My first 100 days as the Director of Nutrition in R4D have been exciting. My team and I are exploring promising approaches to reduce global hunger and malnutrition.
And, for me, this journey is personal.
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As a baby, I was breastfed by my grandmother for survival. As a young girl, I attended a school that organized school farms to provide food for the students and income to the school. And as a professional, I have worked in over 20 countries and partnered with village health committees devoted to combating childhood diarrhea, malaria and malnutrition.
These frontline workers are using innovative approaches, including engaging agricultural extension workers to pass messages to farmers on how to improve household diets with foods from their farms and backyard gardens.
Therefore, I have firsthand understanding of the health and nutrition conditions affecting women, children and communities, and I understand the need for approaches that empower change agents at regional and country levels to lead reforms.
This is one of the reasons I was excited to join R4D — our approaches are evidence-based. We aim to build stronger systems, while maximizing opportunities for integration and reinforcing capacities of local and regional change agents.
And we are finding ways to extend the work in nutrition to achieve maximum impact, for example:
- Adapting innovative health financing methods for sustainable nutrition financing
- Creating adaptive and joint learning networks to identify and share what works and what doesn’t
- Integrating nutrition into universal health coverage
- Using market shaping approaches to expand access to affordable quality essential nutrition commodities
We do not need to reinvent the wheel for nutrition. In this blog, I will spotlight three areas of our work.
1. Strengthening a systems-wide approach to the management of acute malnutrition
Wasting remains one of the largest drivers of mortality for children under 5 years old, and it’s responsible for approximately 2 million deaths annually. Effective, evidence-based approaches exist to address this problem, but they must be scaled up immediately.
To help address this challenge, R4D is joining global efforts to implement the UN high-level Global Action Plan on Child Wasting to reduce the high burden of over 45 million children affected by wasting in 2020.
Through the Strengthening Systems for the Management of Acute Malnutrition project, R4D—in partnership with UNICEF, development partners and government stakeholders—will identify and share effective wasting interventions based on lessons learned across several countries and programs.
We are developing resources and tools that provide practical guidance that country governments and partners can use to advance the integration of management of wasting into health systems (keeping in mind country-specific context and priorities) to increase coverage and equity, and improve sustainability and efficiency for wasting programs.
We are also drawing lessons from innovative approaches of R4D programs, such as marketing shaping and health financing, which will enhance the sustainability of wasting integration into routine health services.
Furthermore, in Ethiopia, the Federal Ministry of Health (FMOH), UNICEF and R4D are working in partnership to develop and rollout a wasting integration strategy and plan across all the regions of the country.
The process involves leveraging multi-stakeholder platforms, applying the wasting resources and tools along the building blocks of systems strengthening and aligning with country priorities. Lessons from Ethiopia will be generated for global learning.
2. Examining evidence on food systems policy
The UN term for “food systems” refers to the constellation of activities involved in producing, processing, transporting and consuming food.
Scientists agree that transforming our food systems is among the most powerful ways to change course and make progress toward all 17 Sustainable Development Goals.
Throughout the food system and across government departments, policies have the potential to influence what populations eat, while simultaneously having effects, intended or not, on outcomes related to the economy, the environment, society and health, with potentially large trade-offs or synergies between these dimensions.
R4D is examining available evidence to support policymakers to minimize vulnerabilities, while maximizing health and nutritional outcomes of the food system. R4D’s synthesis of the evidence and topical briefs will contribute to dialogue at the upcoming 2021 United Nations Food Systems Summit (UNFSS).
In partnership with the Centre for Food Policy at City, University of London, and global experts, R4D is also supporting policymakers in taking a food systems approach to food and nutrition-related policies. We are providing resources to support decision-makers in setting up their policy processes, framing the issues, accessing the right technical tools, addressing trade-offs and ultimately adopting and implementing policies that have the potential to effectively reorient parts of their food systems toward healthy diets and nutrition.
To ensure resources are both grounded in the experience and perspectives of relevant stakeholders and responsive to their needs, we convened an Advisory Group consisting of national policymakers, global experts, and stakeholders in March 2021. This group emphasized the multisectoral and multi-stakeholder aspects of the food system, they recommended focusing on entry points in the food system that influence policies such as availability, accessibility, desirability and food safety.
3. Improving the use of data visualizations tools in nutrition
High-quality and relevant nutrition data is needed to understand progress toward reaching the World health Assembly targets to reduce malnutrition. However, nutrition data systems are fragmented and incomplete in low- and middle-income countries. This makes it difficult for governments, development partners and other nutrition stakeholders to access and use data to plan, implement and monitor ongoing efforts and allocate resources.
As part of the Data for Decisions to Expand Nutrition Transformation (DataDENT) initiative, R4D is strengthening the nutrition data value chain, from prioritization of indicators to translation and dissemination for decision-making. R4D’s stakeholder consultations, literature reviews and data search are revealing innovations and promising opportunities for nutrition practitioners, investors and data partners.
In addition to our global work, DataDENT has collaborated with the Nigeria Governors Forum (NGF)—a non-partisan policy-hub dedicated to promoting good governance and development at the sub-national level—to develop the NGF Nutrition Scorecard that will hold the state governors accountable to key nutrition commitments and motivate them to act.
The scorecard was launched in April 2021 in a meeting of governors from the 36 states. In this recently published blog, we share key takeaways from the scorecard design process, including:
- Start with a clear theory of change, including an explicit understanding of who the target user group is and how the tool will influence their actions;
- Select indicators that reflect the quality of policy implementation;
- Engage target users when selecting indicators because this engagement can build commitment to action; and
- Allow the purpose and audience to dictate key design features of the DVT.
You can find our case study elaborating these and other findings here.
My first 100 days’ journey is timely for many reasons, especially two global phenomena — addressing the impact of COVID on hunger and malnutrition and preparations toward the highly anticipated UN Food Systems Summit in September 2021, which is bringing together governments and stakeholders across many regions.
Photo courtesy of Albertha Nyaku. Albertha is pictured on the far left corner of the back row, sitting among her siblings and grandmother.