5 posts categorized "Millennium Challenge Account"

Secretary of State Hillary Clinton is poised to sign a five-year Millennium Challenge Corporation (MCC) compact with Indonesia—the first such compact to include a nutrition component, “Community-Based Nutrition to Reduce Stunting.”

More than 35 percent of Indonesia’s babies and toddlers under age 2 are stunted, meaning they have a highly visible sign of malnutrition--being significantly shorter than average children of their age. There is growing global attention to this age group, often called the 1,000 day window between pregnancy and age 2, because the consequences of malnutrition for such young children are death for some and lifelong, largely irreversible damage to the health and development of those who survive. A higher risk of death in infancy and early childhood, increased susceptibility to infection and illness, and impaired cognitive abilities caused by early nutritional deficiencies have been well documented in a growing body of scientific evidence, dating to 2006 with the Copenhagen Consensus and followed by studies done by the World Bank and by a series of studies by the respected medical journal The Lancet. Research has also found that survivors of early childhood malnutrition complete fewer years of school and are less productive on the job, which causes countries long-term economic loss.

 
Photo credit:  USAID

The 1,000 Days Partnership, on which Bread has reported previously, champions new investments and partnerships to improve nutrition during this critical period.  Indonesia recognized that taking action against malnutrition during the 1,000-day window must be a top national priority. Its five-year national development plan called for a program of prevention.

Indonesia is the fourth most populous country in the world, with more than 140 million people living on less than $2 a day. The country’s high prevalence of stunting is a legacy of a health service delivery system that lacks capacity at the local level. The Community-Based Nutrition to Reduce Stunting project will work with communities and health systems to “strengthen the demand for and supply of appropriate services to reduce chronic malnutrition among children.” Designed with the participation of local governments, civil society, and the private sector, it will build on an existing program that involves communities in taking action to improve targeted health, education, and nutrition indicators.  Stunting will be reduced by strengthening community engagement, nutrition and sanitation services delivery, and national awareness and advocacy. The project proposes to reach 1.4 million beneficiaries in rural Indonesia.

The MCC administers Millennium Challenge Account funding. Back in 2002, Bread members were instrumental in persuading Congress to establish the program, which makes multi-year grants to promote inclusive economic growth that reduces poverty. To qualify for MCC funds, countries must be low-income or lower-middle-income (meaning that their per capita incomes are less than about $4,000 a year), and they must satisfy set criteria such as investing in the well-being of their people and fighting corruption.

Bread for the World Institute has long been a champion of increased focus on improving maternal and child nutrition. In our 2009 briefing paper, New Hope for Malnourished Mothers and Children, the Institute noted that the Millennium Challenge Corporation was under-investing in nutrition—especially given the importance of nutrition to economic growth. We are encouraged by Indonesia’s plan for this compact and applaud MCC for taking this important step forward.  We look for additional countries to improve nutrition outcomes, especially in pregnant women and children.

 
  Scott Bleggi is a senior international policy analyst with Bread for the World Institute.

The Institute’s 2011 Hunger Report, Our Common Interest: Ending Hunger and Malnutrition, has just become available online at www.hungerreport.org. The 2010 Hunger Report, A Just and Sustainable Recovery, which had been the default landing page till today, remains available on the site along with the 2009 report, Global Development: Charting a New Course.

Who will feed the future? Nepal is one country where the U.S. will increase investments in agriculture. Photo: Richard Lord

At the 2009 G-8 Summit in L’Aquila, U.S. leadership was instrumental in gaining the commitment of member nations to $22 billion to improve global food and nutrition security. For its part, the Obama administration developed its own initiative, Feed the Future. Bread for the World, along with several U.S. civil society groups, provided input into the design of the program. The 2011 Hunger Report is concerned with events that led to the establishment of Feed the Future and with what it will take for the initiative to succeed.

The report argues that Feed the Future is a bold step forward in U.S. foreign assistance, possibly the best opportunity to come along in decades for the United States to contribute to lasting progress against global hunger and malnutrition. Feed the Future stands out with its dual focus on boosting incomes of smallholder farmers and improving the nutritional status of mothers and children, the groups most at risk of hunger and malnutrition.

The report starts with the spike in food prices in 2007-08 that pushed the number of people who suffer from hunger to more than a billion for the first time in history. Prices have fallen since then and so has the number of undernourished people, but as we are seeing in 2010, grain markets are still quite volatile, and so food prices remain a great concern.

For children born in the poorest parts of the world during the 2007-2008 food-price crisis, higher food prices meant that their families could not afford staple foods let alone the more nutritious foods. A series of articles in the British medical journal, the Lancet, published in early 2008 had immediate relevance, as it pointed out that malnutrition during the window of opportunity during pregnancy and in the first two years of life has irreversible consequences for a child. For children who survive early childhood malnutrition, the physical and cognitive setbacks are lifelong, leaving children more prone to illness throughout their lives and reducing earning potential.  

The 2011 Hunger Report includes several recommendations to strengthen Feed the Future and U.S. foreign assistance more broadly. Feed the Future must take a comprehensive approach to fighting hunger and malnutrition, adopting the following elements: increase the productivity of smallholder farmers, help them reach markets, take advantage of the links between agriculture and nutrition while scaling up evidence-based nutrition interventions (especially for pregnant women and young children), empower women, strengthen safety nets, and respond quickly to hunger emergencies.  

Dr. Rajiv Shah, USAID administrator, described "Our Common Interest" as "The best report I've seen in years on this issue" in remarks at the National Press Club.

Moreover, the report argues, Congress should rewrite the 1961 Foreign Assistance Act to make clear that poverty reduction and development are key elements of U.S. foreign policy and reduce earmarks to ensure that U.S. development assistance has the flexibility to respond to realities on the ground. U.S. food aid should be improved to allow for a greater focus on nutritional quality, especially to reach infants and young children. In addition, the United States should take the lead in strengthening international institutions that are complementary to U.S. bilateral assistance in fighting hunger and malnutrition.

After decades of underinvestment in agriculture, Feed the Future is a refreshing throwback to when agriculture held a much more prominent place in U.S. foreign assistance. But Feed the Future has the potential to be much stronger than earlier U.S. programs. Its focus on country-led development is encouraging, but this must include building the capacity of national governments to sustain the progress begun with foreign assistance, and should also include building the capacity of civil society to hold national governments accountable for what they do with this assistance.

The 2011 report is available online and in print and anybody who wants to order a copy can do so via the website.  The online edition includes everything in the print edition and several other features. The Hunger Report has always been a comprehensive source for data on hunger, poverty and other development indicators. The Hunger Report website allows you to visualize these data. An assortment of information covered in the report is displayed in eye-catching graphics. 

Enjoy the report. Tell us what you think of it. And please, get the word out about it.

In April, The New York Times reported that a Lancet study on global maternal mortality—deaths resulting from the complications of pregnancy or childbirth—had caught the international community by surprise. Looking at new data, researchers from the University of Washington and the University of Queensland found that maternal mortality had declined far more than previously estimated—from 526,300 deaths in 1980 to 342,900 in 2008.

Maternal Health  /  With the right interventions and resources, maternal mortality can be reduced dramatically.

A couple days ago, on September 15—just ahead of next week’s Millennium Development Goals Summit—the World Health Organization, UNICEF, the World Bank, and the U.N. Population Fund released their own updated analysis, which reinforced this new information. Their study found that since 1990, maternal mortality has declined by 34 percent, from 546,000 in 1990 to 358,000 in 2008. Putting the two studies together, it is clear that since 1990 the world has made much more progress in reducing maternal mortality.

Reasons for this progress include increased family incomes that allow for better, lower pregnancy rates, increased education among girls, and better access to healthcare. That’s the good news.

The bad news is that the international community is not on track to achieve the fifth Millennium Development Goal (MDG), to reduce by three-quarters the maternal mortality ratio. According to the World Health Organization/UNICEF analysis, the annual rate of decline in maternal mortality, even with the gains since 1990, is half what it should be—2.3 percent instead of the 5.5 percent that is needed.

The 2010 Millennium Development Goals Report indicates that half of all maternal deaths in developing countries are a result of hemorrhage and hypertension. Indirect causes such as HIV/AIDS, malaria, and heart disease account for 18 percent of maternal deaths.

According to the report, a vast majority of these deaths could be avoided with the help of skilled healthcare providers. But less than half the childbirths in South Asia and sub-Saharan Africa are attended by skilled healthcare attendants. Unsurprisingly, the report points out the huge disparities between rich and poor communities in developing countries in accessing health care, especially in South Asia and sub-Saharan Africa. In these regions, the richest women are five and three times more likely, respectively, to have access to a trained healthcare attendant.

There are also big urban-rural disparities. Only 33 percent of rural women have access to the recommended care in developing countries. In South Asia, that figure drops to 25 percent of rural women.

Education also plays a big role. Women with a secondary education are more likely to delay and space pregnancies, which substantially improve their chances of survival.

There are reasons for hope. The Lancet and WHO/UNICEF studies suggest that progress is possible. With the right interventions and resources, maternal mortality can be dramatically reduced. At the 2010 G8 Summit in Muskoka, Canada, on June 25-26, leaders launched the “Muskoka Initiative,” an effort that will invest $5 billion over five years in maternal and child health, focusing on MDG 4 (child mortality) and MDG 5 (maternal health).

The Obama administration has also launched the Global Health Initiative (GHI), which complements the Muskoka Initiative’s focus on strengthening health systems and on reaching women and girls. It is a new approach that builds on existing successes in the area of HIV/AIDS through the PEPFAR program. The GHI aims to help developing countries build healthcare networks that can focus on the prevention and treatment of specific diseases, but also on addressing crosscutting issues such as malnutrition and risks associated with pregnancy and childbirth.

It’s bright and early, and we are bumping along a busy road on the outskirts of Accra on our way to the village of of Big Ado where we will meet Zuta, a good friend of Jim McDonald. The roads running along the coast seem surprisingly good, and I’m especially struck by the fact that traffic signals seem more mandatory than optional here. We’ve been invited to a church service to celebrate the Harvest. It’s been a good year for many farmers in Ghana, and they are rejoicing.

We pass through the city of Tema, a major port city in Ghana and I am also struck by the amount of industrial business taking place in the city. Tema is busy, and seems to be a good place to do business. I wonder how much of this business minded focus is reflected across the rest of the country.

This question is answered in part in our meeting with Katerina N’Tep, the Country Director with the Millennium Challenge Corporation in Ghana.

Last Friday's New York Times front page story had the ominous title "U.S. Agency's Slow Pace Endangers Foreign Aid". But the article went on to present a nuanced analysis about the delicate balance between the short term concerns of Congress as it puts together a budget for the Federal Government and for foreign aid programs in FY 2008 and the long-term commitment to developing countries through the Millennium Challenge Corporation's country programs.

One of the reforms embodied in the MCC was the ability to provide developing countries with a reliable stream of funding for development projects. This was long overdue recognition that development takes time and the way that U.S. aid programs have traditionally been funded, relying on annual appropriations from Congress, did not allow developing countries to put into place multi-year programs--the kind that are needed for the challenges that face the poorest communities.

As appropriators in Congress are moving to finalize the appropriations bills that will fund the federal government next year, they are searching for places to find savings. Unfortunately they are eyeing the