The discussion in this paper does not necessarily
apply to emergency settings. The Lancet series explained:
“There is little published information on the impact of
humanitarian response on nutrition outcomes or, more
specifically, on the impact of nutrition interventions in
emergencies.”21 Despite this lack of information and
the dynamic nature of emergency environments, it is
important to begin incorporating both nutrition-specific
interventions and nutrition-sensitive development into
those contexts. Operational standards for nutritionsensitive interventions—supported by evidence and
better coordination—will allow organizations to improve
their emergency response efforts.
“A series of highly-effective and low-cost nutrition-specific
interventions has been identified… [and] described
in peer-reviewed articles... If implemented within the
context of nutrition-sensitive development programs, they
will have a major impact on nutritional status.”
– Committee on World Food Security, “Nurturing the Movement
for Scaling Up Nutrition: A Proposition”
Introduction
A series of global events and government actions has elevated nutrition, especially for women and children, to the
top of the development agenda. The 2008 Lancet Series on
Maternal and Child Undernutrition22 demonstrated the
devastating and largely irreversible impact of malnutrition on young children (from pregnancy to a child’s second
birthday). It identified cost-effective, evidence-based nutrition interventions to prevent undernutrition in this critical
1,000-day window. The Copenhagen Consensus (a group of
world-renowned economists) rated these nutrition investments23,24 a “best buy”25 in development in both 200826 and
2012.27 In 2008, micronutrient supplements for children (vitamin A and zinc), micronutrient fortification (iron and salt
iodization), and biofortification were ranked among the top
five investments (deworming and other nutrition programs
at school, and community-based nutrition promotion, were
also among the top 10 development “buys”).28 In 2012, the
Copenhagen Consensus reiterated that the single best nutrition investment is a specific set of bundled interventions to
reduce undernutrition in preschoolers (micronutrient provision, complementary foods, treatment for parasites and
diarrheal diseases, and behavior change).29,30 Also recomwww.bread.org
mended were deworming treatments for schoolchildren,
and research and development to increase agricultural
yields (crops and livestock).31
In addition to these proven, nutrition-specific interventions, there is a new global consensus that a multi-sectoral
approach is required to tackle maternal and child undernutrition. This recognizes that there are a complex set of
causes of pervasive or long-term undernutrition that include
lack of access to nutritious foods and a diverse diet as well as
gender and economic inequality.32 A study of 85 countries’
varied progress in reducing stunting looked at what factors
have been most important in explaining their relative success. It concluded that progress in reducing the current high
prevalence of stunting can best be made by investing in both
long-term development and specific interventions.33
The Scaling Up Nutrition (SUN) Movement, launched
in 2010, has underscored the role of both nutritionspecific interventions and nutrition-sensitive development
in improving maternal and child nutrition. The Scaling
Up Nutrition: A Framework for Action, or SUN Framework,
called them “complementary approaches” to reducing
undernutrition.34 The Framework “encourages investment
in development strategies that will contribute to
better nutrition within all societies (‘nutrition-sensitive
development’), combined with universal access to a range of
tried and tested interventions that directly contribute to less
undernutrition, especially among pregnant women, children
under the age of 2—the ‘1,000-day window of opportunity,’
and persons affected by illness or distress (‘nutrition-specific
interventions’).”35
The SUN Framework outlined key considerations,
principles, and priorities for action on undernutrition and
recommended “a multi-sectoral approach that includes
integrating nutrition in related sectors and using indicators of
Catholic Relief Services/Sara Fajardo
Important Caveat Regarding Emergency/
Humanitarian Settings:
This girl in Guatemala receives a nutrition-specific intervention.
Bread for the World Institute 3