When I was growing up in Malawi we tended to link marasmus and kwashiorkor to bewitching – we never linked it to malnutrition. However, I gradually learnt more about food groups at secondary school and University. I started to become more interested in the topic when I was working as Food Security and Nutrition Research Assistant alongside nutritionist in the Area Based Child Survival Development Programme at UNICEF. After a stint as a Government Economist I decided to study the subject and I completed a Masters in Medical Science Human Nutrition in 1997. However, it wasn’t until 17 years later that I would eventually take on a role where I could put this knowledge into practice.
I had been working on diversification of agricultural incomes, marketing and food security issues at the EU Delegation in Malawi for 10 years when in the framework of the 2012 London GlobalHunger Event,the EU made a global commitment to tackling undernutrition. We needed to realign our country programming and because of my background I had an opportunity to take on a lead role. However, after so long without practicing nutrition I really needed to reconnect with the issues and refresh my knowledge so I enrolled in the Transform Nutrition Short Course in 2014.
That one week was very helpful. They approached nutrition from a holistic perspective and presented it as a medical issue as well as a developmental issue. This made me more equipped to engage with stakeholders across the board, instead of looking at it from just one perspective.
The key outcome from the course was a realisation that we needed to carry out a mapping exercise in the nutrition sector in Malawi so that our planning and programming could be informed by what is already happening within the sector. We were able to get all the key development partners and the Government to rally behind this idea and as a result of the mapping, we have now developed a holistic multi-sectoral integrated Four Pillar Approach to addressing nutritional issues that scales up successful previous and existing initiatives and provide a platform for discussion between the different partners.
In July 2015 the Government through the National Nutrition Committee adopted the Four Pillars Approach, and now all partners supporting the government use this framework to coordinate and structure their programs in the countryto ensure the national objectives will be achieved.
The Four Pillar Approach
Pillar 1: Agriculture for food and nutrition security and improved maternal, infant and young child care and feeding
Pillar 2: Health – primary health care, therapeutic care, support and treatment and WATSAN:
Pillar 3: Integration of behavioural change and communication for optimal maternal and young child feeding and care (knowledge, attitudes and practices) among communities, learners, professional and frontline workers through nutrition education
Pillar 4: Governance, human capacity building, research, monitoring & evaluation and fortification.
We have also developed Afikepo, an EU programme to take forward and support the Four Pillar Approach. It translates from the local language as ‘let the children develop to their full potential’ and it has become a moto of some sorts for nutrition programming in Malawi.
Therefore, I took lessons from the 2014 course and applied them in Malawi, which now has the second largest EU nutrition programme in the World. However, I have also enrolled in the 2017 Transform Nutrition Short Course so I can build on my experiences, gain more insights and further improve our programmes and approaches in the country.
Getting governments and others to step up to the challenges of undernutrition requires concerted efforts to build commitment, increase responsiveness and to hold these actors to account for their progress or its lack. For the past six years Transform Nutrition has been at the forefront of research and conceptual development on accountability and nutrition. This brief New approaches to accountability in nutrition describes the research, tools and approaches developed by the consortium to build, monitor and increase commitment, responsiveness and accountability in nutrition
In SouthAsia, social accountability practitioners have been addressing failures in the ‘standard’ health and nutrition model. What can we learn from them? New research report Social accountability initiatives in health and nutrition: lessons from India, Pakistan and Bangladesh from Transform Nutrition and the Institute of Development Studies.
by Neha Raykar, Public Health Foundation of India
Recently, I attended a policy seminar titled ‘Transforming Food and Nutrition Landscape in Assam’ on 29th March 2017 in Guwahati, Assam. The dialogue was co-organized by the Inter-Agency Group, Assam and Coalition for Food & Nutrition Security and was attended by about 50 stakeholders comprising senior policymakers from Government of Assam and Government of India, as well as representatives from local NGOs, educational institutes, and bilateral agencies.
The purpose of the seminar [Read more…]
By Shilpa Deshpande, PhD Candidate, Institute of Development Studies, University of Sussex
Ten years before I joined the ICDS as an anganwadi worker, my cousin mother-in-law used to work here. At that time, the division of the village population between anganwadi workers was such that lower caste households were served by my mother-in-law whereas only the higher caste households were served by Lata madam, this was her rule….so… my mother-in-law’s field area was scattered across the village. Then when I joined, Lata madam said that just like my mother-in-law I should be given the lower caste communities. I refused…. I said give me any part of the village but I want half and I want it along a continuous line then only will I be able to work. This led to a fight, which continued for several days.
Meena, Anganwadi worker [Read more…]
Conference on Delivering for Success at Scale 7- 8 February 2017, BRAC Auditorium, Mohakhali, Dhaka, Bangladesh
This conference built on the longstanding partnership between BRAC, ICDDR,B and the Institute of Development Studies (IDS) to explore the role of knowledge in the conceptualisation, design, delivery and management of development programmes and policies. Bangladesh has been a lead player in the use and integration of research into development decision-making, notably in relation to health systems, nutrition, social protection, agriculture and poverty. Evidence will continue to be important in strategic development planning by the Government of Bangladesh among others.
The conference included examples of how high quality research can be embedded within programmes, showcased research findings, discussed the challenges of integrating research with programmes, highlighted successful examples and discussed future needs. The UK Department for International Development funded Transform Nutrition and Future Health Systems presented relevant research.
Read an article about the conference in the Bangladesh Financial Express ‘On health and nutrition’. We also published a blog by Rittika Brahmachari, IIHMR Pathways to scaling up interventions: reflections from delivering for success at scale
For more information contact Aazia Hossain firstname.lastname@example.org
by Aparna John, PhD candidate, Institute of Development Studies at University of Sussex
Child undernutrition rates in India are among the highest in the world (Raykar et.al, 2015). Despite the decline in undernutrition indicators such as stunting (low height for age), underweight (low weight for age) and wasting (low weight for height), India is home to 40 million stunted and 17 million wasted children. The Government of India has invested in efforts to reduce childhood undernutrition and improve maternal and child health through one of its flagship programmes — the Integrated Child Development Services (ICDS) Scheme. ICDS, the world’s largest community nutrition programme, is delivered by 1.34 million village based female workers, Anganwadi workers (AWWs). [Read more…]
By Neha Raykar and Kavtia Chauhan, Public Health Foundation of India
Since the release of the India Health Report: Nutrition 2015 (IHR), the team has been engaged in disseminating the report at various platforms. We first launched the report in Delhi at a major event that featured the Ministers of Health, and Women and Child Development of the Government of India. This was a rare joint appearance of these two key Ministers and senior government officials to indicate broad support for an agenda to transform nutrition in India. [Read more…]
By Kavita Chauhan, Neha Raykar and Moutushi Majumder, Public Health Foundation of India
The Transform Nutrition project in India focuses on generating evidence and engaging with key stakeholders, including the media, to communicate research findings. The Public Health Foundation of India (PHFI), in collaboration with Vikas Samvad, a non-governmental organisation based in Bhopal, Madhya Pradesh and with support from the POSHAN Project organised a meeting on Data for Nutrition: Role of Media in Strengthening Uptake of Nutrition Evidence. The participants comprised of editors, senior health correspondents, and young journalists from various districts of Madhya Pradesh, who cover health, nutrition and social development issues. [Read more…]