Nutrition As A Transformative Investment Agenda
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Transcript of Nutrition As A Transformative Investment Agenda
Nutrition As A Transformative Investment Agenda
Ziauddin HyderWorld BankOctober 24, [email protected]
Country Resource Allocation Likely to be Associated With Stunting Reduction
Poverty reduction is not automatically translated in nutrition improvement. Public financing reviews lead us to believe that inadequate stunting decline in Africa is linked to poor public resource allocation in nutrition
Rate of under-five stunting
The “Window of Opportunity” for High Impact Investment is narrow…
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0 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45 48 51 54 57 60
Age (months)
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ght f
or a
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-sco
re (N
CH
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Latin America and CaribbeanAfricaAsia
…pre-pregnancy until 24 months of age (1000 days)
Actions after age twoToo expensiveToo littleToo late
But, nutrition narratives are often too technical to be conceived by national politicians and top decision makers for resource allocation
We need to build on this evidence to drive investment priorities in human capital
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-Take advantage of malleability
- Build foundations for further learning
-Prevent early damage and avoid irreversible
loss
EARLY CHILDHOOD PROGRAMS APPEAR PROFITABLE, EVEN IF PAYOFF IS ONLY 20+ YEARS FROM TODAY
• Malnutrition leads to high rates of maternal and child mortality (MDGs 4 & 5) and dramatically increases expenditure on health
• Malnutrition in early years is linked to 7 month delay in starting school and diminishes return on education via reducing quality
• Iodine deficient children lose 13 IQ points; anemic adults have lower work and earning capacity• > 10% reduction in lifetime earnings for each malnourished individual• Collectively, GDP losses is around 8% via poorer cognition and reduced schooling
Why Invest in Nutrition: Getting the right start
But, many arguments are based on global estimates, inadequate efforts to generate local evidence, driven by international bodies:
leading to poor ownership by national policy makers
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Investment opportunities increases by moving to a wider “development lens”
Financing envelope
Health sector
Narrow nutrition lens
Multisectoral nutrition lens
Education sector
Agriculture sector
Private sector
Financial and credit sector
Trade and tax policies sector
Transportation sector
Multiple other sectors
But, efforts are limited to involve multiple sectors to achieve nutrition outcomes
The cost of inaction is high, ANDaction at scale is achievable
Costs of action at scale is:
$ About 10 billion/year globally; of which only $3-$4 billion from external partners
Costs of inaction:• 3.1 million child deaths annually
(45% of all child deaths)• 11% annual loss in GDP (= $140 b in 2011)
• 10-46% loss in individual life-time incomes
• Increase in NCDs & higher health-care costs
HD & SD working together to scale-up evidence-based interventions
Evidence base
“Nutrition-specific” Interventions
“Nutrition-sensitive” Interventions
• Community based programs for behavior change for infant feeding, hygiene, sanitation
• Vitamin A & Zinc suppl.• Micronutrient powders• Deworming • Iron-folic acid supplements
for women• Iron fortification • Salt iodization• Complementary foods • Treatment of Severe
Malnutrition
Scaling these up will save 1 m lives annually, reduce stunting by 20% over existing trend
• Technologies to reduce women’s work• Aflatoxin control• Biofortification of crops• Nutrition education via Agric. Extn.
workers• Technologies to reduce post-harvest
losses• Reducing costs of high nutrient foods• Zinc fertilisers• Hygiene education via WATSAN projects• eat, dairy, fish.
Agriculture
Education• School-based deworming,
Iron suppl for girls, Nutrition/health education in schools
SP• SSNs to target
women/children• CCTs to increase demand for
nutrition services
Scale-up likely to improve nutrition impacts; but documented evidence to-date is limited
Health
Actions Show Results………..
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2009 2010 2011
Stun
ting
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valenc
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Stunting prevalence in children 0-35 months
Tranche 2
DHS Expected Trend (1.4ppts/yr)
Tranche 3
DHS Expected Trend (1.4ppts/yr)
Ethiopia Child Stunting Trends
1990 1995 2000 2005 20100
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Africa Asia
Senegal
Senegal Child Stunting Trends
…on track for achieving MDG 1c (nutrition)
Governments Adopting Nutrition As A Transformative Investment Agenda
•Benin, Malawi, Madagascar, Senegal, The Gambia, Uganda
Multisectoral
• Angola, Burundi, Burkina Faso, Ethiopia, Ghana, Kenya, Mozambique, Tanzania, Uganda, Zambia, Nigeria, Togo
Health
• Burundi, Cameroon, DRC, Ethiopia, Tanzania, Mozambique, Niger, Nigeria, Zambia
Agriculture/SP/Education
Enjoy Your Stay in Addis Ababa