Research to action: The Hunger and Nutrition Commitment Index (HANCI), Tanzania

By Fran Seballos, Tamlyn Munslow and Dolf te Lintelo

On November 14, Tanzanian dailies fronted with headlines estimating that 11.3 per cent of Tanzanians experience extreme (food) poverty. This coincided with an IDS presentation of results from the Hunger and Nutrition Commitment Index (HANCI) to a group of Tanzanian members of the Parliamentary Group for Nutrition, Food Security and Children’s Rights, including two deputy ministers. This blog reflects on some key learning from our engagement with ‘hunger and nutrition champions’.

Co-construction enables greater access to decision-makers

Working in partnership with Save the Children and the Partnership for Nutrition in Tanzania (PANITA) – who supports the Parliamentary Group to act as ‘nutrition champions’ – IDS led the process of co-constructing a set of key findings with which to target the MPs. They married evidence from the HANCI secondary data and primary research conducted in Tanzania to critical issues in PANITA’s existing advocacy strategy and aligned them with ongoing efforts of the Parliamentary Group. As such key findings were first shared with, and approved by, the Chair of the Parliamentary Group to ensure their suitability for our audience.

Evidence-informed messages targeting political leaders

Where evidence allowed, we praised the Government of Tanzania for initiating key actions, notably establishing a National Nutrition Strategy; a coordinating mechanism which brings together stakeholders from across sectors; and having a separate budget line for nutrition. But - based on research undertaken with 40 Tanzanian experts - the first key finding stressed the need for improving the functionality of the coordination mechanism to better support the mainstreaming of nutrition into policies and strategies across sectors. Further evidence from the expert survey was used to highlight the lack of financial resources in the nutrition budget line which impacts on the realisation of policy objectives, particularly at the sub-national level. The third key finding noted that data on both nutrition outcomes and the quality of the delivery of policies and programmes was insufficiently available to usefully inform decision-makers.

While these findings produced affirmative nods from audience, Parliamentarians were surprised to hear that political party manifestoes (2010-2015) were seen to not adequately reflect hunger and nutrition as key development issues. Nevertheless, they quickly accepted that improving this could be a key political driver for greater action on hunger and nutrition in national government policy, laws and budget allocations.

Developing political ownership of findings and solutions

Presenting HANCI evidence on ‘problems’ and ‘why they matter’, and not prefabricating solutions successfully facilitated the MPs to themselves propose (and own) ‘solutions’, and translate these into personal action.

From solutions to action…

The MPs enthusiastically noted that HANCI evidence grounds complex nutrition issues and provides useful ammunition for them to exercise political leadership and strengthen their oversight over the Government. Specifically the MPs were keen to learn from the actions of other African countries that out-ranked Tanzania (8th) in the Index, in order to emulate and leapfrog them in future. Consequently, the MPs proposed several actions:

1. To take the lead in ensuring that nutrition is included as a key development issue in the next set of political manifestoes (2015-2020)
2. To champion nutrition in their regions and districts
3. Seeking to get the National Nutrition Strategy as a permanent agenda item in sub-national committees and council meetings
4. One MP committed to preparing a private motion for Parliament to demand regular and improved collation, access and use of nutrition outcome and policy implementation data at the district level throughout the country, thus enabling MPs to hold policy implementers better to account and to incentivise them to perform better.

All in all, the visit made a very promising start of what we hope will be an enduring relationship with Tanzanian decision-makers, to support them to foster greater political action on hunger and nutrition.

Is social protection an effective toolkit for addressing undernutrition?

by Stephen Devereux

On 13-15 November 2013 a preparatory technical meeting for next year’s ‘Joint FAO/WHO Second International Conference on Nutrition’ (ICN2) was held at FAO in Rome. One panel discussed the role of social protection in protecting and promoting nutrition. The discussion paper for the panel was presented by Harold Alderman of IFPRI, [1] and it included this policy recommendation, which sparked as lively a discussion as is possible in a meeting of 200+ delegates:

“Include nutrition outcomes as an explicit objective of social protection programmes, to promote improved nutrition”.

The discussion paper poses significant challenges to everyone who works on social protection, because many of us have invested much effort into trying to make a convincing argument for the effectiveness of social protection as a set of policy instruments, not only for addressing poverty and vulnerability but also for tackling food and nutrition insecurity. This paper, and the discussion at the ICN2 preparatory meeting, made me realise that we still have some work to do in making that convincing case, especially in terms of nutrition outcomes.

Several findings in the discussion paper suggest that we have too little evidence to give a definitive answer to the question about whether social protection does have significant positive impacts on nutrition status. This statement, about Ethiopia’s ‘Productive Safety Nets Programme’, could be generalised across many other social protection programmes.

“While the program has been successful in improving food security and asset accumulation, there is no evidence to date that this has translated into improved nutritional outcomes for children.”

We do know from impact evaluations that the Productive Safety Nets Programme (PSNP) reduced the annual ‘hunger gap’ by more than one month in participating households, from 3.6 to 2.3 months, between 2006 and 2010. [2] This is a significant positive impact on household food security, so why does it not translate into measurable impacts on children’s nutrition status? I can think of three plausible hypotheses.

1. Maybe it is because nutritional outcomes aren’t measured – but if not, why not? Surely this is one of the most robust and relevant indicators of social protection effectiveness? An important methodological point is that food security indicators, such as dietary diversity and the number of meals consumed per day, are quantifiable indicators but they are self-reported, so they are prone to all kinds of potential bias. Anthropometry is one of the few objectively measured indicators of food security outcomes, so shouldn’t it be included in rigorous impact evaluations whenever possible?
2. Is it because programme evaluators and administrators don’t want to monitor nutrition status, in case they find little evidence of nutritional impacts and their programme will be judged a failure, despite achieving success in terms of other indicators?
3. Or maybe it is because social protection should not even be expected to improve nutrition status? If one primary objective of social protection is to protect vulnerable people against downside risk, then stabilising food consumption through bad times is certainly a core social protection function, but raising food consumption sustainably is arguably more appropriate for poverty reduction and broader development policies.

Whatever the explanation, it is clear that the evidence base on causal linkages from social protection to reduced undernutrition is limited, and needs to be strengthened. This could certainly be achieved by insisting that nutrition is included as a direct objective of social protection programmes. But do we agree with the implication that nutrition outcomes should be included as an impact indicator for all social protection programmes? One contributor to the discussion at FAO pointed out that it depends on the objectives and design of each specific programme, but argued that the overall social protection system in each country should be oriented towards reducing undernutrition rates, as one fundamental indicator of wellbeing that social protection should seek to influence.

“It depends” is always a safe non-committal academic answer, but I tend to agree. Improvements in nutrition status should not necessarily be an indicator of success for each and every social protection programme, but social protection definitely needs to be an integral component of any integrated and systematic approach to reducing malnutrition.

Readings

[1] Alderman, H. (2013) Social Protection and Nutrition Discussion Paper, Preparatory Technical Meeting, Joint FAO/WHO Second International Conference on Nutrition (ICN2). Rome: FAO, 13-15 November.

[2] Guush Berhane, Hoddinott, J., Kumar, N. and Alemayehu Seyoum Taffesse (2011) The Impact of Ethiopia’s Productive Safety Nets and Household Asset Building Programme: 2006-2010. Washington DC: International Food Policy Research Institute.