Developing strategies to end hunger

7 posts from September 2011

What Happened at the Social Good Summit

Silent Killers

Last week, the United Nations General Assembly convened a High-Level Meeting on preventing and controlling non-communicable diseases (NCDs), especially in low- and middle-income countries.

The September 19-20 meeting is the second-ever U.N. High-Level Meeting on a threat to global health (the first was held a decade ago on HIV/AIDS). Organizers called it a "once in a generation" chance to tackle the projected global surge in NCDs.

Non-communicable diseases—such as heart attacks, strokes, cancer, diabetes, and chronic respiratory disease—cause more than 63 percent of all deaths worldwide, or 36 million deaths a year. Projections by the World Health Organization (WHO) indicate that the global burden of NCDs will rise quickly in the next two decades; NCDs will cause as many as 52 million deaths a year by 2030, according to WHO’s 10 Facts about NCDs.

110930_wurdle Image Credit: Faustine Wabwire/ Bread for the World Institute

NCDs are often thought of as diseases of the wealthy world, where fatty foods, sedentary lifestyles, and consumption of tobacco and alcohol have become part of normal life for many. But in recent decades, the risk factors—and therefore the illnesses—have become far more prevalent in low-income countries. NCDs are often even more dangerous in these contexts than in developed countries, since access to doctors and medicines is limited and prevention efforts are still in their infancy.

 A new report released by The Chicago Council on Global Affairs just before the High-Level Meeting calls on the agriculture and food sectors to help mitigate the increase in NCDs. The report also identifies new opportunities for health and agriculture programs to work together to promote better health. Leaders who participated in the High-Level Meeting reiterated that policies to help meet health goals are particularly important in agriculture, food production, and other key sectors. They urged a multi-sectoral approach to preventing NCDs since their causes are varied and interrelated.

WHO’s recommendations for population-wide interventions include raising taxes on tobacco products and banning tobacco advertising and smoking in public places; raising taxes on alcohol and enforcing bans on alcohol advertising; reducing salt intake; replacing trans-fats in foods with polyunsaturated fats; promoting public awareness about diet and physical activity; and delivering hepatitis B vaccinations. Primary health-care interventions include counseling, multi-drug therapy, and screening and early treatment for cervical and breast cancers.

“It will take each and every person to do something about it -- it can’t be the government alone, or the private sector alone.”  Tobeka Madiba-Zuma, South African First Lady.

Mother-to-Mother Nutrition Messaging in Rural Ghana

How do you communicate important messages on nutrition, health, and child care among women who have little formal education and can’t read or write? Bread senior policy analyst Scott Bleggi accompanied staff from World Vision to a rural village west of Ghana’s capital, Accra.

In Ghana, there have been remarkable gains in improving the nutrition of mothers and children, but persistent problems of anemia (lack of iron) remain. More than half of all women are anemic, as are 75 percent of children younger than 5. Donor organizations in Ghana, including World Vision, have a long history of outreach programs designed to educate expectant and new mothers about how improved nutrition can make pregnancy safer and healthier and help their children get off to the best possible start in life.

In cooperation with the Ministry of Health’s Ghana Health Service, World Vision designed an innovative Behavior Change Communication (BCC) education program. It has been successful because it uses traditional communication means at both the village and district levels. Mothers themselves have proven to be very effective messengers. Mother-to-Mother support groups—such as the one Bleggi visited at a health center shared by two villages—can educate and, at the same time, help create new nutrition advocates in villages.

A question and answer session on how nutrition is valuable. (Photo by Scott Bleggi/Bread for the World Institute)

Ghanaians use song as a way of communicating socio-cultural history and as an educational strategy. Once a song is learned and sung a few times, people can convey and reinforce the information in the song’s verses simply by singing the song again or teaching it to others. Ghana Health Service works with traditional birth attendants in villages—who are usually highly-respected older women, often grandmothers—and with community volunteers, who may be fathers or other family members. World Vision trains Community-based Surveillance Volunteers who both educate others in their communities and report key health-related data to a district-level coordinator. With widespread use of cell phones, the volunteers can quickly report in and receive further training. They work throughout rural communities, encouraging prenatal health care and helping with important postnatal practices such as exclusive breastfeeding and proper nutrition for both moms and babies.

In Saltpong-Biriwa, located along the coast 150 kilometers from Accra, an active group of more than 60 mothers who have newborn babies or children under 2 meets regularly at the community health center. These well-attended gatherings offer an opportunity to socialize, exchange ideas, and learn about health, nutrition, and health care. During Bleggi’s visit, the group sang “the breastfeeding song” for him. The Behavior Change Communication messages—aka the verses of the song—are: practice exclusive breastfeeding (no other food or drink) for 6 months; begin breastfeeding within 30 minutes of the birth; breastfeed because it provides all the nutrition a baby needs; and give babies the best start in life by breastfeeding.

110927_Scott2 The village birth attendant is an older mother who commands great respect and is an excellent message giver.

Nutrition improvements are a key part of the U.S. government’s Feed the Future and Global Health initiatives. The Scaling Up Nutrition or SUN movement and the 1,000 Days Partnership encourage national governments and civil society organizations to ramp up nutrition programs—with an emphasis on maternal/child nutrition from pregnancy through the child’s second birthday. In Ghana, there is a well-coordinated effort that includes support from the U.S. government (through the U.S. Agency for International Development, USAID) and other donor governments; leadership and support from the Ghanaian government; educational and other programs planned and implemented by civil society organizations around the country; and local communications and data collection from a network of grassroots volunteers. The result is a remarkable improvement in nutrition and women’s health.

World Vision has been working in Ghana since 1979 on food security and nutrition programs. Past projects have had significant results—for example, World Vision’s Micronutrient and Health (MICAH) project, which ran from 1997 to 2005, reduced wasting (a child too thin for her height) in children under 5 by 13 percent, stunting (a child too short for his age) by 4 percent, underweight (children who weigh too little for their age) by 11 percent, and anemia by 44 percent from baseline measures.

Following Ghana’s example—with government leadership, communication and collaboration at all levels of program implementation, and volunteers who reinforce and sustain nutrition and health messaging—could put many more countries on track to meet Millennium Development Goal 1, to radically reduce hunger and malnutrition.



Derek Blog Profile

Good News Out of Africa

110920-ghana1Photo credit: World Soy Foundation

Ever feel like we never hear good news about Africa? Well, some countries are doing their best to encourage policies that help small farmers and improve the diets and nutrition of their citizens. The result is a remarkable improvement in reducing hunger and poverty that has a few countries on track to meet the ambitious target of U.N. Millennium Development Goal 1--cutting hunger in half by 2015.

Over the next two weeks, Bread for the World Institute senior policy analyst Scott Bleggi will be traveling in two of these countries, Ghana and Tanzania. He is looking at progress and challenges in maternal and child nutrition policies, how the U.S. government is encouraging these policies in its Feed the Future and Global Health Initiative development assistance programs, and how local civil society organizations are supporting nutrition efforts and, in the longer term, preparing to sustain nutrition programs when assistance ends.

His first report comes from the West African country of Ghana, whose former president succeeded Bread’s own David Beckmann as World Food Prize laureate. Former Ghanaian President John Kufuor shares the 2011 World Food Prize with former Brazilian President Lula da Silva for their efforts to reduce hunger and poverty in their countries by modernizing agriculture.

As recently as 10 years ago, a significant percentage of women and children in Ghana were undernourished. Building food security by improving agricultural production, processing, and storage helped reduce hunger in Ghana from 34 percent of the population in 1990 to only 4 percent in 2004. Better agricultural policies also cut the poverty rate nearly in half between 1990 and 2008—from more than 50 percent to 26.5 percent.

What led to such remarkable success? According to the World Food Prize, it’s “visionary leadership.” The Prize was created to recognize those who “improve the quantity and quality of available food.” President Kufuor’s improvements in economic and educational policies not only increased the quality and quantity of food, but raised farmers’ incomes, improved children’s nutrition, and put more children in school.

Ghana’s school feeding program is an example of public-private partnership on nutrition. U.S. development assistance plus donations from U.S. soybean farmers gave the program its start.

The Adventist Development and Relief Agency (ARDA) was an early contributor to the program, leveraging donations and building a processing machine that provides schoolchildren with soy milk and other nutritious products from locally-grown soybeans. The World Soy Foundation, based in Missouri, was another contributor, working with ARDA to help organize nutrition and health training for teachers and students. The result?  A 33 percent increase in enrollment and a 20 percent increase in school attendance.

The U.S. government’s Feed the Future initiative, managed by USAID, is designed to improve the livelihoods of small farmers and to improve the nutrition of women and children—especially during the critical 1,000-day nutrition “window of opportunity,” from pregnancy through age 2. Equally important, Feed the Future works to build local capacities and enable local organizations to sustain the programs after donor funding ends.

Successful efforts such as those in Ghana give people in neighboring countries encouragement and hope that they too can give their families and communities access to “more and better” food.

U.N. and Civil Society Focus: Saving the Lives of Women and Children

Tomorrow, September 20, the United Nations will hold a High-level Plenary and Dialogue for the Every Woman, Every Child initiative. It’s the first anniversary of this initiative designed to save 16 million women and children from premature deaths.

Heads of state, civil society representatives, private sector organizations, and celebrities will be among those participating. Watch the plenary session streamed live tomorrow from 4 p.m. to 6 p.m., follow events on Twitter, or read the latest updates, such as the World Health Organization’s report on a significant reduction in newborn mortality since 1990.

Bread President David Beckmann and other civil society leaders are in New York for meetings surrounding the High-Level Plenary and Dialogue. Beckmann will attend a special event to mark the first anniversary of 1,000 Days: Change a Life, Change the Future, the early childhood nutrition effort launched by Secretary of State Hillary Clinton and then-Irish Foreign Minister Micheal Martin at last September’s U.N. Summit on the Millennium Development Goals.

Bread and others who support the effort emphasize the critical importance of nutrition from pregnancy through a child's second birthday. Malnutrition during these first 1,000 days of life causes irreversible damage. On June 13, 2011, Bread for the World Institute and Concern Worldwide hosted "1,000 Days to Scale Up Nutrition: Building Political Commitment," a meeting held in Washington, DC, to strengthen support for the 1,000 Days effort. The meeting drew nutritionists and other advocates from developing countries—many of them part of the Scaling Up Nutrition (SUN) network—who are working to expand the use of best practices to improve early childhood nutrition.

After the meeting, participants representing civil society organizations in developing countries issued “The Moment Is Now: Civil Society Statement on Scaling Up Nutrition” (download statement). The statement emphasizes five principles for action: national governments must lead the way; scaling up nutrition efforts is imperative; international leadership is needed; human capacity must be built; and accountability is paramount.

At last count, 59 organizations have endorsed the statement, committing to “work together to support, to encourage, and to mobilize robust action and necessary resources to scale up nutrition.” Doing so will save the lives of many young children and prevent others from suffering needless damage to their health and development.

Read Bread’s and Concern’s summary of the meeting or watch any or all of the presentations on Bread’s website.




The End of Immigration from Mexico

20110909_ForAndrewsBlogPost (2)

Demographic shifts in Mexico mean that over the long-term fewer young people – like these high schoolers in San Miguel Huautal, Oaxaca - are entering the workforce. This also means that fewer young Mexicans who can't find jobs will choose to go to the United States. Photo credit: Laura Elizabeth Pohl

While Washington has focused on jobs and the budget this summer, there’s been a subtle but undeniable shift in the national immigration discussion.  

Traditionally, the United States has focused on two poles in its immigration discourse:

1) How do immigrants damage or enhance the economy and culture?

2) How do we either keep unauthorized immigrants out, or better integrate them into our economy and society?

We don’t see as much meaningful analysis of the international causes of unauthorized immigration or of the links between underdevelopment in Mexico (the source of almost 60 percent of all unauthorized immigration) and migration to the United States.

But that’s changing.

In July, The New York Times launched a series, “Immigration Upended,” whose first article argued that a mix of factors in Mexico—including lower birthrates and better educational and economic opportunities—have significantly slowed the flow of immigrants to the United States. The article states that in 2010, fewer than 100,000 unauthorized immigrants from Mexico settled in the United States, down from more than 500,000 per year in the 2000s.

It may be difficult to envision in the current political climate but one day the flow of unauthorized immigration from Mexico is going to end or at least decline steeply. And the cause may not be a U.S. legislative change. It certainly won’t be border enforcement. Demographic changes are already playing a significant role, helped along by moderate improvements in Mexican poverty rates.

As recently as the 1970s, Mexican women were having an average of seven children. In 2010, the average was less than two children. Because population growth is slowing, the population is aging. There are fewer Mexican young people entering the workforce—so there are also fewer who can’t find adequate jobs and therefore choose to go to the United States.

If Mexican demographic trends continue, in 20 or 30 years the United States may be negotiating how to entice Mexican laborers to supplement our own shrinking workforce.

But we are not there yet.

When it comes to the causes of the decrease in unauthorized immigration, the Times article underestimates the impact of the current U.S. recession and overstates the impact of economic development in Mexico over the past 10 to 15 years.

Mexico has been successful in decreasing poverty rates since 2000, but about 40 percent of the population (roughly 50 million people) continues to live in moderate or severe poverty. There is still a large group of potential immigrants waiting in Mexico for the U.S. economy to improve.

We will know whether changes in Mexico have truly had a significant effect on immigration flows only when more low-skill jobs become available in the U.S. economy. If immigration doesn’t begin to increase again once there are unfilled jobs in the United States; that will better indicate the actual impact of factors within Mexico.

It is the combination of negatives in the United States (the recession, anti-immigrant laws) and socioeconomic improvements in Mexico (decreased poverty, increased education, lower birthrates) that have eased migration pressures.  

But it’s great that publications like The New York Times are paying attention to socioeconomic changes in Mexico and their impact on immigration rather than focusing only on the domestic debate.  Over the long run – and independent of powerful demographics trends – significant, sustainable reductions in poverty in Mexico have the potential to slow unauthorized immigration.

Note: Bread for the World has not taken a legislative position on the issue/issues covered in this blog post.

+Watch a video on migration and poverty in rural mexio on the Bread Blog

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