Maternal and child nutrition: Building momentum for impact

Abstract

support for the interventions that can be quickly scaled up or linked to nutrition programmes—such as early child development initiatives. It is equally important to take note of the message of Marie Ruel and colleagues 4 — that in certain sectors, such as agriculture, the evidence of the eff ect of targeted programmes on maternal and child nutrition is largely inconclusive and requires new approaches to fi eld evaluation. Since 2008, there have been only limited increases in donor aid for nutrition. It is true that nutrition is not so readily attractive to politicians as an international development priority. Undernutrition has a complex set of political, social, and economic causes, none of which are amenable to easy solutions that fi t within the timeframe of a single political cycle. For this reason, the outlook today for nutrition is not wholly good. The target endorsed only a year ago at the World Health Assembly—to reduce by 40% the number of children stunted by 2025—is already on course to be missed. As the endpoint of the Millennium Development Goals approaches, countries and the international community may agree that nutrition was one of the great missed opportunities of the past 15 years. But this neglect can be turned around quickly. As sustainable development becomes the dominant idea post-2015, nutrition emerges as the quintessential example of a sustainable development objective. If maternal and child nutrition is optimised, the benefi ts will accrue and extend over several generations. This remarkable opportunity is why Stuart Gillespie and colleagues 5 take a very diff erent approach to implementation than in any previous Lancet Series. Instead of exhorting politicians and policy makers to do something—or worse, simply hoping that political commitment will appear like a rabbit out of a hat—they set out a practical guide about how to seize the agenda for nutrition, how to create political momentum, and how to turn that momentum into results. This is the prize we have to grasp in the next 18 months.