Newsletter of the South Asia

Food And Nutrition Security Initiative

The discussion revolved

around how necessary investments in improved nutrition are for

the region to achieve higher growth rates and poverty reduction.

Estimates cite that up to 3% of the region’s GDP are forgone

due to malnutrition. At the same time, ―Nutrition is like an or-

phan issue, many people recognize its importance but nobody

considers it as their top priority; but as we have heard, nutrition

ought to be considered very central to human development‖

according to panelist Gautam.

Adding emphasis to the prevalence of the problem, Levy stated,

―You go to the slums of any city, whether its Mumbai, Shanghai

or Chicago, you will find urban people that are undernourished:

you will find that the young woman that becomes pregnant does

not seek prenatal care or get prenatal vitamins, she is actually

managed by a local elder woman, often a mother-in-law, and

that baby is delivered and then somebody figures out about

nutrition.‖ Inherent in the need to address this challenging and

persistent problem is a coordinated response from both public

and private sector stakeholders. The panel concluded with Levy

stating, ―The issue really is how do we work together…thinking

about how to make all this discussion a reality…let me leave you

with those challenges.‖ Other themes of the Meetings inter-

twined with the Malnutrition agenda include: the Food Price

Crisis, Climate Change and Gender Equality.

In this issue

Focus on Food

Development Marketplace on Nutrition

An Open Letter from Kul Gautam

Integrated Mapping for Results

Improving Water & Sanitation Coverage

South-South Learning

The SAFANSI Loop Fostering Cross-Cutting Action

World Bank-IMF Annual Meetings: Ensuring Nutrition and Food Security for Results in South Asia

Washington DC, On 23 September 2011, the World

Bank convened country delegates, development

partners, civil society, the media and other stake-

holders from the South Asia region at the Annual

Meetings for an enthralling discussion on Food and

Nutrition Security. With increasingly volatile food

prices, climate shocks and persistently high malnutri-

tion rates there is an increasing call to action for an

effective solution to these vexing problem. It was

noted that two out of the five child deaths that hap-

pen every minute in South Asia could be prevented

by ensuring adequate diet and feeding practices.

The event was an unprecedented opportunity to consider the

role of nutrition in development and to have the World Bank's

regional leadership table such an issue so prominently. The

event featured a high-level panel discussion with remarks from

Isabel Guerrero (VP of South Asia Region, World Bank),

Kalpana Kochhar, (Chief Economist, World Bank), Santiago

Levy (VP for Sectors and Knowledge, Inter-American Develop-

ment Bank), Kul Gautam (former Assistant Secretary General

of the UN and Deputy Executive Director of UNICEF), Memood

Khan (CEO of Pepsico's Global Nutrition Group), and Diane

Jacovella (VP Multilateral and Global Programs, CIDA).

I S S U E

F e b r u a r y 2 0 1 2

02

Ensuring Nutrition and Food

Security for Results in

South Asia

Dear Colleagues,

Food and Nutrition Security is

absolutely crucial to the Bank’s

mission in South Asia, especially

since its indicators of chronic mal-

nutrition are amongst the highest in

the world. Even though food prices

have stabilized in the past few

months, it is now clear that the

MDGs will not be met without sub-

stantial effort and investment in

South Asia to overcome this intrac-

table curse. Until we achieve these

objectives, food and nutrition will

remain a top corporate priority at

the Bank.

Sincerely,

Isabel Guerrero Vice-President, South Asia Region

Focus on Food:

Managing Food

Price Inflation

The World Bank Food Price Index is up 19%

See how South Asia has Faired Using the World Bank’s

Food Price Watch

Washington, DC, The World’s

Food Price Crisis continues to

have affects on food and nutri-

tion security throughout South

Asia. Bad weather, trade

curbs, oil prices and bio-fuel

diversions have all led to

higher food prices, which has

destabilized the incomes and

food security of millions across

South Asia.

While rising food prices risks higher

core inflation in the developing coun-

tries, the volatility seems to be squeez-

ing the poor disproportionately with

considerably detrimental effects for their

nutrition outcomes. José Cuesta, Senior

Economist at the World Bank stated,

"prices remain high and volatile…the

average for 2011 was 24% higher than

for 2011...[As a result] of these high

prices we must remain vigilant, because

high prices may have devastating nutri-

tional consequences which bear reper-

cussions on school performance, health

status, cognitive development and

worker productivity.‖

Recent studies in Afghanistan and

elsewhere have confirmed that rises in

the cost of food have led to a switch in

consumption from nutrient rich foods

(such as vegetables, meats and other

proteins) to nutrient-poor staples (such

as rice and wheat). Cuesta ―also found

evidence of children’s food being pro-

tected, typically at the cost of

women’s...and when the effects of the

crisis are more severe, households may

also sell productive assets, take chil-

dren out of school, and reduce ex-

penses on health.‖

While these are not preferred out-

comes, they are sadly a reality for the

many poor households that face rapidly

fluctuating prices. While concerted

efforts should be made at a national

level to mitigate the nutritional effects of

such shocks, Rice Fortification can be a

cost-effective means to stabilizing the

nutritional impact on these poorest

households. Cuesta further stated, ―We

recommend to have a balanced set of

policies; ones oriented to compensate

for the negative impacts of high prices

especially through safety nets, as well

as medium to long term investments in

agriculture; especially on productivity

and climate-smart agriculture policies.‖

To monitor such fluctuations the World

Bank’s Poverty Reduction and Equity

Washington, DC, The First IMF/WB/

WTO Joint Trade Workshop – inaugu-

rated by Robert Zoellick, President of

the World Bank, and Pascal Lamy,

Director-General of WTO – included a

priority session on ―Trade policy in an

era of high and volatile food prices.‖

William Martin (WB) presented his

paper Agricultural Trade Policies

& Food Security, in which he found

that for individual countries, raising

export barriers or lowering import

barriers to insulate domestic prices

from world prices may help avoid

increases in poverty. If all countries do

this, however, world prices will rise,

reducing the effectiveness of insula-

tion and increasing the problems of

net food importers -suggesting that

careful thought is needed to deal with

this collective action problem.

Michele Ruta (WTO) jointly presented

his paper on, Food Prices and The

Multiplier Effect of Export Policy. Ruta

found that export restrictions and

subsidies in food markets magnify

price shocks, creating a ―multiplier

effect‖: i.e. high food prices trigger

export restrictions that exacerbate the

rise of the world price and feed into

even more restrictive policies. The

empirical analysis confirmed the exis-

tence of this multiplier effects for the

2008-10 food crisis.

First IMF/WB/WTO Joint Trade Workshop:

Trade Policy in an Era of High

and Volatile Food Prices

Group produces its quarterly Food Price

Watch which is complementary to the

FAO’s GIEWS Country Briefs on Food

Security at the country level. As a re-

sponse the Bank has created several

financial instruments to help mitigate

the impacts of climate change on food

price instability. India has begun making

Insurance Markets for farmers, although

there is much scope to scale this up

beyond the current pilot. The IMF,

which also tracks food price commodity

prices, is working through Exogenous

Shocks Facility to provide policy support

and financial assistance to low-income

countries facing such food shocks.

To combat such trends in South Asia,

resources have been made available

through 2012 for the Bank’s Global

Food Price Crisis Response Program

(GFRP) in order to mitigate the worst of

these shocks. In Nepal, a GFRP project

has provided food to approximately

940,000 people through food/cash for

work programs. Some 94% of benefici-

aries reported an increase in food secu-

rity and an average of 5.5 months of

self-sufficiency; 52% of respondents

reported eating more meals each day;

45% reported an increase in the variety

of food consumed; and 30% reported

eating larger meals.

Investing In Child Nutrition

Health Systems Create Healthy Futures: Meet Maya

It is well understood that nutrition by

its very nature is multi-sectoral - it is

an outcome that is influenced by

multiple determinants that lie across

many sectors (agriculture, health,

sanitation, social protection, etc.) and

which depends on the efforts and

actions of multiple actors and institu-

tions. At the same time malnutrition is

also a contributor to the activities and

outcomes of other sectors. Recently,

international initiatives, such as the

Scaling Up Nutrition (SUN) and the

Thousand Day Initiative have

amongst other points, highlighted the

need for countries to adopt gender

sensitive and multi-sectoral nutrition

interventions relevant to their specific

context.

It is known that nutrient deficiencies

suffered in utero are exacerbated by

the low age of first pregnancy in the

region. This linkage can be used to

target this crucial group and leverage

gender’s strategic position in the

complex FNS equation for the im-

provement of nutrition indicators in

many SAFANSI/Bank activities. As

such SAFANSI has continued its

focus on targeting adolescent girls

and mothers in order to break down

the complex layers by which gender

impacts trans-generational nutrition

pathways. Find out more about

the 10 Steps to Beat Malnutrition!

World Bank Innovation Days:

Supporting Local Innovations

Two Years Later

Washington, DC, SAFANSI

has eagerly supported gender-

sensitive, local innovations

through the South Asia Devel-

opment Marketplace (DM) on

Nutrition, which focuses on In-

fant and Young Child Nutrition

(IYCN).

Isabel Guerrero, World Bank Vice

President for the South Asia Region,

stated, ―Undernutrition is one of the

most challenging issues facing South

Asia. Poor nutrition robs a child of a

chance to succeed and live a healthy,

productive life. And yet, an investment

in nutrition is one of the social policy

interventions that has the highest

impact for each dollar spent, in im-

proving a child’s future.‖

The Deepak Foundation and the Soci-

ety for the Elimination of Rural Poverty

– two of the 21 Development Market-

place Grantees – were invited to pre-

sent at the World Bank’s Innovation

Days event, held at the Bank’s Head-

quarters in Washington, DC from June

6 — 8, 2011. The grantees explained

their respective innovations in their

pilot IYCN programs. The Develop-

ment Marketplace on Nutrition pro-

vided seed money and SAFANSI

provided the financing for the imple-

mentation support.

On December 18, 2011, India’s DM

winners convened in Delhi for a dis-

semination workshop to share best

practices, lessons learned and innova-

tive models.

Yet, the development impact of the 21

grantees of the Development Market-

place throughout South Asia, has

been just as notable. Despite its rela-

tively low cost, which highlights the

cost-effectiveness of such interven-

tions, one project is even reporting

that 90% of targeted beneficiaries are

experiencing significant gains in

weight-for-age (underweight). The

effects of these low-cost, high-impact

pilot programs will be felt for years to

come as their innovative models are

replicated and scaled up across South

Asia and even globally. Several case

studies will soon be produced to

showcase select projects.

Interactive!

Food Price Watch

World Food Price Index is

up 19%.

336 Million Chronically

Hungry in South Asia

28% rise in the price of

Rice in Pakistan year-on-

year (2010-2011)

Rising Global Food Prices Trigger World Bank and Donors To

tion facilities or sites for defecation at

US$454 million (Taka 3,000 crore;

10.8%), and drinking water-related

impacts at US$ 207 million (Taka

1,500 crore; 4.9%).

Ninety-five percent of the premature

mortality-related economic losses are

due to deaths and diseases among

children under five. Diarrhea among

these children accounts for US$ 1.46

billion (Taka 10,000 crore; 40.9%) of

all health-related economic impacts.

In Bangladesh, diarrhea is the largest

contributor to health-related eco-

nomic impacts resulting from poor

sanitation, amounting to two-thirds of

the total health-related impacts. This

is followed by acute lower respiratory

infections, which account for about

15% of all health-related impacts.

Poor households are the biggest

victims of inadequate sanitation.

They experience about 71% of the

total economic impact of inadequate

sanitation. ―Over the last decade

Bangladesh has emerged as a global

reference point in experimenting and

implementing innovative approaches

to rural sanitation. Community Led

Total Sanitation, which started in

Bangladesh, has now been repli-

cated in other countries. Bangla-

desh’s basic sanitation coverage

rose from 33.2% in 2003 to 80.4% in

2009. This report shows that despite

great success, much can still be

done in the sanitation sector in Bang-

ladesh‖ said Ellen Goldstein, Country

Director for World Bank in Bangla-

desh.

The losses caused by poor sanitation

exceed Bangladesh’s national devel-

opment budget for 2007–2008 by

33%. The total amount of these

losses is five times higher than the

national health budget, and three

times higher than the national educa-

tion budget in 2007.

―Similar studies carried out in East

Asia and India indicated annual per

capita losses in the range of US$9.3

in Vietnam, US$16.8 in the Philip-

pines, US$28.6 in Indonesia,

US$32.4 in Cambodia and US$48.0

in India,‖ said Christopher Juan Co-

stain, Regional Team Leader for

WSP in South Asia. ―Bangladesh lost

US$29.6 per capita, which demon-

strates the urgency of improving

sanitation in the country.‖

The report underlines that substantial

investments are needed to improve

sanitation. The Government of Bang-

ladesh has made significant invest-

ments towards implementing its

―Sanitation for all by 2013‖ programs.

The rising trend in the Government’s

budgetary allocation to sanitation

indicates a strong commitment to the

goals of the sanitation programs.

The report shows that sanitation and

hygiene improvements will reduce

premature deaths and related mor-

bidity, eliminate domestic water-

related costs, reduce absenteeism at

schools and workplaces, and im-

prove welfare and productivity.

As a result of comprehensive efforts

to improve the level of sanitation, the

report estimates a potential gain of

about US$2.26 billion (Taka 16,000

crore).

Improving Water

and Sanitation

Coverage for

Nutrition

A Study on Bangladesh

Dhaka, Bangladesh, Inadequate

sanitation causes economic losses

totaling US$ 4.22 billion (Taka

30,000 crore) each year in Bangla-

desh. This is equivalent to 6.3

percent of the country’s GDP in

2007, according to a new report

published by the Water and Sani-

tation Program (WSP), a multi-

donor partnership administered by

the World Bank.

The report, Economic Impacts of

Inadequate Sanitation in Bangladesh,

is based on evidence on the adverse

economic impacts of inadequate

sanitation, which include costs asso-

ciated with death and disease, ac-

cessing and treating water, and

losses in education, productivity and

time. The findings are based on 2007

figures, although a similar magnitude

of losses is likely in later years.

The report shows that losses due to

premature mortality and other health-

related impacts of poor sanitation

total about US$ 3.56 billion (Taka

25,000 crore; 84.3% of total eco-

nomic impacts). This is followed by

productive time lost to access sanita-

International Scientific Symposium on Food and Nutrition Security Information: From valid measure-

ment to effective

decision-making

From January 17 to 19 the World

Bank sent delegates to Rome to

participate in the International Sci-

entific Symposium on Food and

Nutrition Security Information. The

conference, sponsored by the FAO

and the European Commission,

brought together leading experts in

the metrics of Food and Nutrition

outcomes. SAFANSI was repre-

sented by its Lead Poverty Special-

ist, John Newman, who presented

on the empirical associations be-

tween the adequacies of food,

health and care with nutritional

outcomes.

Earlier in May 2011 Newman, pre-

sented at the London Conference

on Measuring the Effects of Inte-

grated Agriculture-Health Interven-

tions. Additional relevant literature

can be found on the PREM Notes

publication, entitled: Five Advances

Making It Easier to Work on Results

in Development. Follow up to these

conferences are expected through

the World Bank’s Global Knowledge

Platform on Food and Nutrition in

order to improve monitoring and

effective policy making.

mentation for increasing crop yields

and for improving nutritional outcomes.

Soils in South Asia are

known to be severely

deficient in Zinc, which

translates into reduced

crop yields and wide-

spread zinc deficiencies in

the population. A lack of zinc in a diet

can cause a variety of health problems

including a higher prevalence of diar-

rhea, which has been shown to exacer-

bate morbidity, mortality, malnutrition,

and other micronutrient deficiencies in

South Asia. Zinc-based fertilizers may

Establishing

the Link

Between

Agriculture &

Nutrition Zinc is an essential nutrient

for life and growth, yet it is

widely absent in the soils

and food of South Asia.

Washington, DC, On January 19,

2011, Dr. Andrew Green presented

on Improving Crop Production and

Nutritional Quality, at the World

Bank’s headquarters in Washington.

Dr. Green, Director of Environment,

Health and Sustainability and Direc-

tor of the Zinc Nutrient Initiative (ZNI)

for the International Zinc Association

(IZA), explained how there is sub-

stantial geographic overlay of areas

with zinc deficient soils and zinc

deficient populations.

IZA has a variety of crop and health

programs aimed at increasing aware-

ness about the benefits of zinc supple-

World Zinc Deficiency in Soil:

Major Areas of Reported Problems

be an efficient and effective device to;

increase food security, counteract

diarrheal diseases, and

ensure proper nutrition.

Studies have consis-

tently confirmed the

importance of this link,

w h i c h A l l o w a y ,

explains in his paper,

Soil factors associated with zinc defi-

ciency in crops and humans. Increased

attention to Zinc supplementation in

farmer outreach has the potential to

lead to substantial gains in yield, in-

come and nutritional outcomes for only

a fraction of the cost of investment.

"Almost half of the

world's cereal crops are

deficient in zinc, leading

to poor crop yields."

This Month’s Technology Tips (Interactive Features)

INDIA

New Delhi, India, In conjunction with

the Public Health Foundation of India,

the World Bank has produced a se-

ries of policy notes, entitled: India

Health Beat: Nutrition. These notes,

serve to highlight the importance of

nutrition. They provide an overview of

the situation of nutrition in India, its

variation across socio-economic

groups and states. The first note (Vol.

5, No. 1), uses national data to ex-

plore the undernutrition causal frame-

work with "food-care-environmental

health" as the triad of immediate

causes in order to demonstrate the

association between the adequacy of

these determinants and child nutrition

outcomes. A series of dashboards

developed by SAFANSI for this vol-

ume (No. 1) allow one to explore

different interactions between the

causal factors and nutrition outcomes

at various ages and in various states.

This reveals that 21.6% of children

ages 0-3 months are stunted (29.6%

are underweight), when one exam-

ines the data for children at different

band ranges this reveals, that 59.2%

are stunted and 47.7% are under-

weight for children ages 18 to 24

months. It is apparent that something

is happening in the food-health-care

nexus in Indian households as the

child progresses in age, which stands

in contrast to patterns found in Bang-

ladesh for such age ranges. What is

certain is that this pattern shows

increasingly detrimental affects on

IYCN during the crucial first 1000

days of life.

Health Education and Literacy

Programme (HELP)

Community Based Management of Malnourished Children under Five

5 months. The cost of treatment was

significantly less than that for im-

ported therapeutic food which is

currently being employed in the

country. Akram further stated that the

provision of optimum nutrition to a

child is crucial during the ―window of

opportunity‖ period, i.e. the first 1000

days in a child’s life, from conception

to 2 years of age.

Speaking on the occasion, Dr. Khalid

Shaikh, Additional Secretary, Ministry

of health, Government of Sindh ap-

preciated HELP’s efforts to introduce

a locally manufactured

high-density food supple-

ment. Shaikh noted that it

is important to look for

locally available and

suitable alternatives for

the relief of this crisis,

considering the high rates

of malnutrition in the

country.

According to the FANS survey con-

ducted jointly by UNICEF and the

Government of Sindh, malnutrition

rates are more than the WHO’s

emergency threshold, and yet very

few other organizations in the prov-

ince have the necessary experience

to address this problem. Dr. Dure-

Shehwar Khan, former Focal Person

Karachi, Pakistan, Malnutrition

has attained crisis proportions in

Pakistan with over 42% of children

fully stunted and 31% underweight.

To address this crisis, HELP — an

NGO active in the promotion of

health and education, with a spe-

cial focus on nutrition of children

under 2 and women of childbear-

ing age — has used a locally

manufactured high-energy food

supplement, ―Nutri-HELP‖, made

from indigenous ingredients (dal,

rice, milk, sugar and vegetable oil)

to rehabilitate severely malnour-

ished children.

On 13 December 2012, HELP organ-

ized a seminar in Karachi to dissemi-

nate the results of their SAFANSI-

supported, Development Marketplace

project. Nutri-HELP, which contains

450 calories/100gm, was success-

fully used in two Union Councils of

Taluka Shahdapur, four Union Coun-

cils in Tharparkar and for over 3300

children in Flood Relief camps.

Prof D.S. Akram, Hon. Chairperson

of HELP and renowned pediatrician,

shared the results of the project

reporting that all children who were

given the supplements gained weight

and that over 85% of children at-

tained normal weight over a period of

for Nutrition in the Government of

Sindh, reiterated the fact that malnu-

trition figures in the country are very

high and emphasized the realization

that civil society organizations and

NGOs should share the responsibility

with the government. To rehabilitate

malnourished children, UN agencies

are currently using highly expensive,

imported, ready-to-use therapeutic

foods. Khan further noted, ―It is im-

portant that our government looks for

alternative, locally produced, low cost

products, for the management of

such children.‖ She

went on to stress the

need to create aware-

ness on breast and

complementary feed-

ing practices to coun-

teract malnutrition

a m o n g s t c h i l -

dren. Associate Pro-

fessor S.K. Kauser from AKU shared

the need to ensure that assistance to

decrease food insecurity should

reach the neediest in the country.

She spoke of increasing disparity

between the rich and poor, which she

considered to have exacerbated the

problem of malnutrition.

“It is important that

our government

looks for alterna-

tive, locally pro-

duced low cost

products”

SRI LANKA

Colombo, Sri Lanka,

In 2007 the World Bank pro-

duced the seminal report on

Malnutrition in Sri Lanka. The

report details the scale, scope,

causes and potential responses

for the country. Malnutrition

prevention strategies span

many sectors, and while the

report identifies those sectors, it

primarily focuses on developing

a programmatic framework for

the health sector. The study

also identified problematic Mi-

cronutrient deficiencies, such as

anemia and vitamin A defi-

ciency. Since this study was

conducted Sri Lanka has at-

tained one of the lowest malnu-

trition rates in the region, al-

though much work still remains

to be done there as well.

Civil Society is also taking a

leading role in advancing the

nutrit ion agenda through

Sri Lanka’s Green Friends Envi-

ronmental Organization (GFEO)

— a Development Marketplace

winner — who recently com-

pleted their project on generat-

ing communication for improved

Infant and Young Child Nutrition

through producing radio pro-

grams. Their innovative out-

reach model is just one such

example that can be used else-

where in South Asia.

Community Involvement in

Promoting Neonatal and

Infant Nutr i t ion in Tr iba l

Vadodara, India:

The Deepak Foundation

Vadodara, India, The Deepak Foun-

dation has implemented an intensive

monitoring and advocacy program in

the Vadodara district to improve nutri-

tional behavior through inter-

departmental convergence, commu-

nity participation, and the use of a

unique cultural harness – a horo-

scope – to entice women to accu-

rately record critical newborns health

information.

Previously, only 73% of newborns vital

nutrition-health indicators were re-

corded in these rural areas, which im-

pedes the identification and manage-

ment of high-risk infants. Nandini

Srivastava, Deputy Director, Deepak

Foundation, stated ―The barriers in

improving infant survival in nutrition

have been impaired by the registration

system, the convergence of health

services at the grassroots level, and the

level of community participation.‖

Describing Deepak’s model, Srivastava

went on to state how Deepak utilizes its

network ―to distribute this horoscope to

each and every parent, who would

provide correct information on date of

birth, initiation of breast feeding and the

correct birth weight of the child. The

horoscope, beyond documenting the

birth details of the child, helps in gener-

ating interest in the parents into the

newborn’s health.‖

The project leverages various programs

and government initiatives, which has

proven successful at empowering local

communities and increasing their de-

mand for newborn health services.

Archana Joshi, Director, Deepak Foun-

dation, describing the effects of this

integrated initiative, stated, ―This is the

first time the communities have come

together. There are different platforms

given to them and they see…that to-

gether we can achieve something. The

collective efforts of the community at

different [administrative] levels assures

that once they come together and work

towards a common agenda that the

government will actually listen to them

rather than [if they had] approached the

individual departments.‖

This convergence further extends to

water & sanitation committees, which

raise awareness through wall paintings

on nutrition/health issues, drinking wa-

ter quality, and which ensures distribu-

tion of fortified complementary food

premix and iron supplements. More

information on this project can be found

on The Deepak Foundation’s website.

Innovation Spotlight: The Deepak Foundation

Results in Action

Increase in institutional

deliveries from

14% to 72%

41% Decline in the

Maternal Mortality Ratio

7% Decline in the

Infant Mortality Rate

BANGLADESH

Dhaka, Bangladesh,

Bangladesh is the recipient of a

$50 million, Global Agriculture

and Food Security Program

(GAFSP) funding grant that will

enhance the productivity of agri-

culture in selected agro-

ecologically challenged and

economically depressed areas

where agriculture production is

severely constrained.

At present farmers can cultivate

only one rice crop per year in

tidal surge and flash-flood prone

areas. Production is highly vul-

nerable to weather conditions

and productivity is low, in part

because available mainstream

technology and agronomic prac-

tice are not adapted to field con-

ditions. GAFSP support will aim

to generate and release more

productive and locally adapted

technologies with higher yield,

enhance quality of seed/breeding

material at the small farm level,

provide relevant extension and

advisory support, and improve

irrigation and surface water man-

agement. Expected outputs

within the lifetime of the project

are the release of 10 new crop

varieties, 21 location- and/or

problem-specific packages and

the genetic improvement of the 9

main pond fish breeds of the

country, amongst other outreach

services.

An Open Letter from Kul Gautam

Dear Honorable (Future) Ministers,

Many people recognize the importance of proper nutrition, but nobody considers it as their

top priority. Some governments wisely recognize nutrition as a multi-sectoral issue – which it is

– but making it multi-sectoral often has the disadvantage of nobody taking it as their prime

responsibility, even though it ought to be considered as central to human development objec-

tives in all these ministries. In the greater scope of things, nutrition is indeed like an orphan

issue.

I know that as Ministers and Secretaries you receive delegations every day from advocates

who make a similar case for building roads, airports, schools, opening new industries, helping

the unemployed, etc. Faced with limited budget and unlimited demands and political pressure

to satisfy many constituencies, you may ask, where should nutrition fit in this balancing act?

Yet, I fear that nutrition is often neglected in such decisions. Indeed, the case for nutrition is

not only an urgent humanitarian issue, it is one that should be considered as minimally neces-

sary for proper national development. Healthy and well-educated citizens can be the greatest

asset for our countries, whereas the persistence of high levels of malnutrition will doom our

future generations to a sickly childhood, a lethargic adolescence, and an unproductive adult-

hood.

In order to effectively address this persistent problem we should particularly focus on new-

borns and their mothers. Let us recall that some 80 percent of human brain is formed in the

first 1000 days, or from conception to two years of age of a child’s life. Whether a child will be

a genius or will be physically disadvantaged is largely determined during those first 1000 days.

Such deficiencies can be overcome with many extremely low-cost and effective investments,

which are central to achieving the Millennium Development Goals and building strong founda-

tions for national development. Specific, well-targeted nutrition interventions are necessary if

we are to break the back of this malnutrition.

We ask your help in lifting up nutrition from being the orphan issue that it currently is, to be-

coming a key indicator of our progress in human capital, which is so essential for economic

development. In this respect, nothing would elevate nutrition from being an orphan to a fa-

voured child, as its adoption by the Ministries of Finance and Planning as a critical indicator of

a nation’s long-term economic health. I would hope that they would not only provide ade-

quate funding but insist on regular monitoring of progress in the growth and development of

our children.

If this is going to be an Asian century, South Asia—led by the respective ministries in each

country—will have to overcome its record of being the region with the highest levels of malnu-

trition in the world. As pilots, guardians and partners of the South Asia’s economies, I urge you

all to adopt the fight against malnutrition as a central part of your mission.

Sincerely,

Kul Gautam

“Investment

in nutrition is

precisely one

of those vital

issues crying

out for your

leadership.‖

- Kul Gautam

Mr. Gautam is former

Deputy Executive

Director of UNICEF

and Assistant

Secretary-General of

the United Nations.

He also serves as

Member of the

SAFANSI Technical

Advisory Committee

(TAC).

An Open Letter from Kul Gautam

Google Public Data Explorer: World Development Indicators

Nutrition Progress

to Date

22% Reduction in

(Underweight)

Malnutrition in

Nepal

22% Reduction in

(Underweight)

Malnutrition in

Bhutan

Interactive!

erate with the Ministry of Interior to

promote community food production

and occupational training. The MOI

was responsible for integrating nutrition

into community development efforts

and with establishing training programs

for development workers, managers of

day-care centers, and youth groups.

The MOE was responsible for nutrition

education in schools and day care

centers and nutrition training programs

for teachers. It also organized school

feeding programs in association with

village food production programs, such

as school gardens and fish ponds,

through cooperative programs with the

MOA. MOE also established growth

monitoring in primary schools. The

Bureau of State Universities provided

support through programs at Mahidol

and Kasetsart universities. At the pro-

vincial level Provincial Food and Nutri-

tion Committees were established in

each participating province with a com-

position similar to that of the national

committee. Appropriate incentives

aided in the supply and demand side of

these programs.

This study has found that a key reasons

for progress is the coordination of differ-

ent sectors and ministries to promote

nutrition policies and programs, which is

noticeably absent in South Asia. Respon-

sibility for Thailand’s National Food and

Nutrition Committee was shared by high-

ranking representatives of four ministries

– Public Health (MOPH), Education

(MOE), Interior (MOI), and Agriculture &

Cooperatives (MOA) – which developed

action plans in accordance with their

functional responsibilities.

Although the MOPH was the primary

channel for implementing nutrition pro-

gram, other ministries and institutions

had specific responsibilities. The Ministry

of Agriculture & Cooperatives was re-

sponsible for integrating nutrition into

agricultural extension programs

(including extended it to the fisheries

subsector) and encouraging villagers to

produce and consume their own nutri-

tious foods, including high-protein foods,

fruits, vegetables, and legumes. The

MOA also supported applied research

and promoted nutritious products in

schools. It was also encouraged to coop-

Engaging the

Past with

Lessons for the

Future:

A Study on Thailand

Bangkok, Thailand, It is noted

that South Asia’s severe malnutri-

tion rates are not unprecedented.

In fact, many countries in South

East Asia, were in the same posi-

tion only 30 years before, thus

begging the question, How did

those countries accomplish so

much since then?

The Bank has set out to answer this

question, by engaging in a South-South

learning exercise to determine how Thai-

land, Malaysia and others have reduced

their underweight rates of so drastically.

It is recorded that child malnutrition indi-

cators (underweight) were reduced from

50% in 1980 to 25% by 1986 and 15%

by 1995 while Anemia was reduced to

27% in 1988 from 45% in 1980.

Open Data

Through the Bank’s Open Data

Initiative improvements in malnutrition

indicators can be explored on the

Google Public Data Explorer. This tool

allows one to view and present the

Bank’s World Development Indicators

in new and interactive ways. By view-

ing the Bank’s time series data, it is

easily apparent that huge strides have

been made since the 1970’s, but

much work is still to be done if the

Millennium Development Goals are to

be met by 2015.

World Bank e-Institute:

Professional Development

The Bank’s new e-Institute for Develop-

ment offers innovative courses in fron-

tier topics such as; Health Systems

P o l i c y R e f o r m / E c o n o m i c s /

Management/Service Delivery; Govern-

ance; Gender; Systems of Rice Intensi-

fication; Food Safety; Health, Nutrition,

Population; Climate Change; Climate-

Smart Agriculture; Standards and Agri-

culture Trade and much more. The

content in a variety of these courses is

both useful and applicable to Food and

Nutrition Security in South Asia. Addi-

tional courses are being planned and

will be released on this website when

ready.

BHUTAN Bank Seeks Strong

Engagement in Bhutan

Thimphu, Bhutan, On 19 December

2011 the Ministry of Health in collabo-

ration with the World Bank organized a

Policymakers’ Roundtable on Health

Financing in Bhutan that was chaired

by the Hon'ble Minister for Health. The

consultation was attended by over 60

senior government officials and mem-

bers of parliament, and development

partners. As part of the ongoing Public

Expenditure Review of the Human

Development sector a joint team from

the Ministry of Health and the World

Bank findings from three policy-related

health sector studies recently under-

taken, including: (i) a National Health

Accounts study, (ii) a detailed cost

analysis of public health services, and

(iii) a GIS study on access to health

services. These studies were a

groundbreaking policy engagement

with Bhutan. The World Bank team

discussed how Bhutan was faring in

terms of their nutrition outcomes, and

how malnutrition was affecting cogni-

tive outcomes and future productivity

of the young generation. The roundta-

ble also discussed an upcoming

SAFANSI-supported Bank activity in

the nutrition sector, for which a com-

prehensive nutrition assessment and

gap analysis will shortly be undertaken

in the country.

lifestyle of the migrants from rural to

urban should not be looked at as an

impediment for covering migrant

children under central government

sponsored universal nutrition

and immunization programmes."

This meeting marked an important

step towards institutionalizing possi-

ble ways to ensure that this vulner-

able group is not left out by the sys-

tem, and get adequate care and

support facilities that integrate meet-

ing their nutritional needs at con-

struction sites. The workshop was

attended by over 40 participants from

civil society, public institutions, devel-

opment agencies and government;

including, Mobile Creches, MS Swa-

minathan Foundation, UNICEF,

World Bank, MARG, Public Health

Foundation of India, National Institute

of Public Cooperation and Child

Development, Food and Nutrition

Board, Action Aid, NIN, and the

teachers who ran the centers. The

workshop highlighted the problems of

migrant communities and provided a

platform to discuss integrated strate-

gies and approaches to address the

food and nutrition security of these

communities, and to come together

on a common advocacy and sensiti-

zation platform for engaging with

builders in the private sector, govern-

ment officials and program function-

aries, civil society and communities.

health, education, water and sanita-

tion services remains non-existent.

Such conditions lead to compromised

infant and young child feeding and

catastrophic malnutrition rates. It is

with children in such settings across

10 major construction sites in Hy-

derabad that DRF worked to develop

a model to address child care, edu-

cation, and children’s food and nutri-

tion needs. Supported by the SAR

DM, DRF established ECCE facilities

at construction sites to provide nutri-

tious food, quality care and relevant

education to mothers and children.

Most importantly these centres es-

tablished accessible links with gov-

ernment services provided through

the GOI’s Integrated Child Develop-

ment Services Scheme and the pri-

mary health care system. These

centres have demonstrated that low-

cost, special approaches are re-

quired to ensure access to quality

services. The results of this pilot

highlight the tremendous importance

of such projects and the impact that

appropriate safeguards for project

preparation can have on nutrition

outcomes.

From the findings of this pilot it is

apparent that there is a substantial

need to create greater awareness –

amongst builders' associations, gov-

ernment departments, NGOs, and

development partners – of the impor-

tance of providing adequate care

facilities and nutrition/health services

at construction sites. The workshop

was set up to share the lessons

learnt and to emphasize one ex-

tremely important fact "that transient

Constructing a

Healthy Future for

Migrant Children

Dr. Reddy’s Foundation

Hyderabad, India, On 24 No-

vember 2011, Dr. Ready’s

Foundation (DRF) in conjunc-

tion with the National Institute

of Nutrition (NIN), convened

key policy makers and busi-

ness leaders in Hyderabad at a

workshop to present the re-

sults of their South Asia Re-

gional Development Market-

place (SAR DM) pilot program

on an integrated Early Child-

hood Care and Education

(ECCE) model to improve food

and nutrition security of chil-

dren from migrant families liv-

ing on construction sites.

Often moving from one site to an-

other, the children of construction

laborers remain one of the most food

insecure and nutritionally vulnerable

groups in India. These roaming

households often lose the community

connections that constitute an infor-

mal social safety net – through vil-

lage networks and the traditional

support of extended families – that

would otherwise help ensure at least

minimal food security. Instead, these

children are left to live in deplorable

conditions and play in the rubble of

dangerous construction sites while

both parents work and even the most

basic access to food, nutrition,

Global Conference on Women in Agriculture

Women’s increasingly prominent role in agriculture —

especially for horticultural production of grapes/raisins (a

source of iron to reduce anemia) and almonds (a source

of fatty acids for early childhood brain development at-

tained through breast milk) in Afghanistan — combined

with their importance in achieving nutritional outcomes,

can be used to leverage this position in the complex

equation for Food and Nutrition Security in South Asia.

A high-level Global Conference on Women in Agriculture

is being convened in Delhi between March 13-15, 2012.

The Conference is being co-hosted by the Indian Council

of Agricultural Research and the Asia Pacific Association

of Agricultural Research Institutions. The conference will

be inaugurated by the President of India, H.E. Pratibha

Patil, and will also be addressed by Michelle Bachelet,

Under Secretary General and Executive Director, UN

Women.

Bamyan, Dikundi and Badakhshan)

and the second assessment was

based on responses of NGOs to a

questionnaire from the Provincial

Nutrition Department (PND). Dr.

Mohammad Taufiq Mashal –– Gen-

eral Director of Preventive Medicine

Directorate / SAFANSI TAC Member

–– presented the message of H.E.

the Minister of Public Health and

announced the willingness of the

MoPH for taking the recommenda-

tions of the workshop serious by

assigning a technical team to work

on developing an actionable frame-

work. The PND team summarized

the key recommendations of the

participants and is working with part-

ners to develop this framework. The

final version is set to be presented to

the Bank and Development Partners

to ensure commitment for the support

of its implementation after approval

from H.E. the Minister of Public

Health.

Badakhshan, Takhar and Kunduz.

Ghyasi noted that breastfeeding

messages are difficult to convey

since the subject is largely taboo to

talk about openly in Afghan society.

CAF is also seeking to overturn per-

ceptions that malnourished people

are actually lazy, since it is not widely

realized that such appearances can

be the result of malnutrition. CAF has

worked to overturn such perceptions

and to ensure that women and chil-

dren routinely have the opportunity to

eat three proper meals per day to

counteract the high malnutrition

rates. CAF is taking on a strong role

as a domestic steward of this agenda

by pushing for more monitoring and

evaluation at all levels.

Prior to the workshop, the MoPH

announced the results of the Afghan

Mortality Survey, which showed

significance improvement in maternal

& child mortality rates, although there

is still room for improvement. Dr.

Parwiz, advisor to Preventive Medi-

cine Directorate, presented the result

of two different assessments of the

nutrition component s in the BPHS.

The first assessment was a study of

five provinces (Kabul, Nengarhar,

Baby Friendly Villages Care of Afghan Families Kabul, Afghanistan, From De-

cember 14 - 15, 2011, a prominent

workshop was held in Kabul with

the high authority of the Ministry of

Public Health (MoPH), multiple

NGOs, and the World Bank/UN

agencies in order to discuss the

importance of proper child feeding

and equitable/healthy life styles

and the urgency of chronic malnu-

trition in Afghanistan. Dr. Hemati,

head of GCMU, opened the work-

shop and announced the MoPH’s

willingness to support and opera-

tionalize nutrition interventions

through the Basic Package of

Health Services (BPHS).

Dr. Asef Ghyasi from Care for Afghan

Families (CAF) – a Development

Marketplace winner – presented the

findings and lesson learned of their

pilot ―Baby Friendly Villages‖ pro-

gram, which was implemented in

AFGHANSISTAN

Kabul, Afghanistan,

Following the release in 2011 by

the World Bank of the report on

Malnutrition in Afghanistan;

Scale, Scope, Causes and Po-

tential Response, the Govern-

ment of Afghanistan — with

support from SAFANSI and other

partners — has been preparing a

multi-sectoral Nutrition Action

Framework in Afghanistan. This

report is unique in that it will

integrate sectoral knowledge and

promote the capacity of several

ministries for planning and deliv-

ering an evidence-based re-

sponse to the challenge of food

and nutrition insecurity in Af-

ghanistan, with a particular focus

on equity related to gender,

poverty and geographic location.

In July 2011 the five core Minis-

tries — including the Ministry of

Agriculture, Irrigation and Live-

stock; the Ministry of Rural Reha-

bilitation and Development; the

Ministry of Education; the Minis-

try of Commerce and Industry;

and the Ministry of Public Health

— came together to review

progress on their respective

chapters in the framework and to

explore potential synergies be-

tween the sectors. The Plan of

Action is expected to be finalized

in the first half of 2012.

Prevalence of Child Malnutrition in South Asia

Integrated Mapping for Results

Utilizing GIS systems

for Monitoring and

Operational Targeting

poverty and malnutrition. We there-

fore believe that these maps will be of

considerable benefit when a mecha-

nism for aid allocation is required.‖

The Bank study in Cambodia esti-

mated that such small area

estimation techniques for aid

distribution could increase

budgetary efficiency by an

outstanding 200%-300%,

and could potentially contrib-

ute up to 500% as much

―bang-for-buck‖. With such

savings potential, geographic map-

ping methods are gaining momentum

in the development arena.

The Bank’s Sustainable Development

Unit has used a different mapping

methodology for its Climate Change

Portal in order to integrate multiple

analytical layers into one user friendly

map. Due to the multi-sectoral deter-

mination of FNS, this is incredibly

useful for drawing out relationships

between these determinants for the

Bank’s operational work. Yet these

maps often produce as many ques-

tions as they answer. From a quick

scan it seems as if

there is a correlation

between proximity to

riparian/water sys-

tems and malnutrition

rates, although more

work is needed to

confirm. The combi-

nation of ever richer geographic

analysis with multiple map layers

may be able to help uncover un-

known aspects, dimensions and

roots of this persistent South Asian

Enigma. Although advancements in

these methods (especially in the

visual display of statistical errors) are

still needed to refine the analysis,

these maps can be a very effective

and powerful tool for communication

to policymakers.

“a series of user-

friendly maps...will

make it very easy

to identify areas

with high concen-

trations of poverty

and malnutrition.”

Washington, DC, Modern tech-

nologies have led to the advent of

intuitive new methods to analyze

the spatial structure of food and

nutrition outcomes, which has had

some very practical outcomes for

targeting the Bank’s operational

work.

Many studies have concluded that

the governments have been able to

effectively reduce food insecurity and

malnutrition by geographic targeting.

While seemingly inefficient, targeting

resources to the geographic areas

where malnutrition and food insecu-

rity is the most persistent can have

substantial benefits as compared to

other types of targeting, although

there is scope to combine spatial

targeting with other methods for

maximal affect. A WFP study entitled,

Local Estimation of Poverty and

Malnutrition in Bangladesh, has util-

ized the small area estimation meth-

odology—pioneered by the Bank in

Cambodia—to come up with similar

conclusions. Douglad C. Coutts of

the WFP & Salehuddin M. Musa of

the GoB have jointly written that,

―Through the use of Geographic

Information Systems technology, the

local level estimates have been plot-

ted on a series of user-friendly maps,

which will make it very easy to iden-

tify areas with high concentrations of

PAKISTAN

Islamabad, Pakistan, On 13 Janu-

ary 2012, the D-10 Group of the

main development partners in Paki-

stan met under the chairmanship of

the Secretary Economic Affairs

Division, Ministry of Finance, and in

the presence of senior representa-

tives from the provincial govern-

ments to discuss how to address

malnutrition in Pakistan. The prov-

inces are currently working on de-

veloping the plans they committed

to prepare at that meeting. These

provincial plans will form the basis

for updating the national nutrition

strategy. The World Bank has facili-

tated the formation of a Pakistan

Nutrition Development Partners

Group to enhance the coordination

of a response to these plans.

On 8 – 9 March 2011, the World

Bank also organized a Roundtable

Discussion on Agriculture and Water

for Agriculture in Pakistan to identify

priority areas for investment in the

agriculture sector. SAFANSI pro-

vided co-financing – at a critical

point in time – in an effort to include

food and nutrition security into what

is traditionally a discussion focused

on productivity. The new platform

has enabled the dialogue on Food,

Nutrition and crop diversification to

grow within the national (and provin-

cial) forum for Agriculture. The Bank

and other donors are coordinating

with the National Forum for Agricul-

ture (within the Planning Commis-

sion) and the individual provinces as

they develop an ―out of the box‖

strategy for agriculture.

defining the role of each ministry.

What was uncovered about this Mul-

tisectoral route to success was that

the joint collaboration, but not joint

implementation, was what led to

nutrition outcomes. While Ministries

acted separately, they did so with

clearly defined roles, handed down

by a national plan of action.

This plan mandating inter-ministerial

collaboration was adopted by the

parliament and provided separate

budget for explicit purposes, which

proved to be crucial for incentivizing

action. For instance the MOH and

MRD were given authoritative financ-

ing to prevent and manage infectious

diseases and improve nutrition

through the promotion of improved

drinking water supply and sanitation,

which they might not have pursued

without allocated resources. The

National Environmental Sanitation

Program was implemented and safe

water was provided to most parts of

the country. The goal was to improve

nutrition through the reduction of

diarrhoeal diseases and other food

and waterborne illnesses. Through

coordination between the MOE and

MOH, School nutrition programs

were also established to improve the

nutritional status of children by pre-

venting and controlling specific mi-

cronutrient deficiencies, such as

iodine deficiency disorders, vitamin A

deficiency and Iron deficiency. Nutri-

tion education was emphasized

among mothers with infants, a

breastfeeding program was promoted

and access to nutrition information

among the population was given

emphasis. Finally, improving house-

hold food security and integrating

nutrition into agriculture programs

was of vital importance.

The evaluation of the program after

the first NPANM in 2005 showed

considerable results; the overall

prevalence of underweight among

children aged below five years was

17.3% in 2004 compared to 25% in

1990; the prevalence of anemia in

children below six years of age was

17.7% for boys and 20.5% for girls in

2000 compared to 25% for boys and

29% for girls in 1990. Vitamin A defi-

ciency was 2.5% for boys and 4.5%

for girls in 2000 compared to 6.3%

for boys and 10.4% for girls in 1990.

In addition the number of households

with running water and sewerage

systems reached nearly 99% by

2005. Monitoring using anthropomet-

ric indicators of both school and

agricultural-based programs has also

been crucial for achieving such re-

sults. Most importantly, however, it

was found that the participation of

NGOs and community organizations

is likely to positively affect nutrition

outcomes. Given the strong history of

CSOs in South Asia, the energies of

such groups (e.g. the Development

Marketplace winners) could be util-

ized to obtain nutrition outcomes and

policy/service coherence.

Malaysia A Multi-secotral

Success Story

in Reducing

Malnutrition

Kuala Lumpur, Malaysia,

Malaysia is an example of a

country that has reduced mal-

nutrition significantly in the

past two decades and which

can provide invaluable lessons

for South Asia as it embarks to

replicate this notable success.

In Malaysia there were several ele-

ments which contributed to the coun-

try’s success, the chief among them

being: (i) the role of international

organizations and conferences in

motivating policy changes, including

the implementation of the National

Plan of Action for Nutrition of Malay-

sia (NPANM); (ii) Multisectoral col-

laboration to improve the nutritional

status of the population; (iii) estab-

lishment of the appropriate institu-

tions; and (iv) specifying the imple-

mentation arrangements by clearly

NEPAL

Kathmandu, Nepal,

The Global Agriculture and Food

Security Program (GAFSP) recently

awarded Nepal a $46.5 million grant

to improve household food security

through increased agricultural pro-

ductivity, household incomes, and

awareness about health and nutri-

tion – specifically

focused in the mid-

western and far-

western develop-

ment r eg ions .

GAFSP funding for

Nepal aims to improve food security

in the poorest and most food inse-

cure regions across three key as-

pects of food security – availability,

access, and utilization. The project

is likely to benefit approximately

150,000 small and marginal farm-

ers, 50,000 young mothers, children

and adolescent girls, and 25,000

agricultural wage workers.

GAFSP funding will support sub-

projects designed to provide dietary

support, increase supply of nutri-

tious foods, and promote appropri-

ate nutrition, health, and hygiene

behaviors through community

based programs. These programs

will target pregnant and breast

feeding women, children under two

years old, and adolescent girls.

Educational activities will cover the

source and value of nutritious food,

proper utilization of available foods,

the importance of sanitation, and

the value of appropriate feeding

practices for young children, includ-

ing breast feeding infants.

SAFANSI Technical

Advisory Committee

Inaugural Meeting

The Technical Advisory Committee

(TAC) is a body of seven in-country

leaders — including Sudarshini Fer-

nandopulle (Sri Lanka), Kul Gautam

( Ne p a l ) , M a h ab u b Hoss a in

(Bangladesh), Saba Gul Khattak

(Pakistan), Mohammad Taufiq

Mashal (Afghanistan), Naresh C.

Saxena (India), K. Srinath Reddy

(India) — which advises the Bank on

Food and Nutrition Security (FNS) in

South Asia. It was established to

foster intra-regional cooperation and

learning and to enable domestic

stewardship of the FNS agenda. The

Bank convened a meeting of the TAC

in 2011 to ascertain strategic direc-

tions that the Bank should take in

addressing the alarming rates of

malnutrition. The TAC stressed need

for Gender inclusion, Political Econ-

omy Reform, and simple yet effective

means for conveying information

(using social media) to the necessary

policy makers at different levels. The

TAC also favored a Life-Cycle ap-

proach, which starts with interven-

tions that target adolescent girls and

pregnant women, and then ad-

dresses infant and child feeding,

child growth, schooling, nutrition/

health education, etc. They further

stressed the need to develop a holis-

tic, multi-sectoral action plan that can

harmonize and coordinate the re-

sponses of donors with the govern-

ment and other key players. Using

this guidance, SAFANSI is develop-

ing a multi-sectoral action plan in

several South Asian countries in

order to complement the Bank’s

Regional Assistance Strategy for

Nutrition in South Asia.

Washington, DC, In December

2011 Dr. Archana Patel and

Dr. Leena Dhande – investigators

from the SAFANSI-supported Lata

Medical Research Foundation –

presented on their study entitled,

―The Evaluation Of The Effective-

ness Of Cell Phone Technology As

Community Based Intervention To

Improve Exclusive Breast Feeding

& Reduce Infant Morbidity‖ at the

3rd annual mHealth Summit in

Washington DC. The Lata Medical

Research foundation was one of

21 winners of the Bank’s Develop-

ment Marketplace on Nutrition.

The conference was a meeting point

for leaders from government, NGOs,

and entrepreneurs from the across

the mHealth network (including Medi-

cal, Software, Mobile companies).

With more than 3500 participants

representing 350 agencies from over

50 countries, the

mHealth summit was

an ideal platform for

exploring, examining,

and debating the

ways in which mobile

technology can trans-

form healthcare

delivery, research,

business and policy

for the 21st Century

in underserved communities.

Lata’s work highlighted their ground-

breaking health research which util-

izes mobile technologies for both

clinical medicine and public health

outcomes, including; cardiovascular

disease management, emergency

response strategy, and particularly

maternal & child health.

Their presentation pro-

vided an emphasis on the

importance of exclusive

breast feeding to reduce

infant morbidity, mortality

and malnutrition in India,

which maintains the high-

est number of malnour-

ished children under-five

in the world. Conven-

iently, India also has one of the larg-

est cell phone subscriber rates in the

world with cheap, user-friendly plans.

In this context, the Lata identified cell

phone-based lactational counseling

as an innovative intervention to im-

prove the otherwise dismal rates of

malnutrition prevalent in India. Fortu-

nately, Lata’s project was able to

show substantial improvements in

exclusive breast feeding rates (over

95%) in pregnant women from these

socioeconomically marginalized

target groups. Lata has produced a

paper that describes the methodol-

ogy, results and potential of this

model.

Using Technology To

Improve Exclusive

Breastfeeding

through Cell Phone

Counseling:

Lata Medical

Research Foundation

―Breast milk is the

ideal food for the

infants under six

months. It contains

all the nutrients and

fosters growth for the

first months of life‖

In n o vat io n Spo t l igh t : L a t a M edica l R esearch F ou n d at io n

Dear Colleagues,

We are happy to report on the progress that SAFANSI, the Bank, our Donors and the

Development Partners have been making since we last spoke. A National Plan of Action

for Food and Nutrition Security (FNS) in Nepal and Afghanistan is nearing completing. In

the wake of the 18th Amendment, work is underway for the same in Pakistan. We are

also especially happy to report that the Bank has even begun a groundbreaking engage-

ment with the Government in Bhutan on nutrition; the first of its kind in the country.

Key in all of these engagements are our continued efforts to network in domestic

stewards of the nutrition agenda that serve such a crucial role in advocating for

nutritional improvements. As we continue to grow and expand our initiative, we are

continually seeking contributions, thoughts, concerns and comments on how we can

achieve a more integrated response to the challenges that lie ahead.

In this respect we welcome our new and continuing partnerships with DFID, AusAID,

SUN, LANSA, IFPRI, FAO, WFP, 1000 Days, REACH, the SAR DM and many more. We

hope to hear your thoughts as we advance our mission in South Asia.

Kind regards,

The SAFANSI Team

DFID: Scaling up a multi-sectoral response to undernutrition Tackling hunger and undernutrition remain a top priority for DFID in South Asia and

globally. Our efforts are focused on scaling up what we know works: intervening in the

first 1,000 days from conception to a child’s second birthday to stop the irreversible

effects of undernutrition and joining and supporting a new global movement – Scaling

Up Nutrition (SUN) – which is providing political momentum and coordinated support

to countries. DFID support to SAFANSI and our collaboration with the World Bank and

AusAID and other partners is a keystone in this work in South Asia. DFID’s overall ap-

proach to tackling undernutrition is captured in ‘Scaling up Nutrition: The UK’s position

paper on undernutrition.’ Some highlights with direct relevance to South Asia include:

(i) Working closely with other donors supporting the Scaling Up Nutrition (SUN) move-

ment to align our support behind national plans for scaling up; (ii) Working with the

Institute of Development Studies in the UK to conduct research into the key elements

of political economy which are important in different contexts to support scaling up of

national responses to undernutrition; (iii) Working with the research community in

launching two major programmes: the Transform Nutrition and the LANSA (Leveraging

Agriculture for Nutrition in South Asia) Research Programme Consortia; (iv) Working

closely with the World Bank as it develops guidance for its own staff on integrating nu-

trition into key areas of sectoral spending (agriculture, social protection, health and

poverty reduction).

Food Price Increases

in South Asia:

National Responses and

Regional Dimensions

South Asia Economic

Focus:

Food Inflation

Scaling up Nutrition:

What will it Cost?

Supported by:

The

World

Bank

This volume was created by staff of the International Bank for Reconstruction and Development/The World Bank. The findings, interpretations, and conclusions expressed in this paper do not necessarily reflect the views of the Executive Directors of The World Bank or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of the World Bank concerning the legal status of any territory or the en-dorsement or acceptance of such boundaries. This material has been funded by both AusAID and UKaid from the Department for International Development; however, the views expressed do not necessarily reflect these departments’ official policies.