PANEL 1.1 TYPES OF NUTRITION INVESTMENT LAWRENCE HADDAD
B
ecause a person’s nutrition status depends on a range of immediate, underlying, and basic determinants and their interactions, nutrition investments may take various forms to address these determinants. Nutrition-specific programs address the immediate determinants of nutrition sta- tus (such as inadequate diet and disease bur- den) and are found in a range of policy areas, such as health, humanitarian relief, and food processing.1
Nutrition-sensitive programs and approaches address the underlying deter- minants of nutrition status (such as food
security, health access, healthy household environment, and care practices) and are found in a wide range of policy areas (such as agriculture; education; water, sanitation, and hygiene; social protection; women’s empowerment; and health). They incorporate explicit nutritional goals or actions, although improved nutrition is not necessarily their pri- mary goal.
Enabling-environment investments address the basic determinants of nutrition status such as governance, income, and equity. These investments take the form of laws, regulations, policies, investments in economic
growth, and improvements in governance capacity.
Most investments in actions to address the underlying and basic determinants of nutrition status are not nutrition sensitive—in other words they do not incorporate explicit nutritional goals or actions—but they can be important drivers of nutrition improvement. Efforts to improve nutritional status can come from all three areas. The aim should be to find the most potent blend of them, at scale, given the need, capacities, and political opportunities in each context.
Throughout the report we focus on the need for action on
a broad number of fronts if nutrition status is to improve rapidly and sustainably. We use case studies from Bangladesh, Brazil, Burkina Faso, Indonesia, the Indian state of Maharashtra, the United States, and the United Kingdom to show what can be accomplished when action occurs in different sectors. Case studies in this report and elsewhere show that there is no magic recipe for multisectoral action (Garrett and Natalicchio 2011). Nutrition-specific and nutrition-sensitive programs, together with changes in the underlying determinants and the enabling environment, all have important roles to play. When they come together in a virtuous circle, they can lead to significant improvements in people’s nutrition status. It is vital that national leaders and the nutrition community have a strong vision for the nutrition goals they want to meet and a focused plan for how to do it. But the focused plan needs to be open to all possible actions and combinations of actions.
The report uses a simple accountability framework to guide its work. The framework is based on recent publications on nutrition accountability (Kraak et al. 2014; te Lintelo 2014). The
accountability cycle involves identifying commitments, track- ing progress against commitments, determining accountability (were commitments met?), understanding how the account- ability information is being used (for example, to leverage new commitments), and describing how various actors respond to the assessment of accountability. Data and associated capacity gaps that are barriers to needed action are highlighted at the end of each chapter.3
The conceptual framework is summarized in Figure 1.1.
THE REPORT—FROM DOCUMENT TO INTERVENTION The stakeholder analysis4
that was conducted to shape the pur-
pose and content of the report concluded that it should do four things above all others: (1) be an active intervention rather than merely a report; (2) constantly seek to support nutrition champi- ons and their allies at the national level; (3) focus on all forms of malnutrition, not just undernutrition, and (4) support the efforts of other nutrition reporting processes rather than duplicating or competing with them.
TABLE 1.1 AUDIENCES FOR THIS REPORT: INDIVIDUALS, ORGANIZATIONS, AND NETWORKS Champions
Current Focused on improving nutrition outcomes
Willing and able to work with those outside nutrition to further nutrition status
Willing and able to exhibit leadership on nutrition Future Source: Authors.
Next generation of nutrition leaders Some current allies
Those who have a vested interest in improved nutrition status but who may not be fully aware of that
Allies
Already work with nutrition champions in win-win partnerships to further their own sectoral goals through increased attention to nutrition
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GLOBAL NUTRITION REPORT 2014
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