Social protection: A pathway for sectorial integration of nutrition
1. Social protection: a pathway
for sectorial integration of
nutrition
Nita Dalmiya
Nutrition Specialist
UNICEF
32nd RPCA Annual Meeting
12-14 December, 2016
2. Outline
• Regional situation of malnutrition
• What is social protection? How can social
protection programmes improve nutrition
outcomes?
• Challenges and lessons learned in making social
protection nutrition-sensitive
• Conclusions and next steps
3. Deteriorating regional situation: increase in
number of stunted children
3
Number of children under 5 who are stunted, by region, 1990 to 2014
Source: UNICEF/WHO/World Bank Joint Child Malnutrition Estimates, September 2015 edition
*Central Eastern Europe/Commonwealth of Independent States. Due to consecutive lack of any data, results are not displayed for year 1990 (1995 is presented
instead); the CEE/CIS region does not include Russia due to missing data; Consecutive low population coverage for the 2014 estimate (interpret with caution).
4. Persisting inequalities in stunting
Note: Analysis based on a subset of 87 countries with available data by wealth quintile groupings; regional estimates represent data from countries covering at least half of the
regional population. Data are from 2008 to 2014, except for Brazil (2006), and India (2005-06).
*Excludes China. Source: UNICEF Global Database, 2015
Stunting prevalence is consistently higher among poorer wealth quintiles
Percentage of under-fives who are moderately or severely stunted, by wealth quintile and by region, 2014
5. More than half of all countries in region
with underweight women
5
5 5
6
8 8
9 9 9
11 11 11 11
12
13 13
14
15
16
19
23
0
5
10
15
20
25
Percent
Poor situation
Serious situation
Percentage of women with BMI<18,5 in WCAR
Source : Global Nutrition Report, 2014
6. Cumulative, overlapping vulnerabilities
negatively influence malnutrition progress
6
Cumulative and
overlapping
vulnerabilities
Climate
change
Food
insecurity
Rapid
population
growth and
urbanization
Politial
instability
and
insecurity
7. Regional nutrition crisis. Multi-factorial causality
7
Frequency of violent civil conflict events and people affected by climate, Africa (2000-2014)
8. WHAT IS SOCIAL PROTECTION? HOW
CAN SOCIAL PROTECTION
PROGRAMMES IMPROVE NUTRITION?
8
9. What is social protection?
• Policies and programmes aimed at preventing,
reducing and eliminating economic and social
vulnerabilities and poverty in order to ensure a
minimum standard of dignity and well–being
throughout the life–cycle to all individuals , with a
particular emphasis towards most
disadvantaged groups. Social Protection Inter Agency
Board
9
10. Social protection well positioned to improve
nutrition outcomes
Source: Nutrition and social protection » FAO 2015
Pillars of a universal
Social Protection System
Social Transfers:
Food
Cash/vouchers
Cash for work
Programmes to ensure:
access to services
School feeding
Health insurance
Social support and care:
Empowerment
Legislation and
regulation:
Price subsidies
(to increase
consumption)
11. Strong evidence base linking social transfers with
improved access to nutrition, health and care
11
Improved diet quantity, quality, and
diversity
Decreased vulnerability to shifting
patterns of agriculture and climate
Decreased childhood mortality
Helping children reach their full
potential
Strengthened women’s empowerment
and household investments
12. Global and regional commitments recognize
important role of social protection and nutrition
12
14. Challenges
1. Identifying and reaching the food insecure and nutritionally vulnerable
populations in social protection systems especially in remote areas
2. Creating bridge between humanitarian and development programming:
– Difficulties in ensuring responsiveness of SP programmes to certain types of
shocks and crisis (resilience)
– Creating linkages between social protection/humanitarian activities and
longer term approaches to livelihoods, resilience, food security and nutrition
3. Establishing a single beneficiary register
4. Establishing multisectorial approaches:
– Embedding social protection in other sectors and broader development
agenda
– Creating institutional mechanisms and coordination within multi-sectorial
approach (social protection, health, agriculture, and education), and at
different levels
– Ensuring integration of behavior change communication in SP for longer term
outcomes
15. Challenges (continued)
4. Financing
– Ensuring adequate financial and human resources, as
well as information systems and logistical
arrangements
– Implementing progressive taxation and ensuring
predictability of financial streams
– Ensuring durability/longevity of projects for sustained
positive effects on food and nutrition security
– Ensuring funding for SP programmes to be responsive
in times of crisis (contingency funds)
5. Evaluating impact and building evidence base based on
improved programme design and nutrition outcomes
16. Increasing experiences with social protection
and Nutrition in region
MALI
SOCIALPROTECTIONPOLICIES
MAURITANIA
BURKINA FASO
SENEGAL
NIGERIA
NIGER
SOCIAL PROTECTION POLICY ADOPTED (2011): SOCIAL PROTECTION FLOOR AND
DIALOGUE ON FOOD SECURITY AND NUTRITION (NOV 2016)
IMPROVED AND SECURE ACCESS TO DIETARY DIVERSITY THROUGH SOCIAL TRANSFERS AND
IMPROVED NUTRITION FOR CHILDREN.
SOCIAL TRANSFERS SENSITIVE TO NUTRITION IN THE NEW NATIONAL NUTRITION POLICY
SCHOOL FEEDING PROGRAMMES IN VARIOUS STATES
CASH AND FOOD INTERVENTIONS IN HUMANITARIAN CONTEXT
DRAFT SOCIAL PROTECTION POLICY INCLUDES CASH AND OTHER PROVISIONS FOR
NUTRITIONALLY VULNERABLE FAMILIES
SP STRATEGY IN PLACE SINCE 2009 SUPPORTED BY SINGLE REGISTRY. PRIORITIES ARE
FOOD SECURITY; ACCESS TO HEALTH AND EDUCATION SERVICES; SOCIAL SECURITY,
EMPLOYMENT
LIVING ENVIRONMENT; SOCIAL SECURITY AND PROMOTION OF VULNERABLE GROUPS.
2013-2022 NATIONAL SOCIAL PROTECTION POLICY.
GOVERNMENT HAS ALSO DEVELOPED A NATIONAL NUTRITION PROTOCOL, WHICH INCLUDES
THE PREVENTION AND TREATMENT OF ACUTE MALNUTRITION FOR CHILDREN UNDER 5 AND
PREGNANT AND NURSING MOTHERS.
NATIONAL SP STRATEGY 2005-2015 IN PLACE- UPDATE ONGOING. OBJECTIVES : EQUAL
STRENGTHENING AND EXPANSION, SP TOOLS FOR VULNERABLE GROUPS, PREVENTION TO
SHOCKS AND NEGATIVE IMPACTS, INCREASE ACCESS AND USE OF BASIC SOCIAL SERVICES,
CONTRIBUTION TO COUNTRY ECONOMIC GROWTH.
GOV (&WB) PUT IN PLACE THE JIGISÈMÈJIRI SOCIAL SAFETY NETS PROGRAMME. SUPPORT
FROM WB IS COVERING PART OF ONGOING WORK TO CENTRALIZE TARGETING AND
ENROLLMENT OF SP BENEFICIARIES IN A SINGLE REGISTRY.
17. Advocate for integration of nutrition, gender,
food security, and health in long-term social
protection programmes, interventions, and
legislation
Coordinate with other sectors, including health,
nutrition but also agriculture/ productive
activities
Support social protection programmes in
achieving nutrition objectives
Expand social protection interventions to ensure
adequate coverage of nutritionally vulnerable
Ensure that social protection programmes are
shock responsive in order to adjust to crisis in
terms of both coverage as well as benefit size
Use variety of nutrition indicators (including
sensitive) to monitor and assess effectiveness
of social protection
Conclusions and next steps
National leadership: act to ensure
necessary integration between social
protection and nutrition programmes
18. Panel 1 : Links between social
protection and nutrition
Panel 2 : Success stories and
innovative experiences
Panel 3 : Sustainable financing
of social protection policies
Using the conceptual framework of malnutrition as a starting point to identify opportunities for social protection measures to positively influence nutrition is an effective way of visualizing the multiple linkages between social protection and nutrition outcomes. The main pathways through which social protection can positively impact nutrition are by
increase/stabilize households’ income particularly in crises :
Providing social assistance to poor and vulnerable households by transferring financial resources to them is one of the most basic forms of social protection. The most direct conceptual link between increased household income and the improved nutritional status of its members is straightforward: at least within the context of well-functioning markets, households can decide to spend part of their additional budget on food, leading to improved food security at household level. However there is ample research showing that increased income does not automatically translate into better nutrition. Several conditions must be met for empowering household members to spend their income in a nutrition-sensitive way. Example: From a nutrition perspective, the size of transfer programmes should therefore not only be determined by assessing average household budgets and per capita spending, but should also take into account local prices for nutritionally valuable foods. )
improving the diet of populations vulnerable to shocks:
Food transfers, ex school feeding ; productive asset to help improve food availability and increase dietary diversity ; integrate nutrition education etc
improving utilization of health services
example: A common condition for social protection schemes like conditional cash transfers, is participation in health programmes, such as prenatal care.
promote good care practices:
Social protection schemes can foster care for both women and children by ensuring maternal physical health, education of caregivers, providing income availability and control of resources, giving support to single-headed households, thereby lessening workload and increasing the time that mothers can devote to their families.)
(listing of beneficiaries in one database)
Safety nets World Bank – linkages with humanitarian actions – same beneficiaries. Challenges – different actors, no platform for them talk. Micro insurance safety nets – not linked to crisis response (how to link them).
at local level between multisectoral initiatives reporting to different focal points at the central level (eg Nutritional Security Initiative and Resilience Initiative)
as per WB, ILO, IMF and others, have estimated Social Protection is affordable even in poor countries (Art 4, CRC); and ensure predictability of financial streams