Consider the gravity of this statement by Joy Phumaphi, trustee of the Children’s Investment Fund Foundation: “A mother who has very poor nutrition – if her child is not one of the 2.5 million children who die at birth or before birth – then she is going to have a stunted child.” Sobering, considering that the voice and data charges on my mobile phone on any average day are the equivalent of providing lifesaving nutritional food supplements for a child for two months!
Malnutrition is not only the marasmic infant in Africa. A recent Lancet publication examines the growing number of countries with a double burden of malnutrition: continued stunting and deficiencies of essential nutrients along with the emerging issue of obesity. Richard Horton calls nutrition the quintessential sustainable development goal. It’s worth a read before your next lunch break…
No more the forgotten silent killer, US$4.1bn was recently committed to tackle malnutrition around the world at the recent Nutrition for Growth meeting, jointly hosted by the UK government, the Children’s Investment Fund Foundation and the Government of Brazil, in the build-up to the Group of Eight summit in Northern Ireland. The interesting thing about these commitments is that they are quantifiable public commitments: meaning that governments, public agencies and private organisations are accountable for saving lives.
Having said that, my fear is that press releases and cocktail events don’t effectively translate into sustainable impact amongst those most at need. I am reminded of the more than US$8.9bn that was committed to Every Woman Every Child since 2010 and of the 2012 findings by the iERG that state that unequal distribution of that funding continues to stunt the growth of women and children’s health.
The iERG make several recommendations to improve accountability that should be heeded for the US$4.1bn committed to Nutrition. One of these recommendations relates directly to our mHealth sector: “Accelerate the uptake and evaluation of eHealth and mHealth technologies: The evidence on which to base decisions about implementation of information and communication technology is weak or non-existent.” Touché! A challenge worth getting out of bed for.
Without chasing our tails down the evidence rabbit hole and becoming unstuck on the chicken-and-egg quandary of scale vs. evidence, we need to consider the fact that the average mobile phone user does not want to be plagued by several health, education, agriculture and/or other social mavericks trying to push content and services to an already busy mobile number. We realised a while back that we need to start thinking about the convergence of mobile vertical silos if we want to impact the end user.
Countries like Nigeria, where donors are committing significant resources and effort, can and should be demonstrations of where these convergent mobile services show evidence of sustained impact. I still maintain that the greatest efforts need to go into facilitation between public and private stakeholder groups to create successful public private partnerships. Mobile is a volume-based industry dependent on the millions of malnourished, disadvantaged and marginalised individuals with access to a mobile phone and the mobile network assets of the private sector. The levers of these supply and demand forces aren’t well understood by either side. It requires significant hand holding.
To the governments and funders who made commitments at the Nutrition for Growth event, my tweetable comment for the day is to invest wisely into brokering public private partnerships.
Photo: School students drink milk at Oworonsoki, Lagos, Nigeria. © 2008 Kunle Ajayi, Courtesy of Photoshare.