Preventing early stunting

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Scott Ickes, Rachel Trichler and Brad Parks :
The international development community has made great strides over the past fifteen years to eradicate hunger by prioritizing nutrition-specific spending initiatives, as advocated by the Millennium Development Goals (MDGs). In 1990, before the MDGs were instituted, an estimated 12 million children under the age of five died across the globe – primarily because of malnutrition. By 2010, that number sharply declined to 7.6 million, and the prevalence of global childhood stunting fell by approximately 13%. There is a growing body of evidence that suggests some nutrition interventions have made a significant impact.
However, much remains to be done. As recently as 2014, the WHO estimated that 162 million children worldwide were categorized as stunted. There is also a growing consensus in the international development community that a multi-sector approach is needed to reduce childhood stunting and achieve other nutrition-related goals moving forward. The Scaling Up Nutrition (SUN) movement, in particular, has brought renewed attention to the underlying determinants of nutrition and tracking the full universe of investments that might improve nutrition outcomes, either directly or indirectly (e.g., focusing on underlying determinants of malnutrition such as access to health care or hygiene).
SUN’s inclusive classification scheme is helpful in tracking an additional set of projects that are “nutrition sensitive” and may contribute to advancing nutrition outcomes, but are not considered nutrition-specific interventions. But this nuance is lost with current official development assistance (ODA) sector classifications, which only allow researchers and policymakers to track projects that are nutrition-specific; all other nutrition sensitive investments are excluded.
In a new AidData working paper (and a forthcoming article in the Food and Nutrition Bulletin) entitled “Building a Stronger System for Tracking Nutrition Sensitive Spending: A Methodology and Estimate of Global Spending for Nutrition Sensitive Foreign Aid,” we introduce a new methodology that seeks to more accurately and comprehensively capture nutrition sensitive investments. The approach outlined in our paper creates a uniform system for filtering data from the Creditor Reporting System (CRS) to identify commitments that meet the criteria for a “nutrition sensitive” classification. We build upon the classification of nutrition-specific and nutrition-sensitive spending by implementing a stepwise procedure that distinguishes between these two investment types.
The first step of the procedure involved gathering potential candidates for “nutrition-sensitivity”. In order to create this pool, data on official development assistance for 2010 was pulled from the OECD Creditor Reporting System (CRS) database and filtered using a set of 32 CRS purpose codes that were deemed to be relevant to this study. Purpose codes refer to the stated objective (or purpose) of a given development project. In addition to these purpose codes, we used keywords to search for nutrition-sensitive topics which yielded an even larger pool of potential candidates. In total, nearly 28,000 development assistance commitments were identified using this method.
In the second step of the process, AidData’s double-blind activity coding scheme was applied to this pool of 28,000 commitments. Six of AidData’s activity codes were determined to qualify as “nutrition sensitive” and any project with one of these codes was highlighted. The projects in this newly created “nutrition-sensitive” database were then graded on their level of sensitivity and given a percentage score. Based on these sensitivity scores, we were able to estimate a weighted dollar value for each commitment that took into account both the sum of the commitment and its level of sensitivity toward nutrition.
Using this methodology, we estimate that a total of $1.79 billion aid dollars reported via the OECD CRS went to nutrition sensitive programs in 2010. We also find a modestly positive correlation between the prevalence of stunting in a given country and the level of nutrition sensitive ODA a country receives. In fact, 18 of the top 25 countries that received nutrition-sensitive ODA had a total stunted population of over 1 million children (see Figure 3). We also found that a country’s under-five mortality rate significantly predicts the level of nutrition-specific ODA funding it receives.
Our results suggest that nutrition-sensitive aid is an important tool in the international community’s fight against hunger.
The methodology introduced in this new AidData working paper makes it possible to isolate a broader pool of nutrition-sensitive programs and adds a level of granularity to existing data never before achieved. Going forward, we believe that this methodology could provide a strong foundation for global efforts to accurately and comprehensively track nutrition sensitive investments. As the MDGs wind down and the global development community sets new Sustainable Development Goals (SDGs) for the post-2015 period, efforts to systematically track the full range of investments designed to advance the goals will be crucial.

(Scott Ickes is a Professor of International Nutrition and Epidemiology in the Department of Kinesiology and Health Sciences at the College of William & Mary. Rachel Trichler is a Senior Program Manager and Monitoring and Evaluation Specialist at AidData. Brad Parks is Co-Executive Director of AidData and Research Faculty at the College of William & Mary’s Institute for the Theory and Practice of International Relations.)

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