Briefing Paper - Undernutrition: What Works

8/7/2019 Briefing Paper - Undernutrition: What Works

1/12

Undernutrition: What works?

Worldwide progress in reducing rates of child-hood undernutrition has been relatively slowand variable. Indeed, in too many countries, rates are

unacceptably high. There is no doubt that the fight

against undernutrition will remain relevant for manyyears to come. Nevertheless, behind the global statis-

tics lie some success stories. This briefing is based on

the outcome of secondary research which examines

five such stories Brazil, Peru, Mozambique, Malawi

and Bangladesh which have had relative success

in bringing down their rates of undernutrition over the

past fifteen years, in the quest to find out why and

how these countries in particular have been success-

ful. Research aimed to identify policies and practises

implemented to facilitate the success and analysethe extent to which a reduction in undernutrition has

been achieved due to a responsive policy environment

and or social/civil initiatives. Drawing on evidence pre-

sented in the full report, this briefing presents these six

key success factors in turn, selecting particular exam-

ples which stand out, from case studies examined.

Key messages

A combination of six key success factors strong

political will, civil society participation and owner-

ship, a multi sectoral and multi phase approach,

institutional coordination and contintuity of sus-

tainable financial investment make up an ideal

enabling environment, which if in place should

facilitate a reduction in rates of childhood undernu-

trition. In contexts with the most demonstrable suc-

cess all six factors are present in varying degrees.

Even in some places which have managed to

successfully reduce rates of undernutrion, rates

remain unacceptably high. These are peaceful,

non emergency settings, yet high rates of under-nutrition persist. Surely this demonstrates that

undernutrition is not just an emergency issue.

In fact, addressing undernutrition is clearly linked

to poverty reduction; concrete steps can be taken

as the case studies show.

Strong political will is key if the fight against hun-

ger and undernutrition is to suceed. Governments

with the political will and a signed, demonstrable


A policy briefing

Executive summary January 2011

Action Against Hunger | ACF International is an international humanitarian organisation committed to ending child hunger. Recognised as a

leader in the fight against malnutrition, ACF works to save the lives of malnourished children while providing communities with sustainable

access to safe water and long-term solutions to hunger. With 30 years of expertise in emergency situations of conflict, natural disaster and

chronic food insecurity, ACF runs life-saving programmes in some 40 countries benefiting nearly 5 million people each year.

Action Against Hunger www.actionagainsthunger.org.uk


2/12


2

commitment have put nutrition at the top of their

political agenda, with positive results.

Civil society ownership and participation sig-

nificantly contributes to the development of viable

and sustainable policies. Civil society participa-

tion in the policy making process, and subsequent

ownership of the policies and practises developed

and implemented at community level is essential. It

is likely to improve acceptance and impact among

affected populations.

Undernutrition touches upon a wide range of sec-

tors, including health, food security, agriculture,

water and sanitation, education, gender, eco-

nomic and social development. This multi-causal-ity requires promoting a functional multi-sectoral

approach in order to enhance policy coherence

and coordination.

Long-term, sustained and scaled-up action to

reduce undernutrition is more likely to succeed

with an institutionalised coordination council in

place. These bodies need strong political back-up

to be able to mainstream nutrition and food secu-

rity in other ministries and institutions, and enoughfinancial resources to be effective.

The importance ofcontinued fi nancial invest-

ment from host governments and the international

donor community cannot be overstated. This is

particularly relevant in cases where budget sup-

port is compulsory for policy effectiveness, as in

Bangladesh, Malawi and Mozambique.

Box 1: Background

In order to find out why some countries have had

relative success in bringing down undernutrition

rates, while others have not, ACFIN has embarkedon a research project, entitled Zero Hunger. In

the first phase of this project, trends in indicators

relating to undernutrition were analysed. On

the basis of these trends, five case studies

with demonstrable success in reducing rates of

undernutrition were selected for further analysis:

Brazil, Peru, Bangladesh, Mozambique and

Malawi. Research then involved critical analysis

of policies and best practise implemented to

facilitate this success, with the aim of identifying

common success factors which have together

led to a reduction in rates of undernutrition for

the case studies in question. The outcome of

this part of the project forms the basis for this

policy briefing.The second phase of Zero Hunger

involves analysis of the extent to which these

success factors are applicable in a context in

which undernutrition is a recurring problem; Niger.

The aim is to see if the lessons learned and best

practise can be integrated in Niger and beyond.

Barriers to implementation are identified, alongside

recommendations for overcoming such obstacles.

The third phase of Zero Hunger involves analysis

of regional level institutions in West Africa, which

are involved in the prevention and treatment of

undernutrition. It will examine both policy making

processes and mechanisms.

Brazil Peru Bangladesh Mozambique Malawi

Strong political will

Civil society ownership and participation

Multi-sectoral approach

Institutional co-ordination

Continued fi nancial investment

Table 1: Most signifi cant enabling factors by case study


3/12


3

Introduction

ACFIN recognises that undernutrition rates in many

countries (including in some of the cases examined)

are unacceptably high. Nevertheless some positive

strides have been made, as outlined in this report. It

is important to learn from these contexts so that our

contribution to the fight against hunger builds on what

has already been achieved. By highlighting examples

of best practise and key policy required for successful

nutrition outcomes, this research provides important

lessons for policy makers and practitioners alike.

Drawing on evidence presented in the full report,

this briefing presents six key enabling factors in

turn, selecting particular examples which stand out,


4/12


4

from case studies examined. It will not include best

practises identified at the programme level in case

study contexts, or challenges ahead. These can be

found in the full report.1 The case studies analysed

are an example of how a combination of effective

policy development, good practise at programmelevel, made possible by sustainable investment, some

countries have achieved positive results in their nutri-

tion and hunger rates; evidence that reducing hunger

and under nutrition is an attainable goal. All contexts

studied have prioritised food and nutritional security,

recognising that hunger and undernutrition represent

major challenges.

Key fi ndings

Strong political will

First, the importance ofstrong political will. Despite

widely differing contexts (players, political economy

and social dynamics) in all five case studies, strong

political commitment to reducing undernutrition is

present, as indicated in Table 1, above.

Perhaps the most outstanding example of the impor-

tance of political will is found in Brazil. Here, the

fight against hunger has been at the centre of social

policy-making since 2002. This political impetus has

promoted policy coherence (social, education and

agriculture policies), appropriate resource allocation

and stakeholder participation. The Brazilian govern-

ment has focused on covering basic needs, by inte-

grating Millennium Development Goals into policy,2and developing the national Zero Hunger (Fome Zero)

Programme as a decisive tool. At the core of the Zero

Hunger Programme is the promotion of Brazilian citi-

zens right to adequate food through nutritional secu-

rity and social inclusion.3 This rights-based approach

is enshrined in the Food and Nutritional Security

Organic Law passed in September 2006. The Right

to Food approach strengthens the engagement to fight

against hunger by legally binding the government to

fulfil its commitments.

The government ofPeru has placed the fight against

child undernutrition at the top of the political agenda.

Resources to address both the determinants of under-

nutrition and to improve the delivery of nutrition inter-

ventions through health services are in place. A joint

UN and NGO initiative, Reduce Child Undernutrition,

argues that stunting is the most significant handicap

preventing economic and social development in

Peru. As part of its advocacy effort, Reduce Child-

hood Undernutrition invited all presidential candidates


5/12


5

to commit themselves to the reduction of stunting if

elected. President Alan Garcia committed to reduce

stunting by 5% during his five-year mandate (2006-

2011). As a consequence, the government of Peru

has placed the fight against child undernutrition at the

top of the political agenda, a priority manifested in themajor national strategy, Crecer(to grow).

Malawi has also demonstrated a strong political com-

mitment to fighting hunger with extra impetus given

by the direct engagement of the Presidency. In 2004,

the Department of Nutrition, HIV and Aids was estab-

lished under the Office of the President and Cabinet

(OPC), and since 2006 has been managed directly

under the aegis of the OPC, rather than under the Min-

istry of Health, as in most sub-Saharan countries. The

Department is led by Dr Mary Shewa, an extremely

motivated and committed individual. Indeed some

commentators note that Malawis success is largely

due to her strong leadership; there is no doubt that

having a strong figure head is beneficial. This high

level political engagement has led to more coherent

policy development and in particular the formulation

of the national nutrition policy. While critics argue the

nutrition policy emphasises treatment rather than

prevention, it does address many key determinants

of nutritional status including prevention, therapeutic

interventions and food-based approaches. Malawis

Growth and Development Strategy (2006-2011) high-

lights six key priority areas, three of which are directly

relevant to the fight against hunger: prevention and

management of nutrition disorders and HIV/Aids,

agriculture and food security and irrigation and waterdevelopment. Government commitment to these three

areas was highlighted by a significant budget increase

between 2005/6 and 2008/9: growth averaged 35%,

44%, and 115% a year, respectively.4

Civil society ownership and participation

The fight against hunger in Brazil started 30 years

ago as a civil society initiative. Here, decades of pres-

sure from populations demanding transparency and

accountability led to governments opening dialogue

with civil society. Civil society (scientific experts, com-

munity-based organisations, NGOs, solidarity com-

mittees etc) has continued to push public institutions

to address hunger as a key political issue. The space

for participation promoted by the government, espe-

cially since 2002, has been a decisive boost to the

empowerment of civil society. The National Council for

Food and Nutrition Security, under direct control of the

president, is the most visible example of a number of

initiatives promoting participatory budgets, implement-


6/12


6

ing local committees and monitoring social actions.

The Council takes a multi-sector and multi-stakeholder

approach by integrating and coordinating all ministries

concerned (social action, public health, agriculture),and has played a key role in the promotion of national

policies in the fight against hunger.

Multi sectoral approach

Mozambique provides a good example of the multi-

sector approach to food and nutrition security. In

Mozambique, a wide range of stakeholders such as

the government, NGOs and several civil society insti-

tutions are involved in complementary initiatives. Theagricultural sector provides a good example of this

complementarity. In response to rapidly rising prices

during the food crisis, the government introduced a

plan to increase agricultural production between 2008

and 2011 and reduce Mozambiques future vulnerabil-

ity, 10% of the budget was committed to agriculture, in

line with the CAADP target.5 In conjunction with this,

WFP has implemented the cross-border food trade

monitoring system. The system monitors previously

unrecorded informal trade flows across borders andincorporates data into national food balance sheets to

improve the allocation of food aid and the management

of national food stocks. It also informs trade policy and

procurement decisions, contributes to the design and

targeting of agri-business development programmesand, by tracking agricultural imports, serves as an

early-warning indicator for crop-production decisions

in coming seasons.

Mozambiques National Adaptation Programme of

Action (NAPA), prepared in 2007, sets out priorities

for the management of risk and natural disaster in the

shadow of climate change. Closely associated with

this, is the disaster management institute, which was

set up in 2000, reflecting the governments commit-ment to disaster preparedness and response. In terms

of health, the Ministry of Health developed a strategic

plan for nutritional development in 2005. Focused on

prevention, capacity building and advocacy, there are

six key priorities relating to micronutrient deficiency,

anaemia, iodine deficiency, chronic undernutrition and

capacity development in nutrition research and advo-

cacy. At the same time, the Government of Mozam-

bique recognises the link between undernutrition

and HIV/Aids and so has incorporated an integrated


7/12


7

approach to nutrition related to HIV into its Strategic

Plan (2004 2008).

Bangladesh provides another good example of the

importance of implementing a multi sectoral approach.

The National Food and Nutrition Policy formulated in1997 by the Ministry of Health and Family Welfare

(MoHFW) was a first attempt to include food diver-

sification, health and nutrition as key priorities in the

national food security system. This later evolved into

the National Food Policy (NFP) of 2006 which aims

to ensure food security for all by increasing food pro-

duction and attaining self-sufficiency.6 The NFP was

formulated by the Ministry of Food and Disaster Man-

agement in coordination with partner ministries, devel-

opment partners and NGOs. It is an unprecedented

attempt to consolidate and harmonise existing policy

frameworks and actions for addressing all dimen-

sions of food security. The NFP framework is articu-

lated around three core objectives: the adequate and

stable supply of safe and nutritious food; increased

purchasing power and improved access to food, and

adequate nutrition for all individuals, especially women

and children.

Nutrition issues are addressed in the MoHFWs

Health, Nutrition and Population Sector Programme

(HNPSP), and also by complementary actions from

the Ministry of Agriculture and the Ministry of Fisheries

and Livestock, among others. Key interventions that

are currently being implemented under the HNPSP

include growth monitoring and promotion, infant and

young child feeding, prevention and control of anae-mia, prevention and control of vitamin A and iodine

deficiency. In addition to this, the government of Bang-

ladesh implements a Public Food Distribution System

(PFDS) to address shortfalls in household access to

food. Assistance is mainly in the form of food or cash

based transfers and is targeted at poor and vulner-

able groups.

One of the best examples of an effecive multi sectoral

approach is found in Brazil. Here, initiatives in vari-

ous sectors are implemented a complementary way

to achieve one goal; a reduction in undernutrition. The

parallel promotion of the different health services and

nutrition education basic packages, access to safe

water and sanitation programmes, social protection

programs (cash transfers to purchase food and essen-

tial goods), school feeding initiatives, food production

and household income generation initiatives are key to

this success. The Fome Zero progamme itself involves

work across sectors. Fome Zero is structured around

four main axes: access to food, income generating


8/12


8

activites, social mobilisation and strenghtening small-

holder agriculture. There are many initiatives designed

to improve access to food, the most noteworthy being

the Bolsa Familia programme, a conditional cash

transfer (CCT) scheme now covering twelve millionfamilies.7 In order to receive the cash up to a maxi-

mum of US$ 42 per month 8 families must agree to

the following conditions: health and nutritional follow

ups for all family members, enrolment in school cou-

pled with good attendance rates for school age chil-

dren, and attendance at nutrition education seesions.

Strengthening smallholder agriculture is conducted

through a number of programmes, one of which is the

small holder credit programme. This facilitates access

to investment capital, and the food acquisition pro-gramme ensures state purchases for public institutions

(hospitals, schools and prisons) or for the creation

of national reserves.9 Alongside these activities, the

Government of Brazil has identified public health as a

top priority. The main four initiatives developed include

efforts to expand overall health services coverage,

reduce crude child and maternal mortality, expand

infant vaccination coverage and reduce rates of HIV/

Aids and malaria.

Institutional coordination

Institutional coordination in Peru has been strength-

ened by the consolidation of nutrition programmes into

one integrated nutrition plan (Plan Integral Nutricional).The Inter ministerial Social Affairs Commission (CIAS)

now coordinates 26 programmes in the fight against

child undernutrition. Originally encompassing a hefty

82 separate programmes, the Government of Peru

recognised the need to improve efficiency and so

fused some programmes and cut others. This drastic

slim lining strategy has led to improved efficiency and

effectiveness, helping focus efforts and resources on

the main objectives of reducing stunting and anaemia

among infants aged 6-36 months and their mothers

and, reducing anaemia in 3 to 12 year-olds.

Crecer(which means to grow) is a key intervention

implemented at national level by government (national,

regional and local), cooperation agencies, civil society

and private entities, with the aim of overcoming poverty

and chronic undernutrition. It aims, by 2011 to reduce

chronic undernutrition in under 5s by 9% and reduce

poverty by 30%. Crecerinvolves a wide range of initia-

tives including literacy, food assistance, provision of


9/12


9

water and sanitation infrastructure, rural agriculture,

off farm employment with the continued participation

of regional and local government. As in the Fome Zero

Programme in Brazil the central tenet ofCreceris a

CCT programme, known as Juntos (together) which

has focused on undernutrition since 2007. Evidencesuggests that Juntos is improving a number of key

welfare indicators for programme participants but so

far there is little evidence of impact on final outcome

indicators such as undernutrition rates and anaemia.10

This further reinforces the need for CCT schemes to

be complemented by adequate health services and

health and education practices.

In Mozambique, the emphasis on coordination

is impressive. The coordination effort for food and

nutritional security institutions and initiatives is clearly

addressed through the National Nutrition Coordination

Council (NNCC).11 The Council was set up to facilitate

inter ministry collaboration on nutritional policies and

programmes. It promotes the multi-sectorial approach

outlined above by involving most of the key stakehold-

ers in health, food (from production to trade), and basic

infrastructures. Development of the NNCC created an

essential institutional framework or home for nutrition

at national level. Although this home may have little

power to influence programmatic action, it legitimises

nutrition as a national development priority and cre-

ates a window of opportunity for nutrition advocates

to enter into national level policy debates. The NNCC

also lends permanency to long-term efforts to address

undernutrition in contexts where nutrition advocates

are usually able to coordinate efforts only via loosenetworks, informal coalitions and where the turnover in

personnel and administration threatens the continuity

of the progress.

Multi-phase approach

The Malawian approach to fighting undernutrition

demonstrates the multi phase approach well. The

national nutrition policy addresses approaches to both

treatment (short term) and prevention (long term).12

Community based management of acute malnutri-

tion (CMAM) was adopted as a national strategy in

2006, when its gradual scale up and integration into

the primary health care system began. By 2009, the

programme had been scaled up to 330 outpatient and

96 inpatient sites in all of the countrys 27 districts.13

Between 2005 and 2007, the government implemented

the Malawi Social Cash Transfer Scheme as well as

subsidizing maize production. This led to a reduction in

cereal imports and avoidance of large price increases.


10/12


10

Cash transfers are an effective developmental instru-

ment, and resources are being mobilised for national

scale up. Cross border food trade monitoring is a long

term initiative which has had a significant effect on

food aid allocations and government management of

national stocks. Benefits have been felt by nationalgovernments, regional bodies and donors alike. This,

in combination with a strong early warning system

(implemented by the Malawi Vulnerability Assessment

Committee) is part of Malawis long term approach to

fighting undernutrition and food insecurity and should

allow Malawi to act on evolving food security issues

before they become critical.

Continuity of fi nancial investment

The importance of continued financial investment from

host governments and the international donor com-

munity cannot be overstated. There is no doubt that

sustained financial commitment has been instrumental

in enhancing policy coherence and coordination for

both Malawi and Mozambique.

International development assistance plays a cru-

cial role in Mozambiquesfight against poverty. The

9th European Development Fund (EDF) invested

approximately 35 million in the food security sec-

tor and approximately 10 million in the health sector

between 2001 and 2007. The EU recommends the

integration of both sectors on the basis that improved

health and access to basic services has a positive

effect on household productivity, therefore increasing

food security and helping to break the poverty cycle.Increased agricultural production is one of the main

aims of the National Indicative Plan, which aims to

empower small producers by transforming public serv-

ices into facilitators and supporters and reinforcing

their role in extension services. The Country Strategy

Paper for 20082013 predicts a total of 622 million

from the 10th EDF, with approximately 95 million

(15%) earmarked for food security and agriculture,

and 56 million (9%) for the health sector (focused

on reducing HIV/Aids prevalence).

External funding has also played a key role in address-

ing hunger and undernutrition in Malawi. Bilateral

donors have maintained regular and significant fund-

ing in the country. The EU, a long-time donor to Malawi

recently launched the 10th European Development

Fund. This aims to improve the countrys macro-eco-

nomic situation, strengthen public finance manage-

ment systems and carry out education and health pol-

icy reforms. With a budget of 451 million, the Country


11/12


11

Strategy Paper 2008 2013 has allocated 25% of its

budget to ensure agriculture and food security

UN priorities are outlined in the UNDAF (United

Nations Development Assistance Framework) 20082011, with efforts particularly focused on nutrition and

health, and basic services such as water and sanita-

tion and education. Agriculture, disaster reduction and

social protection are also part of this integrated and

multi-sector approach. Undernutrition will be tackled

by addressing its underlying causes and by supporting

a more integrated response. Moderate and acute mal-

nutrition among children underfive will be treated with

supplementary and therapeutic feeding respectively,

and community therapeutic centres will be expanded.Capacity for emergency prevention, preparedness and

response will be strengthened at all levels. UNDAF

forecasts US$12.6 million for the nutrition sector. .

Conclusion

The case studies examined are peaceful, non emer-

gency settings, yet high rates of undernutrition persist.

This demonstrates that under nutrition is not just an

emergency issue. In fact, addressing undernutrition

is clearly linked to poverty reduction; concrete steps

can and are being taken, as the case studies show.

Despite widely differing contexts, the case studies

analysed demonstrate that reducing rates of under-

nutrition is attainable, given the appropriate enabling

environment. Our research has found that govern-

ments with the political will and a signed, demonstra-

ble commitment have put nutrition at the top of their

political agenda, with positive results. Political impetus

provided by governments is key. Indeed it is a pre

requisite for ensuing policy development. Civil society

ownership and participation significantly contributes

to the development of viable and sustainable policies.

Civil society participation in the policy making proc-

ess, and subsequent ownership of the policies and

practises developed and implemented at community

level is essential. It is likely to improve acceptance and

impact among affected populations.

It is well known that childhood undernutrition has

mulitiple causes. Indeed, it touches upon a wide

range of sectors, including health, agriculture, water

and sanitation and education, with the relative impor-

tance of each differing according to context. This multicausality requires promoting a functional multi sectoral

approach in order to enhance policy coherence and

coordination. Long-term, sustained and scaled-up

action to reduce undernutrition is more likely to suc-

ceed with an institutionalised coordination council in

place. These bodies need strong political back-up to

be able to mainstream nutrition and food security in

other ministries and institutions, and enough financial

resources to be effective.

The combination of both short and long-term

approaches to nutrition has proved effective in many

of the contexts studied. Long-term initiatives, such as

the promotion of food production for self-reliance and

the reinforcement of access to employment for the

most vulnerable, have been complementary to short-

term approaches, such as the improvement of health

services to mothers and children alongside social pro-

tection strategies such as CCT programmes. Indeed,

a recent review of CCT programmes emphasises the

need for a multi-phase approach. It concludes that

CCT will not reduce undernutrition in isolation, but

should be integrated into a more holistic, integrated

approach together with education services and pro-

ductive or economic development initiatives.14

It is essential that governments implement strate-

gies which address both the immediate and underly-

ing causes of undernutrition. Fighting undernutrition

involves implementing both prevention and treatment

activities; the priority given to each will vary according

to context and depends on the wider political econ-

omy. Both prevention and treatment are integral ele-

ments of the fight against undernutrition. Continued

investment and support from state and donors alike is

fundamental if the relative success already achieved,

is to be built upon.


12/12


Endnotes

1 See Sanchez, M. and Salse, N 2010, Undernutrition: What works?

A review of policy and practiceACFIN/Tripode London

2 Objetivos de Desenvolvimento do Milenio, Presidncia da Rep-

blica. Relatrio Nacional de Acompanhamiento, Grupo Tecnico

para acompanhamento dos Objetivos de Desenvolvimento do

Milenio, Maro 2010.

3 Definicin programa Fome Zero, conceito http://www.fomezero.gov.

br/o-que-e

4 Tavakoli, Hedger 2009 Public Expenditure in Malawi: Analysis of

Trends and Performance, ODI London

5 Club of Mozambique, 10 March 2009. Mozambique plans to

increase its grain harvest by 13 percent in 2009 /2010,

http://www.clubofmozambique.com/solutions1/sectionnews.php

?secao=mozambique&id=14405&tipo=one

6 See http://www.nfpcsp.org/Downloads/Homep/National%20

Food%20Policy%202006%20English%20Version.pdf

7 http://www.mds.gov.br/bolsafamilia

8 Paes-Souza, R. and Pacheco L.M. 2009 Measuring the impact of

Bolsa Familia Program based on data from Health and Nutrition

Days (Brazil) FAO Working papers 7. http://www.rlc.fao.org/

iniciativa/pdf/WP7.pdf (Accessed 06/09/2010)

9 OXFAM 2010 Halving Hunger: Still Possible? Building a rescue

package to set the MDGs back on trackOXFAM UK

10 Perova et al. 2009 Welfare impacts of the Juntos Program in Peru:

Evidence from a non -experimental evaluationWorld Bank Washing-

ton

Action Against Hunger briefing papers provide informationon important development and humanitarian issues.

Readers can reproduce material or quote from these

briefing papers if Action Against Hunger is named

as the copyright holder and is given appropriate

acknowledgement. Please email details of publications

that quote Action Against Hunger briefing papers to

[email protected]

Action Against Hunger briefing papers and publications

are available at www.actionagainsthunger.org.uk

Action Against Hunger (ACF-UK)1st Floor, Rear Premises

161-163 Greenwich High RoadLondon SE10 8JA

T: 020 8293 6190 F: 020 8858 8372ti i th k

11 Benson, T. 2004 Improving Nutrition as a Development Priority:

Addressing Nutrition in National Policy Processes in SSA, Interna-

tional Food Policy Research Institute, Research Report 156.

12 Treatment involves therapeutic interventions and food based

approaches.

13 UNICEF 2009 Tracking progress on NutritionUN New York

14 Garret et al. 2009 Designing CCT programs to improve nutrition

impact: principles, evidence and examples. FAO Rome

Briefing Paper - Undernutrition: What Works

Documents

Transcript of Briefing Paper - Undernutrition: What Works