Every year, on 16 October, World Food Day provides an occasion to remind us that undernutrition kills over 3 million children a year. In addition to the health tragedy, it is important to stress that this scourge hinders economic development in countries: it costs between 2% and 11% of GDP. For a long time, it was thought that the increase in agricultural production provided an effective and adequate response to combat this scourge. Yet there are a whole host of causes: food insecurity, but also the lack of access to healthcare, water-hygiene-sanitation, education, the impacts of climate change, as well as gender inequalities. Consequently, in order to be able to combat this health tragedy effectively, all actors in the development community must take action.
Fear of “Christmas tree” projects
In 2010, France adopted a nutrition strategy. It thus highlighted the need for a multisectoral approach to this issue. However, this guideline has been poorly implemented: France’s aid for nutrition is mainly confined to food aid programs (79% of the total volume of ODA earmarked for nutrition) ! It therefore neglects a wide range of interventions, which could nonetheless make a significant contribution to eradicating undernutrition.
Why is it so difficult to implement this guideline? Because there is a fear of multisectorality. In its report “Improving Nutrition Through Multisectoral Approaches”, the World Bank referred to the fear expressed by officers in charge of food security of seeing “Christmas tree” projects spring up when they received the directive to mainstream nutrition-sensitive agricultural activities. What is a “Christmas tree”? In the jargon, a “Christmas tree” refers to a project that brings together various activities, but which have no real coherence between them.
The key question is thus raised: How to effectively achieve the multisectoral approach to nutrition advocated by France? How to implement it in a context where financial allocations are made by sector, where programs are generally devised in the same division or department, and where the evaluation of outcomes is also conducted sector by sector?
The answer: “Think multisectoral, act sectorally”
This involves optimizing the nutritional impact of various sectors, while seeking, at the very least, to ensure that they are consistent (minimize the detrimental overlap of interventions in order to make sure that one intervention does not work against another intervention that may be beneficial for nutrition) and, at best, that there are synergies between them (design interventions that interact in order to maximize the nutritional impact).
Depending on the context, a whole host of effective forms and levels of collaboration can therefore be implemented… provided that nutrition is identified as an objective.
The report « La Nutrition, l’affaire de tous : recommandations sectorielles pour une approche intégrée de la sous-nutrition », released just recently by the collective Génération Nutrition, puts forward recommendations for a more effective mainstreaming of nutrition. From an operational perspective, this can lead to:
- The ex ante analysis of the predictable impacts of projects in order to ensure that they do not jeopardize the nutritional status and therefore the health of populations;
- The nutritional situation being taken into account by mainstreaming specific objectives into areas of intervention where undernutrition rates are high.
- For water-hygiene-sanitation programs, for example, there is a need to step up interventions that help to reduce water-borne diseases and undernutrition, which are seriously lagging, in particular via hygiene and sanitation awareness raising;
- For health programs, there is a need to mainstream the management of undernutrition into the integrated and usual management of childhood illnesses, just like the other illnesses, given the impact they have on child mortality and the vicious circle that links undernutrition with other infections;
- For the fight against climate change, it is necessary to mainstream undernutrition into the vulnerability criteria related to climate change, particularly in the analysis grids of donors, such as Agence Française de Développement.
Let’s put on nutrition glasses to stop over 3 million children continuing to die in 2015!