International Nutrition Policy Expert SECTORS AND POLICY FRAMEWORKS IN SELECTED ASIAN AND LATIN AMERICAN COUNTRIES James Levinson International Nutrition Policy Expert Training on “Comparative Review of the Nutrition Situation and Policies in Selected Countries and with particular reference to Bangladesh” 27 March to 6 April 2014

Political and cultural Environment Disempowerment of women Interconnected causes of malnutrition Lack of good CARE for mothers and children and support for mothers on appropriate child feeding practices Inadequate access to HEALTH sanitation and clean water services Insufficient access to affordable, nutritious FOOD throughout the year ROOTED IN Political and cultural Environment Disempowerment of women Poverty

Alignment of specific nutrition interventions and nutrition-sensitive strategies Nutrition-specific Nutrition-sensitive Agriculture: Making nutritious food available and more accessible to everyone; supporting small farms as a source of income for women and household nutrition and health Clean water and sanitation: Improving access to reduce infection and disease Education and employment: Making sure children have adequate nourishment they need to learn and be productive in adulthood. Health care: Improving access and outreach to services that ensure women and children stay healthy Support for resilience: Establishing a stronger, healthier population and sustained prosperity to better endure emergencies and conflicts Feeding practices and behaviors: Support for exclusive breastfeeding up to 6 months of age and continued breastfeeding, together with appropriate and nutritious food up to 2 years old and beyond Dietary diversification / improved diets (cuts across nutrition specific and nutrition sensitive interventions) Fortification of foods Micronutrient supplementation Treatment of acute malnutrition

Stunting (Height for age) Prevalence Average annual rate of improvement is slow. On track for MDG target on underweight Slow down in stunting reduction Challenge with wasting – seasonal Micro-nutrient deficiencies Maternal nutrition / adolescent girls Handwashing – esp. before feeding/eating Complementary feeding – 6-8 mths Regional disparities Improving Child Nutrition. The Achievable Imperative for Global Progress. UNICEF, 2013

Global Health Initiative Some global initiatives to link Agriculture and Nutrition : FAO/UN involvement Feed the Future Global Health Initiative Agriculture Programs Nutrition Health Services Improved access to diverse and quality foods Improved nutrition-related behaviors Improved utilization of maternal and child health and nutrition services The FTF initiative focuses on agriculture programs while the GHI focuses on improving health services. FTF is best positioned to improve access to diverse and quality foods, while GHI can work towards improved utilization of maternal and child health and nutrition services. However, as we shall soon see, there are ways for agriculture programs to also encourage use of health and nutrition services. (Click mouse twice) Nutrition is the link between the FTF and the GHI and activities in both are required to meet nutrition objectives. To succeed, those working in nutrition must hold the hand of both agriculture and health. Agriculture and Health programs can both participate in the development and use of Social and Behavior Change Communication activities to improve nutrition. (Click mouse) SBCC can lead to improved nutrition-related behaviors. As nutrition is not a ‘sector’ per se, nutritionists work through both agriculture and health, among other sectors, to improve nutrition. In the agriculture sector, SBCC can be used to promote improved food choices, child feeding, and other related behaviors (e.g. food processing, safe handling of food). including hygiene 5 5 5

PRINCIPLES Agriculture affects nutrition outcomes indirectly It works through effects on the underlying causes of undernutrition: access to food and food production, health and care, and most directly through the effects of income and prices on household food security Nutrition is both an input for and an outcome of agricultural productivity The appropriate actions will be identified through an analysis of determinants of food insecurity/ undernutrition Plan multisectorally and implement sectorally

The framework for food security interventions: the National Food Policy and its Plan of Action Bangladesh has been an early adopter of the comprehensive approach to food security through the formulation of the National Food Policy (2006) and its Plan of Action (2008) To reduce undernourishment, stunting and underweight, food should be available, accessible and complemented by nutrition interventions Access Nutrition Availability The National Food Policy Plan of Action consisting of 26 areas of intervention and 314 actions provides a comprehensive long-term (2008-2015) framework for: - Coordinating government interventions - Aligning development support to national priorities in line with the Paris Declaration on Aid Effectiveness - Regularly monitoring progress toward FS &N in line with MDG1 -Identifying needs for investments 7

The framework for food security and nutrition interventions: The Country Investment Plan Responding to L’Aquila Initiative and in line with the 5 Principles agreed in the Rome Food Summit, the CIP was approved in 2010 and revised in 2011 based on extensive consultations. It is a coherent set of 12 strategic priority investment programmes allowing to coordinate Government and Development Partners interventions It is aligned with MDG1, NFP PoA and the Sixth Five Year Plan It focuses on investments included in the Annual Development Budget The CIP and PoA provide the framework for monitoring impacts, implementation and financial commitments 8

Alignment within comprehensive Food security and Nutrition Policies Programmes The IAHBI is fully embedded and aligned with the comprehensive policy and programmatic frameworks which underline concerns around food and nutritional security as exposed in the NFP and its Plan of Action, the CIP, the Master Plan for the Southern Delta and the Health, Nutrition Population Sector Development Programme. In particular, it responds to Programme 10 of the CIP – Community based nutrition programmes and Services.