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DELIVERING IMPROVED NUTRITION:

This report outlines recommendations for enhancing nutrition in U.S. food aid programs, focusing on formulation, quality control, oversight, and innovation. Key suggestions include diversifying nutrient mixes and developing lipid-based products. The consultative process involved expert panels, meetings, and surveys to gather input for optimizing food assistance. Existing successes were acknowledged, but the report emphasizes the need for upgrades, new products, transparency, and coordination among agencies.

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DELIVERING IMPROVED NUTRITION:

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  1. DELIVERING IMPROVED NUTRITION: RECOMMENDATIONS FOR CHANGES TO U.S. FOOD AID PRODUCTS, PROGRAMS AND POLICIES Patrick Webb June 28, 2011

  2. USAID. 1994. Food aid and Food Security. Policy Paper. Washington, D.C. “Food aid is now a scarce resource.” “USAID must ensure that food aid is used as effectively and efficiently as possible.” “USAID is to give greater priority to… improve the nutritional status of… especially women and children.”

  3. Secretary of Agriculture, Thomas Vilsack (2010): “We must still provide food to those who need it most.” USAID administrator Rajiv Shah (2010): The aim is to transform the U.S. food assistance program, “to make it more effective.” Dworken(2010): “Food aid is no longer just about tonnage and logistics.”

  4. U.S. Government Accountability Office (GAO) 2011a • (Better Nutrition and Quality Control can further Improve • U.S. Food Aid) • GAO recommends that USAID and USDA: • “Issue guidance on how to address nutritional deficiencies” • “Evaluate performance and cost-effectiveness of specialized • food products” • “Systematically track key quality indicators” • “Evaluate food packaging”

  5. U.S Government Accountability Office (GAO) 2011b • (USDA oversight of McGovern-Dole Program Needs Improvement) • GAO recommends that USDA: • Issue guidance on monitoring and evaluation for partners • Track performance indicators directly measuring nutrition

  6. Consultative process: • 27 expert panelists; input from 39 USAID and USDA professionals • >100 meetings with individuals and groups (incl. 15 workshops, • 5 conference sessions) • 663 people registered on website (www.foodaidquality.org) • 28 comments on the FAQR draft (>100 pages of comments) • Outside US, meetings and presentations in Italy, Thailand, China, Ethiopia, Jordan, India, Haiti, the Netherlands, Germany, Canada. • Field-level discussions on programming in Nepal, Malawi, Haiti, Honduras. • Surveys of PVO and UN field staff in 40 countries (81% RR) • Telephone survey of all PEPFAR country coordinators

  7. Broad conclusions • USAID, USDA and partners already achieve remarkable success in challenging circumstances. • Existing products not ‘as bad’ as made out to be. • But upgrades, new products needed. • More transparency, communications, flexibility, coordination of oversight needed throughout.

  8. 7 Main Recommendations 1. Improve formulation of existing Fortified Blended Foods (CSB/WSB should be enhanced, not ditched. New variants developed).

  9. Photo credit: Stacey Burke Photo credits: Patrick Webb

  10. Broad Recommendations 1. Improve formulation of existing Fortified Blended Foods (CSB/WSB should be enhanced, not ditched. New variants developed). 2. Upgrade vitamin/mineral mixes used; diversify approaches to addressing micronutrient needs (higher levels of B1 (thiamin), B2 (riboflavin), B3 (niacin), B5, B12, D3, and E; two forms of iron, standardized premix for flours; lipid carriers, etc.) 3. Develop/adopt lipid-based products for management of defined nutritional deficiencies.

  11. Broad Recommendations 4. Provide clearer programming guidance. 5. Establish interagency committee to oversee all government interests in the food aid agenda (coordinate product reviews, specifications, policy harmonization). 6. Enhance food quality oversight along value chain (design comprehensive quality assurance strategy). 7. Strengthen evidence base for innovations in products, programming approaches, and institutional processes (e.g. incorporate cost-effectiveness into evidence base for nutrition programming).

  12. Next Steps…already underway • Interagency meetings – communication, decision-making • Change oil fortification specifications • Adjust flour premix specifications • New lipid products joining the commodity list • New variants of CSB already joining commodity list • Harmonization (simplified?) product specification templates

  13. Next Steps… • Formal mandated interagency body – one-stop-shop • Harmonization of specifications/products with non-US players • New series consultations on key issues (proteins, packaging, • costing, etc.) • Updating (and rationalizing) Commodity Reference Guide • Manual/guidance on programming (products-for-purpose) • Industry, field testing product modifications

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