Photo: Wendy Stone/IRIN

Keeping score: insecticide-treated bed nets are crucial in the fight against malaria

NEW YORK,  – The African Leaders Malaria Alliance (ALMA) has launched a scorecard to improve the fight against malaria on the African continent.

“This,” said Agnes Bingwaho, Rwanda’s Health Minister, holding up the laminated scorecard, “is something that will help Africa make progress.”

Updated quarterly, it provides information from each country on policies formulated, preventative measures initiated, money spent, lives saved and lost.

The latest scorecard, launched on 21 September, describes, for example, how Angola and Burundi removed taxes and tariffs on anti-malarial commodities such as mosquito nets, medicines and insecticides. It tells how Côte d’Ivoire distributed 8.9 million nets in 2011, bringing the country closer to achieving universal net coverage. The scorecard also tracks tracer indicators for maternal, newborn and child health.

“The scorecard is very important,” said Raymond Chambers, the UN Secretary-General’s Special Envoy for Malaria, “because it gives us the lens to see what’s happening but more importantly gives African countries the chance to compare how they are doing with peer countries and to improve where improvements need to be made.”

Founded in 2009, ALMA includes 40 African countries, all pledged to eradicating a disease that has no regard for borders.

Tanzania’s President Jakaya Mrisho Kikwete, ALMA’s chair, said the evidence proved the disease was “receding steadily”. Eleven African countries have slashed malaria cases by more than 50 percent, he said. Among the preventative measures he highlighted were the distribution of 229 million long-lasting insecticide-treated bed nets, providing coverage for 84 percent of Africans deemed at risk.

But he also worried about sustaining the gains. He acknowledged how deadly malaria remains to the continent’s inhabitants and how profoundly it hinders development. It is estimated that Africa experiences a 2 percent loss in GDP each year due to the effects of the illness, which forces people out of work and requires them to spend precious money on treatment, he said.

One issue central to the malaria fight is funding. It is necessary to both protect existing resources and identify new sources of revenue, Kikwete said. “There is a US$3 billion gap in funding that we are trying to mobilize,” he said.

Malaria update
The battle against the anopheles mosquito and the malaria it transmits has been a long and painful one but there are signs the tide could be turning:
	The sterilization of male mosquitoes, which compete with wild males for wild females, is among the techniques being studied. Sterility can be induced by radiation or chemical application.
	There are also studies under way on the genetic manipulation of mosquitoes, which produces the same effect. Other approaches include the production of male-only sterile mosquitoes, notes a study in the Malaria Journal, Transgenic technologies to induce sterility.
	A possible malaria vaccine, merozoite surface protein 3 (MSP3), was tested in Burkina Faso with promising results.

Rwanda’s Bingwaho – whose country has seen as precipitous drop in malaria cases – noted that “we have made progress by an approach based on community, based on integration and, also a word we like to hear, based on country ownership”.

“Everything that we can do to help move ownership and responsibility of these issues back to the African countries and at the same time provide them with investment instead of subsidy is clearly a step in the right direction,” said UN Special Envoy Chambers.

Panellists also emphasized the necessity of cooperation between African nations, a particularly important issue since malaria travels easily. Kikwete said Tanzania, which he said has succeeded in eliminating malaria, was thought to have been clear of the malady twice before. But malarial mosquitoes, he said, travel by bus and on “ships, boats and ferries”. The disease has the ability to re-emerge if not contained in surrounding countries.

“More than 50 percent of all our cases last year were in one district of our country – the border,” said Bingwaho.

“The fight will not be won by any single country,” added Christian Chukwu, Nigeria’s Health Minister. “We need to work across borders and let’s all of us get more committed.”

Kikwete concluded that in this “interdependent world” a malaria-free Africa “is in the best interests of humanity. It means increased productivity, more income for our people, more trade.”

Then he added on a lighter note, “And there’s no more hassle of swallowing malaria pills every time you travel to Africa.”

pd/mw source www.irinnews.org

By API

Foreign affairs Permanent Secretary Thuita Mwangi gave his evidence yesterday in support of Mr Muthaura.

Before he could start, the defence wanted to hand over files that was to be referred to during the examination of the witness. The Judges were unwilling to accept the files and that resulted in a heavy discussion lasting for about 30 minutes from 14.30 to 15.00. The Judges were unhappy that the thirty minutes was used on solving the issue.

The court had to adjourn the proceedings to go and deliberate whether to accept the introduction of the files. On resuming the proceedings they gave a go ahead after having gone through the files.

On the start of his evidence the witness told the court that he was a Kikuyu, married to a Kalenjin who has given him 2 children so far. While giving evidence Mr Mwangi was asked what he thinks of Ambassador Muthaura. Without hesitation, he told the court that Ambassador Muthaura is a man of unquestionable integrity, humble and compassionate.

The defence wanted to know if the suspect was a kind of man who could stand up in a corner during a meeting and shout something and the witness answered in the negative. The question arose due to the prosecution’s claim that Muthaura had shouted in a meeting where the youth from Muingiki attended at the Nairobi Members Club, to plan the attacks in Naivasha. Muthaura has denied that such a meting took place.

The case continues today from 14.30pm with the same witness for twenty minutes before Mr Uhuru Kenyatta’s case starts approximately 15.00 in the afternoon.

End

NEW YORK,  – New global guidelines on best practices to counter non-communicable diseases (NCDs) could avert up to 15 percent of preventable deaths over the next 20 years, but may fail to gain currency in countries already struggling to keep pace with communicable diseases, maternal and child mortality and other public health issues, economic and health experts say.

“Many countries are saying this issue of NCDs is an additional burden where we need to put money, and we are not in a position where we can mobilize additional resources,” Olivier Raynaud, senior director of health and healthcare industries at the Switzerland-based World Economic Forum (WEF), told IRIN.

“This report is saying, ‘Careful. If you do not mobilize resources today, can you afford the cost tomorrow of not doing the right thing?’”

The WEF and Harvard School of Public Health released two reports on 18 September analyzing the economic impact – especially in low and middle-income countries – of an unchecked, increasing prevalence of NCDs, and the action countries must take to prevent them. Their launch marked the beginning of a UN two-day conference on NCDs, coinciding with the opening of the General Assembly autumn session.

The potential economic impact of cardiovascular diseases, cancers, chronic respiratory diseases and diabetes is steep: it will cost the world US$47 trillion over the next decade to treat and care for people with these diseases, which will also contribute to a 17 percent increase in mortality rates.

NCDs are already known to cause about 36 million deaths annually, including nine million under the age of 60.

Developing countries are expected to shoulder the highest numbers of such deaths.

The cost of creating measures to help avoid this trend is far less: $11.4 billion annually to create a sustainable package of best practices, including tax increases on tobacco and alcohol, smoke-free public places and public awareness campaigns on diet and exercise.

Stretching resources

But Dan Chisholm, a health economist at the World Health Organization (WHO), concedes that the package – which does not include any sort of specific global funding goals or national budget strategies – could be a hard sell, as “the real size of the magnitude of this problem has taken a while to be realized”.

“There are always competing priorities, so if you have a low-income country in Africa with a raging HIV epidemic or high rates of child or maternal morality, it’s a very tough choice of how to invest your scarce dollars,” explained Chisholm, who helped present the reports. “I suppose this is really just trying to raise awareness of the consequences of NCDs and that they need to be built into a sort of development agenda.”

Thobeka Madiba-Zuma, South Africa’s first lady, questioned broader issues of economic disparity, saying that people who lived in slums, for example, could not easily exercise or have steady access to healthy food.

Some civil society networks and organizations also said the reports failed to consider challenges such as government ties to tobacco and alcohol producers, for instance, and a shortage of healthcare practitioners in many low-income countries.

“What we need to confront this crisis is the sort of thing we have done with malaria, tuberculosis and HIV,” said Jonathan Brown, vice-president of the International Diabetes Federation. “We need to use those models to set up non-physicians, local people, to monitor the situation.

“There are lots of ways to approach this and it doesn’t have to be expensive, it doesn’t have to be cumbersome. We just have to get going on this thing.”

The conference on NCDs is set to adopt an “action-oriented outcome document”, acknowledging the economic and social risks of NCDs and calling for “multisectoral national policies and plans for the prevention and control” of NCDs by 2013.

It also brings to light the issue of mental and neurological disorders, presented as periphery NCDs that still cause significant financial loss and are often linked with the four core broad diseases.

“You could have visited a country before the UN summit and said, ‘What’s your plan for NCDs?’ and they would have said, “’What NCDs?’,” said Raynaud.

“This meeting will enable that discussion and lead different nations to make a plan. It’s a start.”

al/mw source www.irinnews.org

Photo: Breast Cancer Care

A healthworker in rural Pakistan helps spread awareness of breast cancer

LONDON – Last year, an estimated two million women around the world developed breast cancer or cancer of the cervix (the neck of the womb); more than 600,000 died – the equivalent of six large passenger planes crashing every single day.

These are the results published by a team from the University of Washington in Seattle in the British journal, The Lancet, ahead of the non-communicable diseases conference at the UN in New York.

The study is the first global analysis of trends in cervical and breast cancer incidence and mortality, using data from 187 countries. It shows that while breast cancer deaths are concentrated among older women in richer countries, 76 percent of cases of cervical cancer now occur in developing countries, where the incidence of the disease is still increasing. Almost half those cases are in women under 50.

The authors conclude: “Our findings show that in developing countries in the reproductive age groups, breast and cervical cancer are substantial problems of a similar importance to major global priorities such as maternal mortality.”

The variations in trends for breast and cervical cancer in countries even within the same region mean “known, major risk factors such as obesity and consumption of animal fat do not account for all recorded patterns. The interaction between genes and the known individual risk factors might explain these divergent trends.”

The study emphasizes the need for better surveillance and data gathering systems.

Data gaps

While figures are abundantly available from Western Europe and North America, as well as India, whole swathes of Africa, especially central Africa, provide hardly any data at all. And even in those African countries that do attempt to keep records, accuracy is still patchy.

One gynaecologist of 40 years’ experience in Lagos, Tayo Sawyerr, told IRIN he felt the city’s statistics were reasonably complete because: “They won’t let you bury a body unless you can produce a death certificate. And the death certificates are identical to those in the UK, and have to show the cause of death.”

Meanwhile, in rural Togo, burial is a private matter, inside the family compound. Registering a death costs money, and with no obvious benefit to the family, many are never recorded.

Even where there is data, the researchers found some countries, such as Uganda, recorded the incidence of cancer, but not the mortality rate. In Tanzania, it was the other way round. Some places simply recorded “cancer” without specifying what kind, or did not distinguish between cervical cancer and cancer of other parts of the womb.

Extrapolating

Asked how much confidence he had in the statistics, Raphael Lozano, professor of global health at Seattle’s Institute for Health Metrics and Evaluation, told IRIN: “We were fortunately able to gather information from countries with cancer registries, such as Malawi, Uganda, Namibia, Zimbabwe and South Africa. Both Cape Verde and South Africa had vital registration data [births and deaths]. And we relied on verbal autopsy information from nationally representative studies in Mozambique and Burkina Faso… Our models allowed us to borrow strength from data from countries within the same region and others.

“The quality of the data varies across countries and years, and we correct for this known bias. However, in the case of vital registration, there is good evidence that the quality of reporting of breast cancer on death certificates is acceptable compared to other causes of death.”

He said he was also confident that the apparent rise in cancers among younger women was not just the result of better maternity services, which meant women were seen regularly by health professionals.

“I believe the rise in cancer in women of reproductive age is real. In some countries the increase is modest, but in others it is quite significant. For example, in Cameroon in 1980, 33 percent of breast cancer deaths were in women [younger than] 50 and in 2010, that fraction increased to 43 percent.

“In Equatorial Guinea the increase was even bigger, from 22 to 43 percent. This can’t all be explained with better screening and better surveillance, especially given the health system challenges in some of these countries.”

Sawyerr is also convinced that the rise, especially in cervical cancer, is real. “I have had a long career,” he says, “and I am unfortunately surprised that I am beginning to see a lot of people with cervical dysplasia [abnormal cell growth in the cervix] and with HPV involvement. I am treating one woman at the moment for cancer of the cervix and she is just 34 years old.”

HPV is the Human Papilloma Virus, a sexually transmitted disease implicated in the development of cancer of the cervix. A vaccination against HPV is now available and – together with regular screening – is one of the factors reducing the incidence and mortality from cervical cancer in richer countries.

But with the vaccine initially costing about US$300 for a course of three doses it was priced beyond the reach of developing countries. Now the Global Alliance for Vaccines and Immunisation, GAVI, has negotiated a price of $5 a dose with the manufacturers, and is planning to roll out the vaccine in eligible countries soon.

Senegal’s Health Minister, Modou Diagne Fada, told IRIN in June he hoped it would be available there by 2015. “Nowadays malaria is no longer our leading cause of death. Today the leading causes of death are chronic diseases, and non-transmissible diseases, especially cancer. Among these cancers there is one which is very deadly, cervical cancer, and I think the introduction of the vaccine against the Human Papilloma Virus would help us reduce the number of our women who die from this disease.”

eb/mw source www.irinnews.org

By API

The Pre-Trial Chambers has a problem. There is conflicting evidence to be dealt with. The Kenya case is very unique because it is the first case brought to the court due to the prosecutor’s own initiative. The case was not referred to the ICC by the UN or any other recognised international organ.

The Kenya cases started on the 1st of September with Hon. William Ruto, Hon Henry Kosgey and Joshua Sang classified as case one, and now case two is on with Hon. Uhuru Kenyatta, Mr Francis Muthaura and General Hussein Ali.

The prosecution has had an uphill battle so far. However, if the defence do not present strong defence witnesses, things can turn ugly because the prosecution seems to have a strategy to ensure that the defence witnesses are put in a situation where they fall into a trap, if one has to go by what happened to yesterday’s defence witness, the former District Commissioner who served in Naivasha during the post-election violence, Mr Lucas – now serving the government in Kilifi District in the same capacity.

The prosecution did their best to confuse him during the cross-examination yesterday.

The case is beginning to be complicated. The prosecution wants the case to go to trial, while the defence wants the case dismissed.

We have noted, however, during the proceedings that the Judges are not in unison. There is a particular Judge who seemingly wishes to sent the case into full trial.

Reliable source say that one of the Judges in the Pre-Trial panel has intentions to become the next ICC President and this may play into the judgement in this case.

End

————

uhuru kenyatta, william ruto, defence witness, election violence, and defence witnesses.

Photo: Nebedaay/Flickr

Senegalese families are getting smaller, says UN

DAKAR,  – Talibouya Ka, Muslim leader (imam) of the Omar Kane mosque in the Medina neighbourhood of the Senegalese capital Dakar, encourages his followers to procreate as much as they can. “There are imams who are for family planning, but I am not. I tell worshippers they need to increase the size of the global Muslim family.”
 
Such attitudes, which used to be prevalent in Senegal, are increasingly rare, particularly in Dakar, midwives and doctors at the Hospital Centre for Health and Hygiene in Medina, told IRIN.

Senegalese families are spacing their children, having fewer, and as a result are increasingly searching for long-term family planning solutions, said Fatou Seck, a midwife at the hospital.
 
While in 1990 the average woman in Senegal had 6.7 children in her reproductive cycle; in 2009 when the latest statistics were made available, they had 4.8, according to the Health Ministry.
 
“There is a small revolution going on – husbands and imams who were traditionally against any kind of family planning are slowly starting to accept it,” said Ephie Diouf, 31, a child-minder in Dakar and mother of a five-month-old son.
 
Government push

One reason for contraceptive take-up is the high cost of living, particularly in the capital, said Soda Diagne, 32, a Dakar businesswoman who is married without children. “People are realizing they can’t feed and educate five children at today’s prices.” The price of imported rice – a staple in Senegal – rose sharply in 2007 and 2008 and then again in 2010.
 
While the average fertility rate across the country is five children per woman, in Dakar it is 3.9, according to NGO Marie Stopes International (MSI).
 
But the behaviour shift is also due to a push by the government to encourage family planning in state-run hospitals and clinics as part of its maternal mortality reduction strategy, said the UN Population Fund’s (UNFPA) Senegal joint director, Edwige Adekambi.

Many of the poorest performers in maternal mortality are in West Africa; while Senegal is at the high end of the regional scale, the numbers are still significant: 410 women die per 100,000 live births, according to the UN Children’s Fund (UNICEF).
 
The Health Ministry has doubled the budget for reproductive health, and within that, has doubled the budget for family planning to US$200,000 per year, according to UNFPA.
 
At parliamentary level, politicians are also starting to take into account the need to balance economic and demographic growth, she added. (In many West African states, the potential gains of economic growth are being erased by soaring populations).
 
Stock ruptures
 
Part of the additional funding will be used to ensure that contraceptives start to be included in the list of essential stocks routinely ordered for government pharmacies and medical centres, as per a ministerial order.
 
To date, erratic supplies have severely impeded the ability of some women to access contraceptives, said Adekambi, which also means they are subject to paying more than the government-set tariff – 100 CFA (20 US cents) for one month’s supply of the birth control pill.

Diouf backs this up. She pays 1,500 CFA ($3.10) to a private pharmacy for her monthly contraceptive pill because her local clinic is often out of stock. “Many women I know go to private clinics to get their birth control pill, but end up taking bad or old pills and get pregnant anyway,” she said. Availability is even lower in rural areas, where just one in 20 sexually active people use contraception (versus one in five in Dakar).
 
On 19 September, MSI opened three family planning clinics: two in the capital and one in M’bour, 70km south of Dakar, aiming to give women greater access to affordable family planning services, as well as to give advice and testing on sexual health, and provide basic ante-natal care. Providing these services at an affordable fee could reduce medical expenses linked to reproductive health in Senegal by $20.8 million by 2015, estimates MSI.
 
The government has been very supportive of the NGO’s work, said Senegal director Maaika Van Min; and the local imam attended the opening ceremony of one of the new clinics.
 
Agents for change

But while attitudes are changing, there are still pockets where people cling to traditional beliefs, said Adekambi, particularly in rural areas such as Matam in the northeast, which has the lowest contraceptive use rate in the country.
 
Since 2006 Catholic and Muslim religious leaders have worked together to try and issue updated religious guidelines on family planning, stressing the fact that neither the Koran, nor the Bible are against spacing of births.
 
Midwife Seck said the imam at her local mosque now preaches to families to space their children by 30 months. “He tells families this is how to keep their wives healthy. Family planning is not banned in Islam… Religion is about well-being, and spacing children is part of that.”
 
In Matam, UNFPA worked with couples from the community to become agents for change: they went door to door to discuss family planning with household members. Contraceptive use has risen in the region, but Adekambi said nonetheless, UNFPA may take the approach one step further – by opening a “school for husbands” based on a model they organized in Niger, where reproductive sexual health and other gender issues are discussed.
 
Many husbands or partners are reluctant to embrace family planning at first, said midwife Seck. At consultations “we discuss with them the benefits… that their wife will have more time to look after each child, more time to look after herself, and most importantly, more time to look after him,” she told IRIN.
 
That tactic often seems to do the trick, she said.
 
aj/cb source www.irinnews.org

Photo: IOM

West African migrants with their belongings in Dirkou, northern Niger

AGADEZ/ – While the world’s politicians conjure up fears of a “tsunami of migrants” flooding Europe, in reality it is Libya’s economically vulnerable and chronically food-insecure neighbours Niger and Chad that are struggling to cope with an influx of returning migrants, says spokesperson of the International Organization for Migration (IOM) Jean Philippe Chauzy.

[See LIBYA: Sub-Saharan migrants keep their heads down]

Since April 2011, some 80,000 people have fled Libya to Chad, and 75,000 to Niger – many of them returning to communities already struggling with severe food insecurity, economic crisis, or cholera. 

“Our biggest concern is that these returns are happening in countries that are already economically very fragile, and at least one of the lifelines for families – remittances – is now completely cut off at the very worst time,” said Chauzy. July to October is the lean season in northern Niger and Chad when food prices are generally at their highest and food availability at its lowest.

In addition to the migrants, some 5,000 third-country nationals (TCNs) have been registered by IOM in Niger, and 800 in Chad, most originally from Sudan, Mali, Cameroon and the Democratic Republic of Congo.

Migrants who had left home to work in Libya tended to come from communities in already vulnerable areas, said IOM head in Niger Abibatou Wane – in Niger’s case Agadez in the northeast, Tillabéry in the east, Zinder in the south and Tahoua in central Niger.

US government food security analysts FEWS NET predicted parts of these regions, as well as Maradi in the south, would reach food insecurity “crisis phase” in August and September. Most vulnerable in terms of food security are households living in Bilma in Agadez region, Tahoua as well as Tanout and Gouré in Zinder, says FEWS NET.

In the transit town of Dirkou in Agadez, the price of basic grains, oil and fuel has risen since May 2011 when migrants started arriving in large numbers, say residents. Ousmane Ibrahim, a trader in Agadez, told IRIN: “It is difficult to find even the most basic foods as they are too expensive.”

Several traders told IRIN they have sent their families to the capital, Niamey, until the situation improves.

The government is doing nothing for us. It doesn’t even want to acknowledge our presence… They would prefer to look after the Libyans who have fled, and who have a bit of money on them

Many Nigeriens IRIN spoke to were angry the government is not doing more to help them. Ahmed Zargaw, 26, returned to Agadez where he is now unemployed. Like many migrants, en route to Niger he was beaten by bandits who also stole his phone and all of his money. “The government is doing nothing for us. It doesn’t even want to acknowledge our presence… They would prefer to look after the Libyans who have fled, and who have a bit of money on them.”

Mohamed Annacko, president of the regional council for Agadez, told IRIN the government is “taking all the necessary steps to ensure stability and to secure people’s basic needs”, without spelling out what that meant. But he admits the authorities do not have enough resources to deal with the situation, even with assistance from NGOs and UN agencies: “We are fighting on two fronts. The situation is alarming both in terms of the humanitarian [food security] situation, and security.”

International agencies are also struggling: IOM’s transit centre in Dirkou is “overrun” said Chauzy, and high fuel prices linked to the Libya conflict make it difficult to shift people to Agadez and Niamey quickly enough.

Cholera in Chad

While the Chadian authorities have responded “quickly, and have been excellent at allowing IOM and humanitarian actors to provide assistance”, according to IOM programme officer Craig Murphy, the biggest concern is that cholera has broken out in areas with high migrant return rates in western Chad, including Mao, capital of Kanem region.

Since the beginning of the year 11,000 people have contracted cholera in Chad, and 340 have died, according to the UN Office for the Coordination of Humanitarian Affairs. Aid agencies are running cholera awareness campaigns for migrants and residents to try to stop the disease spreading further.

In northern transit areas, food insecurity is not currently a big problem, said Murphy. The UN World Food Programme (WFP) has been delivering basic food rations to IOM transit sites, the Faya hospital, Mourdi and Zouarke, and will soon do so in Ounianga-Kebir.

For Félix Leger, head of the International Rescue Committee in Chad, which is helping the government give good health care to returnees and host communities in the transit town of Faya, there are two scare scenarios: Libyan refugees start to flee to Chad in large numbers; or a second wave of migrants who have hitherto stayed in the Libyan capital Tripoli, start to cross the border.

Thousands of sub-Saharan African migrants are either stuck or have decided to stay in Libya. Aid agencies are particularly concerned about the 2,500 migrants – among them Chadians, Somalis and Eritreans – who are stuck in Sebha, southwestern Libya, where battles are still raging between the rebel movement-turned-incoming-government (ruling National Transitional Council) and forces fighting for Muammar Gaddafi.

While migrant numbers diminished in August and September from high levels in May and June, the number of Libyans among them rose, according to IOM.

Libyan refugee Mohamed Halil, 42, a former businessman in Tripoli who fled to Agadez, told IRIN: “I fled because Gaddafi’s men wanted to kill me as I have family in Benghazi. I was living a peaceful life in Tripoli before this mess started. I don’t understand what is happening to my country.”

“Before the war we wanted for nothing: water, electricity, gas, housing, free health care… Now I am living in exile and I am suffering a lot. How will I get out? Who will help me?”

The UN Refugee Agency (UNHCR) has been helping with the Chad response, and has sent a protection officer to assess the situation in Niger, said UNHCR spokesperson Fatimata Lejeune-Kaba.

The cycle of vulnerability is likely to continue once security eventually returns to Libya, predicts IOM’s Chauzy. New groups of Nigerien and Chadian migrants will try to head to Libya, since recent returnees will need more time to accumulate enough money to pay for another trip. “The demand for services in Libya will soon start to feed those smuggling networks again and migrants will no doubt once again head straight into situations of vulnerability in Libya.”

aj/bb/id/cb source www.irinnews.org

Photo: Charles Akena/IRIN

Agriculture for better health and nutrition

DAKAR,  – Agriculture is about food production, but often projects ultimately hurt communities’ health and nutrition. When the focus is tons and dollars, experts say, getting people the nutrients they need can be lost.

Aid agencies and governments are increasingly looking at ways to ensure that agricultural investments support proper nutrition, including one methodology being developed by the US Agency for International Development (USAID) and NGOs.

The “nutritional impact assessment tool”, was developed by USAID’s Infant and Young Child Nutrition Project (IYCN), led by PATH, CARE, the Manoff Group, and University Research Co., LLC. 

“The tool would be a way for organizations designing or reviewing agricultural programmes to mitigate any risks or potential negative effects on nutrition – in other words a ‘do no harm’ approach,” said Michael Zeilinger, head of the nutrition division with USAID’s office of health, infectious disease and nutrition.

USAID is working with NGO partners to test the tool — a template for listing project objectives, food insecure groups, people’s nutritional status and possible impact of an agricultural project on each group. “As we start to design major agriculture programmes around value chains and increasing production (such as Feed the Future and Global Agriculture and Food Security Program), we should really remember that there are some practices in agriculture that may have potential negative effects on nutrition, and this is just to make sure that they’re thought through,” Zeilinger told IRIN.

For example, smallholders might not benefit from projects requiring new technologies they can’t afford, so ultimately they and their families are hit economically, according to IYCN; malaria could spike in rice-producing areas that make a breeding grounds for mosquitoes; and agricultural work requiring women to spend more time away from home could harm children’s nutritional status.

“The agriculture sector needs to be accountable – contributing to improved diets and not creating any harm to health and nutrition,” said Charlotte Dufour, food security, nutrition and livelihoods officer with the Food and Agriculture Organization’s (FAO) nutrition and consumer protection division.

But measuring impact is complicated, she said. Some projects can have positive and negative impacts within one community. 

The agriculture sector needs to be accountable – contributing to improved diets and not creating any harm to health and nutrition

Developing a tool to get it right points up a number of challenges, she said. “Information on malnutrition rates of any kind is seldom available by ‘food insecure group’,” she said. “And data on women’s nutritional status is rare.”

Dufour said it is critical to note that one agricultural activity could have different effects on different populations, and that a wide range of socio-economic factors affect nutritional status. “Maximizing the nutritional impact of agricultural programmes requires a good analysis of local livelihoods and causes of malnutrition by population group,” she said, adding that for now the IYCN tool does not yet provide for such analysis.

Gaps

The NGO Action contre la Faim (ACF) pays close attention to the nutritional impact of its interventions, but guidelines for measuring that, including in emergency situations, are lacking, according to Julien Morel, ACF senior food assistance adviser. “Having indicators and methodologies for measuring our actions’ impact on communities’ nutritional status would be extremely useful,” he told IRIN. “We hope the USAID-led effort will help provide precise recommendations in this complex domain.”

Many organizations are working on user-friendly methods to do the kind of analysis needed, Dufour said. “Until now resources for such work have been limited due to a limited interest in nutrition in general, and the role of agriculture for reducing malnutrition in particular. But there has been a significant change marked by much greater political commitment.”

USAID/IYCN’s methodology – a work in progress – is just one attempt to look at the links between agricultural activities and nutrition, according to USAID’s Zeilinger. “It is something useful to get the conversation started.” He said donors could eventually require implementing partners to use a nutritional impact assessment tool during the project design process.

np/cb source.www.irinnews.org