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1. ยฉ 2002 UN Standing Committee on Nutrition
Why Practitioners
in Development
Should Integrate
Nutrition
United Nations System
Standing Committee
on Nutrition
Copyright ยฉ 2002 UN System Standing Committee on Nutrition. All rights reserved.
2. NUTRITION:
Making the Case
Barbara Macdonald,
Lawrence Haddad, Rainer Gross,
and Milla McLachlan
Brief 1 of 12
NUTRITION
A FOUNDATION FOR DEVELOPMENT
A FOUNDATION FOR DEVELOPMENT
ยฉ
PANOS
Pictures
/
Sean
Sprague
3. Making the Case
๏ฎ Nutrition is an excellent investment.
๏ฎ Progress in reducing malnutrition in most
developing countries remains too slow.
๏ฎ Good nutrition is a building block to help
countries meet many development goals:
health, education, gender equality, and poverty
alleviation.
NUTRITION: MAKING THE CASE Brief 1 of 12
4. Preschool low height-for-age 182 million or 33% of children
<5 years
Preschool low weight-for-age 150 million children
Preschool low weight-for-height 50.6 million children
Preschool vitamin-A deficiency 75-251 million children (global)
Anemia 43% of all children and adults;
53% of school-age children
Iodine deficiency >2 billion (38% of all children and
adults)
Insufficient energy (calories) 777 million children and adults
(FAO 2002 food availability estimate)
Undernutrition: The Numbers
NUTRITION: MAKING THE CASE Brief 1 of 12
INDICATORS LEVELS (developing countries)
5. Millennium Development Goals
Eradicate extreme
poverty and hunger
Malnutrition is an outcome of poverty; good
nutrition is an input to poverty alleviation.
Achieve universal
primary education
Good nutrition is essential if learning is to
occur.
Promote gender equality
and empower women
Investment in girlโs nutrition helps advance the
status of women and increase incentives for
smaller family size.
Reduce child mortality 60% percent of under-five mortality is
associated with malnutrition (including the
effects of mild to moderate undernutrition).
NUTRITION: MAKING THE CASE Brief 1 of 12
6. Millennium Development Goals
Improved maternal
health
โข Vitamin A supplements reduce maternal
mortality by up to 44%.
โข Over 20% of maternal deaths are due to
iron deficiency anemia.
Combat HIV/AIDS,
malaria, and other
diseases
Good nutrition bolsters immune systems,
preventing HIV-related infection and slowing
progression from HIV to AIDS.
Ensure environmental
sustainability
When basic survival needs are not met,
environmental conservation is low priority.
Develop global
partnership for
development
Experience from over 50 years of participatory
nutrition programming can suggest ways
forward.
NUTRITION: MAKING THE CASE Brief 1 of 12
7. Nutrition
and Education
Matthew Jukes, Judith McGuire, Frank
Method, and Robert Sternberg
EDUCATION Brief 2 of 12
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A FOUNDATION FOR DEVELOPMENT
ยฉ
World
Bank
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Curt
Carnemark
8. UNDERNUTRITION AND EDUCATION
Preventable impacts
Low height for age Reduction in mental capacity;
adverse school performance
Iodine deficiency Population IQ reduces about 13.5
points; poor cognitive
performance
Low birth weight Poor cognitive performance
during infancy; poor attention
span in school
Iron deficiency anemia Reduced cognitive ability;
reduction in school performance
Nutritionโs Impact on Education
NUTRITION AND EDUCATION Brief 2 of 12
9. What Can Be Done?
๏ฎ Intervene early: Formation of โhuman capitalโ
begins in utero.
๏ฎ Most growth failure occurs between 6 and 24
months.
๏ฎ Early damage can only partially be reversed.
๏ฎ Successful health, family planning, and nutrition
programs exist, including growth promotion,
supplementation, and fortification.
NUTRITION AND EDUCATION Brief 2 of 12
10. Nutrition
and Population
Rolando Figueroa and
Rosalia Rodriguez-Garcia
POPULATION Brief 3 of 12
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A FOUNDATION FOR DEVELOPMENT
ยฉ
World
Bank
/
Curt
Carnemark
11. Nutrition and Population
๏ฎ World population grew from 2.5 billion in 1950
to 6 billion in 2000. Average life expectancy at
birth increased worldwide.
๏ฎ World population will likely peak at about 8
billion in 2030 and then decline for the rest of
the century.
๏ฎ Nutrition and population changes are intimately
linked: Nutrition influences fertility and
mortality rates.
NUTRITION AND POPULATION Brief 3 of 12
12. Nutritionโs Impact on Population
Qualitative aspects
๏ฎ Good nutrition reduces mortality
and morbidity
๏ฎ Higher maternal survival rate at
childbirth
๏ฎ Healthier babies born
๏ฎ Breastfeeding can reduce fertility
๏ฎ Improved child survival reduces
population growth
๏ฎ Better health and survival than
malnourished children
๏ฎ Exclusive breastfeeding important
for baby
๏ฎ Increased life span
Quantitative aspects
๏ฎ Improved child survival
reduces population
growth
๏ฎ Increased birth intervals
๏ฎ Reduced demand for
large families leads to
fewer births
NUTRITION AND POPULATION Brief 3 of 12
14. Nutritionโs Impact on Health
๏ฎ Mortality
๏ฎ 60% of under-five child deaths in developing
countries are associated with malnutrition, including
effects of mild to moderate undernutrition.
๏ฎ Morbidity
๏ฎ Malnutrition (under and over) increases incidence,
severity, and duration of diseases.
๏ฎ Obesity hastens the development of chronic disease
and can add to the burden of undernutrition.
NUTRITION AND HEALTH Brief 4 of 12
15. Micronutrientsโ Impact on Health
๏ฎ Improving vitamin-A status
๏ฎ Reduces mortality rates 23% on average.
๏ฎ Prevents 1.3โ2.5 million deaths per year
๏ฎ Saves hundreds of thousands of children from
irreversible blindness
๏ฎ Improving iron status
๏ฎ Increases levels of national productivity by 20%
๏ฎ Reduces maternal mortality; iron-deficiency anemia
contributes to 20% of all maternal deaths
๏ฎ Improving iodine status prevents mental
retardation and brain damage
NUTRITION AND HEALTH Brief 4 of 12
16. What Can Be Done?
๏ฎ Successful interventions
๏ฎ Universal salt iodization
๏ฎ High-dose vitamin-A supplementation with national
immunization days
๏ฎ Vitamin-A campaigns during child health weeks
NUTRITION AND HEALTH Brief 4 of 12
17. Nutrition and
The Environment
Timothy Johns and
Pablo B. Eyzaguirre
Brief 5 of 12
ENVIRONMENT
A FOUNDATION FOR DEVELOPMENT
A FOUNDATION FOR DEVELOPMENT
ยฉ
World
Bank
/
Tomas
Sennett
18. Nutritionโs Impact on the Environment
๏ฎ Malnourished populations cannot or will not
make environmental protection a priority.
๏ฎ Adequate nutrition increases conservation by
reducing pressure to use resources
unsustainably.
NUTRITION AND THE ENVIRONMENT Brief 5 of 12
19. What Can Be Done?
๏ฎ Research on genetic improvements in crops,
crop diversification, and soil management
๏ฎ More research needed to identify indigenous
crops that are nutritious and genetically diverse
๏ฎ Wild and indigenous foods should be screened to
identify those that are high in nutrients and
micronutrients, soluble fibers, or antioxidants.
๏ฎ Investigate traditional lifestyles and their
human/environment relationship to find
sustainable solutions for the malnourished.
NUTRITION AND THE ENVIRONMENT Brief 5 of 12
20. Arne Oshaug and Lawrence Haddad
AGRICULTURE Brief 6 of 12
Nutrition
and Agriculture
A FOUNDATION FOR DEVELOPMENT
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World
Bank
/
Kay
Muldoon
21. Nutritionโs Impact on Agriculture
๏ฎ Most of the worldโs poor live in rural areas and
depend on agriculture.
๏ฎ Good nutritional status supports agriculture
through enhanced work capacity and
productivity.
๏ฎ Productive agriculture depends on adequate
nutrition status and vice versa.
NUTRITION AND AGRICULTURE Brief 6 of 12
22. What Can Be Done?
๏ฎ Efficient, low-cost production of staple crops
feeds the poor and releases income for other
food expenditures.
๏ฎ As farmersโ incomes rise, so does demand for
fruit, vegetables, and animal products rich in
micronutrients.
๏ฎ Technological change in agriculture can
enhance the nutritional content of foods.
NUTRITION AND AGRICULTURE Brief 6 of 12
23. Nutrition
and Gender
Ruth Oniangโo and Edith Mukudi
GENDER Brief 7 of 12
A FOUNDATION FOR DEVELOPMENT
A FOUNDATION FOR DEVELOPMENT
ยฉ
World
Bank
24. Nutritionโs Impact on Gender Issues
๏ฎ Women/girls often consume less food: Equal
access and distribution benefits the entire
family.
๏ฎ Womenโs reproductive, productive, and social
roles are nutritionally taxing.
๏ฎ Malnutrition disproportionately increases
morbidity and mortality in women and children.
๏ฎ Malnourished women cannot adequately care
for families.
๏ฎ High investment in womenโs nutrition raises
overall human development potential.
NUTRITION AND GENDER Brief 7 of 12
25. Womenโs Control Over Assets
๏ฎ Raises agricultural output
๏ฎ Educates more children
๏ฎ Improves number of infant visits to health
facilities
๏ฎ Accelerates child growth and development
๏ฎ Raises household food security
NUTRITION AND GENDER Brief 7 of 12
26. What Can Be Done?
Immediate
(interventions)
Reform health services
(equalize immunization rates)
Subsidize programs
(subsidize daycare so women
can work; provide iodized salt
for expectant mothers; iron
supplementation)
Underlying
(programs)
Reform service delivery
(equal access to water, sani-
tation, extension services)
Cash transfers to
women
(promote access for girls to
health care systems)
Basic
(legislation)
Equal rights
(monitor gender differences in
nutritional status and reform
legislation along these lines)
Target new resources
to women
(add nutrition component to
womenโs credit programs)
NUTRITION AND GENDER Brief 7 of 12
Promoting catch-up
Creating level playing field
28. Nutritionโs Impact on Poverty
๏ฎ 20% of the worldโs deaths and disabilities are
due to undernutrition.
๏ฎ Loss of GDP from undernutrition can be as high
as 3% (year in, year out).
๏ฎ Better nutrition empowers people and
communities through:
๏ฎ improved intellectual capacity
๏ฎ income generation and access to assets
๏ฎ poverty reduction; and
๏ฎ rapid development
NUTRITION AND POVERTY Brief 8 of 12
29. Undernutrition and GDP
NUTRITION AND POVERTY Brief 8 of 12
0.1 0.3
3.3
1
0.6
1.1
0
1
2
3
4
Pakistan Vietnam
Undernutrition as measured by growth failure
Iodine deficiency
Iron deficiency
Percentage loss in GDP (1990s)
31. Nutritionโs Impact on Crises
Undernutrition
๏ฎ Aggravates social unrest and violent conflicts
๏ฎ Increases vulnerability that transforms shocks
into humanitarian disasters
๏ฎ Raises death rate and hinders timely return to
equitable and durable development after crises
People in food insecure and poor countries are
4 times more likely to die in natural disasters.
NUTRITION AND CRISES Brief 9 of 12
32. What Can Be Done?
๏ฎ Early warning through nutritional surveillance to
pinpoint areas vulnerable to crisis
๏ฎ Relief efforts that protect/re-establish food and
livelihood security of affected population
๏ฎ Rehabilitation to ensure sustainable
development and prevent relapse
NUTRITION AND CRISES Brief 9 of 12
33. Nutrition and
Human Rights
Wenche Barth Eide
HUMAN RIGHTS Brief 10 of 12
A FOUNDATION FOR DEVELOPMENT
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ยฉ
World
Bank
34. Nutrition as a Human Right
๏ฎ The Universal Declaration of Human Rights
stipulates that every individual has the right to
food.
๏ฎ This right provides the context within which
nutrition policies and programs can thrive.
๏ฎ Improved human nutrition is also a moral
imperative and a precondition for sustainable
development.
NUTRITION AND HUMAN RIGHTS Brief 10 of 12
35. What Can Be Done?
Data on nutrition can reveal discrimination.
๏ฎ Nutritional sciences can provide objective
measures of human responses to development
efforts.
๏ฎ Nutrition programs can empower individuals and
groups.
๏ฎ Nutrition can reveal how different food systems are
relevant to the right to adequate food.
๏ฎ Nutrition policy can help clarify state obligations to
provide adequate food.
The right to adequate food requires absolute transparency
regarding nutrition-relevant information and strong institutions
to lodge complaints against violations.
NUTRITION AND HUMAN RIGHTS Brief 10 of 12
37. Nutritionโs Impact on Communities
๏ฎ A focus on nutrition can improve
decentralization and strengthen community
participation.
๏ฎ Monitoring local nutritional status can
๏ฎ Reveal the causes of malnutrition and identify
appropriate actions
๏ฎ Be used to evaluate the success of decentralized
health services
๏ฎ Help maintain political commitment to supplying
public goods
NUTRITION AND COMMUNITIES Brief 11 of 12
38. What Can Be Done?
Integrate the nutrition perspective, because it
๏ฎ Links growth monitoring with community-level
discussions on resource reallocation
๏ฎ Addresses capacity constraints at the local level
๏ฎ Knows how to work with community members,
especially the poorest
๏ฎ Builds sustainable participatory processes at the
local level
NUTRITION AND COMMUNITIES Brief 11 of 12
40. Nutrition and Politics
๏ฎ In general, nutrition concerns do not change
policy because most nutrition practitioners do
not consider political rationales and strategies.
๏ฎ Policymakers often are not motivated by
nutrition goals and may be threatened by them.
๏ฎ Scientific data and arguments can lose out against
values, beliefs, and interests that affect decision-
making.
NUTRITION AND POLITICS Brief 12 of 12
41. Transforming Nutrition Arguments
into Political Rationales
NUTRITION AND POLITICS Brief 12 of 12
Nutrition world
๏ฎ Goals
๏ฎ Outcomes
๏ฎ Policy arguments
Political world
๏ฎ Actors
๏ฎ Interest groups
๏ฎ Institutions
Nutrition
change agents
42. What Can Be Done?
Nutrition change agents can move nutrition
onto the policy agenda by
๏ฎ Appreciating the policy context (e.g. social,
historical)
๏ฎ Understanding policy decisionmaking
processes
(e.g. problem definition, agenda setting,
policy formulation)
๏ฎ Recognizing social processes, values, and
resources brought by policy actors
๏ฎ Seizing opportunities and catalyzing
problems, policies, and politics
NUTRITION AND POLITICS Brief 12 of 12
43. When the Case is Successfully Made
๏ฎ Malnutrition in most developing countries is
rapidly declining.
๏ฎ The Millennium Development Goals are being
achieved.
๏ฎ Nutrition is regarded as an excellent
investment.
๏ฎ Nutrition is recognized as the foundation for
development.
Copyright ยฉ 2003 United Nations System Standing Committee on Nutrition. All rights reserved.
The information in this presentation reflects the views of the authors of the corresponding briefs and not necessarily those of SCN.
Questions regarding content should be directed to the respective authors via the contact information provided on the briefs.