Private sector can help S Asia to meet its SDG target of ending malnutrition by 2030
Governments, civil society organisations, and donors are making significant effort to improve nutrition outcomes through school meals, distribution of micronutrient supplements, mass media campaigns for behaviour change, and other social programmes. But these efforts are likely to fall short.Updated: Nov 16, 2017 12:52 IST
Nutrition outcomes in South Asia are among the worst in the world: 38% of children (below five years) are stunted, as compared with 26% globally. Wasting prevalence at 15% is also high. Women are especially affected, with nearly half of those in the reproductive age suffering from anemia. South Asia not only suffers from under-nutrition related issues, but is also experiencing a growing epidemic of obesity, with nearly 29% of adults now overweight.
In addition to poor water, lack of access to sanitation, poor healthcare, and low education, we found that poor quantity, quality, and mix of food available, also lead to poor nutrition. This results in gross deficit of essential macronutrients (proteins, carbohydrates, etc.) and micronutrients (vitamins and minerals). Some population segments are food insecure, driven by inadequate production, and lack of availability and affordability of certain food groups (eg fruits, dairy and meat).
Where food is available for consumption, it is often of poor quality in terms of nutritional value, safety and hygiene. This results from excessive use of chemicals in farming, export of better quality food, unhygienic food production/processing practices, and poor cooking practices (excessive use of oil and overcooking). Further, the consumption baskets tend to be skewed towards certain carbohydrates (rice in Bangladesh and Myanmar), driven often by low consumer awareness and entrenched food preferences and beliefs.
Governments, civil society organisations and donors are making significant effort to improve nutrition outcomes through school meals, distribution of micronutrient supplements, campaigns for behaviour change and other social programmes. But these efforts are likely to fall short.
If we are to meet South Asia’s SDG target of ending malnutrition by 2030, we must engage the private sector to accelerate progress. Business can play on key strengths such as large-scale production capacity, product and business model innovation, marketing expertise and scale, and extensive distribution networks and supply chains, to complement government and social sector efforts.
In a recent engagement, we worked with an international organisation that is trying to catalyse private sector efforts in driving nutrition outcomes in Asia and Africa. We worked with them to develop country strategies for two countries in Asia and looked at understanding current activity and identify tangible opportunities for the private sector to improve nutrition outcomes in those countries.
We found that existing private sector interventions tend to be focused on fortification and supplements. Businesses leverage their product development expertise and production capacity to manufacture supplements and fortified food products (zinc-fortified rice, vitamin A-fortified edible oil, iodised salt) — and partner with governments and CSOs for distribution through social programmes.
In Bangladesh, for example, edible oil millers mandatorily fortify their oil, and fortified rice is distributed to BoP women by the government through the Vulnerable Group Development Programme.
In Myanmar, CSOs and government support rice fortification by private players by subsidizing capex and distributing through social programmes.
THERE MUST BE ECOSYSTEM-LEVEL CHANGES
In addition to supplements, there are five tangible opportunities to engage the private sector in driving up nutrition outcomes in South Asia:
•Nudging customers to purchase nutrition products: Consumers tend to buy food out of habit and can be “nudged” into more nutritious food shopping. Large and progressive retailers/retail chains can proactively carry nutritious products, display them prominently, and educate consumers on their benefits. They can be a key channel of influence as consumers often rely on retailers for information and point-of-purchase decision-making.
•Tech-enabled nutrition awareness and service delivery: Technology and telecom businesses can build platforms to deliver nutrition-related information, track diets and key nutrition indicators, help in early identification of deficiencies, and connect consumers to relevant health services. For instance, Ooredoo, a major telecom operator in Myanmar, launched a mobile app (May May) to help expectant mothers access information and medical care.
•Influencing cooking practices: Media and food companies can help spread awareness on the nutritional value of different foods and improve cooking practices, through interventions such as health food TV shows. Celebrity chefs can be key influencers.
•Workplace nutrition programmes: Companies can be effective channels for distributing nutritious food and building awareness among employees and their communities. This is aligned to business interest, as improvement in health and nutrition of the workforce will likely reduce sick-days and improve productivity. Local governments in Canada and Australia have explicit guidelines for workplace nutrition – and South Asian governments can take inspiration from them.
•CSR support for nutrition: Businesses that are not directly related to nutrition can also become “nutrition champions” by backing the cause as part of their social responsibility efforts. Large corporate foundations can leverage their extensive networks to generate awareness and deliver nutritious food through their social programmes.
Catalysing private sector engagement will also require ecosystem level changes such as an enabling policy environment. This could include reduced import duties on fortification machinery, tax holidays/incentives, introduction of “fat tax”, input subsidies, among others.
WE NEED A CONCERTED EFFORT
Funding support in the form of grants and other sub-commercial debt options can also crowd-in private sector investment in nutrition. For businesses lacking knowhow to produce nutritious/fortified food items, CSOs could provide the necessary technical expertise. For example, PATH, a CSO, is leading the Ultra Rice programme for rice fortification in Myanmar where it supports rice manufacturers by subsidizing machinery cost, providing training, and setting up distribution channels. Businesses could also benefit from consumer awareness and demand generation drives that educate consumers on associated benefits for products.
Addressing the nutrition crisis in the subcontinent requires concerted effort and the private sector can play an important complementary role. It is time that governments recognise this and formulate favourable policies and encourage the setup of multi-stakeholder networks that can catalyse private participation. Platforms for collaboration could play an important role going forward. Nutrition-focused platforms like the SBN can act as a bridge between the government and private sector and play a pivotal role in soliciting nutrition commitments, facilitating fundraising and collaboration, and disseminating global evidence and best practices.
Nirat Bhatnagar, Keshav Kanoria and Kapil Kanungo work at Dalberg Advisors, a social impact focused global advisory firm.
The views expressed are personal