GLOBAL FORUM REPORT LEVERAGING SOCIAL PROTECTION PROGRAMS FOR IMPROVED NUTRITION Report on the Proceedings of the Global Forum on Nutrition-Sensitive Social Protection Programs, 2015 ANDREA L. SPRAY 3 Russian Federation LEVERAGING SOCIAL PROTECTION PROGRAMS FOR IMPROVED NUTRITION Report on the Proceedings of the Global Forum on Nutrition-Sensitive Social Protection Programs, 2015 About the Series This report is part of the Leveraging Social Protection Programs for Improved Nutrition series. The series was created to capture evidence and next steps related to the Global Forum on Nutrition-Sensitive Social Protection Programs held in Moscow in September 2015. The Forum convened over 150 individuals from 20 countries, and the resulting technical agenda is being explored through seminars and other enga- gements. More information at http://www.securenutrition.org/ Documents in the Series Summary of Evidence Prepared for the Global Forum on Nutrition-Sensitive Social Protection Programs, 2015 Compendium of Case Studies Prepared for the Global Forum on Nutrition- Sensitive Social Protection Programs, 2015 Report on the Proceedings of the Global Forum on Nutrition-Sensitive Social Protection Programs, 2015 LEVERAGING SOCIAL PROTECTION PROGRAMS FOR IMPROVED NUTRITION Report on the Proceedings of the Global Forum on Nutrition-Sensitive Social Protection Programs, 2015 ANDREA L. SPRAY © 2016 International Bank for Reconstruction and Development / The World Bank 1818 H Street NW, Washington, DC 20433 Telephone: 202-473-1000; Internet: www.worldbank.org Some rights reserved 1 2 3 4 19 18 18 17 This work is a product of the staff of The World Bank with external contributions. 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Contents Acknowledgments vii Abbreviations ix Executive Summary 1 Global Forum Objectives and Achievements 1 Summary of Lessons Learned 4 Introduction 9 Goals and Objectives 9 Why Nutrition-Sensitive Social Protection? 10 About the Final Report 12 About SecureNutrition 12 Participants 12 Learning Methodology 13 Case Studies & Selection 14 Communications and Knowledge Management 16 Session Summaries 17 Vocabulary 17 Opening & Welcoming Remarks 18 Statement of the Problem & Keynote Address 20 Solutions to Date: Nutrition Programs and Social Protection Programs 24 Creating Synergies: Strengthening Social Protection Programs 27 Way Forward: Implementation of ICN2 Declaration in Terms of Social Protection and Nutrition – BRICS Partnerships 33 Learning from the Field: Case Studies of Nutrition-Sensitive Social Protection Programs 36 What Have We Learned? 42 Closing Remarks 44 Evaluation 46 Annexes 48 Annex 1: Global Forum Objectives and Achievements 49 Annex 2: Lessons Learned 51 Annex 3: Participant List 54 Annex 4: Detailed Program 60 Annex 5: Communications & Knowledge Management Plan 67 Annex 6: Speaker Biographies 72 Annex 7: Vocabulary Quiz Results 81 Annex 8: Working Group Topics & Facilitators 86 Leveraging Social Protection Programs for Improved Nutrition: Report v Annex 9: Experiences of BRICS Countries in the Development of Nutrition- Sensitive Social Protection Programs Brief 88 Annex 10: BRICS Session Summary 94 Annex 11: Evaluation Results 96 Annex 12: Impact Survey Results & Testimonials 99 Notes 102 Tables 1 Case studies included in the Compendium 15 2 Summary of engagement during the 10-day period around the Global Forum 68 3 Impact Summary 99 4 Interest areas 100 vi Leveraging Social Protection Programs for Improved Nutrition: Report Acknowledgments This report was produced by SecureNutrition with funding from the Russian Federation Ministry of Finance. The goal of SecureNutrition is to support World Bank Group (WBG) staff to catalyze and foster increased nutri- tion-sensitive investments and activities across all key underlying drivers of nutrition. SecureNutrition offers: a curated resource library; original events, blogs, and newsletters on multisectoral nutrition linkages; forum space on LinkedIn for community notices and discussion; social media and email dis- semination; and a hub for reaching potential partners and related networks. This report was written by Andrea L. Spray, with support from Laura Figazzolo. Aaron Buchsbaum led on publishing and dissemination. The report would not have been possible without the substantive contributions of so many people who helped in making the Global Forum on Nutrition- Sensitive Social Protection Programs a reality. We extend our thanks to the following international organizations that contributed case studies to the Global Forum and played a crucial role in designing and carrying out the event: Action Contre la Faim (ACF), the Food and Agriculture Organization of the United Nations (FAO), the Government of Indonesia (GOI), Save the Children (SCI), World Bank Group (WBG), the United Nations World Food Programme (WFP), and the WFP Centre of Excellence Against Hunger (WFP COE). The Global Forum organizing team was led by Andrea L. Spray, with sup- port from Julia Komagaeva, Aaron Buchsbaum, Mario Mendez, Laura Figazzolo, Larisa Fugol, Marina Vasilieva, and Monika Gutestam (all WBG). The program design benefitted immensely from the expertise of consultant Stephen J. Atwood, who also functioned as the Global Forum facilitator. Thank you to keynote speaker, Harold Alderman (IFPRI), and to all pre- senters and panelists, including: Daniel Balaban (WFP COE), Christina Behrendt (ILO), Andrey Bokarev (Russian Federation), Joao Breda (WHO), Maria Margarita Cedeño Lizardo (Dominican Republic), Thando Dalamba (South Africa), Arnoldo de Campos (Brazil), Boitshepo Bibi Giyose (FAO), Iain MacGillivray (IFAD), Sanjay Mahendru (India), Menno Mulder-Sibanda (WBG), Anna Y. Popova (Russian Federation), Carlo Scaramella (WFP), Meera Shekar (WBG), Vyacheslav Smolenskiy (Russian Federation), Josefina Stubbs (IFAD), Rob Vos (FAO), Natalia Winder Rossi (FAO), and Ruslan Yemtsov (WBG). Special thanks also goes to Souleikha Jama Mouhamed (Djibouti), Doddy Izwardy (Indonesia), Yolanda Zuniga (Peru), and Ali Mory Maidoka (Niger), who delivered “program snapshot” presentations. Special appreciation goes to Pratiwi Ayuningtiyas (GOI), Dominique Debonis (WFP), Charlotte Dufour (FAO), Nicola Hypher (SCI), Vinicius Limongi (WFP COE), Julien Morel (ACF), Ahmed Raza (FAO), Katherine Richards (SCI), Matthew Tasker (SCI), and Kerina Zvogbo (SCI). From WBG, we are grateful to the Task Team Leaders (TTLs) and other supporting staff and consultants, whose projects were featured at the Global Leveraging Social Protection Programs for Improved Nutrition: Report vii Forum and who were generous in their time and effort in the compilation of the case studies. The tireless work of the TTLs, as well as their country count- er-parts, is documented here, including: Lucy Basset (Social Protection Specialist), Laura Campbell (Consultant), Luisa Fernandez Delgado (Senior Poverty Specialist), Kevin Hempel (Consultant), Francesca Lamanna (Senior Economist), Philippe George Leite (Senior Social Protection Economist), Stefanie Koettl–Brodmann (Senior Economist), Iftikhar Malik (Senior Social Protection Specialist), Alessandra Marini (Senior Economist), Muderis Abdulahi Mohammed (Senior Social Protection Specialist), Michael Mutemi Munavu (Social Protection Specialist), Carlo del Ninno (Senior Economist), Aleksandra Posarac (Program Leader), Patrick Premand (Senior Economist), Aneeka Rahman (Senior Social Protection Economist), Maria Concepcion Steta Gandara (Senior Social Protection Specialist), Ali Winoto (Health Specialist), and Robert Wrobel (Senior Social Development Specialist). We also thank the Practice Managers in the Social Protection & Labor Global Practice, without whose support we could not have completed this work. Special thanks goes to Jehan Arulpragasam (Practice Manager). Thanks must also go to Global Forum attendees, in addition to those already mentioned, who contributed as working group facilitators, including: Oumar Barry, Elena Bolotnikova, Christiani Buani, Karim Hussein, Lynnda Kiess, Arlene Mitchell, Hideki Mori, Militezegga Abduk Mustafa, Holly Sedutto, Jeremy Shoham, and Christina Tirado. We also extend thanks to all participants of the Global Forum on Nutrition-Sensitive Social Protection Programs, whose valuable contributions are documented in this report, and to WBG staff in Moscow, for their support in making a successful event. Thanks also go to the numerous interpreters who provided an invaluable ser- vice in making the cross-cultural knowledge exchange possible. Finally, the team wishes to acknowledge and appreciate the work being done every day by countless practitioners and volunteers in countries around the globe to imple- ment nutrition-sensitive social protection programs and improve the lives and livelihoods of the most vulnerable. The SecureNutrition team is grateful to the Russian Federation for their leadership in advancing the role of nutrition-sensitive social protection in comprehensive and integrated solutions to eliminating poverty and promot- ing shared prosperity. In funding this work, they are providing a platform for discussion, cooperation, and consensus building among global partners and stakeholders. The work was conducted under the guidance of Leslie Elder (TTL and Senior Nutrition Specialist), Nicole Klingen (Practice Manager), Olusoji O. Adeyi (Director), and Tim Evans (Senior Director). viii Leveraging Social Protection Programs for Improved Nutrition: Report Abbreviations ACF Action Contre la Faim ANC Antenatal Care BCC Behavior Change Communication BRICS Brazil, Russia, India, China &South Africa DBM Double Burden of Malnutrition DFATD  Department of Foreign Affairs, Trade and Development (Canada) DfID Department for International Development (UK) ECA Europe & Central Asia Region ECD Early Child Development ENN Emergency Nutrition Network FAO Food and Agriculture Organization of the United Nations GOI Government of Indonesia HNP Health, Nutrition & Population ICDS Integrated Child Development Services (India) ICN2 Second International Conference on Nutrition IFAD International Fund for Agriculture Development IFPRI International Food Policy Research Institute ILO International Labour Organization IO International Organization IYCF Infant and Young Child Feeding M&E Monitoring & Evaluation MDGs Millennium Development Goals MIS Management Information System MOU Memorandum of Understanding NCDs Non-Communicative Diseases NGO Non-Governmental Organization PLW Pregnant and Lactating women SBCC Social Behavior Change Communication SCI Save the Children International SDGs Sustainable Development Goals SIFI Social and Industrial Foodservice Institute (Russia) SPL Social Protection & Labor SUN Scaling Up Nutrition Global Movement TTL Task Team Lead UN United Nations WASH Water, Sanitation & Hygiene WBG World Bank Group WFP United Nations World Food Programme WFP COE WFP Centre of Excellence Against Hunger WHO World Health Organization WVI World Vision Leveraging Social Protection Programs for Improved Nutrition: Report ix Executive Summary The Global Forum on Nutrition-Sensitive Social Protection Programs, co-hosted by SecureNutrition and the Russian Federation Ministry of Finance, was held in Moscow, Russia on the 10th and 11th of September, 2015. The event drew approximately 150 participants from over twenty countries, and provided a space for in-depth conversations anchored to country case studies that featured programs integrating social protection instruments and nutrition principles. The role of effective nutrition-sensitive social protection programs has been increasing, and the current global development agenda calls for the profile of nutrition to be raised by ensuring strong leadership and commitment at all levels and across multiple sectors. Partnerships are playing an increasingly important role in the development of assistance architecture. The Global Forum on Nutrition-Sensitive Social Protection Programs (Global Forum) aimed to support these efforts by contributing to the evidence base for policy options and operational actions. Global Forum Objectives and Achievements (See also: Annex 1) 1. Better understand existing needs of countries to assist them in setting up well-functioning nutrition-sensitive social protection programs. The Global Forum was anchored to a series of country case studies com- piled especially for the event.1 The case studies were the focus of two work- ing group sessions aimed at facilitating a critical review of how the programs work. All case studies followed a template that was designed to highlight key aspects of social protection programming, approaches to improving nutrition, and, where possible, impacts and challenges. The case studies featured programs implemented by a range of government agencies, donors, and partners, and represented a variety of social protec- tion instruments and strategies for integrating nutrition principles span- ning all global regions. Four of the case studies were selected for “program snapshot” presentations during the Global Forum, which highlighted key cross-cutting themes.2 2. Support countries in catalyzing, building commitment for, designing, establishing, managing, and scaling up nutrition-sensitive social pro- tection programs through providing technical assistance and capacity development to governments. The Global Forum was designed to convey the synergistic potential of nutrition-sensitive social protection. In an evaluation immediately fol- lowing the event (Annex 11), the vast majority of participants (91 per- cent) reported that the Global Forum provided new information, insights and approaches, including exposure to new nutrition terminology and examples of nutrition-sensitive social protection programs. Most Leveraging Social Protection Programs for Improved Nutrition: Report 1 participants also reported their intention to share what they learned with colleagues (85 percent) and use it to inform future nutrition-sensitive social protection program design and implementation (84 percent). In a follow-up survey conducted eight months after the Global Forum (Annex 12), all respondents (20) reported to have shared information gained from the event with colleagues in their organization; 81 percent shared information with colleagues outside of their organization; 81 percent reported to have led or supported training on nutrition-sensitive social protection; 92 percent reported to have used resources learned about or received at the Global Forum in their work; and 85 percent reported to have learned information or approaches that made an impact on their work at the country level. 3. Disseminate best policies and practices and innovative approaches in the area of social protection systems linking food security and nutri- tion, poverty reduction, and agricultural production. Learning from the Global Forum is captured in the three-part series Leveraging Social Protection Programs for Improved Nutrition,3 which includes a Summary of Evidence, a Compendium of Case Studies, and a Forum Report (this document). The Summary of Evidence addresses “the why” for nutrition-sensitive social protection programs, and the Compendium addresses “the how.” All materials from the Global Forum (e.g. resource library, keynote addresses, and program snapshot presenta- tions) were provided to attendees on a USB thumb drive, are available on the SecureNutrition website (www.securenutrition.org), and have been shared through newsletters, seminars, and other fora. 4. Improve access to knowledge and build awareness related to nutri- tion-sensitive social protection through presentation of existing inter- national initiatives, knowledge platforms and tools, including the SecureNutrition Knowledge Platform. The Global Forum catalyzed the compilation of a curated library of resources on nutrition-sensitive social protection, which was provided to participants on a USB thumb drive and made available on the SecureNutrition website (www.securenutrition.org). In conjunction with the Global Forum in Moscow, the FAO Global Forum on Food and Nutrition Security and SecureNutrition cohosted a multilingual online discussion4 that explored key questions related to nutrition-sensitive social protection. Finally, the Global Forum and its associated reports, discussions, and knowledge products formed the foundation for the SecureNutrition nutrition-sensitive social protection seminar series, open to all and accessible globally through web streaming. Global Forum attendees were invited to subscribe to the SecureNutrition monthly newsletter and discussion group to keep up with knowledge products and events. Attendees and other partners were invited to share experiences and resources through SecureNutrition’s dis- semination channels (http://www.securenutrition.org/community). 5. Facilitate South-South and Triangular Cooperation and exchange of experience and lessons learned among countries, allowing them to 2 Leveraging Social Protection Programs for Improved Nutrition: Report identify their own pathways in developing nutrition-sensitive social protection programs specific to their national needs. The participatory format of the Global Forum—based almost entirely on working groups and discussions—facilitated the sharing of diverse expe- riences beyond the 21 selected case studies. The BRICS session focused on lessons in overcoming malnutrition and increasing economic growth (Annex 9) in Brazil, Russia, India, China, and South Africa; this may be particularly instructive for other low- and middle-income countries. A variety of working group and discussion formats were used, recog- nizing that all attendees had experiences to share and could equally learn and teach. The open format and short rotations enabled participants to choose for themselves the examples and topics most relevant to their own country context or interests. Financial support from the Russian Federation enabled approximately 150 participants to attend from over 20 countries, and the provision of simultaneous interpretation in six lan- guages for all Global Forum proceedings ensured that all attendees could participate in a meaningful fashion. 6. Enhance coordination and cooperation among development partners and international organizations to harness the resources of a diverse range of actors involved in nutrition-sensitive social protection programs. Attendees of the Global Forum included high-level government officials, program managers, researchers, and technical practitioners. Multilateral and bilateral donors, United Nations agencies, research and academic institutions, international and local non-governmental organizations, the private sector and, most importantly, country representatives from gov- ernment agencies in low- and middle-income countries, were all repre- sented. Attendees noted the value of participating in such a unique gathering across agencies, sectors, countries, and languages to share experiences and learn from each other. Feedback from an evaluation immediately following the event (Annex 11) and eight months after the Global Forum (Annex 12) suggest that attendees have made use of the information learned and relationships built. The Global Forum provided a platform for fostering dialogue and relationships than can be drawn upon for years to come. 7. Promote engagement of all-interested stakeholders, including govern- ments, private sector, civil society, NGOs, international and regional organizations, and other development partners in designing and implementing nutrition-sensitive social protection programs. The Global Forum leveraged the convening power of WBG and partner organizations to generate awareness around nutrition-sensitive social protection, and its potential for catalyzing individual and national growth and development. As participation at the Global Forum in Moscow was necessarily limited, a multifaceted social media and com- munications campaign was undertaken—in collaboration with part- ners—to engage the broader community of practitioners and other stakeholders (Annex 5). Leveraging Social Protection Programs for Improved Nutrition: Report 3 Summary of Lessons Learned (See also: Annex 2) Progress has been inadequate compared to the Millennium Development Goals (MDGs), and the post-2015 Sustainable Development Goals (SDGs) will similarly challenge the global community. Evidence shows that improved nutrition is a driver of economic growth and that increasing income alone is insufficient to improve nutrition outcomes. Therefore, specific action is required if the global nutrition targets and other SDGs are to be achieved. Experiences highlighted in the Global Forum underline how remarkable progress against poverty and malnutrition is possible with sufficient political will, no matter the context-specific constraints. Political commitment In most cases, progress has only been possible through government owner- ship, continuous political commitment to pro-poor and nutrition objectives in social protection programs, and the coordination of policies and programs at national and local levels. Basic challenges to leveraging social protection investments for nutrition include limited resources and lack of financial sus- tainability. Low-income countries have a large number of vulnerable people, but domestic resources are often insufficient to provide a meaningful amount of transfer to the entire population in need. Prioritization is politically diffi- cult, and there are trade-offs associated with targeting the nutritionally vul- nerable that affect the overall social protection portfolio (e.g. covering the first 1,000 days versus other groups among the poor).5 More work is needed to enhance the evidence base on the impact of nutrition-sensitive social pro- tection and support the design of effective strategies for the most efficient use of public resources. Governments should be held accountable for commitments made regard- ing nutrition and social protection (e.g. at the Second International Conference on Nutrition, or ICN2). It is key to listen to—and involve more—the minis- ters of finance and other authorizing entities. While a strong economic case can be made for nutrition-sensitive social protection,6 some countries (e.g. South Africa) have made great strides using a rights-based approach, codified in legal and normative frameworks. While there is general consensus that increased government financing is crucial, and several mechanisms for gen- erating sufficient resources are available, strategies for making programs financially sustainable require further exploration. Partnership Despite a general consensus that partnership and collaboration in tackling poverty and malnutrition are instrumental for achieving global development targets, the attendees agreed that stakeholders rarely have the opportunity to come together across agencies, sectors, and countries to share experiences from the field and understand their unique perspectives. The results of the Global Forum evaluation indicate that the participants gained valuable insights and awareness of opportunities for partnership. However, given the 4 Leveraging Social Protection Programs for Improved Nutrition: Report current economic climate, global partners need low-cost, high impact plat- forms for sharing experience and knowledge. This will further develop the competency required to effectively advocate for, design, and implement nutri- tion-sensitive social protection programs. Global challenges The challenges inherent to simultaneously tackling poverty and malnutrition in a rapidly evolving program landscape are immense. Rates of stunting remain stubbornly high, while rates of overweight/obesity, which accompany economic growth, are rising. The result, in many countries, is a double bur- den of malnutrition (DBM). Climate change, conflict, and other crises are exacerbating the underlying drivers of undernutrition, while at the same time the global extent of food waste is staggering. Achieving accelerated progress in reducing poverty and malnutrition between now and 2030 will be harder than it has been to date. It will require reaching extremely vulnerable popula- tions living in remote or hard-to-reach locations, many of whom are indige- nous, illiterate and/or otherwise unaccounted for in national registries. To achieve scale and reach the last mile will involve, at minimum, overcoming severe infrastructure and capacity constraints, and ensuring the availability, standardization, and quality of nutrition services. Country governments need strategies for designing nutrition-sensitive social protection interventions that can be scaled up (or down) in response to crises and other changing conditions. Program design and delivery Where poverty is a leading driver of malnutrition, nutrition-sensitive social protection programs are warranted. Synergies do not come automatically, however. Social protection program design and delivery needs to be trans- formed to improve nutrition and other child development outcomes. Each country’s development and nutrition situation is unique, and among Global Forum participants there was general agreement that there is no one-size-fits- all nutrition-sensitive social protection solution. The design of nutrition-sen- sitive social protection interventions—including determining which social protection instrument is best suited to improving nutrition outcomes—must come from the countries themselves, with careful consideration and under- standing of the local context, capacities, and constraints. Designing smart and context-specific nutrition-sensitive social protection programs requires imbedding technical support from both social protection and nutrition specialists. The Global Forum highlighted two distinct path- ways by which nutrition-sensitive social protection There is no one-size-fits-all programs have derived. Some programs were origi- nally designed to put a social protection system in nutrition-sensitive social place, but over time have added components and protection solution. evolved to become nutrition-sensitive. As evidenced through many case studies and experiences shared at Leveraging Social Protection Programs for Improved Nutrition: Report 5 the Global Forum, sometimes even small enhancements to existing programs can go a long way to improving impacts on nutrition outcomes. Other pro- grams were designed from the start to be nutrition-sensitive. The experiences, challenges, and evolution of these two sets of programs are different. Multisectoral collaboration Poverty and malnutrition are multidimensional and require a multisectoral approach, with all actors working in coordination to support national strate- gies, policies, and programs. There is much to be gained synergistically by integrating social protection and nutrition interventions. Adopting a sys- tems approach—aligning with other complementary sector policies and pro- grams—and linking delivery to nutrition-specific and other relevant programs can enhance impact. For example, social protection instruments can be lever- aged to drive inter-sectoral coordination and increased demand for nutrition services. This can be achieved through hard conditionalities (when services are available), soft conditionalities, and/or creating effective linkages between social protection and nutrition interventions (e.g. geographic overlap of ser- vices, nutrition messaging, use of pay points to provide nutrition education, etc.). This approach pushes governments to provide better quality services. Despite general consensus that nutrition is not the purview of any one sec- tor, and that cross-sectoral collaboration is therefore crucial, integrating all of the numerous relevant sectors (e.g. reproductive health and family planning, WASH, child development, education, agriculture, etc.) is challenging. Often there are no mechanisms to facilitate it, especially in the context of decentral- ized governance. To be effective, multisectoral collaboration requires policy coherence, clear institutional arrangements, and interoperable information systems (i.e. databases that can “talk” to one another and follow shared pro- tocols) to facilitate communication and engage key actors. Efforts to improve the nutrition sensitivity of social protection programs also need to be comple- mented by wider policy reforms to address the root causes of poverty, improve the quality and scale of healthcare, education and other basic services, and promote social equity and inclusion. Solutions Despite widely varying conditions, many challenges are shared across countries and, as the Global Forum Global Forum participants evidenced, there is a wealth of knowledge, best prac- frequently cited the tices, and experience from which to draw. For exam- significant potential of mass ple, many African countries are now using community-based, nutrition-focused accompanying media and social media, measures, aimed at increasing the awareness of good especially channels that health, nutrition, and childcare practices among leverage new technologies, social protection beneficiaries. In addition, Global Forum participants frequently cited the significant for the dissemination of potential of mass media and social media, especially nutrition messages. channels that leverage new technologies, for the 6 Leveraging Social Protection Programs for Improved Nutrition: Report dissemination of nutrition messages and communication on changes in social behavior. To scale up in times of crisis, programs must address not only the pressing needs of the family, but also the very specific nutritional needs of the young child. The Global Forum proceedings also frequently cited the impor- tance of community engagement and participation. Finally, the substantial money, resources, and time invested in school feed- ing programs is being better leveraged to provide a complete package, trans- forming from simply a schooling incentive to comprehensive programs for nutrition enhancement. School feeding programs can be used as a vehicle for micronutrient supplementation, deworming, and nutrition education. This can include addressing overweight/obesity by introducing better diets (e.g. more fruits and vegetables) and providing childcare and parenting messages that both female and male There is much we know adolescents will need in the next phase of their life. It about what works. The can also act as an entry point to promote nutri- Global Forum proceedings tion-sensitive agriculture among local producers and/or those that supply these programs. note several evidence-based There is much we know about what works. The approaches that can work if Global Forum proceedings note several evi- appropriately employed. dence-based approaches that can work if appropri- ately employed. These include: • prioritizing nutritionally vulnerable populations (i.e. targeting on the first 1,000 days); • disbursing transfers to women to increase the likelihood that they will be spent in a nutrition-sensitive way; • providing adequate and regular payment of benefits; • promoting the use of nutrition, health, and other human capital building services using conditionalities—either hard or soft—in how transfers are delivered or used; • creating effective linkages between programs targeting the same beneficiaries; • linking programs with nutrition-sensitive agriculture and food systems; • ensuring the adequate supply of quality nutrition services; • incorporating nutrition education and behavior change communication (BCC) to provide mothers and other caregivers with appropriate and timely information to help them make nutrition-relevant choices; and, • measuring nutrition results and monitoring nutrition impact to inform program design and improve quality. Knowledge gaps However, operational knowledge gaps are numerous. Those noted in the Global Forum include: the scale-up of social safety nets that respond to the negative effects of crises on the nutritionally vulnerable; bridging emergency response and social protection; strengthening resilience; and designing for climate change. While we know that the first 1,000 days is the most Leveraging Social Protection Programs for Improved Nutrition: Report 7 cost-effective window of opportunity to intervene for nutrition, effective strategies for reaching adolescent girls and women before pregnancy are gen- erally lacking. In addition, current understanding of the design and imple- mentation ingredients that make nutrition impacts possible is weak, and measuring the impact of nutrition-sensitive interventions is challenging. More work is needed to understand how to ensure that investments in cash transfers and other social protection instruments contribute to nutrition out- comes. Further work is also required to understand the amount of investment required to achieve nutrition behavior change, and to quantify their relative cost-effectiveness. Global Forum proceedings highlighted the unique potential for social pro- tection to play a catalytic role in motivating effective multisectoral collabora- tion mechanisms. It can also link social and human development policies and WASH with economic development, investments in agriculture and food sys- tems, and women’s empowerment. However, there are gaps in realizing effec- tive multisectoral collaboration. These include identifying new and innovative ways for operationalizing linkages between social protection and nutrition, for example taking advantage of strong case management systems of social workforces in many countries. Strategies for sustaining gains achieved by those who have escaped poverty are also needed to prevent them from falling back into poverty, and to improve their resilience. Finally, although gender and women’s empowerment are identified as key themes across case studies, operational mechanisms to address them through social protection for the betterment of nutrition outcomes seem limited. Conclusion The Global Forum has strengthened the capacity among technical practi- tioners to advocate for, and increase the effectiveness of, nutrition-sensitive social protection programs in their respective countries. It achieved this through sharing, and providing dialogue on, evidence and operational expe- riences from around the world. The unique opportunity and substantive for- mat provided by the forum held the attention of participants over two full days of activities, culminating in a foundation to continue building experi- ence and expertise in nutrition-sensitive social protection programs worldwide. 8 Leveraging Social Protection Programs for Improved Nutrition: Report Introduction The Global Forum on Nutrition-Sensitive Social Protection Programs, co-hosted by SecureNutrition and the Russian Federation Ministry of Finance, was held in Moscow, Russia on the 10th and 11th of September, 2015. The event drew approximately 150 participants from over 20 countries, and pro- vided a space for in-depth conversations, anchored in country case studies, on integrating social protection instruments and nutrition principles. Goals and Objectives The role of effective nutrition-sensitive social protection programs has been increasing, and the current global development agenda calls for the profile of nutrition to be raised by ensuring strong leadership and commitment at all levels and across multiple sectors. Partnerships are playing an increasingly important role in developing assistance architecture. The Global Forum on Nutrition-Sensitive Social Protection Programs (Global Forum) aimed to support these efforts by contributing to the evidence base for policy options and operational actions. Specifically, the Global Forum aimed to achieve the following seven objectives: Leveraging Social Protection Programs for Improved Nutrition: Report 9 1. Better understand the existing needs of countries to assist them in setting up well-functioning nutrition-sensitive social protection programs. 2. Support countries in catalyzing, building commitment for, designing, establishing, managing, and scaling up nutrition-sensitive social protec- tion programs through providing technical assistance and capacity devel- opment to governments. 3. Disseminate best policies and practices and innovative approaches in the area of social protection systems linking food security and nutrition, pov- erty reduction, agricultural production. 4. Improve access to knowledge and build awareness related to nutrition-sen- sitive social protection through presentation of existing international ini- tiatives, knowledge platforms and tools, including the SecureNutrition Knowledge Platform. 5. Facilitate South-South and Triangular cooperation and exchange of expe- rience and lessons learned among countries, allowing them to identify their own pathways in developing nutrition-sensitive social protection programs specific to their national needs. 6. Enhance coordination and cooperation among development partners and international organizations in to harness the resources of a diverse range of actors involved in nutrition-sensitive social protection programs. 7. Promote engagement of all-interested stakeholders including govern- ments, private sector, civil society, NGOs, international and regional organizations, and other development partners in designing and imple- menting nutrition-sensitive social protection programs. The achievements against these objectives are catalogued in Annex 1. The Global Forum built on the ICN2 side-event, “Transition from Safety Net Programs to Comprehensive Social Protection Systems: Food Security and Nutrition Perspective,” which was also co-hosted by SecureNutrition and the Russian Federation in November 2014.7 Why Nutrition-Sensitive Social Protection? Among other objectives, the Global Forum aimed to clarify the basic concepts related to the design and delivery of nutrition-sensitive social protection pro- grams, including the relationship between nutrition-specific and nutrition-sen- sitive interventions. Nutrition-specific interventions focus on the immediate causes of malnutrition (inadequate dietary intake and disease); Nutrition- sensitive interventions focus on its underlying and basic causes (e.g. food secu- rity, care practices, the disease environment, and access to health services). There is a globally recognized package of cost-effective nutrition-specific interventions spanning the first 1,000 days, from conception through a child’s first 24 months. These interventions are by-and-large delivered through the health sector, but can also be delivered through social protection programs. They include the promotion of an adequate and diverse diet, supplementation and fortification with essential micronutrients, and the management of 10 Leveraging Social Protection Programs for Improved Nutrition: Report moderate and severe acute malnutrition. However, this core package—even if scaled up to 90 percent coverage in countries with a high burden of undernu- trition—would result in a decrease of only 20 percent in global stunting. This is insufficient to achieve the global nutrition targets of the SDGs.8 More can be done to improve the coverage of nutrition-specific interven- tions. To this end, the underlying factors driving nutrition outcomes must be addressed simultaneously. These underlying determinants of nutrition status are multisectoral—with links to agriculture, social protection, health, water, sanitation and hygiene, and education—so the interventions to address them must be multisectoral too. Social protection is inherently nutrition-sensitive in the extent that it targets families at risk of malnutri- tion. As of the end of 2015, 1.9 billion people were enrolled in social safety net programs in 136 countries, and the share of government expenditures devoted to social protection in low- and middle-income countries relative to other sectors is currently growing.9 The preponderance and scale of social protection budgets, and the potential for social protection programs to tar- get the most vulnerable (the poor and infants within the 1,000-day nutrition window of opportunity),10 together increase the potential for improving nutrition outcomes. There are obvious synergies from combining better access to health and nutrition services with other benefits of social protection coverage: higher incomes, better access to education, greater awareness, and enhanced agency and participation, especially among women. The pathways by which social protection programs can address the underlying determinants of malnutri- tion are fairly well understood.11 Families choose whether and how to invest in health and nutrition, based on their knowledge and preferences, their income, and the price of inputs into health. Health and nutrition outcomes also depend on the available resources (such as nutritious foods and health services), the level of investments (the amount spent purchasing nutritious foods, health services, and clean water) chosen by the household, and the skills of the household in using the chosen resources. Social protection as a platform provides the opportunity to manipulate these inputs to promote improved nutrition outcomes. A number of nutrition-sensitive social protection instruments are available worldwide. For example, the early success of conditional cash transfer pro- grams12 turned attention to other social protection instruments, including public works, in-kind transfers, and unconditional cash transfers. These can be leveraged to achieve greater results for nutrition, for example by targeting nutritionally vulnerable groups (e.g. pregnant and lactating women), or by combining with nutrition education and behavior change or other accompa- nying measures. Other strategies for incorporating nutrition principles are also being deployed that are specific to each social protection instrument and country context. There has been a proliferation of nutrition-sensitive social protection pro- grams in recent years, many of which are rigorously monitored and evaluated. While there have been no pure successes, there have been a lot of experiences and lessons from which all stakeholders can learn. Leveraging Social Protection Programs for Improved Nutrition: Report 11 About the Final Report SecureNutrition developed this Final Report with funding from the Russian Federation. The Final Report is intended to augment the World Bank’s guid- ance on improving nutrition through multisectoral approaches. It will inform ongoing and future efforts by all development partners to improve nutrition outcomes through investments in the social protection sector. The report aims to summarize the proceedings of the Global Forum on Nutrition-Sensitive Social Protection Programs, with the intention of helping technical practitioners at WBG and elsewhere involved in the design and implementation of nutrition-sensitive social protection projects. It aims to provide access to information about the types of interventions being carried out, what works, the achievements that can be realized, and the challenges involved. As a summary of the proceedings of the Global Forum, the Final Report is not necessarily representative of all partners, nor is it intended to be a comprehensive review of all issues or evidence on the topic. The Final Report will be disseminated and made available on the SecureNutrition website (www.securenutrition.org) as one of a suite of knowledge products, which include the Summary of Evidence and Compendium of Case Studies. About SecureNutrition SecureNutrition works to bridge the operational knowledge gaps between nutri- tion and its underlying drivers. SecureNutrition offers: a curated resource library; original events, blogs, and newsletters on multisectoral nutrition linkages; a forum space on LinkedIn for community notices and discussion; social media and email dissemination; and a hub for reaching potential partners and related networks. Participants For at least the past two decades, work has been under- taken to understand how to maximize the impact of These transformative works investments in social protection for nutrition. The evi- have led to the development dence in support of nutrition-sensitive social protection was summarized in WBG’s seminal 2013 report of a number of initiatives in “Improving Nutrition through Multisectoral Approaches” social protection for achieving (http://www.securenutrition.org/resources/improv- nutrition objectives, as ing-nutrition-through-multisectoral-approaches) (the “guidance notes”). Since then, numerous publications evidenced by the increase from other development partners have been produced, in the number of countries further exploring the connections between social protec- implementing nutrition- tion and nutrition and the components (such as condi- sensitive social protection tionality, targeting, payment beneficiary and frequency) that can be leveraged to increase the effect on nutrition programs. outcomes.13 These transformative works have led to the development of a number of initiatives in social 12 Leveraging Social Protection Programs for Improved Nutrition: Report protection for achieving nutrition objectives, as evidenced by the increase in the number of countries implementing nutrition-sensitive social protection pro- grams. The Global Forum aimed to build upon this sizeable work and catalyze substantive dialogue—through peer learning and exchange of experiences—on “the how” of implementing nutrition-sensitive social protection programs in diverse country contexts, among people working on the front line. To bridge the gap between the two sectors (nutrition and social protection) and identify how, by working together, the strengths of each could be maxi- mized, it was key to bring together participants across the spectrum—both those with deeper knowledge on the nutrition side and those with deeper knowledge on the social protection side. It was also important that partici- pants had at least some experience in delivering nutrition-sensitive social protection programs at the country level. Attendees included high-level gov- ernment officials, program managers, researchers, and technical practitioners. They represented multilateral and bilateral donors, United Nations agencies, research and academic institutions, international and local non-governmen- tal organizations, the private sector and, most importantly, country represen- tatives from government agencies in low- and middle-income countries. Country representatives were supported to participate in the Global Forum proceedings in a meaningful way, including complete financial and logistical assistance and simultaneous interpretation provided for all sessions. Based on the make-up of the participants, the supported languages were Arabic, English, French, Portuguese, Russian, and Spanish. Participants from low- and low-middle income countries were prioritized for financial support. The organizations represented included: ACF, CARE, Al-Ikhaa, DFATD, DfID, ENN, FAO, GIZ, Global Child Nutrition Foundation, IFAD, IFPRI, ILO, SIFI, SCI, SUN, University of California Los Angeles, WBG, WFP, WFP COE, WHO, and WVI. The Countries represented included: Armenia, Bangladesh, Brazil, Costa Rica, Djibouti, Dominican Republic, Ethiopia, France, Haiti, India, Indonesia, Kenya, Kyrgyzstan, Madagascar, Mali, Mexico, Mozambique, Niger, Peru, Philippines, Russian Federation, South Africa, Sweden, Syria, Tanzania, The Gambia, and Zambia. A list of the Global Forum attendees is available in Annex 3. Learning Methodology The Global Forum program was developed collaboratively between SecureNutrition, the Russian Federation Ministry of Finance, WBG’s SPL and HNP Global Practices, and other international partners including FAO, WFP, and IFAD. It was designed with the aim of conveying—through engage- ment-oriented learning methodologies14—the synergistic potential of nutri- tion-sensitive social protection, progressing from (i) problem statement to (ii) summary of current evidence base to (iii) experience-sharing to (iv) prob- lem-solving, and finally to (v) synthesis. Leveraging Social Protection Programs for Improved Nutrition: Report 13 The Global Forum aimed to balance the need to provide sufficient time for both deep learning and networking to occur, to retain engagement over the two days. A variety of working group and discussion formats were used, in recogni- tion of the fact that all attendees had experiences to share and could equally learn from each other. Only one session utilized conventional lectern-style pre- sentations. Interspersed through the program were four “program snapshots,” which were brief (ten minute) presentations that highlighted the key cross-cut- ting themes identified in advance from the Compendium of case studies.15 Over a third (35 percent) of the attendees had an active role in carrying out Global Forum proceedings, as either presenters, panelists, or expert facilita- tors; the essence of the Global Forum was the substantive contributions of the attendees themselves. A detailed program of the Global Forum is available in Annex 4. Case Studies & Selection The proceedings of the Global Forum were deeply anchored in the sharing of country experiences in nutrition-sensitive social protection. Countries and international organizations were solicited to contribute case studies to the Compendium using a standard template. The case study template was designed to highlight the key aspects of selected individual social protection programs, identifying their different approaches to improving nutrition and, where possi- ble, their effects and challenges. Although the compendium case studies could not describe in detail all aspects of each program, they aim to present sufficient information and, in an organized fashion, to describe what is possible and how to achieve it. Each case study was comprised of the following sections: • Program Overview. The main characteristics of the program, including the country, budget, duration, target groups, number of beneficiaries targeted and reached, funding and implementing agencies, and cross-cutting themes. • Context Overview. The specific context the program has been designed to address, both the overall country setting and the nutrition situation. This includes the respective country context, social protection data, and nutrition/health data. • Program Details. The program’s components, costs, transfer level, denomination, frequency, and duration. In the case of public works, it also includes the main tasks and working time. In the case of food trans- fers, it details whether food procurement relies on local producers. This section also covers institutional and implementation arrangements, issues of scalability and sustainability, and community participation. • Monitoring and Evaluation. A description of how M&E is carried out, the specific indicators used, a summary of key findings from available evaluation, and harmonization with other programs. • Nutrition-Sensitive Rationale. A description of the pathways leveraged to make the program nutrition-sensitive (either explicitly designed to improve nutrition outcomes or not), including: the promotion of income 14 Leveraging Social Protection Programs for Improved Nutrition: Report TABLE 1  Case studies included in the Compendium Africa Cabo Verde National School Food and Nutrition Programme Ethiopia Productive Safety Net Program Kenya Cash Transfers for Orphans and Vulnerable Children Mali Emergency Safety Nets Project (Jigisèmèjiri) Niger Niger Safety Net Project Nigeria Child Development Grant Program Republic of Congo Nutrition-Sensitive Urban Safety Net Program Tanzania Tanzania Productive Social Safety Net East Asia & Pacific Indonesia PNPM Generasi Program Indonesia Program Keluarga Harapan (PKH) Prestasi Myanmar Tat Lan Program: Maternity Cash Transfer Pilot Philippines Philippines Social Welfare Development and Reform Project Europe & Central Asia Kyrgyz Republic Optimizing Primary School Meals Programme Latin America & the Caribbean Brazil National School Feeding Programme Dominican Republic Progresando Con Solidaridad Haiti Kore Lavi Mexico Mexico Program of Social Inclusion PROSPERA Peru Juntos Results for Nutrition SWAp Middle East & North Africa Djibouti Social Safety Net Project Syrian Arab Republic Fresh Food Vouchers for Pregnant & Lactating Internally Displaced Women South Asia Bangladesh Income Support Program for the Poorest and consumption, caring, and health practices and services; targeting nutritionally vulnerable populations; accommodating women’s needs; and the use of nutrition indicators. • Accomplishments and Challenges. In combining social protection and nutrition objectives. • Further References. Provides links to relevant program documents or contact staff for further information on the intervention. Out of the 79 eligible case studies reviewed (35 from WBG and 44 submit- ted from other international organizations and governments), 21 were selected for inclusion in the Compendium. For WBG case studies, the Global Forum core team first identified pipeline, active, and recently closed social protection projects that included a nutrition component. Practice Managers then made a determination regarding which projects would be prioritized for inclusion in the Compendium from a regional perspective. For non-WBG case studies, each lead international organization or government used its own processes to decide which project to submit for consideration. The Global Leveraging Social Protection Programs for Improved Nutrition: Report 15 Forum core team screened these submissions for concurrence with nutri- tion-sensitive social protection principles, as described by WBG in the 2013 Improving Nutrition through Multi-Sectoral Approaches Guidance Notes. The Final selections (Table 1) were made with the intention of providing a com- prehensive representation of social protection instruments and mechanisms for globally incorporating nutrition principles. In addition, the final Compendium encompasses case studies for projects that were designed from the start to be nutrition-sensitive as well as those that evolved to be nutrition-sensitive over time. Communications and Knowledge Management As participation at the Global Forum in Moscow was necessarily limited, a multifaceted social media and communications campaign was under- taken—in collaboration with partners—to engage the broader community of practitioners and other stakeholders (Annex 5). SecureNutrition created and disseminated a communications kit, including Global Forum branding, key online resources, suggested Twitter messages, etc. through WBG (e.g. corpo- rate WBG/, and regional WBG/Moscow and WBG/ECA) and non-Bank (e.g. FAO, IDS, IFAD, IFPRI, Thousand Days, WFP) channels. SecureNutrition also collaborated with the FAO Global Forum on Food and Nutrition Security to co-host a multilingual online discussion that explored key questions related to the Global Forum.16 The discussion was held from August 28 to September 13, concurrent with the Global Forum in Moscow, and was moderated by Lucy Basset (Social Protection Specialist, WBG) and Ahmed Raza (Nutrition Specialist, FAO). The Global Forum culminated in a three-part Leveraging Social Protection Programs for Improved Nutrition series of reports: Summary of Evidence Prepared for the Global Forum on Nutrition-Sensitive Social Protection Programs (Summary of Evidence); Compendium of Case Studies Prepared for the Global Forum on Nutrition-Sensitive Social Protection Programs (the Compendium); and Report on the Proceedings of the Global Forum on Nutrition-Sensitive Social Protection Programs (the Final Report). The Summary of Evidence addresses “the why” for nutrition-sensitive social pro- tection programs, and the Compendium addresses “the how.” All materials from the Global Forum (e.g. resource library, keynote addresses and program snapshot presentations) were provided to attendees on a USB thumb drive, were made available on the SecureNutrition website (www.securenutrition. org), and have been shared through newsletters, seminars, and other fora. The Leveraging Social Protection Programs for Improved Nutrition series will be the foundation for the SecureNutrition nutrition-sensitive social pro- tection seminar series. This will be open to all, and will be accessible globally through web streaming. Global Forum attendees were invited to subscribe to the SecureNutrition monthly newsletter and discussion group to keep up with future knowledge products and events. Attendees and other partners were also invited to share experiences and resources through SecureNutrition’s dissemination channels. 16 Leveraging Social Protection Programs for Improved Nutrition: Report Session Summaries Vocabulary Both days of the Global Forum began with an interactive session on vocab- ulary, to both set the tone for engagement and assess where participants were in their understanding of key nutrition-sensitive social protection ter- minology. Words and definition choices were projected on the screen, one slide (word) at a time. Each participant was provided a remote device (a “clicker”) to anonymously vote for the best definition among the options provided. Participants were given 30 seconds to vote. The correct answer was projected along with the distribution of responses, the answers were explained, and additional discussion ensued, as needed. The vocabulary for Day One (Session One) was a list of 16 words collated by the organizers. Translations of the vocabulary and definition options for the five supported languages were provided. The vocabulary for Day Two (Session Eight) was derived from feedback from participants on the terminology encountered on Day One. The results (Annex 7) suggested that the attendees’ familiarity with social protection terminology was far stronger than their familiarity with nutrition terminology. Leveraging Social Protection Programs for Improved Nutrition: Report 17 Opening & Welcoming Remarks Opening remarks were delivered by Anna Popova, the Head of the Federal Service for Surveillance on Consumer Protection and Human Well-being, and Chief State Sanitary Physician, Russian Federation (Rospotrebnadzor), and by Maria Margarita Cedeño Lizardo, the Vice President of the Dominican Republic. They welcomed the participants, underlined the potential for the Global Forum to foster collaboration related to nutrition-sensitive social pro- tection, and highlight the related work underway in their respective coun- tries. Prior to these addresses, the facilitator (Stephen Atwood) reviewed the objectives of the Global Forum (Annex 1). The official opening remarks were followed by welcoming remarks by representatives of each of the participating IOs, including: Rob Vos (FAO), Josefina Stubbs (IFAD), Carlo Scaramella (WFP), and Ruslan Yemtsov (WBG). Anna Y. Popova: The Russian Federation supports food and nutrition secu- rity globally through donations to FAO, WFP, WBG, ILO and other interna- tional organizations. The purpose of the Global Forum is to foster cooperation and support of a safe and secure food system, ensure food and nutrition secu- rity, and identify ways of enhancing social protection to respond to social crises. The Global Forum provides an opportunity to share experiences across a breadth of countries, in the implementation of nutrition-sensitive social protection programs. Maria Margarita Cedeño Lizardo: The Global Forum is a unique opportunity to share experiences, with the “Taking good care of potential to foster alliances on the right to quality children means taking nutrition, and cooperation and solidarity in improving good care of all of us.” food and nutrition security. Collaboration is crucial in addressing the “vicious triangle” of poverty, malnutri- tion and hunger. Providing proper food and nutrition is “a complex task in a world governed by uncertainty.” Despite progress made with the MDGs, the 795 million who remain malnourished are an “ethical prob- lem that should make us all ashamed,” especially in light of the “billions of tons of food every year” that is wasted. Progress against malnutrition is possible with political will, technologies and innovations, international cooperation, and interest from governments in providing technical assistance to emerging coun- tries. “Taking good care of children means taking good care of all of us.” Rob Vos (Director for Social Protection and Coordinator of the Strategic Programme for Rural Poverty Reduction, “We need to learn FAO): The Global Forum provides an opportunity to from experience.” strengthen the collaboration and commitments made by all member states during ICN2 to incorporate nutrition objectives into social protection programs. Ending poverty and hun- ger are priorities of the SDGs. To end poverty and hunger, we need multisec- toral approaches. Social protection can improve nutrition outcomes, and 18 Leveraging Social Protection Programs for Improved Nutrition: Report BRICS countries—having successfully reduced hunger and poverty—can and should play a lead role. Given that three-quarters of the poor and hungry live in rural areas and depend on agriculture, there is a crucial nexus between nutri- tion, social protection, and agriculture. “We need to learn from experience.” Josefina Stubbs (Associate Vice-President and Chief Development Strategist in the Strategy and Knowledge Department, IFAD): Smallholder farmers produce 80 percent of the food that is consumed worldwide, and have an important role in conserving world biodiversity and providing fresh, nutritious varieties of food to local and national markets. When farmers lose their ability to pro- duce food, the entire nation suffers. Social protection programs are an import- ant vehicle for bringing about inclusive rural transformation. The goal is to create vibrant rural communities, where young people are looking forward to living their lives. Carlo Scaramella (Deputy Regional Director of the “Strengthening partnerships is Regional Bureau for North Africa, Middle East, indispensable.” Central Asia and Eastern Europe, WFP): Social pro- tection programs play a critical role in building resil- ience and promoting inclusive development pathways, while also realizing the right to social security for all. Making social protection more efficient and sustainable is an urgent necessity across all countries and regions, particularly in those low- and low middle-income countries, which are also most prone to socio-economic shocks. Scaling up social protection is critically important when dealing with protracted crises, whereby governance failures contribute to replicating intergenerational cycles of malnutrition and poverty. “This complex reality is the new normal reflect- ing the increasing demands and challenges,” and is characterized by multiple intersecting drivers of food and nutrition insecurity. This reality demands that we work together to look beyond traditional systems with a view to estab- lishing more efficient, scalable, adaptable and reliable social protection and safety net services. “Strengthening partnerships is indispensable.” Ruslan Yemtsov (Lead Economist in the Social “Neither of them in isolation Protection and Labor Global Practice, WBG): One of can end poverty and the principle, underlying causes of why people face poverty, and why everyday new people fall into pov- malnutrition—what’s erty, is malnutrition. There are long-term effects of important is integration.” child malnutrition on educational attainment, pro- ductivity and health. “To end poverty, it’s important to improve nutrition.” The two strategies historically undertaken to improve malnutrition—increasing income and addressing malnutrition through the health sector—have now both demonstrated their limitations. “Neither of them in isolation can end poverty and malnutrition— what’s important is integration.” The Global Forum provides an opportunity to learn new lessons from integrated approaches. The WBG’s $1 billion annual lending for social safety nets is “impressive, but a drop in the bucket Leveraging Social Protection Programs for Improved Nutrition: Report 19 compared to the need, and compared to what countries are already spending on social protection.” We need to “leverage those limited funds, and look at them as catalytic investments.” Statement of the Problem & Keynote Address This was the only session of the Global Forum that involved conventional lectern-style presentations. It was comprised of two parts: the first was a state- ment of the problem by Meera Shekar, Global Lead for Nutrition and Lead HNP Specialist with WBG’s Health, Nutrition and Population Global Practice. She described the economic case for nutrition and the linkages between pov- erty, equity and malnutrition. This was followed by the keynote note address from Harold Alderman, Senior Research Fellow on Poverty, Health, and Nutrition at IFPRI. He presented the rationale for linking nutrition and social protection programs, describing the synergy between the two sectors and the necessity of integration in order for the goals of each to be achieved. The pre- sentations were followed by a joint moderated discussion. Nutrition-Sensitive Social Protection: Why and What? Meera Shekar Epidemiology of nutrition. Nearly 85 percent of global stunting is concen- trated in 37 countries. Since 1990, both the prevalence of under-five stunting and the number of children stunted has decreased, however progress across regions has been variable. The prevalence of stunting remains severe in South Asia and Sub Saharan Africa. There is simultaneously a global trend of increasing rates of overweight/obesity, also with marked regional variation. Linkages between nutrition and social protection. Income poverty drives many of the factors that contribute to malnutrition (e.g. low food intake, fre- quent infection, reliance on physical labor, frequent pregnancies). In turn, malnutrition causes direct losses in productivity from poor physical status, indirect losses from poor cognitive development and schooling, and losses due to health costs. The trickle-down effect of increased income on nutrition is slow, and the relationship between stunting and GNP is highly variable across countries. Some countries have shown impressive economic growth, yet continue to have high rates of stunting. Improving income growth alone is insufficient to achieve SDG nutrition targets. “The vicious cycle of malnutri- tion and poverty continues unless we do something to break it.” Consequences of malnutrition. Nutrition can con- tribute to economic growth, reduced poverty, and, “By addressing malnutrition, through targeting the bottom 40 percent, enhanced social safety net programs are equity. Because stunting disproportionately affects the poor, “by addressing malnutrition, social safety addressing the poor.” net programs are addressing the poor.” Improved nutrition can increase schooling completion by 20 Leveraging Social Protection Programs for Improved Nutrition: Report approximately a year, and earnings from 5 to 50 percent. Children who escape stunting are 33 percent more likely to escape poverty as adults. In Asia and Africa—the regions with the highest burden of malnutrition—improved nutrition can increase GDP by 4 to11 percent. First 1,000 days. Evidence shows that the first 1,000 “It’s human capital that drives days—the period from conception to the age of two years—is a critical window of opportunity that sets nations.” the foundation for human capital development. Changes that occur during this period are likely irre- versible. Intervention after the age of two is too late and too expensive. “It’s human capital that drives nations.” Multisectoral determinants of malnutrition. Nutrition-specific interventions focus on the immediate causes of malnutrition; Nutrition-sensitive interven- tions focus on its underlying and basic causes. Historically, nutrition-specific interventions have been delivered through the health sector. Nutrition-sensitive social protection offers a chance to expand those delivery platforms. To achieve the SDG target for stunting—a reduction from 162 million to 100 million by 2030—nutrition-sensitive and nutrition-specific interventions are needed. Cost benefit. New research shows that a package of proven nutrition-specific interventions costs approximately $8.50 per child annually. Every dollar invested in stunting reduction leads to about $18 in economic returns. Getting the right start from the beginning is a win-win. Together, social protection and nutrition can take advantage of the early malleability that exists in the brain and body to build the foundation for future productivity and economic growth. Improving Nutrition through Social Protection Programs Harold Alderman Multisectoral collaboration. A package of ten proven nutrition-specific interventions, scaled up to 90 percent of the target population, would reduce stunting by 20 percent. This is “well and good, but not good enough.” To go beyond 20 percent, we need “In order to make social to coordinate across many sectors, including social protection. Social protection is important, amongst protection programs the many sectors, due to its scale—1.9 billion people nutrition-sensitive, you need are estimated to receive some form of social assis- to transform them.” tance. “In order to make social protection programs nutrition-sensitive, you need to transform them.” Pathways from social protection to nutrition. Social protection programs can affect nutrition by increasing the resources that households control, changing their preferences, reducing the price of food, increasing incentives to invest in health, and providing micronutrients. Behavioral change commu- nication is an important element. Leveraging Social Protection Programs for Improved Nutrition: Report 21 How transfers are used. Research shows that if you give a poor household more resources, the largest share will be spent on food. “Food security and nutrition security are not identical.” However, not only does food consumption increase, but also dietary diversity—“they don’t just buy calories, they diversify their diet.” Referred to as “nutrition labeling,” poor households often spend more out of a transfer program—even when there is no requirement to do so—on food than they do out of general income. There is no evidence that transfer programs lead to indolence, nor that transfers are spent on tobacco and alcohol. Enabling Environment. For both conditional and unconditional transfers, many programs do not “Giving households more improve nutritional status. “Giving households more income does not improve the income does not improve the quality of the health quality of the health services services that they can purchase nor the sanitation of the community they live in nor does it give them that they can purchase nor the more information on childcare.” Including special sanitation of the community foods containing the micronutrients that a child they live in nor does it give needs can result in better nutritional impact. them more information on Mode of transfer delivery. In-kind assistance is childcare.” becoming obsolete (except in some emergency con- texts where markets do not function), because we know how to give cash assistance, and the technology to support it is now there. It is generally 15–20 percent cheaper on average to deliver cash than food. The impact of a transfer on consumption depends on the environment, particularly the functioning of the markets. Markets tend to function well outside of emergency situations. One advantage of in-kind assistance is the ability to substitute a fortified food for what (non-fortified alternative) might have otherwise been purchased. School feeding. School feeding is a type of in-kind conditional transfer in that children only receive it if they attend school. Roughly 375 million chil- dren receive school meals or take-home rations every year, at a cost of $75 billion dollars. This is far greater than the cost of achieving the SDG stunting target. “It’s a lot of money and a lot of people.” School feeding is not primarily a nutrition program because the age group of the recipients are not the most vulnerable (i.e. compared to women and children within the first 1,000 days, the “window of opportunity”). School feeding is a social protection program, and it is also an education program. School feeding programs can be used to address the problem of obe- sity through the introduction of better diets and “Poor countries have large nutrition education. School feeding can also affect numbers of poor, as well as nutrition if the food is fortified. small budgets. They have to Prioritization. Limited resources are an obstacle to prioritize and that is politically improving the nutritional impact of social protection very difficult.” investments. Some countries are able to put in safety 22 Leveraging Social Protection Programs for Improved Nutrition: Report nets that cover every group; however, many countries do not have the resources to provide a meaningful amount of transfer to the entire poor pop- ulation. “Poor countries have large numbers of poor, as well as small budgets. They have to prioritize and that is politically very difficult.” Integration. Nutrition-sensitive social protection must be cross-sectorial—not only to increase demand for health services, but also to increase the quality of those health services. Hypotheses to make social protection more nutrition-sensitive: 1. Prioritize nutritionally vulnerable populations. 2. Include behavior change communication. 3. Enhance the quality of nutrition services available to social protection beneficiaries. 4. Leverage the money, resources, and time put into school feeding to ensure it’s a complete nutrition package (i.e. a vehicle for micronutrient supple- mentation, deworming, nutrition education, etc.). 5. Design programs that can scale up in times of crisis and have programs that can scale up to address not only the pressing needs of the whole fam- ily, but also the very specific needs of the young child. Moderated Discussion Below is a summary of the discussion; Comments are not necessarily comprehensive or representative of all partners. Scale-up of social safety nets in emergencies. The reliance on humanitarian assistance financing from international agencies, which comprises a major com- ponent of scaling up, poses a challenge due to the amount of time between when a country requests assistance and when that assistance is received. Some social protection instruments (public works programs were specifically cited here, but others may also apply) are relatively easy to scale up, at least if the program already exists. To start one from scratch in the midst of a crisis is difficult, and to make it nutrition-sensitive is harder still. Different types of crises have different time dimensions. Some countries (e.g. Ethiopia) have included contingency funding. The 2008 food and fuel crisis highlighted that these are important issues that require advance planning, both from a humanitarian perspective and from a development perspective—“those need to work side-by-side.” Conditionalities. Simple conditionalities (either hard or soft) or design elements, which affect how a cash transfer will be delivered or used, are another potential way to make social protection programs more nutri- tion-sensitive. It is important to consider the operational costs of enforcing conditions, as well as the availability of supply and quality of services. Currently, evidence on the costs and impacts of unconditional and condi- tional transfers is mixed. Leveraging Social Protection Programs for Improved Nutrition: Report 23 Social media. Social media (e.g. text messages) can be used to combat unhealthy food marketing and “The nutrition and health sector provide best practices, tips, and advice in dealing have not maximized use of with overweight/obesity. “The nutrition and health sector have not maximized use of social media.” social media.” Economic crisis. Economic crises are a threat to social safety nets and nutrition. There is a need for accommodating economic recovery and improved GDP growth. Overweight /obesity. There is a need for education to combat the growing rates of overweight/obesity that result from increased resources at the house- hold level (e.g. consumption of junk food and soda beverages). Solutions to Date: Nutrition Programs and Social Protection Programs Two facing panels were used to present what is being done by the global com- munity in the nutrition and social protection sectors to tackle malnutrition from the perspective of different International Organizations (IO). The ses- sion aimed to illustrate the division between the sectors by placing four nutri- tion panelists and four social protection panelists on either side of the moderator. This division was then brought towards integration—visually and conceptually—throughout the following sessions. The nutrition panelists were Bibi Giyose (FAO), Iain MacGillivray (IFAD), Menno Mulder-Sibanda (WBG), and Joao Breda (WHO). The social protec- tion panelists were Natalia Winder Rossi (FAO), Josefina Stubbs (IFAD), Christina Behrendt (ILO), and Daniel Balaban (WFP COE). Each panelist responded to pre-selected questions and presented their approach to address- ing the problem articulated in Session Three. The panel presentation was fol- lowed by a moderated discussion. Bibi Giyose (Senior Nutrition Officer for Policy and Programs in the Nutrition Division, Economic and Social Department, FAO): Ensuring that nutrition is not the purview of only any one sector requires pooling resources, putting minds together, putting governance at the center, political will, and investment. Partnerships—for communication, collaboration, coordination, harmonization and joint planning—are important, and have not happened easily. There are numerous global nutrition initiatives that are focused on nutrition-sensitive approaches, including the Zero Hunger Challenge; the SUN Movement; the Committee on Food Security; the Global Panel on Agriculture and Food Systems for Nutrition; and ICN2. With a dedicated SDG for agriculture and nutrition, we are poised to ensure that the world delivers better nutrition through a multi- plicity of approaches, through multiple partners, through heightened invest- ments, and through dedicated tracking and monitoring of progress. 24 Leveraging Social Protection Programs for Improved Nutrition: Report Iain MacGillivray (Special Advisor to the President, IFAD): There is a lot of knowledge, best practice, and experience on furthering the impacts of income, food availability and prices, on nutrition to build from (e.g. women’s empow- erment, diversifying production and consumption, targeting the most vul- nerable, leveraging food supply chains, scale up of bio-fortified crops, etc.). A key challenge for IFAD is scaling up nutrition and nutrition-sensitive inter- ventions in agriculture and rural development, without detracting from the agriculture sector’s conventional goals. Organizationally, IFAD is working to mainstream nutrition by integrating it into all project assessments, analysis, design, quality control, monitoring and evaluation, in-house staff training, and capacity building for multisectoral project design. Menno Mulder-Sibanda (Senior Nutrition Specialist “Complex issues around in the Africa Region, WBG): Malnutrition and its incentives, rules, and power causes cut across income quintiles, and are intracta- relations link the nutritionally bly linked to the intergenerational cycle of poverty. This in turn is exacerbated by vulnerability to exter- vulnerable population to service nal shocks. The first 1,000 days are the window of providers and different layers of opportunity to break the intergenerational cycle of government.” poverty. Social protection has the potential to address the socio-economic inequality of malnutrition through various pathways, including by addressing gender. Gender sits at the nexus of production, consumption and reproduc- tion. The mainstreaming and institutionalization of nutrition objectives into WBG’s core priorities remains an unfinished process, but it is gaining in strength. Complex issues around incentives, rules, and power relations link the nutritionally vulnerable population to service providers and different lay- ers of government. The SUN Movement has raised awareness at three levels of action: the enabling policy environment; scaling up nutrition-specific inter- ventions; and maximizing nutrition sensitivity in a range of development sec- tors, including social protection. Joao Breda (Programme Manager for Nutrition, “We cannot on the one hand Physical Activity and Obesity at the Regional Office for eradicate hunger, while at the Europe, WHO): Despite commonly held beliefs, there same time and in the same are still countries in Europe with stunting around 20–30 percent. Global nutrition targets have been society increase overweight and set—and are relevant—for all countries. However we obesity because we’re increasing risk failing to achieve these targets. Concerted action tremendously the availability of is required in low- and high-income contexts. We need to work to create healthier food and drink envi- fat and sugar.” ronments. “We cannot on the one hand eradicate hunger, while at the same time and in the same soci- ety increase overweight and obesity because we’re increasing tremendously the availability of fat and sugar.” “We need to have a comprehensive approach for tackling the double burden of malnutrition.” Leveraging Social Protection Programs for Improved Nutrition: Report 25 Natalia Winder Rossi (Senior Social Protection Officer in the ESP Division, FAO): FAO and other IOs are making critical contributions in strengthening the evidence base around social protection impacts and operational learning. This will ensure that economic and productive investments are climate-smart and nutrition-sensitive. FAO has evidence for the impact of unconditional cash transfers on poverty, food security, and dietary diversity in sub-Saharan Africa.17 This highlights the need to understand the design implementation ingredients that make these impacts possible. Other operational challenges requiring further evidence include understanding the role of the intra-house- hold dynamic, effectively integrating nutrition education to translate invest- ments into nutrition-sensitive investments, other ways of operationalizing linkages between nutrition and social protection, integrating other sectors such as education and child protection, and using overlapping targeting to create a multidimensional view of vulnerability. We need to be “very creative as we bring together the two sectors.” Josefina Stubbs (Associate Vice-President and Chief Development Strategist in the Strategy and Knowledge “The poor in all countries of the Department, IFAD): “The poor in all countries of the world want to be resilient, world want to be resilient, self-reliant, empowered, and autonomous.” Millions of people around the self-reliant, empowered, world have benefited from conditional cash transfers and autonomous.” and other social protection programs. To sustain the gains achieved, we need to help people receiving social protection support by improving productivity. This will allow them to generate income and graduate those programs. “We need to move from cash to assets.” Eliminating poverty in the next thirty years is going to be harder than it has been so far because it requires reaching people who are extremely poor, many of whom are in faraway places without an identity card, and most of them are indigenous. To mainstream nutrition, we have to think about how to bring peo- ple into the food system, be it as producers, consumers, or processors. Christina Behrendt (Senior Social Protection Policy Specialist in the Social Protection Department, ILO): “If there is one thing we have learned, it is that the synergies don’t come automatically.” A key challenge is how to secure those who have escaped poverty, sustain gains, and prevent them from falling back into poverty. ILO’s approach is a universal social protection system, which does not just provide benefits and services to the poorest and most vulnerable, but also protects everyone in the population—“universal social protection for all.” An “integrated and comprehensive approach” means everyone in the soci- ety has at least a minimum level of social security, including income security and access to health care. The required national capacities include ensuring that the social protection system is rooted in country policies, and financed through national resources with a legal framework that helps to support it. Daniel Balaban (Director, WFP Centre of Excellence Against Hunger): We don’t have just one social protection policy solution, and “we don’t have the 26 Leveraging Social Protection Programs for Improved Nutrition: Report solutions for all the cultures.” The approach of the “We don’t have the solutions WFP COE is to support countries to find their own for all the cultures.” solutions. Good solutions can come from inside each county, but they need support from international organizations. Sometimes we involve ministers of agriculture, ministers of health, and ministers of edu- cation, but we forget the person who decides the budget—we need to listen to and involve the ministers of finance. “They need to understand that social protection is an investment, not an expenditure.” Moderated Discussion Below is a summary of the discussion; Comments are not necessarily comprehensive or representative of all partners. Rights based approach to nutrition-sensitive social protection. The human capital approach and rights-based approach for integrating social protection and nutrition are complimentary, and are both valid. It’s not just a gap with regard to the right to food—the right to calories verses the right to a healthy balanced diet. Accumulated gaps also include the right to health, the right to social security, etc. It is “an enormous challenge to address those issues in a comprehensive way.” Corruption. Resources to finance nutrition-sensitive “It is an enormous challenge social protection programs are limited. Through cor- ruption, capital leaves developing countries that to address those issues in a could have instead been used to finance nutrition comprehensive way.” programs. It is “not only a moral issue, it’s also an economic issue because it’s taking money away from bringing growth and reducing inequality.” Creating Synergies: Strengthening Social Protection Programs The first of several working group sessions used a modified world café meth- odology to develop competence in the design of nutrition-sensitive social protection programs. This addressed the problem identified in Session Three, and promoted awareness of the associated challenges and opportunities. There were ten tables divided into five nutrition principle “themes” and five social protection instrument “themes.” The social protection instruments were: school feeding, public works, cash transfers, in-kind transfers, and conditional- ities. The nutrition principles were: gender, 1,000 days, dietary diversity, target- ing the nutritionally vulnerable, and nutrition education and promotion. Each table had an assigned Expert Facilitator (Annex 8) who remained at the table for the duration of the session. Participants selected a table based on their inter- est and the availability of chairs (16 per table). “Whisper” interpreters were provided to facilitate multi-lingual groups. Given the limited availability of interpreters, some tables were assigned language groups. Leveraging Social Protection Programs for Improved Nutrition: Report 27 Participants at the social protection instruments tables were instructed to discuss what could be gained by using their respective social protection instrument to address the problem of malnutrition, and how it could be adapted. Participants at the nutrition principles tables were instructed to discuss the added benefits of integrating their respective nutrition principle into social protection instruments and what would be required to do so. After 45 minutes, participants switched tables. All those sitting at social protection instruments tables moved to a nutrition principle table, and vice-versa. Participants then had 30 minutes for discussion before return- ing home to their original table to report on their discussions and reflect on (i) how to create synergies between the sectors and (ii) what conditions need to be in place for nutrition-sensitive social protection solutions to work. The session culminated with a brief summary of the key discussion points by a representative from each table, followed by a moderated discussion. Below is a summary of the discussion; Comments are not necessarily comprehensive or representative of all partners. Public Works • Targeting the first 1,000 days (i.e. households with small children and pregnant women) in public works programs is being carried out, but there are trade-offs that need to be considered. • Activities. Typical PW activities—building or restoring infrastructure, sanitation, and education infrastructure—require hard physical labor that would be inappropriate for PLW. Activities involving public services, e.g. childcare, cleaning, or other campaigns, can be used instead. Replacing the infrastructure that would have been built (e.g. sanitation infrastruc- ture), however, also has implications for nutrition. • Benefit amount. There is a need to determine an amount that is sufficient to drive change with a measurable nutrition impact (e.g. changing the diet) without creating a disincentive to work. • Benefit recipient. Many programs—regardless of who actually does the work—give benefits to women, to increase likelihood that it is spent in a nutrition-sensitive way. • Frequency of payments. The predictability of payments is important in encouraging expenditures for nutrition. • Accompanying measures. Other activities can be integrated to improve nutrition impact, such as nutrition education, food demonstrations, dietary supplements, and activities to diversify livelihoods. • Enabling environment. The roles and responsibilities of institutions, col- laboration between ministries, and community participation all need to be clear. • Monitoring & Evaluation. It is important to include nutrition indicators in the results framework at the outcome and process levels to ensure that efforts are having the intended impact. 28 Leveraging Social Protection Programs for Improved Nutrition: Report Cash Transfers • Size of the transfer. The transfer amount should be linked to the nutri- tion needs of the targeted beneficiaries. • Nutrition education and behavior change. Programs should target the first 1,000 days, and should sensitize beneficiaries. This would encourage them to improve nutrition and health seeking behavior, for themselves and for their children. • Demand generation. Transfers should be linked to other interventions, especially health services and information systems. • Local production. Cash transfers can be used to promote local food production. • Transfer frequency and duration. Within the group, there was dis- agreement on the appropriate duration of cash transfers, and on the frequency of payments required to measurably affect nutrition outcomes. School Feeding • Synergies. School feeding is multisectoral, which poses both opportuni- ties and challenges. Schools can serve as a hub for education on a number of nutrition-sensitive social protection issues, including nutrition, hygiene, parenting, agriculture production, life skills, and prevention of adolescent pregnancies. • Linkages to school-based nutrition activities. E.g. deworming, hygiene education, and focus on adolescent girls, including reducing anemia and early marriage. • Linkages to agriculture. Using decentralized approaches to increase food diversity in school feeding through local procurement and job creation. • Targeting. Within the working group there was disagreement on whether, within a given budget envelope, aiming for universal coverage or targeting only the most vulnerable would result in the best nutrition outcomes. Conditionalities • Behavior change. Increasing income alone cannot change nutrition behavior—nutrition education is also needed. Conditionalities have the potential to influence beneficiaries, modify nutrition-related behav- ior (e.g. seek appropriate services or purchase nutrient-rich foods), and therefore achieve nutrition objectives. However, considerations around costs and the capacity to implement and enforce conditionalities, as well as the supply and quality of services, are critical. Community lead- ers may be effective mechanisms for conveying nutrition information. Educational programs, mass media, or other government services like schools and health units can also be used. • Integration. Conditionalities can influence both beneficiaries and pro- viders, with the potential to push governments into providing services. To meet the demand generated by beneficiaries, governments need to offer services, and cross-sectoral work is needed to achieve this. Leveraging Social Protection Programs for Improved Nutrition: Report 29 Gender • Local context. Cultural beliefs and traditional gender roles contribute to malnutrition, and are often very hard to change. Communication cam- paigns and other intervention strategies are necessary to overcome them, as well as an understanding of local beliefs, and how to better influence them. • Community engagement. Joint initiatives at the community level are needed to address nutrition challenges. Local communities and authori- ties also need to be involved. • Behavior change. To better empower women, the behavior of men and politicians needs to change. • Identification. Policies, resources, and activities promoting the rights of women and supporting their access to those resources are needed. This includes securing the mechanisms of identification (e.g. national identity card or passport) required. 1,000 Days • Time-appropriate intervention. There are different stages within the 1,000 days (e.g. pre-pregnancy, pre-natal, antenatal, etc.). They are differ- entiated by respective interventions and counseling. Reaching women and adolescent girls pre-pregnancy is especially challenging. • Enabling environment. Ministries of health and social welfare need to work together to develop policies and harmonize indicators related to the 1,000 days concept. • Localization. The local/national context and existing platforms should be taken into consideration when designing programs targeting the first 1000 days. • Behavior change communication. BCC is crucial, and organizations and social services at the community level must be engaged to dissemi- nate information to young women and young mothers. Organizations must also be able to refer them to services. • Training & capacity building. Changing behavior at the household level requires investment in training for community workers. Dietary Diversity • Social protection instruments. A wide range of social protection inter- ventions have been used to improve dietary diversity, including cash transfers (with and without behavior change communication), programs targeting cooperative farmers contracted to produce a range of goods, livestock offtake programs, etc. • Dietary assessment. A diagnostic is needed to assess the gaps in food commodities, market availability, the functioning of the market, cost issues, demographic groups and their respective dietary requirements (e.g. in emergencies often the elderly are left out of assessments), etc. This will facilitate collaboration across sectors and ministries (or in the case of emergencies, between clusters). • Multisectoral collaboration. Getting different sectors or clusters to talk to each other is challenging, and there often are not mechanisms to do so, especially in the context of decentralized programming. 30 Leveraging Social Protection Programs for Improved Nutrition: Report • Transfer amount. In some cases, there is a minimum transfer amount, which is sufficient for households to purchase higher quality foods, but below which will be spent on calories. This has program cost implications. • Multipurpose programming. Social protection systems that target multi- ple demographic groups may generate competition between sectors and/ or actors, each trying to influence the behavior of the same beneficiaries. Targeting the Nutritionally Vulnerable • Inclusivity. Social protection programs typically avoid targeting an out- come of interest e.g. malnourished children. They err on the side of greater inclusion so as not to, in this case, shift programs towards nutri- tion so much that they fail to reach other goals. • Multisectoral collaboration. Diagnostic tools are needed to understand each unique country context. Targeting nutritional vulnerability requires other sectors to engage (e.g. health and WASH). Multisectoral coordination is needed at the national level and on the ground, ensuring that social work- ers have the capacity to deliver a social protection program that is targeted to the nutritionally vulnerable. They must understand what it means, how to talk to households about it, and how to work across sectors. • Prioritization. When resources are scarce, the prioritization of program- ming and transitioning between different types of programming is a chal- lenge. During a crisis—is it just an expansion of the program or are there other groups that become nutritionally vulnerable, and how do we take that in to consideration? Nutrition Education & Promotion • Synergies. Nutrition education is a platform for fostering integrated approaches. This unleashes a multiplier effect and maximizes nutritional impact. Many types and approaches to nutrition education have evolved over time. • Use of new technologies. There are both opportunities (to leverage new technologies for the dissemination of nutrition education messages) and associated challenges (e.g. no longer being able to disperse cash transfers at the same time that nutrition education messages are being provided). Integrating new technologies into already existing large-scale programs is also a challenge. • Conditionalities. These can be used to instill a sense of responsibility among targeted beneficiaries, however balanced, with the understanding that in seeking to reach the most vulnerable, leniency (e.g. “soft” condi- tions) may be needed. Conditions must be clearly communicated to ben- eficiaries, ensuring that the conditionality is not perceived as a punishment per se, but as an opportunity to maximize the resources being invested. Moderated Discussion Below is a summary of the discussion; Comments are not necessarily comprehensive or representative of all partners. Conditionalities. In response to a question posed about other options available (in addition to conditionalities) to forge the linkages between social protection Leveraging Social Protection Programs for Improved Nutrition: Report 31 and nutrition, it was noted that conditions are used when beneficiaries are not trusted to spend the transfer in ways likely to achieve the intended impact. If it’s reasonable to assume that giving the cash alone will result in intended impacts, then conditions are not needed. Furthermore, it was noted that there are limita- tions and challenges around implementing and enforcing conditionalities (e.g. in contexts where supply is not there, or where the capacity to implement is insufficient). However, it’s possible to leverage the conditionality to induce gov- ernments to do a better job by arguing that the cash transfer will not change behavior if the government in question does not also commit to improving ser- vices. Finally, as illustrated by the 18 years of experience in Mexico, the impor- tance of co-responsibilities for changing paths and increasing human capital was emphasized. Monitoring conditionalities and ensuring some level of supply also play an important role in enabling inter-sectoral coordination. 1,000 days. The importance of framing the first 1,000 days in terms of life- long consequences was also emphasized. It is also important to monitor preg- nant women from the point of conception to address emerging health issues, and to continue monitoring women and children during the remainder of the first 1,000 days. Reaching adolescent girls. A question was posed around how to reach women prior to conception. There was some concern about targeting adolescents with- out encouraging adolescent pregnancy. Although several projects (e.g. Nigeria Child Development Grant Program) are reaching women early in the 1,000 days window of opportunity, during pregnancy, there were no examples cited that reached women prior to conception. It was suggested that girls could be targeted during school with messaging around the responsibility to protect themselves and their children, and to look after their health before and after becoming pregnant. It was emphasized that engagement with the education sector is important, and that the education system should provide not only education but also life skills to girls and boys. There is need for further collaboration. Integration with family planning. It was emphasized that adolescent girls are not prepared to be mothers, and that “kids having kids” sacrifice their life path and fundamentally change their future. Protecting children during ado- lescence is therefore an integral part of social protection programs. This can be achieved by including birth control programs to prevent adolescent moth- ers, and by spreading knowledge about the availability of contraception (per- manent or temporary) as a matter of social/human rights and freedom of self-determination. Nexus between nutrition, social protection and agriculture. A multisectoral response to address malnutrition requires not only health and care, but also a strong focus on providing access to quality and nutritious food. An integrated package of cash transfer, nutrition education and nutrition-sensitive agriculture can enhance nutrition impacts. Social protection has a unique power to gener- ate incentives for food systems to evolve in a way that is better for all consumers. 32 Leveraging Social Protection Programs for Improved Nutrition: Report School feeding programs that procure fruits, vegetables, or other fresh produce from local farmers generate an incentive for the producer to increase produc- tion diversity for example. In some cases, this can improve the quality of their produce, which benefits all consumers. Moreover, an assessment of local pro- duction, foods and products can help to design more culturally appropriate menus, contributing to nutrition and local economic dynamics. Multisectoral targeting. From the point of view of agriculture intervention, it’s difficult to target PLW. In Zambia, for example, work is often done with coop- eratives and groups where there may be only three or four women who are pregnant or have children below two years. Collaboration with the ministry of health is required to target PLW and ensure that, within the targeted commu- nities, adolescent girls of childbearing age are involved in program activities. Women’s groups. Agriculture interventions aimed at increasing the availabil- ity of diverse food often target women in groups. However, when the group shares the field it’s a challenge to ensure that the benefits trickle down to the household. Involving men. As men often are responsible for making household deci- sions on what crops or livestock to produce (typically geared towards produc- tion for sale rather than home consumption), men must be included in nutrition education activities so that they understand the special nutritional needs of women and children. It also highlights the importance of producing nutritious food for consumption within the household. Sensitization is also needed to highlight the important role that men can play in early childcare. Political economy. The difficulty of persuading policy-makers, in particular legislators, to invest money into social protection, nutrition-sensitive or not, was noted as a challenge that requires additional consideration. Policy coherence and the DBM. For countries dealing with the double bur- den of malnutrition (e.g. Mexico and Costa Rica) the coherence of the policy environment is crucial. Disincentives for the production and consumption of nutritionally poor foods, for example, should be combined with incentives to increase the production and consumption of healthy foods (through social protection and agriculture measures). Way Forward: Implementation of ICN2 Declaration in Terms of Social Protection and Nutrition – BRICS Partnerships This panel presentation, organized by FAO, was designed to foster under- standing of the BRICS countries’ policies and programs on nutrition-sensi- tive social protection, share lessons and good practices, promote a common approach and South-South cooperation, share thoughts and define Leveraging Social Protection Programs for Improved Nutrition: Report 33 approaches and modalities for delivery, follow-up on ICN2 outcomes around social protection and nutrition, and draft and adopt a chair summary. The panel was chaired by Rob Vos, Director for Social Protection and Coordinator of the Strategic Programme for Rural Poverty Reduction of the FAO. It was moderated by Bibi Giyose, Senior Nutrition Officer for Policy and Programs in the Nutrition Division, Economic and Social Department at FAO, and was comprised of representatives of the BRICS countries:18 Brazil (Arnoldo de Campos, National Secretary for Food and Nutrition Security of Brazilian Ministry for Social Development and Fight Against Hunger), Russian Federation (Vyacheslav Smolenskiy, Director for Science and International Relations, Rospotrebnadzor, the Russian Federation), India (Sanjay Mahendru, First Secretary – Trade, Embassy of India in Russia), and South Africa (Thando Dalamba, Political Counsellor, Embassy of South Africa in Russia). In preparation for this session, FAO developed a paper on the unique expe- riences of BRICS in designing and implementing nutrition-sensitive policies and programs. This paper also highlighted their role in promoting knowledge exchange and information sharing within the context of South-South Cooperation.19 A brief prepared for the Global Forum is available in Annex 9. Each panelist was asked to comment on the following: What were the effec- tive ways to include nutrition in social protection programs? What were the operational challenges of implementation and political commitment? What were the incentives for all players to come together? Following each presenta- tion, the panelist was asked to respond to a question from the moderator. All presentations were followed by a moderated discussion and a chair summary, delivered by Rob Vos. Rob Vos (Director for Social Protection and Coordinator of the Strategic Programme for Rural Poverty Reduction, FAO) BRICS countries were instru- mental in forging the political will around the ICN2 agenda. The commit- ments made by governments20 for which they must be held accountable included: to “incorporate nutrition objectives into social protection programs and into humanitarian assistance safety net programs” and to “use cash and food transfers, including school feeding programs and other forms of social protection for vulnerable populations to improve diets through better access to food.” Global improvements in undernutrition are driven, in part, by the success of BRICS countries in reducing poverty and hunger, and their experi- ences are instructive in how to bring programs to scale. Despite widely varied contexts, conditions and approaches, shared elements are: • A systems approach to link social protection programs with nutri- tion-specific programs. This enhances impacts and aligns with other complementary sector policies and programs; • Political commitment to pro-poor and nutrition objectives in social pro- tection programs, without which it’s difficult to achieve success; • The right to food and good nutrition, enshrined in legal and normative frameworks; 34 Leveraging Social Protection Programs for Improved Nutrition: Report • Clear institutional arrangements to facilitate communication about the program and engage the actors that deliver the results; and • Commitment to monitoring and evaluation, which can inform program design and improve quality. Arnoldo de Campos (National Secretary for Food and Nutrition Security of the Ministry for Social Development and Fight Against Hunger, Brazil): Zero Hunger was designed as a poverty control program. It was made possible due to the political will of the government, and has achieved dramatic results, including reducing infant mortality by 65 percent. Zero Hunger seeks to provide food and resources to vulnerable social groups, providing 14 million rural and urban households with transfers, access to job opportunities, healthcare and educa- tion. A system of monitoring and control is coordinated between sectors “to organize our work and streamline the process.” This helps to introduce new initiatives into the program and improve the target indicators. Multisectoral approaches are applied to current challenges, including enhancing the quality of the healthcare provided, and addressing overweight/obesity and NCDs. Vyacheslav Smolenskiy (Director for Science and International Relations, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing [Rospotrebnadzor]): Russia employs ICN2 principles in link- ages to the food chain. These aim to ensure healthy diets, including health and nutrition education to prevent NCDs and reduce obesity, provision of essential micronutrients to young children, provision of food allowances and subsidies to pregnant and lactating women, school-age children and workers in vulnera- ble social strata, and food safety. Russia has a three-tier system to ensure food safety and food quality, and scientific research guides policies and recommen- dations for healthy diets and energy requirements. This, together with data on food production and per capita food consumption, informs future planning of the food supply. Russia’s commitment to cooperation in social protection and nutrition is evidenced by over US$200 million in funding to IOs and over two dozen countries. Russia also supplies technical assistance related to healthy life- styles and diet and school feeding, and dissemination of global best practices in leveraging social protection to improve nutrition. The challenging economic environment requires tools to share experience and knowledge more efficient- ly—“less costly but producing greater benefit and impact for countries.” Sanjay Mahendru (First Secretary – Trade, Embassy of India in Russia): India is addressing challenges of social protection and nutrition through a coordinated approach across multiple ministries and programs. These include subsidized food distribution, rural planning programs, and a child grant for girls, school feeding with supplementation of essential micronutrients, and the Integrated Child Development Services (ICDS) program. The approach is supported by 1.2 million Anganwadi centers, which can reach the farthest corners of the country. Reforms underway include a shift from in-kind transfers to direct cash transfers, and the promotion of financial inclusion by requiring a bank account to receive subsidies and cash transfers. Priorities include addressing nutrition Leveraging Social Protection Programs for Improved Nutrition: Report 35 during emergencies, and the gender gap in nutrition that occurs after the age of 1, whereupon girls suffer a “Exchange of successful sharp decline in nutrition status compared to boys. experiences will go a long Thando Dalamba (Political Counsellor, Embassy of way in ensuring that there is South Africa in Russia): South Africa has a compre- no child that is deprived of hensive social protection system, which is guided by nutrition, especially at the the right to health care services. This includes pre- critical period of 1,000 days.” ventive health care, sufficient food and water, and social security. Children are disproportionally repre- sented among the poor; they are the most vulnerable and are at the greatest risk of malnutrition, disease, and abuse. Social assis- tance has expanded at an unprecedented rate, with the number of beneficia- ries increasing from 2.7 million in 1994 to 16 million in 2013. The child support grant has grown the most. In collaboration with civil society, SA has introduced programs on children’s rights to nutrition, education, safety, and protection. “Exchange of successful experiences will go a long way in ensur- ing that there is no child that is deprived of nutrition, especially at the critical period of 1,000 days.” Moderated Discussion Below is a summary of the discussion; Comments are not necessarily comprehensive or representative of all partners. BRICS cooperation on social protection, food security and nutrition. All that is needed is political will. Periodic BRICS meetings—including upcom- ing meetings with the ministers of agriculture and health—are viable plat- forms for country ministers to take up the issue. Chair Summary. Success is achievable despite a variety of contexts, through international and South-South cooperation, and platforms for exchange. The BRICS Session Summary (Annex 10) follows up on the deliberations of the Global Forum. Learning from the Field: Case Studies of Nutrition- Sensitive Social Protection Programs Two working group sessions used the world café method to present case studies21 of nutrition-sensitive social protection programs. They provided a critical review of how they work to generate understanding of the processes and challenges involved. These two sessions held the greatest prominence in the Global Forum. Each of the ten tables were assigned a case study, and a Case Study Representative from the project and Expert Facilitator (Annex 8) remained at each table for the duration of the session. Participants received case studies in advance and selected a table based on their interest and the availability of chairs. “Whisper” interpreters were provided to facilitate multi-lingual 36 Leveraging Social Protection Programs for Improved Nutrition: Report groups. Given limited availability of interpreters, some tables were assigned language groups. After a brief overview of the program by the Case Study Representative, the Expert Facilitator opened the discussion, which aimed to develop the lessons learned in implementing a nutrition-sensitive social protection program in the specific country context. The lessons included: what were the elements of the problem statement that this case addresses? What did the case teach us about how to implement a nutrition-sensitive social protection program or project? What barriers to integration did the implementers of this case face? How did they overcome those barriers? After 45 minutes, participants were invited to move to another table, with the opportunity to visit four case stud- ies. At the conclusion of each session, a representative from each table deliv- ered a brief summary of the key lessons learned. A more comprehensive presentation of each case study is available in the Compendium. Strengths Challenges & Opportunities Bangladesh: Income Support Program for the Poorest Integrated approach. Links cash transfer with Evaluation. Little impact on stunting despite regular growth monitoring and checkups. improvements in dietary diversity and consumption. Women’s empowerment. Earmarking women as Sensitization and nutrition education aims to translate recipients of the transfer aims to increase the well- the cash transfer into improved diets, but the impact being of the household. of BCC on choices is difficult to determine. Community ownership. Participation of local community and institutions in implementation. Brazil: National School Feeding Programme Multisectoral coordination. A 60-year running Local procurement in urban areas. It is difficult to program, coordinated across ministries and levels find farmers who can produce sufficient quantity for (local, state) of government. urban schools to meet the 30% local procurement law. Policy coherence. All public schools must Financial sustainability. The sustainability of the guarantee at least two meals per day; 30% of food budget is only ensured if responsibility is shared for school feeding must be locally procured. across ministries and departments. Integration, Decentralization. Central government transfers decentralization, and social/community participation funds to local and state governments, which are important. contribute additional funds and implement. Each school has a nutritionist who procures the food and prepares the meal, based on the local availability of nutritious foods. Brazil: Zero Hunger Strategy Political will. The strategy had the support and Enabling environment. A lack of trust from the commitment of the President. general public; a lack of legislation at all levels; Decentralization. Cross-sectoral coordination of fragmentation among the ministries, agencies and many institutions and civil societies, achieved through institutions involved; and issues with the distribution of the creation of public systems and clearly defined funds and financing. priorities, will enable programs to run effectively. Cabo Verde: National School Food and Nutrition Programme Comprehensive approach. Promotes nutritious, Decentralization. Tradeoffs in contracts, roles and locally sourced fresh foods, and incorporates nutrition responsibilities, depending on whether each school and hygiene education. has its own kitchen versus centralized preparation and Coordination and collaboration. Across multiple delivery of food. levels of government, UN agencies, farmers, food Targeting. Given the limited budget, there are traders, parent/teacher associations, municipal tradeoffs between universal coverage of school meals governments, and sellers. versus only targeting vulnerable households (e.g. social stigma). (continued on next page) Leveraging Social Protection Programs for Improved Nutrition: Report 37 Strengths Challenges & Opportunities Republic of Congo: Nutrition-Sensitive Urban Safety Net Programme Comprehensive approach. Distribution of Sustainability. Political will is needed to sustain the nutritional supplements in addition to cash transfers, program beyond the planned 18 months. Supporting targets on 1,000 days, and gender sensitivity. the program with BCC and incorporate income- Government ownership. Government funds 60% generating activities is critical to sustain its impact. of the cost. Enrollment selection. Criteria could be modified to incorporate the status of nutrition– identified through health services—as opposed to current the criteria, which is based on vulnerability as identified by the ministry of social affairs. Djibouti: Social Safety Net Project Comprehensive approach. Addresses the various Sustainability. Contributes to the development of obstacles to improving nutrition by targeting on 1,000 a sustainable social protection system by creating days and combining behavior change with income a MIS, rigorous impact evaluation, and other transfer. instruments. Community engagement. BCC happens at the M&E. Rigorous M&E activities aim to inform community level, is led by community volunteers, and implementation and link social protection and nutrition is open to the entire community. interventions. Dominican Republic: Progresando Con Solidaridad Government ownership. Launched by the Meeting the need. Reaching non-targeted groups Executive Office of the President, demonstrating a who suffer from undernutrition. high level of political will. Sustainability. There is a need to allocate the Multisectoral collaboration. Joint efforts between government budget so that social protection programs the ministries of health and social protection to link are not dependent on any particular political party, or to 1,000 days programming, including distributing vulnerable to crises. micronutrients, food supplements, and fortified foods to children up to 59 months of age. Ethiopia: Productive Safety Net Program Program design. The model is a well-functioning, Innovation at scale. Incorporating and financing sustainable, large-scale social protection program; innovations into an existing large national program. over time, it has integrated nutrition in ways that are Multisectoral collaboration. Sustaining progress on practical and doable on a national scale. the core program while being responsive to partner Multisectoral coordination. Links with existing and sectors’ agendas (e.g. nutrition, climate change, etc.). new policies (e.g. national nutrition program, social Financial sustainability. Transitioning to long-term protection policy) and programs (community-based sustainable government financing, rather than relying nutrition systems). on donor funding. Haiti: Kore Lavi Government ownership. The program was Consensus building. Getting key ministries and other designed for institutionalization at its outset, stakeholders to work together for the first time caused supported by multi-donor funding. delays in reaching a consensus on instruments, Multisectoral collaboration. Creation of a national principles, and mechanisms. deprivation and vulnerability index with participation Capacity and governance. Going beyond the usual of key stakeholders. scope of social protection requires issues of civil Linkages to agriculture. Drives support of locally service reform, government staff salaries, incentives, produced food, promoting long-term development etc. to be addressed. and decreasing reliance on foreign imports. Oversight. Monitoring stringent requirements for Linkages to health. Social protection resources (over 500) local partner vendors requires substantial support public health policy, and deployment of the management. community health network. 1,000 days. Conditional nutritious food vouchers require beneficiary participation in behavior change education. Most of the local partner vendors are women. (continued on next page) 38 Leveraging Social Protection Programs for Improved Nutrition: Report Strengths Challenges & Opportunities Indonesia: PNPM Generasi Program Decentralization. Community-driven block grants Evaluation. The innate flexibility of the community- improve education and health outcomes. Strong driven approach makes it a challenge to attributing the community ownership results from the opportunity to impact and assessing the cost benefit of the program. choose. Coordination. Achieves synergies through coordination with other programs (e.g. PKH cash transfer), which drives demand for the services supplied. Indonesia: Program Keluarga Harapan (PKH) Prestasi Women’s empowerment. As a result of education Nutrition impact. A lack of evidence of nutrition programs and the organization of regular informal impacts. However, additional features have been meetings to discuss nutrition issues. incorporated, including capacity-building, sensitization Local government engagement. The sensitization of service providers, and nutrition education for the of local authorities on nutrition issues and the women and communities. promotion of regulations and action plans to address local nutrition challenges. Kenya: Cash Transfers for Orphans and Vulnerable Children Government ownership. The Government funds Hard-to-reach beneficiaries. To minimize 80% of costs, demonstrating a high degree of the burden on beneficiaries, partner banks are ownership and assuring sustainability. contractually required to locate agents within six Targeting. The three-tier targeting system, including kilometers. validation at the community level. Use of technology. Graduated from a manual registration to a MIS. All beneficiaries are registered, and “secure” payments using biometric data are facilitated by two local banks. Kyrgyz Republic: Optimizing Primary School Meals Programme Affordability. Provides a nutritious meal for just Transparency and accountability. Community $0.16 USD. engagement was used to address concerns over Decentralization. Enables closer links with corruption. Through parent associations, parents were agricultural cooperatives and smallholder farmers, involved in the design of the menu and had control of resulting in cost savings and more nutritious meals. the program. Parents provide financial support to the Hot meals are organized by the schools, according to national program. a menu of local dishes that are liked by the children. Feasibility. Schools not in the pilot scheme competed amongst themselves to implement the program improvements (e.g. redesigned menus, improved infrastructure and information campaigns) on their own. Mali: Emergency Safety Nets Project (Jigisèmèjiri) Program design. Originally conceived and funded Financial sustainability. Meeting the needs, given its as an emergency project, and an example of how start as an emergency program and its related budget a short-term program can evolve into more of a constraints. nutrition-sensitive development program. This is Behavior change. Whether quarterly sensitization illustrated by the difference of the official name sessions are sufficient to change behavior, and/or (“Emergency Safety Nets Project”) and the local what more could be done to improve the impact on name, “A tree of hope.” nutrition outcomes. Cross-sectoral collaboration. Harnesses the local Health services supply/demand creation. knowledge of NGOs and communities to improve Annual child development monitoring is insufficient government service provision. to ensure timely intervention. How can we ensure “Soft” nutrition conditions. Cash transfer that beneficiaries and the community have access to sensitization sessions are open to the community. regular health checkups to monitor child growth and Despite not being mandatory for beneficiaries, development? 80–90% of beneficiaries attend. (continued on next page) Leveraging Social Protection Programs for Improved Nutrition: Report 39 Strengths Challenges & Opportunities Mexico: Mexico Program of Social Inclusion PROSPERA Multisectoral integration. Intervenes via different Reaching indigenous households. Communication sectors (e.g. education, early child development, and involvement of indigenous people. agriculture, and nutrition). It also addresses long-term Integrating early child development. Linked to issues by helping beneficiaries engage in income- enhancing provision and opportunities for early child earning opportunities, enrolling beneficiaries in social development at different levels. insurance, and providing activities aimed at improving Addressing DBM. Simultaneously addressing rising social cohesion and participation. obesity in urban contexts and undernutrition in rural Supply/demand integration. Addresses both the and indigenous communities. demand side (via cash transfer itself and via the conditions imposed on the cash transfer), and the supply side (by supporting local health centers). Myanmar: Tat Lan Program: Maternity Cash Transfer Pilot 1,000 days. Pregnant women are eligible and remain Infrastructure. One of poorest areas of the country, in the program until the child is two years old. with severe challenges incl. access by boat, a lack of Evaluation. Evaluating the impact of cash alone banks, a cash-based economy, and no mobile phone versus cash plus behavior change communication on coverage. nutrition indicators (e.g. IYCF, dietary diversity, birth Targeting and enrollment. People commonly do not weight, or stunting). have identity cards, or alternatively there is duplication Program design. Designed from the start to improve in registries. nutrition. Time constraints. Is two years a sufficient duration to build evidence and inform government decision- making? Niger: Niger Safety Net Project Country ownership. Strong country leadership, Meeting demand. The country context is already oversight, and engagement with local governance. dire, and is vulnerable to climate change and variances The safety net unit is coordinated through the Prime in food prices. Reaching a million direct beneficiaries Minister’s office. across five regions with monthly household visits often Comprehensive approach. Transfers are disbursed requires agents to travel over ten km. to the women representatives of the household, Evaluation. Measuring the uptake and adoption of and are accompanied by nutrition sensitization nutrition practices (e.g. eating habits, complementary and training as a soft conditionality. Holistic child feeding) is a challenge, as is assessing and monitoring development includes parental training on nutrition, child development to ensure that the program is health, sanitation, and psychosocial stimulation. having the intended impact. Standardization and quality. The design of the Coordination. How to link to, and align with, program was informed by formative research and complementary activities supported by other piloting to ensure feasibility, uptake and engagement. government programs (e.g. productivity improvement). The effort to understand ex ante potential barriers Sustainability. The Government has been challenged has proven to be extremely beneficial in rollout and to integrate the program into their overall strategy and delivery. address cost issues after the project closes in 2017. Duration and frequency of transfer. Cash transfers are delivered in small, regular increments over a long time (24 months). Nigeria: Child Development Grant Program 1,000 days. Beneficiaries are enrolled at pregnancy Unanticipated fraud. Women purchased urine and benefits continue until the child’s 2nd year. from pregnant women to qualify for the program. To Evaluation. The program is designed as a discourage this, the project instituted randomized Randomized Control Trial Pilot, evaluating the testing of beneficiaries to verify pregnancy status. impacts of varied intensities of SBCC, i.e. nutrition Unintended consequences. To address concerns SBCC “lite” versus “intense” use of mass media and that the program could drive increased fertility, it was mobile marketing, and implications for cost. designed to benefit only one child, and to emphasize Community participation. Uses community SBBC on birth spacing. volunteers to provide nutrition education. Sustainability. The project was implemented by NGOs but was intended for eventual Government ownership. It works to engage the Government (e.g. in costing exercises) to ensure buy-in. (continued on next page) 40 Leveraging Social Protection Programs for Improved Nutrition: Report Strengths Challenges & Opportunities Peru: Juntos Results for Nutrition SWAp Government ownership. Engaging the Minister Financial sustainability. The nutrition-sensitive of Finance has been crucial in raising the political component is a small project within a bigger program importance of the project. for poverty reduction. Government support is needed Multisectoral coordination. Formal agreements to continue it after the project closes. between government sectors provide clarity around Scale-up. Expanding coverage to other burdened resource transfers. geographic areas. Social monitoring. A district-based social Service quality. Ensuring and managing the delivery accountability mechanism oversees nutritional of standard quality services. outcomes led by local government. Quality of data. Accurate monitoring and impact Integrated approach. Using performance-based evaluation relies on inter-sectoral data. financing to address both the demand and supply Infrastructure. Remote areas and poor transportation sides of health and nutrition services. limits access. In some areas, the lack of potable water and electricity can hamper delivery. Philippines: Philippines Social Welfare Development and Reform Project Targeting. Uses community participation to identify Security. Securing the delivery of cash transfers is a and vet vulnerable households. challenge in some areas. Institutional arrangements. MOU between federal Evaluation. The impacts of nutrition-sensitive level government and municipal level government, interventions inherently come from indirect routes (e.g. outlining mutual roles and responsibilities. through information sharing, alleviation of poverty). Information systems. Provides a centralized Deliberate action is needed to measure how they mechanism for information sharing between funnel up to improved nutrition outcomes. government entities and institutions. Syrian Arab Republic: Fresh Food Vouchers for Pregnant & Lactating IDP Women Systems approach. Supplements the standard Crisis. Systemic approaches are used to deploy ration to meet the nutritional needs of PLW by nutrition-sensitive social protection program despite providing access to more fresh fruits, vegetables, and conflict situations. meat. They are provided through vouchers that can Capacity. Only markets that have the capacity be redeemed in partner supermarkets. Enrollment to reliably provide nutritious foods and withstand requires the verification of PLW status at a health delayed payments can participate. This limits the center, which in turn triggers participation in other number of partner shops and increases the burden programs (e.g. ANC, micronutrient supplementation on beneficiaries, who must use specific large and other voucher programs, incl. covering the cost supermarkets. of the delivery). Intra-household power distribution. In extremely Information systems. Database and MIS together poor households, other household members will are an essential backbone of the program. Vouchers inevitably share transfers. Vouchers were designed to are being converted from paper to electronic formats. protect the direct beneficiary (i.e. the PLW), who also Partnership. Implemented through a network of has control over the purchase choices. Sensitization NGOs rather than a single agency. They provide campaigns targeting all family members aim to ensure training and sensitization sessions in addition to the that the importance of good nutrition during the 1,000 vouchers. Partnerships are developed with other days period is understood. agencies providing programs for PLW. Tanzania: Tanzania Productive Social Safety Net Political will. Capitalized on high-level government Capacity. As a large-scale program reaching 50% commitment to 1,000 days period to redesign a of the population (over six million people), human poverty reduction program to be more nutrition- resources, including technical staff engaged from sensitive. other sectors that are already busy with other 1,000 days. Includes childcare as a work activity, responsibilities, are limited. Program activities are in recognition of the importance of care practices sequenced by geographic area to ensure adequate as a cause of stunting, and of the need to offer coverage. childcare support for beneficiaries. Cash transfers are disbursed to the woman of the household. Behavior change. Nutrition education is delivered at the time via the disbursement of cash transfers. Information systems. The electronic registry is designed to interface with other systems and/or sectors. Leveraging Social Protection Programs for Improved Nutrition: Report 41 New Horizons for Nutrition-Sensitive Social Protection This was the last of the working group sessions that a modified world café methodology. Its objective was to consider new challenges and opportunities when improving nutrition through social protection interventions. The New Horizon topics were representative of 18 cross-cutting themes, which were identified in the case studies22 and in consultation with partner IOs. There were 16 tables. Each was assigned a theme and an Expert Facilitator (Annex 8) who remained at the table for the duration of the session. Participants received the list of themes in advance and selected a table based on their interest and availability of chairs. “Whisper” interpreters were pro- vided to facilitate multi-lingual groups. With guidance from the Expert Facilitator, participants were given 15 minutes to discuss how the theme relates to nutrition-sensitive social protection, new opportunities or chal- lenges it poses, how programs can capitalize on these opportunities and/or overcome these challenges, and any gaps in what we know in relation to the theme. After 15 minutes, participants were invited to move to another table, rotating among tables with the opportunity to visit four themes. Time con- straints and fatigue, however, resulted in just two rotations. There was no reporting back from this session. What Have We Learned? This penultimate session aimed to provide participants the chance to reflect on lessons learned from the Global Forum and, together, to outline the key take-away messages and next steps. Participants were asked to spend a few minutes individually reflecting upon and writing down three things (e.g., a message, a method, or a particularly memorable quote) that stood out in their mind from the two days (i.e., a short term “critical incident”). Participants were then given approximately 20 minutes for discussions with their table to determine the most important lessons of the Global Forum. Contributors were then called back into plenary for a moderated discussion. IO representatives were asked to consider the following questions: What are the key points you have learned from the Global Forum? How will these influence or inform organizational operations in the future? What knowledge gaps still need to be addressed? What is needed to move forward? Country representatives and other participants were asked to consider different ques- tions: What are the key points you have learned from the Global Forum? What do country governments recommend for establishing or continuing the integration of nutrition-sensitive / social protection programs at the country level? What support do countries need from the international community in order to carry this forward? 42 Leveraging Social Protection Programs for Improved Nutrition: Report Below is a summary of the discussion; Comments are not necessarily comprehensive nor representative of all partners. Behavior change. BCC can contribute to increasing Given limited project the impact of social protection on nutrition outcomes. resources and the number of However, given limited project resources and the number of topics that need to be covered (e.g., hygiene, topics that need to be covered sanitation, ECD, and family planning), are we capable (e.g., hygiene, sanitation, ECD, of doing enough? How do we make it effective? How and family planning), are we do we sequence it? Technology and the social media capable of doing enough? innovations associated with it offer huge opportuni- ties that have not yet been maximized. Partnership. Government ownership is a cross-cutting theme encompassing the cases featured in the Global Forum. However, government involvement alone is insufficient; effective programs require community support and civil society engagement. Crises. Special strategies are needed for designing nutrition-sensitive social protection interventions in crisis settings and/or social protection programs that can be scaled up to effectively respond to emergencies. Different crises have different characteristics; among those briefly discussed at the Global Forum were conflict, climate change, and food price. Of particular impor- tance, no matter the predicament, are interventions aimed at addressing the specific nutrition needs of children. Financing. Social programs are crucial for reducing malnutrition and pov- erty, yet limited budgets and financing are key issues for many countries. Governments need to integrate social programs into their broader framework and create budgetary safeguards so that they can be adequately funded. Politically difficult conversations around prioritization are also needed. Nutrition-sensitive social protection is both an investment and a step toward equity, which makes it a doubly important. Integration. Social protection can be a lever for driving change in other sec- tors (e.g., agriculture, health, and education) with important implications for sustainability. Knowledge sharing. A “wealth of information” was gained at the Global Forum through airing the struggles and achievements of the cases. There is a lot still to learn and a lot of knowledge and lessons available. Many of the challenges are not unique to any single location, and it is helpful to know that there are shared challenges and, therefore, opportunities to learn from each other. Tapping into compartmentalized knowledge, however, is a challenge, and the Global Forum—though limited—was an enormous and “fantastic” opportunity for collaboration. It was also a unique opportunity for bringing Leveraging Social Protection Programs for Improved Nutrition: Report 43 nutrition practitioners and social protection practitioners together in one room. In order to make an impact, however, the knowledge and lessons shared at the Global Forum—and results of various impact studies being con- ducted—need to disseminate into the wider literature. Improved access to information and knowledge products is key. Social media, as well as global and organizational dissemination platforms can be better leveraged. Local solutions. Though we are working towards a common understanding of a social protection Though we are working towards approach that incorporates nutrition, country con- a common understanding of a texts and resources vary tremendously and so too social protection approach that will their ability to deliver. We are beyond the stage of looking for models. Every country, every context, incorporates nutrition, country every specific locality comes up with its own way to contexts and resources vary solve its own problems. tremendously and so too will M&E. Given widely varied country contexts and their ability to deliver. interventions, ensuring that programs are imple- mented well is a challenge. Measuring program execu- tion, performance, and results is important, as is using that information to inform program design and optimization. Having good data collection pro- cesses, monitoring methods, and transparency is required. Program design & delivery. Improving impact on nutrition can be achieved through design enhancements to existing programs, and does not require cre- ation of new programs. Many case studies featured in the Global Forum included programs that were designed to put in place a social safety net system and evolved to be more nutrition-sensitive over time with added components. Others were designed from the start to be nutrition-sensitive. Technical sup- port is needed at the implementation level from both social protection and nutrition specialists. Targeting. There is no consensus among Global Forum participants on the extent of prioritizing the nutritionally vulnerable in social-protection pro- grams. However, the rationale for “putting a stronger nutrition lens to social protection projects” and the importance of addressing children’s development is generally understood. Social protection and social welfare are fundamental aspects of the sustainability of a society. There are trade-offs to prioritizing the first 1,000 days versus other groups among the poor, and the consequences affect the overall social protection portfolio. Closing Remarks Closing remarks were delivered by Andrey Bokarev, Director of the Department of the International Financial Relations, Ministry of Finance, Russian Federation, to thank participants and close the Global Forum. 44 Leveraging Social Protection Programs for Improved Nutrition: Report Andrey Bokarev (Director of the Department of the International Financial Relations, Ministry of Finance, Russian Federation): Our joint efforts will help us increase efficiency of social protection and nutrition programs, and move this important issue forward. The Global Forum was successful in providing the opportunity for exchanging views and deepening current approaches. It was widely supported and mentioned in the agendas of important global events, including: ICN2, the Third International Conference on Financing for Development, and the UN Summit Sustainable Development Summit. Participation, including among the BRICS countries, demonstrates mutual commitment to building strong support, as well as political will towards reducing poverty and eliminating food insecurity by capitalizing on each oth- er’s experience, networks, and outreach for raising awareness. Leveraging Social Protection Programs for Improved Nutrition: Report 45 Evaluation Evaluation of the Global Forum took place over two sessions, Taking Stock (Session Seven) at the end of Day One and the final evaluation at the end of Day Two. In both cases, the evaluation was conducted using a remote device (a “clicker”) to anonymously vote. Feedback from the Day One Taking Stock session was used to inform Day Two proceedings. Complete results are avail- able in Annex 11. Feedback during the Global Forum and subsequent solicited and unsolic- ited follow-up was overwhelmingly positive. The working group sessions (i.e., Creating Synergies, Learning from the Field, and New Horizons) were the most highly rated, along with the Statement of the Problem and the Keynote Address. In general, participants enjoyed the opportunity to share experi- ences and to learn from each other. The Statement of the Problem and Keynote Address clearly filled a need for foundational information. In corroboration of the results of the vocabulary quiz, participants reported being exposed to new terminology and information about nutrition for the first time, as well as new approaches to nutrition-sensitive social protection. The most prominent key messages were: • “Poverty and malnutrition are multidimensional and require a multidi- mensional approach,” 46 Leveraging Social Protection Programs for Improved Nutrition: Report • “Social protection is an investment, not an expenditure,” and • “A lot can be gained synergistically by integrating social protection and nutrition-sensitive interventions and approaches.” Overall, the vast majority of participants reported that the Global Forum provided “new information, insights, and approaches,” rating the event as “overall excellent, with some gaps” with a quarter rating it as the “best confer- ence ever attended.” Nearly all participants intended to take some substantive action to use what they had learned upon returning from the Global Forum. Leveraging Social Protection Programs for Improved Nutrition: Report 47 Annexes 48 Leveraging Social Protection Programs for Improved Nutrition: Report Annex 1: Global Forum Objectives and Achievements Objective How it was achieved 1. Better understand existing • Mobilization to identify country examples of nutrition-sensitive social needs of countries to assist protection programs and support to create standardized case studies. them in setting up well- • Anchoring of Forum proceedings in the case studies and other functioning nutrition-sensitive examples, including three sessions of varied working group sessions and social protection programs. four “project snapshot” presentations to generate understanding of the instruments, processes, and challenges, as well as to facilitate feedback. • Compilation and publication of the case studies as a compendium to benefit the broader community. 2. Support countries in catalyzing, • Design of an innovative program to guide participants through a process building commitment for, of understanding the synergistic potential of nutrition-sensitive social designing, establishing, protection through participatory learning methods. managing, and scaling up • Majority of participants reported that the Global Forum provided new nutrition-sensitive social information, insights, and approaches “somewhat” or “to a great degree” protection programs through (91%), including exposure to new nutrition terminology and examples of providing technical assistance nutrition-sensitive social protection programs. and capacity development to • Most participants also reported their intention to share what they learned governments. with colleagues (85%) and use it to inform future nutrition-sensitive social protection program design and implementation (84%). • In a follow-up survey, all respondents (20) indicated they shared information gained from the Global Forum with colleagues in their organization; 81% shared information with colleagues outside of their organization; 81% reported to have led or supported training on nutrition- sensitive social protection; 92% reported to have used resources learned about or received at the Global Forum in their work; and 85% reported to have learned information or approaches that made an impact on their work at the country level. 3. Disseminate best policies and • Publication and dissemination of a three-part Leveraging Social practices, as well as innovative Protection Programs for Improved Nutrition series, including: Summary approaches in the area of of Evidence Prepared for the Global Forum on Nutrition-Sensitive Social social protection systems Protection Programs, 2015; Compendium of Case Studies Prepared by linking food security and for the Global Forum on Nutrition-Sensitive Social Protection Programs, nutrition, poverty reduction, and 2015; and Report on the Proceedings of the Global Forum on Nutrition- agricultural production. Sensitive Social Protection Programs, 2015. • Materials from the Global Forum (e.g., keynote addresses and program snapshot presentations) were provided to attendees on a USB thumb drive and will be made available on the SecureNutrition website (www.securenutrition.org). 4. Improve access to knowledge • Compilation of a curated library of resources on nutrition-sensitive social and build awareness related protection that was provided to participants on a USB thumb drive made to nutrition-sensitive social available on the SecureNutrition website protection through presentation (www.securenutrition.org). of existing international • Publication and dissemination of the three-part Leveraging Social initiatives, knowledge platforms, Protection Programs for Improved Nutrition series. and tools (including the • Co-hosting of a multilingual online discussiona by SecureNutrition and the SecureNutrition Knowledge FAO Global Forum on Food and Nutrition Security, which explored key Platform). questions related to nutrition-sensitive social protection and was held in conjunction with the Global Forum. • Design and rollout of a seminar series hosted by SecureNutrition addressing the lessons learned and gaps identified in the Global Forum. • Invitation to Forum attendees to subscribe to the SecureNutrition monthly newsletter and discussion group in order to keep up with future related knowledge products and events. (continued on next page) Leveraging Social Protection Programs for Improved Nutrition: Report 49 Objective How it was achieved 5. Facilitate South-South and • An engagement-oriented format, made up of working groups that were Triangular cooperation through discussion based, facilitated the sharing of other diverse experiences in an exchange of experience nutrition-sensitive social protection programs. and of lessons learned among • Dedicated BRICS session focused specifically on the lessons that can countries for the identification be learned by low- and middle-income countries from the ongoing of individual pathways in experiences of Brazil, Russia, India, China, and South Africa in developing nutrition-sensitive overcoming malnutrition and increasing growth. social protection programs • A flexible program enabled participants to choose for themselves the specific to their national needs. most relevant examples to their own country contexts. • Financial support from the Russian Federation enabled attendance of approximately 150 participants from over 20 countries, and provision of simultaneous interpretation in six languages for all Forum proceedings ensured meaningful participation. 6. Enhance coordination • Participation in the Global Forum included high-level government officials, and cooperation among program managers, researchers, and technical practitioners representing development partners and multilateral and bilateral donors, United Nations agencies, research international organizations in and academic institutions, international and local non-governmental order to harness the resources organizations, the private sector, and, most importantly, country of a diverse range of actors representatives from low- and middle-income countries. involved in nutrition-sensitive • Several participants commented on the value of participating in such social protection programs. a unique opportunity to come together across agencies, sectors, countries, and languages to share experiences and learn from each other. • In a follow-up survey, all respondents reported they have shared information gained from the Global Forum with colleagues in their organization; 81% shared information with colleagues outside of their organization; 81% reported to have led or supported training on nutrition- sensitive social protection; 92% reported to have used resources learned about or received at the Global Forum in their work; and 85% reported to have learned information or approaches that made an impact on their work at the country level. • Over two-thirds (62%) have continued engage with people they met at the Global Forum. 7. Promote engagement of • Leveraged the convening power of the World Bank Group and partner all-interested stakeholders international organizations to generate awareness around nutrition- including governments, sensitive social protection and its potential for catalyzing individual and private sector, civil society, national growth and development. NGOs, international and • Design and implementation of a multifaceted social media and regional organizations, and communications campaign to engage the broader community of other development partners in practitioners and other stakeholders. designing and implementing • Strengthening of capacity among technical practitioners to advocate nutrition-sensitive social for and increase effectiveness of nutrition-sensitive social protection protection programs. programs in their respective countries through sharing and dialogue on the evidence and operational experiences around the world. sensitive social protection programs around the world – What’s being done and to what effect? (http://www.fao.org/fsnforum/ Nutrition-­ forum/discussions/social-­protection-­nutrition). 50 Leveraging Social Protection Programs for Improved Nutrition: Report Annex 2: Lessons Learned Key theme(s) Lessons learned Challenges Gaps Opportunities Political will. Progress made with MDGs was “Poor countries have a large Trade-offs of targeted (e.g., 1,000 ICN2 resulted in substantive Financial sustainability. insufficient. number of poor [people], and small days) verses universal coverage. commitments made by governments Tradeoffs. We will not achieve SDGs if we budgets.” Need to enhance the evidence base on with regard to nutrition and social Prioritization. do not do something dramatically Many countries do not have the the impact of nutrition-sensitive social protection, to which the global different, now. resources to provide a meaningful protection and support development of community must hold them Addressing income growth alone is amount of transfer to the entire strategies to make the case. accountable. insufficient to achieve SDGs. vulnerable population. Listen to and involve more of the Remarkable progress against Prioritization is politically very ministers of finance (i.e., “the man or poverty and malnutrition is possible difficult. woman who decides the budget”). with sufficient political will, no matter Trade-offs of prioritizing targeting the Address nutrition-sensitive social the context-specific constraints. nutritionally vulnerable (i.e., “putting protection from a rights-based Improved nutrition is a driver of a stronger nutrition lens to social perspective. For example, the right to economic growth. protection projects”) and resulting food and good nutrition protected in Government ownership is important. consequences for the overarching legal and normative frameworks. Importance of political commitment SP project portfolio. Generate taxes from people graduating to pro-poor and nutrition objectives out of poverty to close the loop and in social protection programs, make programs financially sustainable. without which it is difficult to achieve success. “They need to understand that social protection is an investment, not an expenditure.” Partnership. Partners must coordinate and Collaboration across partners Despite broad agreement that IT and social media platforms for collaborate to strengthen the and sectors is required in order to partnership and collaboration is vital, it sharing experience and knowledge linkages between social protection achieve global targets (SDGs). is a rare opportunity for stakeholders with minimal cost. and nutrition. Understanding of key nutrition to come together across agencies, There are opportunities to leverage Understanding the unique terminology and evidence underlying sectors, and countries to share new technologies for dissemination of Leveraging Social Protection Programs for Improved Nutrition: Report perspective of each International rationale for nutrition-sensitive social experiences. nutrition education messages and its Organization (IO) in tackling protection is weak. associated challenges. malnutrition and social protection is instructive. (continued on next page) 51 Key theme(s) Lessons learned Challenges Gaps Opportunities 52 Immensity of the Nutrition-sensitive social protection “There is a lot of experience on the How to design for a scale-up of social Leverage the money, resources, and challenge. solutions come from the countries ground but also a lot to learn.” safety nets in emergencies, as well as time put into school feeding and ensure Overweight/ obesity & themselves; “we don’t have the Persistent high rates of to absorb crises. There is currently no they provide a complete package DBM. solutions for all the cultures.” undernutrition. known compendium of best practices. (e.g., nutrition education, micronutrient Climate change. Many challenges are shared across Rising rates of overweight/obesity How to bridge emergency response supplementation, deworming, Crises countries. that accompany economic growth. and social protection. and nutrition education), not just a Food waste. There is a great deal of knowledge, To start a safety net from scratch How to design for climate change. schooling incentive but also a program Resilience. a lot of best practice, and much in the midst of a crisis is difficult. To How to reach adolescent girls or for nutrition enhancement. experience to draw from. make it nutrition-sensitive is harder women pre-pregnancy. School feeding programs can address There are two distinct routes to still. Need to have a comprehensive the problem of obesity, introduce establishing a nutrition-sensitive Food waste as a contributor to approach for tackling the double better diets, and address the childcare social protection program: malnutrition. burden of malnutrition. messages that students will need in the (1) evolution through iterative next phase of their life: how to care for improvements to increase impact on the next generation. nutrition, and (2) designed from the The nutrition sector has not maximized start to impact nutrition outcomes. use of mass media and social media. Synergy. Poverty and malnutrition are Nutrition is not the purview of any Identify other ways to operationalize Social protection has a unique power Integration. multidimensional and require a one sector. linkages, including how to take to generate incentives for food systems Multisectoral multisectoral approach. There often are no mechanisms advantage of the strong case to evolve in a way that are better for all collaboration. A lot can be gained synergistically for getting different sectors to management work that a lot of social consumers. Policy coherence. by integrating social protection talk to each other, especially workforces. It is crucial to account for the nexus Reaching adolescents. and nutrition interventions and in decentralized programming Sustain the gains that have been between nutrition, social protection, approaches. contexts. achieved, we need to help people to and agriculture and rural development. It is neither social protection nor Need to integrate numerous other combine receiving social protection This can also be encapsulated by the nutrition in isolation: the importance relevant sectors (e.g., reproductive programs with improved productivity concept of the food system, and vis-à- of integration. health, family planning, WASH, child so that they can generate income and vis, gender, rural/urban linkages, and A systems approach in linking social development, and education). graduate those programs. Therefore, climate change and other crises. protection programs with nutrition- Need for good and interoperable learning how to secure those who have Linking agriculture through local specific programs to enhance information systems. escaped poverty, sustain the gains, procurement. impact, as well as aligning with Need for clear institutional and prevent them from falling back into other complementary sector policies arrangements to facilitate poverty is essential. Leveraging Social Protection Programs for Improved Nutrition: Report and programs is needed. communication about the program Conditionalities have the potential and engage the actors that deliver to push governments to provide or the results. improve services. (continued on next page) Key theme(s) Lessons learned Challenges Gaps Opportunities Program design & “If there is one thing we have Eliminating poverty for the next 30 What are the ingredients in terms of Have social protection specialists, as delivery. learned, it is that the synergies don’t years is going to be harder than it design and implementation that make well as nutrition specialists, embedded Behavior change. come automatically.” has been so far because it requires nutrition impacts possible? within programs to provide technical Achieving scale. “In order to make [social protection reaching people who are extremely How to measure the impact of support. Last mile. programs] nutrition-sensitive, you poor, many of whom are out of nutrition-sensitive interventions? Prioritize nutritionally vulnerable need to transform [them], to add reach in the rural areas. How to ensure that the investments populations. design features.” Reaching indigenous and other that result from cash transfers Target the first 1,000 days. Which social protection instrument hard-to-reach/rural households. contribute to nutrition outcomes? What Give the benefit to the woman to is best leveraged for improving Infrastructure and capacity transfer amount is sufficient to achieve increase likelihood that it is spent in a nutrition outcomes depends on the constraints. nutrition behavior change? nutrition-sensitive way. specific country context. Standardization and quality of What is the role of intra-household Provide predictable payments. Enhancements to existing programs nutrition services. dynamic? Link to other programs and can go a long way. To make social protection more What is the appropriate duration of interventions, especially health Giving money is insufficient for effective for improving nutrition, cash transfer and the frequency of services. nutrition behavior change—we need many behaviors related to nutrition payment? Use simple conditionalities in how the to inform and educate. (e.g., hygiene, sanitation, and ECD) How to integrate nutrition education cash transfer will be delivered or used. It is not necessary to have hard need to be changed. to translate extra investments into Emphasize nutrition education and conditionalities in order for Measuring impact of nutrition- nutrition-sensitive investments? behavior change communication. beneficiaries the entire community sensitive interventions. “We all agree it’s important but… how Measure results and monitor impact to benefit. do we make it effective, so it’s not to inform program design and improve too shallow.” What intensity of BCC is quality. required to achieve nutrition behavior Design programs that can scale up in change? times of crisis and address not only the Given limited project resources, is pressing needs of the whole family, but what we can do enough? How do we also the very specific nutrition needs of sequence it? the young child. Community engagement/participation. Leveraging Social Protection Programs for Improved Nutrition: Report 53 Annex 3: Participant List Last First Organization Position Ababakirov Nurbek World Food Programme Monitoring Assistant Abkarian Dina Oussrat Alekhaa (NGO) Manager Abramova Tatiana Institute of Nutrition Researcher Aceves Daniel National Commission of Social Protection General Director of Prospera in Health Program, Health Component Aceves Torres Mauricio Daniel University of Mexico Student Afurika Juvenal CARE Program Director Albegova Irina World Bank Group Consultant Alderman Harold International Food Policy Research Institute Senior Research Fellow Alexander Kuzmin Independent Independent Ali Pungkas National Development Planning Agency Head of Division for Community (BAPPENAS) Health Alimov Alexander Ministry of Foreign Affairs of Russia Deputy director, Department of international organizations Anikeeva Yulia Ministry of Finance of the Russian Deputy Head of Division/ Federation Department for International Financial Relations Arnott Sheri Lee World Vision International Director, Research, Policy and Strategy Arous Samer Ministry of Health – Syria Head of Nutrition Department Ashymbaeva Toktobubu Ministry of Education Deputy Minister Atwood Stephen World Bank Group Organizer Balaban Daniel WFP Centre of Excellence Against Hunger Director Barabanova Elizaveta Freelancer Interpreter Barry Oumar World Bank Group ECD Consultant Bay Danilo Ministry of Gender, Child and Social Action Permanent Secretary Behrendt Christina International Labour Organization (ILO) Senior Social Protection Policy Specialist Beruchan Victor Freelancer Translator Bokarev Andrey Ministry of Finance of the Russian Director of the Department for Federation International Financial Relations Bolotnikova Elena SIFI Director on International Cooperation Bossoutrot Sylvie World Bank Group Acting Director World Bank Group Russia Breda Joao WHO Programme Manager Brutus Jean Robert Management Systems International Social Protection Consultant Buani Christiani World Food Programme Head of Programme Buchsbaum Aaron World Bank Group Consultant Camara Sainey Department of Social Welfare Rehabilitation Technician/Social Protection Officer Campbell Laura World Bank Group Social Protection Specialist Cedeño de Maria Margarita Vice President of the Dominican Republic Vice President of the Dominican Lizardo Republic (continued on next page) 54 Leveraging Social Protection Programs for Improved Nutrition: Report Last First Organization Position Charlotte Hanta Baraka Ministry of Population, Social Protection General Manager Chepsongol James Ministry of Labour Social Security & Secretary Administration Services Chernigov Vladimir SIFI President Chiekhdib Hassn Ministry of Health Head of the Directorate of Health of Tartous Crossley Kenneth World Food Programme Deputy Director Policy and Programme Division Dalamba Thando Embassy of South Africa Political Counsellor De Campos Arnoldo Ministry of Social Development National Strategy for Food and Nutrition Security Dufour Charlotte UN FAO Nutrition Policy and Programme Officer Duran Luis Vice-presidency of the Dominican Republic Advance Security Team Efimov Aleksandr Eurasian Development Bank Senior Specialist Emelyanov Mikhail OOO Metaphora Translator Encarnacion Laura Vice-presidency of the Dominican Republic Director of New Media Castillo Fanlo Martin Jorge World Food Programme Country Director Figazzolo Laura World Bank Consultant Fofana Malang N National Nutrition Agency (NaNA) Ag Deputy Executive Director Fugol Larisa World Bank Group Consultant Gautier Massamouna WFP VAM officer Gilligan Daniel IFPRI Deputy Director Gitonga Halima Ministry of Health Advisor to the Principal Secretary Giyose Boitshepo Bibi FAO Senior Nutrition Officer Gomez Bueno Henry Vice-presidency of the Dominican Republic Chief of Security for the Vice President Gorbacheva Daria Social and Industrial Foodservice Institute Specialist on International Cooperation Grinkova Olga World Bank Freelance Interpreter Hempel Kevin World Bank Consultant Herrera Maria Berky Vice-presidency of the Dominican Republic Assistant Hersi Salama Ministry of Health Coordinatrice Nutrition – PNN Hossain Md. Akram Al Government of Bangladesh Additional Secretary Hussein Karim IFAD Policy and Research Advisor Hypher Nicola Save the Children Senior Social Protection Adviser Ibrahim Aichatou Social Safety Net Program Responsable Volet Accompagnement Ivanov Andrei Freelancer Freelancer Izwardy Doddy Ministry of Health Director of Nutrition, Directorate General for Nutrition and Maternal and Child Health Jammeh Mustapha World Food Programme Monitoring and Evaluation Officer Jibrin Ojochenemi Save the Children International Nutrition Coordinator Kamagenge Amadeus Tanzania Social Action Fund (TASAF) Director Kassachoon Khadijah Ministry of Health Principal Secretary (continued on next page) Leveraging Social Protection Programs for Improved Nutrition: Report 55 Last First Organization Position Kazachkov Aleksandr LEXIT Interpreter Keshabyants Evelina Institute of Nutrition Senior Researcher Kiess Lynnda World Food Programme Chief of the Nutrition Division Komagaeva Julia World Bank Group Country Operations Officer Korolev Alexei Metaphora, Inc. GM Kovaleva Julia World Bank Group Consultant Kozyukova Irina Ministry of Labour and Social Protection Head of section in Department of the RF Kudaiberdieva Gulmira The Presidents Administration Head of the Social Policy Department Lababidi Yasmine World Food Programme Senior Programme Assistant (Nutrition) Langa Graciano Ministry of Gender, Child and Social Action Deputy Director of Planning and Cooperation Le Guen Nicolas French Development Agency Head of Project Leite Phillippe World Bank Senior Social Protection Economist Limongi Vinicius World Food Programme Programme Assistant Litovchenko Evgeny LEXIT Freelancer Lopes Marcia Lula Institute Consultant Lopes Filho Marcos Aurelio Ministry of External Relations Special Adviser for Programme Development and Humanitarian Affairs Lukyanova Maria United Nations World Food Programme Head of Office for Tunisia and Morocco MacGillivray Iain Charles International Fund for Agricultural Special Adviser to the President Development of IFAD Mahendru Sanjay Embassy of India First Secretary of Trade Makarov Dmitry Freelancer Interpreter Maluleke Thembani Embassy of South Africa Secretary Godfrey Masylkanova Kunduz World Bank Group Senior Agriculture Economist Mausse Miguel Ministry of Gender, Child and Social Action National Director of Social Action McHale Gulmira UN IFAD Senior Partnership Officer Medvedev Aleksandr Freelancer Interpreter Mendez Mario World Bank Group Program Assistant Menefee Andrea Save the Children International Nutrition Advisor Mikos Stanislav Portuguese.ru Interpreter Mitchell Arlene Global Child Nutrition Foundation Executive Director Morel Julien Action Against Hunger (ACF) Nutrition Security and Social Protection Senior Advisor Mori Hideki World Bank Group Program Manager Mory Maidoka Ali Social Safety Net Program National Coordinator Mouhamed Souleikha Agence Djiboutienne de Development Coordinatrice Nutrition Social Mubamba Francesca Ministry of Community Development Principal Nutrition Officer Mother & Child Health Mugambi Gladys Ministry of Health Head Nutrition and Dietetics Unit (continued on next page) 56 Leveraging Social Protection Programs for Improved Nutrition: Report Last First Organization Position Mukengami Miyoba World Food Programme Senior Programme Assistant Mulder- Menno World Bank Group Senior Nutrition Specialist Sibanda Musembi Daniel Ministry of Labour Social Security and Monitoring and Evaluation Services Coordinator Mustafa Militezegga FAO of the UN Social Protection Consultant Abduk Mwasiaji Willy Ministry of Labour Social Security & National Coordinator Services Nagornov Vitaly National Research University Higher Director of the Center for School of International Development Assistance Negewo Beyene Ministry of Agriculture Food Security Coordination Directorate Nogueira Jaana National Fund for Education Development Head of Cabinet Ogoti Carren Ministry of Labour Social Security and National Coordinator Services Olivares Frank Vice President of the Dominican Republic Executive Director Valenzuela Omari Malilo Tanzania Social Action Fund Conditional Cash Transfer Manager Owigar Joyce World Food Programme Programme Officer (Nutrition) Perez Jorge Embassy in Russia Ambassador Peshekhonova Olga SIFI Project director Popova Anna Rospotrebnadzor Head of Rospotrebnadzor Posarac Aleksandra World Bank Group Program Leader Prawiradinata Rudy Ministry of Planning Director of Poverty Alleviation Rahman Aneeka World Bank Group Social Protection Economist Raobelina Raobelina National Nutrition Office National Coordinator Raza Ahmed Food and Agriculture Organization Junior Professional Officer Razakatoanina Achille Development Intervention Fund Manager Redko Denis World Bank Group Interpreter Richards Katherine Save the Children UK Senior Nutrition Policy and Advocacy Advisor Rubinshteyn Boris World Bank Interpreter Safronova Anna Institute of Nutrition Senior Researcher Sakala Nancy Ministry of Agriculture and Livestock Principal Food Utilization and Nutrition Officer Sako Mahmoud Programme Filets Sociaux Jigisèmèjiri Coordinateur Salazar Rojas Jose Joaquin Ministry of Agriculture and Livestock Deputy Minister Samoura Abdoulaye Programme Filets Sociaux Mali Specialist Sanchez Fernando Vice President of the Dominican Republic Security Scaramella Carlo World Food Programme Deputy Regional Director Sedutto Holly REACH – FAO Programme Consultant Sepulveda Belkys Vice President of the Dominican Republic Security Sergeeva Anna Rospotrebnadzor Assistant of the Head of Rospotrebnadzor, Spokesperson of Rospotrebnadzor (continued on next page) Leveraging Social Protection Programs for Improved Nutrition: Report 57 Last First Organization Position Shaikh Mona UN World Food Programme Nutrition Advisor Shakirov Azat Metaphora Partner Schelina Lidia Freelancer Interpreter Shekar Meera World Bank Group Lead Health Specialist Shkiperova Anna Ministry of Agriculture Consultant Shoham Jeremy Emergency Nutrition Network Director Simakova Tatiana Ministry of Finance of the Russian Chief Expert Federation Siryachenko Karina Social and Industrial Foodservice Institute Specialist on international cooperation Smirnova Anastasia Rospotrebnadzor Head of Unit of International Cooperation Smolenskiy Viacheslav Rospotrebnadzor Director, Department of Science and International Cooperation Smolyakov Anton Self-Employed Interpreter Solamillo Araceli Department of Social Welfare and Regional Director Development Sosnina Olga Eurasian Development Bank Lead Expert Spray Andrea World Bank Group Nutrition Specialist Stepanyan Robert Ministry of Education and Science Head of Development Programs and Monitoring Dept. Steta Gandara Maria World Bank Senior Social Protection Specialist Concepcion Strelkova Lada World Bank Group Country Program Coordinator for the Russian Federation Strokov Anton Eurasian Center for Food Security (ECFS) Head of Economics Department Stubbs Josefina International Fund for Agricultural Associate Vice-President & Chief Development Development Strategist Suriel Altagracia Progresando con Solidaridad Director Tasker Mathew Save the Children Food Security, Livelihoods and Social Protection Advisor Tint Zaw Nicholus Save the Children International Senior Programme Advisor – Nutrition Tirado Maria University of California Los Angeles Consultant Blazquez Trusova Lina Ministry of Agriculture Head of Department Turull Mayol Isabel Vice-presidency of the Dominican Republic Special Adviser Valkova Anna Ministry of Finance of the Russian Deputy Director of the Federation Department for International Financial Relations Vasilieva Marina World Bank Group Senior External Affairs Officer Villalobos Jose MIDIS Peru Castillo Vinokurov Alexander LEXIT Freelancer Vohra Aseem Indian Embassy Deputy Head Economic and Commerce Vos Rob FAO Director, Social Protection Division Winder Rossi Natalia FAO of the UN Senior Social Protection Officer Wrobel Robert World Bank Group Social Development Specialist (continued on next page) 58 Leveraging Social Protection Programs for Improved Nutrition: Report Last First Organization Position Yemtsov Ruslan The World Bank Global lead Zavistyaeva Tatyana Rospotrebnadzor Deputy Director, Department of Science and International Cooperation Zaytsev Yury World Bank Consultant Zhilova Anastasia Ministry of Finance of the Russian Counselor Federation Zuniga Yolanda Ministry of Economic and Finance General Directorate of Public Fernandez Budget Zvogbo Kerina Save the Children International Nigeria Social Protection Advisor Leveraging Social Protection Programs for Improved Nutrition: Report 59 60 Annex 4: Detailed Program GLOBAL FORUM ON NUTRITION-SENSITIVE SOCIAL PROTECTION PROGRAM – DAY ONE SEPTEMBER 11, 2015 Session Time Dur. Topic/Method/Objective(s) Description Speakers & Facilitators 0800 30 Registration 1 0830 30 Vocabulary • Display key terminology with multiple-choice Facilitated by STEPHEN ATWOOD Anonymous voting options. Audience votes and results are Set the tone for engagement and displayed and briefly discussed in real-time. assess where the participants are in • Participants are encouraged to add words their understanding of key nutrition- to the list as the workshop progresses. Flip sensitive social protection terminology. charts will be available in the plenary room. Words added by the end of Day One will be defined in the opening session of Day Two, or as opportunity arises. 2a 0900 20 Opening remarks • Introduction and objectives of the Global Facilitated by STEPHEN ATWOOD Oral presentation Forum Presentations by: Welcome participants and open the • Welcoming address by sponsors of the • Anna Y. Popova (Head of the Federal Service for Surveillance on Global Forum. Global Forum, including its rationale for the Consumer Rights Protection and Human Well-being – Chief State potential for moving the field forward. Sanitary Physician of the Russian Federation) • Maria Margarita Cedeño Lizardo (Vice President, Dominican Republic) 2b 0920 25 Welcoming remarks • Welcoming remarks by participating IOs. Facilitated by STEPHEN ATWOOD Oral presentation Presentations by: • WElcoming address from Fao Director general mr. José Graziano da silva, Delivered by Rob Vos (Director for Social Protection and Coordinator of the Strategic Programme for Rural Poverty Reduction, FAO) • Josefina Stubbs (Associate Vice-President and Chief Development Strategist, ifad) Leveraging Social Protection Programs for Improved Nutrition: Report • CARLO SCARAMELLA (Deputy Regional Direction MENA Region, WFP) • meera shekar (Global Lead for nutrition and Lead HNP Specialist, wbg) / RUSLAN YEMTSOV (Global Lead for Social Safety Nets andLead Economist, WBG) (continued on next page) GLOBAL FORUM ON NUTRITION-SENSITIVE SOCIAL PROTECTION PROGRAM – DAY ONE SEPTEMBER 11, 2015 Session Time Dur. Topic/Method/Objective(s) Description Speakers & Facilitators 3a 0945 20 Statement of the problem • 20-minute presentation; Key topics include: Facilitated by STEPHEN ATWOOD PPT presentation the linkages between poverty, equity, Presentation by MEERA SHEKAR (GLOBAL LEAD FOR Describe the economic case for and malnutrition; 1,000 day window of NUTRITION AND LEAD HNP SPECIALIST, WBG) nutrition and the linkages between opportunity; effects of stunting on brain poverty, equity, and malnutrition. development; health outcomes including overweight/obesity and NCDs; productivity; case for investment in early child nutrition programs, women’s health pre-pregnancy, and adolescence; the relationship between income and malnutrition; limitations of nutrition-specific interventions/rationale for multisectoral approaches. 3b 1005 20 Keynote Address: Nutrition and • 20-minute presentation; With reference to Facilitated by STEPHEN ATWOOD Social Protection Programs the problems/solutions, case studies, and Presentation by HAROLD ALDERMAN (SENIOR RESEARCH PPT presentation vocabulary activity. FELLOW, IFPRI) Describe why the synergy between nutrition and social protection is valuable and necessary if the goals of each taken separately are to be achieved. 3c 1025 30 Moderated discussion • 30-minute Q&A Moderated by STEPHEN ATWOOD 4 1055 65 Solutions to date: Nutrition • Framing statement, five minutes Framing statement by RUSLAN YEMTSOV (WBG) programs, Social Protection • Two facing panels: (1) nutrition and (2) social Facilitated by STEPHEN ATWOOD programs protection. Each panel has 20 minutes (each Facing Panels and Moderated panelist responds to two to three pre- Nutrition panelists: Discussion selected questions) to present their solutions • Bibi Giyose (Senior Nutrition Officer for Policy and Programs, FAO) Present a bird’s eye view of what is to “the problem” as articulated in Session • Iain Macgillivray (Special Advisor to the President, ifad) being done by the global community Three. • Menno Mulder-Sibanda (Senior Nutrition Specialist, WBG) in the nutrition and social protection • 30-minute Q&A • João Breda (Programme Manager, Nutrition, Physical Activity sectors separately to tackle and Obesity, WHO) Leveraging Social Protection Programs for Improved Nutrition: Report malnutrition. Social Protection panelists: • NATALIA WINDER ROSSI (Senior Social Protection Officer, FAO) • Josefina Stubbs (ASSOCIATE VICE-PRESIDENT AND CHIEF DEVELOPMENT STRATEGIST, IFAD) • christina behrendt (Senior Social Protection Policy Specialist, ILO) 61 • Daniel Balaban (Director, WFP COE) • Q&A moderated by STEPHEN ATWOOD (continued on next page) GLOBAL FORUM ON NUTRITION-SENSITIVE SOCIAL PROTECTION PROGRAM – DAY ONE SEPTEMBER 11, 2015 62 Session Time Dur. Topic/Method/Objective(s) Description Speakers & Facilitators 1200 10 Program snapshot Indonesia – PNPM Generasi [WBG] 1210 10 Move to break room 5a 1220 20 Creating Synergies: Strengthening • FIVE SPL INSTRUMENTS and FIVE Facilitated by STEPHEN ATWOOD social protection programs PRINCIPLES of nutrition-sensitive design, Working groups one per table. Participants sign-up to a INSTRUMENTS facilitators: Develop competence in the design table according to interest, not necessarily 1. Public Works [Kevin Hempel, WBG] of nutrition-sensitive social protection expertise (approximately 15 per group). 2. Cash transfers [Maria Concepcion Steta GANDARA, WBG] programs, as well as awareness of 3. In kind transfers [NATALIA WINDER ROSSI, FAO] the challenges and opportunities, 4. School Feeding [Daniel Balaban, WFP coe & Arlene Mitchell, through applying nutrition principles to Global Child Nutrition Foundation] social protection instruments in order 5. Conditionalities [Philippe Leite, wbg] to address the problems identified in Session Three. PRINCIPLES facilitators: 6. Gender [JOSEFINA STUBBS, IFAD] 7. 1,000 days [ANDREA SPRAY, WBG] 8. Dietary diversity [CHARLOTTE DUFOUR, FAO] 9. Targeting nutritionally vulnerable [LYNNDA KIESS, WFP] 10. Nutrition education & promotion [BIBI GIYOSE, FAO] 1300 60 Lunch in plenary room 5b 1400 45 Creating Synergies (cont’d): • INSTRUMENTS discuss how they can be (see above) Strengthening social protection used to address the problem of malnutrition; programs – Rotation #1 PRINCIPLES discuss what would be required (see above) for integration into SP instruments. • Facilitators are responsible for keeping the discussion focused on nutrition-sensitive social protection. • Delegated note-taker (not the facilitator) records the discussion on large butcher paper. Leveraging Social Protection Programs for Improved Nutrition: Report 5c 1445 30 Creating Synergies (cont’d): • INSTRUMENTS switch to PRINCIPLES table (see above) Strengthening social protection and vice versa, preferably each original group programs – Rotation #2 member goes to a different table to guarantee (see above) mixed groups. Limits on table seats remain (i.e., approximately 15 per group). • Facilitators and note-takers stay at their assigned table. • INSTRUMENTS discuss how they can be used to address the problem of malnutrition; PRINCIPLES discuss what would be required for integration into SP instruments. (continued on next page) GLOBAL FORUM ON NUTRITION-SENSITIVE SOCIAL PROTECTION PROGRAM – DAY ONE SEPTEMBER 11, 2015 Session Time Dur. Topic/Method/Objective(s) Description Speakers & Facilitators 5d 1515 15 Creating Synergies (cont’d): • Participants return to their original groups (see above) Strengthening social protection and report back on their discussions in programs – Rotation #3 Rotation #2. (see above) • Participants than discuss the conditions that would have to be in place for these nutrition- sensitive social protection solutions to work. 5e 1545 75 Creating Synergies (cont’d): • Five-minute oral presentations by each Discussion facilitated by STEPHEN ATWOOD Strengthening social protection group (note-taker or other designated team programs – Summary member) to plenary, key points only. (see above) • 20-minute moderated discussion 1700 10 Program snapshot Niger Safety Net Project [WBG] 6 1710 90 Way forward: Implementation of • Introduction of session and speakers • Presentation by ROB VOS (FAO) ICN2 Declaration in terms of social • Background paper presentation protection and nutrition –BRICS • Panel reaction Panelists partnerships (Organized by FAO) • Q&A • ARNOLDO DE CAMPOS (BRAZIL) Panel presentation • Draft communique presentation • Vyacheslav Y. Smolenskiy (Russian Federation) Understand the BRICS national policies • Wrap-up • Sanjay Mahendru (India) and programs on nutrition-sensitive • Thando Dalamba (South Africa) social protection, share lessons, and identify good practices; Promote Moderated by Boitshepo Bibi Giyose (FAO) a common approach and possible cooperation (South-South) on social protection and nutrition; Share thoughts and define approaches and modalities for delivery and follow-up to ICN2 outcomes around social protection and nutrition; Draft and adopt a chair summary. 7 1840 30 Taking Stock • “Clicker machine” used for votes on most Discussion facilitated by STEPHEN ATWOOD Leveraging Social Protection Programs for Improved Nutrition: Report Facilitated discussion important sessions and recap of important Validate and reinforce key messages messages of the day, as well as progress of the day, with a brief analysis that toward N/SP programming. segues to the Day Two agenda. • 15-minute moderated discussion 1915 Free time 1930 120 Social event 63 Welcoming cocktail and dinner during two-hour river cruise (continued on next page) GLOBAL FORUM ON NUTRITION-SENSITIVE SOCIAL PROTECTION PROGRAM – DAY TWO SEPTEMBER 12, 2015 64 Session Time Dur. Topic/Method/ Objective(s) Description Speakers & Facilitators 8 0830 20 Augmenting the vocabulary: development • Individuals were asked to add more Facilitated by STEPHEN ATWOOD of a peer generated glossary of terms terms as Day One progressed, Maintain participation in the development of and overnight words are written on the glossary of terms. post-its to facilitate grouping. • Facilitator reviews each term and either defines or asks for definitions from the group. 0850 10 Program snapshot Peru - Results in Nutrition for JuntosSWAp [WBG] 9a 0900 45 Learning from the field: Case studies • Five-minute overview of case Facilitated by STEPHEN ATWOOD of nutrition-sensitive social protection studies by representatives. programs – Rotation #1a • Each table (approximately 15 Case Study / Sponsor Working groups and facilitated discussion people) is given a different case 1. Nigeria – Child Development Grant Program [STC] Present examples of nutrition-sensitive study and asked to analyze it and 2. Republic of Congo – Nutrition-Sensitive Urban Safety Net social protection programs for a critical prepare a short list of lessons Programme [WFP] review of how they work in order to generate learned from key elements of the 3. Syria – Fresh Food Vouchers for Pregnant and Lactating understanding of the processes and case. Women [WFP] challenges involved. • Facilitators help guide the 4. Kyrgyz Republic – Partnership on Sustainable School Feeding 9b 0945 45 Learning from the field: Case studies discussion. Programs [WFP/GoK] of nutrition-sensitive social protection • 15-minute facilitated discussion 5. Mali – Emergency Safety Nets project ( Jigisèmèjiri ) [WBG] programs – Rotation #1b 6. Tanzania – Productive Social Safety Net [WBG] (see above) 7. Niger Safety Net Project [WBG] 8. Mexico – Social Protection System/ PROSPERA [WBG/GOM] 9c 1030 15 Learning from the field: Case studies 9. Kenya – Cash Transfers for Orphans and Vulnerable Children of nutrition-sensitive social protection [WBG] programs – Rotation #1 wrap-up 10. Bangladesh – Income Support Program for the Poorest (ISPP) (see above) [WBG] 11. Philippines – Social Welfare Development and Reform Project [WBG] 1045 15 Break Leveraging Social Protection Programs for Improved Nutrition: Report Make sure to visit the marketplace for project and product demos/presentations! (continued on next page) GLOBAL FORUM ON NUTRITION-SENSITIVE SOCIAL PROTECTION PROGRAM – DAY TWO SEPTEMBER 12, 2015 Session Time Dur. Topic/Method/ Objective(s) Description Speakers & Facilitators 10a 1100 45 Learning from the field: Case studies • Five-minute overview of case Facilitated by STEPHEN ATWOOD of nutrition-sensitive social protection studies representatives. programs – Rotation #2a • Each table (approximately 15 Case Study / Sponsor (see above) people) is given a different case 1. Indonesia - Program KeluargaHarapan (PKH) Prestasi [GOI] 10b 1145 45 Learning from the field: Case studies study and asked to analyze it and 2. Brazil – Zero Hunger Strategy [WFP COE] of nutrition-sensitive social protection prepare a short list of lessons 3. Brazil - National School Feeding Programme (PNAE) [WFP COE] programs – Rotation #2b learned from key elements of the 4. Myanmar - Tat Lan Program [STC] (see above) case. 5. Djibouti Social Safety Net [WBG] • Facilitators help guide the 6. Dominican Republic- Progresando con Solidaridad [WFP] 10c 1230 15 Learning from the field: Case studies discussion. 7. Cabo Verde - School Nutrition Programme [FAO] of nutrition-sensitive social protection • 15-minute facilitated discussion 8. Ethiopia - Productive Safety Net and Household Asset Building programs – Rotation #2 wrap-up [GOE] (see above) 9. Haiti – Kore Lavi - Appui au programme national de sécurité alimentaire et de nutrition [ACF] 10. Peru - Results in Nutrition for JuntosSWAp [WBG] 11. Indonesia - PNPM Generasi[WBG] 1245 45 Break Make sure to visit the marketplace for project and product demos/presentations! 1330 60 Lunch 11 1430 90 New horizons for nutrition-sensitive • Five-minute framing overview by Facilitated by STEPHEN ATWOOD social protection expert facilitator World Café • Tables (approximately ten people) TOPIC / EXPERT FACILITATOR Consider new challenges and opportunities to are each given one topic relevant to 1. Double Burden of Malnutrition [ Boitshepo Bibi Giyose, FAO] improving nutrition through social protection nutrition-sensitive social protection 2. Multisectoral collaboration [Julien Morel, acf] interventions. and discuss how to implement 3. Integrated (supply and demand) approach [Menno Mulder- nutrition-sensitive social protection Sibanda, WBG] programs in each context, 4. Governance [Christina Behrendt, ilo] starting with examples provided 5. Decentralization [Vinicius Limongi & Christiani buani, WFP COE] by participants and/or the expert 6. Community participation [Robert Wrobel, WBG] facilitator. 7. Local procurement [IAIN MACGILLIVRAY, IFAD] Leveraging Social Protection Programs for Improved Nutrition: Report • Each table has a fixed participant, 8. Urban [Ruslan Yemtsov, WBG] who takes notes on the 9. Rural [Mathew Tasker, STC] deliberations of the group. 10. Climate change [Cristina Tirado BLAZQUEZ, UCLA] • After 15 minutes, all other members 11. Conflict-affected settings [Karim Hussein, IFAD] of the group move to a different 12. Mobile technology [Nicola Hypher, STC] table where they discuss a different 13. Behavior change communication [Kerina Zvogbo, STC] 65 scenario. 14. Lifecycle approach [Lynnda kiess, wfp] • The fixed facilitator of each table 15. Women’s empowerment [Josefina Stubbs, ifad] briefly presents the key discussion 16. Early child development [Oumar Barry, WBG] points plenary. (continued on next page) GLOBAL FORUM ON NUTRITION-SENSITIVE SOCIAL PROTECTION PROGRAM – DAY TWO SEPTEMBER 12, 2015 66 Session Time Dur. Topic/Method/ Objective(s) Description Speakers & Facilitators 1600 10 Program snapshot Djibouti Social Safety Net [WBG] 12a 1610 20 What have we learned? • 20-minute round table discussions Facilitated by STEPHEN ATWOOD Round table discussion to reflect on lessons learned from Discuss key take-away points of the Global the GF. Forum and next steps. 12b 1630 45 What have we learned? • 5-minute presentations from IOs Facilitated by STEPHEN ATWOOD Oral presentation and moderated discussion and countries on key take-away Discuss key take-away points of the Global from the Forum. IO Representatives Forum and next steps. • IO representatives will report on 1. Meera Shekar (WBG) / Ruslan Yemtsov (WBG) (a) how learnings from Global 2. Rob Vos (FAO) Forum will influence and/or inform 3. Josefina Stubbs(ifad) operations in the future and (b) key 4. Kenneth Ray Crossley(wfp) operational knowledge gaps. 5. Vladimir Chernigov (SIFI) • Country representatives will report on (a) key take-away points from Country Representatives & other participants the Forum and (b) requests from (ad hoc) the international community. 13 1715 30 Closing remarks • Closing addresses by co-sponsors Presentations by: Oral presentation of the Global Forum. • Andrey A. Bokarev (Director of the Department of the Thank participants and close the Global International Financial Relations, Ministry of Finance of the Forum. Russian Federation) 14 1745 30 Evaluation • Participants respond to questions Facilitated by STEPHEN ATWOOD using clickers. (continued on next page) Leveraging Social Protection Programs for Improved Nutrition: Report Annex 5: Communications & Knowledge Management Plan The communications and knowledge management plan for the Global Forum encompassed branding, social media, and communications. All components are summarized below. FIGURE 1  Global Forum branded materials Leveraging Social Protection Programs for Improved Nutrition: Report 67 FIGURE 2  Graphic created by FSN Forum staff to promote the online discussion hosted on the FAO’s Global Forum on Food Security and Nutrition (FSN Forum) Branding Branding for the Global Forum was designed by Emerging-360 (http://www. emerging-360.com/). Social Media The #securenutrition hashtag was tracked via Tweetreach (www.tweetreach. com) and Tweepsmap (www.tweepsmap.com). The former assessed tweets, retweets, impressions, and reach, while the latter assessed geographic engagement. TABLE 2  Summary of engagement during the 10-day period around the Global Forum Russian Period of Accounts Countries Total Tweets WBG Accounts Federation Activity Reached Tweeting Accounts 9/5–9/15 234 1.7M 23 5 8 Communications Plan The communications plan below was used to organize materials and releases across web, social media, and organizational channels. Product/Activity Audience Dissemination Deadline Event page on Site users, registrants, On website, and via 10 July www.securenutrition.org external stakeholders activities below Outreach to collaborating FAO, IFAD, WFP, UNICEF, Direct emails and/or 15 July & after organizations WHO, 1000 Days, Save, UN phone calls SP/L, Gates, IFPRI, OECD, others Formal invitations Registrants Global Forum service 25 July & after account (Outlook) 68 Leveraging Social Protection Programs for Improved Nutrition: Report Product/Activity Audience Dissemination Deadline Social Media “toolkit” Global, via WBG and partner Twitter, Facebook 3 August (toolkit #securenutrition; #post2015; social media accounts; reviewed) #SDGs WBG/Russia and ECA social 11 August & After Health msgs | SPL msgs media (dissemination) WBG Event Page WBG Staff WBG intranet 10 August Online Discussion Global; those not attending FAO FSN Forum website; 14 August – 14 the Global Forum SecureNutrition website; September Twitter and Facebook SecureNutrition Spotlight email: SecureNutrition community Constant Contact 2 September Online discussion (6k) Event announcement SecureNutrition community, Constant Contact; Global 3 September WBG staff Forum service account (Outlook) Live event Tweets Global Twitter 10–11 September Completed Global Forum seminar Global SecureNutrition website 22 September page, to include major conference resources Blog Two – Event highlights / Path SecureNutrition users; event SecureNutrition website; 25 September forward attendees; WBG staff (HNP, GP newsletters; Health Ag, SPL) blog; “Corporate Voices” blog; Eurasian Perspectives Today Story – HNP / SPL WBG staff WBG intranet 15 October collaboration, case study launch for practitioners, Input by country staff Conference report Attendees, global Constant Contact, TBD stakeholders SecureNutrition website, social media Online Communications Kit An online communications kit was created to provide hashtags, messages, images, and web links for use across Twitter and Facebook by WBG and other stakeholder communications staff. The kit was made available using a live cloud document on BOX (www.box.com), with embargo dates for each com- ponent. Messages could be adapted as desired, but were to maintain the #securenutrition hashtag in order to track the campaign. In addition to the specific messages for dissemination, a summary description of the Global Forum was included, with information on logistics, country participation, and organizations in attendance. This public information was made available for use as needed. Web Links Global Forum http://www.securenutrition.org/resource/global-forum-nutrition-sensitive-social-protection webpage on SecureNutrition Global Forum ENGLISH - http://www.worldbank.org/en/events/2015/08/03/global-forum-on-nutrition- webpage on the sensitive-social-protection-programs WBG website RUSSIAN - http://www.worldbank.org/ru/events/2015/08/03/global-forum-on-nutrition- sensitive-social-protection-programs Leveraging Social Protection Programs for Improved Nutrition: Report 69 Web Links FSN Forum links to ENGLISH - http://www.fao.org/fsnforum/forum/discussions/social-protection-nutrition online discussion FRENCH - http://www.fao.org/fsnforum/fr/forum/discussions/social-protection-nutrition SPANISH - http://www.fao.org/fsnforum/es/forum/discussions/social-protection-nutrition Twitter Call to action Share your #nutrition-sensitive #socialprotection resources! #securenutrition https://goo.gl/ oAyOjs [logo] Health We can link #nutrition & #socialprotection. 20+ countries to discuss. https://goo.gl/oAyOjs [logo] #securenutrition #nutrition outcomes: what role can #socialprotection play? #Moscow 10–11 September https://goo.gl/oAyOjs #securenutrition Social Protection Can #socialprotection instruments be #nutrition-sensitive? #Moscow 10–11 http://www. worldbank.org/en/events/2015/08/03/global-forum-on-nutrition-sensitive-social-protection- programs #securenutrition SDGs Make #nutrition-sensitive #socialprotection part of this picture. https://goo.gl/oAyOjs [Post- 2015 Graphic] #securenutrition #SDGs Can #nutrition-sensitive #socialprotection support #Post2015 #SDGs? https://goo.gl/oAyOjs [Post-2015 Graphic] #securenutrition Geographic #country, #country, #country, & many more are leaders in #nutrition- sensitive #socialprotection https://goo.gl/oAyOjs What’s being done globally about #nutrition & #socialprotection? https://goo.gl/oAyOjs [logo] General – Coming soon: #nutrition-sensitive #socialprotection case studies. https://goo.gl/ SecureNutrition oAyOjs #securenutrition event site Announcement: Global Forum on #nutrition-sensitive #socialprotection, #Moscow, 10–11 September. #securenutrition https://goo.gl/oAyOjs Coming soon: resources on #nutrition-sensitive #socialprotection. https://goo.gl/oAyOjs [Logo] General – It’s time to bring together #nutrition & #socialprotection. http://www.worldbank.org/en/ WBG event site events/2015/08/03/global-forum-on-nutrition-sensitive-social-protection-programs [logo] #securenutrition #securenutrition, #Russia, @WorldBank organizing global conference, 10–11 September http://www.worldbank.org/en/events/2015/08/03/global-forum-on-nutrition-sensitive-social- protection-programs [Logo] Announcement: Global Forum on #nutrition-sensitive #socialprotection, #Moscow, 10–11 September #securenutrition http://www.worldbank.org/en/events/2015/08/03/global-forum- on-nutrition-sensitive-social-protection-programs FSN Forum @FAOFSNForum hosting #securenutrition discussion: What is #nutrition-sensitive Discussion #socialprotection? http://www.fao.org/fsnforum/forum/discussions/social-protection-nutrition Advancing the agenda: #securenutrition discussion on @FAOFSNForum http://www.fao.org/ fsnforum/forum/discussions/social-protection-nutrition #nutrition-sensitive #socialprotection Relevant Country Hashtags (case studies) #Tanzania #Bangladesh #Brazil #Djibouti #Ethiopia #Haiti #Indonesia #Kenya #Mali #Mexico #Myanmar #Niger #Nigeria #Peru #Philippines #Syria #Syria 70 Leveraging Social Protection Programs for Improved Nutrition: Report Facebook Facebook Q: How can we support links between social protection programs and nutrition? Post (1) A: Engage 20+ countries to discuss their policies, practices, and innovations. On September 10–11, #securenutrition and the Russian Federation will host the Global Forum on Nutrition-Sensitive Social Protection Programs, in Moscow. The Global Forum aims to disseminate best policies and practices, as well as innovative approaches, by bringing together implementers and technical experts from around the world to speak directly with each other. You can follow the #securenutrition hashtag to stay informed, and bookmark http://www. securenutrition.org/resource/global-forum-nutrition-sensitive-social-protection for continued updates and resources. Facebook It’s time to discuss nutrition-sensitive social protection. Post (2) In support of a major forum to be held on September 10–11 in Moscow, SecureNutrition is teaming up with the FAO Global Forum on Food Security and Nutrition to host an online discussion. ENGLISH - http://www.fao.org/fsnforum/forum/discussions/social-protection-nutrition FRENCH - http://www.fao.org/fsnforum/fr/forum/discussions/social-protection-nutrition SPANISH -http://www.fao.org/fsnforum/es/forum/discussions/social-protection-nutrition The discussion, moderated by a World Bank Social Protection Specialist, will allow countries to take stock of what is being done around the world in the area of nutrition-sensitive social protection. Contribute your views, and follow the #securenutrition hashtag to hear more about the online discussion, the Moscow event, and new resources associated with each. Leveraging Social Protection Programs for Improved Nutrition: Report 71 Annex 6: Speaker Biographies Harold Alderman Harold Alderman, with both a master’s in nutrition (Cornell) and a Ph.D. in economics (Harvard), has naturally gravitated to research on the economics of nutrition and food policy. After spending ten years at the International Food Policy Research Institute (IFPRI), he joined the World Bank in 1991 where he divided his time at the Bank between the Development Research Group and the Africa region where he advised on social protection policy. He returned to IFPRI in 2012. His most recent research includes contributing to the October 2011 Lancet state of the art review on Early Child Development and the Lancet review of nutrition-sensitive nutrition investments in 2013 as well as editing the book, No Small Matter: The Interaction of Poverty, Shocks, and Human Capital Investments in Early Childhood Development. He has also coauthored both the 2004 and 2008 Copenhagen Consensus papers on the economic returns for investment in nutrition. Daniel Balaban Daniel Balaban became the Director for World Food Programme’s (WFP) Centre of Excellence against Hunger in August 2011. The WFP Centre of Excellence against Hunger, a pacesetter in South-South cooperation, is a joint project with the Government of Brazil to enable capacity development of national governments in the areas of school feeding, nutrition, and food secu- rity. It is the first of its kind for WFP and plays an integral role in augmenting WFP’s ability to assist governments design and manage their own national- ly-led school feeding and other social safety nets programs. Mr. Balaban, an economist, brings to WFP his expertise in school feeding and capacity development. He led the Brazilian national school feeding program for nine years as the President of the National Fund for Education Development (FNDE), which feeds 42 million children in school each year. Prior to this, he worked in the private sector as the President of Fiscal Council of Bank Banespa Leasing and as the Fiscal Counsellor of Banco do Brasil Turismo. Additionally, he was a financial analyst for the Ministry of Finance, an Economic Advisor to the Secretary of the National Treasury, and the National Coordinator of the Studies of the Fiscal Economy. In 2003, he served as the Special Advisor to the Secretary of the Council of Economic and Social Development under the Presidency of the Federative Republic of Brazil. Mr. Balaban was born in Brazil in 1964. He holds and economics degree from University of Vale do Rios dos Sinos, and has a MA in International Relations a Masters in Finance from the University of Brasilia. He also studied fiscal policy at Getúlio Vargas Foundation and the University of Tokyo. Daniel is also member of the Board of the Global Child Nutrition Foundation (GCNF). Daniel is married and has three children. 72 Leveraging Social Protection Programs for Improved Nutrition: Report Christina Behrendt Christina Behrendt is Senior Social Protection Policy Specialist in the Social Protection Department of the International Labour Office (ILO) in Geneva. Previously, she worked as Regional Social Security Specialist in the ILO Regional Office for Arab States in Beirut, as Social Security Specialist in the ILO’s Social Security Department, as consultant for the International Social Security Association (ISSA), and as lecturer and research fellow at the Department for Politics and Management at the University of Konstanz. Christina holds a Master Degree in Politics and Public Administration and a PhD in Social Policy from the University of Konstanz, Germany. She has widely published on the role of social protection in a development context, social assistance, and other cash transfers in both developed and developing countries, income distribution, and poverty alleviation, as well as the distrib- utive effects of various social protection benefits on poverty and inequality. João Breda João Breda is a PhD in Nutritional Sciences from Porto University. He gradu- ated in Nutritional Sciences also at Porto University. He has done his Master Degree in Public Health by the Medical Sciences Faculty of the University Nova de Lisboa and an MBA from the European University in Barcelona. Dr. Breda is the Programme Manager: Nutrition, Physical Activity and Obesity at WHO Regional Office for Europe and responsible for providing support to the 53 Member States of the WHO European Region on the imple- mentation of the European Charter on Counteracting Obesity and the Vienna Declaration on Nutrition and Noncommunicable Diseases, as well as evaluat- ing their progress implementation. His team is leading the largest and most comprehensive childhood obesity surveillance mechanism globally and they developed both the new European Food and Nutrition Action Plan 2015– 2020 and the first European Physical Activity for Health Strategy. Initiatives, tools and publications he has been involved can be found here: • http://www.euro.who.int/en/health-topics/disease-prevention/nutrition • http://www.euro.who.int/en/health-topics/noncommunicable-diseases/ obesity • http://www.euro.who.int/en/health-topics/disease-prevention/physical- activity In Portugal, João Breda worked as a Public Health Nutritionist at the General Health Directorate and ARS Centro having launched and led for sev- eral years the National Platform Against Obesity. He is published in scientific journals and has presented several dozens of papers at national and interna- tional congresses, and published many original books. He was Researcher and Professor of Nutrition at Universidade Atlântica and Head of Department of the Nutritional Sciences where he developed and implemented the first Leveraging Social Protection Programs for Improved Nutrition: Report 73 Nutritional Sciences Bachelor. Was also had academic functions at Algarve University, Higher School of Agriculture in Coimbra and the Tourism and Hospitality School of Coimbra. Arnoldo de Campos Mr. Arnoldo de Campos is currently the National Secretary for Food and Nutrition Security of Brazilian Ministry for Social Development and Fight Against Hunger, designated in February 2013. Born in the city of Curitiba, State of Paraná, in the Southern Region of Brazil, Mr. Campos is an economist who graduated from the Federal University of Paraná, and a former researcher at the Rural Social and Economic Studies Department. His professional background includes ten years of work at the Brazilian Ministry for Rural Development, as the Director for Income Generation and Value Adding Department of the Familiar Agriculture Secretariat, where he has participated in the formulation and implementation of familiar agricul- ture’s participation in federal programs such as the School Feeding National Program and Brazil Without Poverty Program. In this area, he is also member of the Brazilian National Food Security Council and of the Food Acquisition Program Manager Group. He also participates in the Brazilian Interministerial Executive Commission for Biodiesel, which is responsible for the coordina- tion of the Brazilian Program on Production and Use of Biodiesel, being also a member of the Petrobrás Administration Council. Among others, he was also active as the coordinator of the Brazilian National Plan for the Promotion of Sociobiodiversity Products Chain. Maria Margarita Cedeño Lizardo Maria Margarita Cedeño Lizardo is the first woman in the Dominican Liberation Party that holds the office of Vice President of the Dominican Republic. She served as First Lady of the Dominican Republic in the govern- ment of former President Leonel Fernandez, where she promoted several suc- cessful projects to combat poverty, bridging the digital divide, promoting the values and building human capital. At present, apart from being the Vice President of the Dominican Republic, Her Honor Cedeño Lizardo has been appointed Coordinator of the govern- ment’s social programs. She implements an ambitious program strategy to end hunger and poverty. “Progresando con Solidaridad” is an innovative social intervention model in Latin America, benefiting more than 800,000 people across the country. Vice President Cedeño Lizardo has been appointed Extraordinary Ambassador of the UN Food and Agriculture Organization (FAO), as well as Continental Ambassador for the Elimination of Rubella in the Americas. She has also been appointed Ambassador of the Global Special Olympics and Member of the International Panel of Eminent Persons of UNCTAD. 74 Leveraging Social Protection Programs for Improved Nutrition: Report Vice President Cedeño Lizardo has devoted most of her political career to promoting the rights of women facing discrimination against women, con- vinced that “where there are empowered women, societies progress.” Its pro- grams benefit more than 100,000 women with technical and vocational training every year. Boitshepo Bibi Giyose Boitshepo Bibi Giyose recently joined FAO as the Senior Nutrition Officer for Policy and Programs in the  Nutrition  Division, Economic and Social Department in Rome HQ. Her focus is on integrating nutrition at policy and program level into agriculture and other development agendas. Before join- ing FAO, she worked for the New Partnership for Africa’s Development (NEPAD) Planning and Coordinating Agency where she was Senior Advisor for Food and Nutrition Security for nine years. Prior to NEPAD she worked for the UNDP/UNAIDS as a  regional project  coordinator for HIV and Nutrition, and the Commonwealth Regional Health Community Secretariat for East, Central and Southern Africa (CRHCS-ECSA) as Regional Food and Nutrition Programme Coordinator. She has also served in the Government of Botswana and the private sector in various capacities, and as a consultant for numerous organizations. Ms. Giyose was awarded a “Distinguished Alumna Award” in recognition of exceptional professional achievement by Appalachian State University in North Carolina, USA in April 2007. She holds a MS in International Nutrition from Cornell University, New York, and a BS in Nutrition and Dietetics from Appalachian State University, North Carolina in the USA. Iain MacGillivray Iain MacGillivray is Special Advisor to the President of the International Fund for Agricultural Development (IFAD) focusing on the Post-2015 Sustainable Development framework and on embedding nutrition through- out IFAD. An agricultural economist and agricultural engineer/agronomist by training, he has worked with the UN’s High Level Task Force on Global Food Security (HLTF), the Consultative Group on International Agricultural Research (CGIAR), the Canadian International Development Agency (CIDA), and private sector firms. As Principal Advisor on Agriculture, he led CIDA’s Agriculture Team in Policy Branch and within Multilateral Programs led Canada’s relations with IFAD and served on the Steering Committee of the Global Agriculture and Food Security Program (GAFSP). He was awarded CIDA’s Presidential Award for Excellence for his work in developing Canada’s Food Security Strategy. His career spans farm management in Argentina, farming in the Sudan, integrated rural development in the Americas and marketing and consultative work for private and public sectors. With over 35 years’ experience in international development at the policy, program and Leveraging Social Protection Programs for Improved Nutrition: Report 75 project levels, Iain has worked to strengthen support to agriculture and rural development and developing-country capacity, including emphasis on man- agement, economics, and food security-nutrition policy issues. He is a strong supporter of food-based approaches to micronutrient malnutrition and of bridging the divide between agriculture, nutrition, and health. Menno Mulder-Sibanda Menno Mulder-Sibanda is Senior Nutrition Specialist at the World Bank in the Africa Region. Currently, his professional interest is in effective multisec- toral service delivery to nutritionally vulnerable populations, which is subject to a complex web of incentives, rules and power relationships. This area of interest naturally follows from a long-standing passion regarding governance and political economy of nutrition. Anna Y. Popova After graduating from the Rostov Medical University, Dr. Anna Popova has worked across various positions in the state public health surveillance system ranging from a field epidemiologist to the office of Deputy Head of the Territorial Division for Moscow Region. In 2008, she moved to the Federal Service for Surveillance on Consumer Rights Protection and Human Well-being (Russian Public Health Agency – Rospotrebnadzor) as Head of the Department for Human Resources, Post-Graduate and Hygienic Education. From 2011 until October 2013, she worked as Deputy Head of Rospotrebnadzor before being appointed by the Russian Prime Minister to the position of Head of Rospotrebnadzor and Chief Sanitary Physician of the Russian Federation in April 2014. Rospotrebnadzor is a government agency that carries out the functions for the formulation and enforcement of state policy and legislation in the field of consumer rights protection, as well as the development and approval of the state sanitary and epidemiological guidelines and hygienic norms. Rospotrebnadzor comprises more than 110.000 staff members, located in 84 regional offices and Hygienic and Epidemiological Centers in the Russian Federation, in addition to 28 epidemiological and hygiene scientific research institutions. Dr. Popova has PhD in hygiene sciences. She is an author and co-author of more than 70 scientific publications, two monographs, over 50 regulatory and procedural documents. Dr. Popova is a highly skilled expert in hygiene, health risks evaluation, hygienic safety, heavily involved in scientific and preventive conferences and international fora. She holds a top qualification class in epi- demiology. Under the leadership of Dr. Popova, the Russian Federation devel- oped and increased multilateral and bilateral cooperation with international organizations and foreign state agencies, including in the area of food secu- rity, safety and nutrition. 76 Leveraging Social Protection Programs for Improved Nutrition: Report Carlo Scaramella Mr. Carlo Scaramella is the Deputy Regional Director of the Regional Bureau for North Africa, Middle East, Central Asia and Eastern Europe (RBC), United Nations World Food Programme (WFP). He is currently based in Cairo, Egypt. Mr. Scaramella holds a Doctorate in Political Science (Italy). He spent half of his professional career in challenging humanitarian and devel- opment settings mostly in Africa, Latin America and the Middle East. Mr. Scaramella has also held key corporate functions in Rome, leading WFP’s Emergency Preparedness and Response Branch for several years, and more recently serving as WFP’s Global Coordinator for Climate Change, Environment and Disaster Risk Management. Prior to joining WFP, Mr. Scaramella worked with other UN agencies, private sector and academia. The World Food Programme is the UN frontline agency in the fight against world hunger, reaching every year about 90 million among the most food insecure and vulnerable people living in the world’s poorest countries and regions. In the RBC region, WFP is responding to some of the most critical humanitarian crises of our times, while also supporting resilience building, recovery and development efforts. In total, working with partners, WFP is currently directly reaching about 25 million among the most vulnerable peo- ple in the region with food security and nutrition programs. Meera Shekar Meera Shekar is Global Lead for nutrition and Lead HNP Specialist with the World Bank’s Health, Nutrition and Population Global Practice. Over the last several years, she has led the repositioning of the nutrition agenda within the World Bank and with partners that led to the new global Scaling-up Nutrition (SUN) initiative. The SUN movement is now supported by over 54 client countries and over a hundred global partners. Dr. Shekar has been one of the principals for the emerging aid-architecture for SUN, and the G8 and G20 agenda-setting process for food security and nutrition over the last several years. She leads the global and country-level SUN costing and financing anal- yses in the World Bank. She also works on analytics and operations on the demographic dividend and population and development issues. Dr. Shekar has lived and worked across the globe and has extensive opera- tional experience in India, Bangladesh, Ethiopia, Tanzania, Vietnam, Bolivia, Guatemala, Uzbekistan, Sri Lanka and the Philippines. Before joining the World Bank in 2003, she led UNICEF’s Health, Nutrition and Water and Sanitation teams in Tanzania and the Philippines. Dr. Shekar has a PhD in International Nutrition, Epidemiology, and Population Studies from Cornell University and has consulted extensively including with JHU Population Communications Services and Population Services International. Among other publications, she is the author of the health chapter in the World Bank’s flagship report entitled eTransform Africa: the Transformational use of Information and Communication Technologies in Africa, 2012; Repositioning Leveraging Social Protection Programs for Improved Nutrition: Report 77 Nutrition as Central to Development, 2006; and Scaling-up Nutrition – What will it cost, 2009. Dr. Shekar is an Adjunct professor at Tufts University, USA, and has been a guest speaker at several G8 preparatory events including the G8 parliamentarians’ conference in Canada. Vyacheslav Smolenskiy Graduated from the Tver Medical University Dr. Smolenskiy joined the state public health agency Rospotrebnadzor in 2004 as a leading specialist in Epidemiological Surveillance Department. In 2008, he was promoted to the position of a Deputy Director of the Science and International Cooperation Department and now continues to work in Rospotrebnadzor as a Director for Science and International Relations. Dr. Smolenskiy got his PhD in epi- demiology in 2012. He also received master’s degree in business administra- tion (for executives) from Kingston University London. He is an author and co-author of more than 20 scientific publications and 2 monographs. In his day-to-day work Dr. Smolenskiy coordinates multilateral and bilateral international relations of Rospotrebnadzor with UN agencies (including FAO, WHO, Codex Alimentarius, WB), relevant IOs and intergovernmental organi- zations (CIS, G20, BRICS, SCO, WTO, OECD, etc.). He is a leading Russian expert on international development assistance in the area of public health. Between 2006 and 2014, he was a member and a chair (2006 and 2014) of the G8 Health experts group. Under his supervision Rospotrebnadzor strengthened its’ cooperation with UN agencies working in the area of food security and nutri- tion. Dr. Smolenskiy also coordinates the scientific work being performed by 28 epidemiology and hygiene scientific research institutions of Rospotrebnadzor. Josefina Stubbs She holds a PhD in Political Science and International Development from the Institute of Social Studies in Holland. She has over 25 years of experience in the areas of development and management, gained through her work at national, private, and multilateral development agencies. Prior to becoming the Associate Vice-President and Chief Development Strategist in the Strategy and Knowledge Department on October 1st, 2014, Dr. Stubbs was Director of the Latin America and the Caribbean Division. She previously worked with the World Bank where she held various positions in the Bureau for Latin America and the Caribbean. In addition, Dr. Stubbs worked for sixteen years in Oxfam UK and for the Dominican Republic’s Ministry of Agriculture. Rob Vos Dr. Rob Vos is the Director for Social Protection and Coordinator of the Strategic Programme for Rural Poverty Reduction of the Food and Agriculture Organization of the United Nations (FAO). Previously, he was Director of 78 Leveraging Social Protection Programs for Improved Nutrition: Report Development Policy and Analysis in the United Nations Department of Economic and Social Affairs (UNDESA), New York, Secretary of the UN Committee for Development Policy and coordinator of the UN Secretary- General’s Millennium Development Goals’ Gap Task Force and UN Task Team for the Post-2015 UN Development Agenda. Dr. Vos is also (honorary) Professor of Finance and Development at the International Institute of Social Studies of Erasmus University. Dr. Vos’ most recent (co-authored) book publications include: Ageing and Development (Orient Longman/Zed books, 2008), Uneven Economic Development (Orient Longman/Zed books, 2008), Economic Insecurity and Development (United Nations, 2010), Climate Protection and Development (Bloomsbury Academic, 2012), Retooling Global Economic Governance (Bloomsbury Academic 2013), Financing Human Development in Africa, Asia and the Middle East (Bloomsbury Academic 2014), and Development Strategies for the Post-2015 Era (Bloomsbury Academic 2014). Natalia Winder Rossi Natalia Winder Rossi is a senior social protection specialist with policy and pro- grammatic experience in Latin America and Eastern and Southern Africa. She is a Senior Social Protection Officer at FAO, ESP Division, working on strengthen- ing policy and operational linkages between social protection, food security, nutrition and rural development. Prior to joining FAO, she was the Senior Programme Specialist (Social Protection) at UNICEF’s Regional Office for Eastern and Southern Africa where she led UNICEF’s regional work on social Protection across 21 countries. Moreover, she coordinated the regional UNICEF response on HIV-Sensitive social protection as part of Joint UNAIDS Programme. Ms. Winder Rossi co-led and co-authored the development of UNICEF’s first ever Social Protection Strategic Framework, which lays out UNICEF approach and principles for their work in this. Prior to joining UNICEF, Ms. Winder worked at the Inter-American Development Bank on social protection design, indigenous peoples’ development and education programs. Ms. Winder Rossi holds a Master’s of Science in Foreign Service-Economic Development from Georgetown University and a Master’s of Science in Social Policy Research from London School of Economics and Political Science. Ruslan Yemtsov Dr. Ruslan Yemtsov is a lead economist in the Social protection and Labor Practice of the World Bank. He is responsible for leading the knowledge man- agement in the area of Social Safety Nets, building on 4 years of coordinating the work on monitoring social protection strategy and Global Experts Team on social safety nets. Prior to his current position, he worked as a lead poverty economist in the Middle East and North Africa region, and in the Eastern Europe and Central Asia regions. His experience includes: leading Leveraging Social Protection Programs for Improved Nutrition: Report 79 publication of major flagship reports on the State of Social Safety Nets in the world, directing South-South Learning Fora and global training programs on poverty, data analysis, social protection and labor, conducting country pov- erty assessments (Egypt, Georgia, Serbia, Croatia, Macedonia, Bosnia, Turkey and others), working on targeting and social assistance projects (Morocco, Russia, Croatia), managing fuel subsidy reform dialogue (Egypt, Tunisia, Morocco) and leading regional flagship reports on poverty, subsidy reforms, and statistical capacity. Dr. Yemtsov has also worked on country projects focused on food crisis response (Djibouti), structural adjustment credits (Georgia), energy sector reform, social funds, and social welfare development projects. Author and co-author of over 25 research papers, articles, book chapters and monographs. 80 Leveraging Social Protection Programs for Improved Nutrition: Report Annex 7: Vocabulary Quiz Results Results suggest that participants had good understanding of social protection terminology, whereas over a quarter did not correctly identify the following nutrition terminology: nutrition-specific (64 percent), nutrition-sensitive (72 percent), hunger (73 percent), nutrition security (52 percent), wasting (60 percent), and undernourishment (65 percent). Day Two continued this trend with substantially lower scores for the nutrition terminology: obesity (32 per- cent), metabolic syndrome (52 percent), and adolescent fertility rate (34 per- cent). Economic resilience (69 percent) was also widely unclear. Voted Voted Term/ Definitions (total) (percent) 1. NUTRITION-SPECIFIC 74 a.  Journal articles with Nutrition in the title. 0 0 b.  Only interventions chosen by professional Nutrition experts. 3 4 Interventions that address the underlying and basic determinants of c.  24 32 maternal, fetal and child nutrition and development. Interventions that have an immediate and direct impact on d.  47 64 maternal, fetal and child nutrition and development. 2. NUTRITION-SENSITIVE 72 Interventions that have an immediate and direct impact on maternal, a.  17 24 fetal and child nutrition and development. b.  Foods vulnerable to changes in water and light. 1 1 Interventions that address the underlying and basic c.  52 72 determinants of maternal, fetal and child nutrition and development. d.  Individuals subject to various food allergies. 2 3 3. HUNGER 84 A feeling of discomfort, illness, weakness, or pain due to prolonged a.  8 10 involuntary lack of food. The usual uneasy sensation of temporary absence of food in the b.  3 4 stomach. c.  Not having enough to eat to meet energy requirements. 12 14 d.  All of the above. 61 73 4. MALNUTRITION 93 a.  Poor nutritional status caused by nutritional deficiency or 81 87 excess. b.  Undernutrition alone. 6 6 c.  Over-nutrition alone. 2 2 d.  Consumption of spoiled food. 4 4 5. UNDERNUTRITION 92 a. Hunger. 2 2 Poor nutritional status due to nutritional deficiencies, including b.  80 87 stunting, underweight and wasting. (continued on next page) Leveraging Social Protection Programs for Improved Nutrition: Report 81 Voted Voted Term/ Definitions (total) (percent) c.  Only refers to children who are not gaining weight. 3 3 d.  Food insecurity. 7 8 6.  1000 DAYS 71 The period from conception to the completion of the child’s a.  62 87 second year of life in which nutritional requirements are substantial and damage from malnutrition is largely irreversible. b.  The period of recommended exclusive breastfeeding 3 4 c.  The period from birth to the end of recommended breastfeeding. 5 5 d.  The average period from marriage to birth. 1 1 7.  FOOD SECURITY 90 a.  A private organization dedicated to preventing food theft. 4 4 When all people, at all times, have physical and economic b.  81 90 access to sufficient, safe and nutritional food to meet their dietary needs and food preferences for an active and healthy life. When the cost of available food is affordable to a majority of the c.  3 3 population. d.  The same as nutrition security. 2 2 8.  NUTRITION SECURITY 92 a.  Confidence of a family in their access to adequate food. 3 3 The ongoing access to a balanced diet, adequate care and b.  48 52 feeding practices, a safe and clean environment, clean water, and adequate health care (preventive and curative) for all people, and the knowledge needed to care for and ensure a healthy and active life for all household members. When all people, at all times, have physical and economic access to c.  38 41 sufficient, safe and nutritional food to meet their dietary needs and food preferences for an active and healthy life. The result of food storage and preservation practices that sustain food d.  3 3 supply throughout the year. 9.  STUNTING / STUNTED 94 a.  A short child compared to other children in the same village. 1 1 A short child compared to other children in the same country of the b.  4 4 same ethnicity. Low height for age, when compared to a global sex-specific c.  76 81 standard, which is the result of chronic undernutrition. a.  Determined entirely by chronic malnutrition in post-natal life. 13 14 10. WASTING 94 a.  Low weight for age when compared to a global sex-specific standard. 27 29 An invisible indicator of undernutrition, even when severe, unless b.  5 5 associated with the age of the child. c. Underweight. 6 6 Low weight for height when compared to a global sex-specific d.  56 60 standard. 11.  DIETARY DIVERSITY 91 a.  A population measure of different diets used in the community. 1 1 An indicator of different vegetable groups (green leafy vs yellow) in a b.  3 3 child’s diet. (continued on next page) 82 Leveraging Social Protection Programs for Improved Nutrition: Report Voted Voted Term/ Definitions (total) (percent) The number of food groups consumed over a given period of c.  85 93 time that can be used as an indicator of household food security, or diet quality. d.  A mix of different foods that appeal to a child’s tastes and preferences. 2 2 12.  DOUBLE BURDEN OF MALNUTRITION 81 a.  Twice the burden of bad nutrition because of overweight and obesity. 3 4 The simultaneous occurrence of undernutrition and over- b.  67 83 nutrition in the same community, household, or individual. c.  The result of overweight and obesity. 2 2 The economic costs of non-communicable diseases that are twice as d.  9 11 expensive as communicable diseases. 13.  FOOD SYSTEM 96 A domestic arrangement where one member of a family is responsible a.  3 3 for cooking, while other members are responsible for buying food and cleaning up. A collaborative network that integrates sustainable food b.  91 95 production, processing, distribution, consumption, and waste management in order to enhance the environmental, economic and social health of a particular place. c.  The transportation system for getting food from farm to table. 1 1 d.  An agricultural cooperative. 1 1 14.  SOCIAL PROTECTION 85 a.  The appropriate use of barrier contraception to prevent HIV infections. 0 0 Social programs aimed at strengthening community responses to b.  1 1 military incursions. c.  Programs for the prevention and treatment of child abuse and neglect. 1 1 The set of public interventions aimed at supporting the poorer d.  83 98 and more vulnerable members of society, as well as helping individuals, families, and communities manage risk. 15.  SOCIAL SAFETY NETS 89 Non-contributory transfer programs targeted in some manner a.  73 82 at the poor and those vulnerable to poverty and shocks (also known as “welfare” or “social assistance”). b.  A general phrase for any program that protects all members of society. 8 9 Part of occupational health and safety, a protective device that prevents c.  2 2 injury if a worker should fall from a great height. Investments that are expected to retain their value or even increase their d.  6 7 value in times of market turbulence. 16. UNDERNOURISHMENT 82 A person whose usual food consumption, expressed in terms of a.  53 65 dietary energy (kcal), is below the energy requirement norm. b.  An individual suffering from undernutrition of any sort. 17 21 c.  Low weight for age. 10 12 d. Kwashiorkor. 2 2 17. OBESITY 34 a.  Greater than three SD above the mean of sex-specific reference data. 10 29 b.  Associated with overconsumption of calories and a sedentary lifestyle. 10 29 (continued on next page) Leveraging Social Protection Programs for Improved Nutrition: Report 83 Voted Voted Term/ Definitions (total) (percent) Contributed to by changes in the dominant bacterial divisions of the gut c.  1 3 microbiota. Is significantly associated with presence of antibodies to an adenovirus d.  2 6 suggesting a viral cause. e.  All of the above. 11 32 18.  ECONOMIC SHOCK 62 An unexpected or unpredictable event that causes instability in a.  42 68 an economy, either positively or negatively. b.  A feeling of disturbed surprise resulting from an upsetting event. 2 3 A critical condition brought about by a sudden drop in blood flow c.  1 2 through the body. A feeling of confusion, doubt, or nervousness caused by being in a d.  1 2 place (such as a foreign country or city) that is very different from what you are used to. e.  All of the above. 7 11 19. QUINTILE 37 The division of the population into five equal parts according to a.  29 78 income (each 20%). b.  The division of the population into four equal parts (each 25%). 6 16 c.  The division of the population into three equal parts (each 33.3%). 0 0 d.  The name of a musical group from the London School of Economics. 2 5 20.  CONDITIONAL CASH TRANSFER 54 A program that provides money as social assistance to poor a.  48 89 families contingent on certain behavior. Welfare programs that transfer funds to poor families without any b.  2 4 criteria. c.  Social welfare programs where funds are transferred between families. 3 6 d.  Transfer of funds from rich quintiles to poor quintiles. 1 2 21.  ECONOMIC RESILIENCE 59 An individual’s ability to adapt to stress and adversity using effective a.  15 25 methods of coping. The ability of the economy to cope, recover, and reconstruct to b.  41 69 minimize the losses from a disaster or shock. c.  The ability to change something of oneself to fit to occurring changes. 3 5 d. Flexibility. 0 0 22.  METABOLIC SYNDROME 56 A cluster of conditions that occur together that increase the risk a.  29 52 of heart disease. b.  A combination of opinions about new advances in biochemistry. 1 2 A constellation of strictly laboratory findings that indicate a risk of c.  15 27 developing obesity. d.  All of the above. 11 20 23.  ADOLESCENT FERTILITY RATE 50 a.  Number of births per 1000 girls ages 15–19 years old. 17 34 b.  Number of births per 100 girls 10–19 years old. 3 6 c.  Number of pregnancies per girl during adolescence. 13 26 d.  Number of pregnancies per 1000 women ages 15–19 years old. 17 34 (continued on next page) 84 Leveraging Social Protection Programs for Improved Nutrition: Report Voted Voted Term/ Definitions (total) (percent) 24.  GINI INDEX / COEFFICIENT 54 A measure of the equality of income distribution among a.  42 78 households or individuals. An economist’s best guess at equity in a society using the magical b.  4 7 “Genie” Number. c.  A number between 0 and 100 that measures wealth. 2 4 d.  None of the above. 6 11 25.  SMALLHOLDER FARMER 55 A Farmer owning a small plot of land on which is grown crops a.  47 85 with family labor. b.  A farmer with few possessions or assets. 2 4 c.  A farmer from the poorest economic quintile. 2 4 d.  A farmer with insufficient agricultural tools. 4 7 26.  ECONOMIC ELASTICITY 54 a.  The ability to make your money buy more. 3 6 b. Flexibility. 1 2 c.  Ability to assume Yoga positions without pain. 2 6 Measure of how responsive an economic variable is to a change d.  48 89 in another. Leveraging Social Protection Programs for Improved Nutrition: Report 85 Annex 8: Working Group Topics & Facilitators SESSION 5 – CREATING SYNERGIES: STRENGTHENING SOCIAL PROTECTION PROGRAMS Table Topic Facilitator Social Protection Instruments 1. Public Works Kevin Hempel 2. Cash transfers Maria Concepcion Steta Gandara 3. In kind transfers Natalia Winder Rossi 4. School Feeding Daniel Balaban Arlene Mitchell 5. Conditionalities Philippe Leite Nutrition Principles 1. Gender Josefina Stubbs 2. 1,000 days Andrea Spray 3. Dietary diversity Charlotte Dufour 4. Targeting nutritionally vulnerable Lynnda Kiess 5. Nutrition education & promotion Bibi Giyose SESSION 9 – LEARNING FROM THE FIELD: CASE STUDIES OF NUTRITION-SENSITIVE SOCIAL PROTECTION PROGRAMS Table Case study Case Rep. Table Facilitator 1. Nigeria – Child Development Grant Program STC Andrea Spray 2. Republic of Congo – Nutrition-Sensitive Urban Safety WFP Christina Tirado Net Programme 3. Syria – Fresh Food Vouchers for Pregnant and Lactating WFP Ruslan Yemtsov Women 4. Niger Safety Net Project WBG Iain MacGillivray 5. Mexico – Social Protection System/ PROSPERA WBG/GOM Laura Figazzolo 6. Kenya – Cash Transfers for Orphans and Vulnerable WBG Elena Bolotnikova Children 7. Bangladesh – Income Support Program for the Poorest WBG Militezegga Abduk (ISPP) Mustafa 8. Philippines – Social Welfare Development and Reform WBG Aaron Buchsbaum Project 86 Leveraging Social Protection Programs for Improved Nutrition: Report SESSION 10 – LEARNING FROM THE FIELD: CASE STUDIES OF NUTRITION-SENSITIVE SOCIAL PROTECTION PROGRAMS Table Case study Case Rep. Table Facilitator 1. Indonesia – Program Keluarga Harapan (PKH) Prestasi GOI Militezegga Abduk Mustafa 2. Brazil – Zero Hunger Strategy WFP COE Julia Komagaeva 3. Brazil – National School Feeding Programme (PNAE) WFP COE Ahmed Raza 4. Myanmar – Tat Lan Program STC Hideki Mori 5. Djibouti Social Safety Net WBG Laura Figazzolo 6. Dominican Republic – Progresando con Solidaridad WFP Jeremy Shoham 7. Cabo Verde – School Nutrition Programme FAO Aaron Buchsbaum 8. Ethiopia – Productive Safety Net and Household Asset GOE Laura Campbell Building 9. Haiti – Kore Lavi – Appui au programme national de sécurité ACF Holly Sedutto alimentaire et de nutrition 10. Peru – Results in Nutrition for Juntos SWAp WBG Arlene Mitchell 11. Indonesia – PNPM Generasi WBG Andrea Spray SESSION 11 – NEW HORIZONS FOR NUTRITION-SENSITIVE SOCIAL PROTECTION Table Topic Facilitator 1. Double Burden of Malnutrition Boitshepo Bibi Giyose 2. Multisectoral collaboration Julien Morel 3. Integrated (supply and demand) approach Menno Mulder-Sibanda 4. Governance Christina Behrendt 5. Decentralization Vinicius Limongi Christiani Buani 6. Community participation Robert Wrobel 7. Local procurement Iain MacGillivray 8. Urban Ruslan Yemtsov 9. Rural Mathew Tasker 10. Climate change Christina Tirado 11. Conflict-affected settings Karim Hussein 12. Mobile technology Nicola Hypher 13. Behavior change communication Kerina Zvogbo 14. Lifecycle approach Lynnda Kiess 15. Women’s empowerment Josefina Stubbs 16. Early child development Oumar Barry Leveraging Social Protection Programs for Improved Nutrition: Report 87 Annex 9: Experiences of BRICS Countries in the Development of Nutrition- Sensitive Social Protection Programs Brief The following annex will be made available as a formal publication in 2016. Please visit www.fao.org or www.securenutrition.org to read in full. The Second International Conference on Nutrition (ICN2), held jointly by FAO and WHO in Rome, Italy, in November 2014, called on governments and policy makers to address nutrition issues through various sectors; social protection was emphasized as being a key sector. Member States endorsed the outcome documents of the ICN2, the Rome Declaration on Nutrition and Framework for Action. The latter urged the integration of nutrition objectives into social protection programs and humanitarian assistance safety net programs to holistically tackle hunger, food insecurity and malnutrition. The BRICS (Brazil, Russia, India, China and South Africa) played a key role in mobilizing political will and cooperation for nutrition during the ICN2, and have since led the way in following-up on commitments set forth in the outcome documents. Building on the ICN2 recommendations, this session is an extension of a series of dialogues that are aimed at enhancing the partnership and coopera- tion among and with BRICS countries on the successful implementation of the ICN2 follow-up, with a specific focus on making social protection systems more nutrition enhancing. Growing influence and enhanced cooperation The BRICS countries are increasingly assuming a greater leadership role as a political block in global policy dialogues on economic, social, and environ- mental issues. Together, they represent 3.1 billion people and 42 percent of the total world population. The BRICS have been successful in achieving the Millennium Development Goal of halving the prevalence of undernourishment by 2015. On average, Brazil, India and China reduced the number of undernourished people by 36 percent between 1990 and 2015–2016.23 Furthermore, the BRICS countries have in the recent past emerged as a vehicle for South-South cooperation for the reduction of hunger and malnu- trition by assisting countries’ design and implement of robust social protection programs. 88 Leveraging Social Protection Programs for Improved Nutrition: Report That being said, challenges remain in assisting about 333 million under- nourished people in these countries. Brief summary of Nutrition-Sensitive Social Protection Policies and Programs BRICS countries have shown firm commitment to social protection as a plat- form to reach vulnerable populations. The social protection programs in BRICS countries are framed within state-level institutional structures, domes- tically financed and highly context-specific in their design and implementa- tion. For some countries, these programs have been instrumental in reducing hunger and malnutrition. Brazil Food security and nutrition found political ground in 2003 in President Lula’s government, as he put the hunger eradication goal on top of his politi- cal agenda—with introduction of the Zero Hunger Strategy. It has thus paved the way for a broad National System for Food and Nutrition Security Policies to interact in a multisector, decentralized, and participatory way. This System comprises of two dozen ministries and civil society organizations at the national, state and municipal level. The main sectors involved in the process include social protection, health, nutrition, education, agriculture, rural development, environment, labor, human rights, and gender. Since then the social protection policy has also been revised and strength- ened, and the Right to Food has been included in the Constitution (along with other social rights). In President Dilma’s tenure, the commitment towards hunger and poverty eradication has been further strengthened with the launch of Brazil without Poverty Programme. The Programme, while maintaining the former structure of National System for Food and Nutrition Security, has initiated new mecha- nisms to create more links to nutrition activities, while also focusing on the inclusive production of the extremely poor population in an effort to help them escape the trap of poverty. In recent times, Brazil has stepped up its efforts to share its experience and provide technical assistance to other Latin American, Central American, and African countries, mainly through South-South Cooperation programs. Key Social Protection Programs with linkages to nutrition in Brazil include: • Conditional Cash Transfer Programme – Bolsa Família • School Feeding Programme (PNAE) • Purchase for Africa for Africans (PAA) • Food and nutrition education and distribution of micronutrients and vita- mins through public health services Leveraging Social Protection Programs for Improved Nutrition: Report 89 Russia The issues of nutrition and food quality have traditionally been on top of the agenda in Russia, backed by a strong legislative framework. In 1998, the Concept of the State Policy in the Field of Healthy Nutrition at Federal and Regional Levels was established. In 2014 the Concept of Domestic Food Aid was started, which enacted the Concept for developing internal food aid in the Russian Federation that specifies the latter as “a system of state assistance to population in the form of direct supplies of foodstuffs to relevant individu- als or by providing them with monetary aid for the purchase of food in order to improve nutrition and ensure a balanced diet based on rational rates of food consumption.” Russia is an emerging donor in the areas of agriculture and food security. Eastern Europe and Central Asia have benefited and still do benefit signifi- cantly from Russia’s approach, which had a focus on the social and cultural rights whereby emphasis on food, nutrition, education, and social protection were at the heart of their development. With the Eurasian Center for Food Security, Russia wants to strengthen and use Russian Institutions to provide technical support to the developing countries and regions. Key Social Protection Programs with linkages to nutrition in Russia include: • The School Feeding Programme India In 2010, the Indian Government launched the National Rural Livelihoods Mission, the largest integrated rural poverty reduction program in the world, with its goal of reaching nearly 70 million rural households. Among other things, the Mission will give poor households a voice to demand ser- vices such as early childhood education, pensions, and other safety nets, including programs on maternal, infant, and young child feeding and nutrition. Support for poor rural households through employment schemes, other income generation interventions, and better nutrition delivery are also exten- sively implemented in India. School meals and school nutrition as part of social protection programing has promoted girls’ education and participation in society. Food fortification is also another area where the region is fairly advanced; this provides the much needed micronutrients to a larger popula- tion through different outlets (e.g., supermarkets, community health centers, clinics, etc.). India also maintains extensive public food distribution systems with a goal of smoothing consumption (i.e., managing scarcity) and reducing volatility in food and essential prices. Key Social Protection Programs with linkages to nutrition in India include: • Subsidized Public Food Distribution Systems (PDS) • National Rural Employment Guarantee Scheme (NREGS) 90 Leveraging Social Protection Programs for Improved Nutrition: Report • Child Grant for Girls • School Feeding Programme China China has a large manufacturing capacity and huge commodity export base. Its focus on the diversification and economic transformation of agriculture is paying dividends as China is able to not only provide technical support, but it also partners with many developing countries to support infrastructure devel- opment, investment, and technological transfers. Over the years China has become a major donor to agriculture development and food security. Pledging/donating $15million to FAO demonstrates the most recent example of a strong collaboration towards hunger reduction worldwide. The Food fortification programs to combat micronutrient deficiencies and school feeding programs are widespread in China, and many vulnerable pop- ulations benefit from these. The delivery mechanisms and points for these social protection and nutrition programs may vary according to region (e.g., health sector, education, or agriculture). Main Social Protection Programs with linkages to nutrition in China include: • School Feeding Programme • Food Fortification Programs South Africa South Africa has a number of social grants schemes that aim to protect the poor from extreme conditions. The policies and programs such as the National Integrated Nutrition Programme, and the school feeding programme seek to address challenges of malnutrition in a holistic way, involving several sectors and local communities. South Africa explicitly recognizes the Right to Food and to Social Protection. South Africa’s National Development Plan 2030 accords a central role to social protection in addressing the critical challenges of eradicating poverty and reducing inequality. A role is assigned to social protection to contribute to ensuring that no-one slips below a minimum standard of living, as well as a more transformative and developmental role of moving towards a more inclusive growth path and to ensure more inclusive development outcomes. Key Social Protection Programs with linkages to nutrition in South Africa include: • Child Support Grant • School Feeding Programme – NPSP Leveraging Social Protection Programs for Improved Nutrition: Report 91 Opportunities and Challenges in enhancing the nutrition sensitivity of social protection programs There is an increased momentum around social protection—at global and regional levels—and countries are further expanding the coverage and/or domestic financing of their social protection systems. In addition, there is an increasing recognition towards the need to align social protection with other key interventions to maximize its potential impacts on poverty reduction24. BRICS countries’ experience in the development of nutrition-sensitive social protection interventions is critical, particularly for countries that are progressively moving towards a systems and multi-sector approach to social protection and nutrition. Moreover, there remain numerous challenges in integrating nutrition and social protection in the BRICS countries. However, some of the identified challenges can also be applicable in other contexts. Firstly, there is a need for further exploration and systematic identification of the experiences and les- sons-learned of social protection systems on nutritional outcomes. It is also important to analyze the institutional and governance mechanisms that must be in place in order to ensure successful implementation and posi- tive nutritional outcomes. Lastly, there is a need to identify common international cooperation schemes within BRICS countries and main target countries/regions to strengthen complementarities and synergies. FAO’s Work in Nutrition Sensitive Social Protection FAO acknowledges the necessity of a multisectoral and multi-stakeholder approach in integrating nutrition and social protection. Social Protection has been recognized as instrumental in alleviating pov- erty and it can positively address all dimensions of food security. Poverty and malnutrition both have multiple causes that cannot be addressed by a single sector or stakeholder. Protecting the vulnerable populations from poverty and exclusion, and ensuring improved nutrition, therefore requires a multi- sectoral and multi-stakeholder approach. This approach operates at various levels, from individuals to households to communities, all the way up to the policy level. Through the new Strategic Framework, which includes addressing malnu- trition and rural poverty as Objectives, FAO aims to strengthen government capacities in designing, implementing, and monitoring social protection sys- tems that benefit rural households and those dependent on rural livelihoods, while establishing key linkages with food security and nutrition. FAO’s expertise on supporting the development of sound policies in the agricultural sector is now further enhanced by aligning rural development approaches with strategies that would strengthen poor households’ capacity to better cope and manage risk, reduce negative coping strategies, and increase access to resources and critical services. FAO also generates knowledge and evidence on the impact of national social protection programs on nutrition outcomes, as well as on linkages and 92 Leveraging Social Protection Programs for Improved Nutrition: Report synergies between nutrition and social protection within the wider context of agricultural and rural development. It also works with partners in developing normative and standard setting instruments. Furthermore, a heavy emphasis is placed on facilitating partnerships, out- reach and advocacy among and within countries in the area of social protec- tion and the links with FSN, agricultural and rural development. Further Resources and Information: FAO. 2015. Nutrition and Social Protection. Rome, FAO. Evidence from Protection to Production Team, FAO. (http://www.fao.org/ economic/ptop/home/en/). This concept note is based on the FAO paper on “Experiences of BRICS Countries in the Development of Nutrition-Sensitive Social Protection Programs.” Following discussions at the Global Forum on Nutrition Sensitive Social Protection, the paper will be released on the web. Please contact Natalia Winder Rossi (Natalia.winderrossi@fao.org) or Ahmed Raza (ahmed.raza@fao.org) for queries. Leveraging Social Protection Programs for Improved Nutrition: Report 93 Annex 10: BRICS Session Summary Representatives of Brazil, the Russian Federation, India, and South Africa, assembled on the September 10th, 2015 in Moscow on the occasion of the Global Forum on Nutrition-Sensitive Social Protection Programs: Towards Partnerships for Development (Moscow, September, 10–11, 2015) and reached a number of common views in contribution to the final outcome of the Global Forum. They noted the critical importance of the Second International Conference on Nutrition (ICN2), held last year in Rome, in the fight against hunger and malnutrition. In this regard, they also noted the commitments on nutrition and social protection made, as reflected in the ICN2 outcome documents, the Rome Declaration on Nutrition, and its companion Framework for Action. They welcomed the initiative of the Russian Federation and the World Bank to organize the Global Forum on Nutrition-Sensitive Social Protection Programs, which provided opportunity to share best practices and gain a bet- ter understanding of existing needs of developing countries for support in designing and implementing scaled up nutrition-sensitive social protection programs. They expressed appreciation to FAO for providing opportunity to BRICS countries to follow through on ICN2 commitments, in particular those aim- ing to make social protection systems more nutrition-sensitive through strengthened partnership and cooperation among and with BRICS countries. During the session, the following messages were highlighted: • Important progress has been made in terms of reducing poverty, hunger and malnutrition. • Yet, important challenges remain given still high rates of malnutrition in all its forms and the alarming number of children, women, and rural households that continue to experience extreme poverty, hunger, and limited access to food in many parts of the world. • The international community has made important commitments to address all forms of malnutrition and have placed food security and nutrition high on the political and development agendas. • Ample evidence is showing the critical role that social protection can play in enhancing nutrition outcomes. Such impacts tend to be significantly larger when complemented with other interventions, emphasizing the need for multi-sector approaches in policymaking. • It is essential for policy and normative frameworks to provide a nation- wide vision to integrate nutrition-sensitive programs and policies and establish institutional mechanisms to engage all relevant stakeholders to 94 Leveraging Social Protection Programs for Improved Nutrition: Report ensure coherence across interventions at national, sub-national, and community levels. • BRICS countries are firmly committed to social protection as a means to reach vulnerable populations and ensure their food security and nutri- tion. The social protection programs in BRICS countries are set up through government-led institutional structures and are domestically financed. The designs of the programs vary and are specific to each con- text. The programs have been instrumental in reducing hunger and malnutrition. • Investments on social protection systems have to be considered as critical catalyzers for inclusive growth and sustainable development. Considering their emerging leadership and key role of BRICS countries in global policy dialogues on economic, social, and environmental issues and building on the ICN2 recommendations they agreed on the following: 1. Continue efforts in promoting the establishment of more comprehen- sive nutrition-sensitive social protection programs and systems aimed at enhancing food security and nutrition. Further, support should be given through complementary measures to enhance agricultural sustainable production and productivity, including through the strengthening of smallholder family farming, measures to reduce food waste and losses, to promote local food purchases, and other instruments towards the inclu- siveness and efficiency of food systems. This establishes enabling condi- tions for enhanced income-earning opportunities and purchasing power of poorest, improving access to health, education, and basic services, and raising awareness about healthy food and healthy diets. 2. Promote partnership and cooperation among the BRICS countries in this area, aiming to develop a knowledge-sharing network and platform on best practices. Additionally, to enhance South-South and Peer-to-Peer Cooperation for improved social protection systems that foster food security and better nutrition. Leveraging Social Protection Programs for Improved Nutrition: Report 95 Annex 11: Evaluation Results DAY 1 Of the following sessions, which did you find to be the most important? Total Rank Session 1: Vocabulary 16 5 Session 2: Opening and welcoming remarks 1 9 Session 3a: Statement of Problem 26 3 Session 3b: Keynote Address 31 2 Session 4: Solutions to date 17 4 Session 5: Creating Synergies: Strengthening social protection programs 35 1 Session 6: The Way forward : BRICS panel discussion 13 6 Program snapshot 1: PNPM Generasi 5 8 Program snapshot 2: Niger Safety Net Project 7 7 Of the following methodologies, which did you find to be the most effective? Total Rank Select 3. Crowd-sourced Vocabulary 11 6 Clicker machine 11 6 Presentation 16 4 Program Snapshot 6 9 Panel discussion 16 4 Working Groups (general) 41 1 Rotating Groups 24 2 Case Studies 17 3 Open Discussion (Q&A) 8 8 Which of the following were you exposed to for the first time today? Select all Total Rank that apply. New social protection instruments 14 5 New nutrition principles 13 6 New ways to implement nutrition-sensitive interventions 13 6 New ways to implement social protection instruments 16 4 The need for multisectoral approaches 6 8 New terminology 20 1 Information on global nutrition problems 18 3 Examples of approaches relevant to my work 19 2 Which of the following do you feel were not covered with enough depth or Total Rank clarity? Select all that apply. Social Protection Instruments N/A Nutrition Principles N/A Implementation of nutrition-sensitive interventions N/A Terminology N/A The ICN2 declaration N/A Other N/A (continued on next page) 96 Leveraging Social Protection Programs for Improved Nutrition: Report DAY 2 Of the following sessions, which did you find to be the most important? Total Rank Select 3. Session 8: Augmented vocabulary 8 5 Session 9: Learning from the field: case studies 31 2 Session 10: Learning from the field: case studies 2 29 3 Session 11: New horizons for nutrition–sensitive social protection 33 1 Session 12: What have we learned: round table, presentations, discussion 22 4 Session 13: Closing remarks 7 6 Program snapshot 3: Peru: Results in Nutrition for Juntos SWAp 5 7 Program snapshot 4: Djibouti – Results in Social Safety Net 5 7 Of the following key messages/lessons learned, which did you find to be the Total Rank most important? Select 3. In order to improve nutrition and other child development outcomes SP needs to do 9 7 something different, beyond just delivering SP platforms A lot can be gained synergistically by integrating SP and nutrition sensitive 23 3 interventions and approaches Nutrition has a lot to gain from leveraging SP platforms 14 4 Poverty and malnutrition are multidimensional and require a multisectoral 24 1 approach Partners must coordinate and collaborate together to strengthen the linkages 11 6 between social protection and nutrition We must learn from experience in nutrition-sensitive social protection and there are a 13 5 lot of experiences to learn from Nutrition-sensitive social protection solutions come from the countries themselves 7 8 SP is an investment, not an expenditure 24 1 Which SP instrument is best leveraged for improving nutrition outcomes depends on 5 10 the specific country context SP instruments can be leveraged to affect not only demand for nutrition services 7 8 Of the following methodologies, which did you find to be the most effective? Total Rank Select 3. Voting process 14 7 Presentation (prepared PowerPoints) 18 5 Presentation (without PowerPoint) 11 8 Program Snapshot 11 8 Panel Discussion 27 2 Case Studies 51 1 Open Discussion (Q&A) 19 4 World Café 27 2 Round table discussion 15 6 Which of the following were you exposed to for the first time today? Select all Total Rank that apply. New social protection instruments 12 6 New nutrition principles 10 9 New ways to implement nutrition-sensitive interventions 20 3 New ways to implement social protection instruments 14 4 The need for multisectoral approaches 12 6 New terminology 14 4 (continued on next page) Leveraging Social Protection Programs for Improved Nutrition: Report 97 DAY 2 Information on global nutrition problems 12 6 Examples of approaches relevant to my work 26 1 Approaches to new challenges to improving nutrition through SP interventions 24 2 Which of the following do you feel were not covered with enough depth or Total Rank clarity? Select all that apply. Social Protection Instruments 24 4 Nutrition Principles 8 5 Implementation of nutrition-sensitive interventions 27 3 Terminology 1 6 The ICN2 declaration 28 2 New challenges to improving nutrition through SP interventions 29 1 Overall, has this meeting provided you with new information, insights, and Total Rank approaches? Hardly at all 4 3 To a minimal degree 4 3 Somewhat 23 2 To a great degree 56 1 Overall, how would you rate this conference as you compare it to other work- Total Rank shops/fora that you have attended? I should have gone shopping 4 4 Could have been much better 8 3 Overall excellent; some gaps 57 1 Best I’ve ever attended 21 2 When you return to your work after this Forum how likely are you to: Debrief close colleagues in my office with the content and outcome of the Total Rank Global Forum Not very likely; I have too much to do already 3 3 Possibly if I have time 7 2 Very likely 56 1 When you return to your work after this Forum how likely are you to: Debrief colleagues in other related sectors of my organization about the Total Rank content and outcome of the Global Forum Not very likely; I have too much to do already 10 3 Possibly if I have time 23 2 Very likely 39 1 When you return to your work after this Forum how likely are you to: Organize a training for staff in my organization on ways to improve nutrition Total Rank outcomes through social protection interventions Not very likely; I have too much to do already 22 2 Possibly if I have time 20 3 Very likely 28 1 When you return to your work after this Forum how likely are you to: Use ideas I’ve learned in this Forum to design my next intervention, project, Total Rank or program Not very likely; I have too much to do already 1 3 Possibly if I have time 8 2 Very likely 49 1 98 Leveraging Social Protection Programs for Improved Nutrition: Report Annex 12: Impact Survey Results & Testimonials In May 2016, SecureNutrition surveyed Global Forum attendees to under- stand how participation at the Global Forum had made an impact on their work. The survey was conducted using Survey Monkey and made available in English, French, Russian, and Spanish. In total, 20 participants completed the survey. Results of the survey (Table 3) suggest that feedback garnered during the evaluation immediately following the Global Forum was largely born out. All (100 percent) participants of the survey reported to have shared information gained from the Global Forum with colleagues in their organization, and 92 percent reported to have used resources learned about or received at the Global Forum in their work. Among survey participants, 85 percent reported to have learned information or approaches that made an impact on their work at the country level. Over 80 percent of participants shared information with colleagues outside of their organization (81 percent) and have led or sup- ported training on nutrition-sensitive social protection (81 percent). Over two-thirds of attendees have continued to engage with people they met at the Global Forum (62 percent). These results provide additional supporting evi- dence that the Global Forum on Nutrition-Sensitive Social Protection Programs has made an important and lasting impact on the work for techni- cal practitioners globally. Qualitative feedback indicates that attendees gained understanding and skills to advocate for and design nutrition-sensitive social protection policies and programs. Participants learned about the linkages between nutrition and social protection, how social protection instruments can be leveraged for nutrition outcomes, and evidence in support of nutrition-sensitive social pro- tection. They also learned new approaches and best practices. Information and resources gleaned from the Global Forum has been discussed and shared TABLE 3  Impact Summary Survey Question Yes No % Did the Global Forum provide you with information or approaches that have had an 22 4 85% impact on your work at a country level? Have you shared Global Forum information with colleagues in your organization? 26 0 100% Have you shared Global Forum information with anyone outside of your organization? 21 5 81% Have you spoken, emailed, or worked with people you met at the Global Forum? 16 10 62% Have you used resources in your work that you learned about or received from the 24 2 92% Global Forum? Have you led or supported a training on ways to improve nutrition outcomes through 21 5 81% social protection interventions since the Global Forum? Did the “Learning from the Field” case study discussions impact work you are doing at 18 6 75% a country level? Leveraging Social Protection Programs for Improved Nutrition: Report 99 widely, with colleagues and managers in organizations, academic institutions, and government through reports, in-person and virtual meetings, and “brown bag” lunches. These same information and materials have been shared broadly outside attendees’ organizations too, with nutrition colleagues, partners, stu- dents, government stakeholders, donors, and civil society organizations. Due, in part, to connections made at the Global Forum, attendees have partici- pated in site visits and exchange missions, and continued collaboration through emails and video conferences. Attendees have also supported or con- ducted training with program partners, government counterparts, and local authorities and associations. The “practical advice” encapsulated in the case studies has proven to be “inspiring” and “helpful.” In addition to evaluating the impact of the Global Forum, the survey aimed to gather information to guide ongoing SecureNutrition programming. Key topics of interest (Table 4) identified include: Integrated approaches in a sin- gle program (7), Behavior change communication (6), Community participa- tion (6), Double burden of malnutrition (6), and Early childhood development (6). Also of interest is Governance of programs (5), Harnessing nutrition data (5), Local procurement of food, services, etc. (5), and Multisectoral collabora- tion among partners (5). Additional feedback from survey participants included both praise for the Global Forum and specific requests for additional support, including: more TABLE 4  Interest areas What topics are you most interested in learning more about? Count Rank (Pick 3) Integrated approaches in a single program 7 1 Behavior change communication 6 2 Community participation 6 2 Double burden of malnutrition 6 2 Early childhood development 6 2 Governance of programs 5 3 Harnessing nutrition data 5 3 Local procurement of food, services, etc. 5 3 Multisectoral collaboration among partners 5 3 Implementation in conflict-affected settings 4 4 Lifecycle approach in project design 4 4 Resilience 3 5 Use of mobile technology 3 5 Gender and women’s empowerment 2 6 Rural settings 2 6 Decentralization of services and delivery 1 7 Performance-based financing for programs 1 7 Urban settings 1 7 100 Leveraging Social Protection Programs for Improved Nutrition: Report Russian language materials, establishment of virtual sub-regional networks, field visits, and the Global Forum to be repeated on a bi-annual basis. Select testimonials • “We believe that the Forum promoted the role of effective nutrition-sensitive social protection programs in current global development agenda and sup- ported efforts of all interested stakeholders from different countries in designing and implementation of nutrition-sensitive social protection pro- grams. We look forward to our continued fruitful cooperation with the World Bank Group.” • “[We were] thrilled to be able to present … and benefited greatly from the interactions with other countries.” • “It was a very good forum, excellent organization and [we] were very happy with the results of the event. It was a very good opportunity to share experi- ences and learn.” • “It was really very important event, superbly organized, with a lot of lessons learned!” • “I found it highly useful and organized in an exceptional way to support knowledge and experience sharing.” • “The quality of the presentations and the many case studies was incredible.” Leveraging Social Protection Programs for Improved Nutrition: Report 101 Notes   1. WBG. (2016). Compendium of Case Studies Prepared for the Global Forum on Nutrition-Sensitive Social Protection Programs, 2015.   2. The compendium’s 18 cross-cutting themes are: Double burden of malnutri- tion (DBM) Multi-sectoral collaboration, Integrated approach, Governance, Decentralization, Performance-based financing, Community participation, Agriculture and local procurement, Urban, Rural, Resilience, Conflict-affected setting, Harnessing nutrition data, Use of mobile technology, Behavior Change Communication (BCC), Life-cycle approach, Gender and women’s empower- ment, Early Child Development (ECD).   3. The Leveraging Social Protection Programs for Improved Nutrition series is available on the SecureNutrition website (www.securenutrition.org).   4. Nutrition-sensitive social protection programs around the world – What’s being done and to what effect? (http://www.fao.org/fsnforum/forum/discussions/ social-protection-nutrition).   5. WBG and ILO in 2015 endorsed a shared mission for universal social protec- tion (http://www.ilo.org/global/topics/social-security/WCMS_378991/lang- -en/index.htm).   6. Studies estimate that every $1 invested in nutrition generates $18 in economic returns. Reference: Hoddinott, J., Alderman, H., Behrman, J. R., Haddad, L., & Horton, S. (2013). The economic rationale for investing in stunting reduction: Economic rationale for stunting reduction. Maternal & Child Nutrition, 9, 69–82. http://doi.org/10.1111/mcn.12080. See further economic rationale for nutrition-sensitive social protection in the Statement of the Problem summary below.  7. Transition from Safety Net Programs to Comprehensive Social Protection Systems: Food Security and Nutrition Perspective resource page: https://www. securenutritionplatform.org/Pages/AboutSeminar.aspx?CID=33.   8. Bhutta, Z. A., J. K. Das, A. Rizvi, M. F. Gaffey, N. Walker, S. Horton, P. Webb, A. Lartey, R. E. Black. 2013. “Evidence-Based Interventions for Improvement of Maternal and Child Nutrition: What Can Be Done and at What Cost?” Lancet 382 (9890): 452–77.  9. WBG. (2016). Summary of Evidence Prepared for the Global Forum on Nutrition-Sensitive Social Protection Programs, 2015.   10. The 1,000-day window of opportunity begins at conception and ends at 24 months.   11. The UNICEF conceptual framework identifies three underlying determinants of nutrition outcomes: food security, care practices, and the disease environ- ment and access to health services.   12. Conditional cash transfers require beneficiaries to access services that aim to improve nutrition outcomes—such as pre-natal care, immunizations, growth monitoring and promotion, nutrition education, etc.—to receive benefits. “Hard” conditions mean there is a stoppage of benefits in the case of non-com- pliance; “soft” conditions mean that a failure to meet conditionalities triggers increased social worker engagement to address barriers, rather than the stop- page of benefits.   13. These reports are available on the SecureNutrition website (www.securenutri- tion.org).   14. Drawing upon Participatory Adult Learning methods, influenced by Robert Chambers (PRA), Rolf Lynton (Training for Development with Udai Pareek), John Batten (Action Aid, AMREF, and CARE International), Paolo Freire (Pedagogy of the Oppressed) and Jack Mezirow. 102 Leveraging Social Protection Programs for Improved Nutrition: Report   15. The compendium’s 18 cross-cutting themes are: Double burden of malnutri- tion (DBM) Multi-sectoral collaboration, Integrated approach, Governance, Decentralization, Performance-based financing, Community participation, Agriculture and local procurement, Urban, Rural, Resilience, Conflict-affected setting, Harnessing nutrition data, Use of mobile technology, Behavior Change Communication (BCC), Life-cycle approach, Gender and women’s empow- erment, Early Child Development (ECD). More on the 18 cross-cutting themes can be found in the (WBG) Leveraging Social Protection Programs for Improved Nutrition: Compendium of Case Studies Prepared for the Global Forum on Nutrition-Sensitive Social Protection Programs, 2016. Please see: www.securenutrition.org.   16. Nutrition-sensitive social protection programs around the world – What’s being done and to what effect? (http://www.fao.org/fsnforum/forum/discussions/ social-protection-nutrition).   17. Davis, B. and Handa, S. (2014). The broad range of cash transfer impacts in sub-Sa- haran Africa: Consumption, Human Capital and Productive Activity. (https:// transfer.cpc.unc.edu/wp-content/uploads/2015/09/TransferProjectBrief_ 2014–01_BroadImpactsofSCT.pdf).   18. With the exception of China, which was unable to attend.   19. FAO. (2016). Experiences of BRICS Countries in the Development of Nutrition- Sensitive Social Protection Programs. Rome, FAO. (forthcoming).   20. ICN2 Framework for Action (http://www.fao.org/3/a-mm215e.pdf).   21. Case studies can be found on the SecureNutrition website (www.securenutri- tion.org) and in the (WBG) Compendium of Case Studies Prepared for the Global Forum on Nutrition-Sensitive Social Protection Programs, 2015.   22. The compendium’s 18 cross-cutting themes are: Double burden of malnutri- tion (DBM) Multi-sectoral collaboration, Integrated approach, Governance, Decentralization, Performance-based financing, Community participation, Agriculture and local procurement, Urban, Rural, Resilience, Conflict-affected setting, Harnessing nutrition data, Use of mobile technology, Behavior Change Communication (BCC), Life-cycle approach, Gender and women’s empower- ment, Early Child Development (ECD). More on the 18 cross-cutting themes can be found in the WBG Compendium of Case Studies Prepared for the Global Forum on Nutrition-Sensitive Social Protection Programs, 2015.   23. FAO, IFAD and WFP. 2015. The State of Food Insecurity in the World 2015. Meeting the 2015 international hunger targets: taking stock of uneven prog- ress. Rome, FAO.   23. FAO, IFAD and WFP. 2015. Achieving Zero Hunger: the critical role of invest- ments in social protection and agriculture ROME, FAO. Leveraging Social Protection Programs for Improved Nutrition: Report 103 Global Forum on Nutrition-Sensitive Social Protection Programs Towards Partnerships for Development Russian Federation SKU K8703