This report discusses the remarks delivered by Jim Yong Kim, President of the World Bank at the 2018 IMF Annual Meetings Plenary, Indonesia. He discussed about reducing poverty by using three pillars strategy as follows: (i) first, to drive inclusive, sustainable economic growth by crowding in private sector investment, help countries manage debt levels, and harness the power of technology like FinTech; (ii) second, to build resilience to shocks and threats by taking urgent action on climate change, and help countries share the risks of disasters with the capital markets; and (iii) and finally, to help countries invest more, and more effectively in their people to prepare for what is certain to be a more digitally-demanding future. He spoke in length about Human Capital Index, to change the conversation around human capital. He concluded by saying that the most important thing we do to prepare our country for the future is to give every child, everywhere in the world, a chance to reach for the stars. (Indonesia,World)
Despite a substantial decline in poverty, an increase in access to water and sanitation and a large decline in open defecation, diarrhea and stunting rates in Pakistan show few signs of a decline. This report provides evidence that the policy focus on eliminating open defecation rather than the safe management of fecal waste has been largely responsible for this. Water tests reveal shockingly high rates of E. coli contamination in both surface and ground water. To make matters worse, few households practice water treatment and untreated waste water is routinely mixed with surface and ground water for use in crop irrigation. This multiplies the channels through which the oral transmission of fecal bacteria can occur and creates strong downstream effects through food supplies headed to urban centers. Unsurprisingly, rates of diarrhea have remained stubbornly high even among the wealthiest households in metropolitan cities like Karachi. While the impact of of E. coli on diarrhea is well known, new research is showing the far more damaging impact of environmental enteropathy, a process by which fecal pathogens like E. coli can permanently damage the intestinal villi of young children making it difficult to absorb nutrients, even during periods when the child shows no signs of diarrhea. The report urges urgent action on safe sanitation and the treatment of water to combat this health crisis. (Pakistan)
The development objective of the Investing in Early Years for Growth and Productivity Project for Malawi is to improve coverage and utilization of early childhood development services with focus on nutrition, stimulation and early learning from conception to 59 months in selected districts of Malawi.It has four components. First component, Community-based nutrition and early stimulation interventions to consolidate and scale up the delivery of a comprehensive set of high impact and cost-effective nutrition and early stimulation interventions; Second component, Center-based early learning, nutrition and health interventions to improve the coverage and quality of preschool education and reproductive, maternal, and adolescent health services; Third component, Multisectoral coordination, capacity and system strengthening is to support capacity-building activities from national to district levels to strengthen management, coordination and implementation of nutrition, and early stimulation and early learning interventions; enhance systems and service delivery at all levels; and improve citizen engagement; Fourth component, Contingent emergency response component will allow for rapid reallocation of project proceeds in the event of a future natural or man-made disaster or crisis that has caused or is likely to imminently cause a major adverse economic and/or social impact during the life ofthe project. (Malawi)
Poor breastfeeding and complementary feeding practices predict child stunting and wasting in South Asia, suggesting that initiatives to end undernutrition in the region should focus on improving the diets of young children. This review of the literature finds that South Asia has made relatively good progress in improving breastfeeding practices compared with other regions, but the lack of diversity in complementary foods and low frequency of feeding continue to be problems. Children who are most at risk of experiencing poor feeding include those who are born small, have younger mothers, and live in poorer households or in communities with less access to, or lower uptake of, primary health services. Initiatives to improve feeding practices have not produced substantial improvement, particularly in complementary feeding, because such efforts have lacked the coverage, intensity, comprehensiveness, and continuity needed. Policy, legal, and program actions to protect, promote, and support recommended feeding practices should be informed by situation analyses and formative research on context-specific drivers of poor practices. The actions should involve multiple sectors and stakeholders, including governments, the private sector, communities, and households. (South Asia)
In Senegal, government commitment to nutrition has increased progressively in recent decades. Thecreation in 2001 of the Cellule de Lutte Contre la Malnutrition (the Nutrition Coordination Unit) (CLM) and its Bureau Exécutif National (the National Executive Bureau) (BEN) marked a major turning point, as did an increase in annual budget allocations to nutrition (from US$0.3 million in 2002 to US$5.7 million in 2015) and concomitant intensification of community-based nutrition interventions. This commitment is reflected in the improvement of nutrition indicators. With a 46 percent reduction in under-five stunting, from 34.4 percent in 1992 to 19.4 percent in 2014, Senegal has witnessed one of the biggest rates of improvement in the fight against undernutrition in the world and currently has one of the lowest rates of stunting in Sub-Saharan Africa (Spray 2018). However, these developments have not led to greater visibility of pronutrition interventions in relevant sectors such as agriculture, livestock, health, education, social protection, and hydraulics. Moreover, some nutrition-specific problems with major consequences—low birthweight, iron-deficiency anemia, adolescent nutrition, and maternal undernutrition—still receive little attention. These shortcomings threaten the gains achieved in recent decades. Recognizing the challenge, the government of Senegal joined the SUN Movement in 2011 and adopted the United Nations REACH approach in 2014. Both initiatives aim to strengthen institutional capacity and facilitate a multisectoral process to help governmentsplan, prioritize and more efficiently manage nutrition actions involving multiple stakeholders. With respect to national policy, the Document de Politique National de Développement de la Nutrition (National Policy for the Development of Nutrition) (PNDN) has been adopted for the period 2015 to 2025. The PNDN will be operationalized through a multisectoral nutrition strategy, the Plan Stratégique Multisectoriel de la Nutrition (Multisectoral Nutrition Strategic Plan) (PSMN). The PSMN is designed as a sectoral reform program to broaden coverage and improve the quality of nutrition services.Against this background, this institutional and organizational capacity assessment (IOCA) analyzes the performance of Senegal’s nutrition sector and makes 8 Analysis & Perspective: 15 Years of Experience in the Development of Nutrition Policy in Senegal recommendations for strengthening implementation of the PNDN and forthcoming PSMN. (Senegal)
"Leaving no one behind" is an overarching principle of the Sustainable Development Goals. Many countries are prioritizing resources for those who are furthest behind. Existing malnutrition indicators—underweight, stunting, wasting, overweight, and severe wasting—are headcount ratios. They do not capture how far behind malnourished children are relative to the World Health Organization growth standards. To understand the severity of malnutrition, this study develops a new malnutrition measurement, using the method originally developed for estimating poverty. This study estimates the prevalence, gap, and gap squared for stunting, wasting, overweight, and underweight, using data from 94 developing countries over 20 years. The results show that although in most cases the headcount measures and gap measures are moving in the same direction, in many other cases, they are moving in opposite directions. Moreover, employing the new measures, the study can identify countries that have low levels of headcount for a malnutrition measure but comparatively high severity of malnutrition according to the gap measures, and vice versa. This suggests that these new malnutrition measures provide additional information on the severity of malnutrition that is not possible to be known from headcount measures. These new measures of the severity of malnutrition can therefore improve the monitoring of child malnutrition across countries, and consequently help countries to achieve their Sustainable Development Goals. (World)
In recent decades, most health indicators for Sri Lankan children have improved, but the prevalence of undernutrition has stagnated and inequities among sub-populations, particularly those in Sri Lanka’s estate sector, persist. Despite some improvement in the nutritional status indicators for children in the estate sector from 2006 to 2016, the stunting prevalence for children under five years was 31.7 percent in 2016. Undernutrition among young children is the result of a complex interaction between social, behavioral, economic, health, and other related factors. A multisectoral nutrition assessment in Sri Lanka’s estate sector, for example, identified low birth weight, sub-optimal child care practices, and lack of dietary diversity as key factors contributing to undernutrition. Many nutrition studies, including the multisectoral nutrition assessment, focus mainly on problems and barriers that prevent children from reaching their full potential rather than exploring practices that help achieve good nutrition outcomes in a given context. Positive deviance nutrition studies identify successful practices and behaviors associated with a ‘satisfactory level of nutrition’ among young children and promote these practices to other community members. The objective of this study was to explore the practices and behaviors of mothers and caregivers that enable them to achieve better nutritional outcomes in their young children. The study was conducted in two estates within the Nuwara Eliya district on a purposive sample of children in the age group six to 59 months (i.e. PD and NPD). Various qualitative research methods were used to identify the successful behaviors and practices, including (i) focus group discussions among mothers; (ii) in-depth interviews with mothers/other care givers; (iii) key informant interviews with various health staff categories (field level staff, supervisory staff, administrative staff etc.); (iv) observational visits to homes of a sub-sample of children; and (v) observational visits to child development centers. The study focused on identifying the intentional and unintentional behaviors and practices of caregivers and the strategies that enable them to achieve better nutrition outcomes for their children. Data analysis compared the findings of the two groups (PD and NPD) based on a modified nutrition conceptual framework developed by the United Nations Children’s Fund. (Sri Lanka)
The development objective of the Climate Resilient Transport Project for Samoa is to improve the climate resilience of Samoa’s road network and improve Government’s ability to respond to an Eligible Crisis.Some of the negative impacts are include : (i) high environmental risk; (ii) may create impacts that require more sophisticated planning and preparation of mitigation measures; (iii) have technical complexities and requirements that would go beyond the capacity normally available in-country; (iv) would trigger additional safeguards policies or change the project’s safeguards category; and (v) are not aligned with public interests or do not benefit common goods or public services; Some of the mitigation measures are include : (i) soil excavation and other earth-moving works to widen existing roads, protect and stabilize vulnerable slopes, improve existing or construct new drainage and replace at least two existing river crossings in Upolu and Savaii; (ii) extreme weather events such as cyclones, strong winds, storm surges, king tides, and heavy rainfall, associated with climate change are now being experienced with increasing regularity and intensity; (iii) utility services have traditionally occupied the road reserve as a convenient corridor, with a number of services already located underground and alongside the existing roads; (iv) reduced air quality as a result of dust released from site works, vehicle fumes and smoke from burning wastes; (v) contractor offices in laydown areas and workers camps also attract men and women from surrounding communities looking for employment, as well as local vendors and sellers (including children) of fresh produce, cook food etc.; (vi) occupational health and safety is a concern for employers and especially workers who will be directly exposed during construction to hazards such as noise, fumes and vibration from moving equipment and vehicles, heavy lifting and others. (Samoa)
Ratings for the Fourth Global Partnership for Education Project for Tajikistan were as follows: outcome was satisfactory, Bank performance was satisfactory, and monitoring and evaluation (M and E) quality was high. Some lessons learned included: sustained and continuous external funding over time, in a coordinated framework, and with full government commitment, can have a strong impact not only on results, but on institutional capacity building, as well. Government commitment and ownership, together with coordination among donors (when applicable) are fundamental for curriculum reform, and implementation requires advance planning and an adequate implementation period. On-the-ground implementation support that is continuous over time can be extremely effective, especially in a low capacity environment. Per capita funding for education can work without school autonomy, but when schools have autonomy in decisions on their budget allocation, per capita funding can have an important impact on school efficiency. Early learning centers (ELCs), or other forms of community-based early childhood education (ECE) programs, are a viable model to expanding preschool education, especially in a resource-constrained environment. Building good M and E in project, and working with government through implementation support to show the value and use of information obtained can help develop a solid culture of M and E in the country. (Tajikistan)
