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Shenggen Fan, April 2015
Brussels Development Briefing no. 41 Improving Nutrition through Accountability, Ownership and Partnership
Overview: Undernutrition,
Malnutrition and
How to Improve Nutrition at Scale?
Marie Ruel
Director | Poverty, Health and Nutrition | IFPRI
Shenggen Fan, April 2015
Malnutrition: A Continuum
From hunger (lack of food), to deficits in
protein, energy, essential micronutrients
to unbalanced diets (excess fat, sugar,
salt) leading to overweight/obesity/NCDs
1 common thread: poor diets
Shenggen Fan, April 2015
THE CHALLENGE
Shenggen Fan, April 2015
Hunger: 805 Million still undernourished
Prevalence of undernourishment (%)
Source: FAO 2014
Shenggen Fan, April 2015
Stunting: ~162 M children (1 in 4)
Figure 4
5
2.1% annual rate of
reduction is not
fast enough to
reach WHA target
Source: Lancet 2013
Shenggen Fan, April 2015
Wasting: 52M (19M severely)
Source: Lancet 2013
Shenggen Fan, April 2015
Wasting: 52M (19M severely)
Source: Lancet 2013
Shenggen Fan, April 2015
Micronutrient deficiencies: 2 Billion people
Source: HarvestPlus 2011 from WHO data
Prevalence of Iron, Vitamin A, Zinc Deficiencies
Shenggen Fan, April 2015
Overweight/obesity: increasing rapidly
Also rising rapidly in children:
41% of the world’s overweight/obese
children live in Asia
Women
Source: Lancet 2013
Shenggen Fan, April 2015
0
10
20
30
40
50
60
70
80
90
100
Egypt Peru Mexico
%
Other
Overweight
Obese
†*, †
Anemia in overweight/
Obese women
0
5
10
15
20
25
30
35
2003 2005 2008
Stunting Wasting Overweight
Egypt
In same country
In same household
In same individual
Under and over-nutrition coexist
Shenggen Fan, April 2015
WHY DOES NUTRITION MATTER?
2 12-y old Bangladeshi girls
Shenggen Fan, April 2015
A stunted child is a stunted adult
Height
at 18 y
81.2
Severe Moderate Mild Well-nourished
Height
at 3 y
Damage is irreversible
Shenggen Fan, April 2015
Nutrition is the foundation of development
Fuente: Shenggen Fan, 2014
For survival (45% child
deaths associated with
poor nutrition)
For health, physical and
cognitive development
For education, economic
productivity, income
For breaking the inter-
generational transmission
of poverty
For preventing NCDs Economic cost of malnutrition:
$2.8- 3.5 trillion (4-5% global GDP) (FAO 2013)
Shenggen Fan, April 2015
HOW CAN WE ACCELERATE
PROGRESS IN IMPROVING
NUTRITION?
Shenggen Fan, April 2015
1. Focus on the 1st 1000 days
Source: Kay Dewey
Shenggen Fan, April 2015
2. Scale-up nutrition-specific interventions
Set of 10 nutrition-specific interventions that
focus on FOOD, HEALTH, CARE:
(e.g. Optimal BF + CF; MN supplementation;
high-quality diets; preventive health care;
treatment of severe acute malnutrition, etc.
Shenggen Fan, April 2015
3. Work multi-sectorally to address
underlying determinants of malnutrition
multiple sectors
Social
Protection
Health Agriculture &
Food Systems
Gender
Water and
Sanitation
Education
Shenggen Fan, April 2015
4. Make the food system more nutrition-
sensitive
Policies that:
Increase
availability/access
to nutrient-rich
foods & diets
Make value chains
more nutrition-
sensitive
Reduce
inequalities
PPP in food
marketing sector
FOOD SYSTEM ENVIRONMENT
Health & Nutrition
Biophysical Environment
Socioeconomic Environment
Political Environment
Demographic Environment
FOOD SYSTEM
Natural Resources & Inputs
Primary Production
Transport, Storage, Processing
Consumption
Retailing, Marketing
HEALTH & NUTRITION
CHANGES IN FOOD SYSTEM ENVIRONMENT OUTCOMES
Shenggen Fan, April 2015
5. Empower Women
Source: Sundberg, Birxs, Ruel; BMGF Learning Session; January 2014
Shenggen Fan, April 2015
Final Messages
Be purposeful about nutrition and gender
Make multisectorality a mindset
Develop/embed right set of incentives for multisectoral work at all levels (top to ground)
Strengthen capacity
Build solid partnerships
Recognize opportunities, risks, limitations of agriculture/food systems, exploit synergies with other sectors
Ensure policy coherence & coordination around nutrition
Invest
Document and measure – build evidence base