Global Workshop on Nutrition-sensitive Fish Agri-food Systems 5-8 December 2017, Siem Reap, Cambodia

1. Why nutrition? The global
momentum for nutrition-
sensitive approaches
Jessica Bogard
Post-Doctoral Fellow
Value Chains and Nutrition

2. Overview
• Definition and types of malnutrition
• The size of the problem
• Who is affected
• What are the causes
• What are the consequences
• The gathering global momentum behind nutrition

3. The different types of malnutrition
Slide adapted, courtesy of Anna Herforth, 2015
The double burden
The triple burden
Malnutrition refers to deficiencies,
excesses or imbalances in a
person’s intake of energy and/or
nutrients

4. The nutrition problem in 2017
Global Nutrition Report, 2017

5. The nutrition problem in 2017
The number of undernourished people has been rising

6. Who is affected?
Prevalence of stunting in children < 5 years over the last 10 years

7. Who is affected?
Prevalence of overweight in children < 5 years over the last 10 years

8. Care and feeding
practices
Nutrient intake Health status
Food security and
quality
Health resources
and WASH
Malnutrition
Institutions
Political and ideological framework
Economic structure
Resources, environment, technology, people
Immediate
determinants
Underlying
determinantsBasicdeterminants
The causes of malnutrition

9. Care and feeding
practices
Nutrient intake Health status
Food security and
quality
Health resources
and WASH
Malnutrition
Institutions
Political and ideological framework
Economic structure
Resources, environment, technology, people
Immediate
determinants
Underlying
determinantsBasicdeterminants
(UNICEF, 1990)
The causes of malnutrition

10. Care and feeding
practices
Nutrient intake Health status
Food security and
quality
Health resources
and WASH
Malnutrition
Institutions
Political and ideological framework
Economic structure
Resources, environment, technology, people
Immediate
determinants
Underlying
determinantsBasicdeterminants
(UNICEF, 1990)
The causes of malnutrition

11. The consequences of malnutrition
Long term
• Mortality
• 45% of all child deaths
are caused by
malnutrition (>3 million
deaths each year)
• Morbidity
• Disability
• Brain development (cognition)
• Education
• Income earning potential
• Economic productivity
(undernutrition costs equivalent
of 8-11% of GDP in Africa and
Asia)
• ↑ risk of obesity, heart disease,
stroke and diabetes
• Costs global economy $3 trillion
in lost productivity and health
care costs
Short term

12. Intergenerational cycle of malnutrition

13. Care and feeding
practices
Nutrient intake Health status
Food security and
quality
Health resources
and WASH
Malnutrition
Institutions
Political and ideological framework
Economic structure
Resources, environment, technology, people
Immediate
determinants
Underlying
determinantsBasicdeterminants
(UNICEF, 1990 ; Bhutta et al., 2013)
What can be done?
Nutrition-
specific
interventions
Nutrition-
sensitive
interventions
Scaling of top 10 most
evidence based interventions
to reach 90% of population in
34 countries which have 90%
of the worlds stunted children
 only 15% reduction in child
mortality

14. What can be done
Framework for Action

15. US$4 billion - nutrition
specific interventions
US$19 billion - nutrition
sensitive interventions
2013 2014 2016
Gathering global momentum for nutrition-
sensitive approaches

16. Healthy diets (and good nutrition) can drive
greater environmental sustainability
Livestock uses 70% of all agricultural land
Good nutrition provides ‘grey matter
infrastructure’ for economic development
Nutrition gives a 16:1 $ return on investment
Good nutrition means less pressure on
struggling health systems
Good nutrition supports equity and inclusion
As a platform for improved education, women’s
empowerment and poverty reduction
Good nutrition supports peace and security
Investment in food and nutrition security promotes
stability and less unrest
Sustainable food production is essential for
healthy diets
Increasing agricultural diversity and production of nutrient-
rich foods is essential
Strong infrastructure is essential for a
functioning value chain, water & sanitation
30% of food is wasted often linked to poor infrastructure
Health systems are essential in promoting
IYCF, supplementation, treatment of
malnutrition
But are underperforming and overburdened
Equity and inclusion matter
From 1970-1995 more than half of global reductions in child
stunting was attributable to improvements in women’s
empowerment
Peace and stability are vital for ending
malnutrition
The proportion of undernourished in conflict zones is 3X
higher than other developing countries
2, 13,
14, 15
6, 7, 8, 9,
11, 12
3
1, 4, 5,
6, 8, 10
16
NUTRITION
ESSENTIAL
INPUT
AND
OUTCOME
(Adapted from Global
Nutrition Report, 2017)

17. Conclusion
• Causes of malnutrition are multi-
factorial and operate at different
levels
• Traditional approaches (nutrition-
specific) alone will not be sufficient
to achieve global targets
• Now we have a unique opportunity
to act
• This workshop was designed to
give us the tools to take
advantage!

18. Thank You