This book is a joint product of the World Bank and the Asian Development Bank (ADB), and of a con... more This book is a joint product of the World Bank and the Asian Development Bank (ADB), and of a consultation process with key members of the child development community in the Philippines. It is based on a report that was produced to help in the preparation of a national investment plan for early childhood development (ECD). This is the first time either development bank has done a country study that looks at ECD in an integrated way, across health, nutrition, and early education. It is hoped, therefore, that this book will be of interest to the international child development community, as well as in the Philippines. The first draft of the report was based on the findings of a joint mission in March 1994. Team members were Richard A. Heaver, IBRD (mission leader and management specialist); Joseph M. Hunt, ADB (ADB team leader and economist); ADB consultant Keith McInnes (financial analyst); and IBRD consultants Rosendo Capul (public health), Sony Chin (nongovernmental organizations and community participation), John Kevany (nutrition), and Fred Wood (early education). During this mission a workshop was held with leading specialists in child development in the Philippines, including governmental and nongovernmental organizations and the United Nations Children's Fund, to define the main issues on which the report should concentrate. A second workshop with similar participants was held in Manila in September 1994 to provide reactions to the first draft. Both workshops were chaired by the Philippine Council for the Welfare of Children. The current version of the report, on which this book is based, took into account comments from the second Manila workshop as well as comments by reviewers from inside and outside the World Bank at review meetings in Washington, D.C., in July and December 1994. The broad findings of the report were endorsed by a steering committee-consisting of representatives of the main government agencies involved in ECD in the Philippines-that was tasked with developing a proposal for a national ECD program. Institutions vii viii FOREWORD represented on the steering committee include the Department of Health (chair); the National Council for the Welfare of Children; the National Nutrition Council; the Department of Social Welfare and Development; the Department of Education, Culture, and Sports; the Nutrition Center of the Philippines; the Department of Interior and Local Government; and the Museo Pambata Foundation. The findings helped the committee to prepare an ECD strategy paper for submission to the Social Development Committee, a high-level Philippine policymaking body, seeking endorsement of an integrated national ECD program. Although the report was broadly endorsed by the steering committee, the specific findings in this book and the levels of investment proposed represent the recommendations of the joint team, rather than the position of the government of the Philippines. To provide a smaller, more accessible volume for the nontechnical reader, the eleven annexes to the report are being published in a separate companion volume, Supplenmefit to Imryroving Early Chtildhood Development. The authors gratefully acknowledge the contribution of all those in the Philippines and in the international agencies, as well as each member of the mission team, who provided data, shared their views about issues and priorities, and commented on drafts. Errors and omissions remain the responsibility of the authors alone. Children represent the future of the nation. This book is dedicated to the many Filipinos who are working for the cause of children, in the hope that preschoolers, especially the disadvantaged, will have a better future.
Traditional food security strategies are reviewed and generally found to have a weak impact on lo... more Traditional food security strategies are reviewed and generally found to have a weak impact on lowering child malnutrition. Unless these programs are properly targeted and linked to employment and micro-credit opportunities for women, they are unlikely to be effective or sustainable. The links between food policy and nutrition security require greater attention to dietary quality through agricultural research and technology, directed to reducing both undernutrition and overnutrition; social security policies that protect poor women and children; and food aid policies that are developmental in intent and impact. One element in the final solution to malnutrition is to provide increased consumption of a range of nonstaple foods. To reach the poor, this will require a relatively large investment in agricultural research and other public and on-farm infrastructure over several decades. In the medium run, a much smaller investment in improving the nutrient content of food staples through plant breeding can make a major contribution to reducing deficiencies in selected micronutrients. The role of women is central to nutrition outcomes through child care, so that policies and programs must consider how to enhance women's decision-making power in the household, how they affect time demands on women, and how to increase women's education and nutritional knowledge. Finally, community-based programs, which are central to the RETA strategy for improved nutrition, should be used to monitor the nutrition effects of agricultural policies and programs and to provide feedback to agricultural policymakers as to how to enhance the positive effects and minimize the negative effects of agricultural policies and programs.
Child malnutrition is pervasive and persistent in Asia, and at present rates it will take decades... more Child malnutrition is pervasive and persistent in Asia, and at present rates it will take decades to halve the prevalence—a goal common to many national plans. Nutrition-oriented programs are familiar in most countries, but have far too low coverage and resources, which is wasteful as well as ineffective. A massive expansion of community-based programs is feasible, with well-established activities (usually including support to: antenatal care, breastfeeding, caring practices including complementary feeding, growth monitoring, access to health care). Networks of local workers, ensuring individual contact with families, are the essential feature. Requirements including costs are proposed. Micronutrient deficiency control programs must also be expanded towards universal coverage. Context is crucial to success, important examples being women’s status, social exclusion, political commitment, community organizations, and literacy; policies should be directed to improving these. Assessing ...
Vitamin and mineral deficiencies adversely affect a third of the world's people. Consequently, a ... more Vitamin and mineral deficiencies adversely affect a third of the world's people. Consequently, a series of global goals and a serious amount of donor and national resources have been directed at such micronutrient deficiencies. Drawing on the extensive experience of the authors in a variety of institutional settings, the article used a computer search of the published scientific literature of the topic, supplemented by reports and published and unpublished work from the various agencies. In examining the effect of sex on the economic and social costs of micronutrient deficiencies, the paper found that: (1) micronutrient deficiencies affect global health outcomes; (2) micronutrient deficiencies incur substantial economic costs; (3) health and nutrition outcomes are affected by sex; (4) micronutrient deficiencies are affected by sex, but this is often culturally specific; and finally, (5) the social and economic costs of micronutrient deficiencies, with particular reference to women and female adolescents and children, are likely to be considerable but are not well quantified. Given the potential impact on reducing infant and child mortality, reducing maternal mortality, and enhancing neurointellectual development and growth, the right of women and children to adequate food and nutrition should more explicitly reflect their special requirements in terms of micronutrients. The positive impact of alleviating micronutrient malnutrition on physical activity, education and productivity, and hence on national economies suggests that there is also an urgent need for increased effort to demonstrate the cost of these deficiencies, as well as the benefits of addressing them, especially compared with other health and nutrition interventions.
Iron deficiency anemia (IDA) depresses human productivity, but policymakers do not generally view... more Iron deficiency anemia (IDA) depresses human productivity, but policymakers do not generally view this effect as an impediment to sustained economic growth. Economic logic should be enfolded in public advocacy for increased investment in the prevention and control of IDA. This paper argues that integrated strategies are required, with each intervention clearly related to particular groups at risk, and benefits carefully calibrated with costs. Protecting women's lives through supplementation has the first call on public resources, but the most productive investments reduce population prevalence at least cost, and these lie with food-based approaches within the competence of the processed food and seed industries. The public and private sectors must embark on modernization of the food industry in developing countries and reorientation of the international agricultural research complex so that iron-enriched essential foods will be affordable and accessible to the poor, especially children. The costs of IDA, the availability of cost-effective strategies and the benefits of sustained iron nutrition improvement to individuals, families and nations are reviewed. The roles of iron supplementation, food fortification, plant breeding and biotechnology, both actual and imminent, are described. The paper concludes that a recast Green Revolution directed toward dietary quality may be the key to enhancing the learning and earning capacity of young people in the developing world.
This book is a joint product of the World Bank and the Asian Development Bank (ADB), and of a con... more This book is a joint product of the World Bank and the Asian Development Bank (ADB), and of a consultation process with key members of the child development community in the Philippines. It is based on a report that was produced to help in the preparation of a national investment plan for early childhood development (ECD). This is the first time either development bank has done a country study that looks at ECD in an integrated way, across health, nutrition, and early education. It is hoped, therefore, that this book will be of interest to the international child development community, as well as in the Philippines. The first draft of the report was based on the findings of a joint mission in March 1994. Team members were Richard A. Heaver, IBRD (mission leader and management specialist); Joseph M. Hunt, ADB (ADB team leader and economist); ADB consultant Keith McInnes (financial analyst); and IBRD consultants Rosendo Capul (public health), Sony Chin (nongovernmental organizations and community participation), John Kevany (nutrition), and Fred Wood (early education). During this mission a workshop was held with leading specialists in child development in the Philippines, including governmental and nongovernmental organizations and the United Nations Children's Fund, to define the main issues on which the report should concentrate. A second workshop with similar participants was held in Manila in September 1994 to provide reactions to the first draft. Both workshops were chaired by the Philippine Council for the Welfare of Children. The current version of the report, on which this book is based, took into account comments from the second Manila workshop as well as comments by reviewers from inside and outside the World Bank at review meetings in Washington, D.C., in July and December 1994. The broad findings of the report were endorsed by a steering committee-consisting of representatives of the main government agencies involved in ECD in the Philippines-that was tasked with developing a proposal for a national ECD program. Institutions vii viii FOREWORD represented on the steering committee include the Department of Health (chair); the National Council for the Welfare of Children; the National Nutrition Council; the Department of Social Welfare and Development; the Department of Education, Culture, and Sports; the Nutrition Center of the Philippines; the Department of Interior and Local Government; and the Museo Pambata Foundation. The findings helped the committee to prepare an ECD strategy paper for submission to the Social Development Committee, a high-level Philippine policymaking body, seeking endorsement of an integrated national ECD program. Although the report was broadly endorsed by the steering committee, the specific findings in this book and the levels of investment proposed represent the recommendations of the joint team, rather than the position of the government of the Philippines. To provide a smaller, more accessible volume for the nontechnical reader, the eleven annexes to the report are being published in a separate companion volume, Supplenmefit to Imryroving Early Chtildhood Development. The authors gratefully acknowledge the contribution of all those in the Philippines and in the international agencies, as well as each member of the mission team, who provided data, shared their views about issues and priorities, and commented on drafts. Errors and omissions remain the responsibility of the authors alone. Children represent the future of the nation. This book is dedicated to the many Filipinos who are working for the cause of children, in the hope that preschoolers, especially the disadvantaged, will have a better future.
Traditional food security strategies are reviewed and generally found to have a weak impact on lo... more Traditional food security strategies are reviewed and generally found to have a weak impact on lowering child malnutrition. Unless these programs are properly targeted and linked to employment and micro-credit opportunities for women, they are unlikely to be effective or sustainable. The links between food policy and nutrition security require greater attention to dietary quality through agricultural research and technology, directed to reducing both undernutrition and overnutrition; social security policies that protect poor women and children; and food aid policies that are developmental in intent and impact. One element in the final solution to malnutrition is to provide increased consumption of a range of nonstaple foods. To reach the poor, this will require a relatively large investment in agricultural research and other public and on-farm infrastructure over several decades. In the medium run, a much smaller investment in improving the nutrient content of food staples through plant breeding can make a major contribution to reducing deficiencies in selected micronutrients. The role of women is central to nutrition outcomes through child care, so that policies and programs must consider how to enhance women's decision-making power in the household, how they affect time demands on women, and how to increase women's education and nutritional knowledge. Finally, community-based programs, which are central to the RETA strategy for improved nutrition, should be used to monitor the nutrition effects of agricultural policies and programs and to provide feedback to agricultural policymakers as to how to enhance the positive effects and minimize the negative effects of agricultural policies and programs.
Child malnutrition is pervasive and persistent in Asia, and at present rates it will take decades... more Child malnutrition is pervasive and persistent in Asia, and at present rates it will take decades to halve the prevalence—a goal common to many national plans. Nutrition-oriented programs are familiar in most countries, but have far too low coverage and resources, which is wasteful as well as ineffective. A massive expansion of community-based programs is feasible, with well-established activities (usually including support to: antenatal care, breastfeeding, caring practices including complementary feeding, growth monitoring, access to health care). Networks of local workers, ensuring individual contact with families, are the essential feature. Requirements including costs are proposed. Micronutrient deficiency control programs must also be expanded towards universal coverage. Context is crucial to success, important examples being women’s status, social exclusion, political commitment, community organizations, and literacy; policies should be directed to improving these. Assessing ...
Vitamin and mineral deficiencies adversely affect a third of the world's people. Consequently, a ... more Vitamin and mineral deficiencies adversely affect a third of the world's people. Consequently, a series of global goals and a serious amount of donor and national resources have been directed at such micronutrient deficiencies. Drawing on the extensive experience of the authors in a variety of institutional settings, the article used a computer search of the published scientific literature of the topic, supplemented by reports and published and unpublished work from the various agencies. In examining the effect of sex on the economic and social costs of micronutrient deficiencies, the paper found that: (1) micronutrient deficiencies affect global health outcomes; (2) micronutrient deficiencies incur substantial economic costs; (3) health and nutrition outcomes are affected by sex; (4) micronutrient deficiencies are affected by sex, but this is often culturally specific; and finally, (5) the social and economic costs of micronutrient deficiencies, with particular reference to women and female adolescents and children, are likely to be considerable but are not well quantified. Given the potential impact on reducing infant and child mortality, reducing maternal mortality, and enhancing neurointellectual development and growth, the right of women and children to adequate food and nutrition should more explicitly reflect their special requirements in terms of micronutrients. The positive impact of alleviating micronutrient malnutrition on physical activity, education and productivity, and hence on national economies suggests that there is also an urgent need for increased effort to demonstrate the cost of these deficiencies, as well as the benefits of addressing them, especially compared with other health and nutrition interventions.
Iron deficiency anemia (IDA) depresses human productivity, but policymakers do not generally view... more Iron deficiency anemia (IDA) depresses human productivity, but policymakers do not generally view this effect as an impediment to sustained economic growth. Economic logic should be enfolded in public advocacy for increased investment in the prevention and control of IDA. This paper argues that integrated strategies are required, with each intervention clearly related to particular groups at risk, and benefits carefully calibrated with costs. Protecting women's lives through supplementation has the first call on public resources, but the most productive investments reduce population prevalence at least cost, and these lie with food-based approaches within the competence of the processed food and seed industries. The public and private sectors must embark on modernization of the food industry in developing countries and reorientation of the international agricultural research complex so that iron-enriched essential foods will be affordable and accessible to the poor, especially children. The costs of IDA, the availability of cost-effective strategies and the benefits of sustained iron nutrition improvement to individuals, families and nations are reviewed. The roles of iron supplementation, food fortification, plant breeding and biotechnology, both actual and imminent, are described. The paper concludes that a recast Green Revolution directed toward dietary quality may be the key to enhancing the learning and earning capacity of young people in the developing world.
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