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Synthesis of Evidence of Multisectoral Approaches for Improved Nutrition

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Synthesis of Evidence of Multisectoral Approaches for Improved Nutrition Acknowledgements Synthesis of Evidence of Multisectoral Approaches for Improved Nutrition is a product of Banking on Nutrition Partnership, an initiative of the African Development Bank (AfDB), undertaken with the support of Big Win Philanthropy and Aliko Dangote Foundation and with technical assistance provided by Results for Development (USA). This work was overseen by AHHD, with Maïmouna Diop Ly (Chief Health and Social Protection Officer) leading and support from Margaret Wagah (Nutrition Technical Specialist), Ann Defraye (Senior Nutrition Officer), and Carol Obure (Principal Health Economist). Nalini Tarakeshwar (Big Win Philanthropy), Tokunbo Oshin (Big Win Philanthropy), Francis Aminu (Aliko Dangote Foundation) and Wale Falade (Aliko Dangote Foundation) provided leadership on behalf of the other members of the Banking on Nutrition Partnership. The work was supported by the Nutrition team at Results for Development (R4D): Yashodhara Rana (Senior Program Officer) and Carol Levin (Consultant; University of Washington) led the development of the synthesis with support from Daniel Arias (Senior Program Associate), Erin Swearing (Senior Program Associate) and Emily Thacher (Program Associate), with guidance from Augustin Flory (Managing Director), Jack Clift (Program Director), and Julian Schweitzer (Senior Fellow). The team extends a special thanks to the following experts who reviewed findings pertaining to different sections of this report: Harold Alderman (IFPRI), Anna Herforth (Columbia University), Sue Horton (University of Waterloo), Mduduzi Mbuya (Cornell University) and Caroline Wilkinson (UNHCR). DISCLAIMER Unless expressly stated otherwise, the findings, interpretations and conclusions expressed in this publication are those of the various authors of the publication and are not necessarily those of the African Development Bank (the “Bank”), the African Development Fund (the “Fund”), Big Win Philanthropy, the Dangote Foundation and their respective Management, Boards of Directors, Boards of Governors or the countries they represent. Use of this publication is at the reader's sole risk. The content of this publication is provided without warranty of any kind, either express or implied, including without limitation warranties of merchantability, fitness for a particular purpose, and non- infringement of third-party rights. Neither the Bank, the Fund, Big Win Philanthropy nor the Dangote Foundation make any warranties or representations as to the accuracy, completeness, reliability or current validity of any information contained in the publication. Under no circumstances including, but not limited to, negligence, shall the Bank, the Fund, Big Win Philanthropy and/or the Dangote Foundation be liable for any loss, damage, liability or expense incurred or suffered which is claimed to result directly or indirectly from use of this publication or reliance on its content. This publication may contain advice, opinions, and statements of various information and content providers. The Bank, the Fund, Big Win Philanthropy and the Dangote Foundation Bank do not represent or endorse the accuracy, completeness, reliability or current validity of any advice, opinion, statement or other information provided by any information or content provider or other person or entity. Reliance upon any such opinion, advice, statement, or other information shall also be at the reader’s own risk. Foreword The determinants of nutritional status are multifaceted and include individual health status and access to health care; access to safe, nutritious, and diverse foods; access to safe water and proper sanitation facilities; conduction of optimal feeding, caregiving, and hygiene practices; and adequately spaced birth intervals. A 2013 Lancet series on maternal and child nutrition underscored that both nutrition-specific and nutrition-sensitive interventions are necessary to eliminate maternal and child malnutrition. Nutrition-specific interventions help to ensure adequate food and nutrient intake and proper feeding, caregiving, and parenting practices. Nutrition-sensitive interventions address food security; availability of adequate caregiving resources at the maternal, household, and community levels; and access to health services and a safe and hygienic environment. Multi-sectoral nutrition programming enables donors, countries, and implementers to address the multifactorial causes of national nutrition challenges by linking and integrating program design, delivery, and evaluation across disciplines and sectors. Nutrition offers an opportunity for the AfDB to act on, and invest in one of the most important paths to sustainable development outcomes. Investments in nutrition—particularly in support of grey matter infrastructure - are at the heart of the AfDB’s equitable growth agenda, including the Bank’s Ten-Year Strategy (2013-2022) and Poverty Reduction Strategy (2014-2018). To accelerate progress on green and inclusive growth, the Bank has developed the “High-5s” priorities (Light Up and Power Africa, Feed Africa, Industrialize Africa, Integrate Africa, and Improve the Quality of Life for Africans). Nutrition is an integral part of the Feed Africa strategy, and is strongly embedded and contributes to the High Five “Improve the Quality of Life for Africans”. The Banking on Nutrition Partnership November 2017 Table of Contents Rationale Chapter 1 : Investing in nutrition ................................................................................................. 2 The value of investing in nutrition in Africa .............................................................................. 2 Chapter 2 : Determinants of nutrition .......................................................................................... 6 Chapter 3 : Purpose and methods of the review ......................................................................... 7 Scope of report ....................................................................................................................... 9 Synthesis of evidence for impact on undernutrition Chapter 4 : Health interventions ................................................................................................10 Health interventions included in the review ............................................................................10 Evidence for nutrition-specific health interventions ................................................................11 The role of the private sector .................................................................................................17 Value for money of health interventions .................................................................................19 Conclusion ............................................................................................................................21 Chapter 5 : Agriculture interventions .........................................................................................22 Agriculture interventions included in the review .....................................................................22 Evidence for nutrition-sensitive agriculture interventions .......................................................23 General guidance ..................................................................................................................28 The role of the private sector .................................................................................................31 Conclusion ............................................................................................................................35 Chapter 6 : Water, sanitation and hygiene interventions ...........................................................36 WASH interventions included in the review ...........................................................................36 Evidence for nutrition-sensitive WASH interventions .............................................................37 General guidance ..................................................................................................................41 The role of the private sector .................................................................................................42 Conclusion ............................................................................................................................44 Chapter 7 : Social protection interventions ................................................................................45 Social protection interventions included in the review ............................................................45 Evidence for nutrition-sensitive social protection interventions ..............................................45 General guidance ..................................................................................................................51 The role of the private sector .................................................................................................52 Conclusion ............................................................................................................................53 Chapter 8 : Early childhood development and education interventions ......................................54 ECD and education interventions included in the review .......................................................54 Evidence for nutrition-sensitive ECD and school-based interventions ....................................54 Conclusion ............................................................................................................................56
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