ending child hunger and undernutrition initiative overview of issues and moving forward

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• ending child hungerand undernutritioninitiative
  overview of issuesand moving forward
• Copenhagen, 19 June 2006

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Session Overview

• Overview of Initiative
• Where did it come from?
• What are its major elements?
• Whats new? Whats not?
• When will the Initiative be initiated?
• Major challenges moving forward
• Field Highlights
• Regional Level Political Mobilisation and
  Partnership Development in Latin America and the
  Caribbean
• Partnering with Local Institutions for National
  Advocacy in India
• Delivering the essential package for child
  survival in Ethiopia
• General Discussion
• Global Campaign Efforts Update on Walk the
  World

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Initiative Reference Points

• Agreed MDG Targets and Indicators
• Partnership with UNICEF
• 2005 MOU between WFP and UNICEF
• Shared conceptual framework
• 30 country offices already collaborating on child
  hunger efforts
• Key publications
• Concept Note (WFP, UNICEF, World Bank)
• Repositioning Nutrition as Central to
  Development, World Bank, 2006
• Progress for Children A Report Card on
  Nutrition, UNICEF 2006
• Two Strategic Questions

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1. why a specific focus on CHILD hunger?

• major input and outcome synergies with other
  MDGs
• less reliant than overall hunger on increased GDP
  and agricultural production for results
• more subject to interventions focused on
  vulnerable children and their families

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2. what is different now that makes this
achievable?

• increasing understanding of hunger, nutrition and
  growth
• increasing national resources and capacities
• financial
• organizational and technical (e.g. in
  communications, media, and information
  networking)
• civil society (e.g. improving gender equality and
  development)
• increasing international assistance
• increasing effectiveness and decreasing costs of
  information technology
• global consensus on Millennium Declaration and
  Goals

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MDG-1 two targets and five indicators
Initiative target
Key Indicator for the Initiative
Sources 1. Progress for Children A Report Card
on Nutrition (UNICEF, 2006) 2. State of Food
Insecurity in the World (FAO, 2004) 3. WFP
working estimate
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UNICEF and WFP decades of partnership

• 1976 MOU on consultation and exchange of
  information, joint action in assistance
  programmes, collaboration in development and
  nutrition policies and more.
• 1985 Additional complementary parameters for
  cooperation on emergency response.
• 1998 MOU on Emergency and Rehabilitation
  Interventions
• 1999 Technical Agreement on Field
  Telecommunications, Global Coordination and
  Mutual Assistance
• 2001 Technical Agreement for Logistics
  Co-operation
• 2005 MOU with Technical Matrices on Education,
  HIV/AIDS and Nutrition

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Agreed Hunger Definition

• In the most fundamental sense, hunger exists
  when a persons body lacks the required nutrients
  to grow and develop a productive, active and
  healthy life
• It cannot be measured directly but the most
  appropriate way for monitoring progress on child
  is underweight.

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Healthy growth for children in society
Healthy Growth
Adapted from Strategy for Improved Nutrition
of Children and Women in Developing Countries.
New York UNICEF, 1990.
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Major elements of the Initiative

1. mapping children at risk
2. delivery system and interventions
3. ongoing costing and resource tracking
4. communications strategy for advocacy
5. accountability framework

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1. mapping children at risk micro-level targeting
   and implications for geographic focus

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Distribution of Underweight Children in Latin
America (Children per square kilometre)
Source Millennium Project Hunger Task Force
Halving hunger it can be done, 2005
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Distribution of Underweight Children in
Asia(Children per square kilometre)
Source Millennium Project Hunger Task Force
Halving hunger it can be done, 2005
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Regional distribution of underweight children
Latin America Caribbean (3)
Central Eastern Europe and CIS (1)
Middle East, North Africa (6)
East Asia/Pacific (15)
Eastern/Southern Africa (11)
West/Central Africa (12)
South Asia (53)
Source UNICEF, Progress for children. Number 4,
May 2006, Page2.
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Distribution of Underweight Children in
Africa(Children per square kilometre)
Half of the approx. 32 million underweight
children in Africa live in 22 percent of its
geographic area corresponding to less than 10
percent of its sub-national administrative units
Source Millennium Project Hunger Task Force
Halving hunger it can be done, 2005
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Distribution in 144 Countriesof underweight
children
Percentage of total Cumulative percentage
72 countries with sub-national data Top 24 regions in top 5 countries 55 55
72 countries with sub-national data Top 2 regions in next 67 countries 10 65
72 countries with sub-national data Balance remaining in top 5 countries 7 72
72 countries with sub-national data Balance remaining in next 67 countries 15 87
72 countries without sub-national data 13 100
Source Calculated from Millennium Project Hunger
Task Force Halving hunger it can be done, 2005
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Ranking by global share of underweight children
Country Prevalence of underweight children in country () share of total underweight children in the world () Cumulative percentage of total
India 47 39.0 39.0
Bangladesh 48 5.7 44.7
Pakistan 38 5.5 50.2
China 8 4.8 54.9
Nigeria 29 4.4 59.3
Ethiopia 47 4.2 63.5
Indonesia 28 4.2 67.7
Democratic Republic of Congo 31 2.3 70.0
Philippines 28 1.9 71.9
Viet Nam 28 1.5 73.4
Source UNICEF, 2006. The State of the Worlds
Children. Compiled from Table 2 and Table 6.
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Ranking by prevalence of underweight children
Country Prevalence of underweight childrenin country () Percentage share of total underweight children in the world Cumulative percentage of total
Bangladesh 48 5.7
Nepal 48 1.2 1.2
Ethiopia 47 4.2
India 47 39.0
Timor-Leste 46 0.1 1.3
Yemen 46 1.1 2.4
Burundi 45 0.4 2.8
Cambodia 45 0.6 3.3
Madagascar 42 0.9 4.2
Eritrea 40 0.2 4.4
Lao People's Democratic Republic 40 0.2 4.7
Niger 40 0.8 5.4
Afghanistan 39 1.4 6.9
Source UNICEF, 2006. The State of the Worlds
Children. Compiled from Table 2 and Table 6.
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Low prevalence countries
global distribution
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High prevalence countries
global distribution
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Implications for Geographic focus of the
Initiative

• Global focus for advocacy, policy development
  and monitoring
• efforts in 4-8 large countries focused on
  technical collaboration projects in the 15-25
  States/Provinces with the majority of underweight
  children
• efforts in 10-20 high prevalence countries
  focused on national program development and
  broad-based operations
• efforts in 40-50 moderate prevalence countries
  efforts focused on highly targeted operations

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Applying VAM to child hunger
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Connecting children at risk to community support
organizations

• Map areas of high undernutrition
• Identify potential outreach partners
• Identify support organizations
• Strengthen linkages between outreach partners and
  support organisations

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A live mapping and monitoring system is
required to support partners in
addressing child hunger
including

• Administrative boundaries, village locations,
  census blocks, population estimates
• Health facility locations, schools, water supply
• Linked databases for intervention monitoring
• Partner intervention areas

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1. delivery system and interventions

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Implications for levels of programming and
targeting

MDG deadline 2015 global ensure the
sustainable supply of affordable health and
nutrition commodities and the delivery of
increased financial resources macro integrate
child health and nutrition needs into national
policies, plans and budgets meso strengthen
district and community health and nutrition
systems ensure access to water and
sanitation micro empower families to improve
their health, . feeding and
childcare practices


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Available Anti-Hunger Interventionsfor
household and school level
A. Supplemental Food Interventions
B. Non-Food Interventions
Base Health Nutrition Education
2. Micronutrient Supplementation
3. Household Water Treatment
4. Hand-washing Soap
5. Deworming
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Implications for programming priority
strengthen community capacity to assist
families-in-need
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International Food Aid
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Major components of Ending Child Hunger and
Undernutrition Initiative
100

Hunger Needs
-

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Essential Package
Initiative interventions
Complementary interventions

• Ensure adequate diet
• HIV prevention
• Disease Control
• Water and Sanitation

• State National Level
• Micronutrient fortification

• Household and School Level
• Health and Nutrition Education (inc.
  breastfeeding and growth promotion)
• Complementary, supplementary and therapeutic
  feeding
• Micronutrient Supplementation (inc. Vit. A,
  Iron and prenatal vitamins)
• Hygiene promotion
• Household water treatment
• Deworming

• Primary and Secondary Education

• ARI and Diarrhoea Treatment

• Immunization

• Birth spacing, safe motherhood and other
  reproductive health interventions

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• Summary of operational objectives

1. map areas of high undernutrition
2. identify potential outreach partners
3. support linkages between key levels required to
   strengthen outreach capacity and deliver an
   essential package of interventions
4. leverage complementary interventions to the same
   geographic/demographic focus

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Summary of operational commitment
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1. annual price tag ongoing costing and resource
   tracking

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Estimate 1 the cost of doing nothing

• economic and social costs and consequences of 50
  million child deaths by 2015 due to underlying
  hunger and undernutrition
• prospects of achieving other MDGs is
  significantly jeopardized
• higher costs of meeting other MDGs, to the extent
  that they can be met at all without addressing
  child hunger

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The Cost of a package of Household Level
Interventions
Rough Annual Costs (US per household per annum) Rough Annual Costs (US per household per annum)
A. Supplemental Food Interventions (average) 55
B. Non-Food Interventions 55
Base Household Health Nutrition Education 3.8
2. Micronutrient Supplementation 14.4
3. Household Water Treatment 4.1
4. Hand-washing Soap 25
5. Deworming 7.5
Household Level Total 110

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Estimate 2 the cost of doing something

• country-specific cost estimates should form basis
  of global estimate
• costing exercise should be related to model of
  Initiative inputs and outcomes
• collaboration underway with academic and
  technical organisations and the World Bank to
  develop consensus on costing parameters
• requires ongoing engagement of regional and
  country offices

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Initial costing parameters

• base initial costs on Initiative-specific
  interventions deliverable with existing community
  infrastructure
• phase in additional costs of interventions
  corresponding to anticipated expansion of
  infrastructure
• consider limiting estimates to geographic areas
  corresponding to approximately 80 of
  undernourished children
• consider giving higher priority to interventions
  for children under five
• include estimates to strengthen technical and
  managerial capacities for
• monitoring and evaluation
• intervention adaptation and implementation
• community organization development

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1. communications strategy for advocacy to
   mobilise political, financial and other resources

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Successful Efforts to Reduce Child Mortality
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Less Successful Efforts to Reduce Child Mortality
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Advocacy Objectives

• increase awareness and understanding of needs,
  opportunities and solutions
• with an enhanced evidence base and metrics
• strengthen national policies and programmes
• with country-to-country exchange of experience
  and the promotion of the Three Ones in country
• mobilise adequate resources

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Advocacy partnership approach

• create shared brand, campaign entity and
  strategy
• build a broad partnership that will create
  urgency and maximize outreach all speaking in a
  common voice
• keep children and their families at the centre of
  the message
• maximize linkages with other relevant campaigns
  at global and national level, e.g.
• Partnership for Maternal, Newborn and Child
  Health
• International Alliance Against Hunger
• Unite for Children Unite Against AIDS
• Education for All

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Major audiences (potential partners)

• policymakers in both developing and
  industrialized countries including
  parliamentarians
• donors and foundations
• faith-based organizations
• other international and national civil society
  NGOs
• private sector WEF Regional Process
• opinion leaders and the media
• technical and professional organisations
• goodwill ambassadors and champions
• UN agencies

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1. accountability framework clarifying roles and
   responsibilities for WFP/UNICEF units and
   external partners

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Initiative accountability country level

• one agreed action framework that provides the
  basis for coordinating the work of all partners
• one national coordinating authority, with a broad
  based multi-sector mandate and
• one agreed country-level monitoring and
  evaluation system

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Initiative accountability regional level

• Country-to-country experience exchange for
• Political Mobilisation
• Partner Mobilisation
• Technical Collaboration Partnerships
• mapping
• social marketing
• monitoring and evaluation
• costing and resource tracking

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Initiative accountability global level

• annual global reporting of results through
  adaptation of Progress for Children A Report
  Card on Nutrition
• regular joint reports to Executive Boards of WFP
  and UNICEF on Initiative progress against
  milestones
• explicit integration with WFP and UNICEF
  Strategic Plans
• integrated workplans across WFP and UNICEF units
  with implementation support responsibilities
• related workplans of Partners Group members to
  be compiled, monitored and updated annually

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Light Global Level Partnership Process

• Inclusive Partnership Group with sub-groups for
  civil society and NGOs, technical collaborators,
  UN agencies, the private sector, donors, and
  governments
• Steering Group of limited size co-chaired by
  UNICEF and WFP Executive Directors
• UNICEF-WFP Initiative Team to serve as
  secretariat to Steering Group and Partners Group
  including for workplan development and
  monitoring

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Major challenges moving forward

• commitment to the goal
• common organisational context with respect to
  mandate
• bring hunger issues to the centre of the
  international agenda
• advocate policies, strategies and operations that
  directly benefit the hungry poor
• clarity of purpose and role in the Initiative
• capacity and confidence
• openness to change
• internal and external collaboration
• (cash)

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When will the Initiative be Initiated?
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Upcoming milestones
2006 end June WFP Global Staff Meeting consultation Global advocacy and communication strategy prepared
mid-July Consultation with NGO and private sector partners
end July Review of draft Plan of Action by multi-agency advisors group
end August end August Final draft of Plan of Action completed
September Informal consultations of WFP and UNICEF Executive Boards
November Review and guidance from WFP Executive Board
2007 January Review and guidance from UNICEF Executive Board Anticipated publication of the Series on Maternal and Child Undernutrition in The Lancet
February Convening of Partners Group and formal adoption of Plan of Action Publication of UNICEF and WFP programme and policy resources on addressing maternal and child undernourishment
March Public launch of Initiative
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1st Quarter of 2007