8 We exclude zinc supplementation for diarrhea from the analysis in the table because its coverage is so low. For the remaining five interventions and practices, we use a conservative coverage level of 50 percent for each.
9 For children under five, WHO/UNICEF define MAM as a weight-for- height Z-score < −2 standard deviations (SD) but > −3 SD. SAM is defined as a weight-for-height Z-score of < −3 (severe wasting), mid-upper-arm circumference of < 11.5cm, bilateral pitting edema, or marasmic kwashiorkor (both wasting and edema). The definition appears at
http://www.unicef.org/nutrition/training/2.3/13.html.
10 Wasting is defined as a weight-for-height Z-score of < −2 SD.
Panel 5.1 1 The Coverage Monitoring Network is a multiagency initiative co-funded by the European Commission’s Office for Humanitarian Aid and Civil Protection and the Office of Foreign Development Assistance of the US Agency for International Development. It is designed to improve nutrition programs by promoting high-quality coverage assessment tools, capacity building, and information shar- ing. For more information, go to
www.coverage-monitoring.org.
CHAPTER 6 1 There are few econometric analyses of the underlying drivers of obesity across a wide range of countries, and they tend to focus on income, urbanization, and food prices (for example, Font et al. 2010; Popkin et al. 2012; Ruel and Alderman 2013).
2 We aim to focus on social protection, education, health systems, and women’s empowerment programs in future Global Nutrition Reports.
3 See Technical Note 3 at
www.globalnutritionreport.org for details on methodology. More work needs to be done to understand whether this indicator adds value and whether it should be presented in future Global Nutrition Reports.
4 As with anemia prevalence, coverage data for water, sanitation, and hygiene are modeled, and therefore estimates (not data) are available for each country.
5 In addition, it is not clear how improved the “other improved” sources are. WHO and UNICEF (2014) defines “other improved” as the “number of household members living in households using public taps or standpipes, tube wells, protected springs, or rainwater collection.”
6 The rate can be much higher than 100 if there is extensive grade repetition, so an optimal rate is just above 100.
7 Spending data on water, sanitation, and hygiene are difficult to find. The Government Spending Watch (2013) report found data for only 30 countries. The report states:
Due to the difficulty of disaggregating water and sanita- tion spending at country level, this GSW report therefore assesses country progress against an overall target of 1.5 per cent of GDP. Planned spending is well below this target in most countries, as Figure 3.21 shows. Of the 30 countries for which GSW has data, seven (Cambodia, Lesotho, Mozambique, Niger, Samoa, the Solomon Islands, and Tanzania) have recently spent more than 1.5 per cent of GDP on WASH. However, nine others (Central African Republic, Côte d’Ivoire, Ghana, Guyana, Haiti, Madagascar, Liberia, Papua New Guinea, and the Gambia) are spending much less than 0.5 per cent of GDP (the amount needed for sanitation alone) on all aspects of WASH. (p. 39)
8 USAID (2013) provides a good review of how to bring water, san- itation, and hygiene into nutrition programming, but we have not found guidelines on accomplishing the inverse—that is, bringing
ACTIONS & ACCOUNTABILITY TO ACCELERATE THE WORLD’S PROGRESS ON NUTRITION 93
nutrition into water, sanitation, and hygiene programming. We wel- come information on any such guidelines: globalnutritionreport@
ids.ac.uk.
Panel 6.2 1 For India between 1999 and 2006 the decline in under-five stunting prevalence was 5 percentage points, from 51 percent to 46 percent or 0.85 percentage points a year (India, Ministry of Health and Family Welfare 2009). For Bangladesh between 1997 and 2007 the decline was from 59 percent to 43 percent or 1.6 percentage points a year.
CHAPTER 7 1 For more information on enabling environments for nutrition and on governance issues, see Gillespie et al. (2013), Swinburn et al. (2011), and Nisbett et al. (2014).
2 This figure is based on the annual cost estimates in Bhutta et al. (2013a).
3 The 2015 Global Nutrition Report aims to have more to say on this vital issue, but for now Panels 7.1 and 7.2 are useful summaries of the current situation.
4 Nutrition-specific flows are those defined by the Organization for Economic Co-operation and Development’s (OECD) Development Assistance Committee (DAC) Creditor Reporting System code 12240. (Note that this way of classifying nutrition-specific interven- tions is not without problems; see Action Against Hunger 2012). According to the SUN Donor Network (2013):
To be nutrition-sensitive, the actions must fulfill ALL the following criteria: Aimed at Individuals: the actions must intend to improve nutrition for women or adolescent girls or children; AND The project has a significant nutrition objective OR nutrition indicator(s); AND The project must contribute to nutrition-sensitive outcomes, which are ex- plicit in the project design through activities, indicators and specifically the expected results themselves. (p. 2)
Further details of the methodology used by donors can be found at SUN Donor Network (2013).
5 Note that Switzerland is not an N4G signatory although the remain- ing funders are.
6 An official from USAID informed us that USAID reported on disbursements as reported to the OECD-DAC for nutrition-specific investments (excluding school feeding) but not yet on nutrition- sensitive investments because they are still refining their tracking methodology for this area. A World Bank official informed us that given the bank’s large portfolio of projects that disburse money every year, a tally of nutrition-sensitive disbursements—using the methodology adopted by this report—was not available.
7 The N4G commitment document is at Nutrition for Growth (2013).
8 Forty countries that had joined the SUN Movement before Septem- ber 2013 were involved in the self-assessment exercise conducted between April and July 2014. Thirty-seven countries were able to complete and send their reports and scoring.
Panel 7.2 1 This website is
https://sicoin.minfin.gob.gt/sicoinweb/login/frmlogin. htm. To access it, follow these steps: User = prensa, password = prensa, log in, select year, click on “Reportes para la ley de acceso a la información pública,” click on “00818983 Plan del Pacto Hambre Cero,” parameter values = select the period, continue.
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