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Improving the nutrition status of children and women

The high world food prices that we are currently experiencing provide a chilling reminder of the vulnerability of large parts of sub-Saharan Africa and South Asia to hunger and undernutrition. Many children in these regions are vulnerable to poor growth, poor development and death.

Even before these high prices, child undernutrition was increasing in Africa. In booming South Asia, stubborn child undernutrition rates provide a sombre reminder that income growth does not solve all problems.

Good nutrition status for children and adolescent girls is fundamental for attaining many of the Millennium Development Goals. Despite this, donors and governments underinvest in interventions to improve nutrition.

In this issue of insights, Andy Sumner, Johanna Lindstrom and Lawrence Haddad argue that this underinvestment is due to a lack of incentives for donors; few take a strategic approach to investments that have the potential to improve nutrition and they have little idea whether current investments are making a difference. Furthermore, their 'critical friends' – research institutes and non-governmental organisations – lack the leadership to engage with donors strategically on this issue.

The nutrition of the world’s children and women desperately needs improving. Failure to do so violates their human rights and will undermine development today and in the next generation

What types of nutrition intervention work? Many families in Africa and Asia simply do not have enough money for a healthy diet. David Mepham argues that cash transfer programmes, which are popular in Africa, improve diets and protect against shocks. But could they achieve even more by being conditional on participation in health care, as is the case in Latin America? David Sanders and John Mason highlight the importance of building community and household resilience to shocks, noting the success of several programmes in Africa.

Nicolas Alipui reminds us that private sector resources are vital in the drive to accelerate reductions in child undernutrition. There have been successes (such as salt iodisation) but also examples of where great care must be taken to establish common vision and values, such as the appropriate use of breastmilk substitutes.

Barbara MacDonald highlights philanthropic giving as another source of resources, and a way to channel them – the Global Alliance for Improved Nutrition. However, donors face coordination problems in delivering nutrition resources. There is an urgent need for more field workers to empower communities to demand and use these resources effectively. Isatou Jallow echoes these messages, outlining the World Food Programme's new initiatives for greater community engagement in maternal and child nutrition.

Ricardo Uauy focuses on the challenges for international nutrition organisations. He highlights the lack of leadership, strategy, resource mobilisation and connection with country priorities as areas in need of major improvement.

The nutrition of the world's children and women desperately needs improving. Failure to do so violates their human rights and will undermine development today and in the next generation. If undernourished children survive their first few months of life, they will suffer more illness, learn less in school and be less productive in the workforce. In turn, their children are more likely to be born undernourished.

This desperate cycle can only be broken by a new alliance between donors, governments and critical friends. This will require new leaders to come forward and develop politically aware strategies that raise public consciousness and put human and financial resources, both public and private, to effective use.

Lawrence Haddad
Institute of Development Studies, University of Sussex, Falmer BN1 9RE, UK