Investing in Nutrition and Child Health

1. Investing in Nutrition and Child Health A strategy for economic development: the Senegalese experience Mamadou Sidibe Minister of Planning and Sustainable Development - Senegal

2. Costs of Malnutrition • The costs of malnutrition are found in… • morbidity and mortality • excess health expenditure • reduced school performance • reduced work productivity • If unaddressed… …over 10 years malnutrition would cost $ 1.6 billion $ 800 million for protein-energy malnutrition $ 600 million for iodine deficiency disorders $ 190 million from anemia …and thousands of children < 5 would die unnecessarily each year.

3. An Evolving Response 1970 1980 1990 2000 SAP CFA Devaluation MDG/PRSP Drought PPNS (1973-1985) PNC (1995-2000) NUT POLICY PRN (2002-2012) Ministry of Health/CRS AGETIP NGO/MINISTRIES

4. National Committee against Malnutrition (CLM) • Mission: • Define a multi-sectoral national nutrition policy • Monitor nutrition program implementation • Location: Prime Minister’s Office • Composition: technical ministries, local government, civil society • Development partners: World Bank, USAID/BASICS, UNICEF, WFP, WHO, KFW, NGOs

5. Vision for Economic Growth in Senegal Policy shift in 2000 leading to: • Positive vision to invest in good nutrition for child and sustainable development—not simply to combat malnutrition: CLM Vision: a country where every individual has satisfactory nutritional status, and adopts adequate behaviors for her/his own well-being and for the development of the community. • Emphasis on achieving Millennium Development Goals

6. Identify cost effective and sustainable strategies PHASE 1 (2002-2006) To test different intervention strategies Extend nutrition interventions in rural areas PHASE 2 (2006-2010) To extend interventions to all regions PHASE 3 (2010-2015) To ensure integration of nutrition objectives into sectoral programmes Sustainable improvement of nutritional status of vulnerable groups Nutrition Enhancement Program Phases

7. Nutrition Enhancement Program Description • Built on Successful Pilots • Strategies • Integration of nutrition objectives in sectoral ministries such as Health, Education, Agriculture • Community based nutrition and IMCI for vulnerable groups • Core interventions • C-IMCI • Essential Nutrition Activities • Growth Promotion

8. Core Interventions Tailored to District Needs • Shift from “umbrella” delivery approach to district-specific approaches • Grandmother’s groups • Pregnant women’s support groups

9. Nutrition Program Coverage and Malnutrition Rate

10. 30 25 22 18 20 20 17 15 10 10 5 0 1992 1996 2000 2005 2010 2015 Millenium Development Goals Results of National Surveys (DHS and MICS) Projection without intervention Projection with current interventions intensifiied Progress Toward Nutrition MDG 26 Prevalence under 5 Underweight (%)

11. 175 150 125 100 75 50 25 1992 1997 2005 2010 2015 2020 Millenium Development Goals Results of National Surveys (DHS ) Projection without intervention Projection with current interventions intensifiied Progress Toward Child Mortality MDG 175 139 131 121 Under 5 Mortality (per 1000)) 44

12. Costs • Cost to reach MDG target: $150 million over 10 years • Cost to “do nothing”: $1.6 billion and thousands of child deaths over 10 years • $150 million investment for nutrition nets $1.6 billion in savings…a 1,000% return!

13. Reaching MDGs in Nutrition and Child Survival in Senegal • Commitment by the highest level of Government • Partnership with NGOs and Local Governments to scale up and sustain proven nutrition and child health interventions • Integration of nutrition within the health system • Community ownership through the involvement of local government • Investment of both government funds and international partners

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