From protection to production of human capital: Linking social protection programs to positive outcomes for nutrition

The Nutrition Landscape

The 2013 Lancet Nutrition Series estimated that scaling up 10 proven effective nutrition-specific interventions would reduce the burden of child stunting (162 million stunted children under five in 2012) globally by 20 percent. This would be a tremendous accomplishment, resulting in better health, nutrition, and development for 32 million children—but it isn’t good enough. We need to deliver for the remaining 80% of affected children. We know that this will take more knowledge, better evidence, and operational experience with nutrition-sensitive interventions delivered through a variety of sectors including social protection, agriculture, water/sanitation/hygiene and education.

Social Protection Options

Social protection programs designed to alleviate poverty, eradicate hunger, and promote economic and social development have already proved to be important tools for addressing undernutrition. They help to raise household income increase access to markets and services, bolster the resilience of households and their ability to weather shocks, and improve conditions of food insecurity. There is a range of diverse social protection instruments—including social insurance, social transfers (in cash and in kind), other forms of social assistance exemptions, subsidies for social services, school and other specialized feeding programs, and labor market policies—that can be employed in different combinations, depending on the context/setting.

Making the Link

With all of these programming tools available, and understanding that many can, if designed well, impact nutrition, how do we begin more deliberately linking social protection programming with food security and nutrition outcomes? Several ideas are considered below.

Conditional cash transfer programs may contribute to improved health and nutrition by fostering links to the health system through conditionalities such as attendance at health clinics where families receive micronutrient supplements and nutrition education or participate in community-based growth monitoring and promotion sessions. Social protection targeting mechanisms can also enhance programs’ focus on vulnerable populations such as pregnant women and children in the first two years of life, helping to position programs to achieve the greatest impact for optimal physical and cognitive growth and development.

Additional social protection programs with the potential to contribute to positive nutrition outcomes include conditional in-kind transfers such as school feeding programs which bolster school attendance particularly among girls, and food subsidies/food vouchers in large public distribution schemes; public works programs focused on generating employment and raising incomes that provide childcare at the worksite to facilitate women’s ability to earn money and provide adequate nutrition care for their children; and insurance programs to help smooth consumption over time and mitigate detrimental practices such as reduced meal frequency during drought, floods, and other shocks.

Recent Work on Social Protection and Nutrition (SP/N)

As part of the recent Second International Conference on Nutrition (ICN2) organized by WHO and FAO in Rome, Italy, SecureNutrition and the Russian Federation hosted a well-attended side event titled, Transition from Safety Net Programs to Comprehensive Social Protection Systems: Food Security and Nutrition Perspective. Ably moderated by Lawrence Haddad, the panel of speakers representing IFPRI, FAO, WFP and the Russian Federation sought to articulate the current state of SP/N operational linkages, current challenges, and what’s on the horizon.

The panel marked a first step towards building a collaborative operational research agenda for SP/N linkages, which will be used as a foundation for a 2015 Global Forum devoted to aligning researchers and implementers.

Although made up of multiple international agencies and several country perspectives, the panel presentations highlighted strong recurring themes such as the acknowledgement that all governments spend money on social protection. The opportunities to leverage links with nutrition are already in place; these programs can be positioned not only to address poverty in the short-term, but to contribute to longer term sustainable development through the improved nutrition and health of its children in the critical early years of life.

However, it is also evident that there is no “automatic” impact on nutrition through social protection programming. In order to increase the likelihood of impact on nutrition outcomes, there are several areas identified by the panel participants that are in need of both evidence and innovation. These include:

• What works in different country contexts?
• How do we better integrate and link different sectors in order to achieve consistent wins for nutrition (e.g. between social protection and health; social protection, agriculture, and Education; etc.) and systems (health systems, food systems, etc.)?
• How do we bring vulnerable populations along the full social protection continuum—from protection through to transformation?
• How can we ensure nutrition-sensitive social protection programs reach women in the first or second trimester of pregnancy?

Next Steps

Design failings are often blamed for weak impact of SP programs on nutrition. With an eye towards the Post-2015 development agenda, working together across both technical sectors and stakeholder groups—the private sector, NGOs, governments, and the community—will be vital to more thoughtful programming. As the panel noted, there is a huge opportunity to “get away from old dichotomies… developed vs. developing, this generation vs. the next generation, emergencies vs. development.” On the cusp of the adoption of the Sustainable Development Goals, the ability to integrate nutrition into key sectors like social protection, agriculture, health and others is one that could help turn the 2030 targets from rhetoric to reality.

Watch the SNKP newsletters for updates on a multi-day Global Forum on social protection and nutrition in 2015, where these ideas will be addressed in depth by leaders from different sectors.

Leslie Elder, Senior Nutrition Specialist, Health, Nutrition and Population Global Practice, The World Bank Group