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Author: Hoddinott, John F.
Publisher: Intl Food Policy Res Inst
ISBN:
Category : Health & Fitness
Languages : en
Pages : 60
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Book Description
This paper brings structure to the discussion of private-sector engagement in nutrition by clarifying different models of engagement, reviews the evidence base on public-private partnerships (PPPs) for the reduction of undernutrition, and outlines some potential ways forward. We find that there are few independent, rigorous assessments of the impact of commercial-sector engagement in nutrition. Considerable caution is thus warranted when assessing PPPs in nutrition. Looking forward, future progress requires that the private sector recognize that past and current actions by some firms have created an environment of mistrust. It requires that the public sector accept that sustainable PPPs are those which permit private firms to generate profits. There is significant scope for the private sector to drive innovations that could reduce undernutrition, and, more speculatively, there may be scope for the private sector to act as a financier. Underpinning all these efforts must lie open discussions of the objectives, roles, and expectations of all parties along with potential conflicts of interest; an open space or platform where issues and challenges can be discussed and addressed; incentives for the private sector to take on pro-nutrition roles; strong, transparent, and well-enforced monitoring processes; and serious, independent evaluations of these activities.
Author: Hoddinott, John F.
Publisher: Intl Food Policy Res Inst
ISBN:
Category : Health & Fitness
Languages : en
Pages : 60
Get Book Here
Book Description
This paper brings structure to the discussion of private-sector engagement in nutrition by clarifying different models of engagement, reviews the evidence base on public-private partnerships (PPPs) for the reduction of undernutrition, and outlines some potential ways forward. We find that there are few independent, rigorous assessments of the impact of commercial-sector engagement in nutrition. Considerable caution is thus warranted when assessing PPPs in nutrition. Looking forward, future progress requires that the private sector recognize that past and current actions by some firms have created an environment of mistrust. It requires that the public sector accept that sustainable PPPs are those which permit private firms to generate profits. There is significant scope for the private sector to drive innovations that could reduce undernutrition, and, more speculatively, there may be scope for the private sector to act as a financier. Underpinning all these efforts must lie open discussions of the objectives, roles, and expectations of all parties along with potential conflicts of interest; an open space or platform where issues and challenges can be discussed and addressed; incentives for the private sector to take on pro-nutrition roles; strong, transparent, and well-enforced monitoring processes; and serious, independent evaluations of these activities.
Author: Richard Heaver
Publisher: World Bank Publications
ISBN: 082136037X
Category : Medical
Languages : en
Pages : 114
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Book Description
Annotation Technical and economic issues get the lion's share of attention in designing poverty reduction programs. Yet politicians, bureaucrats, or communities are not committed to implementing them well. This book draws attention to this gap in analysis and planning and suggests practical ways, based on country experience, to build commitment.
Author: Thomas J. Marchione
Publisher: Routledge
ISBN: 1134390971
Category : Political Science
Languages : en
Pages : 324
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Book Description
The individual and institutional capacities required for the prevention and reduction of nutritional insecurity and hunger in lesser-developed countries as the twenty-first century approaches are identified in this book. Household nutritional "security" can be defined as the successful The essays in this book champion the idea of increasing, or scaling up, grass roots operations to provide nutritional security, while scaling down the efforts of national and international institutions. Scaling up involves strengthening local capacities to improve and expand upon current successful programs by building upon existing local culture and organizations. This, in turn, enables the programs to strengthen relationships with national governments, international bilateral/multilateral donors, as well as non-governmental organizations. Scaling down concerns the ways and means by which these various organizations encourage and complement the local development. Therefore, as local capacities are scaled up, the national/international control over decisions and functions is, ideally, scaled down. The volume also directly addresses the resultant complication: how to create programs that are both culturally specific and that will flourish well into the future.
Author: Todd David Benson
Publisher: Intl Food Policy Res Inst
ISBN: 0896291650
Category : Social Science
Languages : en
Pages : 114
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Book Description
Undernutrition remains a major source of human suffering and an obstacle to national economic and human development in many African countries. This report investigates undernutrition's persistence, drawing on case studies of the public response to the problem in Ghana, Mozambique, Nigeria, and Uganda. Analyzing each nation's policymaking structures, political actors, understanding of undernutrition, and the timing of public responses, the author explains why none of these four nations has mounted an effective campaign to eliminate undernutrition. The author identifes several different causes of this shortcoming, with one underlying flaw in the various public responses standing out: a fundamental failure on the part of political leaders to see undernutrition as a grave problem that undermines development efforts in their nations. The author concludes that an effective response to undernutrition in these countries requires the formation of national advocacy coalitions that can raise public awareness of the problem, highlight policymakers' duty to ensure the nutrition of their citizens, and link proper nutrition to general national development. This report should serve as a resource for advocates, researchers, and others concerned with undernutrition in Africa.
Author:
Publisher: World Bank Publications
ISBN: 0821364006
Category : Developing countries
Languages : en
Pages : 274
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Book Description
Persistent malnutrition is contributing not only to widespread failure to meet the first MDG--to halve poverty and hunger--but to meet other goals in maternal and child health, HIV/AIDS, education, and gender equity. The choice is now between continuing to fail, or to finally make nutrition central to development. Underweight prevalence among children is the key indicator for measuring progress on non-income poverty and malnutrition remains the world's most serious health problem and the single biggest contributor to child mortality. Nearly a third of children in the developing world are either.
Author: The World Bank
Publisher: World Bank Publications
ISBN: 0821384074
Category : Medical
Languages : en
Pages : 102
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Book Description
Evaluation Summary What Can We Learn from Nutrition Impact Evaluations? High levels of child malnutrition in developing countries contribute to mortality and have long-term consequences for children s cognitive development and earnings as adults. Recent impact evaluations show that many different interventions have had an impact on children s anthropometric outcomes (height, weight, and birth weight), but there is no simple answer to the question What works? to address the problem. Similar interventions have widely different results in different settings, owing to differences in local context, the causes and severity of malnutrition, and the capacity for program implementation. Impact evaluations of programs supported by the Bank, which are generally large-scale, complex inter-ventions in low-capacity settings, show equally variable results. The findings confirm that it should not be assumed that an intervention found effective in a randomized medical setting will have the same effects when implemented under field conditions. There are many robust experimental and quasi-experimental methods for assessing impact under difficult circumstances often found in field settings. The relevance and impact of nutrition impact evaluations could be enhanced by collecting data on service delivery, demand-side behavioral outcomes, and implementation processes to better understand the causal chain and what part of the chain is weak, in parallel with impact evaluations. It is also important to understand better the distribution of impacts, particularly among the poor, and to document better the costs and effectiveness of interventions. High levels of child malnutrition in developing countries are contributing to mortality and present long-term consequences for the survivors. An estimated 178 million children under age 5 in developing countries are stunted (low height for age) and 55 million are wasted (low weight for height). Malnutrition makes children more susceptible to illness and strongly affects child mortality. Beyond the mortality risk in the short run, the developmental delays caused by undernutrition affect children s cognitive outcomes and productive potential as adults. Micronutrient deficiencies vitamin A, iron, zinc, iodine, for example are also common and have significant consequences. Progress in reducing malnutrition has been slow: More than half of countries are not on track to achieve the Millennium Development Goal of halving the share of children who are malnou-rished (low weight for age) by 2015. The food price and financial crises are making achievement of this goal even more elusive. The World Bank has recently taken steps to ex-pand its support for nutrition in response to the underlying need and the increased urgency due to the crises. WHAT DO WE KNOW ABOUT REDUCING MALNUTRITION? The increased interest and resources focused on the problem of high and potentially increasing rates of undernutrition raises the question, what do we know about the causes of malnutrition and the in-terventions most likely to reduce it? The medical literature points to the need to inter-vene during gestation and the first two years of life to prevent child malnutrition and its consequences. It suggests that investments in interventions during this window of opportunity among children under 2 are likely to have the greatest benefits. Recently published meta-analyses of the impact evaluation literature point to several interventions found effective for reducing undernutrition in spe-cific settings. However, there are limitations to the generalizability of those reviews findings, particularly in the context of large-scale government programs most likely to be supported by the World Bank. The reviews tend to disproportionately draw on the findings of smaller, controlled experiments; there are few examples of evaluations of large-scale programs, over which there is less control in implementation. In reviewing a large number of studies, interventions, and outcomes, they tend to focus on average impacts. They generally do not explain the magnitude or variability of impacts across or within studies. Very few address the programmatic reasons why some interventions work or don t work, nor do they assess the cost-effectiveness of interventions. Objectives of the Review This paper reviews recent impact evaluations of interventions and programs to improve child anth-ropometric outcomes height, weight, and birth weight with an emphasis on both the findings and limitations of the literature and on understanding what might happen in a non-research setting. It further reviews in greater detail the experience and lessons from evaluations of the impact of World Bank-supported programs on nutrition outcomes. Specifically, the review addresses four questions. First, what can be said about the impact of different interventions on children s anthropometric outcomes? Second, how do these findings vary across settings and within target groups, and what accounts for this variability? Third, what is the evidence of the cost-effectiveness of these interventions? Finally, what have been the lessons from implementing impact evaluations of Bank-supported programs with anthropometric impacts? While there are different dimensions of child nutri-tion that could be explored, the report focuses on child anthropometric outcomes -- weight, height, and birth weight. These are the most common nutrition outcome indicators in the literature and the most frequently monitored by national nutrition programs supported by the World Bank. Low weight for age (underweight) is also the indicator for one of the MDGs. Methodology and Scope Forty-six nutrition impact evaluations published since 2000 were systematically reviewed. These evaluations assessed the impact of diverse interven-tions community nutrition programs, conditional and unconditional cash transfers, early child devel-opment programs, food aid, integrated health and nutrition services, and de-worming. All of the evaluations used research designs that compared the outcomes among those affected by the project to the counterfactual that is, what would have happened to a similar group of people in the absence of the intervention. About half used randomized assignment to create treatment and control groups, while the remainder used matching and various econometric techniques to construct a counterfactual. Among the 46 evaluations, twelve assessed the im-pact of World Bank-supported programs on nutri-tion outcomes in eight countries. While the broader review relies on the analysis of the published impact evaluations as the main source of data, for these twelve evaluations project documents and research outputs were reviewed and World Bank staff, country officials and the evaluators and re-searchers who conducted the studies were interviewed. Findings A wide range of interventions had a positive impact on indicators related to height, weight, wasting, and low birth weight. There were a total of 10 different outcome indica-tors for the four main anthropometric outcomes. A little more than half of the evaluations addressing a height-related indicator found program impacts on at least one group of children, and this was true for about the same share of interventions aimed at improving weight-related and wasting (low weight for height)-related indicators. About three-quarters of the 11 evaluations of interventions that aimed at improving birth weight indicators registered an impact in at least one specification, including five out of seven micronutrient interven-tions. There was no clear pattern of impacts across interventions in every intervention group there were examples of programs that did and did not have an impact on a given indicator, and with varying magnitude. Evaluations of the nutritional impact of programs supported by the World Bank, which are generally large-scale, complex, and implemented in low-capacity settings, show equally variable results. Even controlling for the specific outcome indicator, studies often targeted children of different age groups that might be more or less susceptible to the interventions. It is thus difficult to point to inter-ventions that are systematically more effective than others in reducing malnutrition across diverse set-tings and age groups. Differences in local context, variation in the age of the children studied, the length of exposure to the intervention, and differing methodologies of the studies account for much of the variability in results. Context includes factors like the level and local determinants of malnutrition, differences in the characteristics of beneficiaries (including their age), the availability of service infrastructure, and the implementation capacity of government. Outside of a research setting in the context of a large government program there are many things that can go wrong in either service delivery or the demand response that can compromise impact. Beyond this, there are social factors like the status of women or the presence of civil unrest that can affect outcomes. These findings underscore the conclusion that it should not be assumed that an intervention found effective in a randomized controlled trial in a re-search setting will have the same effects when im-plemented under field conditions in a different set-ting. They also point to the need to understand the prevailing underlying causes of malnutrition in a given setting and the age groups most likely to benefit in selecting an intervention. Further, impact evaluations need to supplement data measuring impact with data on service delivery and demand-side behavioral outcomes to demonstrate the plausibility of the findings, to understand what part of a program works, and to address weak links in the results chain to improve performance. There is scant evidence on the distribution of nutrition impacts who is benefiting and who is not or on the cost-effectiveness of interventions Just because malnutrition is more common among the poor does not mean that they will disproportio-nately benefit from an intervention, particularly if acting on new knowledge or different incentives relies on access to education or quality services. Only a third of the 46 evaluations looked at the distribution of impacts by gender, mother s education, poverty status, or availability of complementary health services. Only nine assessed the impacts on nutritional outcomes of the poor compared with the non-poor. Among the evaluations that did examine variation in results, several found that the children of more educated mothers or in better-off communities are be-nefitting the most. Bank-supported cash transfers, community nutrition, and early child development programs in six of eight countries had some impact on child anthropometric outcomes. Of the 12 impact evaluations of Bank support, all but one were of large-scale government programs with multiple interventions and a long results chain. Three-quarters found a positive impact on anthro-pometric outcomes of children in at least one age group, although the magnitude was in some cases not large or applied to a narrow age group. Most of the impact evaluations involved assessment of completely new programs and involved World Bank researchers. Most used quasi-experimental evaluation designs and two-thirds assessed impact after at most 3 years of program implementation. Only half of the evaluations documented the distribution of impacts and only a third presented information on the costs of the intervention (falling short of cost-effectiveness analysis). In two of the countries (Colombia and the Philippines) the evaluations likely had an impact on government policy or programs. Lessons A number of lessons for development practi-tioners and evaluators arose from the review of impact evaluations of World Bank nutrition support. For task managers: Impact evaluations of interventions that are clearly beyond the means of the government to sustain are of limited relevance. The complexity, costs, and fiscal sustainability of the intervention should figure into the decision as to whether an impact evaluation is warranted. Impact evaluations are often launched for the purpose of evaluating completely new pro-grams, but they may be equally or even more useful in improving the effectiveness of ongo-ing programs. There are methods for obtaining reliable impact evaluation results when randomized assignment of interventions is not possible for political, ethical, or practical reasons. For evaluators: In light of the challenges of evaluating large-scale programs with a long results chain, it is well worth the effort to assess the risks to disruption of the impact evaluation ahead of time and identify mitigation measures. The design and analysis of nutrition impact evaluations need to take into account the likely sensitivity of children of different ages to the intervention. For the purposes of correctly gauging im-pact, it is important to know exactly when delivery of an intervention took place in the field (as opposed to the official start of the program). Evaluations need to be designed to provide evidence for timely decision-making, but with sufficient elapsed time for a plausible impact to have occurred. The relevance of impact evaluations for po-licymakers would be greatly enhanced if im-pact evaluations were to document both the
Author: H.K. Biesalski
Publisher: Karger Medical and Scientific Publishers
ISBN: 3318062537
Category : Medical
Languages : en
Pages : 244
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Book Description
Hidden hunger has long been an overlooked problem. Vitamin and mineral deficiencies have to be remedied and the availability of calories needs to be increased. As a matter of fact, the number of people who do not have access to a balanced diet has multiplied in rich and poor countries, with lasting consequences for health and well-being. Hidden hunger not only affects childhood growth and cognitive development, but also reduces productivity and well-being later in life, thus keeping the affected population trapped in a circle of poverty and malnutrition. This book illustrates the global fight against hunger by national governments and international organizations. Presented at the Third Hidden Hunger Conference held at the University of Hohenheim in Stuttgart, Germany, it presents a range of strategies being implemented in various regions of the world to improve nutrition quality and combat this international crisis.
Author: Younger, Stephen D.
Publisher: Intl Food Policy Res Inst
ISBN:
Category : Social Science
Languages : en
Pages : 32
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Book Description
Ghana is in the midst of a severe but not unprecedented macroeconomic crisis. This paper helps to evaluate the government’s policy options by (1) explaining the crisis’ causes, and (2) comparing it to previous macroeconomic crises and the policies that corrected them. Two large shocks are to blame for the crisis: an increase in the fiscal deficit of about 6 percent of GDP and a reduction in hydroelectric production that has not been replaced with thermal generation. This latter is more difficult to quantify, but may be as large as 4 percent of GDP. While large, Ghana has recovered from similar shocks in the past, and with luck, should be able to do so now. But this will require reversal of the large increases in the public sector wage bill that drove much of the fiscal shock.
Author: Ragasa, Catherine
Publisher: Intl Food Policy Res Inst
ISBN:
Category : Social Science
Languages : en
Pages : 44
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Book Description
This paper aims to test this hypothesis and to contribute to better understanding of strategies to revitalize the agricultural extension system in Malawi. Specifically, it examines the interplay between the fertilizer subsidy and access to extension services, and their impact on farm productivity and food security in Malawi. Results show that the fertilizer subsidy has inconsistent impact on farm productivity and food security; at the same time, access to agricultural advice was consistently insignificant in explaining farm productivity and food security. Further analysis, however, shows that when access to extension services is unpacked to include indicators of usefulness and farmers’ satisfaction, these indicators were statistically significant. Households who reported that they received very useful agricultural advice had greater productivity and greater food security than those who reported receiving advice that they considered not useful. This result implies the need to ensure the provision of relevant and useful agricultural advice to increase the likelihood of achieving agricultural development outcomes
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309151953
Category : Medical
Languages : en
Pages : 201
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Book Description
In 2007 and 2008, the world witnessed a dramatic increase in food prices. The global financial crisis that began in 2008 compounded the burden of high food prices, exacerbating the problems of hunger and malnutrition in developing countries. The tandem food price and economic crises struck amidst the massive, chronic problem of hunger and undernutrition in developing countries. National governments and international actors have taken a variety of steps to mitigate the negative effects of increased food prices on particular groups. The recent abrupt increase in food prices, in tandem with the current global economic crisis, threatens progress already made in these areas, and could inhibit future efforts. The Institute of Medicine held a workshop, summarized in this volume, to describe the dynamic technological, agricultural, and economic issues contributing to the food price increases of 2007 and 2008 and their impacts on health and nutrition in resource-poor regions. The compounding effects of the current global economic downturn on nutrition motivated additional discussions on these dual crises, their impacts on the nutritional status of vulnerable populations, and opportunities to mitigate their negative nutritional effects.
