Many 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.

 

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.

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.

The 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.

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.

Three projects were awarded as winners of the 2013 Harvesting Nutrition contest  organized by  SecureNutrition . The contest was organized to promote initiatives with a holistic approach linking nutrition, agriculture and food security. The award ceremony was held at The World Bank on February 19, 2015. According to SecureNutrition the contest attracted 50 submissions from projects around the world showcasing  a global effort to close the gap between agriculture, food security and nutrition. A panel of five judges from SecureNutrition, GAIN, and Save the Children took part in the decision process. The three winning projects were selected according to their potential for impact, innovation and scalability.

Below is the profile of the three winning projects and assessment of their unique approach provided by the decision panel ;

• Realigning Agriculture to Improve Nutrition (RAIN): Potential Impact on Nutrition 

  Aiming to increase year-round availability of and access to high-quality foods at the household level, preliminary data from RAIN shows encouraging results, with increased production of various micronutrient rich crops, such as leafy green vegetables, and increased dietary diversity during both the hunger as the post-harvest seasons.  With rigorous data collection and analysis, conducted by the International Food Policy Research Institute (IFPRI), integrated into the program design and strong government coordination, the potential impact – and potential for demonstrating an impact – of RAIN on nutrition outcomes is likely to increase as the project unfolds. (Realigning Agriculture to Improve Nutrition (RAIN)

• Shamba Shape Up : Innovation 
  

  A “make-over”-style reality TV show targeting rural smallholder farmers, Shamba Shape Up was a clear standout as an innovative platform for presenting and disseminating a nutrition message. Shamba Shape Up reaches over 10 million farmers in East Africa with tools and information to improve productivity and income on their farms  (Shamba Shape Up)

•  N2Africa: Scalability 
  

  A large-scale multi-country “development to research” project aimed at promoting new technologies for improving productivity of legumes such as groundnut, cowpea and common bean – commonly regarded as women’s crops – N2Africa works with a wide variety of stakeholders across the value chain from seed to fork and from field to market.  A strong evaluation system provides the basis for ongoing feedback and learning. (N2Africa)