Nutrition and Gender – A happy Marriage Nutrition and Gender Training21 November, 2016 IFAD HQ, Rome

Presented by Juliane FriedrichSenior Technical Specialist Nutrition, PMD-OPE

• Understanding nutrition and its developmental consequences• Understanding the relevance of nutrition for gender and gender

for nutrition• Understanding the IFAD nutrition and gender mainstreaming

strategy• Being able to ask the right questions• Being able to analyse gender and nutrition issues in the Project

Cycle• Understanding the dynamics of women’s empowerment and

nutrition

To take home

Part 1 – Basics of Nutrition

Part 2 – Conceptional Framework

Part 3 – Mainstreaming Nutrition in IFAD

Part 4 – Theory of Change and Pathways

Part 5 – Framework of Action and Conclusions

Content

Facts and Figures

PART I

Basics of Nutrition

Key Terms: What is malnutrition?

Malnutrition • inadequate, excessive or imbalanced intakes of carbohydrates, proteins or fat

(macronutrients) and vitamins and minerals (micronutrients)

Three forms of malnutrition1. Undernutrition

– inadequate nutrition– stunting: short height for age / chronic undernutrition– wasting: too thin for height / acute undernutrition

2. Micronutrient inadequacy– deficiencies in specific vitamins and minerals

3. Overweight / obesity– excess of certain food components, such as fats and sugars, relative to

activity levels

Types of undernutrition – Acute undernutrition

Acute undernutrition (wasting) can be moderate or severe.

A typical form of severe wasting is Marasmus.

Types of undernutrition – Acute undernutrition

Another form of severewasting is Kwashiorkor.

Nutritional oedema(bilateral pitting oedema) may maskwasting as the child does not appear thin or undernourished.

Acute undernutrition - Symptoms

Nutritional oedema In order to determine the presence of oedema, normal thumb pressure is applied to both feet for three seconds. If a shallow print or pit persists on both feet when the thumbs are lifted, then the child presents oedema. This is the only way to confirm nutritional oedema. You cannot tell by just looking.

Undernourished?

The challenge:Undernourished or not..?

Undernourished?

Chronic undernutrition - stunting

Chronic undernutrition (stunting) is another form of growthfailure. It occurs over time, unlike acute undernutrition. A child who is stunted or chronically undernourished often appears

to be normally proportioned but is actually shorter than normal forhis/her age.

Stunting starts before birth and is caused by poor maternal nutrition, poor feeding practices, poor food quality as well as frequent infections which can slow down growth.

Stunting is not reversible after a certain age. To have an impact on stunting levels, nutrition interventions need to be targeted to women during pregnancy and to children from birth to 23 months of age (1000 days).

Facts and Figures - stunting

•156 million children stunted in 2015

•85% of stunting concentrated in 37 countries

•Global target: to reduce stunting to ~ 100 million by 2025

Undernutrition – Micronutrient Deficiencies

Micronutrient deficiency also known as “hidden hunger” as symptoms of a deficiency are usually visible at a late stage only.

Deficiencies of vitamin A and zinc adversely affect child health and survival, and deficiencies of iodine and iron, together with stunting, contribute to children not reaching their developmental potential.

Undernutrition – who is affected

Priority target groups:• Children under two years• Children under five years• Pregnant and lactating mothers (PLWs)

But also particular nutritional vulnerable are• Elderly• Disabled• Chronically ill (incl. HIV/AIDS)

Why is nutrition so important?

Nutrition is central to development

Essential for :- Survival- Child well-being- Preventing irreversible brain damage- Preventing chronic disease

Nutrition and cognitive Development

What is the Difference in Brain Scans of these two under-5 children?

Malnutrition & infection

“Otak Kosong” or Empty Brain is permanent “Irreversible loss of opportunity”

LOST GENERATION(Labor)

Well nourished & healthy

Smart child—Life in all its Fullness

Quality Human Resource

Higher Income (>7% more)

Burden Resource

Impact of Nutrition and Health towards Brain’s Growth and Development

By: Prof. Ascobat Gani

The 1000 days or the window of opportunity

•The timing for interventions•From conception to 23 months (U2)• If not, the damage to future capital is irreversible

!!!!Actions after age two are:TOO LATETOO EXPENSIVETOO LITTLE

Developmental Impacts of Undernutrition

Cost of Hunger in Africa:Losses in Health, Education, Productivity for Child Undernutrition

Country USD Losses % GDPEgypt 3.7 billion 1.9Ethiopia 4.7 billion 16.5Swaziland 92 million 3.1Uganda 899 million 5.6

Source: African Union Commission, NEPAD Planning and Coordinating Agency, UN Economic Commission for Africa, and UN World Food Programme. The Cost of Hunger in Africa: Social and Economic Impact of Child Undernutrition in Egypt, Ethiopia, Swaziland and Uganda. Report. Addis Ababa: UNECA, 2014.

The 1000 days

Growth Faltering, global• Focus on -9 to 24 months

-2

-1,75

-1,5

-1,25

-1

-0,75

-0,5

-0,25

0

0,25

0,5

0 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45 48 51 54 57 60

Age (months)

Und

erw

eigh

t Z-s

core

(NC

HS

)

Africa Asia Latin America and Caribbean

The intergenerational cycle of malnutrition

Too young to wed

Child/Teenage Marriages

PART II

Conceptual Framework of Malnutrition

Is Food Security the same as Nutrition Security?

Conceptual Framework of Malnutrition

The gender gap in agriculture

Women comprise an average of 43% of the agricultural labour force of developing countries:

From 20% (Latin America) to50% in Eastern and Southeastern Asia

What does this mean for nutrition?

The gender gap in agriculture

linkages between excessive physical activity during pregnancy and low birth outcomes

increased energy requirement for icreased/high physical activity

overburdened with tasks - her caring capacity is compromised

Closing the gender gap

Women could increase yields on their farms by 20-30 %

Could raise the agricultural output by 2.5 – 4%

could reduce the number of hungry people by 12 – 17%

Adequate care for women and children

1.Meeting nutritional requirements (women and children are nutritionally vulnerable)2.Taking physiological determined condition of women in agriculture into consideration3.Positive discrimination of female youth4.Nutrition to be considered a family/community responsibility not only a woman’s affair

PART III

Mainstreaming Nutrition in IFAD

The Challenge

1. To mainstream nutrition in agriculture

2. To mainstream gender in nutrition sensitive agriculture

What is nutrition sensitive agriculture?

1. Integration of nutritional considerations at all levels – applying the nutritional lens

2. Reflected in objectives, indicators, and activities

Steps to make an agricultural project nutrition sensitive

1.Explicitly incorporate improved nutrition as an objective and indicator(s) of the project and identify specific actions that will make project components nutrition sensitive, e.g. promote crops with high nutritional value (e.g. millet instead of rice; orange fleshes variety of sweet potatoes)

Steps to make an agricultural project nutrition sensitive

2. Trace the steps from production to consumption needed for this intervention to improve nutrition – the impact pathway. For example, determine if a change in dietary habits is needed to encourage the consumption of orange fleshes sweet potatoes

Steps to make an agricultural project nutrition sensitive

3. Through policy dialogue and partnership, address opportunities that can affect the impact pathway and the effectiveness of the intervention, such as institutional environment, gender or environmental sustainability.For example , determine how promotion of orange fleshed sweet potatoes affects women in terms of their time or income; how production affects the environment, or how climate change affects the crop; and what other actors need to be involved so that the activity improves nutrition.

Nutrition at IFAD: IFAD’s Renewed Focus on Nutrition

• Support for design and implementation (KM, capacity)

• Integrated into corporate documents • Strategic Framework• IFAD10 Commitments

• Nutrition Action Plan

• IFAD as Chair of UN SCN

Goal Improve nutritional levels of the

rural poor, especially smallholders

Objective Increase the nutritional impact of IFAD’s investments and its advocacy and policy engagement activities at global and national levels, primarily through agriculture and food-based approaches that improve the quality and quantity of diets of rural families

Strategic Outcome 1.Nutrition-sensitive projects shape agriculture and food systems to contribute to nutritious diets

Strategic Outcome 2.Projects promote behavior change communications, and related nutrition education activities, to improve food choices and nutrition-enhancing preparation and post-harvest practices

Strategic Outcome 3.Projects promote equality and empowerment of women in ways that improve nutrition

Strategic Outcome 4.Policy engagement, advocacy, and partnerships, and research and knowledge management, contribute to a more supportive nutrition governance, an enabling environment, and projects that improve nutrition, at global and country levels

IFAD’s Action Plan for Nutrition

Action area 1.Operations

Action area 2.Capacity strengthening

Action area 3.Policy influence, engagement & partnerships

Action area 4.Knowledge and Evidence

Action area 5.Organizational Capacities

For IFAD, Making Agriculture and Food Systems Nutrition Sensitive

Some examples (not a comprehensive list)...

Make Value Chains More Nutrition-Sensitive. Value chains should be developed not only for monetary value, but also for nutrient value

Incorporate Homestead Food Production. Backyard gardens, tree crops, small livestock, and fish ponds can contribute to dietary diversity

Include Behavior Change Communications and Nutrition Education. Targeted messages can augment the positive effects of multiple interventions

Improve Post-Harvest Processing and Storage. Simple advances in post –harvest practices can help to preserve and enhance nutrient quality

Pay More Attention to Drinking Water Supply. Water for agriculture is important, but water for people should not be overlooked.

PART IV

Theory of Change and Pathways

Theory of Change

Pathway Framework

PATHWAYS

1. Making existing disease burden visible and understand consequences

At the heart of this pathway is the realization that mere provision of safe drinking water, sanitation (toilets) and education does not guarantee ‘sustained use’. Communities first have to acknowledge that they have a high disease burden that is caused by unsafe water, poor hygiene and sanitation, and then be made aware that disease is preventable.

Awareness of gender inequalities in labour division, access to clean water sources and decision-making within households, which may contribute to the high burden of diseases and poor WASH practices

PATHWAYS

2. Creating awareness about and improving feeding and caregiving practices

Competing claims on the mother’s time for cooking, cleaning, fetching water, feeding and taking care of children, and also engaging in farm work and other income generation activities, takes away valuable time from caregiving, especially for the younger children in the household.

Pregnant women seldom get opportunities for extra rest or to eat nutritious food. Fathers are often ignorant about nutrition and do not make informed decisions while buying food items. Secondly, even though women are (expected to play) the main caregivers, they do not have the freedom to make independent decisions.

PATHWAYS

3. Food utilization i.e. preparation of nutritious meals and dietary diversity at household level

The power to make decisions about food choices, how they prepare it and how to divide the food among household members. Understanding current customs and beliefs around the meaning of what constitutes nutritious foods.

PATHWAYS

4. Food availability and accessibility

For nutritious food to be available to households, these foods either have to be produced, or have to be available at affordable prices in local markets. Food accessibility, where both men and women ought to decide how much: a) household income is to be spent on food and non-food items; and b) food is to be sold and kept for home consumption.

Building awareness regarding dietary diversity as closely linked to production diversity. Agro-biodiversity creates better chances to contribute to dietary diversity. Food produced in the homestead is more likely to be consumed compared to deliberately buying the same food items for consumption. Time and labour spent mostly by women on growing such food items with limited potential to generate income is often under-valued.

Causal Analysis

Asking the right questions:1.What exactly is the problem? 2.Is there reliable information?3.Are there seasonal or gender patterns in malnutrition?4.Who is concerned? Who is involved?5.Which changes are desirable/affordable/feasible?6.Are there obstacles to address the problem?7.What needs to be done to promote changes?8.Is there need to engage other actors?9.Who is the target group – justification?10.Who needs to be involved with what?

PART V

Framework of Action and

Conclusions

Framework for Action on Food and Nutrition

Conclusion

•Gender & Nutrition highly context specific•Mainstreaming gender in nutrition-sensitive agriculture is

critical for strengthening gender & nutrition linkages in recognition of their substantial contribution to agricultural and their central role in hh food collection, preservation/processing and preparation

•IFAD’s commitment to address gender issues in particular empowerment of women (including female youth) needs to integrate automatically nutrition issues