Scaling Up Nutrition for a More Resilient Mali

Shekar, Meera; Mattern, Max; Eozenou, Patrick; Dayton Eberwein, Julia; Kweku Akuoku, Jonathan; Di Gropello, Emanuela; Karamba, Wendy

Scaling Up Nutrition for a More Resilient Mali

Autores

Shekar, Meera

Mattern, Max

Eozenou, Patrick

Dayton Eberwein, Julia

Kweku Akuoku, Jonathan

Di Gropello, Emanuela

Karamba, Wendy

Editor

World Bank, Washington, DC

Descripción

This paper builds on the global experience and Mali s context to identify an effective nutrition approach as well as costs and benefits of key nutrition programs, as part of a resilience agenda after the crisis. It is intended to help guide the selection of the most cost-effective interventions as well as strategies for scaling these up. The paper looks at both relevant nutrition-specific interventions, largely delivered through the health sector, and at multisectoral nutrition-sensitive interventions delivered through other sectors such as agriculture, social protection, and water and sanitation that have the potential to strengthen nutritional outcomes in Mali. We first estimate that the costs and benefits of implementing 10 nutrition-specific interventions in all regions of Mali would require a yearly public investment of $64 million. The expected benefits are large: annually about 480,000 Disability-adjusted Life Years (DALYs) and more than 14,000 lives would be saved and over 260,000 cases of stunting among children under five would be averted. However, because it is unlikely that the Government of Mali or its partners will find the $64 million necessary to reach full national coverage, we also consider three potential scale-up scenarios based on considerations of their potential for impact, the burden of stunting, resource requirements, and implementation capacity. Using cost-benefit analyses, we propose scale-up scenarios that represent a compromise between the need to move to full coverage and the constraints imposed by limited resources. We identify and cost six nutrition-sensitive interventions that are relevant to Mali s context and for which there are both evidence of positive impact on nutrition outcomes and some cost information. These findings point to a powerful set of nutrition-specific interventions and a candidate list of nutrition-sensitive approaches that represent a highly cost-effective approach to reducing child malnutrition in Mali.

Palabras clave

ACCESS TO FOOD, ACUTE MALNUTRITION, ACUTE RESPIRATORY INFECTIONS, AGED, AGRICULTURAL EXTENSION, AGRICULTURAL INNOVATION, AGRICULTURAL PRODUCTION, ANEMIA, ANIMAL HUSBANDRY, BASIC HEALTH, BASIC HEALTH SERVICES, BREASTFEEDING, CALCIUM, CAPACITY CONSTRAINTS, CASH TRANSFER PROGRAM, CHILD CARE, CHILD FEEDING, CHILD FEEDING PRACTICES, CHILD MALNUTRITION, CHILD MORTALITY, CHILD MORTALITY RATES, CHILD NUTRITION, CHILD STUNTING, CHILDHOOD ILLNESSES, CHRONIC MALNUTRITION, CHRONIC UNDERNUTRITION, COMMUNITY HEALTH, COMMUNITY NUTRITION, COMPLEMENTARY FEEDING, CONDITIONAL CASH TRANSFERS, COST-EFFECTIVENESS, DETERMINANTS OF MALNUTRITION, DIAGNOSTICS, DIARRHEA, DIARRHEAL DISEASES, DIETS, DISEASES, ECONOMIC PRODUCTIVITY, EQUITABLE ACCESS, ESSENTIAL NUTRITION ACTIONS, EXTENSION AGENTS, FAMILIES, FAMILY MEMBERS, FAMINE, FARMER, FARMERS, FEEDING PROGRAMS, FEMALE-HEADED HOUSEHOLDS, FLOUR, FOLIC ACID, FOOD CROPS, FOOD DISTRIBUTION, FOOD INSECURITY, FOOD INTAKES, FOOD POLICY, FOOD SAFETY, FOOD SECURITY, FOOD STANDARDS, FOOD SUPPLEMENTATION, FOOD SUPPLIES, GEOGRAPHIC REGION, GROUNDNUTS, GROWTH MONITORING, GROWTH PROMOTION, HEALTH CARE, HEALTH INDICATORS, HEALTH SERVICES, HEALTH STATUS, HIV/AIDS, HOUSEHOLD HEAD, HOUSEHOLD HEADS, HOUSEHOLD INCOME, HOUSEHOLD VULNERABILITY, HOUSEHOLDS WITH CHILDREN, HUMAN CAPITAL, HUMAN DEVELOPMENT, HUMAN DEVELOPMENT INDEX, HUMANITARIAN AID, HUNGER, HYGIENE, HYGIENE PRACTICES, INCOME QUINTILE, INFANT MORTALITY, INFANT MORTALITY RATE, INFECTION, INTERVENTION, IODINE, IRON, IRON DEFICIENCY, IRRIGATION, LACK OF KNOWLEDGE, LIFE EXPECTANCY, LIVE BIRTHS, LIVER CANCER, LIVER CIRRHOSIS, MALARIA, MALNOURISHED CHILDREN, MALNUTRITION RATES, MATERNAL HEALTH, MATERNAL MORTALITY, MEASLES, MICRONUTRIENT DEFICIENCIES, MICRONUTRIENT SUPPLEMENTATION, MICRONUTRIENTS, MINERAL, MINERALS, MODERATE MALNUTRITION, MORBIDITY, MORTALITY, MORTALITY RATES, NATURAL DISASTER, NUTRIENT, NUTRITION, NUTRITION EDUCATION, NUTRITION INTERVENTIONS, NUTRITION OUTCOMES, NUTRITION POLICY, NUTRITION PROGRAMS, NUTRITION SECTOR, NUTRITION SERVICES, NUTRITION STATISTICS, NUTRITION STATUS, NUTRITIONAL OUTCOMES, NUTRITIONAL STATUS, ORAL REHYDRATION SALTS, PHYSICAL DEVELOPMENT, POOR HEALTH, POOR HOUSEHOLDS, POOR NUTRITION, POPULATION GROWTH, POVERTY GAP, POVERTY RATE, POVERTY REDUCTION, POVERTY REDUCTION PROGRAMS, PREGNANCY, PREGNANT WOMEN, PRIMARY HEALTH CARE, PRIMARY SCHOOLS, PUBLIC HEALTH, REGIONAL DISTRIBUTION, REGIONAL VARIATION, RESPIRATORY INFECTIONS, RICE, RURAL AREAS, SAFETY NETS, SALT IODIZATION, SANITATION, SCHOOL ATTENDANCE, SCHOOLING, SMALL-SCALE AGRICULTURE, SOCIAL PROTECTION, SPATIAL DISTRIBUTION, STAPLE FOODS, STUNTED CHILDREN, STUNTING, SUPPLEMENTARY FEEDING, SWEET POTATO, UNDERNUTRITION, VITAMIN, VITAMIN A, VITAMIN A SUPPLEMENTATION, VITAMINS, VULNERABILITY TO POVERTY, VULNERABLE REGIONS, WASTING, WATER SOURCES, WORKERS, WORLD FOOD PROGRAM, YOUNG CHILD