Transform Nutrition Learning Journey: Katharine Kreis, PATH, USA

Kreis-1215I am Director of Strategic Initiatives and Lead for Nutrition Innovation at PATH, an international non-profit organisation in the field of global health innovation.

I first became interested in public health, epidemiology and nutrition when I was in the Peace Corps and I have maintained my interest in this area ever since. I went on to study Epidemiology and Global Health at graduate school and after a short stint working on an immunisation programme in Africa I became a Foreign Service Officer for USAID. I was at USAID for around 8 years focussing on the programmatic application and policy implications of maternal and child health and nutrition programmes.

After leaving USAID, I worked at the Bill and Melinda Gates Foundation in Seattle for about 10 years, eventually heading up the Nutrition Team.  Following that, I worked for the Swiss based Global Alliance for Improved Nutrition (GAIN) where I focused primarily on public-private partnerships to help address nutrition working on large scale fortification, infant and young child nutrition and the enabling environment.

Missing the Seattle vibe and focus on innovation, I took a position at PATH, which offered a workplace dedicated to innovating to improve health outcomes in low and middle income settings.  Initially, my primary role was focussed on strategic planning, which then led to a focus on nutrition innovation- assessing what types of tools and interventions might be instrumental in helping to address stunting, wasting, vitamin and mineral deficiencies and overweight/obesity

Just as we finished a strategic planning exercise to identify opportunities for innovations within the nutrition sector I took the Transform Nutrition Short Course in 2016. I was delighted to have the opportunity to join the wide range of participants in the course and it raised a number of considerations for how PATH could move forward in this field and leverage the expertise of a wide range of sectors  and disciplines to help solve nutrition challenges. In particular, I was interested in platforms for innovation, and business models such as incubators and accelerators that could be used in a public sector setting to source ideas, drive impact and  ‘crowd’ in ideas and knowledge from different perspectives. As a result, PATH has designed and developed an incubator approach which broadly looks to foster innovation in 4 key areas:

Develop and advance new tools and technologies to measure and improve nutrition outcomes, increase income opportunities, and increase food safety and food security, particularly in low- and middle-income countries.

Strengthen the collection and use of data, analytics, and knowledge about nutrition and how it intersects with other development sectors. This “nutrition intelligence” will help national and global leaders plan, implement, evaluate, and align efficient and effective policies and programs.

Strengthen the systems that bring food from producers to consumers so that systems are more effective, sustainable, efficient, and resilient. This includes identifying or protecting agricultural practices or food sources that can close nutritional gaps.

Develop and strengthen partnerships across disciplines and sectors so that nutrition solutions are holistic, effective, and build on the best information and expertise possible.

Through our nutrition innovation incubator approach, PATH is  working with a number of academic institutions, foundations and the private sector on several novel ideas targeted at improving nutrition outcomes.  These include development of a commercially available multiplex diagnostic with Quansys Bioscices that will enablable simultaneous measurement of a number of vitamin and mineral deficiencies using only a finger prick, new food-based delivery mechanisms for antibiotics for acutely malnourished children, a meta analysis looking at the contribution of tobacco use during pregnancy and growth outcomes, research on the potential for edible insects to be micro-farmed and improve diets, and work with Prestige, India’s largest producer of kitchen products, to modify their pressure cooker to add iron to food during the cooking process, among others.

We hope to redefine how we engage with the private sector to engage companies- from start-ups to very mature organisations across a number of sectors to help improve nutrition. Some of what I learned in the  Transform Nutrition course informed some of our work, and validated the need for new interventions.

Transform Nutrition Learning Journey: Kenaw Gebreselassie, Amref Health Africa, Ethiopia

I am currently working as Communications Manager for Amref Health Africa in Ethiopia, the largest African-led  International NGO which works to ensure health equity by serving women and children and reaching the most disadvantaged and inaccessible communities. Before this, I worked for Save the Children’s Health and Nutrition team  as a Communications and Research Uptake Manager where I disseminated research findings, developed key messages and communications materials on health and nutrition, coordinated the SUN Civil Society Network, and advocated for better health and nutrition services.

However, I wasn’t exposed to nutrition issues until later on in my life. Drought, famine, and the government’s and its partners’ emergency response was all I knew about nutrition issues but I didn’t know about the bigger picture. I started learning more about nutrition at Save the Children, but the first formal training I received was on the Transform Nutrition short course in 2014, where I learnt about the key issues, case studies and country experiences. The short course gave me the confidence I needed to talk about the issues, which had a major impact on my advocacy work at Save the Children and it continues support my communications and advocacy efforts at Amref Health Africa.

For example, I was part of the communications working group at the Ministry of Health so I advised on nutrition advocacy and contributed research uptake materials. As part of this working group, I participated in the development of the nutrition communication section of the National Nutrition Program II, which is currently operational and contributed to Ethiopia’s first 1000 days campaign messaging.  At Save the Children, I coordinated, among other things a radio panel seminar with government representation from the Ministry of Health, Ministry of Agriculture, Ministry of Education, as well as Ministry of Women and Children’s Affair.

I have also used Transform Nutrition course materials to develop a media training programme that I have conducted all around Ethiopia. The media in Ethiopia tend focus on food security when covering nutrition related stories so the course teaches journalists how to spread nutrition related lessons, such as back yard gardening, the importance of diversity in diets, agriculture, and the impact of undernutrition on child development so they can present a more rounded and nuanced message for their audience.

 

Transform Nutrition Learning Journey: Tomaida Msiska, EU Delegation, Malawi

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.

Transform Nutrition Learning Journey: Arvind Singh, Matri Sudha, India

Matri Sudha’s mission is to help urban slum children in South East Delhi through social empowerment projects, bringing social change from the grass roots and mobilising people from within the community to uphold their rights.

Putting public health nutrition on the agenda

Public health nutrition is now a key focus area for the organisation but it wasn’t always our approach, nor was it my area of expertise. We came across a government report in 2012 which looked at child malnutrition in Delhi and I started reading more and more journals and learnt about how malnutrition is linked to various other aspects of adolescent health, diarrhoea, pneumonia, and child brain development and we also studied the laws, policies and programmes impacting food security and nutrition in India. It is now my dream, and Matri Sudha’s mission, to improve India’s nutritional status.

We started working at the grass roots level to improve the child and maternal welfare centres usually called ‘Anganwadi centres’ under the government’s Integrated Child Development Services (ICDS) scheme and to strengthen their linkages with the wider health systems. We work with adolescents, pregnant women, lactating mothers and children below the age of six on both preventive and curative aspects of malnutrition in early childhood years.

At Matri Sudha, I lead our work with families to improve their nutritional status, our research work, and our advocacy efforts to improve the nutrition governance issues in Delhi. As a result of Matri Sudha’s research, we filed a Public Interest Litigation in the Delhi High Court to implement the Food Security Act of 2013 and constitution of State Food Commission as an independent body to monitor the nutrition issues in Delhi.

Knowledge, Networks and Nutrition Champions

I enrolled in the Transform Nutrition Short Course in 2015 to deepen my knowledge and I remember on the very first day there was a moment when everyone stood up to introduce themselves – and then it was my turn. I stood up and I said I am neither a public health nutritionist nor a doctor, I am a social worker and I am here for 7 days to understand exactly what public health nutrition is all about.

I knew I wouldn’t understand everything in 7 days but I knew I could take whatever I did learn and incorporate it with my own work to improve our programing at Matri Sudha.

For example, on the third and fourth day of the course we had in-depth discussions about how to evaluate community based programmes. On my return, I discussed with my colleagues in Matri Sudha how our own programme could be revised to make sure the objectives were clear, that we understand why we are implementing the programme and how it can be evaluated. We now have a clear set of goals, objectives, outcomes and outputs so that we can monitor and evaluate its progress, identify challenges, and adapt our approach as we learn.

We have also adopted Transform Nutrition’s approach to supporting Nutrition Champions, who could be the primary care giver, school based nutrition champion or community health worker, or anyone promoting the overall goal of child nutrition within the community. We have developed a programme to identify and highlight the good work of people within the community in order to support their efforts and encourage others to do the same. So far, 12 such Nutrition Champions have been created as our first step toward improving the nutritional status within the community.

One of the key features of the Transform Nutrition course was that it provided a platform to express your views, share your opinions and an excellent opportunity to come into the network of people with different backgrounds and make good friends. For example, I have recently authored a review paper on Infant and Young Child Feeding Practices in India with a colleague I met on the Transform Nutrition short course.

HANCI Africa

On the 26th and 27th of January, 2017, a group of leading experts on food and nutrition security, including Transform Nutrition Leaders gathered in Johannesburg, South Africa, to discuss a new research product, the African Hunger and Nutrition Commitment Index (HANCI Africa). The workshop aimed to present and debate the HANCI-Africa as a tool for advocacy, monitoring commitment and accountability and to discuss how regional and continental level bodies can adopt, adapt, own and sustainably use the HANCI-Africa for monitoring the Malabo Declarations and other commitments towards addressing hunger and malnutrition. HANCI Africa aims to measure political commitment of 45 African countries’ governments to tacking issues of hunger and undernutrition. The index looks at hunger, and nutrition separately, since actions which are taken to address hunger may not successfully address undernutrition and vice-versa. The index compares countries looking at three areas of commitment: laws, policies, and spending. More information about the index, including a complete list of the rankings and score cards for each country can be found here: http://hancindex.org/

 

Leaders meet at Micronutrient Forum, Cancun

In October 2016 a number of Transform Leaders attended the Global Micronutrient Forum in Cancun, Mexico. The theme of this years’ conference was ‘Positioning Women at the Centre of Sustainable development’ with many interesting sessions on numerous topics including market based approaches, ideas on scaling up implementation, adolescent nutrition, and discussions on national level commitment and ownership. Jessica Meeker, Transform Nutrition Leaders Network Co-ordinator was attending and caught up with most of the leaders in person over the week, highlighting what a great opportunity conferences are for linking in with network members.

If you are attending a conference in the next few months, do let us know so we can link you up with other attending members.

Leaders from CARE India develop a Nutrition Gender Toolkit

CARE India has been working in Odisha in the Technical Assistance and Research for Indian Nutrition and Agriculture (TARINA) project. The TARINA project is mandated to develop a more nutritious food system for India, by providing technical assistance to make agriculture projects nutrition sensitive, promote policy reforms and develop leadership and capacity to institutionalize nutrition sensitive agriculture in India.

CARE is working with women Self Help Groups across 72 villages in Kalahandi and Kandhamal districts in Odisha, towards providing access to a more affordable nutritious diet for them and their families. Accordingly, seven interventions have been identified – kitchen gardens, pulses, poultry, goatery, dairy, drudgery reduction and postharvest management of nutritious crops. The project aims at bringing in perceptible changes in the behavior and practices of poor and marginalized women and their family members in terms of consumption and distribution of nutritious food, promoting awareness and adoption of improved practices leading to improved production (access, availability and affordability) and consumption of quality diets in households.

Impacts targeted through TARINA however will become sustainable only when behavior change is triggered, supported through discussions and decisions are taken by small and marginal women farmers and their households. Such a process is time consuming and requires support for changemakers as they navigate their way towards a more nutritious future for their families.

To do this, CARE India is drawing on its extensive experience across livelihood, health and education projects to develop a Nutrition Gender Toolkit with a set of 14 tools. The tools help in creating awareness of the current status quo and promote a healthy discussion in women Self Help Groups that highlights aspects of the patriarchal society, and seek to enhance appreciation by stakeholders of women’s role, contributions, and needs in promotion of nutritious food value chains. The tools help women question our belief systems and its impact on our nutrition needs – especially for those who are traditionally less empowered and are needy. Some of the tools are supported by colorful picture cards and other aids that develop curiosity and aid dialogue. The engagement process includes women and men in the household and community opinion makers and actors, taking their inputs into consideration and working towards changes in belief systems and food systems. The tools are developed, field tested, finalized and then shared with partners’ teams in a phased manner for implementation in Odisha, Uttar Pradesh and Bihar.

Leaders in Tanzania contribute to the development of the National Multi-sectoral Nutrition Action plan.

Transform Nutrition Leaders in Tanzania contributed to the recent development of the National Multi-sectoral Nutrition Action plan (2016 – 2021). This plan is a great step for nutrition in Tanzania, with One plan, One coordination mechanism and One M&E system across sectors. Nutrition has also been integrated into The National Five year Development Plan (2016/2017- 2020/2021). The whole process has been Co-ordinated by the Prime Minister’s Office and was successfully launched by the High Level Steering Committee in Nutrition (HLSCN) in October 2017 where by the Permanent Secretary, PMO is a chair.  TN network members, were instrumental and fully participated in this process.

Transform Nutrition Learning Journey: Oluwatoyin Oyekenu

Toyin, a 2015 participant in the Transform Nutrition Short Course, tells us what she learned during that week, how she has been able to put it into practice and what she has gained from being part of the Transform Nutrition Leaders Network since then.

My path to nutrition I am Oluwatoyin Oyekenu, known to my friends as Toyin. I grew up on a farm in Ilesha Osun State, Nigeria. I was always able to access fresh, nutritious food when I was young. My problem, was that all I wanted to eat was junk food, especially doughnuts, so my understanding of nutrition was just about dieting. I didn’t really understand the problem of nutrition in Nigeria until much later on in my life. [Read more...]