Developing strategies to end hunger
 

Recognizing Nutrition-Sensitive Development Actions

When we look at ways to improve maternal and child nutrition, better availability and access to food first comes to mind.  This has been the traditional response in agricultural development assistance, but evidence has shown that increasing farm yields, while increasing producer incomes, in and of itself will not improve individual and household nutrition status.

If providing more food alone won’t improve nutrition, what other interventions are needed? One is a direct, or “nutrition-specific”, intervention that addresses the immediate causes.  These have been well-defined in the first Lancet Series on Maternal and Child Nutrition, and have a strong evidence base showing their effectiveness. Interventions such as providing micronutrients (vitamins and minerals) such as zinc, iron and iodized salt were shown to have a profound impact on childhood stunting and early childhood death.

The studies also showed that to be effective in the long-term, these interventions needed to be supplemented by improvements in the underlying, or indirect, causes of malnutrition.  Bread for the World Institute published a briefing paper on defining these other types of interventions, and addressing malnutrition through “nutrition-sensitive” development actions. These can take place in multiple sectors, including agriculture. Interventions that address poverty, gender inequality, food insecurity, education, health and access to basic services can all improve nutrition.

An examination of 14 different studies on improving water, sanitation and hygiene (WASH) in ten low and middle-income countries shows that improvements in this area can “slightly improve height growth in children under five years of age”, which is a measure of malnutrition.  Only slightly? Well, that’s disappointing.  Lawrence Haddad reported in his blog that “we shouldn’t give up” on WASH interventions based on this lukewarm report for a number of reasons, including the fact that the study was only 12 months in duration. And the authors stated that “none of the studies is of high methodological quality”.

Latrine
A Peace Corps latrine project in Senegal nears completion.  Photo credit: Charity Water

Are WASH efforts an effective way to improve nutrition? Yes! A number of current studies will add to what are the first data points in an evidence base of nutrition-sensitive development actions.  The evidence base of successful nutrition outcomes based on these actions is being built. According to the second Lancet series on Maternal and Child Nutrition, nutrition-sensitive development actions “have an enormous potential to enhance the scale and effectiveness of nutrition-specific interventions”.

Key to sustaining improved nutrition outcomes is a combination of both nutrition-specific and nutrition-sensitive actions. Identifying, measuring and reporting on them across developmental assistance sectors in overseas projects will quickly build an evidence base of successful nutrition outcomes.

The U.S. Agency for International Development is developing its agency nutrition strategy, one that will eventually grow to be “whole of government”.  Recognizing that many of its global development assistance activities, especially those in the Feed the Future Initiative, already have substantial nutrition-sensitive components should be an important part of developing that strategy.

Scott Bleggi

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