Building the Capacity of Caribbean Countries to Protect and Promote Nutrition of Mothers and Children during Crises
Several Caribbean countries face similar challenges including inadequate policies, interventions, and systems to protect the most vulnerable from the irreversible effects of recurring crises impacting the health and nutrition status of mothers and children. Grenada, Haiti, Dominica, St. Lucia, and St. Vincent recognized their need for assistance in building capacity to formulate country disaster and emergency plans. The World Bank assisted by connecting them with other countries both within the Caribbean and Latin America and outside the region to share knowledge and experiences.
The 2008 global economic crisis made the situation in five vulnerable Caribbean countries—Grenada, Haiti, Dominica, St. Lucia, and St. Vincent—particularly dire. As net food-importing countries, they were highly susceptible to high food price volatility. Improved management during economic crises and natural disaster emergencies was a clear priority for all five countries. Without adequate policies, interventions, and systems in place, it was difficult to protect the most vulnerable.
Given this context, a key challenge was building their capacity to protect the health and nutritional status of mothers and children living in poverty. Due to limited resources and technical expertise, Grenada, Haiti, Dominica, St. Lucia, and St. Vincent asked the World Bank to assist them in building capacity in country disaster and emergency plans to be able to identify entry points for protecting health and nutrition. In addition, they wanted to be connected with other countries within the Latin America and Caribbean Region (LCR) to share knowledge and experiences on the issue.
The exchange was focused around the creation of a community of practice (CoP) and a regional workshop. The World Bank, as an intermediary, organized the exchange. Consultations and dialogue among the beneficiary countries had taken place earlier under a Rapid Social Response (RSR) Trust Fund project that resulted in a toolkit on How to Protect and Promote the Nutrition of Mothers and Children. This prior work allowed participating countries to identify knowledge and capacity gaps prior to forming the CoP.
The CoP relied heavily on virtual communication to engage participants in sharing their experience and lessons learned from the toolkit implementation. Utilizing a web-based platform, the CoP helped coordinate the ongoing activities of the World Bank’s Networks on Health, Nutrition, and Population; Sustainable Development; and Social Protection. The CoP platform served primarily as a repository of information, resources, good practice approaches, and case studies on the nutrition of mothers and children in times of crisis. It was also the main tool used in the virtual conferences conducted prior to the regional workshop, which brought together the community participants and key decision-makers from each country.
Workshop activities included plenary presentations by countries that led outstanding activities (for example, Haiti had reduced malnutrition by 6 percent despite the 2010 earthquake). Expert panels from Panama and Japan presented and discussed international gold standards on the workshop themes. The workshop showcased posters on good practice approaches in participating countries and regional expert institutions and offered interactive kiosks for participants to use the CoP platform and the toolkit.
The workshop presented an opportunity to disseminate the findings of the consultations from the RSR Trust Fund project, including good practice approaches and lessons learned. It also provided cross-sectoral sharing and discussion on health, agriculture, education, and social protection. Another workshop take-away was the capacity building of decision-makers from key institutions in each of the countries involved in improving the design, effectiveness, and sustainability of integrating nutrition policies and programs into crisis and emergency response systems.
An unexpected result was the request from the Eastern Caribbean countries for a self-paced online learning course for the Caribbean on protecting nutrition in disaster situations. An introductory web-based course on Nutrition, Food Safety and Health in Emergencies was customized and disseminated in 2014. The course was based on the Harmonized Training Package (HTP) on Nutrition in Emergencies Version 2, 2011, which captured the aspect of over-nutrition in its conceptual framework and focused on non-communicable disease risk factors of obesity. The 2011 course was delivered as a shared initiative of the Institute of Nutrition of Central America and Panama (INCAP), Pan American Health Organization (PAHO), University of the West Indies (UWI), national health ministries and national disaster offices, and the World Bank.
The customized web-based course that resulted from this exchange is also a partnership among the same stakeholders and accessible at: http://www.campusvirtualsp.org/?q=en
- The exchange renewed focus on some common issues shared by the Caribbean countries. For instance, Caribbean countries would benefit from technical assistance to strengthen their data collection and analysis capacity to guide evidence-based planning for protecting nutrition in times of disasters. The lack of validated data in the Caribbean with respect to the impact natural disasters have on nutritional status, particularly over-nutrition, limits the region's ability to develop comprehensive emergency plans with policies in place to protect nutrition in these situations.
- The approach and sequence of the exchange was effective in achieving the desired outcomes. It allowed for access to knowledge providers outside the region and allowed the target countries to come together as a knowledge community for practical implementation. Carmen Carpio, World Bank Task Team Leader for the Exchange, commented, “If we could do one thing different, it would be to hold additional virtual South-to-South exchanges building up to the workshop to allow the Caribbean beneficiaries to benefit from additional country experiences.”
This exchange was implemented in harmony with a Rapid Social Response (RSR) trust fund for US$230,000 under which a toolkit on how to protect nutrition in times of emergencies and disasters was developed. The exchange grant of US$49,375 complemented the RSR by facilitating the follow-up knowledge-sharing work around the toolkit through the CoP and regional workshop. Caribbean countries would benefit from technical assistance to strengthen their data collection and analysis capacity to guide evidence-based planning for protecting nutrition in times of disaster.
- Experts from Panama and Japan
- Officials from Dominica, Grenada, St. Lucia, St. Vincent and the Grenadines, and Haiti representing the Ministries of Health, Ministries of Agriculture, National Emergency Organization, and other governmental institutions working in nutrition.
This exchange was not a stand-alone activity but part of a broader program, jointly implemented by the World Bank and Pan American Health Organization, with sequenced activities leading to the development of a validated course for the Caribbean and a focus on protecting the nutritional status of mothers and children in emergency and disaster situations. Follow-up activities have taken place with the World Bank and PAHO financing and providing technical assistance to develop a tailored tool for Caribbean needs. PAHO organized a workshop in late January 2014 with the Bank's participation to finalize the online course.
The following are comments from the survey carried out in the face-to-face regional workshop in Grenada:
- “Sharing experiences with professionals from other countries allows to identify new strategies or in some cases, identify gaps and opportunities for improvement of existing strategies, to improve nutrition for the population in need. The workshop organized by the Bank was an important effort because it puts isolated activities into a comprehensive framework that can be adopted by anyone.”
- “Very practical and relevant training need for multi-sectorial approach.”
- “After the virtual knowledge exchange, I am more aware of critical topics/areas that should be included in the National Plan."
Ministry of Health and National Emergency Organization officials working in nutrition indicated that the exchange was successful because it was relevant to the Caribbean context. The knowledge providers from Panama and Japan shared their personal knowledge and experiences through focused presentations on how lessons learned from their own country’s actions could be relevant to the Caribbean context (for example, the response on non-communicable diseases).
- Scaling Up Nutrition (SUN): Haiti - http://scalingupnutrition.org/sun-countries/haiti
- Caribbean Public Health Agency (CARPHA): http://carpha.org/About
- Promoting Nutrition Security in Haiti (report) - http://siteresources.worldbank.org/NUTRITION/Resources/HaitiNutritionAssessmentEnglishFINAL.pdf
- Global Nutrition Report: Haiti - http://globalnutritionreport.org/files/2014/11/gnr14_cp_haiti.pdf
- Grenada Food and Nutrition Council - http://www.gfnconline.org/
- HNP voices(06/18/13) - Protecting and Promoting the Nutrition of Mothers and Children in Latin America and the Caribbean http://siteresources.worldbank.org/EXTLACREGTOPHEANUTPOP/Resources/832774-1363293422759/HNP-NUTRITION_final.pdf
- Toolkit on How to Protect and Promote the Nutrition of Mothers and Children. The toolkit was designed to guide countries in crafting policy responses to nutritional needs of mothers and young children in unstable context. It also provides direction on how to protect and promote the nutrition of mothers and children during stable times and emergencies, and during the transition in and out of crisis. http://web.worldbank.org/WBSITE/EXTERNAL/COUNTRIES/LACEXT/EXTLACREGTOPHEANUTPOP/EXTLACREGTOPNUT/0,,contentMDK:23342299~pagePK:34004173~piPK:34003707~theSitePK:4160378,00.html
- Virtual Campus (Pan American Health Organization) - http://www.campusvirtualsp.org/?q=en The World Bank has partnered with PAHO, INCAP, and UWI to ensure the online course on Nutrition, Food Safety, and Health in Emergencies in the Caribbean has long-standing dissemination channels through different recognized international platforms.