Together for Nutrition 2014: Day 2 Conference Proceedings

The second day of the Together for Nutrition 2014 Conference was filled with yet another set of very interesting and enlightening presentations covering a range of themes: building and sustaining action for nutrition, innovative partnerships for nutrition, women’s groups as a way to strengthen community-level nutrition actions, the first 1,000 days, and the role of nutrition-sensitive interventions.

The first session, chaired by Lawrence Haddad (IFPRI) and Suneetha Kadiyala (LSHTM), featured presentations on preventive and curative measures for nutrition from a biological standpoint, on social causes of nutrition, and on the role of agriculture in improving nutrition in India. Vinod Paul (All India Institute of Medical Sciences) reminded us that almost of half of childhood undernutrition is about fetal growth and infections, and not food per se, and that it is critical to focus on the under twos and on quality coverage of interventions. Harold Alderman (IFPRI) emphasized the importance of thinking about what other sectors can do for nutrition (and vice versa), such as early childhood development and education, and water and sanitation, and that income growth does not necessarily guarantee improved services. Mahendra Dev (Indira Gandhi Institute of Development Research) held an excellent video presentation on the linkages between agriculture and nutrition, and the crucial role of women’s empowerment along the agriculture-nutrition pathways.

Mahendra Dev IGIDR

Mahendra Dev (IGIDR) presents on the role of agriculture in improving nutrition in India.

The second session focused on partnerships for nutrition. Archana Patel (Lata Medical Research Foundation and Indira Gandhi Medical College) spoke about cell phone counseling as a way to improve nutrition practices through a partnership between cell phone companies, public hospitals, and a research NGO. Anjan Ghosh (IIM Calcutta) and Sadhana Bhagwat (GAIN) shared examples of innovative partnerships that focused on, respectively, reducing malnutrition and poverty through a community-driven model Nutrimix Community +, and on improving the quality of ICDS supplementary nutrition.

Working to improve nutrition practices through women’s self-help groups was another key theme of the day, with presentations from CARE-India, Freedom from Hunger-India, and Rajiv Gandhi Manila Vikas Pariyojana-GAIN. Questions related to integrating health and nutrition information into SHG programs in Bihar (CARE-India), SHG involvement in ICDS supplementary feeding in Andhra Pradesh and Madhya Pradesh (CARE-India; see the related POSHAN Implementation Note), integrating health and financial services platforms in 5 states in India (Freedom from Hunger, see the related POSHAN Implementation Note), and expanding the scope of the SHG model to a social empowerment platform in Uttar Pradesh (RGMVP) dominated this session, as well as questions around the role of leadership and inter-caste conflict.

During lunch time, thirteen poster presentations showcased experience from a variety of projects, many of which focused on capacity strengthening activities, and all of which focused on different mechanisms for convergence on health and nutrition, mostly at district and block levels. It is clear that projects were able to effectively engage communities, which in turn contributed to improvements in health and nutrition services and improvements in health and nutrition indicators. For example, community awareness and mobilization of Dalit communities on nutrition issues as part of the NACDOR’s initiative leading to improvements in ICDS schemes (Ashok Bharti, NACDOR). In Chhattisgarh, 300 community managed nutrition and day care centers known as Fulwaris, led to improvements in children’s weight gain and a decision by the state government to scale up the Fulwari model across all 85 tribal blocks of Chhattisgarh through the Panchayats (Samir Garg, State Health Resource Centre) (see also the related POSHAN Implementation Note).

During the second part of the conference, we also heard about convergence between the Departments of Women and Child Development and Family Welfare and the Department of Health regarding the first 1,000 days, another packed session with representation from IFPRI, IPE Global Technical & Management Support Team, the Society for Nutrition, Education & Health Action, CARE-India (see the related POSHAN Implementation Note), Options-Odisha, Jawaharlal Nehru University, and the Public Health Resource Network. The presentations examined convergence at different levels, focusing primarily on coordination with the Department of Women and Child Development and the Department of Health, but also others such as the Department of Rural Development (Options-Odisha), Municipal Corporations (Jawaharlal Nehru University), and NGOs (Jawaharlal Nehru University; CARE-India, see also the related POSHAN Implementation Note). Many of these presentations focused on the management of SAM (severe acute malnutrition) and how operational mechanisms can be improved.

One of the last sessions of the day focused on the important role of how nutrition-sensitive interventions in improving nutrition and health behaviors and outcomes. Water, sanitation and hygiene (WASH), investment in women and girls, social protection, food security, and agriculture were all discussed as important platforms through which nutrition behaviors and outcomes can be improved. Neha Rakyar(Public Health Foundation India) discussed the spillover effects that (quality of) schooling, fertility, and economic empowerment have on nutrition, as well as the challenges surrounding availability of comprehensive data on both nutrition-sensitive and nutrition-specific indicators, cost-benefit analysis, measuring causality, and monitoring. Jyotsna Puri (3iE) spoke about the lack of studies of the nutritional impacts of NREGA. Sangita Vyas (Research Institute for Compassionate Economics) examined the important role of WASH in reducing undernutrition and highlighted the recently launched Swachh Bharat mission on sanitation. Avinash Kishore (IFPRI) discussed the evidence on the health/nutrition impacts of the Public Distribution System (PDS), and Sara Ahmed (International Development Research Centre) looked at the role of agriculture for nutrition and the need to focus on women’s empowerment, value addition and scaling up, as well as income expenditure analyses.

The day came to a close with a key note by Satish Agnihotri (Secretary (Coordination), Cabinet Secretariat, Government of India) who emphasized that often, decisions are made based on ‘impression-based’ advocacy rather than evidence-based advocacy and that this needs to change. He cautioned against relying too much on data based on national averages, which masks the huge variability in health/nutrition outcomes in the various Indian states, as well as on prevention rather than cure. Ultimately, he stated that, ultimately, actions on nutrition need to be implemented by everybody but that we need to come up with ways in which this can best be done.  Shenggen Fan (Director General, IFPRI) further emphasized the important role of agriculture and women’s empowerment, as well as the need to do more research into scaling up, and on the importance of determining the best modality to provide social protection. Farming data and leadership are critical, he said, as well as behavior change. Stuart Gillespie (IFPRI) and Purnima Menon (IFPRI-India) wrapped up the session with some final reflections on the day and the conference as a whole.

All in all, another full day of the Together for Nutrition 2014 conference here in Delhi!

Written by: Mara van den Bold, IFPRI