Webb a4 nh-ispc

A Multi-Dimensional Index of Nutrition Patrick Webb, H. Luo and U. Gentilini A4NH/ISPC Workshop on Nutrition Washington, D.C. September 2014

Not another index?!!!
Yes, because we need to better communicate to policymakers and donors that…:
1.No single policy suffices – it’s not just one ‘thing’ 2. Multiple burdens (undernutrition, obesity, VMDs)
3.Post-2015 SDGs – ‘new’ metrics proposed
4.Which metrics can agriculture affect specifically?

World Health Assembly’s endorsement (in 2012) Comprehensive Implementation Plan on Maternal, Infant and Young Child Nutrition
To be achieved by 2025:
40% reduction in child stunting (against 2010 baseline)
50% reduction in anaemia in adult women
30% reduction in low birth weight (LBW)
0% increase in childhood overweight
>50% target for exclusive breastfeeding (EFB 6 months)
< 5% prevalence of child wasting.

The problem….
Eradicate extreme poverty and hunger Where do we stand? 1.2 billion still live in extreme poverty, even though poverty rates have been halved between 1990 and 2010 and the MDG target has been met.
http://www.undp.org/content/undp/en/home/mdgoverview/mdg_goals/mdg1/

4. ICN2 (2010 – 2025)
“create consensus on how to achieve the global nutrition targets by 2025 set by the World Health Assembly.”
1. MDG 1 (1990-2015) - child underweight (<2 SD of weight-for-age)
3. Draft SDGs (OPW June 2014): 2015-2030
“By 2030 end all forms of malnutrition, including targets on stunting, wasting and anemia.”
2. World Health Assembly (2010-2025):
Stunting, wasting, anemia, LBW, EBF, obesity

퐻퐷퐼= [(푥푖 3 푖=1 − 푚푖푛푖)/(푚푎푥푖− 푚푖푛푖)] × 1/3
The HDI ranks countries based on 3 dimensions:
a)life expectancy at birth;
b)achievements in education;
c)GDP per capita

Indicator
Max
Min
Stunting
58
4
Anaemia
67
9
Low Birth Weight
32
3
Overweight
26
1
Exclusive Breastfeeding
85
1
Wasting
20
1
Net State of Nutrition Index (NeSNI) goalposts
Data sources: WHO and UNICEF databases

8
Rank
Country
NeSNI
Stunting
(%)
Anaemia
(%)
LBW
(%)
Obesity (%)
EBF
(%)
Wasting
(%)
1
Uruguay
4.8
15
16.9
9
9
65
2
2
Colombia
4.8
13
23.6
6
5
43
1
3
Mongolia
4.7
16
13.6
5
14
59
2
4
China
4.7
10
19.9
3
7
28
2
5
Brazil
4.7
7
23.1
8
7
41
2
6
Nicaragua
4.6
22
9.0
9
6
31
1
7
Tuvalu
4.6
10
26.3
6
6
35
3
8
Moldova
4.5
10
23.4
6
9
46
5
9
Costa Rica
4.5
6
18.9
7
8
15
1
10
Belarus
4.5
4
19.4
4
10
9
2
Net State of Nutrition Index (NeSNI)

9
Source: Black et al. (2013) Lancet series II
Source: Black et al. (2013) Lancet series II

10
Rank
Country
NeSNI
Stunting
(%)
Anaemia
(%)
LBW
(%)
Obesity (%)
EBF
(%)
Wasting
(%)
1
Uruguay
4.8
15
16.9
9
9
65
2
2
Colombia
4.8
13
23.6
6
5
43
1
3
Mongolia
4.7
16
13.6
5
14
59
2
4
China
4.7
10
19.9
3
7
28
2
5
Brazil
4.7
7
23.1
8
7
41
2
6
Nicaragua
4.6
22
9.0
9
6
31
1
7
Tuvalu
4.6
10
26.3
6
6
35
3
8
Moldova
4.5
10
23.4
6
9
46
5
9
Costa Rica
4.5
6
18.9
7
8
15
1
10
Belarus
4.5
4
19.4
4
10
9
2
Net State of Nutrition Index (NeSNI)

11
35
Rwanda
3.9
44
59.4
7
7
85
3
36
Morocco
3.9
15
32.6
15
11
31
2
37
Burundi
3.9
58
28.0
11
3
69
6
38
Zambia
3.8
45
29.1
11
8
61
5
39
PNG
3.8
43
43.1
11
3
56
5
40
Algeria
3.7
15
31.4
6
13
7
4
41
Ghana
3.7
28
43.1
13
6
63
9
42
Sao Tome
3.7
29
26.2
8
12
51
11
Rank
Country
NeSNI
Stunting
(%)
Anaemia
(%)
LBW
(%)
Obesity (%)
EBF
(%)
Wasting
(%)

12
Rank
Country
NeSNI
Stunting
(%)
Anaemia
(%)
LBW
(%)
Obesity (%)
EBF
(%)
Wasting
(%)
79
Haiti
2.9
29
54.4
25
4
41
10
80
Djibouti
2.8
31
46.4
10
10
1
10
81
Timor-Leste
2.8
58
31.5
12
6
52
19
82
Benin
2.7
43
63.2
15
11
43
8
83
Sierra Leone
2.6
44
62.9
11
10
32
9
84
Pakistan
2.4
44
27.9
32
6
37
15
85
Chad
2.2
39
52.4
20
3
3
16
86
Nigeria
2.1
41
62.0
12
11
13
14
87
India
2.1
48
52.0
28
2
46
20
88
Niger
2.0
51
62.2
27
4
27
12
89
Yemen
1.5
58
51.0
32
5
12
15

Value of NeSNI
1.Helps clarify “the complexity” to policymakers: think through how policy instruments affect different aspects of nutrition
2.Allows us to track ‘net’ progress towards multiple targets simultaneously
3.Forces attention to life-course issues (not only 1,000 days)
4. Makes clear the disconnect between high GDP and nutrition.

Where does agriculture ‘fit’ here?
Scale – markets and income versus home gardens
Location – where stunting high, not always optimal for ag.
Timing – impacts of ag investment on <2s mediated through mothers’ status, empowerment, etc.
Duration - ag. programs take 3-5 years to scale up.
Seasonality – timing of birth/cycle of production
Nutrient cycles - soil nutrient deficiencies – human VMDs
Shocks – timing of droughts/floods , blight/diseases
W
S
A
LBW
EBF
O

Conclusions
1.We need new ways to communicate: a) the multifaceted nature of nutrition, and b) the multi-policy approach for solutions
3. We need to focus relatively more on ‘diet quality’ at the heart
of the food environment/systems - not easily captured by NeSNI
2. NeSNI allows for more nuanced dialogue on policy-to-nutrition impacts which can be visualized in various ways.

Webb a4 nh-ispc

More Related Content

What's hot (11)

Viewers also liked (8)

Similar to Webb a4 nh-ispc (20)

More from Independent Science and Partnership Council of the CGIAR (20)

Recently uploaded (20)

Webb a4 nh-ispc