DELIVERING FOR NUTRITION IN SOUTH ASIA 2021: LESSONS FROM RESEARCH AND IMPLEMENTATION IN THE CONTEXT OF COVID-19 TO IMPROVE NUTRITION IN THE REGION
COVID-19 has caused major economic and health shocks globally. Since the onset of the pandemic, there have been daunting projections on the impacts of COVID-19 on food security and nutrition, particularly in resource-constrained settings like South Asia if the epidemic is prolonged. What does the available evidence and ongoing implementation efforts in South Asia suggest about our progress in mitigating the impacts of COVID-19?
On December 1-2, 2021, IFPRI and a consortium of 15 co-hosts convened the virtual conference, Delivering for Nutrition (D4N) in South Asia: Implementation Research in the Context of COVID-19, which gathered about 800 participants over the two-day program (100-200 participants per session) to explore the available evidence to inform and support policy and program initiatives aimed at prioritizing and improving maternal and child nutrition during COVID-19 and beyond. This year represents the fourth annual and first regional conference of its kind, covering research and implementation from eight South Asian countries, including Bangladesh, Cambodia, India, Indonesia, Nepal, Pakistan, Sri Lanka, and Vietnam.
The opening plenary set the stage, discussing what is known about the impacts of COVID-19 on food security and nutrition in the region. The session was co-chaired by Vinod Paul, Member, NITI Aayog and Shahidur Rashid, Director for South Asia, IFPRI, and speakers from The Society for Implementation Science in Nutrition (SISN), Micronutrient Forum, SickKids Centre for Global Child Health, and Helen Keller International (HKI) gave their remarks. Vinod Paul urged the nutrition community to identify and address the determinants of malnutrition, which have been exacerbated by the COVID-19 pandemic.
Two pre-conference workshops were convened, which focused on (1) the use of phone surveys to measure health and nutrition, and (2) measuring food security to assess COVID-19 impacts, organized and facilitated by IDinsight and IFPRI, respectively. The main conference was broadly organized into three topical sessions based on the accepted abstracts: (1) impacts of COVID-19 on nutrition outcomes and its determinants; (2) disruptions, restorations, and adaptations to nutrition and health interventions during COVID-19; and (3) impacts of COVID-19 on food security and the role of social safety nets. One-minute rapid-fire poster presentations related to the three thematic tracks, adapted from and inspired by the Agriculture, Nutrition, and Health Academy (ANH), complemented the oral presentations. Throughout the two-day program, messages from conference co-hosts reiterated the role of implementation research to support efforts to deliver nutrition interventions at scale in South Asia in the context of COVID-19.
The implementation research findings provided sobering insights on the impacts of COVID-19 on health, food security, and diets across the region. Research from Bangladesh found that children presented to hospitals with more severe illness, and another study found that infants born during the pandemic were more malnourished. In India, a study found lower pregnancy weight gain during COVID-19. In Pakistan, a study found increased anemia among children post-lockdown compared with pre-lockdown. Likewise, evidence from Sri Lanka indicated that livelihoods and household food security have significantly diminished due to the COVID-19 crisis.
The conference also highlighted substantial COVID-19-related disruptions in nutrition services across the region, and a dip in the quality of services delivered. For instance, a study in Mumbai, India found that 80% of surveyed pregnant women reported unavailable or interrupted antenatal care (ANC) services, and more than 80% of pregnant and lactating women experienced unavailable or interrupted delivery and postnatal care services. A study from Pakistan found a substantial decline in healthcare visits for ANC, scheduled child immunization, and overall careseeking for childhood illness. Evidence from Nepal reinforced the decline in health service utilization during the pandemic, including fewer visits for iron and folic acid (IFA) supplementation, postnatal care, growth monitoring, immunization, and other essential services.
Social safety nets are intended to protect poor and vulnerable families from the impact of shocks, yet COVID-19 spotlighted gaps in the quality of safety nets. For example, a study in India found that the public distribution system appeared successful in addressing food security needs during the pandemic; however, there were issues with eligibility and the lack of commodity choices. Moreover, research across various Asian-Pacific countries found that, although food availability and access improved to pre-pandemic levels in some countries, economic conditions and livelihoods continue to lag and warrant greater attention across the region.
Encouragingly, research and implementation experiences reveal remarkable restorations and adaptations underway across South Asia. Novel approaches that have emerged to close gaps in nutrition service delivery include adapting digital platforms for tele-counselling in India and Nepal; reimagining mHealth and eHealth interventions to continue maternal, infant, and young child nutrition (MIYCN) education in Bangladesh; piloting an interactive voice calling nutrition rehabilitation program in Cambodia in lieu of in-person counselling visits; and many more.
The discussions and deliberations across the two-day conference culminated in a closing panel, which brought together national and regional leadership to synthesize and distill the key findings from the conference, identify the key challenges, and propose solutions for enhancing nutrition and social protection.
Despite the adverse effects of COVID-19 on food security and nutrition to date, Saskia Osendarp, Executive Director of Micronutrient Forum states reassuringly, “Projections do not have to be destiny.” Purnima Menon, Senior Research Fellow, IFPRI closed the conference, acknowledging the challenges and urgency to address the region’s nutrition challenges: “In 2021, we live in a context where a virus reminds us of our shared humanity and of the futility of political and geographic boundaries. The region faces many forms of malnutrition, stunting, wasting, burden of anemia, overweight and obesity, and non-communicable diseases. This conference is a platform to bring together learnings and experiences along one thread to enable collective action. Together, we can improve many lives still hanging in the balance.”
This year’s Delivering for Nutrition in South Asia conference highlights the extensive evidence base of research and implementation on the impacts of and ongoing recovery from COVID-19 on food security and nutrition in the region. This conference is an entry point to deepen country- and regional-level engagement to address persisting challenges, namely by identifying research and data needs and stimulating cross-country engagement on research and policy to avert the projected damages.
The conference co-hosts include:
- Aga Khan University (Pakistan)
- Alive & Thrive (India)
- Bill & Melinda Gates Foundation (BMGF) (India)
- Helen Keller International (HKI) (Nepal)
- IDinsight (South Asia)
- Institute of Policy Studies (IPS) (Sri Lanka)
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) (Bangladesh)
- International Food Policy Research Institute (IFPRI) (South Asia)
- National Institute of Nutrition (NIN) (India)
- NITI Aayog (India)
- SickKids Centre for Global Child Health (South Asia)
- Standing Together for Nutrition (STfN) (Global)
- Society for Implementation Science in Nutrition (SISN) (Global)
- UNICEF Regional Office for South Asia (ROSA) (Regional)
- World Health Organization South-East Asian Regional Office (WHO-SEARO) (Regional)
- World Bank South Asia (Regional)
Esha Sarswat is a Communications Specialist under the Partnerships and Opportunities to Strengthen and Harmonize Actions for Nutrition (POSHAN) program in India. Julie Ghostlaw is a Country Program Manager under the Poverty, Health, and Nutrition Division at IFPRI.
YouTube recording (Opening Session, Thematic Session 1, Thematic Session 2a, Thematic Session 2b, Thematic Session 3, Closing Session)
Oral presentations (Day 1), Day 2)
Poster presentation showcase (Vimeo)
Event photos (Flickr)