a priority at the district level
  • Empowering district assembly members more
  • Strengthening the subdistrict structure, so as to aid district assembly members more effectively

Agricultural extension rates in Ghana are low. Improvements can be made by:

  • Better management practices
  • Focusing more on goals and outcomes of the agricultural extension workers
  • Increasing access to female farmers
  • Reconsidering the roles of farmer-based organizations to deliver agricultural extension services more effectively

Access to clean water is hindered by the misunderstanding around Ghana’s Water and Sanitation Committees (WATSANs). WATSANs have limited coverage, so expanding their capacity and strengthening their role in the accountability system is key for more effective implementation.

Ethiopia
Local government has a lot of potential in Ethiopia. The recommendations encapsulate the need for strengthening the capacity and skills of local government and supporting regional government as well. Additionally:

  • There are suggestions to better monitor local service delivery
  • Pay attention to the gender dimensions of service delivery and local leadership
  • Investigate the ruling party process and systems.

Currently agricultural extension services are narrowly focused and delivered from a very top-down approach. Promising strategies to make agricultural extension more effective are:

  • Giving extension workers more discretion
  • Extending coverage to where it is currently limited, like pastoral areas
  • Identifying innovative ways to bridge the gender gap in access to agricultural extension services

Ethiopia struggles with perceptions of clientelism in the delivery of public services. Effective delivery of gender-sensitive and inclusive water systems from water committees, and not political actors, will help make clean water more accessible and better maintained.

The book can be found in PDF form here.

Image courtesy of india.com

Linking WASH, Nutrition and Agriculture: Indicators to Measure Progress Across SDGs

IMG_1425Many development actors and United Nations Member States have suggested – where possible – that indicators for the SDGs measure progress towards more than one target, or be “multi-purpose.” On March 27th, the International Coalition on Advocating for Nutrition (ICAN) hosted a discussion at the UN titled Indicators with Impact: how to measure nutrition in the post-2015 development agenda. CONCERN Worldwide, Action Against Hunger, The Hunger Project, Farming First, WaterAid and WASH Advocates co-organized a follow-up discussion on Thursday, April 23rd about inherent linkages between nutrition and water, sanitation and hygiene (WASH) and agriculture during a week of negotiations about Financing for Development and Means of Implementation. Attendees and panelists discussed how indicators for these three sectors can meaningfully measure progress to ensure a sustainable and comprehensive Post 2015 framework.

With only 15 years to meet this agenda, efforts will require broad scale-up of effective partnerships, the realization of national ownership and efficient methodologies.

In her opening remarks, moderator Åsa Skogström-Feldt, CEO of The Hunger Project, stated that the development community knows that “nutrition-sensitive agricultural interventions address both hunger and nutrition, and failure to address WASH issues can undermine both nutrition and food security…These issues are inextricably linked.” Åsa challenged attendees to ensure that solutions – and the way in which we measure progress towards them – acknowledge interlinkages and address the root causes underlying the manifestations of hunger and poverty in all of their forms.

Susan Carlson, Chair of the Women’s Committee of the World Farmer’s Organization set the context for discussion as a female farmer herself and representative of rural, farmers’ voices from the Global South. She urged that agricultural initiatives seek to shift subsistence farming toward sustainable livelihoods through an increase in funding and investments from a variety of actors to ensure adequate commitments.

Indicators in the UN Statistical Commission’s preliminary list for target 2.2 for nutrition do not reference lactating mothers and two indicators on target 2.4 address climate change mitigation but omit adaptation, resilience, and the vital topic of soil quality referenced in the target. Improving these indicators to more holistically measure progress will not only uphold the targets and their goals, but also offer a significant avenue of opportunity for partnerships between actors focused on value-add for nutrition and WASH.

Expounding on gaps in the current draft of the SDG indicator framework, Dr. Andrew Trevett, UNICEF’s Senior Adviser for WASH, stated that a crucial and clearer global indicator for water security – as it affects food production and the linkage to time poverty – is missing. Improved water supplies and access yields increased productivity of small farmers and opportunity for economic empowerment of women [in rural areas.] Current WASH priorities in the SDGs include elimination of open defecation, universal access to basic water and sanitation, raising service levels to deliver safely managed water and sanitation services and progressive elimination of inequalities. WASH access – as it reduces exposure to fecal pollution – is critical for improved nutrition outcomes, especially stunting in children and pregnant women’s retention of nutrients.

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These points brought the discussion full-circle to the driving topic of this event: nutrition. Hien Tran of Global Policy and Advocacy at the Bill and Melinda Gates Foundation returned after speaking on the previous event’s panel about specific nutrition indicators that can be broadly and feasibly applied across sectors at both the global and national levels.

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On this panel, Hien focused on the conceptual approaches to selecting the best indicators for the Post 2015 framework, noting that they must be sensitive to differing national capacities: “We can see how the integration of these sectors paves the way for partnership opportunities, thus improving [our] shared capacity to strengthen the implementation of the Post-2015 Agenda.” Looking at nutrition in its simplest form – with respect to agriculture – Hien highlighted a “feedback loop,” wherein nutrition-sensitive agriculture can provide an accessible supply of diverse, nutritious foods, and improved nutrition leads to better health which can help improve productivity on the farm. The glue in this “feedback loop” is the inclusion of WASH, reinforcing Dr. Trevett’s point that without safe water and adequate sanitation, any possible gain in improved nutrition will be undermined by water-borne diseases and unclean conditions.

So, what implications do the inherent linkages between WASH, nutrition and agriculture have in determining [the best] indicators for the post-2015 framework? Hien noted that considering policy implications across sectors is particularly important because it has been emphasized that developing indicators is a technical process, and rightfully so. However, the technical process must be informed by a very strong, complete, and nuanced understanding of linkages and policy implications across sectors.” The baseline criteria for indicators is that they be methodologically sound, outcome-focused and allow for global comparisons. But, the value of an indicator is not only in its effectiveness in measuring progress for a particular target, but also how policy implications from the interventions underlying a particular indicator apply to progress toward other targets.

Hien used the example of an indicator for the prevalence of stunting in children under 5, which will solidly measure progress towards ending all forms of malnutrition (target 2.2). This indicator captures a non-income dimension of poverty as stunting reflects cumulative effects of inadequate food intake and poor health conditions that result from exposure to unsanitary environment common in communities living in endemic poverty. The implications from initiatives to address stunting have implications for eradicating poverty in all its forms as well as measuring progress toward target 1.2 to reduce – at least by half – the proportion of all persons living in poverty in all its dimensions (according to national definitions).

Those living in poverty – the people at the heart of what the SDGs are intended to address – face multiple burdens, thus programmatic interventions cannot ignore these overlapping challenges. The selection of indicators must reflect and take this into account.

Multi-purpose Nutrition Indicators: Measuring Progress of Comprehensive Post 2015 Development Agenda

IMG_0895The Sustainable Development Goals (SDGs) are meant to be a comprehensive and universal framework for improving development and eradicating hunger and poverty – in all of its forms. Its current draft is favorably ambitious. However, there is wide concern among implementing multi-laterals, NGOs and member states about the capacity to achieve the goals given the large number of targets and a possibly exponentially larger set of indicators.

During the United Nation’s Inter-Governmental Negotiations last week (March 23rd – 27th) member states expressed general favor for indicators and targets that are cross-cutting and multi-purpose to ensure that implementation, monitoring and measuring be feasible without compromising the goals; indicators must heed synergistic approaches for multi-sectoral prioritization. The United Nation’s Standing Committee on Nutrition’s policy brief, Priority Nutrition Indicators, notes that 194 Member States unanimously endorsed the below eight nutrition indicators at the 65th World Health Assembly, broadly consenting that they can efficiently and comprehensively measure progress in the most critical areas of nutrition and other development outcomes.

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On Friday, the 27th, members of the International Coalition on Advocating Nutrition (ICAN) – World Vision, The Hunger Project, Save the Children, CONCERN and Action Against Hunger – hosted a timely, multi-stakeholder discussion at the United Nations to discuss specific nutrition indicators that are inherently multi-purpose and thus critical for inclusion in the SDGs. Moderated by World Vision Ireland’s CEO, Helen Keogh, panelists discussed achievements in various development areas via nutrition initiatives, opportunities to leverage the comprehensive nature of the SDGs, why nutrition indicators are so crucial and how nutrition can be fully addressed in the Post 2015 Global Development Agenda Framework.

Anthony Caswell Pérez, Director of International Affairs, Advocacy and Child Rights Governances of Save the Children Mexico, noted that these eight indicators were devised from lessons in development over the last 15 years and have strong, supporting scientific evidence. Pérez pressed the importance of breastfeeding as a multi-purpose indicator: high impact, but low investment for food security and nutrition, and also benefits the SDG health target on ending preventable deaths of newborns and children under five years of age by 2030.

Hien Tran, Global Policy and Advocacy of the Bill and Melinda Gates Foundation, challenged that the current targets of Goal 2 lack strength and ambition to truly improve nutritional impact for all people, not just those considered to be “low hanging fruit.” The nutrition indicators above will not only pave way for improved nutrition for marginalized people, but will also behoove other areas of development (i.e. education, health and decreases in maternal morbidity). This allows for broader application, increased capacity in measuring across sectors and feasibility in their application at both the national and grassroots levels.

Nutrition is a driver of development, but also an outcome of development improvements. Ambassador Caleb Otto of the Mission of the Republic of Palau to the UN noted that achievements to improving nutrition can be hindered by a multitude of issues: addiction, poverty, breastmilk substitutes and poor policies supporting gender equality. He called for stronger political will to address the critical issues of poverty and women to enhance nutrition. While this will rely heavily on much needed data about ideal methodologies of implementation, it is nevertheless an example of needed policies for an enabling environment.

Attendees furthered the technical discussion by highlighting the linkages between agriculture and nutrition, stating that without good agricultural practices, access to land, women’s labor rights and access to markets, nutrition will not be possible for all people. Additional attention was placed on linkages between WASH and nutrition and others discussed the impact of climate change on nutrition as it affects crop availability or composition.

Nutrition is not only a cross-sectoral issue, but also universal. Almost every country in the world faces longterm health risks attributed to some form of malnutrition. This is true across classes, ages and gender. Addressing malnutrition will not only save lives, but will also reduce inequalities and build resilience (ICAN, February 2015). If the development community intends to achieve sustainable development in a mere fifteen year period, efficiency and effectiveness through nutrition initiatives as they are specified in the SDGs’ indicators will be critical.

Senate Committee approved Water for the World Act

koira, sathkhira, Bangladesh
Image courtesy of wateraid.org

Senator Paul Simon Water for the World Act (H.R 2901), a bipartisan bill authored by Congressmen Earl Blumenauer (D-OR) and Ted Poe (R-TX) was presented to the House Foreign Affairs Committee on Thursday, November 19. The committee approved the bill, clearing the path for a vote on the House floor soon after the Thanksgiving recess.

Currently, nearly 800 million people lack access to clean water.  An astounding 2.5 billion people worldwide live without access to proper sanitation. Every day, women and girls spend a combined 200 million hours collecting water, keeping them from school, work, and family. Every year, 3.4 million people lose their lives due to water related diseases. At any given time, half of the world’s hospital beds are occupied by people with illnesses that could be prevented by access to clean water and sanitation. Worldwide, children lose many school days because of water born diseases.

The Water for the World Act is a response to these direly needed improvements. The bill will ensure that :

  • Resources go to the countries and communities most in need of water, sanitation and hygiene programs (WASH)
  • The US government agencies working on WASH and all other groups work together to make sure that the resources invested achieve long-term impact
  • WASH programs are included in other critical measures that address child survival, global health, food security and nutrition, and gender equality
  • There is proper review of WASH projects by the US government to increase transparency in reporting and ensure that projects are effective and impactful

On a press release a day before the  bill was presented to the House Foreign Affairs committee, Congressman Blumenauer noted the strong bipartisan support the bill has by “good people on all sides of the political spectrum.” He pointed out that the swift passage of the Water for the World Act will insure “America’s security, global health, and the lives of women and children without burdening taxpayers or making enemies abroad.”

You can read the proposed bill here Water for the World Act -HR 2901-Nov 17.

World Health Day 2014: Combating vector-borne diseases

boy130WHO

World Health Day is celebrated on 7 April every year to mark the anniversary of the founding of World Heath Organization (WHO) in 1948. Each year a theme is selected that highlights a priority area of public health. The Day provides an opportunity for individuals in every community to get involved in activities that can lead to better health (WHO, 2014).

The theme/topic for 2014 anniversary is vector-borne diseases.

To download and read A global brief on vector-borne diseases by WHO, click here.

Summaries on Vectors and Vector-born diseases (Adopted from WHO)

  • Vectors are organisms that transmit pathogens and parasites from one infected person (or animal) to another.

  • Vector-borne diseases are illnesses caused by these pathogens and parasites in human populations.

  • The most commonly known vectors are :

    • mosquitoes, sand flies, bugs, ticks and snails.

  • The above vectors are responsible for transmitting a wide range of parasites and pathogens that attack humans or animals. Mosquitoes, for example, not only transmit malaria and dengue, but also lymphatic filariasis, chikungunya, Japanese encephalitis and yellow fever.

  • They are most commonly found in tropical areas and places where access to safe drinking-water and sanitation systems is problematic.

  • The most deadly vector-borne disease, malaria, caused an estimated 660 000 deaths in 2010. Most of these were African children.

World Malaria Report 2013 is accessible here.

  • The fastest growing vector-borne disease is dengue, with a 30-fold increase in disease incidence over the last 50 years.

  • 40% of the world’s population is at risk from dengue (2014)

          To learn more about Dengue, click here.

  • More than half of the world’s population is at risk of these diseases. Increased travel, trade and migration make even more people vulnerable.

Goal: better protection from vector-borne diseases

The campaign aims to raise awareness about the threat posed by vectors and vector-borne diseases and to stimulate families and communities to take action to protect themselves. A core element of the campaign will be to provide communities with information. As vector-borne diseases begin to spread beyond their traditional boundaries, action needs to be expanded beyond the countries where these diseases currently thrive.

More broadly, through the campaign, WHO member states are aiming for the following:

  • families living in areas where diseases are transmitted by vectors know how to protect themselves;

  • travelers know how to protect themselves from vectors and vector-borne diseases when travelling to countries where these pose a health threat;

  • in countries where vector-borne diseases are a public health problem, ministries of health put in place measures to improve the protection of their populations; and

  • in countries where vector-borne diseases are an emerging threat, health authorities work with environmental and relevant authorities locally and in neighboring countries to improve integrated surveillance of vectors and to take measures to prevent their proliferation.

References:

WHO, 2014. Retrieved on 1 April 2014 from http://www.who.int/campaigns/world-health-day/2014/en/.

CDC, 2014. Retrieved on 1 April 2014 from http://www.cdc.gov/ncezid/dvbd/about.html.

 

Malaria Maps Reveal that 184 million Africans still live in extremely high-risk areas (The Lancet)

malaria map by lancet
Source: The Lancet

A KEMRI-Wellcome Trust research team led by Dr. Abdisalan Noor and Professor Robert Snow have recently produced malaria maps by geocoding data from surveys in 44 African countries and territories endemic for malaria in order to identify which populations were at risk of the disease in 2000 and 2010. According to the findings by the research team, ten countries in Sub-Saharan Africa including Nigeria, Democratic Republic of Congo, Uganda, Ivory Coast, Mozambique, Burkina Faso, Ghana, Mali, Guinea, and Togo together account for 87.1 percent of areas that have the highest prevalence of malaria. Democratic Republic of Congo and Nigeria (2013) have some of the highest malaria prevalence and 40% malaria deaths in Africa. (Noor et al, 2014, RBM, 2013).

To download and read a publication by The Lancet Medical Journal on malaria infection in Africa, click here.

The Global Partnership for a Malaria Free World’s Roll Back Malaria (RBM), the Millennium Development Goals (MDGs), the World Health Assembly  and many other initiatives have helped reduce malaria related deaths and infections over the past several years. Despite substantial reductions in malaria transmission that have been achieved in endemic countries of Africa over the 2000 – 2010 period, more than 184 million people still live in extremely high-risk areas. Fifty seven percent of the population in 2010 continued to live in areas where transmission remains moderate to intense and global support to sustain and accelerate the reduction of transmission must remain a priority. (Noor et al, 2014, p. 8).

To download and read World Malaria Report 2013, click here.

Key Malaria Facts (according to RBM):

Cases (2012) : 207 million globally

Deaths (2012) : 627,000 (90% of all malaria cases occur in Sub-Saharan Africa and 77% occur in children under five)

Population at risk : 3.4 billion

Affected countries (2013) : 97 have ongoing malaria transmission, 80% of estimated malaria deaths occur in 18 most affected countries, and 40 % of malaria deaths occurs in Nigeria and Democratic Republic of Congo (DRC)

Progress  (2000 – 2012) : malaria mortality rate was reduced by 45% globally

Required Health Expenditure: USD 5.1 billion every year. In 2012, the global total of international and domestic funding for malaria was US$ 2.5 billion

Economic Cost : USD 12 billion per year in direct losses, a lost 1.3% of GDP growth per year in Africa

Costs of interventions:

  • Long-lasting insecticidal net that lasts three years: USD 1.39 per person per year of protection
  • Course of artemisinin-based combination therapy (ACT) for an adult: USD 0.90 – 1.40
  • Course of artemisinin-based combination therapy (ACT) for a young child: USD 0.30 – 0.40
  • Rapid diagnostic test: US$ 0.50

For a complete list of malaria facts by RBM, click here.

The Importance of Multi-sectoral and Integrated Nutrition Strategies

Global-Health-Targets_imagelarge
credit:ncdhild.org

Those who wish for a more peaceful, just and sustainable world are helping to make ending world hunger a major priority… Together we can end hunger.  Robert Alan Silverstein

According to the Food and Agriculture Organization (FAO), an estimated 870 million people in the world, or one in eight, were suffering from chronic undernourishment in 2010-2012. Almost all the hungry people, 852 million, live in developing countries, representing 15 percent of the population of developing countries, and there are 16 million people undernourished in developed countries (FAO, 2012). An outcome of malnutrition, stunting alone affects 165 million children under 5 years of age around the world. (UNICEF, 2013). Malnutrition is the largest single contributor to disease, according to the UN’s Standing Committee on Nutrition (SCN), and under-nutrition among others, affects school performance, leads to a lower income as an adult, depletes immunity to diseases and causes women to give birth to low birth-weight babies. (WFP, 2014). The multidimensional effects of malnutrition makes nutrition interventions imperative to incorporate a multi-sectoral and integrated development approach . The Millennium Development Goals (MDGs) , WHO, World Food Programme (WFP), FAO, and projects by several bilateral and multilateral organizations have helped reduce child and maternal mortality, extreme hunger, malnutrition and poverty over the past decade. Despite the achievements, there still a long way to go to end malnutrition problems. The causes, effects and relationships between malnutrition and other development challenges makes it important to  have a multi-sectoral approach as it enables planning and programming nutritional programs efficient and sustainable. ¨The determinants of malnutrition are multifaceted; stemming from individual health status to household food access, to social, economic, political, and environmental factors at national and global levels¨ (USAID, 2013).

USAID Nutrition Strategy 2014- 2015 Draft and The World Health Organization (WHO) Global Targets 2025

In response to the challenges of malnutrition , the United States Agency for International Development (USAID) has released the USAID Nutrition Strategy 2014- 2015 draft in late 2013,  and the agency’s  nutrition strategy draft calls for public comment before its final draft. The aim of the nutrition strategy( NS) 2014- 2025 is to improve nutrition to save lives, build resilience, increase economic productivity, and advance development. As to interventions and approaches, the NS 2014 -2025, advances two types of interventions : a timely nutrition-specific interventions at critical points in the lifecycle that can have  a dramatic impact on reducing malnutrition globally if taken to scale in high burden countries; and nutrition-sensitive interventions which have more potential to enhance the effectiveness of nutrition investments worldwide.(USAID, 2013). According to the ND 2014 – 2025 draft there are opportunities for nutrition impact with a number of nutrition-sensitive interventions including :

  • Family planning,

  • Water, Sanitation and Hygiene (WASH),

  • Nutrition-sensitive agriculture,

  • Food safety, food processing, and dietary diversity in partnership with industry,

  • Early childhood care, development and education and

  • Economic strengthening and livelihoods and recovery

To download and read USAID’s Nutrition Strategy 2014-2025 draft, click here.

Many of the current development interventions in the above listed areas of are being approached in separation from each other. The one-sector approach lacks synergy and fails to integrate nutrition intervention with other projects . Today, there are far more governmental, non-governmental, bilateral and multilateral, for profit and nonprofit organizations  working in the development arena, and many of them follow a one-sector approach while the challenges of the poor_especially malnutrition and poverty are interrelated and interdependent. For instance, provisions of nutritious foods in schools and de-worming at health centers will only capture a few percentage of population with access to the two services. But, an alternative intervention of the above would reach far more people if coupled/integrated with robust agricultural and rural development programs projects. An excerpt from NS 2014- 2025 draft notes the following about nutrition intervention strategies.

Although economic growth has been linked to improvements in under-nutrition (Shekar & Elder, 2013; Webb & Black, 2011), investments in agriculture have demonstrated even greater impact on both poverty alleviation and malnutrition since most of the poor are working in agriculture (Headey, 2011; Webb & Black, 2011).

The World Health Organization (WHO) Global Targets 2025

At the global level, the World Health Organization (WHO) member states have endorsed the Global Targets 2025 for improving maternal, infant and young child nutrition following the sixty-fifth World Health Assembly that took place in Geneva, Switzerland from 21-26 May 2012. The assembly approved a comprehensive implementation plan on maternal, infant and young child nutrition. WHO’s Global Targets 2025 include the following:

1. 40% reduction in the number of children under-5 who are stunted

2. 50% reduction of anaemia in women reproductive age

3. 30 % reduction in low birth weight

4. no increase in childhood overweight

5. increase the rate of exclusive breastfeeding in the first 6 months up to at least 50%

6. reduce and maintain childhood wasting to less than 5%

To read more WHO’s Global Targets 2025, click here

Both the USAID’s Nutrition Strategy and Global Targets 2025  call for comprehensive and all inclusive implementation plan on malnutrition. Though the former stresses the importance integration of nutritional programs and advancing a multi-sectoral approach to solving the global nutrition challenges, the resolutions and decisions annexes of the Global Targets 2025 falls short of calling upon member states to adopt an integrated and multi-sectoral nutrition intervention strategy. The following is an excerpt from USAID’s NS 2014- 2025 draft.

Effective interventions must reach across disciplines to address the multi-sectoral nature of malnutrition. In the past, many nutrition initiatives have been vertical programs implemented through isolated delivery systems: however, there has been a recent recognition that multi-factorial causation is best addresses with multi-sectoral interventions. (Lartey, 2008).

Multi-sectoral  and Integrated Approach to Nutrition Intervention

¨A successful strategy for alleviating poverty and hunger in developing countries must begin by recognizing that they are mainly rural phenomena and that agriculture is at the heart of the livelihoods of rural people.¨ (FAO, 2014).

To ensure sustainability of the nutrition programs and to bring about a lasting solutions to malnutrition and poverty in developing world,  development players at level should keep in mind the role of agriculture in the livelihood of the majority global poor and the advantages of multi-sectoral and integrated nutrition intervention approaches.  Nutrition interventions should be part of agricultural and rural development policies as 75% of the poor live in rural areas, and governments and decision makers at level should integrate nutritional interventions in their policies. (FAO, 2012).  “Economic and agricultural growth should be ¨nutrition-sensitive” and growth needs to result in better nutritional outcomes through enhanced opportunities for the poor to diversify their diets; improved access to safe drinking water, and sanitation; improved access to health services; better consumer awareness regarding adequate nutrition and child care practices…” (FAO, 2012)

To download and read FAO’s State of Food Insecurity in the World 2012, click here.

References:

FAO. (2012). The State of Food Insecurity in the World: The multiple dimensions of food security. Retrieved on 19 February 2014 from http://www.fao.org/docrep/018/i3434e/i3434e.pdf

USAID. (2013). Nutrition Strategy: 2014-2025 Draft. Retrieved on 19 February 2014 from http://agrilinks.org/sites/default/files/resource/files/Nutrition%20Strategy%20Draft%20for%20Public%20Comment-12.20.13.pdf

World Water Day 2014

Photo: gwp.org
Photo: gwp.org

The World Water Day (WWD) 2014 will be celebrated on 22 March 2014 around the world. The main celebration of World Water Day will be organized by United Nations University (UNU) and the United Nations Industrial Development Organization (UNIDO) on behalf of UN-Water. The celebration will  take place at the UNU Heaquarters in Tokyo, Japan from 20-21 March 2014.

The main theme of the 2014 WWD will be water and energy, and the key messages of this year’s WWD are the  following:

1. Water requires energy and energy requires water

2. Supplies are limited and demand is increasing

3. Saving energy is saving water. Saving water is saving energy

4. The “bottom billion” urgently needs access to both water and sanitation services, and electricity

5. Improving water and energy efficiency is imperative as co-ordinated, coherent and concerted policies

The UN-Water, UNIDO and UNU have released  a World Water Day 2014 Advocacy Guide. The main aim of the Advocacy Guide are the following:

– To help communicate the purpose of WWD 2014 and to introduce key information relevant to the theme of WWD2014: water and energy.

– To encourage advocacy and stakeholder action towards improving combined and co-ordinated water and energy management and governance.

– To promote information sharing about WWD 2014 activities, efforts and events, and also to encourage longer-term sharing of success stories and other valuable water and energy knowledge.

To download and read a PDF version of the World Water Day 2014 Advocacy Guide, click here.

source: unwater.org
photo:unwater.org

Community-Led Total Sanitation (CLTS) Approaches to Creating Open Defecation Free (ODF) Community

Photo Credit: sanitationupdates.wordpress.com
Photo Credit: sanitationupdates.wordpress.com

Trigger, a 2012 Annual Report publication on the Pan-African Community-Led Total Sanitation (CLTS) programmes, states that community empowerment and collective behavioral change including safe sanitation and hygiene with hand washing is an effective and sustainable way to creating open defecation free (ODF) community. According to the report, in community mobilization, self empowerment and collective behavioral change  instead of hardware and shifting the focus from toilet construction for individual households to the creation of ODF villages. (CLTS, 2012).

To read more about CLTS and its programmes around the world, click here.

CLTS, was introduced to Africa by Plan International in 2007 as an effective approach to achieving its child survival and millennium development goals (MDGs). So far, implementation of the ten CLTS programmes in African countries helped reduce infant and child morbidity and mortality, and the program has inspired other national, regional, continental  and multi-country sanitation initiatives. (CLTS, 20120). The followings are African countries in which the project was launched: Malawi, Zambia, Tanzania, Uganda, Kenya, Ethiopia, Sierra Leone, Ghana, Niger and Tanzania.

To read and download the CLTS programmes and its progress in Africa, click here.

Source: Institute of Development Studies (IDS)