1. 1 Investing in Nutrition and Child Health A strategy for economic development: the Senegalese experience Mamadou Sidibe Minister of Planning and Sustainable Development - Senegal

2. 2 Costs of Malnutrition The costs of malnutrition are found in… morbidity and mortality excess health expenditure reduced school performance reduced work productivity If unaddressed… … over 10 years malnutrition would cost $ 1.6 billion $ 800 million for protein-energy malnutrition $ 600 million for iodine deficiency disorders $ 190 million from anemia …and thousands of children < 5 would die unnecessarily each year.

3. 3 Drought SAPCFA Devaluation PPNS (1973-1985 ) PNC (1995-2000) Ministry of Health/CRS AGETIP 1970198019902000 An Evolving Response MDG/PRSP NUT POLICY PRN (2002-2012) NGO/MINISTRIES

4. 4 National Committee against Malnutrition (CLM) Mission: Define a multi-sectoral national nutrition policy Monitor nutrition program implementation Location: Prime Minister’s Office Composition: technical ministries, local government, civil society Development partners: World Bank, USAID/BASICS, UNICEF, WFP, WHO, KFW, NGOs

5. 5 Vision for Economic Growth in Senegal Policy shift in 2000 leading to: Positive vision to invest in good nutrition for child and sustainable development—not simply to combat malnutrition: CLM Vision: a country where every individual has satisfactory nutritional status, and adopts adequate behaviors for her/his own well-being and for the development of the community. Emphasis on achieving Millennium Development Goals

6. 6 PHASE 1 (2002-2006) To test different intervention strategies PHASE 1 (2002-2006) To test different intervention strategies PHASE 2 (2006-2010) To extend interventions to all regions PHASE 2 (2006-2010) To extend interventions to all regions PHASE 3 (2010-2015) To ensure integration of nutrition objectives into sectoral programmes PHASE 3 (2010-2015) To ensure integration of nutrition objectives into sectoral programmes Identify cost effective and sustainable strategies Extend nutrition interventions in rural areas Sustainable improvement of nutritional status of vulnerable groups Nutrition Enhancement Program Phases

7. 7 Nutrition Enhancement Program Description Built on Successful Pilots Strategies Integration of nutrition objectives in sectoral ministries such as Health, Education, Agriculture Community based nutrition and IMCI for vulnerable groups Core interventions C-IMCI Essential Nutrition Activities Growth Promotion

8. 8 Core Interventions Tailored to District Needs Shift from “umbrella” delivery approach to district-specific approaches Grandmother’s groups Pregnant women’s support groups

9. 9 Nutrition Program Coverage and Malnutrition Rate

10. 10 Prevalence under 5 Underweight (%) Millenium Development Goals Results of National Surveys (DHS and MICS) Projection without intervention Projection with current interventions intensifiied 0 5 10 15 20 25 30 199219962000200520102015 10 20 22 18 17 Progress Toward Nutrition MDG 26

11. 11 Under 5 Mortality (per 1000)) Millenium Development Goals Results of National Surveys (DHS ) Projection without intervention Projection with current interventions intensifiied 25 50 75 100 125 150 175 199219972005201020152020 44 131 139 121 Progress Toward Child Mortality MDG 175

12. 12 Costs Cost to reach MDG target: $150 million over 10 years Cost to “do nothing”: $1.6 billion and thousands of child deaths over 10 years $150 million investment for nutrition nets $1.6 billion in savings…a 1,000% return!

13. 13 Reaching MDGs in Nutrition and Child Survival in Senegal Commitment by the highest level of Government Partnership with NGOs and Local Governments to scale up and sustain proven nutrition and child health interventions Integration of nutrition within the health system Community ownership through the involvement of local government Investment of both government funds and international partners

14. 14 THANK YOU FOR YOUR ATTENTION