Foro Global sobre Seguridad Alimentaria y Nutrición (Foro FSN)

It is a common knowlege that: 1. the poorest of the poor spend most of their earning on food; 2. the inflation, and for that matter food inflation, being a sort of regressive tax, hurts the poor the most.

Given this, social protection programmes need to help improve the quality & safety of food s/he consumes, which is generally compromised for the reason of low income sources. Control of food inflation and provision of fortified food and supplements for lactating & pregnant mothers and children under 5 can help this object.

Dr. Wajid Pirzada

Executive Director

SAFWCO Foundation,(www.safwcofoundation.org)

Islamabad,Pakistan.

 

Dear members,

A recent study on a social protection scheme in Bangladesh showed important evidence that nutrition education is a key element in cash delivery programs which aim to have an impact on child nutrition.

The study has not been published yet but preliminary findings are available at https://www.wfp.org/news/news-release/safety-nets-cash-nutrition-education-has-greatest-impact-child-nutrition

Ellen

 

Ellen Muehlhoff

Senior Officer

Nutrition Education and Consumer Awareness Group, Nutrition Division

Food and Agriculture Organization of the United Nations

Dear Ms Basset, Dear Mr Raza,

Below are my comments on the suggested five questions, which certainly approach the widespread problem of nutrition- sensitive issues.

Setting the stage: Because of my position of Chair of the Technical Advisory Group on Nutrition of the International Pediatric Association (IPA) nutrition-sensitive issues are of main concern and activity. We were able to detect in LMIC the coexistence of undernutrition and increasing overweight. The last situation went unrecognized by the family and health care and we think it was related to inappropriate promotion of infant formula feeding in the first year of life and later on the dense caloric food consumption.

Nutrition-sensitive programs: In the Sub-Saharan countries we couldn’t detect the presence of such programs in the places where the health care provider cared/ listened the child and mother. Programs are certainly in the high health offices but not at this important step.

Nutrition sensitive aspects: Food industry with its marketing actions among other better known, are using new ways such as the  pseudoscientific information for promoting their products.

Institutional arrangements:  We were not able to find the actors from any agency for improving Nutrition- sensitive programs whose results are clearly expressed  in the last para of  your Digest Nº 1185 of 26 August. This empty space is a target for marketing people.

Monitoring and evaluation: Monitoring is difficult because health care providers are not enough motivated, for doing this extra work. Our impression is that Health Authorities are more concerned with acute situation, mainly infectious diseases. Evaluation is more difficult even. We tried a simple program for identifying houses with under/ overweight and giving very basic food information, our feedback was disappointing.

In conclusion:In our opinion the situation is improving concerning underweight ( food access and sanitation) but food education and very basic nutritional principles goes clearly behind.  Education should be focused on health care providers but to the general population specially mothers. The open question is:  Who is going to plan and deliver this knowledge to this target population?

Should you require additional information, please let me know

With my kindest regards

Manuel Moya

Catedrático E/ E Professor & Head

Chair of the Technical Advisory Group on Nutrition of International Pediatric Association (IPA)

Editor in Chief of IPA Newsletter

Board of Directors of IPA Foundation

Vice-President of European Pediatric Association

Academician of the Real Academia de Medicna

Pediatric Dept. University Miguel Hernández

Ctra Valencia s/n. 03550 S Juan. Alicante. Spain 

Dear members,

This is to share the exprience that I tought  very improtant.  

"Ethiopian Productive Safety Net Program (PSNP), Social Protection Nutrition Sensitive intervention"

The Government of Ethiopia has developed several policies, plans and strategies with a view to progressively fulfil constitutional rights of the nation.  Among many, food security program can be mentioned as one major strategy which enable the vulnerable community to strive to fulfil their right to food. The Ethiopian Food Security Program consists of the Productive Safety Net Program (PSNP), Household Asset Building Program (HABP), the Voluntary Resettlement Program and the Complementary Community Investment Program (CCI).

The Productive Safety Net Program (PSNP) is a development-oriented social protection program launched in Ethiopia in 2005. PSNP is aimed at enabling the rural poor facing chronic food insecurity to resist shocks, create assets and become food self-sufficient. PSNP provides multi-annual predictable transfers, as food, cash or a combination of both, to help chronically food insecure people survive food deficit periods and avoid depleting their productive assets while attempting to meet their basic food requirements. The combination of cash and food transfers is based on season and need, with food given primarily in the lean season between June and August. Vulnerable households receive six months of assistance annually to protect them from acute food insecurity.

Read the full attached document to see the contribution of PSNP as a nutrition senstive social protection intervention to reduce malnutrition in Ethiopia

On Nutrition-Sensitive Social Protection

My point of departure is quite simple; social protection becomes a need when some members of a society are unjustifiably denied of the possibility of their satisfying one or more of man’s six fundamental needs with reference to their own cultural norms. While these needs are universal for all cultures, how they are satisfied is subject to cultural variation. One of these fundamental needs is nutrition.

Therefore, holistic social protection entails that when necessary, ensuring that the members of a social group are enabled adequately to meet their nutritional needs with reference to their own cultural norms in a way that does not harm anyone or our shared habitat.

A group specific mechanism to enable a social group to meet their nutritional needs that entails harm to some other group or to our habitat is unacceptable for obvious reasons.  One may legitimately call them ethico-pragmatic reasons, respect of which in the long run, is essential for the continued existence of the human race.

Nutrition-Sensitive Social Protection then, represents undertaking an appropriate set of actions that would enable a social group adequately to meet its nutritional needs with reference to its own cultural norms in a manner that entails no harm to anyone or our environment.

The current failure to holistically address the question, what makes nutrition sensitivity a critical component of social protection intervention, has led to an unprecedented degree of urban and rural misery in Asia, Africa and in Americas. Indeed, this is a serious charge, and I shall try to justify my position with a few examples from real life that can be easily confirmed.

Let me begin by stating the obvious; unless an appropriate and adequate supply of affordable food is available to the people, neither their sound economic status nor their enjoyment of human rights can prevent them from either being malnourished or inappropriately nourished. The former results in retarded mental capacity, deficiency diseases and other developmental problems, while the latter additionally leads to obesity and its well-known consequences.

It is vital to understand that social protection endeavours that are not nutrition-sensitive do more harm than good in the long run not only to the already deprived social groups, but also those who are about to enter their midst. Leaving aside the obvious ethico-pragmatic requirements any suitable social protection effort should meet, I will concentrate on the what constitutes the appropriateness, adequacy, and the availability of the nutritional component of social protection.

APPROPRIATENESS:

A significant part of the current nutritional habits of a social group is a product of a long evolution with reference to the group’s geographic location, climate, local flora and fauna on the one side, and the people’s nutritional needs on the other which are dependent on their energy and growth needs. This is an undisputable physio-biological fact. Over a long period of time, how those nutritional needs are met under those conditions get embodied as the food culture of that group.

Naturally, food culture will change over time as the conditions change, but this is a slow natural process. It is reflected in the agricultural products of a group. These products are able to satisfy both the taste and the nutritional needs of its members, provided an adequate supply of those are at their disposal at reasonable prices.

Often indeed those products come from the traditional farmers who are distributed around larger population centres (eg. Former southern Angola). The political ploy of raising people’s expectations to an impossible level, military conflicts of every kind, climatic changes injurious to agriculture, usury, and over-population have drastically reduced the rural agricultural production in many areas of southern Africa and some areas of Asia. At the same time, any one or a combination of those factors have resulted in huge and continuous migration of the poor to the cities (eg. Consider the continuing growth of shanty towns around the former ‘townships of South Africa and around cities in Angola).

For the sake of balance, let me also note that a similar growth slums obtain within and around the Indian cities like Bombay supposed to be in the throes of an economic ‘miracle’. It seems that  noone  knew about the poverty stricken slums around New Orleans until they were submerged under water in the aftermath of a cyclone a few years ago and the slum dwellers emerged in their thousands. All these people have something in common, viz., they are ill-nourished and their ability to work and learn is considerably reduced owing to their inability to meet their nutritional needs adequately. Moreover, their susceptibility to diseases is significantly higher than their national average.

So, how to ensure appropriateness of social protection with reference to nutrition? First of all,  it is essential to re-populate the already depopulated rural areas with agriculturalists trained to produce the foods of the country or the area concerned. This may require education and training, equipment, appropriate seed and livestock, and financial incentives as well as an adequate infra-structureincluding storage and cheap transport, not magnetic levitation and fancy air ports for tourists.

Now to the other side of the coin, i.e., those who are to be protected. Monetary help may enable them to buy food in the slum shops, but paradoxically enough, it is very expensive, its quality is poor to bad, and very often, it takes the form of some food foreign to the people. The solution seems to be the establishment of suitable outlets in deprived areas where the produce of their environs may be bought at reasonable prices. But, I do not know how this may be achieved for the law and order situation in some such areas would not allow it unless it is improved rapidly and effectively.

One of the greatest obstacles to real progress and a huge depopulator of rural areas leading to an ever growing need for social protection in under-developed countries is rogue aid provided by China, India, Russian Federation, etc. Evil effects of Chinese aid is brilliantly visible in southern Angola where Chinese capital and Chinese prisoners work to build tourist facilities and prestige projects. As a result, the Angolan capital has an immense population of poorest of the poor running into several millions. I think unless the caring nations intervene to halt rogue aid, it will become increasingly difficult to provide any social protection to many millions in the recipient countries.

My reason for this seemingly off-the-topic comment is quite simple. If the number of people who require social protection should continue to increase at the present rate, it is difficult to see how a country could produce enough appropriate food stuffs to meet their nutritional needs. It is often those who are engaged in agriculture who migrate into cities in search of a ‘better life’.

I have touched on food production and equally important, its equitable distribution. Apart from that, it is necessary that every development initiative does not entail a reduction in the number of agricultural workers, nor yet in the area of the arable land. Ideally, such an endeavour ought to provide either a direct or an indirect incentive to an increase in both, especially when it is not directly concerned with agriculture.

It would be wise to discourage capital intensive industrialized agriculture, particularly where the need for social protection is acute, for it renders many unemployed who add to the growing numbers of those who require social protection. Its opposite, viz., practical encouragement of small farming involving traditional crops could not only reduce the increase in the number of those who need social protection, but it could also increase our ability to take care of the nutritional aspect of that help as well as support the bio-diversity in food crops and livestock.

I shall now sum up some means of increasing the nutrition sensitivity of social protection interventions and what may be done to make sure that they will not lead to an increase in the numbers who require them.

1. Incorporate suitable agricultural education/training programmes and provision of start capital/material packages in social protection initiatives.

2. Include help to rural farmers and active expansion of small farming, and an equitable distribution of agricultural produce as an integral part of national development.

3. Help to establish and run agricultural cooperatives in rural and semi-rural areas, preferably via less formal but more transparent mechanisms.

4. Distributed and non-intrusive industrial development, which may provide employment without affecting the manpower needs of the vital agriculture sector.

5. Discourage ‘development schemes’ that uproots rural populations, loss of arable land, require cheap but often inappropriate food imports, and intrusive and mendacious food and drink advertising.

6. Some international mechanism to halt rogue development aid, possibly by giving world-wide publicity to its visible harmful effects.

7. The most difficult,  viz., tolerably good governance and its actual use, especially with respect to  agriculture, actively enforced labour laws, and holistic policy formulation and implementation.

 Adequacy:

Adequacy of an appropriate food supply is an individual issue, dependent on the the particular nutritional needs of a given individual, which in turn depends on one’s age, sex, specific energy and growth needs at a given time, etc. In generalising on food needs, it would be salutary to remember these variations rather than to engage in mechanical thinking and depend on caloric content of food items. At the same time, it would be wise to recall that what constitutes a balanced diet has to be determined with respect to the variations mentioned above for there can never be a universal balanced diet unless we are mass produced to a set of fixed specifications.

Affordability:

My final comments here are to underline the importance of ensuring an affordable supply of appropriate foods for those who require social protection.  Monetary help can hardly ensure anything more than a starvation diet to the needy unless we ensure the availability of affordable food. It is therefore essential that guidelines 1-7 above are observed both by the general development activities, and the broader social protection endeavors.

Best wishes!

Lal Manavado.

To respond to each of the questions I would need to reframe the way we look at nutrition within present situation in India. Land as a resource for the poor, forest dwellers and excluded communities like Dalits need to be reassured and redistributed within the rights framework. The current high levels of malnutrition is an outcome of denial of land and forest rights, which are guaranteed by law, yet not given in practice, lack of attention to sustainable agriculture and multi-cropping practices within traditional agricultural practices.

In India the hard fought negotiations to ensure adequate food to the poor has been ensured under the National Food Security Act, however there are a multiplicity of programmes for health care and a closer look at them show less of rights and more of charity through inclusion of private players in public health processes. Hence, making right to adequate health care as a public good and right of all citizens is a must. The discourse from charity to rights is imperative for such basic services and I am not sure if the Social Protection floors ensure the same. It’s like taking away from one hand and giving in charity from another with  a patronizing and top-down approach.

Several laws like the SEZ Act in India take away fertile land from farmers and of course the landless workers on farms are not counted at all. So more farmers are being diverted from land in a quiet and insidious manner. Since the government may not provide adequate support prices for the agricultural produce more farmers especially young farmers are selling land as its not profitable for them. Hence crop insurance, insurance against climatic changes and disasters need to be urgently introduced through state funded and monitored programmes. The private insurance companies are not covered under accountability mechanisms hence often they resort to devious tactics for return of loans etc.

Two critical programmes for nutrition are the Integrated Child Development Scheme (universal in nature) and the Mid-day meal scheme. Both have shown good possibilities for dealing with nutrition delivery. However there has been strong budget cuts in both schemes in the new budget. And the monitoring and accountability mechanisms are weak in several parts of the country. Also the catch in most of these schemes is the dependence on delivery on resource poor, gender discriminated women from the local communities who receive a pittance with regard to their salaries and honorariums. All evaluations tend to focus on their roles instead of locating power hierarchies where salaries are higher for those who work the least within the system.

Critical to ensuring nutrition of communities and people is the adoption of a rights-based approach wherein they are empowered with resources through land, livelihoods and social security, which means that countries work towards a 'development with equity' rather than 'growth as development.'

Dear participants,

Thank you for sharing your valuable experiences and thoughts on the topic.

At its core the concept of Nutrition-Sensitive Social Protection embraces the notion of a multi-sectoral and multi-stakeholder approach, and in numerous cases social protection, when linked with other development interventions – particularly in the areas of agriculture and food security, can lead to better nutrition outcomes. To this end, institutional arrangements at all levels of the policy sphere hold key importance. Building on the recent discussion posts, it is interesting to explore how such arrangements, in different contexts, have been able to incorporate the unique role of Non-Governmental Organizations (NGOs), Civil Society Organizations (CSOs) and other relevant partners. The following questions on the programmatic and implementation side also become relevant: how can synergies across sectors be best realized? Which sectors (as well as agencies and ministries) in this regard are significant?

The meeting in Moscow next week aims to gather experts and policy makers from a wide range of sectors, such as health, labour, food security, agriculture and rural services – to name a few, to deliberate on the challenges and opportunities associated with the design and implementation of Nutrition-Sensitive Social Protection.    

We look forward to hearing about your experiences in the coming days.

Ahmed Raza

Nutrition Specialist

FAO

Family Farming was the theme propagated by UN and many countries including India. The whole year 2014 was devoted and many conferences held to focus on Family farming as a way for empowering families with nutritive food, indirect employment, residue free organic food and above all family peace resulting from collective farm operations. In Kerala alone there are 60 million homesteads and back yard farming is an established practice passed over generations. Tuber crops like yams and cassava saved families from famine due to drought and flood. Leaf vegetables -indigenous-provided needed fibres and minerals to the diet. A detailed chapter on Economics of Family Farming is attached. The chapter is from the book HORTICULTURE FOR NUTRITION SECURITY published by New India Publishing Agency New Delhi. Preambles are policy papers published by FAO, National Academy of Agricultural Sciences New Delhi and Indian National Science Academy, New Delhi. Copies are available at: [email protected]

>> English translation below <<

Los programas de protección social hay que manejarlos con sumo cuidado pues en ellos se filtran una serie de elementos e incluso familias completas que reciben la protección, aun estando fuera del país de origen, esto a la larga crea una carga económica al presupuesto del estado y deja fuera muchos que realmente lo necesitan. Si analizamos con detenimiento vemos que ayudas sociales destinadas a la niñez van a manos política partidarias. Y otras ayudas sociales destinadas a ancianos y convalecientes no llegan a los estratos realmente necesitados. Monitorear esas ayudas de parte de organizaciones no gubernamentales responsables debe ser tarea del estado.

Social protection programs must be managed very carefully, as several individuals -and even entire families- who are away from the home country, manage to have access to the coverage. Eventually this is a financial burden on the state budget, excluding many people who really need these programs. A detailed analysis shows that social assistance intended for children is subject to biased policies. And other social aid targeting the elderly and the sick does not reach the deprived recipients. Monitoring the assistance provided by responsible non-governmental organizations should be a state duty.

The school mid day meal scheme is a powerful tool for nutrition security and child literacy. In many of the states in India like Kerala, Tamil Nadu, Karnataka and Madhya Pradesh, the school mid day scheme has attracted both male and female children to schools for education. In a few states like Gujarat milk is included. In Tamil Nadu one egg /day is served. Pulses are invariably served.

Many socially responsible NGO s have programmes to feed homeless, aged and orphans. Much more has to be done in view of the escalating population. Hidden hunger due to micro-nutrient deficiency is a matter of concern. Promotion of nutrition garden with one tree of drum stick and curry leaf will go a long way in making a household self sufficient in nutrition.

Recently I compiled a book titled "Horticulture Crops for Nutrition Security" published by NIPA New Delhi (www.bookfactoryindia.com) carrying chapters on food and nutrition. Prof. M S Swaminathan Father of Green Revolution in India made the statement"There is a horticultural remedy for every nutritional malady".