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Brussel 23-Apr-04 <address removed> <address removed> Alex Duncan Dear Alex, Please find below some reflections suggesting pathways for more effective cross sectoral interventions including agriculture in addressing chronic poverty. Best regards, Per P.S. Please as of April 26 send any mail to both email addresses appearing above. FOR DFID DISCUSSION ON POVERTY AND GROWTH Per A. Eklund DFID early on articulated its position that addressing chronic poverty, food insecurity and vulnerability requires a multisectoral response. Confronted with evidence of aid ineffectiveness, reflecting little attention in service delivery to vulnerability, location specific constraints and exclusion of resource poor households, DFID conceptualized its livelihoods system concept. Widely accepted is now the notion that poverty has many dimensions beyond income. Yet across donors, capability in programme design for effectively addressing chronic poverty, demonstrating measurable impact, has not progressed in line with expectations. Agricultural line agencies and extension services are rarely geared to support community driven development, where cross sectoral interventions are combined to reinforce reductions in prevalence of child malnutrition, where facilitators empower resource and knowledge poor households to express preferences for mix of interventions, for technology and supporting infrastructure and where they begin to influence and control budgetary allocations. There is much room for experimentation in these dimensions, how to raise capabilities, how to involve local NGOs, in short for learning by doing. DFID is positioned to extend further the knowledge frontier in designing and testing more effective poverty alleviation programmes. Market based interventions on their own - in the absence of empowerment mechanisms - do not suffice in removing underlying causes to endemic poverty. DFID has concluded that 'support to agriculture, as part of a multisectoral response, will play a major part in meeting this challenge .' DFID's comparative advantage may well rest in continued conceptualization of cross sectoral approaches for empowering deprived populations, empirical testing of selected interventions, validating context and modalities. Evidence based policy recommendations are essential prior to scaling up, and replication. Clearly stated objectives for measurable progress drive organizations and development. A relevant mix of indicators is needed for targeting and tracking poverty reduction. Income poverty is not necessarily well correlated with indicators for nutritional status. Mere use of income or monetary measurements of poverty within official development assistance easily leads to excessive focus in programme design on the role that market forces can play in poverty reduction. Non monetary poverty is associated with deprivation in terms of access to education, health, human and civil rights, gender equality and not least to health and nutrition knowledge; indicators are called for that reflect and relate to variations in these dimensions. Anthropometric indicators particularly stunting (height-for-age) have been confirmed as relevant composite indicators for targeting cross sectoral interventions to population groups at risk, and with high prevalence of non monetary poverty: they are well suited for monitoring performance of cross sectoral interventions, and for evaluating impact. For children under 5, nutrition and health dominate genetic factors in explaining variations in stunting. Stunting reflects longer term deprivation, limited capabilities, exclusion of public goods. Underweight (weight-for-age) in contrast relates largely to the seasonal variations in food supply. The relevance of anthropometric indicators of nutritional status for tracking poverty, particularly stunting, is reconfirmed in recent literature (Gillespie and Haddad, IFPRI 2003). Moreover, data on stunting and underweight for children under 5 are collected in the field at little cost relative to measurements of production, consumption and income. Stunting is particularly sensitive to gender inequality, to the mother's status, her nutrition, resource endowments, labour load, education and knowledge (IFPRI). Stunting is related to mother's BMI that reflects mother's exposure to stress... Child malnutrition improves, the more the mother has food or cash to procure food, the more formal schooling she has acquired, the more she is empowered, the more she has access to safe drinking water, and the more there is reasonable access to an effective health outreach (IFPRI 1999). Stunting is a powerful indicator with which to gauge capabilities or their absence within and across livelihood systems. Stunting implies probability of permanently impaired livelihood systems even for the next generation. Stunting is a powerful predictor of cognitive and motoric impairment with negative impact on schooling, and with substantial productivity loss in adulthood (see inter alia Alderman, Hoddinott and Kinsey study for Zimbabwe, under www.chronicpoverty.org). Tracking variations in stunting and in food security, health access and sanitation for resource poor households over time and across sites is useful. Differential benefits to households from accessing cross sectoral services emerge. But few donors have as yet begun to use stunting, with a minimal set of other indicators, for gauging complementarity, and resource use efficiency, of cross sectoral interventions. Large numbers of households are deprived of essential nutrition knowledge, this is yet another dimension of non monetary poverty. Studies in several countries suggest that large proportions of mothers are not aware that their children are stunted and what this implies. Resource allocations within and across their livelihood systems then remain non optimal, based on an inferior choice. On the other hand, when mothers learn to diagnose the growth status of their children and learn about underlying causes and solutions, this is a powerful instrument driving reductions in chronic malnutrition. Studies confirm that when mothers through growth promotion programmes learn if her child is stunted or not, understand causes and wider solutions, they become empowered, motivated to change behaviour within their given resource constraints. Overall, the UN system and many other aid organisations have remained ineffective in transmitting knowledge for rural populations to diagnose growth faltering, learn causes and find sustainable local solutions. Few decision makers seem to realise the extent of this information failure and the high opportunity costs of omissions. Recent studies (China, Ethiopia, Indonesia, Morocco and Nepal) have pointed to the value of processes that empower parents with relevant knowledge about the nutritional status of their own children. The acquisition of 'out-of-school' maternal knowledge by women in fertile age has an immediate and powerful effect in reducing deprivation relative to the delayed effect of primary schooling for female household members, and to per capita income growth. Such knowledge acquisition is found associated with accelerated reductions in stunting prevalence over and above the effect of growth in private income (e.g. see Alderman and Christiaensen's study in Ethiopia, World Bank). This knowledge diffusion is a particularly cost-effective instrument with which to empower and activate parents. Community based organisations, especially women groups, represent a valid platform for ensuring that women, and men, access knowledge in diagnosing child malnutrition, and actively apply such knowledge in expressing their priorities across cross sectoral interventions. Parents seek to address causes to malnutrition as individuals but also at community level. Once parents find out that their child is stunted, this acts as an incentive for advocacy and resource mobilisation also for public goods. Cooperative local public good solutions may emerge. Women, probably more than men, drive the provision of safer drinking water, improved access roads during the rainy season, improved credit and savings associations for income generation, etc. A study from Bangladesh demonstrates that child malnutrition is significantly lower for members of women groups where credit is used for income generation through back yard poultry production (Pitt and Khandker, World Bank). The results are consistent with the view that women's participation in micro-credit programs helps to increase women's empowerment. A recent study in two districts in Nepal suggests that children of members of autonomous community based self-help women organisations have better nutritional status, when these organisations have higher capabilities. (Eklund, Imai, Felloni, see updated papers www. chronicpoverty.org). Yet, the latter study confirms that access to outside technical or scientific knowledge is important in addressing stunting. For other groups that received training from UNICEF in diagnosing malnourished children and finding solutions, such activity was found associated with reduced stunting prevalence. In many countries, especially in South Asia, stunting remains high, at 40% to 50% prevalence, declining by less than one percentage point p.a. Nepal is but one such a case. In Sub-Saharan Africa, recent data from UNICEF for year 2000 suggest that stunting prevalence was constant or decreasing for 16 of the 22 countries for which data were made available. Unless governments, better assisted by donors, begin to make concerted efforts to directly target stunting with a conceptual framework for decentralised service delivery, with particular support for women groups, prevalence will remain unacceptably high during this century. Thailand has demonstrated that successful efforts can be generated. It remains that with the suggested conceptual framework, tracking stunting prevalence for deprived population groups generates insights for the design and evaluation of agricultural interventions with supporting infrastructure, not least in generating preconditions for reducing widespread protein-energy malnutrition.
Please visit dfid-agriculture-consultation.nri.org.