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This document discusses how nutrition can support resilience programming and gender mainstreaming. It provides several key points: Nutrition is both an input and outcome of resilience efforts. It is an effective entry point for addressing gender issues and multi-sectoral planning. Nutrition indicators should be used to identify vulnerable groups and target programming. Nutrition objectives should be explicitly included in resilience and disaster risk management planning. Approaches that enhance nutritional impact include diversifying livelihoods and crops to meet nutritional needs, incorporating nutrition education, and linking food/agriculture interventions to social protection.

Nutrition: an ally for
resilience programming &
gender mainstreaming
 How nutrition can support resilience
programming and gender mainstreaming
 What can you do to enhance the nutritional
impact of your resilience programmes

Nutrition is…
An input to, and an outcome of resilience
An effective entry point to address gender
issues where culturally/politically sensitive
An effective entry point for people-centred,
multi-sectoral planning combining a short &
long-term perspective
A reminder to think of both producers and
consumers and not overlook the most
vulnerable households

Nutrition: operationalizing the concept of
resilience
Good Nutrition
Adequate food
intake
Agriculture
Safety
nets
Education
Health
services
Food
safety
Sanitatio
n
Employment
Feeding
pratices
Family
planning
Security
Good health
G
E
N
D
E
R
Political
will
Infrastructure
« Emergency »
« Development»
R
E
S
I
L
I
E
N
C
E
Market
access

Nutrition to improve governance (Pillar 1)
Use nutrition figures to build the case for
nutrition-sensitive resilience measures
Integrate explicit nutrition objectives and
interventions in resilience/DRM planning
Support synergies between resilience and
FNS policies and coordination mechanisms
Nutrition as an enabling entry point for
gender and equity-sensitive resilience-
enhancing measures

Watching nutrition to safeguard people (2)
Include indicators of food consumption &
diet-related coping strategies as early
indicators of impending crisis
Consider nutritional status as an indicator of
the erosion of people’s resilience and of
greater vulnerability
Analyse causes of malnutrition in different
livelihoods groups to anticipate impact of
shock on vulnerable groups

Key entry points for nutrition-sensitive resilience
programming
Use nutrition indicators to identify and target
vulnerable groups
Use the causes of malnutrition by livelihoods group
as an entry point for multi-sectoral programming
Make nutrition an explicit objective of food and
agriculture programmes and monitor progress
against these indicators (esp. food consumption)
Ensure programmes meet nutritional needs of, and
support both women and men
Investing in nutrition to better prevent &
respond to shocks and stress (3&4)

Investing in nutrition to better prevent &
respond to shocks and stress (3&4)
Approaches that enhance nutritional impact
Strengthen & diversify household livelihoods and
promote dietary diversification  Choose crops not
just for market potential but also to respond to
nutritional needs.
Incorporate nutrition education to improve dietary
practices, especially of young children
Link food and agriculture interventions to social
protection measures
Link food and agriculture to programmes that
address other causes of malnutrition (health, water…)

Tips for nutrition technical assistance
Nutrition is a vast field covering different types of
expertise! So…
FAO promotes food-based appraoches  make
sure the nutritionist has experience of working with
food and agriculture and not just treatment!
Be specific in the areas of greatest relevance for
your programme:
Policy / programming?
Information systems / assessment / M&E?
Nutrition education & behaviour change?
Food safety?

The SAARC Regional Action Framework for Nutrition aims to ensure children in South Asia grow up healthy and productive. It has four strategic pillars: 1) gain high-level political commitment for multi-sectoral nutrition policies and plans; 2) scale up evidence-based nutrition interventions for women and children; 3) increase human and institutional capacity for nutrition programs; and 4) strengthen monitoring, evaluation and knowledge management. The framework emphasizes proven nutrition-specific interventions during the first 1,000 days of life as well as nutrition-sensitive programs in agriculture, social protection, education, and women's empowerment.

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Malnutrition must be addressed beyond just health issues through advocacy and national development plans that integrate nutrition priorities. Early implementation of Thailand's national nutrition plan faced coordination challenges between sectors due to rigid government structures and resource allocation. Integrating nutrition into broader social and health development plans, spearheaded by a Poverty Alleviation Plan, helped scale up nutrition programs. Community health volunteers were trained to conduct growth monitoring and promotion activities, and marked improvements in child malnutrition were seen within 5 years.

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Changing patterns of malnutrition in Ethiopia and lessons learned. Stunting, wasting, and underweight rates in children under 5 have declined significantly from 2000 to 2014 due to decisive government commitment and leadership. Key factors contributing to improvements include strengthened primary health care and nutrition-specific interventions, expanded access to agriculture and education, and multi-sectoral nutrition policies integrated across health, agriculture, education, industry, and social protection sectors. Remaining challenges include continuing to address equity and quality, strengthening nutrition-sensitive actions and information systems, and managing the emerging issues of overweight and obesity.

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Nepal experienced rapid reductions in maternal and child undernutrition from 1996-2011, despite civil war and political instability. The prevalence of stunting in children under 2 fell from 48% to 27%, and maternal underweight fell from 28% to 20%. These gains were achieved through increased access to health services, household asset growth, improved education levels, and sanitation access. Lessons learned include the importance of improved service delivery, multi-sector collaboration, and addressing social and gender norms to sustain nutrition progress.

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THAILAND REDUCED CHILD undernutrition by more than half within one decade—an achievement recognized by the nutrition community as one of the best examples of a successful national nutrition program. Underweight rates among children under five decreased from more than 50 percent to less than 20 percent from 1982 to 1991, and severe and moderate underweight rates were nearly eliminated. The underweight rate was further reduced to 10 percent by 1996 and to 9 percent by 2012. Maternal care interventions were also successful. Thailand improved the reach of antenatal care—coverage increased from 35 percent in 1981 to near 95 percent in 2006. And iron-deficiency anemia prevalence among pregnant women was reduced from nearly 60 percent in the 1960s to 10 percent in 2005.

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PERUVIANS HAVE MUCH to celebrate in regards to the rapid progress the country has made in reducing malnutrition. In 2013, only 3.5 percent of children under five years of age in Peru were underweight. Even smaller proportions— 0.5 percent and 0.1 percent—were moderately or severely wasted. But the statistic that many nutritionists point to when lauding the country as a nutrition success is Peru’s rate of childhood stunting (Figure 14.1). In 2014, 14.6 percent of children under five years of age were stunted. While this rate is not as low as the country’s other nutrition indicators, it reflects a remarkable improvement. Less than a decade earlier, the prevalence was twice as high (29.5 percent).4 How was this rapid progress achieved—not only at a national level, but across all of Peru’s diverse regions, even poor rural ones including the Andean Highlands, and even amongst the poorest 20 percent of the population?

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SEVERE ACUTE MALNUTRITION (SAM)—extremely low weight for one’s height—is a life-threatening condition affecting mostly children under five years of age. It is caused by a combination of infection, such as diarrheal disease, and poor diets that are inadequate for nutritional needs. SAM is one of the top three nutrition-related causes of death in children under five according to the 2008 Maternal and Child Nutrition Lancet Series. A child with SAM is 11 times more likely to die than a well-nourished child. Despite the size of the problem, until the early 2000s SAM appeared to be a so-called neglected disease: little support went to large-scale treatment programs targeted toward children with SAM. Few countries-even among those with a high prevalence of malnutrition-had a clear national policy for detecting and treating SAM children.10 The development and adoption of a new approach-the community-based management of acute malnutrition (CMAM)-was to change the public health nutrition landscape by bringing treatment out of hospitals and into the community

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Nutrition&resilience rne so5_nopics (1)

1. Nutrition: an ally for resilience programming & gender mainstreaming  How nutrition can support resilience programming and gender mainstreaming  What can you do to enhance the nutritional impact of your resilience programmes

2. Nutrition is… An input to, and an outcome of resilience An effective entry point to address gender issues where culturally/politically sensitive An effective entry point for people-centred, multi-sectoral planning combining a short & long-term perspective A reminder to think of both producers and consumers and not overlook the most vulnerable households

3. Nutrition: operationalizing the concept of resilience Good Nutrition Adequate food intake Agriculture Safety nets Education Health services Food safety Sanitatio n Employment Feeding pratices Family planning Security Good health G E N D E R Political will Infrastructure « Emergency » « Development» R E S I L I E N C E Market access

4. Nutrition to improve governance (Pillar 1) Use nutrition figures to build the case for nutrition-sensitive resilience measures Integrate explicit nutrition objectives and interventions in resilience/DRM planning Support synergies between resilience and FNS policies and coordination mechanisms Nutrition as an enabling entry point for gender and equity-sensitive resilience- enhancing measures

5. Watching nutrition to safeguard people (2) Include indicators of food consumption & diet-related coping strategies as early indicators of impending crisis Consider nutritional status as an indicator of the erosion of people’s resilience and of greater vulnerability Analyse causes of malnutrition in different livelihoods groups to anticipate impact of shock on vulnerable groups

6. Key entry points for nutrition-sensitive resilience programming Use nutrition indicators to identify and target vulnerable groups Use the causes of malnutrition by livelihoods group as an entry point for multi-sectoral programming Make nutrition an explicit objective of food and agriculture programmes and monitor progress against these indicators (esp. food consumption) Ensure programmes meet nutritional needs of, and support both women and men Investing in nutrition to better prevent & respond to shocks and stress (3&4)

7. Investing in nutrition to better prevent & respond to shocks and stress (3&4) Approaches that enhance nutritional impact Strengthen & diversify household livelihoods and promote dietary diversification  Choose crops not just for market potential but also to respond to nutritional needs. Incorporate nutrition education to improve dietary practices, especially of young children Link food and agriculture interventions to social protection measures Link food and agriculture to programmes that address other causes of malnutrition (health, water…)

8. Tips for nutrition technical assistance Nutrition is a vast field covering different types of expertise! So… FAO promotes food-based appraoches  make sure the nutritionist has experience of working with food and agriculture and not just treatment! Be specific in the areas of greatest relevance for your programme: Policy / programming? Information systems / assessment / M&E? Nutrition education & behaviour change? Food safety?

Editor's Notes

Households water cisterns allow to buy water in large quantities at a cheaper price : annual saving per year per family : 2400 USD (= X% income?) Cash-for- work scheme under supervision of a site engineer providing 15 days of additional income to XXXX beneficiaries, injecting cash directly into affected communities. Cost effective and timely method for large-scale project with wide geographical scope. Community in-kind contribution to 40% of the estimated cost with unskilled labour is an asset for future maintenance of their own cistern Water harvesting contributes to soil and water conservation, preserving the natural capital of the communities
Households water cisterns allow to buy water in large quantities at a cheaper price : annual saving per year per family : 2400 USD (= X% income?) Cash-for- work scheme under supervision of a site engineer providing 15 days of additional income to XXXX beneficiaries, injecting cash directly into affected communities. Cost effective and timely method for large-scale project with wide geographical scope. Community in-kind contribution to 40% of the estimated cost with unskilled labour is an asset for future maintenance of their own cistern Water harvesting contributes to soil and water conservation, preserving the natural capital of the communities
Households water cisterns allow to buy water in large quantities at a cheaper price : annual saving per year per family : 2400 USD (= X% income?) Cash-for- work scheme under supervision of a site engineer providing 15 days of additional income to XXXX beneficiaries, injecting cash directly into affected communities. Cost effective and timely method for large-scale project with wide geographical scope. Community in-kind contribution to 40% of the estimated cost with unskilled labour is an asset for future maintenance of their own cistern Water harvesting contributes to soil and water conservation, preserving the natural capital of the communities
Households water cisterns allow to buy water in large quantities at a cheaper price : annual saving per year per family : 2400 USD (= X% income?) Cash-for- work scheme under supervision of a site engineer providing 15 days of additional income to XXXX beneficiaries, injecting cash directly into affected communities. Cost effective and timely method for large-scale project with wide geographical scope. Community in-kind contribution to 40% of the estimated cost with unskilled labour is an asset for future maintenance of their own cistern Water harvesting contributes to soil and water conservation, preserving the natural capital of the communities
Households water cisterns allow to buy water in large quantities at a cheaper price : annual saving per year per family : 2400 USD (= X% income?) Cash-for- work scheme under supervision of a site engineer providing 15 days of additional income to XXXX beneficiaries, injecting cash directly into affected communities. Cost effective and timely method for large-scale project with wide geographical scope. Community in-kind contribution to 40% of the estimated cost with unskilled labour is an asset for future maintenance of their own cistern Water harvesting contributes to soil and water conservation, preserving the natural capital of the communities
Households water cisterns allow to buy water in large quantities at a cheaper price : annual saving per year per family : 2400 USD (= X% income?) Cash-for- work scheme under supervision of a site engineer providing 15 days of additional income to XXXX beneficiaries, injecting cash directly into affected communities. Cost effective and timely method for large-scale project with wide geographical scope. Community in-kind contribution to 40% of the estimated cost with unskilled labour is an asset for future maintenance of their own cistern Water harvesting contributes to soil and water conservation, preserving the natural capital of the communities
Households water cisterns allow to buy water in large quantities at a cheaper price : annual saving per year per family : 2400 USD (= X% income?) Cash-for- work scheme under supervision of a site engineer providing 15 days of additional income to XXXX beneficiaries, injecting cash directly into affected communities. Cost effective and timely method for large-scale project with wide geographical scope. Community in-kind contribution to 40% of the estimated cost with unskilled labour is an asset for future maintenance of their own cistern Water harvesting contributes to soil and water conservation, preserving the natural capital of the communities

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Editor's Notes