November 3, 2023

By: Dr. Justine Kavle

Women’s nutrition is critical for health and well-being during pregnancy and lactation. The need for sufficient maternal food intake in coupled with scaling up complementary interventions—such as multiple micronutrient supplements and calcium supplementation—through national health systems is emphasized by the 2021 Lancet series. We share our reflections, based on evidence and on-the-ground experience during the 2023 Micronutrient Forum Powering Women’s Nutrition panel which highlighted experiences and recommendations to address gender inequality and develop comprehensive multisectoral nutrition actions to address issues & barriers facing women & girls.

What are the main barriers and policy gaps when it comes to women nutrition?

In our experience as a woman-owned social enterprise of public health nutritionists and implementers, Kavle Consulting has worked on the dire effects of COVID-19 on women’s nutrition and on the drought in northern Kenya, as well as community approaches and capacity building models for nutrition across Africa.  Through that lens, I will address two barriers:

1. 1. Given the imminent health workforce shortage by 2030, its critical to invest in capacity around women’s nutrition.  While much training and implementation has focused on child nutrition and health outcomes, in our experience via a compilation of evidence and there is a notable demand from our community for skillsets and knowledge around women’s nutrition during pregnancy and lactation. We need to consider task shifting to community workers, grassroots organizations, civil society and youth-led clubs.   We worked with Vitamin Angels on an online women’s nutrition course for continuing medication education that can address the gap in health provider knowledge and practice.
   2. In terms of policy gaps, operationalizing and contextualizing global guidelines to country realities, systems and structures for women’s nutrition is a challenge, particularly around how do countries implement such guidance within the context of routine health service delivery) and acute/prolonged crises/emergencies.  We partnered with USAID’s Momentum project, to understand how countries can feasibly integrate balanced energy protein supplementation through antenatal care – targeting acutely malnourished women given the gaps in aligning country guidelines to WHO guidance, and the confusion around how its defined and how to deliver BEP outside of emergency programming. Furthermore, while much needed, renewed efforts on child wasting may lessen the prioritization of maternal malnutrition within routine health service delivery.

What are the most immediate and concrete opportunities for building an enabling environment for women’s nutrition and what is required to be successful?  

Thank you – I will talk about three sectors across the enabling environment and a bit about data.

1. 1. Youth – Given 70% of Africa and Asia’s population is under the age of 30, it’s the next generation that will drive actions for change through national youth-led movements and advocacy platforms, building consensus, such as leveraging the recently launched SUN Youth Network in Kenya, pressing for government accountability.  To be successful, we need to actively strengthen and shape youth capacities as leaders for informing, designing, implementing, and monitoring multisectoral nutrition programming.

1. 1. Mental health Women need comprehensive support during this poly crises- especially those who are marginalized and working in the informal sector. Our data from Kenya collected in partnership with UNICEF Kenya and Ministry of Health, Kenya indicate pregnant and lactating women experienced extreme stressors, including widespread unemployment, like borrowing money, taking food on credit, and gender-based violence during the COVID-19 pandemic. We also noted that access to and availability of psychosocial support was low, and in terms of equity – and quality youth-friendly responsive services was often not available to young women and adolescents who are not lactating or pregnant.

1. 1. Social protection intended to buffer against economic shocks during COVID-19 needs to be targeted towards pregnant and lactating women. In Kenya, despite widespread food insecurity, most women who expected to be considered for support reported not being able to access either food or cash transfers and those that received them felt was insufficient and short‐term- only for a few months.

1. 1. Co-alignment of health and food system data We need to ensure linkages between health systems strengthening efforts for improving service delivery and food systems efforts that increase access, availability and affordability of food, conjoining documentation, collection and co- alignment of health system and food system data. For example, the new DHIS-2 standardized nutrition indicators are good place to start for health.