Mobilising evidence, data, and resources to achieve global maternal and child undernutrition targets and the Sustainable Development Goals: an agenda for action.

As the world counts down to the 2025 World Health Assembly nutrition targets and the 2030 Sustainable Development Goals, millions of women, children, and adolescents worldwide remain undernourished (underweight, stunted, and deficient in micronutrients), despite evidence on effective interventions and increasing political commitment to, and financial investment in, nutrition. The COVID-19 pandemic has crippled health systems, exacerbated household food insecurity, and reversed economic growth, which together could set back improvements in undernutrition across low-income and middle-income countries. This paper highlights how the evidence base for nutrition, health, food systems, social protection, and water, sanitation, and hygiene interventions has evolved since the 2013 Lancet Series on maternal and child nutrition and identifies the priority actions needed to regain and accelerate progress within the next decade. Policies and interventions targeting the first 1000 days of life, including some newly identified since 2013, require renewed commitment, implementation research, and increased funding from both domestic and global actors. A new body of evidence from national and state-level success stories in stunting reduction reinforces the crucial importance of multisectoral actions to address the underlying determinants of undernutrition and identifies key features of enabling political environments. To support these actions, well-resourced nutrition data and information systems are essential. The paper concludes with a call to action for the 2021 Nutrition for Growth Summit to unite global and national nutrition stakeholders around common priorities to tackle a large, unfinished undernutrition agenda-now amplified by the COVID-19 crisis.

Landscape of official development assistance for nutrition data and information systems.

Nutrition data and information systems (ND&IS) are critical to guide the prioritisation, collection, analysis and dissemination of nutrition data in countries. However, there is limited guidance for countries regarding how to invest in their ND&IS and little is known about current financing allocations by both countries and donors. This hinders our ability to identify the most critical funding gaps and to effectively advocate for increased financial commitments to ND&IS. To better characterise donor investments, we conducted a review of Official Development Assistance (ODA) financing for ND&IS between the years 2017 and 2019. The analysis showed overall donor financing for ND&IS is not trending up between 2017 and 2019 with the majority of funding being channelled through multilateral organisations to the health sector and spent on global initiatives and emergency early warning system and surveillance activities. Given these findings, donors should dedicate at least 5% (4%-6%) of nutrition investments, alongside country governments, to support country capacity building and strengthening of ND&IS. Donors should also consider channelling a larger part of ODA for ND&IS activities through public institutions to build their capacity to manage ND&IS strengthening.

The COVID-19 crisis will exacerbate maternal and child undernutrition and child mortality in low- and middle-income countries.

The economic crisis and food and health system disruptions related to the COVID-19 pandemic threaten to exacerbate undernutrition in low- and middle-income countries (LMICs). We developed pessimistic, moderate and optimistic scenarios for 2020-2022 and used three modelling tools (MIRAGRODEP, the Lives Saved Tool and Optima Nutrition) to estimate the impacts of pandemic-induced disruptions on child stunting, wasting and mortality, maternal anaemia and children born to women with a low body mass index (BMI) in 118 LMICs. We estimated the cost of six nutrition interventions to mitigate excess stunting and child mortality due to the pandemic and to maximize alive and non-stunted children, and used the human capital approach to estimate future productivity losses. By 2022, COVID-19-related disruptions could result in an additional 9.3 million wasted children and 2.6 million stunted children, 168,000 additional child deaths, 2.1 million maternal anaemia cases, 2.1 million children born to women with a low BMI and US$29.7 billion in future productivity losses due to excess stunting and child mortality. An additional US$1.2 billion per year will be needed to mitigate these effects by scaling up nutrition interventions. Governments and donors must maintain nutrition as a priority, continue to support resilient systems and ensure the efficient use of new and existing resources.

How are countries planning for costs of nutrition data and information systems?

Background: The first Global Nutrition Report in 2014 called for a "data revolution" in nutrition, so that countries have the latest data to set priorities and monitor progress. Integral to this revolution is understanding how countries are investing in the data, systems and capacity required to support decision-making around nutrition, i.e. their nutrition data and information system (NDIS). Methods: For this reason, our team conducted a desk review of national nutrition plans for 58 Scaling Up Nutrition (SUN) countries to better understand how countries are planning for and estimating the costs of their NDIS. Results: We found that of the SUN national nutrition plans that are publicly accessible, not all are costed and less than half of these have explicit data and monitoring and evaluation (M&E) sections. Of the 19 national plans that had costed data and M&E sections, our initial estimates show costs for data systems ranged from 0.1%-12.8% of total plan costs with limited information on data system components. Conclusions: There is an imminent need for more comprehensive and strategic approaches - including the planning for and financing of - NDIS in countries.