Developing a Pro-Equity Nutrition Policy Agenda for Africa

DEVELOPING A PRO-EQUITY NUTRITION POLICY AGENDA FOR AFRICA

by Janet Hodur | December 1, 2020

To develop a pro-equity nutrition policy agenda for Africa, what factors must be looked at? What considerations must be made? How do shocks impact efforts? These issues were up for discussion at Cultivate Africa, in a session sponsored by the CGIAR Research Program on Agriculture for Nutrition and Health (A4NH) and the CGIAR Gender Platform. The discussion was part of the two-day virtual event, held November 17 and 18 and designed to reach across sectors and strengthen understanding and reinforce efforts to tackle immediate and long-term challenges facing agriculture and food systems in Africa.

In a series of three opening presentations, researchers tackled different aspects of nutrition and equity. Aulo Gelli, Senior Research Fellow at the International Food Policy Research Institute (IFPRI), shared results from work looking at the importance of keeping track of women’s time. From work balance and relationships between co-wives in Burkina Faso; to women’s participation in nutrition-sensitive agriculture programs as part of child care responsibilities in Malawi; to school meals shifting girls’ time use from work to school, increasing their access to school and attainment, in Mali, Gelli drew on how tracking time shone light on impacts. “Keeping track of time use…can improve intervention design,” he noted, “and check how interventions work and avoid unintentional consequences of how programs work.” Moreover, he added, tracking time can help realize the potential of programs to improve maternal and child nutrition. In response to an audience question, he cautioned “Putting women at the center of interventions can work really well for nutrition, but we have to be careful of unintended effects. If you do it right, it’s valued by the community and generates positive spillovers.”

Situations are not always stable, however, and unanticipated shocks like COVID-19 can have particularly negative impacts on nutrition and equity efforts. Nina de Roo, Advisor for Inclusive Food Systems at the Wageningen Centre for Development Innovation presented research on rapid assessments of food system shocks from COVID-19 conducted in four countries. The pandemic has created challenges for small holder farmers and small and medium enterprises with relation to inputs such as seeds and labor, however, she said, “vulnerable groups have become affected more.” Who is most vulnerable? “Female headed households and young women,” she answered, “groups who have few protections.”

Compounding the impacts for the vulnerable, the pandemic is also placing health systems in distress, while myths related to food, for example that uncooked vegetables put people at risk of contracting the virus, affects consumption of these nutritious items. Moreover, food has become less affordable, particularly for the poorest of the poor, de Roo noted, and households react by providing fewer meals and focusing on calories, not nutrients.

The overall implications for nutrition and equity can be quite pronounced, de Roo continued. “Existing inequalities are getting worse.” However, she added, it is important to note that COVID-19 is only one of the shocks affecting food systems in these countries. “Systematic approached are needed to address structural, interrelated problems,” she concluded, and later added, “Resilience is a difficult concept to measure, and everyone sees something different in it. We are trying to approach it from how people see their own resilience, as well as their perceptions around priorities and support.”

Filippo Dibari, Nutrition Team Leader in Ethiopia for World Food Programme (WFP), picked up the issue of availability, access and demand of nutritious foods, but also of cost and non-affordability of healthy diets, considering the impacts particularly for adolescent girls. The work conducted by WFP and the Ethiopian Public Health Institute revealed that while a diet that meets just the energy, or caloric needs, of a person is relatively affordable in Ethiopia, a diet that also meets micronutrient and protein needs costs four times as much – jumping from approximately US$0.90 (kcal) to US$3.20 per day (complete healthy diet). Also, in Ethiopia, the nutritional needs of adolescent girls are among the most expensive of anyone in the household, he added, and there is no single solution. In view of the early pregnancy, the vicious intergenerational cycle of malnutrition, and the first 1,000 days of life approach, he reported that evidence for effective interventions appoint towards more nutrient dense (primary) school meals, nutrition-sensitive social protection programs prioritizing households with adolescent girls, with social behavior change communication strategies tailored for this target group.

Namukolo Covic, Senior Research Coordinator with A4NH, who moderated the session, reflected on how each aspect of the research presented highlighted the need for paying attention to context in each situation, as challenges are interrelated and vary from situation to situation at many levels, ranging from national to community to household. She then called upon Jemimah Njuki, IFPRI Regional Director for Africa, to comment on what the researchers had shared.

Njuki drew out key considerations that span the issues raised. These included developing more multisectoral approaches; reducing, redistributing, and recognizing women’s time burden related to unpaid work; addressing affordability even at the intrahousehold level; and targeting interventions so they address the underlying inequities, whether gender, geographic, age, or other. It will be particularly important to succeed in efforts to ‘build back better’ after the COVID-19 pandemic and ease the burden of future shocks.

Beyond that, Njuki stressed, is the need to engage men for nutrition and gender equality. “Men and boys,” she said, “are the hidden half for better outcomes for women, girls, and all household members. Their engagement is critical.” This engagement, she added, will be necessary on production decisions and land allocation, as well as matters such as care giving.

From households to policy, nutrition is a complex issue that touches on many factors. For progress on policy, she concluded, we have to coordinate investments and targeting better among the many different departments that have bearing on nutrition.

Bibi Giyose, Senior Nutrition Officer for Policy and Programmes in the Nutrition and Food Systems Division at FAO, currently on secondment to the African Union Development Agency, joined Njuki in offering comments on the research presented. She stressed the need to move from policy to action: “Let’s not forget policies, instruments, guidelines on their own can never be enough. They have to be translated, contextualized, and implemented. If you don’t have the right advocates and champions to make the case for investment across health, education, social protection, and nutrition, you’ll always end up with the short end of the stick,” she said.

She went on to highlight the importance of having all voices at the table. “There is an unfortunate perception that “uneducated” people are not sophisticated enough to participate. This doesn’t give poor and marginalized the agency to be involved. We are missing out on traditional and indigenous knowledge systems, and there’s so much wisdom there. Changing perceptions, changing mindsets, and ensuring inclusiveness is critical to moving forward.”


Janet Hodur is Senior Communications Specialist for A4NH.

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