ATNI (Access to Nutrition Initiative) assesses the performance of the food and drink industry in providing affordable nutrition to consumers
Transforming markets for improved nutrition – Access to Nutrition
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Thank you for your question Annabel! First I’d like to pop in some resources and our latest trend reports in maternal, neonatal and adolescent health.
State of the World’s Children Report (UNICEF) - https://www.unicef.org/reports/state-worlds-children-2023
Improving maternal and newborn health and survival and reducing stillbirth (WHO, UNICEF, UNFPA) - Improving maternal and newborn health and survival and reducing stillbirth - Progress report 2023
Born too soon, a decade of action (WHO, UNICEF, UNFPA, PMNCH)
Born too soon: decade of action on preterm birth
Trends in Child Mortality: Levels and trends in child mortality - UNICEF DATA
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The use of advanced market commitments – examples including the development of the pneumococcal vaccines. This approach helped stimulate the development of three qualifying vaccines that collectively have led to the vaccination of 150 million children and saved up to 700,000 children’s lives.
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Hi! I am Lauren Maitland. Sr Advisor Global Corporate Partnerships for ChildFund International which connects children with the people, resources and institutions they need to grow up healthy, educated, skilled and safe, wherever they are. Looking forward to this discussion!
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At the 2021 Tokyo Nutrition for Growth (N4G) Summit, companies committed to drive greater action to tackle malnutrition in all its forms and helping ensure everyone, everywhere can access to healthy and sustainable diets. Several companies such as DSM, Google, Griffith Foods, Unilever and Olam committed to provide good workforce nutrition for all employees, especially the most vulnerable, notably women.
- Olam announced that by 2030, 100% of Olam’s total workforce will have access to nutrition programmes (NAF Tracker - Workforce nutrition - Global Nutrition Report);
- Griffith Foods announced that by 2025, 100% of our global workforce will successfully complete a nutrition education program developed by credentialed healthcare professionals by 2025 (NAF Tracker - Workforce nutrition - Global Nutrition Report)
- Quornfoods announced to reach 100% of our global workforce with a nutrition education, healthy eating, and wellbeing programme by the end of 2024 (NAF Tracker - Educating our workforce on nutrition - Global Nutrition Report)
- DSM partnered with civil society, including WFP, UNICEF to develop school feeding programs in emerging markets, ensuring children receive at least one meal a day through the inclusion of fortified foods – such as rice, cereal blends, juice, milk, baked goods or yogurt (DSM | World Food Programme). Between 2002-2013, DSM and WFP achieved their target of fortified food products reaching 80% of its beneficiaries. They have since extended their partnership through to 2021, with an increased focus on nutrition awareness-building and the development of new solutions including fortified rice.
Visit the dedicated website to find out more about the companies involved in the Workforce Nutrition Alliance (Workforce Nutrition Alliance) - led by GAIN and CGF.
The Private Sector Zero Hunger Pledge (The Zero Hunger Private Sector Pledge (zerohungercoalition.org)) is another great example of private sector investments to achieve zero hunger by 2030. Nasinya Dairy Company invested in programmes to empower women to improve pastures and generate income for their families (Nasinya Dairy Company | The Zero Hunger Coalition).
The pledge is led by a coalition of ten international organizations and non-governmental organizations, namely: the Food and Agriculture Organization (FAO), the Global Alliance for Improved Nutrition (GAIN), Grow Africa, Grow Asia, the International Fund for Agricultural Development (IFAD), the International Institute for Sustainable Development (IISD), the Shamba Centre for Food & Climate, the World Benchmarking Alliance (WBA), the World Business Council for Sustainable Development (WBCSD), and the World Food Programme (WFP).
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Some of the cool projects to improve adolescent Health that at YLabs we have been doing:
- CyberRwanda- Using a human-centered design approach, the CyberRwanda program was co-designed and tested with over 1000 Rwandan youths, teachers, parents healthcare providers and community leaders. Using digital education to improve the health and livelihoods of urban adolescents. Its objectives: Improve knowledge, improve access and improve quality.
- Tegura ejo Heza- Tegura Ejo Heza aims to create a digital-self care platform to support mental health literacy in Rwanda and will be the first of its kind. Our innovation, co-designed with youth, will address mental health stigma among Rwandan youth and improve knowledge and self-efficacy to access supportive services.
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One good example of such an initiative is that between the Philips Foundation and Save the Children who jointly deployed a mobile ultrasound services to improve maternal and child health in Yemen. They enable midwives to better assist expectant mothers both at home and in their villages, by equipping nine rural community centers across the country with Philips mobile ultrasound technology and training 17 local midwives.
The key ingredient according to them is the partnership, which leverages the strengths and expertise of different organizations and have a greater impact. You can read more here: Innovating for patients and planet: driving equitable and sustainable healthcare – Blog | Philips
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In the last two decades, significant global efforts have been made to reduce maternal and child mortality rates, although progress falls short of meeting SDG targets. Innovations such as telemedicine, electronic health records, and awareness campaigns have improved healthcare and connected remote communities with professionals. At national level, data-driven approaches, using Health Management Information Systems and State Health Indices, have enabled government to make informed decision-making.
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The implants access initiative which has led to an huge increase in contraceptive implant use in low and lower middle-income countries. Again, this initiative de-risked private investment in a priority product area for women and girls’ health and created the conditions for a win-win-win between public purchasers, business, and most importantly, family planning users.
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Innovations often occur sporadically without concerted efforts. Accessible and affordable healthcare is a collective responsibility, underscoring the crucial need for ongoing global collaboration in maternal, child, and adolescent health. It is crucial to recognize the necessity of integrating innovations where health and nutrition are interlinked, addressing both the demand and supply aspects of services and healthier diets.
We are working on one such innovative program within GAIN’s framework known as Workforce Nutrition (Workforce Nutrition). Unlike programs solely focusing on maternal and child health, this initiative targets the entire working population, with a particular emphasis on female workers. Its goal is to improve the availability, demand, and consumption of nutritious diets among workers and farmers in low to middle-income countries, utilizing existing business infrastructures.
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At a national level, we see significant promise in the use of service delivery contracting and strategic purchasing to engage private healthcare providers in a mixed health system approach while also pursuing equity and quality-related objectives. These approaches have been used successfully in diverse settings, including in fragile settings and in countries pursuing more ambitious UHC reforms.
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Innovating in Data and Digital:
Leveraging data and digital health technologies on an ongoing basis, including during the COVID-19 response was extremely useful to fill in data gaps and provide better evidence to policy and programming that will save children’s lives and improve health outcomes. These include data platforms and geospatial solutions to strengthen health systems and enhance the reach and quality of care. At the primary health-care level, it is important to streamline data processes, improve data integrity and increase capacity to make informed decisions. UNICEF works with partners to leverage all these technologies and uses chatbots, SMS, interactive voice response and other technologies to reach affected communities with life saving information. In 2021, WHO and UNICEF launched the Digital Health Centre of Excellence to make health services more equitable and attainable with a data-driven approach and by harnessing the power of sustainable and scalable digital health solutions.
To find out more about DICE: https://www.digitalhealthcoe.org/
Supply Chain Strengthening:
Innovation in Supply Chain Strengthening and Delivery: Effective national supply chains are critical to provide sustainable access to safe, quality and affordable supplies and services for pregnant women, mothers, newborns, children and adolescents. While significant resources to strengthen national supply chains are often allocated, the performance of these supply chains frequently does not meet the expectations of their stakeholders or end-users.
UNICEF Supply Chain Maturity Model is a participatory, qualitative and government-led supply chain assessment that allows to determine whether supply chain management is a barrier to access. It reviews the performance of 13 critical operational and technical supply chain functions - linked to the UNICEF supply chain rainbow below - across five levels, where level 1 brings evidence of minimum development while level 5 reflects best supply chain management and practices.
Oxygen Plant-in-a-Box: During COVID-19, UNICEF set to work with industry partners on an innovative emergency solution: The Oxygen Plant-in-a-Box package. The package includes everything needed to install and operate a fully functional pressure swing adsorption (PSA) oxygen plant within days of arriving at a health facility. The device can produce enough oxygen to treat up to 50 COVID-19 patients, or 100 children with severe pneumonia.
The innovation transformed rapidly from idea to reality. A long-term agreement was in place in a matter of months, and in mid-December 2021, patients at the Soroti Regional Referral Hospital in Uganda were the first to receive life-saving oxygen from a UNICEF Oxygen Plant-in-a-Box. By the end of the year, over 16 other countries were in the process of ordering this innovative product to respond to COVID-19 and strengthen health systems for the long-mile.
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Broad points on Q1:
*Investment in WASH: Ensuring access to clean water in healthcare facilities is a fundamental requirement for maternal and child health. A per WHO , inadequate WASH conditions in healthcare facilities contribute to infections and complications during childbirth. This highlights the urgent need for investment in WASH infrastructure worldwide to improve maternal and child health outcomes. We can’t innovate without access to a reliable water source…
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Peer Partnerships for Innovation: Collaborative partnerships between healthcare systems and professionals from different regions have proven effective in driving innovation. Eg, the Global Network for Maternal and Newborn Health, a consortium of researchers and healthcare providers from various countries, works together to identify and implement effective maternal and newborn health interventions based on shared experiences and evidence-based practices.
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Bottom-Up Data Influencing National Targets: locally-driven data collection and community engagement can drive innovation. The 2YoungLives initiative prioritised mentorship of young girls and women to build health literacy, as well as empowerment through small business support to enable them to have independence through growing their funding.
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Another area where there are some innovations but where we need to continue to drive innovation is in menstrual hygine products. Access to innovative products like cups and underwear also help women and girls manage menses with dignity and ease. We need to find ways to build knowledge and awareness while really plugging into what adolescent girls need and want in product development.
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Innovation to reach the last mile:
Holistic, systemic, and human-centered innovative solutions and approaches play a crucial role by offering impactful and scalable pathways to accelerate results.
As such, innovation is a strong ally in building more resilient, sustainable, and inclusive health systems for children to survive and thrive. Innovative solutions and approaches can help inclusively deliver access to healthcare services for children and their communities by tackling the root barriers and challenges in health systems – from the lack of quality and timely data for decision-making, to challenges in access to healthcare facilities and trained medical personnel for communities in remote or rural areas, to the rising cost of healthcare services for families everywhere.
Supported by UNICEF, these innovations are strengthening localized health systems to deliver quality, accessible, and affordable health care for all children and young people around the world:
- In Kenya, Neural Labs uses AI to accelerate the detection of respiratory diseases. With support from the UNICEF Venture Fund, the startup is expanding its clinical trials to new regions. “Thousands of Africans lose loved ones to preventable diseases every year. Patients in marginalized communities wait up to two weeks to receive their lab results. But two weeks is a death sentence when aggressive diseases like pneumonia can kill a child in less than 72 hours”, says Tom Kinyanjui, Neural Labs co-founder. “With this technology, we help doctors provide accurate diagnoses even before patients can get their shirts back on after an imaging procedure, making real-time diagnosis a reality.”
- In the Philippines, the digital monitoring tool Real-Time Vaccination Monitoring and Analysis (RT-VaMA) processes data to enable daily tracking of vaccine coverage focusing on reducing inequity by encouraging distribution to remote populations that ordinarily would not have access to immunization services.
- In Brazil, Portal Telemedicina created a platform for streamlining health information from fragmented and disparate data sources for faster, more reliable, and lower-cost diagnostics. The platform is designed to enable doctors to make online diagnoses, levering AI integrated layer and insights for medical providers, providing that critical window of time that can make a difference between sickness and death or a healthy, fulfilled life.
- A multi-country initiative, Oky is the first period-tracking app co-created with girls for girls. Oky offers a fun, creative, and positive way for adolescent girls to learn about their periods, featuring individualized cycle trackers and calendars, tips, and even games in which they can personalize the app design, select and unlock their avatars, and play menstrual health quizzes.
- In South Africa, Cloudline and UNICEF Namibia are implementing a medical drone delivery network to transport specimen samples, vaccines, and medical commodities from 17 local health clinics to the central laboratory in the Katima district. The initiative considers the migratory patterns of the Himbas, a nomadic tribe, while providing health services in challenging terrains.
- A similar innovation in Uruguay is bridging the gap in access to health care services and medical supplies to communities in remote areas. In a first-of-its-kind in Latin America, Dronfies Labs by CIELUM recently piloted the use of unmanned drones to transport medicines, blood samples, and donated breastmilk to and from Tacuarembó Hospital and the rural communities of Tambores, Curtina, and Ansina.
- In Kazakhstan, the USupportMe app aims to connect adolescents with free, on-demand online mental health information and counselling services via peer-volunteers, psychologists, and professional counselors trained in evidence-based practices.
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A noteworthy example of successful supply chain management in the nutrition sector is found in Assam. Private sector organizations addressed the challenge of limited market access and inadequate infrastructure by establishing the Healthy Line Shop model (You can check out the working paper here https://www.gainhealth.org/resources/reports-and-publications/gain-working-paper-series-33-healthy-line-shops-last-mile) - Inspired by the Assam government’s Nutrition Shops known as Bagan Bazar initiative (Nutrition Shops (Bagan Bazar) at Tea Garden areas of Assam | Assam State Rural Livelihood Mission (ASRLM) | Government Of Assam, India) , GAIN India with private sector funding which included tea sector companies like Unilever, JDE, and others, developed a market-based supply chain model, ensuring a consistent supply of nutritious foods to 35 tea estates. Households on tea estates relied on small retail shops, known as “line shops,” for their food supply. However, these line shops struggled to stock fresh, nutritious, and fortified foods due to a disconnect with distant food wholesalers. The wholesalers found it economically unviable to supply to these shops because of low order volumes. Thus, we introduced an aggregator a central small town, willing to transport goods within a 5-8 kilometer radius. We linked up this aggregator to wholesalers as well as retailers. This aggregator know as Healthy-Line-Shop Distributor (HLS Distributor), gathered demand from each HLS, procured food products at competitive prices from various wholesalers, and delivered them directly to the HLSs doorstep which was non-existent before. This streamlined the process of replenishing nutritious food stocks at the retailer’s doorstep.
This initiative not only increased access to nutritious foods but also empowered local businesses and gained support from tea estate management. As of now, we have reached 60000 workers and their families in 7 districts of Assam, India. This approach significantly increased the consumption of fortified foods, with a 64% rise in availability, particularly fortified oil, pulses, milk, and eggs. Women in tea estates were 14 times more likely to consume fortified oil compared to the project’s baseline. In addition, I would also like to highlight that these shops are now functional without any external support. Thus, the outcomes demonstrated the potential of market-based solutions in transforming communities’ lives.
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With obvious bias: I believe that our work with Ubuntu-Afya Kiosks is one such innovation. As a hybrid public-private model - our kiosks are health center level facilities that provide integrated health care services that include RMNCAH services alongside NCD services - on the awareness that diseases often co-occur; and incorporate community ownership to promote target community participation in defining their priorities; and supplementary enterprises to help cross-subsidize cost of providing care.
Other innovations include those that integrate hospital and community health digital health information systems, improving follow up and better record and referral systems.
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Clean water is interesting area of intersection for climate and health. As climate change gets worse and causes greater health shocks, clean and safe water becomes more of a priority. Another area of climate-health integration that also has tremendous impact on maternal health outcomes is electrification of primary care facilities. If we can explore ways to drive clean energy through solarization we can help provide more stable electricity while also reducing dependence on diesel generators or inconsistent electricity grids.
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UNICEF’S Venture Fund is calling for applications!
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AfriPads is a really successful social business that started in Uganda that has been working on innovation in MHH.
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