Dr. Habiba Hassan- Regional Symposium on Sustainable Food Systems (FAO)
Exploring pathways for increasing
the nutrition returns of Egypt’s
investment in social protection
Habiba Hassan-Wassef, MD
National Research Center, Cairo
Former Director, Inter-Agency Affairs Division, WHO HQ
• The Egyptian context and its challenges.
• Overview of social protection programmes (SPP) and social
safety net (SSN) schemes.
• Nutrition specific and nutrition sensitive social assistance
• Applying a nutrition lens to social protection programmes.
• Principles governing strategic approaches to increase
• Importance of the life course approach.
• Enabling environments in support of nutrition goals
• Suggestions for increasing the nutrition returns of SPP
• Policy and strategy implications
• Concluding remarks
The Egyptian context and its challenges (1)
• Egypt is fully engaged in making the move to a targeted
social protection system and safety net schemes that
protect poor households and reduce the cost of economic
reforms to be borne by the vulnerable segments of the
• The Ministry of Health and Population (MOHP) is
presently working with all sectors and partners for
formulation of the new National Nutrition Policy and
Strategy 2018-2030. Prevention and control of the impact
on the health and nutrition of Egyptians of the economic
crisis and economic reforms is a shared objective.
The Egyptian context and its challenges (2)
• More than half a century of dependence on a generous
• Currency devaluation
• High inflation rates
• Spiking of food prices and increase in cost of living
• High level of unemployment
• Growing number of vulnerable households
• Presence of other determinants impacting on the
nutritional status of Egyptians
• Health care and nutrition system undergoing reform
• Diminished capacity to access a balanced and safe diet
Addressing the Challenges
Measures accompanying the expansion of the social
protection system and safety net schemes aim at:
• Tackling the high complexity of long standing problems
• Accelerating the pace of service expansion
• Improving the system’s governance and raising the
efficiency and quality of services
• Rigorous verification of eligibility and reform of the
• Strengthening the working partnership with civil
society and the private sector
• Automation of the system
• Completion of a unified database, accessible to all
partners, for all social and other services received by
Overview of the magnitude of the main social
assistance services and their coverage*
• Food subsidies (69 mn.)
• Cash transfers to identified vulnerable groups (9.5 mn.)
• Social Solidarity pensions (8 mn.)
• Compensations from SIF** in cases of crises (in times of need)
• Nurseries (14 000 registered nurseries)
• Free school meals to 11 million pupils at preschool and primary
education levels, and 114 939*** pupils in community schools
• Health insurance to beneficiaries of social solidarity pension
• Energy subsidies (benefits general public)
• Public transport subsidies (benefits general public)
*Source: Live personal communication by Assistant-Minister, Ministry of Social Solidarity, on 5 Dec 2011
Coverage figures continue to increase as work is still in progress.
**SIF: Social Insurance Fund
*** Ministry of Education Statistical Yearbook 2015-2016
Source: IMF Country Report No.: 17/290, July 2017
Components of the Food Subsidy System, Ministry
of Supplies and Internal Trade (MOSIT)
• The subsidized “baladi” bread scheme
• Subsidized wheat flour distribution to remote
• Food ration smart cards for purchasing of
subsidized food items allow access to a more
diverse list of foods through substitution of the
unused bread allowance credit . Benefiting about
69* million beneficiaries, the system is currently
refining its targeting criteria and expanding the
national coverage by the distribution outlets.
*Source: IMF Country report 17/290 of 6 July 2017
Ministry of Social Solidarity, (MOSS 1)
Overview of services, programmes and schemes
• Social care of vulnerable segments of the
population: women, children, youth,
families/households, elderly, individuals with
special needs, and minors.
• Social protection in form of: monthly solidarity
pensions to targeted beneficiaries; time-bound
assistance during crises and emergencies;
assistance to veterans and their families; extra-
ordinary financial solidarity assistance in special
cases; assistance to victims of desertification and
water scarcity in locations at risk; child pensions
for eligible cases.
Source: Egypt Government Portal: Ministry of Social Solidarity official website
Ministry of Social Solidarity (MOSS 2)
Summary of services, programmes and schemes
• Assistance for social development includes, the
‘productive families’ scheme; technical training and
guidance services to ‘productive families’; marketing
and exhibitions for products of supported
communities; development of local communities;
professional training centers for youth and women;
engagement of public service manpower in support of
MOSS social development work.
• Civil society support for realization of their mission
and the development of a working partnerships in
areas with shared objectives.
• Maintaining open channels of communication with
the public at large.
Source: Egypt Government Portal: Ministry of Social Solidarity official website
Some recent initiatives for protection and
• “FORSA”فرصة scheme, offering training offering
training and work opportunities for those who can work to
border cases not qualifying for financial transfer schemes.
• “Decent Housing” كريم سكن, scheme for rehabilitation
of homes in the identified poorest villages, and
connecting them to water and sanitation services.
• A limited pilot program is underway whereby continuation
of social protection benefits to pregnant women is
conditioned by the attendance of nutrition education
sessions. Evaluation of outcomes is awaited.
Connecting the dots in favor of
• The caring and protecting work of MOSS already extends
across the human life course from preconception to old age.
• Much of MOSS work aims at protecting the quality of Egypt’s
human capital, a shared objective with the health and
• This opens up valuable opportunities for MOSS to contribute
to nutrition specific/sensitive actions throughout the life
• The period with greatest potential for enhancing nutritional
outcomes is the First 1000 Days where MOSS is already
• The inter-ministerial national programme for nurseries to be
managed by MOSS, now in the final stages of preparation,
can become one of the most valuable nutrition specific
contributions for MOSS.
Applying a nutrition lens to social
The various programmes, activities and
interventions of MOSS can be grouped into 3
groups in function of their contribution, actual or
potential, to nutrition goals:
1- Nutrition specific
2- Nutrition sensitive
3- Can potentially increase nutrition returns
Examples of nutrition specific/sensitive MOSS actions
• The national food and bread subsidy
• Emergency food aid
• Food distribution in crisis situations
• In kind food aid to families
• In kind food aid associated with
school feeding schemes
• Institutional catering benefiting
inmates of the various types of MOSS
• School meals and snacks
• Nursery snacks
• Nutrition awareness and education of
• Conditional Cash Transfer scheme
(Takaful, social safety net scheme for
mothers of 1ry level school children)
• Solidarity pension schemes benefiting
different groups of the population
• Support to income generation through
social protection schemes such as
‘Productive Families’ scheme.
• Home rehabilitation in poorest villages
(healthy environment) and connecting
them to clean water supply and
sanitation systems (‘Sakan Kareem’
home rehab scheme)
Some actions that can raise the nutrition returns of SPP*
• The important initial step is for MOSS to brief all its staff on the
importance of nutrition to the health, well being of the human
• All food and meal distribution to be accompanied by nutrition literacy
and nutrition education and personal hygiene messages.
• To change the significant investment made in school feeding from a
simple procurement and distribution of energy rich snacks to a well
conceived comprehensive program combining school feeding and
• A comprehensive school feeding program with local procurement
from smallholder producers can contribute to local improvement of
the food and nutrition security situation in the long run.
• To keep the Nursery Services program within the integrated approach
to early childhood development(First 1000 Days)and not to isolate it
as a separate social service.
*SPP: Social Protection Programs
Importance of adoption of a life course approach
The integration of nutrition specific and/or nutrition
sensitive dimension in the social protection and safety
net system in Egypt through the application of a life
course approach is not expected to pose any difficulty for
MOSS as its scope of work in fulfilment of its mandate
spans the entire life course.
Observing such a commitment through joint coordinated
action with the Ministry of Health and Population within
the framework of the respective program in this area can
produce rewarding outcomes for protecting Egypt’s
human capital in the long term.
Enabling environments in support of nutrition goals
• Accessibility to the unified database and classified registry for social
services and social protection schemes.
• Automation of service delivery/management for all social sectors,
(special case of the health sector) contributing to transparency and
• Alignment of social protection programs with national program that
serve shared objectives, ex. the MOSS Nursery services with the First
• Integration of MOSS inputs in the new national nutrition policy and
• Rehabilitation of the governance of the national nutrition system and
re-instatement of the national food security committee to accompany
the new NNPS. Availability of updated nutrition system tools such as
the food analysis tables, the food based dietary guidelines, the
alignment of old nutrition education materials with the realities of
the present situation.
Examples of types of action to increase
nutrition returns of social protection programs
• Ensuring the relevance of the nutritional quality of
distributed food and meals to the nutrition status of the
• Mobilization of agronomic technical support to help cases
receiving emergency food aid in communities suffering
from natural disasters, desertification and climate change.
• Mobilization of competent/concerned authorities or
development partners in all cases receiving emergency
food aid to help overcome, in the long run, the causes of
the sudden food insecurity.
• To adopt and apply measures as required to ensure the
environmental hygiene of the distribution locale and the
recipient community, including access to potable water and
safe sanitation facilities.
Some general policy and strategy implications
• Enabling the bridging of the MOSS resource gap for
financing of social protection schemes through
institutionalizing a working relation with CSOs and
the private sector.
• Adopt measures to improve the performance of
cash transfer programs, integrating nutrition
specific and/or sensitive inputs as relevant.
• Adopt measures to ensure data availability for
sharing by all partners, including the health sector.
• The health sector to adopt a policy for the MOHP
to use the ID card in delivery of its services so as to
integrate the unified database for social services.
There is great scope for increasing the
nutrition returns of the extensive and broad
range of programs and interventions handled by
the Ministry of Social Solidarity (MOSS). This is
reinforced through the active participation of
MOSS in the planning of the new National
Nutrition Policy and Strategy.