Accelerating Progress to Meet 2030 Goals to Improve Child and Maternal Nutrition

 

The recently launched UNICEF-World Health Organization (WHO) 2017 Countdown to 2030 report shows mixed results for childhood health and nutrition. The 81 Countdown countries have made progress, but remain far from universal coverage for most essential interventions for reproductive, maternal, newborn, child health, and nutrition. The report presents detailed country and equity profiles on women’s, children’s and adolescents’ health for countries that together account for 95 percent of maternal deaths and 90 percent of deaths among children under five.

Countdown to 2030 Report/UNICEF

To galvanize attention and mobilize action around priorities in maternal and child nutrition, various global targets have been set, including the United Nations' 2030 Agenda for Sustainable Development and the WHO’s Every Woman Every Child Global Strategy for Women's, Children's and Adolescent's Health (2016–2030). The Countdown to 2030 report systematically tracks progress towards achieving these. IFPRI is a member of the Countdown to 2030 collaboration.

In the accompanying Countdown to 2030 paper published in The Lancet on tracking progress towards universal coverage for reproductive, maternal, newborn, and child health, Countdown collaborators have underscored the need to accelerate the rate of decline in prevalence of maternal and child mortality, stillbirths, and stunting among children under five, to achieve the Sustainable Development Goals by 2030. Such efforts will require a rapid scale-up of effective interventions to all population groups within affected countries, supported by improvements in underlying socioeconomic conditions, including women’s empowerment.

India is one of the priority Countdown countries, and as the findings of this report reflect, is still a long way from achieving universal coverage for most essential interventions in these key health and nutrition areas. The Countdown work has been an inspiration for POSHAN’s research and data visualization work on coverage of interventions across the continuum of care in Indian states. POSHAN’s state-level Policy Notes, based on updated coverage data now available in NFHS-4 (2016), reveal that the coverage of interventions for mothers and children in the first 1,000 days has improved substantially over time, but challenges remain. There are significant state-level variabilities in the coverage for some interventions. Coverage during pregnancy is generally high, up to 75 percent for some interventions, like pregnancy registration. However, coverage of nutrition interventions integrated into pregnancy care is low at less than 33 percent for women who consumed iron and folic acid supplements. During delivery, coverage is high: Nearly 80 percent for interventions pertaining to institutional delivery, skilled birth attendance, and birth registration. However, coverage of interventions for lactating women remains much lower than 50 percent.

An effective way to track a country’s progress towards any global goals is to apply them at the national level. In India, there is much optimism pegged on the recently launched National Nutrition Mission, which aims to reduce stunting, undernutrition, and low birth weight by 2 percent and anemia by 3 percent annually, covering states and districts in a phased manner over three years (2017-20), benefiting more than 100 million people. Meeting these goals will require that India deploy the interventions already in the policy framework at high coverage, reaching across states and districts. Analyzing coverage levels and trends is an important first step in prioritizing interventions where gaps are large and where efforts need to be scrutinized and accelerated.

As 2017 Countdown to 2030 report points out, to address the targets at the global and national levels, it is important to focus on the strengthening of vital statistics, understanding drivers of coverage change, and obtaining better data on early childhood development and adolescent health. In India, the government think tank NITI Aayog now has a Nutrition Dashboard that provides nutrition charts of India's states and districts and examines coverage of some (but not all) critical interventions. POSHAN’s district-level interactive maps and 640 District Nutrition Profiles also provide disaggregated data and detailed in-depth analyses.

In addition to outcomes and coverage, it is also important to focus on the indirect and underlying determinants, like sanitation and hygiene, access to drinking water, women’s literacy, girls’ age at marriage, etc. Countdown’s national profiles and POSHAN’s state and district profiles provide ready reckoners for an assessment of these underlying drivers and help to identify the gaps that need to be closed to accelerate change in health and nutrition outcomes.

Changes in health outcomes will only become a reality with changes in coverage of interventions and in the drivers of these outcomes. Promising beginnings have been made on the nutrition and health landscape and there is much anticipation on the horizon. However, efforts to address coverage and drivers now need to be strategically navigated to catalyse progress towards 2030, both globally and in India.

Purnima Menon and Stuart Gillespie are Senior Research Fellows with IFPRI's Poverty, Health and Nutrition Division and members of the Countdown to 2030 Collaboration: Menon participated in the Coverage Technical Working Group; Gillespie in the overall Technical Review Group. Pratima Mathews is an IFPRI Communications Specialist. This post originally appeared on the POSHAN blog.

Research for Agricultural Insurance in South Asia: A Regional Dialogue

This article was originally posted on IFPRI.org  by Berber Kramer and Patrick Ward

Julie Lang/IFPRI

In South Asia, livelihoods are intricately intertwined with agricultural production, and thus highly dependent on weather. For millennia, the yearly monsoon rains have been the lifeblood of agriculture, but climate change is making this annual boon increasingly unpredictable both in timing and intensity, exposing farmers’ livelihoods to increased production risks.

There is considerable interest within the international development community in mitigating these risks through insurance. While insurance has been around for a very long time, many of its more traditional forms have suffered from low demand and asymmetric information between insured and insurer, giving rise to adverse selection and moral hazard.

The agricultural research community has responded to these challenges by identifying and developing research-based innovations for agricultural insurance, such as index-based insurance programs that can minimize the severity of adverse selection and moral hazard; the use of cutting edge remote sensing and information technologies; and the bundling of insurance with novel “climate-smart” agricultural technologies and practices (CSA) that are more resilient to adverse weather conditions than traditional technologies and practices, thus serving an important risk management function in their own right.

In order to better understand how CGIAR research can further contribute to the development, implementation, and evaluation of agricultural insurance programs, IFPRI organized a regional dialogue in Dhaka, Bangladesh on December 17. The event was mounted in partnership with the CGIAR research programs on Policies, Institutions and Markets (PIM) and Climate Change, Agriculture, and Food Security (CCAFS), as well as the Cereal Systems Initiative for South Asia (CSISA).

Policy makers, practitioners, and researchers from Bangladesh, India, and Nepal convened to share their experiences with implementing agricultural insurance across the region, and to learn about the latest agricultural research on this subject. The chief guest, Wais Kabir, executive director of the Krishi Gobeshona Foundation, and keynote speaker, Saleemul Huq, director of the International Center for Climate Change and Development(ICCCAD), helped to lay the foundation for the day’s discussion.

Huq’s keynote address highlighted the role of agricultural insurance as an instrument for meeting the key targets in the Paris climate agreement—not only by offering compensation for crop losses and other economic damage, but also by providing a mechanism to improve adaptation, with subsequent benefits from reduced agricultural sector emissions. The workshop presented evidence and case studies that vividly illustrated how research can help improve insurance products and programs to help meet compensation, adaptation, and emissions targets.

One of the main challenges in implementing the largest agricultural insurance program in South Asia—India’s Pradhan Mantri Fasal Bima Yojana (PMFBY)—is loss assessment: To verify losses, PMFBY aims to measure average yields at the village level through intensive crop-cutting exercises. This is a daunting task, requiring crop samples to be collected from three million fields within the short period before harvest. Herein lies an important role for the agricultural research community and the CGIAR more specifically. Agricultural research has helped advance the use of satellite imagery and other remote sensing techniques for crop loss assessment, and case studies are showing that it is possible to use such methods to detect prevented or delayed sowing, which could ultimately reduce the number of crop samples required for village-level yield assessments.

While promising, remote sensing is hardly a panacea. First, the resolution of open-access or affordable satellite imagery is still too coarse to detect plot-level losses. Second, the notion of satellites orbiting the earth and collecting images from space is an abstract concept to many farmers, and much evidence has shown that insurance products must be presented with simplicity and transparency to generate sufficient interest among potential buyers. Third, data processing and evaluation of remotely sensed images is often a major challenge. Unmanned aerial vehicles (UAVs) offer higher resolution imagery than satellites, but are expensive to operate and may face various regulatory hurdles in different contexts.

There are other solutions that can complement remote sensing techniques and address some of these challenges. The IFPRI-led picture-based crop insurance (PBI) project, for example, demonstrates that it is possible to engage farmers directly in taking a stream of smartphone pictures to document crop losses. Going forward, researchers from CGIAR and other agricultural research institutions will have an important role to play in evaluating and validating different interventions.

The agricultural research community can also play an important role by positioning insurance as one instrument in a larger portfolio of risk management tools. Smallholder farmers can also shield their livelihoods from risk through savings, credit, and informal insurance networks, and by adopting CSA technologies. Examples of the latter include conservation agriculture (a suite of sustainable agricultural and land management practices) and stress-tolerant cultivars such as drought-tolerant maize or flood-tolerant rice.

CGIAR researchers, working with counterparts from national agricultural research systems, have developed many improved seed varieties for various staple crops that can reduce farmers’ exposure to weather-related production risk and increase yield stability. But these stress-tolerant varieties can protect crops only up to a point, leaving production exposed in the event of severe droughts or floods. When sold in tandem with a complementary insurance product, however, the bundle provides a near comprehensive risk management solution, as demonstrated by IFPRI-led research in Odisha, India. Under this approach, weather index insurance can be designed to pay out only under more extreme weather conditions causing catastrophic losses, while CSA technologies shield livelihoods from more moderate weather shocks and accompanying income losses. This can also help lower premiums, improving the demand for insurance.

A final, important issue that arose during the dialogue is that the countries of South Asia vary in many aspects: In topography and the risks farmers face, and in the policy and regulatory environments where insurance markets operate. In India, for instance, the government is very active in promoting agricultural insurance under PMFBY through large subsidies, while in Bangladesh and Nepal, insurance is not a prominent feature of agricultural development strategies or policies. Such differences raise important questions about how to best organize insurance markets and innovation activities country by country. These questions remain unanswered, but may prove to be an important area for IFPRI’s policy research in the coming years.

Berber Kramer is a Research Fellow in IFPRI's Markets, Trade, and Institutions Division; Patrick Ward is a Research Fellow in IFPRI's Environment and Production Technology Division.

World Water Week: Experimental games spark community cooperation on groundwater in India

Cross-posted from ifpri.org written by Ruth Meinzen-Dick, IFPRI

I grew up in Tamil Nadu, south India. It was a dry area, but a good well supplied our house and a few other houses around us. Then one year a farmer nearby installed a deeper well with an electric pump, and our well ran dry. That started a “race to the bottom”: As more and more farmers got pumpsets, the water table continued to fall and everyone had to deepen their wells to keep up.

Today, India faces this problem writ large. Over 60 percent of the irrigation and 85 percent of domestic water in India now comes from water below the ground. As water tables fall, wells need to be dug deeper and more pumping power is required to deliver water to users. Ultimately, groundwater becomes unavailable.

World Water Week 2017 (Aug. 27-Sept. 1) focuses on conserving and reducing waste in water use. These efforts are especially relevant for groundwater supplies, which are often overtaxed and difficult to manage responsibly.

Because well owners who take water from the same aquifer may be geographically dispersed, it is hard for them to know how much others are taking, let alone regulate their own withdrawals. And because underground water dynamics are complicated, people often don’t understand how their water use affects others.

Experimental games can help reveal what motivates people to cooperate in the use of any jointly used resource—including groundwater, as well as forests, fisheries, and surface irrigation. Until recently, no one had assessed whether these games could help stimulate cooperation as well. To investigate this issue, IFPRI partnered with the Foundation for Ecological Security (FES), an NGO in India, and Arizona State University, with support from the CGIAR program on Water, Land and Ecosystems. FES, which helps communities in Andhra Pradesh better manage their water resources, added a “groundwater game” designed by ASU experts to its program in some of the communities affected by groundwater depletion.

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Agricultural Mechanization in South Asia

Farmer in the field at Nalanda District, Bihar. Source: (Flickr) Divya Pandey, IFPRI

Australian Centre for International Agricultural Research (ACIAR) and International Food Policy Research Institute (IFPRI) organized a two day, Regional Dialogue on Agricultural Mechanization in South Asia on July 20-21, 2017 in New Delhi, India. The focus of the regional dialogue was to work towards the four key issues related to agricultural mechanization and farmers.

Adoption and Impact: Machines are critical to the sustainable intensification of agriculture. Machines not only help increase land and labor productivity and allow intensification of agriculture, but are also essential to adoption of conservation agriculture (CA). Adoption of CA equipment is uneven even after 25 years of promotion. The adoption rates are especially low in the Eastern Gangetic Plains (EGP). What can eastern India learn from north-western India? What are the barriers to wider adoption and use of CA equipment? What is the impact of these machines on crop yields, crop economics and crop resilience? What kind of public policies, financing arrangements and business innovations can speed up mechanization?

Custom Hiring Centers: Ninety percent of farmers in South Asia access machines through informal rental markets that emerged spontaneously. Uncompetitive machine rental markets have become yet another source of rent extraction from poorer farmers. How should public finances (subsidies, incentives and credit) be deployed to ensure equitable access to machine services for all?  In recent years, private companies, governments, farmer organizations and startups are also entering the rapidly growing machine rental market by setting up custom hiring centers (CHCs). Can CHCs compete with the machine owning individual farmers? What is the comparative advantage of the formal sector in machine rental markets, hitherto dominated by enterprising farmers? Can they be more efficient than the informal service providers and more effective in promoting new machines for sustainable farming? What business models of CHCs are likely to thrive in different parts of South Asia? What is the role of public policies in promoting CHCs?

Effect of Mechanization on Women and Agricultural Laborers: There are more agricultural laborers than cultivators in South Asia. How does farm mechanization affect laborers? Women perform a large share of the back-breaking work in South Asian agriculture. IFPRI data on women empowerment in agriculture index (WEAI) shows that women farmers and farm laborers enjoy much less leisure than their male counterparts. On one hand, machines reduce drudgery and free-up more time for women, but on the other hand, they can also take way income earning opportunities for women farm laborers.  How does mechanization affect women? Are the effects different for women farmers and farm laborers? Researchers and grassroots organization working closely with women in farming present empirical evidence and share experience in this session.

Role of Public Policies in Promoting Mechanization: While a large share of the machines capital in South Asian agriculture has been financed largely by private investments, public policies on credit, capital subsidies, tariffs and trade for machines have a huge influence on mechanization of agriculture. Why are machine rental rates lower in Bangladesh than West Bengal or Nepal? Are tariffs and trade restrictions for infant industry protection, import substitution or revenue generation anti-poor? Do heavy capital subsidies hurt, not help, widespread adoption of sustainable technologies like solar pumps, drip irrigation and conservation agriculture? Researchers and policy makers from Bangladesh, India and Nepal will exchange notes in this session to improve existing public policies. Why agriculture is less mechanized in West Bengal than Bihar even when wage rates, crop yields and cropping intensity are higher there? What can Nepal learn from Bangladesh?

Presentations 

New Abstract Digest on Maternal and Child Nutrition Research – Issue 7

We are pleased to release Issue 7 of our bi-monthly Abstract Digest on maternal and child nutrition. This issue features interesting publications examining nutrition from both a biological and political lens, in India and beyond. Highlights include:

Abstract Digest-Issue 07
Abstract Digest-Issue 07
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Abstract Digest-Issue 07

  • A special open-access issue of Annals of the New York Academy of Sciences on integrating nutrition and early childhood development interventions
  • Two articles from Advances in Nutrition discussing 1) how nutrition research can become more useful in informing global nutrition guidelines (Stoltzfus 2014), and 2) arguing for the need to develop implementation science to enable stronger delivery of adequate nutrition to those in need (Habicht and Pelto 2014).
  • One study in Bio Medical Education identifying gaps in South Asian postgraduate nutrition programs to build capacity to address the current public health nutrition challenges (Khandelwal et al. 2014).
  • Two reviews, one providing an overview of the evidence-base for nutritional deficits in early life and greater risk for non-communicable diseases in later life (Langley-Evans 2014) and the other recommending investments in improving maternal autonomy to improve child nutritional status (Carlson et al. 2014).
  • Several articles focusing specifically on malnutrition in India, including on determinants of anemia (Anand 2013), vitamin A programming in India and its reach (Aguayo 2014), and management of severe acute malnutrition (Singh et al. 2014; Kumar et al. 2013).

 

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