Hidden Hunger: Strategies to Improve Nutrition Quality. Группа авторовЧитать онлайн книгу.
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Not only growth, but also good governance is positively correlated with the reduction of undernutrition. Indicators for good governance1 plotted against the reduction in the GHI suggest that the nutritional status and prevalence of hunger benefit from a safe and accountable policy environment as well as responsible and corruption-free leadership.
Governance is not only a matter of governments, but given their global reach, multinational food companies have a powerful role to play alongside governments, international organizations, and civil society in reducing hunger and impaired nutrition. The Access to Nutrition Index is an independent benchmarking tool that measures companies’ contributions to good nutrition against international norms and standards. According to the Access to Nutrition Index report from 2016 [2], “companies have shown improvement since 2013 in:
•Assigning top-level managerial responsibility and oversight to undernutrition.
•Explicitly committing to tackling micronutrient deficiencies in developing countries through targeted fortification of products.
•Reporting on engagement with governments in developing countries on undernutrition.”
The report shows that the world’s top food and beverage companies have taken some steps towards improving consumers’ diets. However, many of the companies are still lagging behind and overall greater efforts are required.
Drawing partly on recent reviews [3, 4], key success factors for the political economy of nutrition are:
1 Three sets of factors shape enabling environments for nutrition: knowledge and evidence, politics and governance, and capacity and resources.
2 Leadership for nutrition is fundamentally important for results.
The private sector has substantial potential to contribute to improvements in nutrition, but there is scarcity of credible evidence and trust.
4 Operational research of delivery, implementation, and the scaling of interventions, and contextual analysis is essential.
Fig. 1. Instruments and actions for improved nutrition. Source: designed by author.
5 Systematic political economy analysis should be embedded with identification of potentially improved roles of stakeholders to avoid disappointments with public-private and NGO-private partnerships.
The Principal Challenge of Mapping Nutrition Goals and Instruments
The reduction of hunger and improvement of nutrition remain key policy goals in international policy. This is reflected in the United Nation’s Sustainable Development Goals (SDGs). The “Zero Hunger” goal No. 2 of the SDGs explicitly deals with ending the problem of hunger and all forms of malnutrition, which include hidden hunger, by 2030. The international political leaders commit to providing universal access to safe, nutritious, and sufficient food, in particular for the poor and people in vulnerable situations. Furthermore, virtually all other SDGs relate to nutrition directly or indirectly as well. However, there are trade-offs between specific policy goals that have to be taken into consideration.
In order to achieve a policy goal, there is a need for proper and well-defined instruments and specific actions. A prerequisite for effective and efficient policy action is that policy makers are equipped with more instruments than goals. Figure 1 presents an illustration of this principle emphasized by Tinbergen in the early 50s [5]. The defined goal of improving nutrition requires at least 2 instruments: (1) improving nutrition services and (2) generating or transferring income to the poor. Specific actions for improving nutrition services may include (1.1) (bio-)fortification of food, that is, increasing the content of micronutrients in food during processing or in the crops through agronomic practices, conventional plant breeding, or modern biotechnology and/or (1.2) promoting behavioral change. The second instrument would require a focus on (2.1) propelling agricultural productivity and/or (2.2) cash transfers.
Fig. 2. Framework of nutrition and food systems. Source: von Braun [6].
The multi-dimensional character of nutrition challenges requires the deployment of a combination of multiple instruments and policy actions. This means that complex problems related for instance to income, food access, and micronutrient deficiencies require context specific combinations of interventions. Better nutrition policy therefore implies more coordination in policy making across different policy domains and innovative approaches, such as the combination of conditional cash transfers, employment guarantees, fortification, sanitation programs, small farm productivity programs, or mother and child focused nutrition interventions.
Economic and Political Innovations for Better Nutrition
In view of the noted complexities, an effective policy for improved nutrition needs a framework that helps in understanding causal relations of determinants, and shaping priorities for action. An aggregate but comprehensive conceptual framework is presented in Figure 2. The concept takes a broad perspective on the food and agricultural sector, income and employment, markets and services, and hunger and malnutrition. Institutions, information, and behavior are cross-cutting issues that influence linkages in all the domains that describe the framework. Generally, all 4 dimensions in Figure 2 and their interrelations can benefit from innovations making the food and nutrition system more effective, efficient, and resilient.
Even in a rather aggregate framework such as presented here, at least 6 critical linkages need consideration when addressing hunger and malnutrition (see arrows in Fig. 2). Overarching and surrounding are environmental as well as macroeconomic framework conditions. Related linkages exist at large or even global scale, such as greenhouse gas emissions through land use change, and at local scale, such as water and sanitation in the context of irrigated agriculture and waste disposal. All the links operate with diverse dynamics under short- or long-term time lags, which require attention in policies and programs. Structural problems, such as access to markets and resources including land, have to be considered and there are risks affecting the resilience of poor people and low-income countries, often eroding societal cohesion. Furthermore, a multitude of drivers far beyond agriculture can shape food security in positive or risky ways, for example, bio-energy systems, financial markets integrated with food commodity markets, novel non-land-based foods, and more. Priorities in targeting nutritional problems can be identified from this framework. Targets for economic and political innovations are to
1 Increase investment in food and nutrition research and development (R&D),
2 Provide more innovative social protection, transfer, and nutrition enhancement programs,
3 Strengthen communities’ own innovation capacities, including for improved health, sanitation, and water environment, and
4 Improve nutrition in complex emergencies.
Furthermore, policy makers should seek innovation in the implementation process [7].