Multi-Sectoral Linkages to Improve Diet, Nutrition & Food Security Work

… but we need to do more & better

Keynote address

Alexander A. Kalimbira, PhD

Calorie deficiency in Malawi (1990-2015)

0

10

20

30

40

50

0

1

2

3

4

5

Prevalence (%) Number of undernourished (Millions)

Sources: FAO (2016)

Progress in reducing hunger, but more to be done

Hunger fell from 45% to 21% (1990/02-

2014/16)

• Number of hungry people somewhat stable over a

decade

• However, full effect of 2016-17 crisis not reflected

here

Malawi food deficit: 139 kcal/day

Poor spend 77% of income on food

Food availability increasing with room for improvement

4

Production Area Yield

Cereals 60 22 31

Roots &Tubers 98 34 48

Pulses 155 71 48

Vegetables 44 103 -29

Fruits 48 7 38

Change in production, area, & yield for selected crops,

2000 to 2013/14 (%)

Sources: FAO (2016)

GDP per capita & poverty headcount ratio national poverty line

0

10

20

30

40

50

60

70

0

100

200

300

400

500

600

700

800

9001990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

% (

Po

ve

rty h

ea

dco

un

t ra

tio

)

$ (

PP

P I

ntl D

olla

r)

GDP per capita

National poverty headcount ratio

Sources: World Bank (2016), NSO (2012)

Poverty persists despite strong economic growth

Low income country with modest GDP growth

• 4.3% average GDP growth (2000-2014)

• 1.3% average GDP per capita growth (2000-2015)

Poverty high with 51% living below national

poverty line (2010)

• Majority of poor live in rural areas

6Sources: World Bank (2016), NSO (2012)

Despite gains, child stunting is high

Sources: NSO (1994, 2001, 2005, 2011, 2015, 2017)

Hidden hunger: Progress & Problems

80

6259 59

47

5551

31

22

83

28

22

9

4

60

Anaemia Iron deficiency Iron deficiencyanaemia

Vitamin Adeficiency

Zinc deficiency Salt with >15ppm I

Perc

ent

2001 2009 2015/16

Sources: GoM (2003), NSO (2011, 2017)

Frequent feeding but poor quality

31

24

9

19

30

4

29

25

8

Minimum MealFrequency

Minimum DietaryDiversity

Minimum AcceptableDiet

Perc

ent

Breastfed Non-breastfed All children 6-23 months

Sources: NSO (2017)

Where diets are diversified, risk of undernutrition is low

-2.5

-2

-1.5

-1

-0.5

0

Benin Ethiopia* Malawi Mali* Rwanda* Zimbabwe*

Adju

ste

d M

ean H

AZ

Low Diversity Medium Diversity High Diversity

Source: Arimond & Ruel (2004)

Hunger and undernutrition are costly

Child undernutrition imposes social and economic costs via

• Impaired physical and cognitive development

• Productivity losses; direct healthcare costs

Malawi loses an estimated US$ 597 million (10.3% of GDP

in 2012) due to child undernutrition

• Highest element of cost: Loss in potential productivity from

undernutrition-related mortalities

BUT returns to investing in nutrition are high

• Global estimate: Every $1 invested yields $16 in returns

11Source: WFP 2012, GNR 2015

Multi-sectoral drivers of nutrition and food security

Food availability

HH food access

Ind. Utilization (diets and

absorption)

*Total food

security*

Agricultural production and diversity

Markets and prices

Women’s decision-making power, time-use and knowledge

Health environment

Income for food purchase

-Production support, seeds for diverse & nutritious foods

-Enhance market infrastructure-Marketing groups

-Humanitarian food transfers-School meals-Social cash transfers

-Nutrition training -ECD training -Reproductive health-girl’s education

-sanitation-disease prevention and treatment-treatment of SAM/MAM

6 Key General Evidence and Knowledge Gaps

1. Becoming more nutrition-sensitive is related to having

solid understanding of nutrition issues of target

population, vulnerable groups within the population, &

immediate and underlying determinants of the nutrition

issues

2. How can different types of multisectoral programmes

be used as platforms to reach nutritionally vulnerable

groups?

3. What is the optimal size, composition and timing of

social transfers?

13* Adapted from Olney et al. (2016)

6 Key General Evidence and Knowledge Gaps

4. What combination of multisectoral interventions is

needed and how best can we optimize their joint potential

for impacts?

5. What are the impacts on the enabling environment and

some of the underlying determinants of nutrition; e.g.

availability and affordability of nutrient-rich foods at local

markets and access to basic social, health and hygiene

infrastructure?

6. What are the pathways through which multisectoral

programmes work to achieve impact, and how can they

be further optimised for nutritional impacts?

14

* Adapted from Olney et al. (2016)