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The PepsiCo Foundation MeetingMarch 31, 2008

International Food Aid ConferenceKansas City - April 15, 2008

The Evolving Role of Food Aid in Reducing Malnutrition – An NGO

PerspectiveHeather Danton

Advisor, Livelihoods

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MalnutritionMagnitude of the Problem• 150 million children under 5

undernourished

• 35% of child deaths (under 5 yrs) are attributable to undernutrition (3.5 million annually) 1 every 9 seconds

• Maternal undernutrition during pregnancy and lactation impacts child’s nutritional status

• For those who survive, stunting impacts are irreversible, with permanent reductions on physical growth, intellectual development, and economic productivity

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Global Distribution of Stunting

90% of stunted children live in just 36 countries

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Save the Children USFood Aid Programming in 2007

UgandaMalawiMozambiq

ue

Bangladesh

Indonesia

Pakistan

Tajikistan

Bolivia

Ethiopia

Guatemala

Haiti

Honduras

Mali

Nicaragua

Sudan

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Save the Children USFood Aid Allocations in 2007

Total Program Value: $99 million

Development53%

Emergency 47%

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Save the Children USFood Security Conceptual Model

Reduced Hunger & Malnutrition

Adequate Availability of Food

Adequate Access to Food

Optimal Utilization of Food

Resiliency to shocks

Source: Webb and Rogers (2003)

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Addressing MalnutritionThe Window of Opportunity

Source: Shrimpton et al., 2001

We target children

under the age of two

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Addressing MalnutritionProven Interventions

We focus on proven

interventions

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3947

4030

20

55

0102030405060708090

100

Exclusive BF Water,Sanitation,Hygiene

Treatment(pneumonia)

Treatment(diarrhea)

Oralrehydration

therapy

Vitamin A

Addressing MalnutritionPoor Coverage of Interventions

Source: Lancet Volume 362, PP. 65-71

We work to reduce the coverage gap

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Intended Impact: Reduced Malnutrition in Children

Strategic Objective Increase the Use of Key Nutrition Related Practices and Services

Reducing MalnutritionThe SC Approach

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Reducing MalnutritionSC Priority Interventions

Practices Services

Nutrition

• Immediate Breastfeeding• Exclusive Breastfeeding through 6

months of age• Timely introduction of appropriate

complementary foods

• Vitamin A supplementation (Maternal and Child)

• Iron supplementation• Iodine supplementation

Health

• Proper disposal of feces• Hand washing at appropriate times• Appropriate home care for Illness,

including oral rehydration therapy for children with diarrhea

• Timely referral of seriously ill children

• Timely appropriate treatment of malnutrition, pneumonia, diarrhea, and malaria, including zinc therapy for diarrhea

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Intended Impact: Reduced Malnutrition in Children

Strategic Objective Increase the Use of Key Nutrition Related Practices and

ServicesBehaviors

Reducing MalnutritionThe SC Approach

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Strategic Objective Increased Use of Key Health and Nutrition Practices and

ServicesBehaviors

Intermediate Result 1:Increased

Access to, & Availability of,

food and health

services

Intermediate Result 3:Improved

Knowledge, Attitudes, and

Skills

Intermediate Result 4:

Enabling Social &

Policy Environment

Intermediate Result 2:

Increased Quality

Of Services

Intended Impact: Reduced Malnutrition in Children

Reducing MalnutritionThe SC Approach

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Reducing MalnutritionSC’s Use of Food Aid

Monetization: Cash for comprehensive nutrition programming

Direct Distribution:• Preventive Rations • Incentive Rations • Recuperative Rations

Monetization51%

Distribution49%

Development Programs 2007

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Reducing MalnutritionThe Evolving Role of Food Aid

Three Trends in SC Food Aid Programming:

• Trend 1: Monetization to Direct Distribution• Trend 2: Development to Emergencies• Trend 3: Dry Rations to Ready to Use Foods

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The Evolving Role of Food AidTrend 1: Monetization to Distribution• Declining CASH

resources for development food aid programming

• Cost/benefit ratio of delivering food is on the increase

• Decreased ability to affect behavior and create change at scale

0%

10%

20%

30%

40%

50%

60%

70%

Monetization 2006 Monetization 2007

Save the Children Development Food Aid Programs – Monetization 2006 to 2007

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The Evolving Role of Food AidTrend 2: Development to Emergency

• Clear shift in the relative size of Save the Children’s portfolio and future growth

• Emerging questions regarding emergency food aid:– Effectiveness of Supplementary Feeding (SC-

UK publication and an upcoming global meeting to explore this subject)

– Food aid versus Cash-based programming

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The Evolving Role of Food AidTrend 3: Ready to Use Foods (RUF)

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The Evolving Role of Food AidTrend 3: SC RUF Portfolio Growth

2003 2004 2005 2006 2007 2008

1. Ethiopia2. Sudan3. Malawi4. Mozambique5. Pakistan6. Bangladesh7. Haiti8. Uganda

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The Evolving Role of Food AidTrend 3: SC RUF Priorities• Emergency Programs:

Community-based Therapeutic Care (CTC)

• Development Programs: Community-based Management of Acute Malnutrition (CMAM)

• HIV/AIDS: “Food by Prescription” PEPFAR

• Potential for Prevention: Lipid-Based Nutrient Supplements