This Keynote address was presented by Dr. Alexander Kalimbira (Head of Nutrition Department at LUANAR) at the agriculture nutrition event on "Improving Food Security, Diets and Nutrition through Multisectoral Action" on 30 May, 2017 at Capital Hotel, Lilongwe.

1. Multi-Sectoral Linkages to Improve Diet,
Nutrition & Food Security Work
… but we need to do more & better
Keynote address
Alexander A. Kalimbira, PhD

2. 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)

3. 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

4. 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)

5. 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
900 1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
%(Povertyheadcountratio)
$(PPPIntlDollar)
GDP per capita
National poverty headcount ratio
Sources: World Bank (2016), NSO (2012)

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

7. Despite gains, child stunting is high
Sources: NSO (1994, 2001, 2005, 2011, 2015, 2017)

8. Hidden hunger: Progress & Problems
80
62
59 59
47
55
51
31
22
83
28
22
9
4
60
Anaemia Iron deficiency Iron deficiency
anaemia
Vitamin A
deficiency
Zinc deficiency Salt with >15
ppm I
Percent
2001 2009 2015/16
Sources: GoM (2003), NSO (2011, 2017)

9. Frequent feeding but poor quality
31
24
9
19
30
4
29
25
8
Minimum Meal
Frequency
Minimum Dietary
Diversity
Minimum Acceptable
Diet
Percent
Breastfed Non-breastfed All children 6-23 months
Sources: NSO (2017)

10. Where diets are diversified, risk of
undernutrition is low
-2.5
-2
-1.5
-1
-0.5
0
Benin Ethiopia* Malawi Mali* Rwanda* Zimbabwe*
AdjustedMeanHAZ
Low Diversity Medium Diversity High Diversity
Source: Arimond & Ruel (2004)

11. 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
11
Source: WFP 2012, GNR 2015

12. 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

13. 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)

14. 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)