Agriculture for improved nutrition and health

Our project partners Egerton University, Kenya convened a workshop Agro-biodiversity and Dietary diversity for optimal nutrition and health on Tuesday 22nd August, 2017 at the ARC Hotel Egerton University, Kenya. Forty-Five participants from academia, Ministry of Health, Ministry of Agriculture and NGOs working on Agriculture, nutrition and health gathered together with representative from County Government to discuss the important issue of tackling malnutrition and links between agriculture and Nutrition.  See workshop report.

They have also written a blog Agriculture for improved nutrition and health

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: 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.

Public-Private Partnerships and undernutrition: Examples and future prospects

In recent years, political commitment to reducing undernutrition has risen globally. Nutrition features prominently on development agendas, in prime ministerial speeches,
in international development discourse and in the media. The multisectorality of nutrition is better recognised with the corresponding need for engagement by multiple actors in different sectors and at different levels. While this has thrown a spotlight on the issue of private sector engagement in nutrition-relevant actions, looming over new initiatives that engage the private sector is a deeply suspicious nutrition sector.  This research brief from Transform Nutrition Public-Private Partnerships and undernutrition: Examples and future prospects examines this issue.

Accountability in health and nutrition in South Asia

Social and community accountability initiatives in health and nutrition have been associated with the potential for significant improvements in outcomes when applied to relevant services. A new Transform Nutrition working paper is now available Accountability in health and nutrition in South Asia – a conceptual and practical review of lessons from the global literature and from India, Pakistan and BangladeshThis  paper outlines community-specific factors, drawn from recent literature, which are likely to be of interest to researchers and practitioners in the field of health and nutrition delivery, stressing the importance of context in understanding accountability initiatives. It then brings together some of the findings of the practice review and practitioner consultation.



Pastoral Community Platforms as channels for Behavioural Change for Nutrition

New research just been published by Transform Nutrition and Vétérinaires Sans Frontières Suisse with preliminary findings of a study on Pastoral Community Platforms as Channels for Behavioural Change for Improved Nutrition (BCIN) The research was designed to explore the potential of using pastoral-community platforms for channeling maternal, infant and young-child nutrition messages to community members. We have also published some useful case studies which provide an insight into the perceptions of the participants of the study who live in the study area.

What factors influence community nutrition workers in performing their jobs? Preliminary findings from Bihar, India

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, 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...]

The role of the media in strengthening uptake of nutrition evidence

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...]