Developing strategies to end hunger
 

122 posts categorized "Latin America"

Second International Conference on Nutrition: Moving the Discussion Forward

In the 20 years since the first  International Conference on Nutrition (ICN), global awareness of the critical role of nutrition in human development has grown to record levels. Today, the dual problems of malnutrition -- undernutrition and obesity – are the focus of efforts by both governments and private companies. Undernutrition rates have dropped in the intervening years, but obesity has grown to the point where it now kills more than three times as many people as undernutrition. 

The first ICN was seen as an opportunity to bring leading nutrition scientists together with governments to address a growing problem. ICN2, being held this week in Rome, goes further by finalizing the wording of a Declaration on Nutrition, as well as details of its implementation, and seeking the signatures of the governments in attendance.

The proposed declaration is a pivotal document that, after reaffirming commitments made at the 1994 ICN and at World Food Summits, sets out specific plans of action and international targets that will lead to the eradication of all forms of malnutrition. Action items include reshaping food systems through public policy; improving nutrition by strengthening institutional capacity and encouraging collaboration among all stakeholders; promoting initiatives for healthy diets before pregnancy, through the 1,000 days period of early childhood, and in schools; and ensuring that a framework with actions and objectives is integrated into the 2030 global development agenda that will be finalized in the coming year.

Advocates are concerned about the very small role of nutrition thus far in this Sustainable Development Goals (SDGs) process: there are more than a dozen goals and nearly 200 targets, but nutrition is mentioned only once. The declaration also asks the United Nations General Assembly for its endorsement and declares a “Decade of Action on Nutrition.”

Proposing such aspirational goals for ICN2 has led to wide-ranging discussions. Some have criticized the declaration’s lack of accountability and spending targets. Others have criticized its lack of emphasis on nutrition-sensitive issues such as water, sanitation and hygiene (WASH), and a lack of recognition that nutrition directly impacts health interventions.  Another point raised is that in order to make advances in nutrition, there must be economic solutions as well. Critics have also pointed out that in some countries, “donor interest in nutrition is waning.” It is in fact true that scaling up successful nutrition outcomes in a district, region, or country requires multiple-year planning and adequate funding.

One bright spot of ICN2 was Pope Francis adding his voice to the fight against hunger and malnutrition.  

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Pope Francis addresses political leaders at ICN2 Photo credit: FAO

In his apostolic exhortation, Evangelii Gaudium (Joy of the Gospel), Francis said, “We are scandalized” by not having enough food for everyone and the resulting hunger. In his remarks at ICN2 on November 20, Francis said that food, nutrition, and the environment must be viewed as global public issues at a time when nations are more tightly linked with each other than ever before. He admonished global leaders to make sure their pledges to assure food security for all citizens are put into concrete practice, saying that the right to a healthy diet is about dignity, not charitable handouts.

The U.S. government’s commitment to improved nutrition increased when it began to fund the Global Health Initiative (GHI), which is now complemented by nutrition components of the Feed the Future initiative. Recognizing nutrition as a concern that crosses traditional development sectors, USAID adopted and has begun to implement a Multi-Sectoral Nutrition Strategy. Other government agencies and offices have begun working on a Global Nutrition Coordination Plan that will encourage collaboration and hopefully add value to the efforts of individual programs to improve nutrition. Finally, the House of Representatives has introduced H.R. 5656, the Global Food Security Act, which has a primary objective of reinforcing programs that “accelerat[e] inclusive agricultural-led economic growth that reduces global poverty, hunger and malnutrition, particularly among women and children….”

The objectives of ICN2, the policy goals of U.S. government nutrition strategies, and passage of H.R. 5656 are all reachable if we are, in the words of Roger Thurow, “outraged and inspired” to take action on global hunger, poverty, and malnutrition.

Scott Bleggi

The “Third Way” of Women’s Empowerment

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Policy discussions of U.S. development assistance that promote women’s empowerment tend to head in two directions: improving women’s ability to participate in the economy and increasing girls’ enrollment in school.

There’s no question that policymakers should indeed be talking about these dimensions of empowerment. But I wish they’d also talk about what I’ll describe as a “third way”: increasing the share of women leaders in government. Here we scarcely hear a word.

The eight Millennium Development Goals include a goal to promote gender equality and empower women. One of the targets is to increase the percentage of women in national parliaments to 33 percent. Globally, women currently hold about 25 percent of seats in national parliaments. Given that women are half the population, I think it’s fair to say that they are still grossly underrepresented in government leadership. In addition to the obvious injustice here, there are implications for efforts to end hunger and poverty. Experience worldwide shows that when women gain a larger share of political power, governments enact more policies that reduce gender inequalities and promote women’s empowerment.

Earlier this year I was in Rwanda, the only country in the world where women hold a majority of the seats in the national parliament. Sixty-three percent of Rwandan parliamentarians are women. One way countries have increased the share of women in parliament is by reserving a fixed percentage of seats for women. These countries include Rwanda, which reserves 30 percent of seats for women. But in the last three election cycles, women’s share of parliamentary seats has increased from 49 percent to 56 percent to 63 percent. Clearly, it’s more than the reservation policy that has brought a majority female parliament to Rwanda.

I went to Rwanda because I wanted to see the effects on policy development of having a majority of women in parliament, and I guess I wanted also to test my own assumptions about women’s leadership. I tend to think that the fastest way to reduce gender inequality and promote women’s empowerment is to elect more women to office. I’m all for improving women’s ability to participate in the economy and increasing enrollment rates of girls in school, but those are part of the longer-term strategy. A reservation policy allows a society to put gender equity on the fast track by giving a jolt to the status quo.

Having a female parliamentary majority has made Rwanda a more equitable society. For example, all proposed legislation is reviewed to determine whether it perpetuates or reduces gender bias. No piece of legislation that moves through parliament escapes this scrutiny. That’s the kind of jolt I’m talking about.

In the 2015 Bread for the World Institute Hunger Report, When Women Flourish…We Can End Hunger, we recommend that all U.S. development assistance include similar gender analysis – aimed at ensuring that policies and programs do not perpetuate gender inequalities or discriminate against women and girls. In practice, this would mean, for instance, that agricultural development assistance must serve female and male farmers equitably.

A major change like this might even produce a great enough seismic effect to affect how the U.S. government conducts domestic policy. Here in the United States, women hold less than 20 percent of seats in Congress. In the 1970s, when Congress was debating the Equal Rights Amendment, policymakers considered congressional reservations as a way of giving women more political voice. This was not the sole reason the ERA failed to gain ratification, but an association with the ERA may be one reason we scarcely ever hear members of Congress -- including women -- talk about political reservations as a strategy to increase the share of women in Congress.

It is difficult to imagine what the impact on legislation of a female majority in Congress would be. Perhaps there would be no difference at all, although I doubt it. There is too much room for improvement. Just one example: the United States remains the only developed country in the world that does not offer paid maternity leave. I suspect that would change if there were a majority of women in Congress. Todd Post

Benefits of Addressing Neglected Tropical Diseases and Malnutrition in Tandem

(Blog was originally submitted to the Sabin Vaccine Institute and the Global Network for Neglected Tropical Diseases in support of their policy brief Toward a Healthy Future: Working Together to End Neglected Tropical Diseases and Malnutrition, endorsed by 22 global health organizations)

Nutrition is a foundational element in human development, and a growing body of evidence shows that it is a vital link across international development sectors. Although nutrition was once solely the domain of public health professionals, development assistance practitioners in agriculture, education, gender, and water/sanitation/hygiene (WASH) are realizing that their successful project outcomes can have a direct and positive effect on nutrition.

Does a value-chain project in horticulture or livestock production improve nutrition? What about efforts to keep girls in school an extra year or two before they assume family and village responsibilities? Does improved hand-washing and food preparation hygiene improve nutrition?  The answer to all these questions is a resounding yes!

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WASH activities are nutrition-sensitive! Photo credit: Sabin Vaccine Institute

The number of people in the world affected by at least one of the 17 NTDs listed by WHO is approaching 1.5 billion, and we know now that NTDs can damage a person’s nutritional status at any point in life. Worse, contracting an NTD can cause infection and other problems that cancel out or even reverse efforts to improve nutrition.

As nutrition started to be at the core of development assistance across sectors, it was clear that a comprehensive strategy to coordinate efforts was necessary. In May 2014, USAID announced its Nutrition Strategy. Bread for the World Institute participated in its development, along with other members of the nutrition stakeholder community (advocacy and operational partners of USAID).

The nutrition strategy recognizes the essential role of nutrition in human development (especially during the “1,000 Days” period from pregnancy to age 2). Moreover, the strategy acknowledges that high rates of chronic malnutrition can cause significant losses in a nation’s GDP and impose other economic costs. The USAID strategy also lays the foundation for the development of a comprehensive Global Nutrition Coordination Plan among all U.S. government offices.

The strategy treats nutrition as “multi-sectoral”-- meaning that effective nutrition interventions can be made not only in health programming, but also in agriculture, education, and WASH projects. The most important direct nutrition interventions include 11 “essential nutrition actions” articulated by the World Health Organization and identified as particularly effective in fighting malnutrition in the research published in the Lancet Maternal and Child Nutrition series. Indirect nutrition actions are nutrition-sensitive activities that target the underlying causes of undernutrition, and direct interventions can be complemented by indirect nutrition actions for maximum impact. In fact, combining direct and indirect actions by “bundling” projects that include both has been found to be the most effective development investment a country can make.

USAID is committed to the World Health Assembly 2025 Nutrition Targets and is developing additional nutrition targets it will use to track and evaluate its development assistance. Included in these is a target in Feed the Future of reducing stunting  by 20 percent in five years in regions where this initiative has programs.

Companion legislative bills have been introduced in the Senate and the House that would authorize Feed the Future as the government’s primary program for global food and nutrition security. Despite recent improvements reported by FAO, there are still 805 million chronically undernourished people in the world. With legislation, we can solidify U.S. leadership in fighting hunger and malnutrition, build and improve upon vital work that has been done, and leverage a government approach across all sectors and programs to meet specific goals for progress against global hunger and malnutrition.

Scott Bleggi

Long-Term Solutions to the Child Migration Crisis

Mother & Child Nutrition

Photo by Joseph Molieri/Bread for the World

The child migration surge is out of the headlines and the number of children reaching the U.S. border has decreased dramatically, but the three nations of Central America’s Northern Triangle continue to grapple with violence and poverty. It may be only a matter of time until history repeats itself, because the root causes of unauthorized migration for both children and adults remain unchanged.

At the height of the crisis, Congress granted U.S. government agencies such as the Department of Homeland Security’s Customs and Border Patrol and the Department of Health and Human Services’ Office of Refugee Resettlement increased flexibility in spending previously allocated funds to respond to the crisis. So far, however, Congress has not approved Obama administration requests for additional funding, either for services at the border or for development assistance in the child migrants’ home countries of Honduras, Guatemala, and El Salvador.

Some congressional policy makers continue to seek long-term legislative solutions to the poverty and violence driving migration through increased and more effective U.S. foreign development assistance to the region. Bread for the World supports integrating migration issues into U.S. development assistance, including targeting programs to high-propensity migration regions in Central America and other regions that are sources of many immigrants.

In addition to congressional efforts to build momentum for a comprehensive solution to the root causes of migration from Central America, country-led solutions to reduce insecurity and poverty in the region are emerging. Multilateral organizations such as the Inter-American Development Bank are also involved in these discussions.

One of the plans emerging is the "Plan of the Alliance for Prosperity in the Northern Triangle." This plan was announced in late September 2014 by Secretary of State John Kerry and the foreign ministers of Guatemala, Honduras, and El Salvador during the UN General Assembly meeting in New York. It includes a plan by Central American governments to boost economic growth in the region and reduce unauthorized immigration to the United States.

So far few details of the plan have been made public, but the focus on the “root causes” in migrants’ nations of origin is a promising first step -- both in responding to the poverty and violence that drive child and adult unauthorized migrants from Central America to the United States and in engaging all countries involved in doing their part. It will take the engagement of both the United States and Central American nations to help solve the socioeconomic problems driving immigrants north.  Andrew Wainer

On the Way: The 2015 Hunger Report

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On November 24, which is the Monday of Thanksgiving week, Bread for the World Institute will launch our 2015 Hunger Report: When Women Flourish … We Will End Hunger. Just before Thanksgiving is when we launch each new edition of the report. What better time of the year in the United States to draw attention to hunger?

In the coming weeks, as the launch approaches, I plan to preview the report on this blog. I’ll share a little of what’s in the report and offer some personal reflections. I write most of the report, but I don’t get the opportunity within it to discuss how writing it has affected me.

When Women Flourish is about women’s empowerment, and why women’s empowerment is so important to ending hunger. The last several editions of the Hunger Report also had plenty to say about women’s empowerment, but this is the first one where we’ve put the issue front and center.

Hunger persists mainly because poverty persists. To really eradicate hunger, you have to address the root causes of poverty, and discrimination is the most fundamental of all root causes. Discrimination defines who we think people are and what we believe they are worth. It determines the limited aspirations that too many parents have for their daughters. If girls are seen as an economic burden to a family, for example, it is not surprising that they die in greater numbers than boys as a result of underinvestment in their health -- including the share of food they receive.

Ending hunger ultimately depends on working with and through women: in the developing world, women work predominantly as subsistence farmers, and subsistence farming is the backbone of community food security. In addition, at the household level, women are responsible for preparing the food that nourishes children and other family members. (This holds true for the most part in rich countries, too).

Yet we did not want to instrumentalize women – seeing and talking about them only as foot soldiers in the fight against hunger. Empowerment is about much more than food production and preparation.

Similarly, discrimination is about more than just gender discrimination. Race, ethnicity, religion, caste, and other drivers of social exclusion also figure into who goes hungry and who doesn’t. We could have done a report focused on race, ethnicity, or any other layer – they all interact. But in this report, we start with gender.

The report looks at three fundamental topics: improving women’s bargaining power in the economy and in the household; reducing the burden of unpaid domestic work and sharing it more equitably between men and women and between families and government; and strengthening women’s collective voice by increasing their political representation and leadership in civil society. I’ll write more about each of these in the coming weeks. For the remainder of this blog post, I’d like to offer a personal reflection.

I learned a great deal while working on the 2015 Hunger Report, as I do on each edition, but on this report there were some real jaw droppers. Let me single out child marriage. When I learned that one out of nine girls around the world becomes a child bride – that’s 39,000 per day -- it was a moment when amazement doesn’t seem too strong a word.

Why was I so surprised? Maybe because child marriage isn’t a big issue here in the United States. I was already aware of the grotesque levels of gender-based violence, the one in three women who will experience it during their lives. Gender-based violence, on the other hand, is also common right here in the United States as elsewhere, so even though the statistics are still disturbing and I wouldn’t say I’ve become indifferent, there’s a certain degree of numbness that sets in after time.

The child marriage figure one in nine is for the whole world, so when you zero in on the countries where this is a common occurrence, you find statistics like three out of four girls in Niger, two out of three in Bangladesh, and one in two in India. Most countries where child marriage is prevalent have laws against it, but changing cultural norms is not as simple as changing laws.

Five years ago, I was in Bangladesh visiting an agricultural program and talking with beneficiaries. The program officer brought me to the farm of probably the most successful farmer in the village. She was not only an able farmer but clearly had charisma. She was probably no more than 30 at the time, and her daughter, a girl about half her age, walked with us by her mother’s side. Behind us was a much older man, over 60 at least, possibly beyond 70. He had trouble keeping up. Only when we stopped and she described what she was doing on each part of the farm did he catch up, standing quietly off to the side until we charged on ahead again. He was her husband. The word marriage doesn’t seem to fit this situation, though. Given the age of their daughter, the farmer could have become this man’s wife when she was as young as 12 or 13. Find out more about child marriage and the damage it does here. Todd Post

World Food Day 2014: A Clearer Look at Climate Change

  Photo for World Food Day 2014

This year's World Food Day focuses on supporting and strengthening the 500 million smallholders growing food in developing countries, including Joao, a maize farmer in Mozambique. Photo by Kate Raisz.

Over the past few years, most lists of global problems have come to include climate change -- along with older concerns such as hunger, poverty, limited resources, and population growth. It often appears to be simply another challenge on the list. But although our mission of ending hunger requires facing and overcoming a number of challenges, climate change is different from other problems.

We can't make an "apples to apples" comparison between climate change and longstanding human problems. Climate change is much more like an apple tree than simply an apple among other apples. If we don't find ways to prevent further damage to Earth's climate and to mitigate the impacts that poor communities in particular have already been suffering for years, it will not matter nearly as much what we do about individual apples. Responding effectively to the dangers of climate change (improving the health of the tree, if you will) is a precondition for responding effectively to any other development challenge.

As we mark World Food Day (and, bracketing today, the three-day Borlaug Dialogue in Des Moines, Iowa), I've been thinking about the concept that language shapes our reality. What people think about the importance and urgency of climate change depends partly on how we talk about it. For example, when the administration launched its Global Alliance for Climate Smart Agriculture last month, it said that climate change poses "a range of unprecedented threats to the livelihoods of the world’s most vulnerable people..." [emphasis added]. By definition, "unprecedented" can only be used once for any given category of events -- otherwise, it's just hyperbole. It's a word that should catch people's attention, information overload notwithstanding.

The evidence shows that human activity is causing the changes in the world's climate that are now so readily observable. Climate change must be an urgent global priority for the foreseeable future if we are to contain the damage we have already caused to the planet that sustains us.

One pressing need is for communities to be able to access data on climate issues specific to them, so that they can make informed decisions at the local level. This is a relatively neglected middle ground between global- and continent-level data, and a myriad of anecdotal accounts from people who are witnessing climate change firsthand.

Three U.S. agencies, including the National Aeronautics and Space Administration (NASA), are making available higher-resolution elevation datasets based on information collected by sensors on the U.S. space shuttle. Datasets for Africa have been released and are available at the USGS’s Earth Explorer website. Datasets for Latin America are to follow in the coming months. 

Designed "to empower local authorities to better plan for the impacts of severe environmental changes," the data resolves to 30 meters (compared to the 90 meters that was the clearest previously available) and will be used to "improve environmental monitoring, climate change research including sea-level rise impact assessments, and local decision support."

Of course, better data alone will not enable local leaders to solve a global problem with roots in faraway developed countries. But equally obviously, informed decision-making requires information. Climate change is enormously complex. Distilling what is happening in particular locations will help support country ownership of a global problem.

Michele Learner

 

Teenage Wives Are Girls Too

Photo for 2014 Day of the Girl

Photo by Laura Elizabeth Pohl/Bread for the World

Two years ago, on the eve of the first-ever United Nations Day of the Girl, 15-year-old schoolgirl Malala Yousafzai was in the hospital. We reported here on Institute Notes on her courageous advocacy for girls' education in Pakistan -- advocacy that so angered conservative Taliban forces that, in a now world-famous act of barbarism, they shot her in the head at point-blank range.

Tomorrow, October 11, we celebrate the third Day of the Girl. Things have changed. Malala Yousafzai has just been named a a Nobel Peace Prize laureate. Her work has galvanized support for adolescent girls denied the right to go to school. World outrage greeted the abduction of nearly 300 Nigerian schoolgirls by another reactionary armed group, Boko Haram. The global rate of girls' enrollment in secondary school is catching up to boys' enrollment, at between 97 and 98 girls for every 100 boys.

Also in recent years, there has been an intensified global campaign against child marriage, an all-too-common form of gender-based violence. An unwitting activist even younger than Malala published a book about her story, I Am Nujood, Age 10 and Divorced. Media coverage of girls who have fled marriage has become more frequent. Numerous education and advocacy campaigns have helped communities understand that the poverty that often leads them to arrange for their young girls to marry much older men is only being perpetuated by child marriage, and have supported them in finding alternatives.

Poor communities cannot afford the waste of human potential when a 13-year-old becomes a mother rather than studying algebra in a junior high school. She has a much higher chance of dying in childbirth --as a girl under 15, her risk is five times that of a woman older than 18. She and her surviving children are far more likely to be malnourished than women who married as adults. As we have said many times here on Institute Notes and in our other materials, education for girls is the factor that has made the biggest difference to child malnutrition -- it has helped more than having more food available.

They don't seem to get much attention, even on the Day of the Girl, but girls of 13, 14, 15 who are married are girls just as much as their peers who are closing those secondary school enrollment gaps. Very few (estimates are 2 percent) continue to attend school once they are married, and even they drop out once they become pregnant. Prevention of child marriage is, of course, an urgent necessity. So are efforts to help married girls and young women who were married as children regain hope for a better life.

Very often, they are the most isolated from their communities. One way to reach them is through the health sector as they come in during complications of pregnancy and childbirth and afterwards -- for example, with conditions caused by giving birth at an age when a person's body is not yet mature, such as obstretric fistula. Another time when community services can reconnect with married girls is when the teenagers bring their babies and young children in for vaccinations and medical care.

Programs can build on those contacts to put girls in touch with other community services and with each other in support and self-help groups, as well as with programs such as bridge schools that allow them to resume their education to some degree. These efforts exist, but are far more rare than they should be given the world's tens of millions of child wives. On this Day of the Girl, the world should recommit to helping teenagers whose lives, though marred by child marriage, are not over. Barriers can be removed so that they may yet take their places as empowered contributors to their societies.

Michele Learner

 

Child Migration Decreases, But Poverty and Violence Do Not

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Central American child migrants are less likely to be in the U.S. headlines these days, but that doesn’t mean children are not still struggling to get to the United States. It’s just that fewer are reaching the U.S.-Mexico border than during this past June and July.

Almost 60,000 Central American child migrants have arrived so far in 2014, but in recent weeks the number who cross the border has dropped dramatically. The Border Patrol reported that the number of child migrants was 60 percent lower in August than during the height of the migration earlier in the summer.

With the lower numbers comes the key question: Why?

There are probably multiple causes. One may be the weather. There is a seasonal pattern of unauthorized migration to the southwestern United States: the migration of Central Americans through Mexico traditionally drops during the summer because of the extremely hot temperatures in the desert that straddles part of the U.S. –Mexico border. Reports also indicate that heavy rains and flooding along the Mexican-Guatemala border may have deterred some migrants from making the journey in the late summer.

For its part, the Department of Homeland Security claimed that its increased and quickened deportations of adult migrants reinforced the message to Central Americans that unauthorized migrants arriving in the United States will not be given refuge and deterred some from leaving home. The U.S. government also claimed that its public relations campaign in Central America, which advised people considering migration not to risk the difficult journey to the United States, contributed to the decline in unauthorized migrants at the border — although this was questioned by experts who noted the failure of similar past efforts.

Perhaps the most important factor in the decreasing number of Central Americans reaching the border is a crackdown on illegal migration in Mexico. Immigration authorities have stepped up their efforts to interdict and deport Central Americans heading across Mexico to the United States. As a National Public Radio (NPR) report stated, “Under pressure from the United States, Mexico has begun arresting and deporting tens of thousands of Central Americans long before they reach the U.S. border.”

Traditionally, the Mexican government has not stopped Central American migrants en route to the United States, but migrants now report more immigration checkpoints in Mexico’s interior, and the Mexican government announced that it would heavily reinforce its southern border with Central America. NPR quoted one Mexican expert, "We are now the servants of the [United States] in this role."

What does this new role of Mexico as a sort of “buffer state” for the United States in interdicting unauthorized migrants mean for Central Americans trying to reach the United States?

Mexican analyst Sergio Aguayo said that migrants are still fleeing Central America and that the root causes -- poverty, exploitation, and violence -- remain. "It is not a simple issue that can be solved by closing the doors of Mexico or convincing them not to come."

The problem can hardly be considered solved just because it has dropped off U.S. news reports. The first wave of the child migrant crisis has abated without signs of improvement in the poverty and violence that are driving children to flee. In future posts, we’ll examine some of the long-term policy options that Bread for the World supports to improve conditions in Central America so that its people – whether adults or children – are not compelled to leave their homes to survive.

 

Andrew Wainer

Children’s Mortality Cut By Half

A new report, issued by UNICEF along with other U.N. agencies and the World Bank, highlights a dramatic decrease in child mortality. Since 1990, the number of children under age 5 who die each year has been cut in half: from 12.7 million then to 6.3 million now. This is a remarkable achievement that amounts to saving 17,000 lives every day.

Looking at it another way, the rate of decline in child mortality is falling three times faster than previously projected. As a result, 100 million children are alive who would have died if the death rate had remained at 1990 levels—including 24 million newborns that would not have made it more than a few weeks.

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Girls playing in Angola, which still has the world’s highest rate of under-5 mortality. Young children there are 25 times more likely to die than those born in the United States.  © UNICEF/NYHQ2007-1773/Nesbitt

The report, Committing to Child Survival: A Promise Renewed, says that the child deaths over the past 20 years were largely preventable. There were large geographical disparities: where a child was born made a big difference as to whether he or she survived.

Together, sub-Saharan Africa and South Asia were the homes of 80 percent of those who died. In sub-Saharan Africa, one in every 11 children die before their fifth birthday. That is 15 times the death rate in high-income countries, where an average of one in 159 children don’t reach their fifth birthday.

Moving forward, the most important area in which to focus health and nutrition interventions is the first month of a child’s life, which is called the neonatal period. Two million infants die within a week of birth. Some effective and low-cost interventions for both mothers and children are available. These could make a big difference, but sometimes this needs to be communicated to pregnant women, their husbands, their families, and their communities. For example, breastfeeding within an hour of birth reduces the risk of neonatal death by 44 percent—but less than half of newborns around the world have that opportunity.

The “Promise Renewed” of the report title has two goals. The first is to keep the promises of Millennium Development Goal (MDG) 4 — to reduce the under-5 mortality rate by two-thirds between 1990 and 2015, and MDG 5 – to reduce maternal mortality by three-fourths in this time period.  The second goal is to keep moving forward, beyond 2015, until no child or mother dies from preventable causes. In 2012, nearly 180 governments pledged to scale up efforts and speed up the decline in preventable maternal, newborn, and child deaths.

The Institute has written extensively about the MDGs, most recently in a blog about another recent report, the 2014 State of Food Insecurity in the World,  whichconfirms that the goal of halving hunger that is part of MDG 1 is within reach. What’s clear in both reports is that despite recent successes, a concerted effort focused on MDG goals and targets must be sustained. Further country-led development efforts in nutrition, health, and agriculture are key to achieving the goals.

The U.S. contribution to the MDGs is largely made through two USAID programs, the Global Health Initiative (GHI) and Feed the Future (FtF).  Congress has enacted legislation on the President’s Emergency Plan for AIDS Relief, PEPFAR (part of GHI), through which nutrition funding is authorized. FtF currently lacks formal authorization through legislation, but both the House of Representatives and the Senate are considering versions of the Global Food Security Act, which will make FtF part of U.S. law.

U.S. efforts in international agricultural development and nutrition largely focus on the 1,000 Days, the “window of opportunity” between a woman’s pregnancy and her child’s second birthday.  Leading economists agree that development assistance investments here yield a very high rate of return. More importantly, these investments save mothers’ and children’s lives.

Scott Bleggi

 

Fleeing Gender-Based Violence in Central America

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“In Honduras, violence against women is widespread and systematic,” U.N. Special Rapporteur on violence against women, Rashida Manjoo, July 2014

Between October 2013 and July 2014 57,000 unaccompanied child migrants (UAC) arrived at the U.S. southern border. The large majority were from the Northern Triangle nations of El Salvador, Honduras, and Nicaragua. During this time, 22,000 children travelling with at least one parent also arrived from this region. The surge of children – alone and sometimes with a parent – is widely acknowledged as a humanitarian crisis.

Within the broader influx of children and mothers is an even greater increase in UAC girls. Since October 2013 there has been a 77 percent increase in unaccompanied girls going to the United States compared to only an 8 percent increase for boys. Over the same period more than 13,000 UAC Honduran girls under traveled to the United States compared with just over 7,000 for the previous fiscal year. For girls 12 and younger the increase has been even larger – 140 percent.

What would cause parents to go into debt to send their daughters on a dangerous journey more than 1000 miles long – sometimes alone – to the United States? United Nations interviews with child migrants finds that they are typically fleeing a combination of poverty and violence. Among Honduran UACs, the UN found that 44 percent included violence as a reason for migration and 80 percent included work and study opportunities and a chance to help their families.

Some of society’s most vulnerable members – women and girls face additional threats beyond the endemic violence and pervasive poverty in the Northern Triangle. During a recent visit to Honduras, the United Nations Special Rapporteur on violence against women Rashida Manjoo, said, “Violence against women is widespread and systematic. The climate of fear, in both the public and private spheres, and the lack of accountability for violations of human rights of women, is the norm rather than the exception.”

Honduras is the murder capital of the world and presents a dangerous environment for most Hondurans and particularly for the poor. But for women and girls the persistent fear is compounded by gender-driven violence and coercion. Manjoo said the country suffered from “high levels of domestic violence, femicide and sexual violence” with a 263 percent increase in the number of violent deaths of women between 2005 and 2013.

With weak rule-of-law and compromised police and judicial systems there are few options for Honduran women to defend themselves. There’s a laundry list of societal barriers facing women seeking justice: Lack of effective implementation of legislation, gender discrimination in the justice system, and the lack of access to services that prevent future acts of violence are just some of the gaps and barriers Honduran women face. With an estimated 95 per cent impunity rate for sexual violence and femicide crimes in Honduras, it shouldn’t be surprising that Honduran women and girls are compelled to flee the country no matter what the cost

  Andrew Wainer

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