Challenges for the Future: Implications of NIPN Findings M. Asaduzzaman, Senior Policy Advisor, NIPN/BIDS 25 February 2021 Objectives The presentation has two basic objectives: 1) Review some of the research findings of NIPN during the past year and also earlier 2) Based on review, suggest what appears to be some of the future challenges to improving human nutrition in the country 2 Types of Challenges for Future a. Two types of challenges b. Scientific evidence behind any particular intervention – this is not what NIPN looks into – it takes what science says as given c. NIPN tries to see how the recommendation of science is put in practice – whether deliberately in designing such intervention and/or what factors influence specific nutritional outcomes or processes influencing them d. In doing that NIPN believes it has found some challenges for improving nutrition in the country 3 Limitations a. NIPN studies suffer from some limitation b. All are by design to be based on existing information and data which generally have two types of problems; not all related and relevant information are available easily and information are not always collected in the best possible manners precluding use of variables precisely in analysis – these we will come back to later c. Some of the data sets known to exist are not available anywhere – one example is Micronutrient Survey 2012 – NIPN had been requested early on to analyse these data but non-availability precluded this analysis 4 Policy Studies Reviewed Studies completed by NIPN or on-going a. Policy Mapping b. Systematic Review of Literature c. Regional HDDS Diversity d. Impact of Homestead Gardening e. Factors influencing exclusive breast-feeding f. WASH Impact g. VGD Impact h. Climate Change Impact 5 Progress in Nutritional indicators • Country made major progress in lowering stunting & underweight but not in wasting – by and large helped by rising per capita income 6 Present and Post-covid Challenges ● Rising per capita income & consequent falling poverty had a major role in nutritional improvements ● May not be easy to repeat due to covid-related rise in poverty and slower growth ● Analysis indicates every 1 percentage fall, say, in stunting needs 9% or so rise in GDP - a hard slog even in the best of times 7 Low DD still a major problem • Low freq of animal source protein and dairy raises odds of stunting • Is it due to availability or econ access – likely both 8 High regional variation in DD • High regional variation in dietary diversity • NW has highest incidence of low diversity- broadly conforms to poverty situation • Income, HFP and women’s agency – major factors in raising DD 9 FCS Diversity and HFP ● HFP has significant positive influence on FCS – those with HFP has 50% more chance to have acceptable (>42) FCS ● Incidence of HFP in turn is influenced, among others by low access to assets, particularly housing conditions – those living in huts more than 2 times likely to have HFP indicating poor more in HFP ● Question is how to support HFP by poor so that they have better nutrition ● Much talk about HFP models by DAE; are those effective, accepted by people? – seems unknown 10 Intervention Challenges ●Many interventions for stunting, wasting, LBW, anemia, women’s nutrition but limited rigorous assessments ●Whatever evidence is there clearly indicates that single interventions do not work well, more holistic approach needed with at least BCC as well as attention to women’s agency ● Yet, not clear how far this is how projects are designed ● Projects are mainly for nutrition-specific interventions; nutrition-sensitive interventions are comparatively rare 11 Policy Challenges ●Policies in nutrition-sensitive sectors, specifically in food producing, are not that much nutrition- sensitive and in some cases completely lacking ● Only 5 out of 22 policies appear to be comprehensive ●Main problem is Allocation of Business or mandates of ministries – nutrition as a whole is explicitly nobody’s business (though some of its elements are), not even of Health Ministry though it is the most involved 12 Data Challenges ● Very few large scale data sets, except some global ones; not tailored to country-specificity ● In many cases, data collected in a way that precludes precise estimates – economic data are often unreliable – more multi-disciplinary team work is necessary ●Some time data collected are unusable because of lack of strict adherence to rules of sampling – in one case, NIPN had to exclude 90% of such data before analysis 13 In sum ●While nutritional interventions have to be based on scientific facts, even when these are known, actual interventions may not be effective for several reasons - Problems of accurate and large scale data - Problems of policy inadequacy particularly in nutrition- sensitive sectors - Problems of not designing projects more holistically; particularly three points may be emphasized, raising economic capacity of the poor, women’s agency and BCC 14 A Few Recommendations ●First and foremost, all nutrition data collection should be under supervision of a multi-disciplinary team including social scientists ● All data collected by public authorities should be in public space with adequate safeguard measures ● Projects should be designed holistically as far as possible with adequate attention to economic, gender and BCC issues ● Sectoral policies should be streamlined, more comprehensive and harmonized with each other and be clearly nutrition-oriented 15 Thank you all https://hkw.sharepoint.com/teams/66467/SitePages/NIPN-Bangladesh.aspx Facebook: https://www.facebook.com/NIPNBangladesh Twitter: https://twitter.com/NIPN_BD LinkedIn: https://www.linkedin.com/company/47581946
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