Public Disclosure Authorized Public Disclosure Authorized Overview and research directions Public Disclosure Authorized Dhushyanth Raju Office of the Chief Economist, South Asia Region World Bank June 25, 2018 Public Disclosure Authorized
Reducing undernutrition is a global development priority
Child undernutrition is worryingly high in the region Stunting burden Stunting rates
Subnational child undernutrition status varies considerably Stunting rates Wasting rates
World Bank Group’s strategic directions Resilience Sustained & inclusive growth Eliminate extreme Eliminate extreme poverty & boost poverty & boost shared prosperity shared prosperity Human capital Nutrition is viewed as critical for and impacted by these strategic directions
Strategic pillars of WBG’s South Asia Region Enhanced support Greater social and for private sector financial inclusion development, with emphasis on including climate addressing gender gaps and resilient imbalances investments Strengthened governance and security, addressing fragility
SAFANSI Aim To improve food and nutrition security (FNS) in South Asia through strengthened commitment and increased capacity for more effective and integrated FNS actions Partners Eligible countries Afghanistan, Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka Regional activities covering two or more countries
Strategic pillars
Products
Selected recent research Sri Lanka : World Bank Group. Multisectoral Nutrition Assessment in Sri Lanka’s Estate Sector. World Bank, Washington DC, 2017 Bangladesh : Gautam and Faruqee. Dynamics of Rural Growth in Bangladesh: Sustaining Poverty Reduction. Directions in Development, World Bank, Washington DC, 2016. India : Majumdar, Rao, and Sanyal. Scaling-Up on the Frontlines: A Qualitative Analysis of Implementation Challenges in a CDD Project in Rural India. World Bank Policy Research Working Paper 8039, March 2017
Undernutrition problem in the region Regional child and maternal nutrition status is (relatively) insensitive to three phenomena • Levels of national economic development • Gains in national economic development • Presence of public food, health, and nutrition programs Three potential sources of failures • Household (behavioral failures) • Government (service delivery failures) • Private market
Regional report: Ending Undernutrition in South Asia Approach Audience Aims • • Government • Present the determinants Synthesize existing relevant, • multidisciplinary literature for of undernutrition in the Research community the region region • • Draw insights for potential Supplement with key insights from relevant literature from development action by other developing regions governments and actors • • Serve as a source of Supplement with limited primary data analysis guidance for decisions on future Bank analytical, policy, and operational work
Report areas Subgroup and Food Water, sanitation, spatial patterns, and hygiene changes Child feeding and Urban Diet-related care practices undernutrition diseases
Looking forward: Potential research themes Gender Private sector Wasting Urban undernutrition Climate change
Wasting is particularly high in the region, and progress has been limited Recent trend s Current levels
Climate change is predicted to reduce food output and increase food prices Source: Nelson et al. (2009)
Climate change is predicted to reduce calorie availability and increase malnourishment Source: Nelson et al. (2009)
Urban populations and shares have grown substantially in South Asia …and are predicted to continue growing at a fast pace
Undernutrition rates are lower in urban than rural areas Stunting rates Inequality in height-for-age But rates remain high in urban areas, and inequality in undernutrition tends to be higher in urban areas
Thank you
Undernutrition rates for boys are generally similar or higher than for girls Stunting rates Inequality in height-for-age The aggregate picture may mask inequities in nutrition status in subgroups and inequities in nutrition inputs
Areas where maternal disadvantages can undermine nutrition status of both boys and girls Knowledge and beliefs Health and nutrition status Mental health/stress Autonomy and control over resources Workload and time availability Social support
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