Uncategorized Archives - Closing the gap

Supporting breastfeeding to close the Gender Nutrition Gap

Community health worker supported by APHRC (African Population and Health Research Center), visiting a young mother at her home in Korogocho slum, one of Nairobi’s most populated informal settlements. During the home visit, the health worker discusses family planning options, and teaches the mothers best ways for breast feeding. Credit: Jonathan Torgovnik/Getty Images/Images of Empowerment

The Gender Nutrition Gap is felt by women and girls every day in their homes, schools and workplaces. Women and girls’ unequal access to good nutrition affects their health, productivity, educational achievement and lifetime income.

But did you know that it can also prevent mothers from feeding their children the way that they want to?

Breastfeeding gives all children the healthiest start in life, promotes cognitive development, and acts as a baby’s first vaccine, providing critical protection from diseases. It also lowers maternal risk for breast cancer, ovarian cancer, diabetes, and other noncommunicable diseases. But many women who would like to breastfeed lack the support and information they need to be successful. In order to breastfeed successfully, mothers often require support from a range of individuals and systems including healthcare providers, lactation consultants, partners, families, workplaces, and governments.

Billions of women around the world are missing these crucial supports, and the gap means that only one in two babies in the world are exclusively breastfed for six months as recommended by the World Health Organization. At the country level, exclusive breastfeeding rates are often well below global targets.

The gender nutrition gap is complex, but the Action Agenda aims to make the solution clear. Here are some concrete solutions the Action Agenda recommends to help governments and donors promote, protect, and support breastfeeding:

Counter the aggressive marketing of the commercial milk formula industry, by:

– Incorporating the International Code of the Marketing of Breastmilk Substitutes Code (BMS Code) and its subsequent resolutions into national laws and regulations, monitoring national legal measures, and enforcing violations;

– Advocating for the BMS Call to Action;

– Implementing multi-channel social and behavior change interventions to ensure an enabling environment for breastfeeding that can counter the marketing of the commercial milk formula and baby food industry; and

– Preventing commercial influence on health care providers by training and supporting healthcare workers in infant and young child feeding, especially breastfeeding.

Support breastfeeding and nutrition, by:

– Expanding access to quality breastfeeding and infant and young child feeding counseling at health facilities and community-based services;

– Integrating essential nutrition interventions and nutrition counseling in antenatal care; and

– Developing or strengthening national policies and guidelines for infant and young child feeding in humanitarian contexts to protect breastfeeding in emergencies.

Provide support to mothers in paid employment, by:

– Adopting family-friendly policies in both formal and informal sectors, including maternity protection policies — paid maternity leave, paid breaks to breastfeed, and dedicated space to breastfeed/express milk — to support a mother’s ability to breastfeed.

Investing in breastfeeding is one of the ‘best buys’ a country can make. A $1 investment in breastfeeding yields $35 in economic returns in low- and middle-income countries. It reduces the burden of childhood and maternal illness, lowering health care costs, creating healthier families, and strengthening the development of nations. By giving women the information and resources they need to breastfeed successfully, they can be empowered to make an informed choice about how to feed their children.

Closing the Gender Nutrition Gap at Nutrition for Growth (N4G) Paris

Around the world, more than a billion adolescent girls and women suffer from undernutrition, micronutrient deficiencies and/or anemia. Malnutrition is robbing women of their earnings and energy, adolescent girls of their educational opportunities, and young girls of the chance to grow up to reach their full potential. Without tackling malnutrition, we will never reach gender equity or achieve SDG5.

The Nutrition for Growth (N4G) Summit is a global pledging moment that brings together governments, philanthropies, businesses, and NGOs to accelerate progress against malnutrition. The next N4G Summit will take place in early 2025 in Paris, France and will be a critical opportunity to spotlight women’s and girls’ nutrition. We call on governments and other donors to prioritize women’s and girls’ futures by investing in closing the gender nutrition gap at N4G Paris.

Here are five key nutrition issues threatening women and girls, and some concrete solutions governments and donors can pledge to scale at the next N4G summit:

1. Women and adolescent girls face unequal burdens of micronutrient deficiencies, especially anemia.

Anemia is the number one threat to the long-term health of adolescent girls and afflicts almost one-third of women of reproductive age. Progress against anemia lags other nutrition achievements, and only one country (Guatemala) is on track to meet the globally agreed 2030 target on anemia. Meanwhile, deficiencies in vitamin and mineral status, particularly of folate, iron, vitamin A, and zinc, affect 67% of all women of reproductive age (WRA) worldwide. Micronutrient deficiencies can be life-threatening and cause extreme fatigue and poor concentration, hindering learning potential, educational attainment, and productivity. By scaling interventions that target anemia, we can cure millions of women and girls of this debilitating condition.

Here are two actions that can help:

– Fortify staple foods with essential nutrients to prevent, reduce, and control micronutrient deficiencies at the population level.

– Supply all pregnant women with multiple micronutrient supplements (MMS). Focus on increasing adherence by improving product availability combined with nutrition counseling in ANC services and mid and mass media communications.

2. Climate change poses a disproportionate threat to women’s nutrition and food security.

Climate change is increasing extreme weather events like heat waves, droughts, and floods, which impact food quantity, quality, and diversity. These climate shocks will put growing stress on food and nutrition security in the years to come. The food that does grow will be less nutritionally dense, which can lead to deficiencies in certain vitamins and minerals. Women are most likely to bear the brunt of this climate-related food insecurity. Not only are women more susceptible to micronutrient deficiencies, but women and girls are more likely to reduce their food intake and eat last and least in their households. Additionally, poorer regions and disadvantaged adolescent girls and women already bear the brunt of undernutrition and anemia and will be least equipped to respond to the climate impacts likely to hit many of these same regions the hardest. By investing in strategies to build resilience to climate-related malnutrition, we can mitigate some of these effects.

Here are two actions that can help:

– Promote long-term, climate-resilient food and nutrition security and protect the livelihoods of woman farmers by developing diverse, climate-resilient crop varieties. Contribute to initiatives like the Vision for Adapted Crops and Soils (VACS) Multi-Donor Fund hosted by IFAD.

– Expand conditional cash transfers (CCTs) targeted to women to allow for greater flexibility in the face of humanitarian emergencies like natural disasters.

3. Every year, millions of girls miss out on the opportunity to grow, learn, and earn to their full potential because of malnutrition experience in early childhood.

As we strive to address inequities in adult women’s nutrition, we must keep in mind the life-changing impact good nutrition can have on young girls today. Girls who are well-nourished are healthier, more productive, and more likely to finish and excel in school, be economically independent, and have healthy babies. Targeted nutrition interventions are a cost-effective way to give girls today a bright future and boost their chances of overcoming poverty and reaching their educational goals.

Here are three actions that can help:

– Protect large-scale Vitamin A supplementation to prevent vision problems, illness, and death.

– Ensure children and their parents have access to quality nutrition counseling to promote dietary diversity and the consumption of animal-sourced foods.

– Expand access to specialized foods (eg. RUTF and SQ-LNS) to prevent and treat child wasting.

4. Women who choose to breastfeed often face workplace barriers and lack the support they need to be successful.

Breastfeeding provides numerous benefits to both mothers and their babies. Breastfeeding gives all children the healthiest start in life, promotes cognitive development, and acts as a baby’s first vaccine, providing critical protection from diseases and death. It also reduces the burden of childhood and maternal illness, lowering health care costs, creating healthier families, and strengthening the development of nations. Family-friendly workplace policies promote gender equity and women’s economic participation while strengthening the economy. By giving women the information and resources they need to breastfeed successfully, they can be empowered to make an informed choice about how to feed their children.

Here are three actions that can help:

– Enact and promote adequate paid family leave, including maternity and parental leave, and breastfeeding breaks for women who choose to breastfeed.

– Support breastfeeding mothers with one-to-one and group breastfeeding counseling

– Promote greater male engagement in infant and young child feeding (IYCF) to lessen the care burden for mothers.

5. Commitments made at large pledging moments often lack accountability mechanisms.

Though large pledging moments are critical for raising the profile of nutrition interventions, they can only be truly successful if governments, philanthropies, businesses, and NGOs are held accountable for the commitments they make. This accountability requires commitment makers to invest in clear, quality data on spending, outputs, and outcomes.

Here are three actions that can help:

– Invest in strong nutrition data systems that ensure routine collection of data on girls and women to support effective policies and programs and to advocate for nutrition investment across sectors.

– Improve accountability by tracking how global and national actors are currently investing in nutrition data and information systems.

– Invest in a global nutrition financing tracking system to improve coordination, resource mobilization and resource allocation and regularly track progress on commitments made in the Nutrition Accountability Framework.

Why the Time is Ripe for a Global Movement to Close the Gender Nutrition Gap

December 26, 2023

Nutrition is a feminist issue. This is the message of the Close the Gender Nutrition Gap campaign, cited as one of the biggest announcements at Women Deliver in Kigali in July, and it is the message at the heart of a global webinar series hosted by Global Nutrition at FHI 360 with support from Alive & Thrive, the Scaling Up Nutrition Civil Society Network (SUN CSN) and the Scaling Up Nutrition Civil Society Alliance Viet Nam with support from the Swiss Agency for Development and Corporation and Irish Aid. Two webinars, hosted on December 5^th and 11^th 2023, engaged over 180 participants from more than 40 countries, fostering insightful questions and discussions.

The statistics are alarming. Every year malnutrition kills more women than any other risk factor, including tobacco, alcohol, and air pollution. Women produce more than half of the world’s food, yet they comprise 70% of the world’s hungry. Today, more than one billion women and adolescent girls experience at least one form of malnutrition, while the gender gap in food insecurity more than doubled from 2019 to 2021. One-third of adolescent girls suffer from anemia – a debilitating condition with life-threatening implications, with progress unabated and no country on track to meet global anemia targets.

Put simply, if we fail to close the Gender Nutrition gap, we will fall short on almost every single Sustainable Development Goal. And we will be turning our backs on a moral equity crisis.

The webinar was opened by Mr. Sean Farrell, Deputy Head of Mission, Embassy of Ireland to Vietnam, Lao PDR, Cambodia, who explained that improving nutrition and tackling hunger and gender equality are the two pillars of Ireland’s foreign policy.

To date, the Gender Nutrition Gap coalition has more than 40 member organizations, including United Nations bodies, such as the World Food Program, and the African Development Bank Leaders for Nutrition, implementing agencies, research organizations, international non-profits, and national societies, such as the Indian Federation of Obstetric and Gynaecological Societies. Together, members define the Gender Nutrition Gap as the way in which women and girl’s unique biological needs, disparities in access to food and services and harmful social norms have a bearing on their health and economic outcomes.

The Closing the Gender Gap Action Agenda is a global framework of concrete actions to improve women and girls’ rights, advance gender equality and improve their nutrition. Designed to be interpreted and adapted at the national level, it is a guide to increase funding for evidence-driven interventions and gender-responsive policies that consider and address unique needs and challenges women and girls face. As Deborah Ash, Senior Nutrition Specialist at Global Nutrition, FHI 360, outlines, “The need to focus on gender transformative actions emerged as a central theme during global and national consultations. It is not a theoretical document. The Action Agenda is a practical tool drawn from the latest evidence, opinion leader research, policy reviews, stakeholder mappings, and extensive consultations with global and national experts.”

UNICEF’s recent flagship report, Undernourished and Overlooked: A Global Nutrition Crisis in Adolescent Girls and Women, sheds light on the gravity of the challenge and calls for urgent and decisive action to prevent further failure in addressing the nutritional needs of adolescent girls and women, safeguarding the well-being of future generations.

“Undernutrition, micronutrient deficiencies, and anaemia on gender inequalities hinder the learning potential, wages, and life opportunities for adolescent girls and women, making them more susceptible to infections and complications during pregnancy,” said Ms. Emily Mates, Maternal Nutrition Specialist, UNICEF HQ.

Ms. Isabelle Wyss, Program Manager in the Health Determinants Section for the Swiss Development Cooperation (SDC) highlighted the importance of civil society in advocating for women and girls’ rights. Local actors in Uttar Pradesh, India, demonstrate the power of civil society, where local partners carried out a stakeholder mapping and strategy development with participation from the Ministry of Health and Family Welfare, leading to the inclusion of a clause on women’s and girls’ nutrition in the G20 New Delhi Leaders Declaration. Member organisations of the Gender Nutrition Gap campaign in India call for coherence to nation-wide national technical guidance and strategies across the Ministry of Women and Child Development and Ministry of Health and Family Welfare.

Similarly, in Nigeria, SUN CSN demonstrated the power of advocacy directed by the local political economy. Mr. Sunday Okoronkwo, Executive Secretary, Civil Society Scaling-up Nutrition in Nigeria (CS-SUNN) reminded the webinar participants that “men have a role to play in ensuring that the girl child can aspire to whatever she wants to become in life.”

The coalition was the first of its kind in Nigeria to go beyond the focus on maternal nutrition and include women’s and girls’ nutrition across their lifecycle, including adolescent girls and non-pregnant and non-lactating women. Partners, together with the government, defined a joint advocacy plan, securing the buy-in and leadership of the Ministry for Women Affairs to lead on the development of National Guidelines for Women’s and Girls’ Empowerment for Optimal Nutrition.

During the development of the Action Agenda, advocates spoke to the need to establish standardized nutrition data to ensure consistency and comparability to facilitate informed decision-making, target interventions and build accountability at country levels. This will be a focus for future campaigning efforts in the French presidency of Nutrition for Growth, a global Summit designed to encourage governments, donors, philanthropy and civil society to make bold, ambitious and SMART commitments to end malnutrition.

As we advance into the new year, the campaign will call for governments, donors, and philanthropic organizations to adopt Action Agenda policies, increasing policy integration and embedding nutrition considerations into education, health, agriculture, and employment policies. The Action Agenda covers eight policy domains to close the Gender Nutrition Gap across four Action Areas:

Action Area One: Healthy Diets
Boitshepo Bibi Giyose, Senior Nutrition Advisor, African Union Development Agency explored the various gender aspects of a healthy diet and the importance of changing social norms around intrahousehold food allocation where it is common practice for women to eat last and least in many countries. Similarly, the Action Agenda calls for targeted education on the importance of healthy diets and actions to protect consumers from predatory marketing practices through global regional and national regulations, financial disincentives (taxation on sugar-sweetened beverages) and mandatory front-of-pack nutrition labelling. Rody Gangte, Senior Manager, Programs, EngenderHealth India recalled how mainstreaming gender in large-scale food fortification requires gender analysis and capacity building on gender sensitivity and gender disaggregated metrics.

Action Area Two: Care – Integrate Nutrition into Health and Social Protection
Dr. Sebanti Ghosh, Senior Technical Adviser for Alive & Thrive South Asia, explained how the Action Agenda emphasizes calling for a doubling down on high-impact, cost-effective interventions within maternal, newborn and child health services and antenatal and postnatal care platforms. For example, a well-delivered package of iron supplementation could cut maternal and newborn deaths by 28 percent and reduce stillbirths by 22 percent.

Strengthening the links to support women across the care system can be achieved by embedding critical contact points to prevent, detect and treat malnutrition. Equally, we must expand functions of social protection systems for nutrition and women’s and girl’s economic empowerment, including maternity leave, as well as extend employment protections to the informal sector where women and girls are overrepresented. Globally, 58 percent of all women’s employment is informal. In lower-income countries, this can rise to 92 percent.

Action Area Three: Gender Equality
Mandana Arabi, Vice-President, Global Technical Services and Chief Technical Advisor, Nutrition International reminded attendees that gender transformative policies and programs must address the root causes of gender inequalities including providing equitable access to quality education for girls and promoting their economic empowerment. Currently, being malnourished can reduce potential lifetime earnings by at least 10 percent due to decreased education and productivity.

Action Area 4: Multisectoral Policy Environment
Alongside closing vast data gaps on women and girls’ nutrition, multiple actions can improve cohesion in multisectoral policy environments. Such actions include prioritizing women and girls’ nutrition in humanitarian responses and accounting for the immense value of the unpaid care economy, largely carried out by women, including incorporating breastfeeding into national food systems balance sheets and national planning frameworks. Ultimately, effective multi-sectoral policy will made considered trade-offs to prioritize those actions that respond to the unique needs of women and girls and the underlying causes of gender inequality and malnutrition.

As a lead organizer for this webinar series, SUN CSN Viet Nam looks forward to hosting a learning retreat for SUN CSNs from 8^th to 12^th January 2024 to share lessons and experiences relating to innovations and policy integration for women and girls’ nutrition in Viet Nam. One such innovation is the Little Sun Clinics, established by Alive & Thrive and the National Institute of Nutrition Viet Nam, in partnership with the government, to bring quality care and nutrition counseling to antenatal and postnatal care services to improve exclusive breastfeeding rates and infant and young child feeding practices. Today, there are 1,200 Little Sun nutrition counseling clinics across fifteen provinces.

Another innovation in Viet Nam is the Centers of Excellence for Breastfeeding, which improves the quality of care in the health service, especially in the first 1,000 days of life. Accredited by provincial Departments of Health, Centers of Excellence are connected to Birthing Experience Surveys, which enable women to voice their experience. Human Milk Banks have also been piloted and scaled to collect, pasteurize, test, and store breastmilk donated by volunteer lactating mothers who have passed a health screening to support optimal health outcomes and save infant lives. Ensuring maternity protection and breastfeeding-friendly workplace policies are part of a supportive policy package that extends the continuum of care.

As the webinar series closed, participants were invited to consider ways in which they can be active and vocal advocates to Close the Gender Nutrition Gap. Going forward, the success of the campaign depends not only on our existing members, but on those already actively campaigning to close gaps for women and girls in all sectors and domains, including climate, education, tech, and global and national workforces.

As Ms. Mates said, “A global movement is happening. For the first time in twenty years, we are seeing a step up for adolescent girls and women. We must make the most of this moment.”

If you want to become a gap closer in the Close the Gender Nutrition Gap Campaign, find out more and read the full Action Agenda Policy Framework. SUN CSN is thrilled to announce the creation of a vibrant Gender & Nutrition Community of Practice. If you are interested in joining, please sign up here.