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Published on 26/02/2016

Involving the local private sector to prevent malnutrition in developing countries

To mark its 20 years of actions against malnutrition, on 29 January 2016, GRET organised a day of discussions on the involvement of the local private sector to sustainably prevent malnutrition in developing countries. Here is an overview of the seminar, which brought together 90 public and private stakeholders from Europe, Africa, the Indian Ocean, as well as from academia, the associative sector and the world of politics.

 

What role can the local private sector play in the prevention of malnutrition?

Six million children under the age of five die every year in the world and malnutrition is the direct or indirect cause of one out of every two of these deaths. Among the various forms of malnutrition, chronic malnutrition is the least visible and the most forgotten. However, it affects 30% of children under the age of five in developing countries and in children under the age of two it causes damage that is irreversible in adult life (high level of morbidity, physical and mental handicap) with serious consequences for the development of a country. Inadequate nutrition of young children is one of the immediate causes of malnutrition: breast-feeding is rarely practised according to international  recommendations and complementary food is very often  used inadequately, in terms of quantity/quality.

Various solutions exist to sustainably improve complementary food: improvement of knowledge on best feeding practices, implementation of nutritional safety nets (food distribution) and promotion of balanced recipes for young children. Although they are vital and complementary in certain contexts, these strategies seem to be insufficient and it is often difficult for disadvantaged families to prepare balanced meals for their children (complicated recipes, too many different ingredients that are often difficult to find, expensive prices, time-consuming preparation and nutritional coverage that is seldom optimal, especially in terms of micronutrients.)

In these conditions, GRET recommends mobilising the local private sector for the production and marketing of manufactured complementary food. This is one of the solutions that make it possible to provide quality food that is quick and easy to prepare, and affordable for a majority of people. The various stakeholders present at the seminar agreed on the pertinence and importance of the role the local private sector can play in the prevention of malnutrition:

  • Produce quality food locally that makes it possible to improve food for vulnerable groups
  • Sustainably market solutions that are financially and geographically accessible to a majority of people
  • Contribute to creating jobs and participate in the economic development of countries

What role can the local private sector play in terms of commercial activities and in governance of the fight against malnutrition in developing countries? Combining the economic profitability of local businesses and a public health objective is possible. As put by Pierre Jacquemot, chairperson of GRET in his introduction of the seminar: “in certain circumstances, the market approach is  an appropriate model to satisfy social demand, and it has proved successful for a number of services. It is particularly promising for the area of food and nutrition, which led GRET to promote social businesses such as Nutri’zaza in Madagascar, the Amret microcredit company in Cambodia and autonomous services centres providing services to manufacturers or to local populations.” 

High barriers to the involvement of the local private sector in the prevention of malnutrition

The discussions generated a strong consensus on the fact that the local private sector is not very mobilised in the improvement of complementary food. Contrary to certain preconceived ideas, the market is complicated and risky for local businesses and economic profitability is difficult to reach if it is related to a social objective. The current offer of accessible quality products is very poor or inexistent in certain countries. There are numerous barriers:

  • The manufactured complementary food market is a niche market for a constantly changing small target group (families with children between the ages of 6 and 24 months). The competition is strong, especially with local products that are not adequate for the needs of young children and/or imported products not suitable to local constraints and not affordable for disadvantaged populations.
  • Local businesses have poor investment capacities and technical know-how, and they are therefore reticent to enter this difficult market. Currently, the technical difficulties involved in producing affordable quality food are  known and can be overcome with sufficient investments and the necessary know-how. However, there is still a challenge to be met in terms of the capacities of these businesses to develop their distribution network and promote their products so as to facilitate their consumption by a majority of people. “Why enter such a regulated market requiring government certification?” asks Klaus Kramer, Director of the Sight&Life Foundation, “It’s an obstacle for small local businesses, especially as, to be accepted, they must conduct large-scale testing of their products, which is costly and has consequences on the price and accessibility of the product, hence they run the risk of catering to the more comfortable classes.” 
  • Fluctuations in the price of raw materials can generate high financial risks
  • The legal framework is one of the main constraints. The role that the local private sector can play in terms of public health is not always recognised by public policies and quality local products remain not widely known or widely promoted in the institutional network focusing on the fight against malnutrition. So-called “social” businesses are rarely legally recognised. International and national quality recommendations and standards are very strict, not well known and poorly managed by local entrepreneurs and consumers have no guarantee regarding these types of products. The strict and poorly managed regulations regarding marketing of food for children, although absolutely necessary, are not very encouraging and the confusion between breast milk substitute and complementary food is a constant risk. Taxes are sometimes high on these local products. “For the past while, the Ministry of Health has called upon the Nutri’zaza social business to participate in reflections on the national nutrition policy, one of the objectives of which we also contribute to. However, it is not easy to combine social objectives and financial profitability, even if our shareholders do not expect profits. The main difficulty is that the Malagasy policy does not feature clear legislation for social businesses in Madagascar, in terms of taxes and legislation, they receive no encouragement and we find it hard to be recognised as a business like any other”, says Mieja Vola Rakotonarivo, Director of Nutri’zaza.
  • Coordination between nutrition stakeholders is insufficient, especially between emergency and development players. Free distribution of food to local populations in periods of crisis can also, when they are insufficiently targeted, be detrimental to local businesses marketing the same type of food.
  • The role of the local private sector is unclear and its contribution to  governance of the fight against malnutrition is not clearly defined. The various stakeholders involved in nutrition come from different areas and know little of each other, they have different approaches and this does not facilitate  coordination.
  • Financial profitability is very difficult to attain and local business people are afraid to enter this market or are quickly discouraged by it.

How to encourage and facilitate the involvement of the local private sector while at the same time ensuring restriction and control in terms of potential risks of conflict of interests and negative influence on public policies?

Mobilising a stakeholder coalition is necessary to remove these barriers

In an environment that is more restrictive than encouraging for local businesses that could in fact play an important role in the prevention of malnutrition, all stakeholders can be active:

  • International and national institutions and public authorities can  encourage the adoption of a legislative framework that is strict in order to avoid risks, but encouraging for businesses in that it gives greater recognition to the role they can play;  they can support the implementation of behaviour change communication campaigns with the general public and stakeholders concerned by nutrition to create a positive framework for the development of social businesses and an adequate offer; “In Burkina Faso, we adopted a national quality standard for infant flours and incorporated local production in the national nutrition policy. Today, the SUN-private sector movement platform is establishing itself with local Burkina Faso businesses, especially to strengthen and promote their action with all nutrition stakeholders”, says Bertine Ouaro, Director of Nutrition at the Burkina Faso Ministry of Health.
  • Local and international NGOs can support local business people in terms of technical support with production, distribution and promotion in compliance with current regulations and in a manner that is appropriate for the contexts and needs of local populations, including disadvantaged populations. They can test innovative solutions and capitalise on results, and support the public sector to define and apply appropriate legislation;
  • Research must continue to specify the impacts of food solutions proposed by businesses (types of products), as well as distribution and promotion strategies used. More focus must be placed on searching for innovative  pilot-scale solutions, while at the same time testing change of scales for strategies;
  • Donors can support these actions for periods of time that are sufficient to support the development of innovative pilot-scale solutions, but also  large-scale solutions, that facilitate the creation and development of local social businesses and greater dialogue between stakeholders.

Today it is necessary to:

  • conduct dialogues in stakeholder coalitions, notably to ensure better  coordination between emergency and development stakeholders, to enable clarification of roles for the public and private sectors, and civil society, in governance of the fight against malnutrition.
  • unite and advocate to promote awareness of the role of the local private sector via stakeholder coalitions; and greater inclusion of the local private sector within coalitions.

“Today there is a real need to understand each other, get to know each other better and, in order to do this, ensure frameworks for consultation to facilitate dialogue and transparency, as well as a favourable regulatory framework [for the  local private sector], while at the same time setting certain limits. It is also necessary to capitalise on experiences to exist on the international stage”, adds Florence Lasbennes, head of the SUN movement secretariat.

The diversity of experiences and points of view made it possible to define an outline for a consensus on the role of the local private sector, the barriers impeding its mobilisation and the actions to be taken to remove these barriers. But above all, “it made it possible to define a dynamic for discussion in a coalition of the stakeholders concerned by this subject, which is insufficiently discussed internationally. Let us pursue our discussions to continue progressing together in the search for sustainable, innovative, effective solutions for the prevention of malnutrition involving the local private sector”, adds Mirrdyn Denizeau, Head of Nutrition at GRET.


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