I’m honored to represent Feed the Children at the 2nd International Conference on Nutrition (ICN2) and at the Civil Society Organizations (CSO) Pre-Conference this week in Rome, Italy. I’m joining 10 Ministers (e.g., Ministers of Health, Ministers of Agriculture) and representatives from 160 governments there. The last ICN was held 22 years ago to urge governments around the world to commit to very specific actions designed to improve nutrition, both in the Global North and Global South (these terms are the preferred way to refer to what we used to call the Developed and Developing world or First/Third-world).
This week, I will be advocating for three things I believe to be essential in order to improve the nutritional status of children around the world. (To understand terms we use when discussing hunger and nutrition, check out this infographic and post).
1. The need for prioritization
Right now, the framework for action being promoted at ICN2 contains a list of 60 policy and program options. We need to prioritize the options on this list if we expect measurable improvements in child nutrition.
One of the reasons that UNICEF’s child survival revolution was so successful in lowering child deaths is that they prioritized. They agreed to focus first on four specific actions, or interventions (referred to by the acronym GOBI – Growth monitoring, Oral rehydration, Breastfeeding, and Immunization).
This is more difficult to do in nutrition, but it’s still possible. I believe that in developing countries at least, we could (and should) focus on promoting three things : Essential Nutrition Actions, Essential Hygiene Actions, and women’s empowerment. This is entirely doable. I have also suggested language changes in the CSO Vision Statement about the importance of water interventions (e.g. purification) and improved sanitation which can improve child nutritional status, and those changes have now been incorporated into the document.
2. The need for research
No nutrition program/project conducted at scale (e.g. with 1 million or more beneficiaries) in a developing country has come close to normalizing child growth. We still need more research, and formative research (e.g. Barrier Analysis), but there has been little discussion here about the need for that. In spite of everything we throw at it, malnutrition remains a problem and any reductions are often much less than 50% in 4-5 year projects. That shows us that some of what we need to be doing is not being done, even when funding is available.
An example of the sort of interventions we may need:
- Reduce maternal depression. One study by Pamela Surkan found that we could potentially reduce stunting by about 19-23% through elimination of maternal depression, and a randomized trial has been done that shows that depression can be reduced 93% at low cost in a developing country.
- Eliminate open defecation (when people don’t properly dispose of human waste, it contaminates their water and soil and sickens their children). In many countries, this is a huge problem, and it’s one of the main causes that we see so much stunting in children in Asia despite the number of calories that they take in. When children live in a dirty environment, their immune systems are chronically activated, and they don’t absorb the foods that they eat as well. We know that is a large underlying cause of stunting. Learn more here. To see the sanitation conditions many children face around the world, look at these photos curated by photographers from Panos Pictures and Water & Sanitation for the Urban Poor for World Toilet Day.)
For that reason, we need to push countries to conduct more formal and formative research to find what works in reducing malnutrition, and the barriers and enablers to behaviors that we know can reduce malnutrition.
3. Access to nutrition promotion as a right
We need to affirm that access to nutrition promotion is a right in the same way that access to formal education of children is a right. We know the lives it can save, and how it can decrease malnutrition at low cost, especially through the use of volunteer peer educators (e.g. Care Groups).