Each day, tens of thousands of girls worldwide are married while still children, often before they may be physically and emotionally ready to become wives and mothers. Child marriage, defined as marriage or a union taking place before the age of 18, endangers the life trajectories of these girls in numerous ways. Child brides are at greater risk of experiencing a range of poor health outcomes, having children at younger ages, having more children over their lifetimes, dropping out of school, earning less over their lifetimes and living in poverty than their peers who marry at later ages. Child brides may also be more likely to experience intimate partner violence, have restricted physical mobility, and limited decision-making ability. Most fundamentally, thesegirls may be disempowered in ways that deprive them of their basic rights to health, education, equality, nondiscrimination, and to live free from violence and exploitation, which continue to affect them into adulthood. These dynamics affect not only the girls themselves, but their children, households, communities and societies, limiting their ability to reach their full social and economic potential. While child marriage is widely considered a human rights issue closely connected to gender inequality, the significance of the practice’s impacts at both the individual and societal levels suggests that ending child marriage may play an important role in alleviating poverty and in promoting economic development. Ending child marriage can improve health at the individual and population levels, increase productivity and enhance the opportunity to realize the gains in a country’s economic growth that can result from declining birth rates and a shifting population age structure, commonly referred to as the ‘demographic dividend.’ To date, however,there has been relatively little in the way of rigorous assessment of the economic impacts of child marriage or how much child marriage may “cost” countries and societies. To address this challenge, the International Center for Research on Women (ICRW) and the World Bank collaborated on an extensive and innovative research project to assess the impacts of child marriage on arange of development outcomes, and to understand the economic costs associated with these impacts across countries. By establishing the effects that child marriage has on economic outcomes, the research project aimed to catalyze more effective and evidence-based action to prevent it. This brief describes research undertaken for Ethiopia to better assess the impacts of child marriage on a range of development outcomes and the costs associated with these impacts. (World)
The international community is increasingly aware of the negative impacts of child marriage on a wide range of development outcomes. Ending child marriage is now part of the Sustainable Development Goals. Yet investments to end the practice remain limited across the globe. Ethiopia recently adopted a strategy to end child marriage, and some of the projects being implemented in the country should contribute to reduce the practice child marriage. Still, more could be done. In order to inspire greater commitments towards ending child marriage, this study demonstrates the negative impacts of the practice and their associated economic costs. The study looks at five domains of impacts: (i) fertility and population growth; (ii) health, nutrition, and violence; (iii) educational attainment and learning; (iv) labor force participation and earnings; and (v) participation, decision-making, and investments. Economic costs are estimated for several of theimpacts. Overall, the costs are high. They suggest that investing to end child marriage is not only the right thing to do, but also makes sense economically. (World)
This study qualitatively explores early stimulation practices in Katavi region, Tanzania. It also quantitatively investigates the links between these early stimulation practices and development of children 0-3 years of age in the Katavi region. A comparative qualitative case study was carried out in Zanzibar region and findings have been presented throughout discussion section of this report, in parallel to the case of Katavi. Through this work the research team has developed a robust package of early childhood development research tools that have been carefully adapted and tested for use in Tanzania. The study uses and validates the combined use of tools to measure children's development (the CREDI tool) and the home environment (the HOME tool) for the first time in Tanzania. This package includes a complete survey including culturally-adapted, Kiswahili versions of the CREDI and HOME tools plus a caregiver information form that have all been digitized for data collection using electronic tablets. There is an accompanying video that guides users through the digitized version of the tool. The package also includes a four-day training guide with power points that may be used to prepare enumerators to collect the survey data. The adapted versions of these tools are free to users and easily accessible for others who wish to explore early stimulation and child development in Tanzania. (Tanzania)
The development objective of Accelerating Nutrition Results in Nigeria Project is to increase utilization of quality, cost-effective nutrition services for pregnant and lactating women, adolescent girls and children under five years of age in select areas of the Recipient's territory. This project has two components. 1) The first component, Basic Package of Nutrition Services, aims to scale up a basic package of nutrition-related interventions in twelve states. 2) The second component, Stewardship and Project Management, aims to strengthen key stewardship functions at the federal and state levels for the sustained delivery of nutrition services. (Nigeria)
The objective of the Investing in Nutrition and Early Years Project for Indonesia is to increase simultaneous utilization of nutrition interventions by 1,000‐day households in priority districts. Indonesia is the world’s largest archipelagic state, fourth most populous nation, and tenth‐largest economy in purchasing power parity terms. It is a member of the Association of Southeast Asian Nations group of countries as well as the G‐20. Indonesia has a population of more than 261 million, with 300 distinct ethnic groups and over 700 languages and dialects. With a gross national income per capita of about $3,440 (2015), Indonesia is classified as a lower middle‐income country. Indonesia has made significant gains in economic growth and poverty reduction in the past decade. Relatively strong economic growth (5.5 percent per year since 2000) has been accompanied by a sustained decline in poverty rates: about 31 percent and 6.8 percent of the population lived on $3.1 a day and $1.9 a day, respectively, in 2016, down from 82 percent and 48 percent, respectively, in 1998.1 However, Indonesia’s progress on poverty reduction contrasts sharply with its performance in sharing prosperity. Inequality, as measured by the Gini coefficient, increased from 30 points in 2000 to 41 points by 2014, by far the fastest widening in the East Asia and Pacific Region. The county’s strong growth and sustained investments in human capital, allocating 25 percent of the national budget to health and education, have translated into significant progress in service delivery and human development. In education, gross enrollment has reached 100 percent, 83 percent, and 32 percent in primary, secondary, and tertiary education, respectively; life expectancy at birth has steadily increased to 69 years in 2015, up from 63 years in 1990; and the under‐five mortality rate has declined from 85 per 1,000 live births in 1990 to 26 in 2016. Furthermore, the convergence of priority nutrition‐specific and nutrition‐sensitive interventions on households with pregnant mothers and children under two is low. There is growing global and local evidence that a ‘convergence’ approach, in which multisectoral interventions are coordinated to jointly target priority geographic areas and beneficiaries, is critical to accelerating improvements in health and child development outcomes and can help address stunting. (Indonesia)
Poverty rates in Guatemala are among the highest in Latin America and the Caribbean, and Guatemala is now the second poorest country in the region, with only post-earthquake Haiti being poorer. Guatemala is an extreme outlier in the region in terms of chronic malnutrition, and almost half of all children in the country suffer from stunting. This report is part of a global initiative to improve the evidence base on the linkages between water supply, sanitation, and hygiene (WASH), human development, and poverty and seeks to understand this paradigm through a careful examination of trends in access to water and sanitation and in corresponding linkages to poverty and health. It also reviews the governance structure and expenditure plans underpinning service delivery in WASH sectors in Guatemala. Finally, the report the challenges facing the water and sanitation sector in Guatemala are significant and will require, among other things, stronger political leadership to successfully reform and regulate the sector, greater focus on rural sanitation, and increased spending and budget execution. One of the key elements of this diagnostics is highlight what conditions led to a struggling WASH sector, particularly in rural areas. Despite a steep increase in water and sanitation coverage in the last 15 years, sanitation coverage is falling far behind drinking water coverage, with the lowest levels of coverage in rural areas affecting predominantly indigenous populations. (Guatemala)
Nutrition has been ingrained in key social and economic development policies in Senegal since the birth of the Republic. The evolution of nutrition policy, and its impact on the state of nutrition in Senegal, is the result of a constant interplay between social, environmental, and economic events; politics; the state of nutrition knowledge; and the engagement and influence of external stakeholders. Nutrition policy also encompasses what actually gets implemented; therefore, it is also influenced by available capacity and resources at all levels. With a 46 percent reduction in under-five stunting, from 34.4 percent in 1992 to just over 19.4 percent in 2014, Senegal has witnessed one of the biggest rates of improvement in the world and currently has one of the lowest rates of stunting in West Africa. This success has put Senegal in the spotlight, and other countries, especially those in Francophone Sub-Saharan Africa, look to Senegal as a model for nutrition intervention. Indeed, in the global fight against malnutrition, more often than not Senegal has been ahead of the curve, in a position of informing global advocacy initiatives, not just a beneficiary of the global evidence base. The purpose of this report is to provide an historical overview of nutrition policies in Senegal including analysis of the nutrition policy landscape, the evolution of nutrition policies and institutions, and their implications in terms of programming and prioritization of interventions. In so doing, the report aims to provide context to future nutrition investment and the PSMN currently under development, and to inform the decision-making process at this critical juncture. Here, ‘policy’ refers to all guidance for the management of nutrition, be it effective (everyone does it) or ineffective (it never leaves the paper it is written on), formal (written and adopted) or informal (unwritten institutional behaviors and practices). The timeline of nutrition policies and related initiatives is provided in appendix A. (Senegal)
The objective of the Towards Zero Stunting in Djibouti Project is to reduce stunting among children under five in Djibouti. There are four components to the project, the first component being high-impact health and nutrition services to reduce stunting. This component focuses on the delivery of services and interventions that address stunting at both the facility and community levels. This component includes two subcomponents: strengthening of health and nutrition services at the facility level; prevention and management of stunting and wasting at the community level. The second component is the strengthening multi-sectoral interventions for stunting reduction. This component will focus on creating an enabling environment for strengthening multi-sectoral interventions that are critical for reduction of stunting. This component includes three subcomponents: using multi-sectoral platforms for the prevention and management of stunting; addressing stunting in relevant policies and strategies; and multi-sectoral capacity building. The third component is the strengthening coordination, project management and monitoring and evaluation. This component includes two subcomponents: institutional strengthening for coordination, project management and M&E, and strengthening the use of information systems for enhanced M&E capacity. Finally, the fourth component is the contingent emergency response component. (Djibouti)
Uganda needs to allocate more resources to the social sectors (education, health and social protection) and to productivity-enhancing policies in the agriculture sector. Higher levels of investment in education, social protection, health (complemented by investments to increase access to water and sanitation services), and agriculture, are required for Uganda to attain two of its medium-term policy objectives: reducing poverty and inequality, and promoting economic growth in Uganda. While education has been a major factor in reducing poverty and inequality in the past, current levels of funding are inadequate. Education also helps households to smooth adverse shocks, making them less vulnerable to factors outside the control of households and individuals. Additional investment is needed to address the recent decline in primary enrollment rates and increase the quality of education at this level. Also, improving the availability and affordability of secondary education, especially in rural areas, is essential the raise the stubbornly low secondary enrollment rates. Addressing the high levels of under-five mortality, child stunting and teenage pregnancy requires the GoU to improve the provision of health care services to women and children. This in turn requires devoting more resources to the delivery of these services. Given the multi-faceted nature of these issues, complementary efforts in other sectors are also required, particularly through education programs and investments in sanitation and hygiene facilities. Programs aimed at increasing the agricultural productivity of smallholder farmers should have sufficient funding in the budget. The GoU should promote programs that improve the quality of inputs in local markets through certification programs and should increase the availability of extension services and credit to smallholder farmers. (Uganda)
