Series Summary: Nutrition and Social Protection

Series Summary: Nutrition and Social Protection


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The World Bank and other development stakeholders have well described the theoretical foundation for nutrition-sensitive social protection interventions.[1] Evidence demonstrates that strategic deployment of key levers can maximize impact on nutrition outcomes, which is a crucial factor for improving long-term child development.[2] That is, by maximizing returns for nutrition, social protection interventions can in turn maximize returns on the reduction of poverty and inequality. Globally, while nutrition remains hugely underfunded, investment in social protection systems in low and middle income countries is in the billions and expanding. Governments and their partners are also increasingly implementing nutrition-sensitive social protection programs, with promising examples in all regions of the world.[3]

A Focus on Improving Programs

While the linkages between nutrition and social protection now seem obvious and the historical record is full of successful examples, too often the impact on nutrition outcomes delivered by at-scale nutrition-sensitive social protection interventions is disappointing. Such mixed results underscore that “doing” nutrition-sensitive social protection is not at all straightforward; context matters, as do minute design decisions, coherent implementation arrangements, and incorporation of appropriate nutrition indicators. During the process of operationalization, the “soft” stuff that matters for nutrition sometimes gets lost in the shuffle of simply putting in place a social protection system. Even programs well-conceived at the start can wind up underperforming in terms of their nutrition results due to expedient decisions made on the ground. For this reason, it is best practice to include a nutritionist on the team who is responsible for maintaining fidelity to nutrition principles, and empowered to ensure that project-level objectives to improve child growth and development are translated into what is ultimately implemented.

Current Challenges and Key Topics

As evidenced by the recent Global Forum, there are many countries, donors, and NGOs involved in the design and implementation of nutrition-sensitive social protection programs around the world.[4] Although each program is uniquely designed to address a specific context, many of the obstacles they face are universal. Programs are struggling with similar issues but practitioners rarely have the opportunity to come together as a community to share challenges, trade-offs, and solutions.

The purpose of this SecureNutrition blog series is to provide a view from the trenches of at-scale nutrition-sensitive social protection programming and to explore discrete facets of the design and operationalization processes that affect the magnitude of impact on nutrition outcomes. We will tackle topics such as:

  • What are the key contextual characteristics that must be taken into consideration in the design of nutrition-sensitive social protection programs? What context-specific design elements can be employed to positive affect?
  • Which sector or actor has responsibility for what?
  • What are the qualities of effective nutrition intervention that, at minimum, must be maintained so that potential impact on nutrition is not compromised in the transition from design to implementation?
  • And, what obstacles arise and what trade-offs must be weighed?

The intention is not to deliver guidance per se, but rather to share experiences as they unfold and make the ongoing dialogue more explicit, therein contributing to global efforts to carry out more effective nutrition-sensitive programming.

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[1] World Bank. (2013). Improving Nutrition Through Multisectoral Approaches. Washington, DC: World Bank.
[2] Alderman, Harold. (2016). “Leveraging Social Protection Programs for Improved Nutrition: Summary of Evidence Prepared for the Global Forum on Nutrition- Sensitive Social Protection Programs, 2015.” World Bank, Washington, DC.
[3] Spray, Andrea. (Ed.) (2016). "Leveraging Social Protection Programs for Improved Nutrition: Compendium of Case Studies Prepared for the Global Forum on Nutrition-Sensitive Social Protection Programs, 2015." World Bank, Washington DC.
[4] Spray, Andrea. (2016). "Report on the Proceedings of the Global Forum on Nutrition-Sensitive Social Protection Programs, 2015." World Bank, Washington, DC

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As an agronomist I have been looking at nutrition in terms of its impact on basic crop production, particularly in Africa that continues to rely on manual labor. In this case I think there is a 50% deficit between the amount of calories needed to undertake a full day of agronomic labor (4000 kcal) and what impoverished smallholder farmers have access to (2000 - 2500Kcal). This can greatly curtail the work day and spread the time to complete agronomic task, reducing potential yield and increasing food insecurity. Thus my major concern is which is the higher priority getting sufficient calories to undertake a full day of field work, or diversifying the diet for better overall nutrition. Sorry but this could represent some tough choices for individuals involved. I have been asking this question for over 2 years to various nutrition forums with no replies. Please look at the following webpages: . . Thank you

Your Name: 
Dick Tinsley, Prof. Emeritus Colorado State University

Thank you for your comment, Professor Tinsley, it’s a good reminder of the close nexus between nutrition, social protection, and agriculture. I think everyone would agree that in the discussion of nutrition-sensitive agriculture, the issue of labor – especially women’s labor – is of foremost concern. However, nutrition is a wicked problem and there are several issues tied up in your comment that I would like to address.

First, in nutrition-sensitive agriculture its crucial to consider ‘diet for who’. In the development context, we focus on optimizing the diet for pregnant and lactating women and children in the first 1,000 days. It is well established that nutritional needs are greatest during these phases of the lifecycle and nutritional status during this period has life-long consequences. The cost-benefit of intervening during this period is highest.

Second, I’m a bit wary the false dichotomy offered (e.g. sufficient calories versus sufficient dietary quality). Our current understanding of the pathways from agriculture to nutrition include both production (i.e. production for home consumption) and income (i.e. purchase of foods in markets). Smallholder farmers are in fact typically net purchasers of food, relying on the market to buy foods they do not grow themselves. So, improving diets of mothers and children during the first 1,000 days is not necessarily solely reliant on own grown production. There also tends to be a lot of variation by gender in the roles of agriculture production, as well as the amount of labor required by season (and by whom). Unfortunately, we do not yet have adequate models describing the trade-offs made in the decisions for own-production vs. market purchase – someone should work on this! - but we do know that the food environment in rural contexts is quite complex.

Finally, with regard specifically to productivity, a major cause for decreased agricultural productivity is anemia related to iron deficiency, which is a factor of diet quality rather than quantity of calories consumed.

Your Name: 
Andrea L Spray

Andrea, Thank you for your comments. However, I am not certain they undermine my basic concern. While I recognize that smallholder farmers do purchase some of the food they consume when they cannot produce it, the funds to purchase this food has to come from the sale of some of their agricultural production in the form of cash crops/animals or surplus of more staple crops. The productivity of these marketed farm enterprises and thus the funds available for purchase will be directly dependent on the available labor to produce them. If the farmer work day is restricted by available calories the marketable produce will also be restricted and back to the hard choice they have to make to provide for their families and maximize their production.

If you have a chance please work though the exercise I posted on the Secure Nutrition forum. I would be very interested in the results you obtain.

Thank you,

Your Name: 
Dick Tinsley, Prof. Emeritus Colorado State University