Disease. Drought. Conflict. It is not your imagination; there are more emergencies today than in years past. Storms are growing more frequent and extreme in some regions, while other areas are becoming more arid, with growing seasons disappearing before farmers’ eyes. More competition for scarce resources means more displacement and more conflict.
The One Health concept calls for a worldwide approach to expanding interdisciplinary collaboration and communication on all aspects of health for humans, animals and the environment. This approach has tremendous implications for human health because an estimated sixty-one percent of human infectious diseases originate from animals. At the same time, there is a growing sense of urgency to advance One Health collaborations before more ground is lost in the fight for a healthy planet.
Drought is threatening livelihoods in the Horn of Africa and is increasing the vulnerability of households to food insecurity, economic shocks and resource-based conflicts. Approximately 12 million people in the region are expected to need food aid in the coming months. A response that protects household assets and helps people grow their own food and minimize livestock losses is critical to their survival.
Timely interventions, such as fodder production, are needed to keep livestock healthy, prevent a rise in hunger and deepen community engagement in building resilience to shocks. Beyond the drought, fodder production is also a system-level response to growing demand for animal source foods and the rapidly expanding dairy sector in Kenya in particular. This expansion has many positive aspects but does put pressure on sourcing the necessary animal feeds, further reason to explore and develop efficient and integrated animal feed and fodder production and the integration of crop-livestock production systems to ensure high land productivity.
Four major famines have taken place so far in 2017, which has renewed attention on the urgent need to address food security globally. However, food security involves much more than responding to famines, and it is closely linked to factors such as governance, which plays a significant role in fragile states and developing countries. FHI 360 held a Facebook Live discussion on how integrating governance, agriculture and food security can benefit food security programs. The conversation was moderated by Gregory Adams, Director of the Locus Coalition at FHI 360, with FHI 360 experts Joseph Sany, Technical Advisor, Peacebuilding and Conflict Mitigation, and Annette Brown, Director, Research and Evaluation Strategic Initiative.
Despite decades of investments to improve food security for the world’s poorest people, hunger and malnutrition are still problems for many. Indeed, a daunting food security crisis currently puts more than 20 million people at risk of starvation in just four countries: Nigeria, Somalia, South Sudan and Yemen. In sub-Saharan Africa, an estimated 42 million children under the age of 5 will be malnourished by 2050, and 10 million additional children will be malnourished if climate change impacts continue unabated.
This crisis calls for improvements in identifying, understanding and addressing the interlinked factors that result in broadscale food security crises. The cycle of resource degradation caused by climate change that leads to food insecurity, starvation and ongoing conflicts raises the question of whether climate change itself is a “threat multiplier” that increases the potential for conflict. Evidence suggests that the interplay between these sectors is critical to the emergence or development of many humanitarian crises. However, the complexity of these relationships and the role of climate change as a threat multiplier are less understood.
Whether he’s aware of his influence or not, almost every father in every culture influences his family’s choices about how to feed the children. His everyday decisions about how many of the eggs the family’s chickens lay will be sold at market and how many will be kept at home for the family to eat can make the difference between a stunted child and one who reaches his or her full growth potential.
The Alive & Thrive project reviewed programs from around the world that were designed to engage fathers in child feeding, identifying the strategies that seem to make these programs work. Not surprisingly, the six strategies we identified in the most innovative “dads” programs echo sound principles from behavior change and social marketing. Our review indicated that, especially when program planners apply these six strategies, fathers’ actions can lead to real improvements in nutrition.
Good nutrition is critical in preventing child and maternal deaths. Deficiencies in micronutrients, such as iodine, iron, vitamin A and zinc, can lead to impaired physical and cognitive development, poor pregnancy outcomes (for example, a low birth weight baby), a weakened immune system, anemia, night blindness and even death. It is estimated that micronutrient malnutrition affects more than 2 billion people worldwide.
For more than a decade, the Food and Nutritional Technical Assistance (FANTA) project, funded by USAID, has been a key contributor to the global effort to reduce micronutrient deficiencies. Our work has focused on the development of new methods to identify dietary gaps, through research on the impact of lipid-based nutrient supplements on the health status of vulnerable populations and dissemination of the most up-to-date, relevant information to a wide range of nutrition stakeholders.
Recently, FANTA contributed to the development of software called Optifood, which can be used to identify local food combinations that can fill (or come as close as possible to filling) micronutrient gaps based on local foods and diet. Optifood results contribute to the development of cost-effective, context-specific approaches.
What does it REALLY take to ensure young children get the proper nutrition to grow strong and healthy? This is an especially important question in poor rural communities in Guatemala, where about half of the children under five years of age are stunted (too short for their age—a sign of long-term deficits in the quantity and/or quality of food, including the right vitamins and minerals). In some parts of western Guatemala, more than eight in ten young children are stunted.
Now there’s a new tool to help answer the question: Optifood is a computer software program, developed by the World Health Organization (WHO) in collaboration with the London School of Hygiene and Tropical Medicine, Food and Nutrition Technical Assistance III Project (FANTA), and Blue Infinity, that provides scientific evidence on how to best improve children’s diets at the lowest possible cost using locally available foods. Optifood identifies nutrient gaps and suggests food combinations the local diet can fill—or come as close to filling. It also helps identify local foods’ limits in meeting nutrient needs and test strategies for filling remaining nutrient gaps, such as using fortified foods or micronutrient powders that mothers mix into infant or young children’s porridge.
The Government of Guatemala is fighting stunting through its Zero Hunger Initiative, which aims to reduce stunting by 10 percent by 2015 and 24 percent by 2022 through nutrition, health, agriculture, and social safety net programs. The U.S. Government and USAID are supporting these efforts through Feed the Future and Global Health Initiatives focused on the Western Highlands. USAID/Guatemala asked the USAID-funded FANTA/FHI 360 to help find strategies to improve the nutritional quality of children’s diets in the region. The challenge was to develop realistic and affordable diets for children that both meet their needs and are firmly based on scientific evidence. FANTA worked with its local partner, the Institute of Nutrition of Central America and Panama (INCAP), to collect the diet data needed for Optifood from communities in two departments of the Western Highlands, Huehuetenango and Quiché. FANTA then used Optifood to analyze the information.
Arénia Massingue is a master trainer from the National Nurses Association in Mozambique (Associação Nacional de Enfermeiros em Moçambique [ANEMO]). Massingue, who was trained by the Food and Nutrition Technical Assistance (FANTA) project on home-based nutrition care for people living with HIV (PLHIV), explains how what she learned helped her work: “We can now see a change in behavior among our beneficiaries. Before health activists started educating them about nutrition, there was a common belief that eating well was eating purchased goods. For example, many believed that the best fruit juice was the one they bought from the store, even though they had oranges in their garden. Now they know that the oranges in their garden can produce a juice that is not only cheaper, but also more nutritious.”
Since being trained by FANTA, ANEMO master trainers trained 55 community-based organization (CBO) trainers. To date, the CBO trainers have trained 440 heath activists, home-based health care workers who provide counseling to PLHIV. PLHIV are counseled on the importance of using locally available foods in a balanced diet, management of HIV-related symptoms through diet, and potential drug-food interactions. Health activists also provide cooking demonstrations using recipes they learned during the training to help PLHIV meet their increased energy needs and eat a balanced, healthy diet. ANEMO, the Ministry of Women and Social Welfare and Ministry for Health are also working in collaboration with FANTA to integrate nutrition into the government’s official training curriculum for home-based care workers.
FANTA is a project that works globally to improve the health and well-being of vulnerable groups through technical support to the U.S. Agency for International Development (USAID) and its governmental and nongovernmental partners. The project improves nutritional outcomes by strengthening policies, programs and systems for maternal and child health and nutrition, nutrition and HIV and other infectious diseases, food security and livelihood strengthening, agriculture and nutrition linkages, and emergency assistance during nutrition crises.
For more information about FANTA, email the project at fantamail[at]fhi360.org.
An Interview with
Sergio Ramirez, Senior Project Director, Global Education Group, FHI 360
Why is it important that education programs include lessons on healthy lifestyle habits?
We talk so much about reading and literacy in global education, but that is just one part of a child’s life. If we want to look at development in a holistic way, we have to look at a child in his or her entirety, not just his or her academic ability. There is plenty of evidence out there that shows that schools with better sanitary conditions attract more children. Parents vote with their feet, and if they see a school that is clean, has food and has hand-washing facilities, they are more likely to enroll their child in that school.
How do you see this kind of integration playing out in global education programs?
My dream is that we can inject health messages into teachers’ daily lesson planning, especially in primary education. Four major areas of concern are oral hygiene, handwashing and sanitation, malaria prevention and nutrition. Handwashing and proper use of latrines should be part of every school’s daily routine. Research shows that promoting handwashing in students, especially when they first arrive at school, greatly reduces the number of sick days among children.
In Latin America, proper nutrition is a major issue. Children are eating, but they are not getting the proper nutrients. They tend to eat a lot of junk food that is easily accessible in their neighborhoods.
Other than teachers, who else can help promote healthy habits in education?
Part of the magic of FHI 360’s active learning methodology is that we integrate parents’ participation in very specific ways. We have done this by asking parents to help schools provide children with breakfast each morning, and we have engaged parent associations to improve sanitation in schools. By actively engaging parents in daily school routines, they not only participate in the success of the schools, but also learn healthy habits themselves. This takes some of the burden off of teachers.