For the nutrition community, the numerous links between empowering women and improving nutrition are well understood. However, less clearly understood is how we can build food systems that put women and children at the center.
Women are the most critical target group from a nutrition standpoint. Many adverse health outcomes like stunting are determined by the health and nutritional status of women and adolescent girls. At the same time, improving the nutritional status of women can lead to better education and higher incomes -- raising the social standing of women in their communities. Yet, the barriers for women in accessing nutritious diets are numerous and encompass the cost and availability of healthy foods; knowledge about nutrition; as well as the social, cultural and regulatory barriers that shape behaviours and markets.
We've spent the past five years working with our partners through a combination of proven interventions -- such as the protection and promotion of breastfeeding -- and a novel focus exploring the potential role of the private sector in improving access to fortified complementary foods or micronutrient powders. Combining market mechanisms and public delivery systems has unleashed experimentation and innovation in the sector, but our understanding of what works is still far from complete.
One example is the research that we carried out in East Java, Indonesia to understand what influences women when feeding their children, in order to help women to make positive choices without feeling lectured. We found that to be successful you have to involve the whole community -- family members, friends and neighbours all play a big role in determining the choices that mothers make about what they and their children eat. Women need to feel empowered to make the decisions that they know are best for themselves and their families.
Another example is the support we've provided to female entrepreneurs in rural Rajasthan and Cote D'Ivoire, helping them to develop high quality nutritious products, and build trusted brands that appeal to local women. We've found that it is important to promote local agricultural raw materials and take account of the food habits of populations so that they more readily adopt complementary foods or any fortified food. In Cote D'Ivoire we worked with local experts to develop the best formulas on the basis of the agricultural raw materials cultivated in abundance such as corn and rice. In Rajasthan we learned the value of working with governments both as a purchaser of the product and as distributor of it to the intended audience, which includes the job of educating mothers on how to appropriately cook and consume the product.
We have a long way to go before we can make any firm conclusions about what works. However, one thing we can all agree on is that it's an area that is fraught with complexity.
At the heart of this complexity lies the debate over the balance between specially formulated nutritious products and local food systems. We need to look at integrated solutions that support diverse, sustainable local food systems, while ensuring that women can access the nutrients they need at critical times.
Understanding behaviours is another important part of the picture. Deeply held beliefs about infant and child feeding are not easy to change. Yet, behaviour change has been underinvested in and poorly understood by the nutrition community. Behaviour change is much more of a cornerstone than any of us in the sector were led to believe -- and something that the private sector has been doing for many years. We should be open to learning from other sectors about how we can package and market nutrition to women.
But, we can't do this alone. Changing the food environment will rely on us working in alliances to build a regulatory environment that sets the stage for a healthy food environment. An optimal regulatory framework should protect breastfeeding while enabling mothers to make well-informed decisions about the foods they purchase.
While experimentation and promising pilots are emerging, there is no single solution that will provide a model for the nutrition community to follow. But, with the need to scale up nutrition interventions greater than ever, this complexity shouldn't excuse inaction.
We don't have a blueprint, but we do have a start.
This blog post first appeared on the Lancet Global Health blog on 11 March.