1. ending child hunger and undernutrition initiative overview of issues and moving forward Copenhagen, 19 June 2006

2. Session Overview Overview of Initiative  Where did it come from?  What are its major elements?  What’s new? What’s not?  When will the Initiative be initiated?  Major challenges moving forward Field Highlights  Regional Level Political Mobilisation and Partnership Development in Latin America and the Caribbean  Partnering with Local Institutions for National Advocacy in India  Delivering the ‘essential package’ for child survival in Ethiopia General Discussion Global Campaign Efforts: Update on ‘Walk the World’

3. Initiative Reference Points 1.Agreed – MDG Targets and Indicators 2.Partnership with UNICEF  2005 MOU between WFP and UNICEF  Shared conceptual framework  30 country offices already collaborating on child hunger efforts 3.Key publications  Concept Note (WFP, UNICEF, World Bank)  Repositioning Nutrition as Central to Development, World Bank, 2006  Progress for Children: A Report Card on Nutrition, UNICEF 2006 4.Two Strategic Questions

4. 1. why a specific focus on CHILD hunger? major input and outcome synergies with other MDGs less reliant than overall hunger on increased GDP and agricultural production for results more subject to interventions focused on vulnerable children and their families

5. 2. what is different now that makes this achievable? increasing understanding of hunger, nutrition and growth increasing national resources and capacities financial organizational and technical (e.g. in communications, media, and information networking) civil society (e.g. improving gender equality and development) increasing international assistance increasing effectiveness and decreasing costs of information technology global consensus on Millennium Declaration and Goals

6. MDG-1: two targets and five indicators TWO TARGETS FIVE INDICATORS ONE GOAL Sources: 1. Progress for Children: A Report Card on Nutrition (UNICEF, 2006); 2. State of Food Insecurity in the World (FAO, 2004); 3. WFP working estimate Initiative target * Key Indicator for the Initiative

7. UNICEF and WFP: decades of partnership 1976 MOU on consultation and exchange of information, joint action in assistance programmes, collaboration in development and nutrition policies and more. 1985Additional complementary parameters for cooperation on emergency response. 1998MOU on Emergency and Rehabilitation Interventions 1999Technical Agreement on Field Telecommunications, Global Coordination and Mutual Assistance 2001Technical Agreement for Logistics Co-operation 2005MOU with Technical Matrices on Education, HIV/AIDS and Nutrition

8. ‘Agreed’ Hunger Definition In the most fundamental sense, hunger exists when a person’s body lacks the required nutrients to grow and develop a productive, active and healthy life It cannot be measured directly but the most appropriate way for monitoring progress on child is underweight.

9. Healthy Growth Adapted from: “Strategy for Improved Nutrition of Children and Women in Developing Countries.” New York: UNICEF, 1990. Healthy growth for children in society Access to adequate food Access to essential health services and a healthy environment Care for mothers and children Intermediate Contributors Direct Contributors Disease prevention control Adequate dietary intake Underlying Contributors Formal and non-formal institutions Potential resources Political, economic and cultural environment Appropriate education

10. Major elements of the Initiative 1. mapping children at risk 2. ‘delivery system’ and interventions 3. ongoing costing and resource tracking 4. communications strategy for advocacy 5. accountability framework

11. 1.mapping children at risk: micro-level targeting and implications for geographic focus

12. Distribution of Underweight Children in Latin America ( Children per square kilometre) Source: Millennium Project Hunger Task Force: Halving hunger: it can be done, 2005

13. Distribution of Underweight Children in Asia (Children per square kilometre) Source: Millennium Project Hunger Task Force: Halving hunger: it can be done, 2005

14. Regional distribution of underweight children South Asia (53%) East Asia/Pacific (15%) West/Central Africa (12%) Middle East, North Africa (6%) Latin America & Caribbean (3%) Eastern/Southern Africa (11%) Source: UNICEF, Progress for children. Number 4, May 2006, Page2. Central & Eastern Europe and CIS (1%)

15. Half of the approx. 32 million underweight children in Africa live in 22 percent of its geographic area – corresponding to less than 10 percent of its sub-national administrative units Distribution of Underweight Children in Africa (Children per square kilometre) Source: Millennium Project Hunger Task Force: Halving hunger: it can be done, 2005

16. Distribution in 144 Countries of underweight children Percentage of total Cumulative percentage 72 countries with sub-national data Top 24 regions in top 5 countries55 Top 2 regions in next 67 countries1065 Balance remaining in top 5 countries772 Balance remaining in next 67 countries1587 72 countries without sub-national data 13100 Source: Calculated from Millennium Project Hunger Task Force: Halving hunger: it can be done, 2005

17. Ranking by global share of underweight children Country Prevalence of underweight children in country (%) share of total underweight children in the world (%) Cumulative percentage of total India4739.0 Bangladesh485.744.7 Pakistan385.550.2 China84.854.9 Nigeria294.459.3 Ethiopia474.263.5 Indonesia284.267.7 Democratic Republic of Congo 312.370.0 Philippines281.971.9 Viet Nam281.5 73.4 Source: UNICEF, 2006. The State of the World’s Children. Compiled from Table 2 and Table 6.

18. Ranking by prevalence of underweight children Country Prevalence of underweight children in country (%) Percentage share of total underweight children in the world Cumulative percentage of total Bangladesh485.7% Nepal481.2%1.2 Ethiopia474.2% India4739.0% Timor-Leste460.1%1.3 Yemen461.1%2.4 Burundi450.4%2.8 Cambodia450.6%3.3 Madagascar420.9%4.2 Eritrea400.2%4.4 Lao People's Democratic Republic400.2%4.7 Niger400.8%5.4 Afghanistan391.4% 6.9 Source: UNICEF, 2006. The State of the World’s Children. Compiled from Table 2 and Table 6.

19. Low prevalence countries global distribution

20. -5S-4S global distribution High prevalence countries

21. Implications for Geographic focus of the Initiative Global focus for advocacy, policy development and monitoring efforts in 4-8 ‘large’ countries focused on technical collaboration projects in the 15-25 States/Provinces with the majority of underweight children efforts in 10-20 ‘high prevalence’ countries focused on national program development and broad-based operations efforts in 40-50 ‘moderate prevalence’ countries efforts focused on highly targeted operations

22. Applying VAM to child hunger

23. 1.Map areas of high undernutrition 2.Identify potential outreach partners 3.Identify support organizations 4.Strengthen linkages between outreach partners and support organisations Connecting children at risk to community support organizations

24. A ‘live’ mapping and monitoring system is required to support partners in addressing child hunger Administrative boundaries, village locations, census blocks, population estimates Health facility locations, schools, water supply Linked databases for intervention monitoring Partner intervention areas …including:

25. 2.‘delivery system’ and interventions

26. Implications for levels of programming and targeting MDG deadline: 2015 global ensure the sustainable supply of affordable health and nutrition commodities and the delivery of increased financial resources macro integrate child health and nutrition needs into national policies, plans and budgets meso strengthen district and community health and nutrition systems; ensure access to water and sanitation micro: empower families to improve their health,. feeding and childcare practices

27. Available ‘Anti-Hunger’ Interventions for household and school level A. Supplemental Food Interventions B. Non-Food Interventions 1.Base Health & Nutrition Education 2. Micronutrient Supplementation 3. Household Water Treatment 4. Hand-washing Soap 5. Deworming

28. Implications for programming priority: strengthen community capacity to assist families-in-need

29. International Food Aid

30. 100% Hunger Needs - Major components of Ending Child Hunger and Undernutrition Initiative

31. Essential Package Ensure adequate diet HIV prevention Disease Control Water and Sanitation Initiative interventions Complementary interventions State & National Level Micronutrient fortification Birth spacing, safe motherhood and other reproductive health interventions Primary and Secondary Education Immunization ARI and Diarrhoea Treatment Household and School Level Health and Nutrition Education (inc. breastfeeding and growth promotion) Complementary, supplementary and therapeutic feeding Micronutrient Supplementation (inc. Vit. A, Iron and prenatal vitamins) Hygiene promotion Household water treatment Deworming

32. Summary of operational objectives: 1.map areas of high undernutrition 2.identify potential outreach partners 3.support linkages between key levels required to strengthen outreach capacity and deliver an essential package of interventions 4.leverage complementary interventions to the same geographic/demographic focus

33. Summary of operational commitment

34. 3. annual price tag: ongoing costing and resource tracking

35. Estimate 1: the cost of doing nothing economic and social costs and consequences of 50 million child deaths by 2015 due to underlying hunger and undernutrition prospects of achieving other MDGs is significantly jeopardized higher costs of meeting other MDGs, to the extent that they can be met at all without addressing child hunger

36. ‘Rough’ Annual Costs (US$ per household per annum) A. Supplemental Food Interventions (average) ~ 55 B. Non-Food Interventions ~ 55 1.Base Household Health & Nutrition Education 3.8 2. Micronutrient Supplementation 14.4 3. Household Water Treatment4.1 4. Hand-washing Soap~25 5. Deworming7.5 Household Level Total~110 The Cost of a ‘package’ of Household Level Interventions

37. Estimate 2: the cost of doing something: country-specific cost estimates should form basis of global estimate costing exercise should be related to model of Initiative inputs and outcomes collaboration underway with academic and technical organisations and the World Bank to develop consensus on costing parameters requires ongoing engagement of regional and country offices

38. Initial costing parameters base initial costs on Initiative-specific interventions deliverable with existing community infrastructure phase in additional costs of interventions corresponding to anticipated expansion of infrastructure consider limiting estimates to geographic areas corresponding to approximately 80% of undernourished children consider giving higher priority to interventions for children under five include estimates to strengthen technical and managerial capacities for: monitoring and evaluation intervention adaptation and implementation community organization development

39. 4. communications strategy for advocacy: to mobilise political, financial and other resources

40. Successful Efforts to Reduce Child Mortality

41. Less Successful Efforts to Reduce Child Mortality

42. Advocacy Objectives 1.increase awareness and understanding of needs, opportunities and solutions  with an enhanced evidence base and metrics 2.strengthen national policies and programmes  with country-to-country exchange of experience and the promotion of the ‘Three Ones’ in country 3.mobilise adequate resources

43. Advocacy partnership approach create shared ‘brand’, campaign entity and strategy build a broad partnership that will create urgency and maximize outreach – all speaking in a ‘common voice’ keep children and their families at the centre of the message maximize linkages with other relevant campaigns at global and national level, e.g.: Partnership for Maternal, Newborn and Child Health International Alliance Against Hunger Unite for Children Unite Against AIDS Education for All

44. Major audiences (potential partners) policymakers in both developing and industrialized countries including parliamentarians donors and foundations faith-based organizations other international and national civil society NGOs private sector – WEF Regional Process opinion leaders and the media technical and professional organisations goodwill ambassadors and ‘champions’ UN agencies

45. 5. accountability framework: clarifying roles and responsibilities for WFP/UNICEF units and external partners

46. Initiative accountability: country level one agreed action framework that provides the basis for coordinating the work of all partners; one national coordinating authority, with a broad based multi-sector mandate; and one agreed country-level monitoring and evaluation system

47. Initiative accountability: regional level Country-to-country experience exchange for: Political Mobilisation Partner Mobilisation Technical Collaboration Partnerships mapping social marketing monitoring and evaluation costing and resource tracking

48. Initiative accountability: global level annual global reporting of results through adaptation of Progress for Children: A Report Card on Nutrition regular joint reports to Executive Boards of WFP and UNICEF on Initiative progress against milestones explicit integration with WFP and UNICEF Strategic Plans integrated workplans across WFP and UNICEF units with implementation support responsibilities related workplans of Partners Group members to be compiled, monitored and updated annually

49. ‘Light’ Global Level Partnership Process Inclusive Partnership Group with sub-groups for civil society and NGOs, technical collaborators, UN agencies, the private sector, donors, and governments Steering Group of limited size co-chaired by UNICEF and WFP Executive Directors UNICEF-WFP Initiative Team to serve as secretariat to Steering Group and Partners Group – including for workplan development and monitoring

50. Major challenges moving forward commitment to the goal common organisational context with respect to mandate:  bring hunger issues to the centre of the international agenda  advocate policies, strategies and operations that directly benefit the hungry poor clarity of purpose and role in the Initiative capacity and confidence  openness to change  internal and external collaboration (cash)

51. When will the Initiative be Initiated?

52. Upcoming milestones 2006 end JuneWFP Global Staff Meeting consultation Global advocacy and communication strategy prepared mid-JulyConsultation with NGO and private sector partners end JulyReview of draft Plan of Action by multi-agency advisors group end AugustFinal draft of Plan of Action completed SeptemberInformal consultations of WFP and UNICEF Executive Boards NovemberReview and guidance from WFP Executive Board 2007 JanuaryReview and guidance from UNICEF Executive Board Anticipated publication of the Series on Maternal and Child Undernutrition in The Lancet FebruaryConvening of Partners Group and formal adoption of Plan of Action Publication of UNICEF and WFP programme and policy resources on addressing maternal and child undernourishment MarchPublic launch of Initiative

53. 1 st Quarter of 2007