The Architecture of Growth

One of the most respected medical magazines in the world, The Lancet, released a five-part series on boosting nutrition in the fall of 2007. By rationalizing systematic evidence of the impact of undernutrition on child and infant mortality as well as the long-term implications on cognitive, physical growth, and health, it filled a long-standing gap. Additionally, it demonstrates how simple it is to become involved in proven ways that help solve these problems and save a great deal of lives. The lancet conventional engagements and interventions fixated on the prospect that arises from conception to two years for a massive impact on avoiding irreversible harm, disease, and death. Other studies that draw on the same set of involvements have shown a high level of cost-effectiveness and huge profits to individual earnings, cognitive progress, and commercial growth.

The Lancet, however, bewailed that nutrition had regard for the best chunk of an addition in priority growth and that it is underrated by donors and emerging countries. This valuation though is collective in and outside the nutrition family. There is a broad consensus on a wide framework for accomplishment to negate this kind of neglect and a is growing partnership among the main stakeholders-UN, United Nations, NGOs, development agencies, developing countries, civil society organizations, the private sector, and researchers.

This policy brief has two primary goals. The first one being providing the summary of the framework of the main attentions, guidelines, and priorities to follow while addressing undernutrition. The second goal is mobilizing support so that there is improved venture in a couple of nutrition involvements amongst the diverse sectors. Hence the message goes to the opinion leaders and policy makers and not the nutrition specialists.

Key messages and recommendations

 Start from the guidelines that what matters is what happens at the country levels. Nutrition programs and strategies in individual countries should be “owned” by the state and based on the particular needs and capabilities of that country.

 Bring up cost-effective, evidence-based interventions to help treat and prevent undernutrition with the highest priority being the window of opportunity between conception and two years old.

 Put in place a multi-sectoral tactic with the integration of nutrition in similar divisions and make use of indicators of undernutrition amongst the major actions of the progress in these areas. The very first links are food security, emergency relief, social safety, health; maternal and child care, family planning and immunization. Other relevant links include education, sanitation, gender equality, governance, water supply and state fragility.

 Offer substantially scaled up external and domestic assistance for nutrition programs owned by the individual country. To this end, nutrition should have support explicitly in national as well as global initiatives for health and social protection, food security and support significant efforts at the global and national levels for of the solidification indication base, monitoring, and assessment and for advocacy.

Why Now Focus on Reducing Undernutrition?

Undernutrition is one of the most severe but under-addressed health problem in the world. The economic and human expenses are huge, affecting mostly the destitute, women and children. In the emerging countries mainly, closely to a third of the children are born underweight or experience a stunted growth. Undernutrition intermingles with stretches of infectious diseases, and this causes an estimate of 3.5 million maternal and child deaths per year most of these deaths if not all are preventable (Bryce et al. 2008). There are also huge economic costs in economic growth and lost national productivity.

There are many more reasons also for significant effort in addressing malnutrition. Preventing undernutrition is easy and there being exceptionally high growth in returns to direct nutrition involvement is conclusive. Addressing malnutrition and gaining success is a crucial step to meeting the MDGs- Millennium Development Goals and contributing to the human rights for an end to hunger and a start of total global health.

While it is a crucial need to promote higher growth on socio-economic that determine undernutrition e.g. income growth, waiting for these factors alone is a grave slipup and could serve to extend the global development long abandonment of undernutrition. It may take many years to end the plain poverty in many developing countries. To top it off the evidence indicates that not only are developments in nutrition lagging behindhand on income growth, but also families with enough incomes for sustenance also suffer from undernutrition (Haddad 2003).

When economic disruptions occur intentionally, it is the poorest in the world that suffer most. The global crisis in fuel, food, and finance go further to demonstrate that they cause an increase in undernourishment and an increase in death rates. This crisis goes below the importance of taking undernutrition as a part in donor support for societal safety nets.

Since the Lancet concluded in early 2008 that leadership is absent and there is a crack in the nutrition system internationally, many companies have started new nutrition initiatives and strategies (Black et al. 2008). These efforts being supported by key global civil societies and organizations. There is now a widened acceptance of a shared support for joint action. These signs of growth predict positively efforts being made to broaden global collective action and fight undernutrition.

To sum it all, the scaling up the context in today’s global nutrition is quite new and by far more preferred. This is evidenced by an increase in high development interventions coupled with high health returns, an increased potential for partnerships between the private and public sectors and a joint action framework in the global nutrition family. This helps offer an opportunity for the international community to change the neglection that was there initially and efficiently fight to end undernutrition.

The broad multi-sectoral approach

There are two approaches to reduce undernutrition, more general approach on all sectors and targeted interventions. There are three ways this can contribute to reducing malnutrition. First is accelerating the action on the determinants of undernutrition e.g. lack of income and no production in agriculture (Ergo, Gwatkin, and Shekar 2009). Improving the water supply helps not only by addressing the disease cycle but also gives mothers more time to spend on nutrition and their children’s health. There also are deeply underlying issues like the value of institutions, governance, and matters that relate to peace and security. Strategic plans in nutrition that do not address the limitations and gaps these fundamental problems bring are more likely not to, make any progress.

Secondly, integrating nutrition (i.e. including specific actions for nutrition) in all sectors. An example is that basic knowledge of nutrition should be taught in school, this should include nutrition practices in families. There is a growing need to place nutrition interventions in the rural livelihoods and small-scale agriculturalists. Similarly, research on biofortification and increasing proceeds of staple foods and those rich in nutrients should be intensified. The best way to encourage the emphasis on objectives relating to nutrition is by holding the related sectors accountable and put in place indicators of undernutrition that will help gauge the overall progress.

Thirdly, we can use government-wide attention to unexpected adverse consequences on policies on nutrition in other sectors to increase “policy rationality.” This can be applied in both the developing countries and donors. It is required that there be better and well-timed analysis of consequences arising from nutrition and their inclusion on all government mechanisms for coordinating policies. Developing the capacity for nutrition in sectors alike is also of importance.

Bringing up unswerving nutrition interventions and the benefits.

Field study results indicate that the package of 13 interventions would bring a decline in infant mortality of close to 1 million deaths in a year (Hoddinott, Maluccio, Behrman, Flores, and Martorell 2008). Having partial progress would also produce better results. A study in Guatemala, e.g. it found out that boys getting complementary food before the age of 3 ended up having wages46% higher than the ones in the control group. The study further estimated a GDP increase of at least 2-3% (Hoddinott, Maluccio, Behrman, Flores, and Martorell 2008). These significant benefits are the reason for the importance of addressing mild and severe undernutrition.

Nutrition interventions are crucial to hitting the Millennium Development Goals. The study from Guatemala made this point insistently, underlining the evidence with clarity on the need of nutrition in achieving all MDGs and capitalize on effectiveness in the developmental interventions.

Pulling together diverse data on cost effectiveness makes the costing study unique in its way. The recommended interventions package demonstrates good results and ranks higher than costs per DALY, disability-adjusted life years, to other interventions in public health.

Heading to Action

Improvements in scaling the planned interventions to scale necessitate work at all levels, international and country, coming from these ideologies:

Improve the support for capacity development and nutrition programs: The extraordinary event goes back to address undernutrition giving an explicit justification of a fast track to improving both external and domestic investment. In comparison with international initiatives, sharing foreign assistance has to be substantial mostly taking into account the historical abandonment of nutrition by all donors and countries in need. The challenge becomes how to bridge and then close this gap.

Using Paris-Accra Principles of Aid Effectiveness. This could be used to support countries’ policies. In the long run, accomplished nutrition will not be decided by projects of global development agencies but by ownership, capacity, and commitment to results of individual developing country. The Paris Declaration (2005) focused on: division of labor, mutual accountability, ownership, making monetary assistance more foreseeable and sustainable, including pool funding and aligning donors with country strategies and systems. These are essential principles in helping achieve sustainable growth in nutrition. Modalities for external support at the state levels would also be by the Paris declaration using both programmatic assistance and beset projects, and use of use of country systems as a first result of the programs backing activities in the public sector.

Rally vital investors in a comprehensive approach to state ownership: the development history clearly tells us that positive country-wide plans need ownership by the governments and civil society and the private sector. The leadership roles of governments surpass nutrition services offered by the public sector and incorporates preparation of strategic policies, enforcement and regulatory framework for the providing of services while supervising to measure improvement and enhance accountability. The civil society has a crucial role in advocating and maintaining political will for the government’s action in service delivery.

Using the “Three Ones”: the country’s nutrition strategies should apply the “three ones” widely endorsed globally in efforts to combat HIV/AIDS. These are; “one agreed … framework providing basis for coordinating all partners; a national coordinating authority, with a broad mandate; and another approved social monitoring and assessment system.

Developing prioritized and healthy country strategies: nutrition policies in each country is supposed to be grounded due to its unique needs, capacities. Challenges, constraints, and priorities. Most of the efforts made by developing countries in the past were often drafted by the donors and did not respect this necessity. The strategy should have a tremendous sense of federal ownership.

Drawing support from global initiatives: There is a developing scope for the integration of a country’s nutrition strategies needs integration into international efforts in areas closely related: agriculture and food security, vulnerability protection programs and health. To achieve a scale up to the proper levels would require that a there is a substantial share of resources from the associated global initiatives being used to fund the nutrition strategy.

Supporting special needs of the friable states: aid effectiveness needs to put into consideration the unique needs of fragile countries. In most of these cases, it is hard and completely not feasible developing or implementing state-owned strategies. Such situations call for donors to play an activist role in essential nutrition and emergency nutrition programs.

Conclusion

This policy brief helps explain the reasons behind scaling up domestic and global support for nutrition and mostly in times of recession. The problem is serious, and the evidence more overwhelming mostly because fulfilling the MDGs without prioritizing food is nearly impossible. The unacceptably high costs of not working summed up by the increased infant mortality rates, reduced economic production, and the compromised life chances. This policy brief, therefore, should bring about a high sense of urgency and help create an action plan for developing countries the international community as a whole, private and public sector partners and the civil society.

References

Black, R.E., Allen, L.H., Bhutta, Z.A., Caulfield, L.E., De Onis, M., Ezzati, M., Mathers, C., Rivera, J. and Maternal and Child Undernutrition Study Group, 2008. Maternal and child undernutrition: global and regional exposures and health consequences. The lancet, 371(9608), pp.243-260.

Bryce, J. et. al., 2008. Maternal and Child Undernutrition 4: Effective action at the national level. The Lancet. Child: Care, Health and Development, 34(3), 405-405. doi:10.1111/j.1365-2214.2008.00848_6.x

Haddad, L. (2003). Reducing Child Malnutrition: How Far Does Income Growth Take Us? The World Bank Economic Review, 17(1), 107-131. doi:10.1093/wber/lhg012

Ergo, A., Gwatkin, D.R. and Shekar, M., 2009. What difference do the new WHO child growth standards make for the prevalence and socioeconomic distribution of undernutrition?. Food and nutrition bulletin, 30(1), pp.3-15.

Hoddinott, J., Maluccio, J.A., Behrman, J.R., Flores, R. and Martorell, R., 2008. Effect of a nutrition intervention during early childhood on economic productivity in Guatemalan adults. The lancet, 371(9610), pp.411-416. http://data.unaids.org/UNA-docs/Three-Ones_KeyPrinciples_en.pdf