Robert Allen’s recent AER paper on “Absolute Poverty: When Necessity Displaces Desire” is a fascinating read, on many levels. The paper uses linear programming (LP) to compute (four variants of) least-cost diets for twenty countries, using prices from the International Comparisons Project (ICP) microdata. To the resulting least-cost food budgets, estimates of non-food costs covering housing, fuel, lighting, clothing and soap are added, generating “basic need poverty lines” (BNPL) for each country.
Yet, these deficiencies -- often referred to as ‘hidden hunger’ -- go largely unnoticed and affect large populations.
Night blindness, a condition afflicting millions of pregnant women and children, stems from low intake of foods rich in essential nutrients like Vitamin A.
Budget constraints limit access to nutrient-rich foods for many families, who are unaware or unable to afford a nutritious diet.
National programs help supplement diets with Iron and Vitamin, but their scope is too narrow to adequately address these deficiencies.
Fortified Milk Helps Increase Vitamins Intake
When fortified with vitamin A and D, milk, which remains a staple for many Indians, can help alleviate dietary deficiencies when supplementation is not available.
Food fortification is a relatively simple, powerful and cost-effective approach to curb micronutrient deficiencies. It is in general socially accepted and requires minimal change in existing food habits.
The process is inexpensive and costs about 2 paisa per liter or about one-tenth of a cent. And because it only adds a fraction of daily recommended nutrients, the process is considered safe.
For these reasons, food fortification has been successfully scaled up in some emerging economies.
However, except for salt fortification with iodine, India has not yet achieved large-scale food fortification.
With India’s rapidly growing dairy industry, large-scale milk fortification of Vitamins A and D is a robust vehicle for increasing micronutrients intake across the population.
One year ago, we did not know how many Somalis were poor and how programs and policies could help to reduce poverty or at least build resilience against falling deeper into poverty. We knew that Somalis receive an estimated $1.4 billion (24 percent of GDP) in remittances every year. But we did not know whether the poor received the remittances and whether they helped mitigate the impact of poverty. To overcome this dearth of information, we implemented the Somali High Frequency Survey and established a near real-time market price monitoring system.
Co-author: Sophie Durrans, Research Uptake Officer at London School of Hygiene & Tropical Medicine
A child who is stunted early in life – who fails to grow as tall as expected for their age – often has reduced physical and mental development. Water supply, sanitation, and hygiene (WASH) influences a child's growth in multiple ways. Evidence across low and middle-income countries demonstrates that higher open defecation rates are associated with stunting and higher overall incidence of poverty.
Beatrice Montesi, GAIN
Martin P. Gambrill, The World Bank
Rebecca Jean Gilsdorf, The World Bank
Crowded slums, poor sanitation and unhealthy diets. It’s a potent cocktail and for too many families across the world, a daily reality. Right now, an estimated one billion people live in slums and that number is expected to double by 2030. Slums are where the many deprivations facing the urban poor collide, including lack of access to clean drinking water, sanitation, safe and nutritious foods, sufficient living space, durable housing and secure tenure (UN Habitat). They’re where human waste is routinely emptied into streets, canals, and garbage dumps. And where overcrowding and low rates of immunization and breastfeeding combine to exacerbate the already perilous problems children face.
Children growing up in these surroundings are at a higher risk of death and disease and are more likely to be chronically malnourished (Ezeh et al. 2017). For example, forthcoming World Bank research from Bangladesh shows that children living in slums are 50 percent more likely to be stunted than children living in other urban areas. This doesn’t just have implications for today - , and face a higher risk of chronic disease as they grow older. Tragically, these effects are often passed on to offspring, trapping families in poverty and malnutrition for generations, as per findings in a forthcoming World Bank report called Uncharted Waters.
“If breastfeeding did not already exist, someone who invented it today would deserve a dual Nobel Prize in medicine and economics.” - World Bank Vice President of Human Development, Keith Hansen
This is a sentiment long-shared by many of us in the nutrition community and as the global movement in nutrition grows, so does our body of evidence supporting how powerful nutrition interventions are for individuals and for societies.
The state of Madhya Pradesh in India is largely vegetarian with limited consumption of eggs and meat.
While these dietary preferences are commonplace in other Indian states, Madhya Pradesh is facing a protein deficiency epidemic which threatens the long term health of its population.
How did it get there?
In 2015 I spent five weeks in rural and tribal areas of Madhya Pradesh evaluating the World Bank’s Madhya Pradesh District Poverty Intervention Project (MPDPIP II), with the support of the South Asia Food and Nutrition Security Initiative (SAFANSI)
Across the 8 districts I visited, families shared how they had improved their agricultural productivity, started backyard kitchen gardening, and supplemented their income through dairy and poultry farming, collective procurement and small scale enterprises.
As I examined local village level health records, Anganwadi Center (AWC) registers, Auxiliary Nurse and Midwife (ANM) registers and Primary Health Center (PHC) documents, I noticed a reduction in severe malnutrition and severe anemia among pregnant women and under 5-year-old children.
However, this decrease did not extend to moderate or mild malnutrition and anemia.
“Why would I want to?” Because in poor countries, chickens are everywhere, they are pooping wherever they want, and chicken feces is dangerous for young children.
Our Top Ten blog posts by readership in 2016. This post was originally published on June 17, 2016.
Our Green Competitiveness Launchpad team is looking at agriculture supply chains in Bangladesh and how they’re affected by climate change – as farmers change the crops they plant owing to drought or flooding. As a result, we’ve been exploring the supply chains of a number of crops from guavas to sunflower and mung beans.
There’s a fascinating infographic from CIAT (International Center for Tropical Agriculture) that illustrates the geographical diversity of the common foods we eat every day. It shows that the globalization of food began centuries ago. Many cultures incorporate foods that originated thousands of miles away. For example, sunflower originated in North America and is now widely produced in Eastern Europe, and guava originated in Central America and is now mainly produced in South Asia.
While child mortality rates have plummeted worldwide, . Children who are stunted (having low height-for-age) suffer from a long-term failure to grow, reflecting the cumulative effects of chronic deficits in food intake, poor care practices, and illness. The early years of life, especially the first 1,000 days, are critical; if a child’s growth is stunted during this period, the effects are irreversible and have lifelong and intergenerational consequences on their future human capital and potential to succeed.
For the water and sanitation community the year 2009 marked a turning point in our understanding of the role that Water, Sanitation and Hygiene (WASH) has on child stunting. A provocative Lancet article (Humphrey 2009) put forth the hypothesis that a key cause of child stunting is asymptomatic gut infection caused by ingestion of fecal bacteria. Small children living in poor sanitary environments are especially at risk, through frequent mouthing of fingers and objects during exploratory play, playing in areas contaminated with human and animal feces and ingesting contaminated food and water (Ngure et al. 2013). Researchers now estimate that up to 43 percent of stunting may be due to these gut infections, known as environmental enteric dysfunction (EED) (Guerrant et al. 2013).
Just last week estimates were released suggesting that (Danaei et al. 2016). In a key departure from previous work, the researchers defined risk as the sanitation level of a community, rather than an individual. This is consistent with mounting evidence showing that a community’s coverage of sanitation is more important than any one household’s (Andres et al. 2013). Across different studies, data sets and outcomes the evidence consistently shows that a threshold of around 60–70 percent household usage within a community is needed before the health and nutrition benefits of sanitation begin to accrue. Studies that have focused on an individual’s toilet use as a predictor, rather than a community’s use, may have vastly underestimated the impacts (Hunter and Prüss-Ustün 2016).
As we advance our understanding of the ways in which a poor sanitary environment impacts growth in small children, we can better design water and sanitation interventions to target these pathways. While there is a role for multi-sectoral interventions, which can simultaneously target the underlying determinants of child undernutrition, such as food security, access to health services, and childcare practices — there are ways that the water sector can adapt its own approaches so that they are more nutrition-sensitive, and more impactful on nutrition. Here are four key actions: