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On December 2nd Nutrition International co-hosted an official Nutrition for Growth (N4G) Summit side event with the Asian Development Bank (ADB) entitled Promoting better nutrition outcomes through a multi-sectoral approach in post-COVID19 in the Asia Pacific. The discussion spoke to the role of social protection programs in the region, and how these programs could be best designed and implemented alongside existing nutrition programs and systems to deliver optimal outcomes – especially in the post-pandemic world. The discussion highlighted examples from Indonesia and Mongolia as case studies for successful social protection integration into nutrition programming. Watch the full event and read our recap of the key points below.

The Asia Pacific region is facing multiple nutrition burdens, which have been exacerbated since the start of the COVID-19 pandemic. According to the United Nations, the undernourished in Asia increased 15 percent between 2019 and 2020, rising from 361.3 million people to 418 million people. Nearly 1.9 billion people in the region cannot afford a healthy diet, and more than two billion adults in the region are overweight or obese – demonstrating burdens of both undernutrition and overweight/obesity. The prevalence of stunting and wasting continues to be higher in Asia Pacific as compared to the global average, and there continues to be a significant gap in access, affordability and availability of nutritious food to children and their families. In many countries across the region children aged 6 to 23 months do not have access to minimum dietary diversity, minimum meal frequency or a minimum acceptable diet, contributing to poor health outcomes and developmental delays. Moreover, nutritional and health knowledge, attitudes and practices are lagging, contributing to worsening dietary practices.

Building back from COVID-19 offers an opportunity to create a more resilient and nutrition-smart food system in the region, and leverage multisectoral action for more holistic and comprehensive approach to improving nutrition outcomes. Access to healthy diets, improved food systems, strengthened social protection programs and evidenced-based interventions offer key entry opportunities to build more comprehensive nutrition programs and to integrate action across sectors like WASH, education and agriculture.

Approaches to multisectoral action have been well researched and documented within the nutrition and global health sectors. Social protection programs offer some of the highest nutrition returns. They are well positioned within existing systems in low-and-middle-income countries (LMICs) and are malleable to nutrition integration. LMICs spend 1.5% of their gross domestic product on social safety net programs such as cash, in-kind transfers, and school meals, and this tripled between 2000-2016. Social assistance programs (SAPs) are primarily designed to support the incomes and resilience of the poor. But in recent years, SAPs has increased and have been seen as a tool to improve nutrition and health outcomes by making them nutrition sensitive. While most SAPs seek to increase food security, this has not often translated into improvements in nutrition. The International Food Policy Research Institute recently conducted a review of the effectiveness of SAPs for improving diet and nutrition outcomes among women and children. Summary results were presented for cash transfers, in-kind transfers, vouchers, and school meals. Results showed that cash transfers have positive impacts on women’s diet diversity, body mass index, haemoglobin, and anaemia. In children, the study showed positive impacts on diet diversity, about a third on stunting, about 15% on wasting.

A 2021 report on the food and nutrition situation in Asia called for integrating actions across sectors and leveraging social protection opportunities with nutrition interventions including targeting nutritionally vulnerable groups, especially women, children and girls, ensuring adequate quantity and nutritional quality of transfers, making transfers conditional or tied to nutrition interventions and broadly aligning social protection programs with national nutrition action plans.

The ADB has integrated social protection directly into its Strategy 2030, with plans to establish a multisectoral working group on nutrition security to prepare a strategic framework to increase and address nutrition security over the next three to five years.

Existing examples from Mongolia, Indonesia and the Philippines demonstrate social protection integration in action, and point to how working within the country context can enhance and support these programs.

  • In Mongolia, ADB approved US $73M for a social welfare support program that offers cash grants to children and their families from nutritional risks due to the pandemic. The project also supports the government’s food stamps program for the poor. This initiative will protect about 85% of poor households from falling into the malnutrition thread. ADB is also supporting to build the country’s overall capacity to produce and preserve more nutritious vegetables and make them available to consumers at affordable prices. The program has also demonstrated resilience and adaptation. During the pandemic in 2020, demand doubled twice in eight months and the program was adapted in delivery starting in paper forms and moving to be 100% electronic. By 2021, the program was reaching the poorest 7% to 8% of the population in the country.
  • In the Philippines, ADB provides short-term support for targeted and social assistance to national feeding program to tackle malnutrition and stunting and prevent them from falling into poverty and malnutrition while supporting long-term capacity building to modernize the agriculture sector. Pregnant women living in vulnerable situations are also the target of the nutritional food program. The policy baseline program anchors on implementation of key policies and agricultural reforms to increase productivity and better management of food stamps to cope with any emergency or shocks.
  • In Indonesia, ADB is preparing a project to adopt an integrated approach to improve vegetable and fruit farm productivity, profitability, and supply chain. The project is designed to reduce post-harvest losses through provision of processing, logistics facilities and farmer training. Local governments will also be supported through regulatory mechanism to better manage agriculture stocks and prices.

To make these programs a reality, organizations and governments alike must build strong partnerships, leverage evidence-based planning supported by technical assistance, and commit to stable and predictable financing for program implementation. Bringing these areas together –as Nutrition International is doing – creates a nexus point where evidence, capability, and action come together to drive the scale. At country level, supporting governments by building costed multisector action plans and demonstrating the ‘cost of inaction’ helps drive political will and make implementation of nutrition programming much more palatable.

As partners, countries, donors, stakeholders and international organizations come together at N4G and consider their commitments this year and beyond, a ‘no missed opportunities’ approach to integrate nutrition into social safety nets and social protection programs offers the opportunity to deliver significant returns and improve nutrition outcomes multi-fold – especially in a post-pandemic world. Safety nets amount to major investments in human capital. These represents huge opportunity to ensure the healthy growth and development of children, adolescent, and women through good nutrition.