Briefing Papers Number 20, November 2012 | Page 12

tors to include will be needed. Decisions can be guided by discussions with government and other stakeholders, taking into consideration the initial data gathered by the nutrition analysis as well as national and/or program capacities and budgets. Depending on the sector, these indicators may include, for example, household access to and intake of nutrient-rich foods, dietary quality, dietary diversity scores, effects on women’s time and labor, or changes in child feeding practices. Impact Indicators Impact indicators measure the long-term effects, or end results, of the program. These are generally changes in nutritional and health status, since “impact” is the nutritional and health status or conditions that the program is intended ultimately to influence, generally mortality and/or morbidity. The most common nutritional impact indicators are: • Prevalence of underweight children under 5 years old (MDG 1c indicator) • Prevalence of stunting among children under 2 years old • Prevalence of wasting among children under 5 years old • Prevalence of low birth weight • Prevalence of anemia in women of reproductive age • Prevalence of iodine deficiency disorders In nutrition-sensitive development programs, both nutrition-sensitive and nutrition-specific interventions can affect the results of some impact indicators. (Optional) Impact Evaluations Evaluations should be specifically designed to provide causal evidence of the impact of nutrition-sensitive development (or combination of nutrition-specific interventions and nutrition-sensitive development).90 Impact evaluations are a specific type of evaluation activity that seeks to determine how much of an observed change in outcomes or “impact” can be attributed to the nutrition-sensitive program. Of course, being able to attribute the impact to the program itself is very important in gauging progress and building the evidence base for particular programs and interventions. Moving Toward Consensus: A Call to Action UN Photo/Mark Garten Clearly defined nutrition-sensitive programs are critical to aligning and coordinating efforts to scale up nutrition, building the evidence base, and maintaining momentum. The L’Aquila Food Security Initiative, Feed the Future, the Global Health Initiative, and the New Alliance for Food Security and Nutrition provide opportunities to scale up both nutrition-specific interventions and nutrition-sensitive development. A consistent understanding and way of measuring nutrition-sensitive activities will help align efforts, quantify outcomes, and accurately demonstrate nutritional impact. Once defined, donors and program implementing partners will need to develop and measure indicators of progress for nutrition-sensitive programming in sectors such as agriculture; food security; water, sanitation, and hygiene; and livelihoods. Key policy decisions on how much, when, where, and how to invest in nutrition-sensitive development will be facilitated by reaching a consensus on definitions. We recommend that a global normative body or bodies take on the task of defining nutrition-sensitive development. 12  Briefing Paper, November 2012