Transcript ending child hunger and undernutrition initiative

ending child hunger
and undernutrition
initiative
overview of issues
and moving forward
Copenhagen, 19 June 2006
Session Overview
• Overview of Initiative
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Where did it come from?
What are its major elements?
What’s new? What’s not?
When will the Initiative be initiated?
Major challenges moving forward
• Field Highlights
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Regional Level Political Mobilisation and Partnership Development in
Latin America and the Caribbean
Partnering with Local Institutions for National Advocacy in India
Delivering the ‘essential package’ for child survival in Ethiopia
• General Discussion
• Global Campaign Efforts: Update on ‘Walk the World’
Initiative Reference Points
1. Agreed – MDG Targets and Indicators
2. Partnership with UNICEF
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2005 MOU between WFP and UNICEF
Shared conceptual framework
30 country offices already collaborating on child hunger
efforts
3. Key publications
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Concept Note (WFP, UNICEF, World Bank)
Repositioning Nutrition as Central to Development, World
Bank, 2006
Progress for Children: A Report Card on Nutrition, UNICEF
2006
4. Two Strategic Questions
1. why a specific focus on CHILD hunger?
• major input and outcome synergies
with other MDGs
• less reliant than overall hunger on
increased GDP and agricultural
production for results
• more subject to interventions focused
on vulnerable children and their families
2. what is different now
that makes this achievable?
• increasing understanding of hunger, nutrition and
•
growth
increasing national resources and capacities
 financial
 organizational and technical (e.g. in communications, media,
and information networking)
 civil society (e.g. improving gender equality and development)
• increasing international assistance
• increasing effectiveness and decreasing costs of
•
information technology
global consensus on Millennium Declaration and Goals
MDG-1: two targets and five indicators
Millennium Development Goal 1
Initiative
target
ONE GOAL
1. Poverty Target:
Halve, by 2015, the proportion
of people on income of less than
$US1 a day
1. Proportion of
population living
below $US1
(World Bank)
2. Poverty gap
ratio [incidence x
depth of poverty]
(WB)
3. Share of poorest
quintile in national
consumption (WB)
* Key Indicator
for the Initiative
TWO
TARGETS
FIVE
INDICATORS
2. Hunger Target:
Halve, by 2015, the
proportion of people who
suffer from hunger
* 4. Prevalence of underweight children
under 5 (UNICEF-WHO)
Currently 146 million children under 51
5. Proportion of population below
minimum level of dietary energy
consumption (FAO)
Currently 852 million2 (of which approximately
350-400 million3 are children under 18
plus pregnant and lactating women)
Sources: 1. Progress for Children: A Report Card on Nutrition (UNICEF, 2006); 2. State of Food Insecurity in the World (FAO, 2004); 3. WFP working estimate
UNICEF and WFP: decades of partnership
1976
MOU on consultation and exchange
of information, joint action in assistance programmes,
collaboration in development and nutrition policies and more.
1985
Additional complementary parameters for cooperation on
emergency response.
1998
MOU on Emergency and Rehabilitation Interventions
1999
Technical Agreement on Field Telecommunications, Global
Coordination and Mutual Assistance
2001
Technical Agreement for Logistics Co-operation
2005
MOU with Technical Matrices on Education, HIV/AIDS and
Nutrition
‘Agreed’ Hunger Definition
• In the most fundamental sense, hunger
exists when a person’s body lacks the
required nutrients to grow and develop a
productive, active and healthy life
• It cannot be measured directly but the
most appropriate way for monitoring
progress on child is underweight.
Healthy growth
for children in
society
Direct
Contributors
Intermediate
Contributors
Healthy Growth
Disease
prevention control
Adequate
dietary intake
Access to
adequate food
Care for mothers
and children
Access
to essential
health services
and a healthy
environment
Appropriate education
Formal
and non-formal
institutions
Underlying
Contributors
Adapted from:
“Strategy for Improved Nutrition of
Children and Women in Developing
Countries.”
New York: UNICEF, 1990.
Political, economic and cultural environment
Potential
resources
Major elements of the Initiative
1. mapping children at risk
2. ‘delivery system’ and interventions
3. ongoing costing and resource tracking
4. communications strategy for advocacy
5. accountability framework
1. mapping children at risk:
micro-level targeting and
implications for geographic
focus
Distribution of Underweight Children in Latin America
(Children per square kilometre)
Source: Millennium Project Hunger Task Force: Halving hunger: it can be done, 2005
Distribution of Underweight Children in Asia
(Children per square kilometre)
Source: Millennium Project Hunger Task Force: Halving hunger: it can be done, 2005
Regional distribution of underweight children
Central & Eastern Europe
and CIS (1%)
Latin America & Caribbean (3%)
East Asia/Pacific
(15%)
Middle East,
North Africa (6%)
Eastern/Southern
Africa (11%)
West/Central Africa
(12%)
South Asia (53%)
Source: UNICEF, Progress for children. Number 4, May 2006, Page2.
Distribution of Underweight Children in Africa
(Children per square kilometre)
Half of the approx.
32 million underweight
children in Africa live
in 22 percent of its
geographic area –
corresponding to less
than 10 percent of
its sub-national
administrative units
Source: Millennium Project Hunger Task Force: Halving hunger: it can be done, 2005
Distribution in 144 Countries
of underweight children
Percentage
of total
72 countries
with
sub-national
data
72 countries
without
sub-national
data
Cumulative
percentage
Top 24 regions in top 5 countries
55
55
Top 2 regions in next 67 countries
10
65
Balance remaining in top 5 countries
7
72
Balance remaining in next 67 countries
15
87
13
100
Source: Calculated from Millennium Project Hunger Task Force: Halving hunger: it can be done, 2005
Ranking by global share
of underweight children
Prevalence of underweight
children in country (%)
share of total underweight
children in the world (%)
Cumulative
percentage of total
India
47
39.0
39.0
Bangladesh
48
5.7
44.7
Pakistan
38
5.5
50.2
China
8
4.8
54.9
Nigeria
29
4.4
59.3
Ethiopia
47
4.2
63.5
Indonesia
28
4.2
67.7
Democratic Republic of
Congo
31
2.3
70.0
Philippines
28
1.9
71.9
Viet Nam
28
1.5
73.4
Country
Source: UNICEF, 2006. The State of the World’s Children. Compiled from Table 2 and Table 6.
Ranking by prevalence
of underweight children
Prevalence of
underweight children
in country (%)
Percentage share
of total
underweight
children in the
world
Bangladesh
48
5.7%
Nepal
48
1.2%
Ethiopia
47
4.2%
India
47
39.0%
Timor-Leste
46
0.1%
1.3
Yemen
46
1.1%
2.4
Burundi
45
0.4%
2.8
Cambodia
45
0.6%
3.3
Madagascar
42
0.9%
4.2
Eritrea
40
0.2%
4.4
Lao People's Democratic Republic
40
0.2%
4.7
Niger
40
0.8%
5.4
Afghanistan
39
1.4%
6.9
Country
Cumulative
percentage of
total
1.2
Source: UNICEF, 2006. The State of the World’s Children. Compiled from Table 2 and Table 6.
Low prevalence countries
global distribution
34.13%
2.14%
34.13%
13.60%
2.14%
13.60%
0.13%
-3S
0.13%
-2S
-1S
0
+1S
+2S
+3S
68.26%
Underweight
95.46%
99.73%
Overweight
High prevalence countries
global distribution
34.13%
2.14%
34.13%
13.60%
2.14%
13.60%
0.13%
-5S
-4S
-3S
0.13%
-2S
-1S
0
+1S
+2S
+3S
68.26%
Underweight
95.46%
99.73%
Overweight
Implications for Geographic focus
of the Initiative
• Global focus for advocacy, policy development
and monitoring
• efforts in 4-8 ‘large’ countries focused on technical
collaboration projects in the 15-25 States/Provinces with
the majority of underweight children
• efforts in 10-20 ‘high prevalence’ countries focused on
national program development and broad-based
operations
• efforts in 40-50 ‘moderate prevalence’ countries efforts
focused on highly targeted operations
Applying VAM to child hunger
Connecting children at risk to
community support
organizations
1. Map areas of high
undernutrition
2. Identify potential
outreach partners
3. Identify support
organizations
4. Strengthen
linkages between
outreach partners
and support
organisations
A ‘live’ mapping and monitoring
system is required to
support partners in
addressing child hunger
…including:
• Administrative
boundaries, village
locations, census blocks,
population estimates
• Health facility locations,
schools, water supply
• Linked databases for intervention
monitoring
• Partner intervention areas
2.‘delivery system’
and interventions
MDG
deadline:
Implications for
levels
of programming and
targeting
2015
global
ensure the sustainable supply of
affordable health and nutrition
commodities and the delivery of
increased financial resources
macro
integrate child health and nutrition needs
into national policies, plans and budgets
meso
strengthen district and community health and
nutrition systems; ensure access to water
and sanitation
micro: empower families to improve their health,
feeding and childcare practices
Available ‘Anti-Hunger’ Interventions
for household and school level
A. Supplemental Food Interventions
B. Non-Food Interventions
1.Base Health & Nutrition Education
2. Micronutrient Supplementation
3. Household Water Treatment
4. Hand-washing Soap
5. Deworming
Global Level
National Level
Implications for
programming priority:
strengthen
community
capacity to assist
families-in-need
State/Provincial Level
10 to 25,000
support
organizations
1 million outreach
partners
100 million families
~350 million
undernourished kids
International Food Aid
100%
Food
Needs
International food aid
Other donors
WFP gap
Other donors
WFP
WFP gap
WFP
Other donors
WFP gap
WFP
% of Hungry Kids
Major components of
Ending Child Hunger and Undernutrition Initiative
100%
Hunger
Needs
Immunization
Water and
sanitation systems
Micronutrient
supplementation
Health and
nutrition education
Complementary
Efforts
Communicable
disease control
Handwashing
Household
water treatment
Additional Initiative
Interventions
Non-food
interventions
Primary and
secondary education
Birthspacing/
safe motherhood
Deworming
100%
Food Needs
Domestic food
assistance
Household food
security assistance
% of Hungry
Children
Food
interventions
International
food aid
100
~ 350 million
-
Initiative interventions
State & National Level
• Micronutrient fortification
Essential Package
Complementary interventions
•
•
•
•
Ensure adequate diet
HIV prevention
Disease Control
Water and Sanitation
Household and School Level
• Health and Nutrition
Education
(inc. breastfeeding and
growth promotion)
• Complementary,
supplementary and
therapeutic feeding
• Micronutrient
Supplementation
• Primary and Secondary
Education
• ARI and Diarrhoea
Treatment
• Immunization
(inc. Vit. A, Iron and
prenatal vitamins)
• Hygiene promotion
• Household water
treatment
• Deworming
• Birth spacing, safe
motherhood and other
reproductive health
interventions
Summary of operational objectives:
1. map areas of high undernutrition
2. identify potential outreach partners
3. support linkages between key levels
required to strengthen outreach capacity
and deliver an essential package of
interventions
4. leverage complementary interventions to
the same geographic/demographic focus
A
Summary of
operational
commitment
“Ain’t no
mountain high
enough...”
“Ain’t no river
wide enough...”
C
D
“...to keep us
from you”
B
“Ain’t no valley
low enough...”
3. annual price tag:
ongoing costing and
resource tracking
Estimate 1: the cost of doing nothing
• economic and social costs and
•
•
consequences of 50 million child deaths
by 2015 due to underlying hunger and
undernutrition
prospects of achieving other MDGs is
significantly jeopardized
higher costs of meeting other MDGs, to
the extent that they can be met at all
without addressing child hunger
The Cost of a ‘package’ of
Household Level Interventions
‘Rough’ Annual Costs
(US$ per household per annum)
A. Supplemental Food
Interventions (average)
~ 55
B. Non-Food
Interventions
~ 55
1.Base Household Health &
Nutrition Education
3.8
2. Micronutrient
Supplementation
14.4
3. Household Water Treatment
4.1
4. Hand-washing Soap
~25
5. Deworming
7.5
Household Level Total
~110
Estimate 2: the cost of doing something:
• country-specific cost estimates
•
•
•
should form basis of global estimate
costing exercise should be related to
model of Initiative inputs and
outcomes
collaboration underway with academic
and technical organisations and
the World Bank to develop
consensus on costing parameters
requires ongoing engagement of
regional and country offices
Initial costing parameters
• base initial costs on Initiative-specific interventions
deliverable with existing community infrastructure
• phase in additional costs of interventions corresponding
to anticipated expansion of infrastructure
• consider limiting estimates to geographic areas
corresponding to approximately 80% of
undernourished children
• consider giving higher priority to interventions for
children under five
• include estimates to strengthen technical and
managerial capacities for:
 monitoring and evaluation
 intervention adaptation and implementation
 community organization development
4. communications strategy
for advocacy: to mobilise
political, financial and other
resources
Successful Efforts
to Reduce Child Mortality
Less Successful Efforts
to Reduce Child Mortality
Countries with highest level of under-five mortality in 1960
Mali
600
Sierra Leone
Guinea
500
Gambia
400
Malawi
Afghanistan
300
Niger
200
Angola
Central African
Republic
Yemen
100
0
1960
1970
1980
1990
1995
2000
2004
Advocacy Objectives
1. increase awareness and understanding
of needs, opportunities and solutions
 with an enhanced evidence base and metrics
2. strengthen national policies and
programmes
 with country-to-country exchange of
experience and the promotion of the ‘Three
Ones’ in country
3. mobilise adequate resources
Advocacy partnership approach
• create shared ‘brand’, campaign entity and
strategy
• build a broad partnership that will create urgency
and maximize outreach – all speaking in a
‘common voice’
• keep children and their families at the centre of
the message
• maximize linkages with other relevant campaigns
at global and national level, e.g.:
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Partnership for Maternal, Newborn and Child Health
International Alliance Against Hunger
Unite for Children Unite Against AIDS
Education for All
Major audiences (potential partners)
• policymakers in both developing and
•
•
•
•
•
•
•
•
industrialized countries including
parliamentarians
donors and foundations
faith-based organizations
other international and national civil society NGOs
private sector – WEF Regional Process
opinion leaders and the media
technical and professional organisations
goodwill ambassadors and ‘champions’
UN agencies
5. accountability framework:
clarifying roles and
responsibilities for
WFP/UNICEF units and
external partners
Initiative accountability: country level
• one agreed action framework that provides
the basis for coordinating the work of all
partners;
• one national coordinating authority, with a
broad based multi-sector mandate; and
• one agreed country-level monitoring and
evaluation system
Initiative accountability: regional level
Country-to-country experience exchange for:
• Political Mobilisation
• Partner Mobilisation
• Technical Collaboration Partnerships
• mapping
• social marketing
• monitoring and evaluation
• costing and resource tracking
Initiative accountability: global level
• annual global reporting of results through adaptation
•
•
•
•
of Progress for Children: A Report Card on Nutrition
regular joint reports to Executive Boards of WFP
and UNICEF on Initiative progress against
milestones
explicit integration with WFP and UNICEF
Strategic Plans
integrated workplans across WFP and UNICEF
units with implementation support responsibilities
related workplans of Partners Group members
to be compiled, monitored and updated annually
‘Light’ Global Level Partnership Process
• Inclusive Partnership Group with sub-groups for civil
society and NGOs, technical collaborators, UN agencies,
the private sector, donors, and governments
• Steering Group of limited size co-chaired by UNICEF and
WFP Executive Directors
• UNICEF-WFP Initiative Team to serve as secretariat to
Steering Group and Partners Group – including for
workplan development and monitoring
Major challenges moving forward
• commitment to the goal
• common organisational context with respect to
mandate:
 bring hunger issues to the centre of the international
agenda
 advocate policies, strategies and operations that
directly benefit the hungry poor
• clarity of purpose and role in the Initiative
• capacity and confidence
 openness to change
 internal and external collaboration
• (cash)
When will the Initiative be
Initiated?
Upcoming milestones
2006
end June WFP Global Staff Meeting consultation
Global advocacy and communication strategy prepared
mid-July Consultation with NGO and private sector partners
end July Review of draft Plan of Action by multi-agency advisors group
end August Final draft of Plan of Action completed
September Informal consultations of WFP and UNICEF Executive Boards
November Review and guidance from WFP Executive Board
2007
January Review and guidance from UNICEF Executive Board
Anticipated publication of the Series on Maternal and Child
Undernutrition in The Lancet
February Convening of Partners Group and formal adoption of Plan of
Action
Publication of UNICEF and WFP programme and policy
resources on addressing maternal and child undernourishment
March Public launch of Initiative
1st Quarter of 2007
January
February
01/02/2007
March
01/03/2007
1
3
Technical Series
in The Lancet
Joint Policy and
Programme
Guidance
(and WHS)
Public (Global)
Launch of
Initiative