 We're expecting a number of others probably caught up in some Nairobi traffic, so we'll just get started. We also, this workshop is being live streamed through Webex, so we also have I think eight or ten people somewhere out there in the cyberspace who are following, so welcome to you also. So just to remind people in the room here, we're going to be online, so as we move through and as you have a chance to talk, the whole world will be listening and engaging with you, so you need to speak in a very clear voice. So I'm going to start by immediately just going straight in, we're a little bit late, going to the formalities, so I'm going to invite Jimmy Smith, Hillary Director General, could you come up and say a few words, Jimmy, and then I think John Allenberger will follow from Land of Lakes. Thank you Peter. Ladies and gentlemen, John, the senior vice president from Land of Lakes and other colleagues here, I'm delighted to have you at Illry, it's a real pleasure when we have meetings like this and so many important people come to visit our campus. We're very pleased to be partnering with Land of Lakes on this seminar or this workshop and I want to join with my Hillary colleagues in thanking all of you for being here to participate in this very important workshop. For us, there are at least two reasons why this is so important for us. One is that the nutrition debate is now high up in the global agenda and animal food is a certain part of that. And the second reason why we are pleased that this is happening is because livestock is also part of the big debate and the role of livestock on environmental sustainability but also on the impact of human health. Let me make a few remarks about both of these. One gave me a nice chart recently that shows that of 7 billion people, only about 30 percent are regarded as well nourished. About 20 percent or so of that 7 billion are supposedly obese and the rest are suffering from insufficient nutrients. Some are cute and so they go to bed very hungry at night. Overlapping with that are those who are stunted over 150, 160 million I'm told and 50 million are so wasted. So nutrition is a really big issue and it has evolved over time from calorie counting. Many of you are too young to remember but I'm sure some in the room would remember when we calculated the calories and calculated the population and divided that and said oh we had sufficient food and we're good. And after calorie counting we went to looking at how much protein and now I think we are beginning to understand this better that we're looking at micronutrients and the hidden hunger part. And that's where livestock hits the sweet spot because of the very dense high nutrients not only of good protein but of many of the micronutrients some of which are not found in plants. So we have to get this message that animal source foods is certainly part of the nutrition agenda. And I'm very pleased that some of that information is going to be presented today because I look forward to harvesting it and using it to promote livestock and animal source foods in this debate. And it's very important that we get this because the whole livestock sector is on some challenge. There are those who say if you want to save the planet you should get rid of all the livestock and if you want to protect your health you should stop eating meat at least. So the whole sector quite recently I was on a BBC debate with a vegan and a vegetarian this was quite interesting. I tried to defend the livestock sector and part of that defense is the very important role that animal source food means to so much of the world. At that debate I pointed out that my understanding is that for the first 1000 days it's almost impossible to meet all the nutrient needs without having animal source foods. I hope we get confirmation of that because I'd like to get on my soapbox and use it that it can't be done without animal source foods in the first 1000 days. If we can nail that down we have a very strong position to argue. But even beyond the 1000 days it is I suppose I'm told that you can meet the nutrient needs from crop based foods but you need a lot of diversity to do that. You need access to great diversity. In many in the developing world we at Ilri argue that animal source foods complement supplement in very important ways the poor quality basal diets of maize and cassava and so on which are the common diets of many of the poorer people. For those who spend forty to sixty percent of their income on food having rich sources of high density nutrients is very important to them. The other argument is that in the case of poultry for example an agade makes a big difference it's cheap it's relatively cheap in relation to other sources. So the divisibility at which this can be had small amongst you can get an egg or you can buy a chicken and so on. So it's not just the nutrients but how they become available to many in the developing world. So I'm really glad to have this workshop happening. I'm going to be in and out of it because I have a real personal interest in this. I'm charged with in my institution like all of us who work at Ilri well with presenting the case for livestock in the development agenda and nutrition is a key one of this and therefore this workshop is of immense importance I hope to all of you but particularly so to us. So let me thank my colleagues Delia and Isabel and other Ilri colleagues who are here for the partnership with Landau Lakes and with all of you USAID and the many partners who thank you for coming and I hope that when you get some free time those of you here for the first time with one wrong and get to know our campus and get to know us a little better. You're always welcome here. Thank you very much. Thank you Jimmy. John can you say something from Landau Lakes. Good morning. My name is John Ellenberger. I'm an unfamiliar face to most all of you in the room. I'm the senior vice president of international development at Landau Lakes a role that I have had for all of the past nine weeks. My background my background is in the commercial side of our business where I had read running our dairy foods business one of our primary businesses at Landau Lakes for the past nine years and I have a number of years prior to that in commercial business experience but this world of moving into the development space is quite new to me. So it's with great pleasure that I made the trip over to join you for today's conference I want to thank Jimmy for not just hosting this event but being a real partner with our team primarily Carmen and Jenny and others over the past number of weeks really actually the past year in total. We are very excited to partner with both Ilri and with USAID Tops program and others to help advance this important topic that Jimmy spoke so eloquently about about the role of animal source foods in delivering the nutrition that's needed particularly through the first thousand days of life. It's vital I think that the network of development resources that are present in this room and outside of it work together to solve some of the problems that have caused previous programming efforts to fall short of the potential reaching the potential that livestock and animal source foods can play in delivering the kind of nutrition outcomes that are so needed in those first three years of life and for families in general. Throughout this four part series I've come to learn we've really sought to advance the state of the art in terms of combining the deep research from Ilri and others with practical on from the field kind of on the ground experiences and that's a theme that will certainly carry through with the balance of today's program. It's important I think that you'll be hearing lessons from presenters that were successful but also lessons that have yet to change and need to evolve to become successful in the future not just a lot of Tory tale of successes it's also calling out those areas for learning and advancement and gaps because that's an important part of the learning process. Land O'Lakes international development is a very fortunate to have been played a very central role in this program. Many of you may know but maybe not all Land O'Lakes as a company has been around for nearly a hundred years but the international development activities of Land O'Lakes have been around for about thirty five and what's really vital to understand about us is that dairy and livestock programs have been the absolute core of our development efforts over that period of time and the fact that we've done about three hundred programs in eighty different countries speaks to the type of scope and scale and frankly the importance that we see for livestock programming overall. So this is a very very important topic for us. It's also important because it presents a great opportunity for our international development team to take advantage of some of the insights and capabilities that are resident within the for-profit part of our company and bring those to bear in terms of better programming and that's something that we brought into this program as well using some food safety and food quality ideas that helps to inform some of the curriculum that's been a part of this work series over the past year. I think you'll find today will be a rich day combined or including a number of meaningful topics number one the growing demand for animal source foods and also its growing importance in delivering nutrition outcomes in sharing the perspectives from the field that I mentioned both different approaches and also different lessons learned will spend time delving into the challenges that are found in improving nutrition outcomes and also taking on the question of how do we measure the impact that nutrition or that livestock programs can have on nutrition how do we measure program or how do we measure advancement for impact overall. We'll work today to get to both insights and recommendations to identify knowledge gaps areas that need further work and also voices that need to be heard in this process. So in closing I want to say thank you again to Ilri for hosting to our team for being such an important part of this program to the top program for providing the funding to help us all do this work. Thank you very much and I look forward to a wonderful day. Thank you John. Nine years and nine weeks was it and then nine minutes that's good. Okay. You referred to this as being the fourth in a series. Carmen maybe you can tell us what the series is. Carmen has been heavily involved in this workshop from the very beginning. She left for a while and then she came back. So tell us about this top thing. Okay. Good morning everyone. For many of you the last time I saw you I was very large and it was at the CRS nutrition conference. A happy day boy was born a week later. We're all good. So again my name is Carmen Jacquez. I'm with Landa Lakes. I'm the practice area manager for Dairy Livestock and Environment. As John mentioned for Landa Lakes we received a small grant from the USA Tops Program which is through the USA Food for Peace Office. Managed by Mercy Corps ACDI and a few others. Through this small grant we've been co-hosting four learning events over the last year starting in June last year. The first was a webinar in conjunction with the spring program another USA program really looking at some of the metrics around measuring nutritional gains within a household. Our component was really looking at the role of the benefits that livestock programs had on household nutrition and some indicators that were being developed through the spring program that we piloted on our Rwanda Dairy program. The second program was a very successful event in Washington DC very similar to today some of the same speakers but really getting at these issues that was more focused on the tension between production for household consumption of animal source foods to really investing in people producing more but that tension with the need to sell livestock products from an economic perspective. So market development versus household nutrition a bit of tension there and that was the focus of that event. That is up on the web that was also live streamed and recorded. So if you haven't heard about it we'll be sharing out some updates towards the end of the end of today on where you can get more information. The third event was Dr. Jenny Lane hosted through AgriLinks a webinar on safety and animal source foods back in January and then this is the fourth event and the final event so and you know we had to keep Nairobi the best place so the final for the best the best for the final. But again we'll share out more information and you'll be getting information after this event on all of those events. Thank you. Carmen so you'll see Carmen again during the day but also particularly the end because she has the task of kind of pulling together and making sense of our conversations as they go on. Okay so my role is really just to facilitate and manage the time and the process and try to make sure we have a rich and good day. I know nothing about nutrition and nothing about I said something about life I guess I know something anyway so I'm not an expert so I just do process facilitation for today so what I got to do now is just run briefly through the objectives of the meeting give you a little bit of an introduction to the process a little bit of an introduction to the agenda and we'll have a round of introductions. So I just want to remind you and John I think said a little bit about what he's hoping from today about identifying those gaps looking at what really works but these are kind of the official objectives so we're looking at livestock nutrition pathways and we will hear a bit more what they are how they can be used how they are being used and that'll be a piece of the first part of the morning we want to be able to demonstrate how animals source food and you'll hear animal source food research quite often by some people as ASF so this is not African swine fever this is animal source foods so we'll hear animal source foods or ASF quite a lot so we want to be able to demonstrate to illustrate how they can really contribute to those nutritional outcomes. So some of the questions Jimmy was asking we hope we can answer by the end of the day and the final objective really is to begin to the evidence. Ilri is a research organization a scientific organization and we want to really get what is the evidence what do we really know what really works so we're hoping to tap into all of that but also to engage it with that the practitioner element that I think John mentioned about the strength of Landau Lakes really is bringing in what the practice what the practice shows and many of you in the room from the NGO sector are deep in there what evidence do we have and what does it look like and when and how our nutrition results are achieved that's the aim objectives of the day that perhaps a bit more ambitious than we might be able to do in a few hours but that's what we're moving towards we're hoping that the end of the day you go away with some takeaways now takeaway food is not always the most nutritious but we hope you have some takeaways particularly I want you to have you we ask to increase our knowledge about the contributions that ASF have on improving those nutrition outcomes and the second one is tangible advice to better support nutrition sensitive programming yeah so it's really about improving our knowledge but also improving getting the good advice and the advice is not necessarily only from the speakers we hope to tap into you in the room here so that's why we're here you have a package you have an agenda I put it up here just so we can run through a little bit where we are and how it looks so we're now at the session around welcome and introductions we're going to spend a bit of time before the coffee break almost called livestock to nutrition 101 now we understand there's quite a few people here who are nutritional experts there's also called agricultural experts livestock experts and probably other types of experts so what we wanted to try to do was use this session to come to common playing field common playing field in a sense so what are animal source foods how do they actually contribute to nutrition what is the kind of biology, what does the science say and Jenny is going to take us through that the second part are these livestock nutrition pathways what are they, how do they work, how can we use them and Delia will introduce those fundamental notions that we will come back to in the rest of the day so the first part of the morning before the break we'll really just focus on this 101 101 is one of those things they have in American universities you have kind of math 101 it means like basic another country you may not have a 101 but anyway that's what 101 means so by the end of that session we should all be on the same kind of level more or less after the break we're going to dive into the evidence we've also added the phrases there assumptions and practice because when we were planning this we found it quite difficult actually to actually dive in and find who actually has all this evidence that we can share so we have three presentations Delia will talk about the results from a big study that was done together with Chatham House and I think with Illry looking at ASF, well livestock derived food a slightly different term on nutrition in the first thousand days and that was something that Jimmy mentioned this first thousand days so there's some real evidence a kind of a global review there the second thing we're going to hear about is guidelines technical guidance for program planning and Paul Paola will present that I think this is derived from some FAO guidelines so we're going to hear what's the official kind of guidelines and then the third present there is Robin Alders and she will give a real concrete example from Tanzania about how poultry interventions have impacted on household nutrition we hope to have more of those cases but when we sat down and planned it was quite difficult to really say actually where is the science that proves some of these things so that's going to be in the morning after lunch we're going to go into practitioner design aid exercise that Jenny and Carmen will take us through one of the products by Land of Lakes to help people do this better we're going to have a couple of hours working through that exercise to see what it does, how it works how it can be improved and then we will conclude with a summarizing session making the case for livestock for nutrition so that's what the day looks like you have a timed agenda ladies and gentlemen the next stop of this service will be Christmas if you're leaving this evening we also have to bear in mind that we have the people online they will be opening in and joining in between questions and suggestions talk a little bit about process there are going to be a few presentations they're going to be quite short Paula wanted to have more minutes than she was allocated but we're going to try to keep it short and focus to allow space for interaction and discussion amongst us we want to really tap into the experiences the experiences in the room so although it's about generating advice it's also about harvesting advice we're going to do an under-appreciated foods exercise I'll come back on that but please already begin to think about are there some nutritious under-appreciated or less well known foods that you think should be more prominent in this agenda so begin to think about that talk about that we're going to have a lot of Q&A sessions so we want you as you go please you have several cards in your folder and I think before the meeting to identify burning questions or boiling questions or hot questions we want to get your questions so please if you have questions that need to be answered please do write them down and I think, I'm looking at Jenny maybe Jenny will help to collect we can stand up for a second Jenny and if you have those questions please share them with Jenny you can do it some coffee and tea in lunch or online or by email so we want to make sure we capture those and respond to them also online if you have questions as we go along we need to have those we're going to be face to face here 40-50 people we think there's going to be a crowd online there are some already as the time zones move we expect more people to arrive this afternoon so we will try to make sure we engage with those people but just be aware that there's a whole other crowd out there and they will be listening so if you have the microphone they're going to be listening so I think there are people here on Twitter so we have a webinar with a chat people can ask their questions with the chat there's also a Twitter where people are talking about what's going on here let me just mention a couple of more process related things we would love it if you turn your emails off unless you're on Twitter or something like that or on some other social thing where you're sharing there is internet in here it's a decent internet but please be with us when you're face to face let's use the time together please turn your mobile to silent just so we can get into the room together if you want to make phone calls please go outside let's use the coffee and tea break toilets are outside that way we're going to be taking photographs of you if you don't want to have your photograph shared or taken please tell the photographer they will also probably go online they may be shared with the whole world you may be liked by Mr. Trump so be aware that we're very careful with what we do with the photograph but if you don't want your photograph to be used that's very important that you know that we're not going to abuse your photographs anything else I'm looking at Jenny or Carmen that I've missed as we go along we will be coming up with some other interesting exercises then I'm going to do an introductions exercise we're all sitting together in the room here people who are not here you're going to have to do this on your own online but for those of us here we're going to have a chance to stand up to each other briefly and engage I saw outside lots of people hugging and getting to know each other there's obviously some people who know each other quite well in the room but most of us don't really know each other so we're going to spend a little bit of time getting to know each other and we're going to do an exercise where we stand up there's a statement on the wall which says livestock products are a luxury food and hence not very relevant to the nutrition of poor people I want you to think about that for a second I want you all to come to the front of the room and I want you to stand if you fully agree if you think that's exactly I want you to stand over here somehow it's a bit chaotic if you totally disagree you do stand over here and if you're somewhere in the middle well you can stand in the middle so if you can think for a second where you want to be and come and stand mind you, livestock products are a luxury food not relevant to the nutrition of poor people please stand where you this is fully agree fully agree is here they are a luxury fully disagree over there oh my gosh wow this is incredible let's see how are we doing let's see I'll let everybody come to the front stand where you think this is yeah I'm trying to block it yeah it's a bit yes okay where are you standing can you come to the front come to the front please yes okay so we're gonna try to some people are plugging themselves in here so are you standing can you come we need you in the front so we can move you around or you can move yourself around Jenny you need to come forward you need to come out of your chair somehow and try to stand so I'm gonna look for the person who is most at my back okay wow right it's obviously the question where there's quite a lot of consensus it looks like I'm gonna stand let me see you're the most on the left are you standing where you want to be okay good that means that you tell us tell us why you disagree who are you my name is Rose Kihara I'm a lecturer in Strathmore University I teach food science and nutrition I disagree because as Jimmy Smith stated poor or rich nutrition animal source food is very important and I've worked in several hospitals for example Bugatti there are people who are quite poor good there and they all of them eat well depending on the age but they eat animal source food they are poor and they eat animal source foods not a luxury not a luxury do you have evidence on that from the hospital I ask them a question I don't think I need to okay we'll come back to hear the scientists later on so you're actually in reality you want to stand over there somewhere okay is anybody really standing a bit in the middle or on this side yes tell us who you are my name is Melinda Schmidt and I work with Farm Promotions Africa and we have engaged in the work with dairy farming now in western Kenya for the first time up to this point we have focused mainly on crops we're not a nutrition based organization and I'm not a scientist at any time so I have limited evidence to offer for anything but what I'm aware of is that animals take a higher level of skill and effort and resources to keep so it's been really enlightening for our organization to start working on this program I think luxury and not relevant are very extreme statements but I don't agree with animals who obviously are important to everyone in every context but I think it's important to acknowledge that it's more complicated for people to keep standing in the middle which means you're not a full believer you're not in full agreement that they are luxuries no I'm not in full agreement with luxuries or irrelevant I wouldn't agree with those statements my feeling is more that it's important to acknowledge that it is more complex to get people to be able to keep blood stock even if we agree it's important that they do it so it might not be the starting point okay good, complexity anybody else standing in the middle yes I'm called Dr. Odedez and I work for today I hail from a rural area and the rural area in the rural areas where I come from everybody would wish to take animal protein but you find somebody has milk they'll sell all the milk because they believe it belongs to people who can afford the milk and they will take it without milk and if you look at the setting when animal protein is taken mostly when they are getting so it's taken when the occasion cannot be avoided but it is not that they don't want it but they can't afford it so it's a lot better I'm going over here are you standing in the middle or where are you standing tell us why you're in the middle who are you for why you're standing here I'm Gizal Odedez from Ethiopia I'm in the middle I've struggled a lot where I should stand because as an Ethiopian we have our own tradition and we respect that tradition and referring the rural area and me as an agricultural expansionist we consider animal source food as a luxury food and that's why the consumption of meat animal source food is very low even in comparison with our own neighboring East African countries but me as a scientific touch and working for integrated human nutrition program in Ethiopia with Landon X for the last five years we call it engine empowering new generation to improve nutrition and economic opportunity which we got the second phase that grows our nutrition program which is an integrated human nutrition program in West so I'm more of on that side but taking my population and my touch with the nutrition I prefer to put myself in the middle you're speaking as yourself for Rosalindor Lakes you seem to have to identify there yourself okay let's go over here and go all the way to the back somebody has his back to the wall which means you fully disagree with the statement my name is Timodin Zioka and I work with Landon Lakes I disagree with the statement I come from a rural setting yes and I I've only known animal source foods to provide basic nutrition for children within my family and within the community where I've grown people are able to keep chicken inexpensively you let them free if it doesn't cost too much unless there is an outbreak of disease it is a source of protein through the eggs when they multiply quickly you can throw out one whether it is for holiday and it is a very good source of nutrition and I don't consider it a luxurious just a very big comment on the milk it's true people don't know milk but from my experience not only from the village where I've grown up but everywhere where I go in Africa communities people know how to feed their little ones with milk that they produce in their cows and they have got so if not a luxury it is longer you can be a bit shorter because it is quite long statement it goes to the very very even further than you my name is Ibar Dider I work for Sidi Africa Limited in northern part of Kenya I completely agree where I come from the most important thing is actually you don't spend you don't need much technology for the skills to keep them and for that reason I believe it's not a luxury they are cheap to keep they are not luxury my name is Robin Alders I'm a farmer from New South Wales in Australia I also spend some time at the University of Sydney with food and nutrition security resources I believe that animal source food is not a luxury because it's extremely difficult to live healthily and to have young children conceive and grow health well if you don't have an animal source food component to your diet so I believe it's essential so therefore it can't be considered a luxury I'm going to go over here to the lady yes that's why you are here hi my name is Marma and I'm with the Welsh Food Programme I don't know if I'm getting in the middle but I just want to say because actually I am helping design a programme in CFS so what you said resonated but because of the engine programme I felt that meat animal source protein is extremely relevant like you said to nutrition status of children where the protein is really high and we have found that life cross is available and people may not have meat and they might not understand that it's really important to develop more food so for the luxury once they understand the usefulness have you ever heard about the streets for the luxury ok let's go on my name is my name is Marama I'm serving for pediatrics looking at that to have meat and meat products as well as eggs which are very clear to be very beneficial to both the good and the bad then secondly I also do with my colleagues that they achieve especially having grown from the rural and then maybe I can forget in the urban we see they've been in the urban population in the slums currently in Nairobi even keeping doing small life is very beneficial so coupled with nutrition education I think it can work those poor people have them it means enough luxury I'm attending a kawabina here I'm attending a kawabina here I'm attending a kawabina here I'm not outrageous but you know it's obvious we don't need to do research on it unless it's for a religious reason the food the food that is always available to us where we grow up and it's not toxic we should be able to eat it and in many places there are nothing whether insects or whatever so we just do research for the sake of it where do you work tell us who you are I can't see your name there oh here we go from your root and your canyon any more perspectives on this you are saying that animal food is not a luxury for many but really Charlotte Newman's research which I was involved in years ago that risk project proved that you need only 10% 10% of your diet to be animal food and it makes a huge difference so when WSP says we can't tackle chronic malnutrition just because animal foods are missing ok I'm a scientist it sounds like a very well informed grandmother anybody else got a perspective on this women are coming what are they saying Mahub I don't know where you're from but we are very convinced that we are very determined that a nutrition food and a complete diet is a basic human right he strongly disagrees with the statement as let me get up here Emanuel Kadoubi strongly disagrees so they're all standing over here as well and we've heard there's a human right it's not a luxury it's a right we've heard about it being if it's affordable it's not a luxury we've heard about it being the evidence says it has to be there let's take another question I'm going to put this one up here you can't read it maybe you can move the water so what it says is producing more animal source foods will result in better household nutrition if you agree on my left if you disagree over there please yes producing if you're in between producing more animal source foods will if you if you agree with that statement you're on my left here over here if you agree over there if you disagree yes so this is all about producing more ASFs will result in better household nutrition if you produce more your nutrition will improve right agreed disagree there's a middle can be a middle you can choose okay right I'm going to go over here to the lady who strongly agrees her name is Mary particularly milk as the animal protein it's a complete food in itself so you have milk in the house and you've sorted a lot of issues particularly on the the basics of what you're picking from the food you eat so milk is a complete food in its own but because you produce more of it does that mean your family will be a better nutrition once you take a glass of milk every day you are sure that you have enough of what you need and also meat but milk is the number one animal protein you have milk and you have it all lady here strongly agreeing I'm strongly agreeing with a condition that with nutrition education then everybody will move over yeah because if you're producing you can consume them and then you produce more of more market value you can sell and with nutrition education you use the money to purchase other nutrition food I suspect you're a nutrition education list okay let's go to the lady over here you strongly agree yes hi my name is Catherine Moreira I work with Afeatimiza located in Afeatimiza, Amherst yes and located in Turkana I strongly agree to the statement first I support my colleague that milk is a very important food component on its own when it comes to animal food surface and second of all in Turkana children are the only people who go to migrate they go to take care of them to graze animals and with that when they go to graze animals they do have food in the field yeah so the only source of animal food animal food is blood they drink blood with that they have energy they have iron on itself thank you so are you saying that as the children graze the animals and because they are producing more they get more blood okay more energy okay let's go to the disagreeers let's go over here find somebody who disagrees I did have someone over the grandmother said it all depends so let's see tell us who you are or why you stand here I'm Mildredi Rungu I'm standing here strongly disagreeing the production does not equal to consumption so the statement as it is does not hold because they should have food production and consumption but just production no okay so more isn't enough the lady over there said if you have nutrition education it is enough she added something to the recipe Jeff Dahl with and I'll reference a U.S. movie this is not the field of dreams you can't build it and they will come there as we heard with education we need to train people to consume because we've heard in Ethiopia it exists but we need to train the importance of having such things so as a statement reads alone you can't just produce more and expect an outcome okay good any more of this side yes okay yes okay didn't the slide move can someone to read it for me probably I don't know there's a health hold nutrition there's a health hold nutrition there's a health hold nutrition you've already spoken I'll come back to you let's go to the lady here yes thank you my name is thank you my name is from the University of Nairobi I totally I okay the question is does producing more mean that the health hold nutrition will be improved no thank you that's a very good mind there isn't why I say so for one you need nutrition education to educate these people that's number one that has already been said secondly you need to empower these households so that they can be able to access the other basic needs because if they don't have other basic needs like just the basic flour to make the oogali, vegetables cooking oil soap they'll definitely sell these animals to be able to buy those basic needs so it's not always a guarantee that if they produce more of these animal products they'll be able to the nutritional status of the children and the mothers and other vulnerable members of that those households will improve no okay so producing more doesn't mean the vulnerable people's nutrition will improve okay other people's nutrition might improve aha okay my name is Sylvia Alonso from Illery I have nothing to add I mean it's exactly the same as the other state I think what I don't agree with in the statement is the word will so it's you know forcing that having more animal sources could use will translate nutrition it's good it may but they need sort of things Spanish speaker correcting my English very good Christian Gravez I'm an independent consultant and I agree with most of the statements over here production does not equal consumption but sometimes it can but what I what I wanted to say is that nutrition education is also not always the answer so it's you know production plus nutrition education also does not equal consumption in all cases it's complex sociocultural issues economic it depends on the very specific context you're working with them you're standing more in the middle so you're not totally disagreeing yes you're in the middle tell us who you are and why I'm Hannah I work for caves caves yes and I agree with the Christian because what happens is at times it's by producing more will consume by default and in turn will actually improve household production it happens a lot especially in poorer communities because if there is excess milk and there is no even market for it the children will be forced to just continue drinking the milk because it's actually there so this is a market failure it might happen so we should be promote ok so market failures can lead to better nutrition ok interesting I'm Daniel Mohinja I'm in the middle you can produce a lot sell everything and buy the wrong food so production alone is insufficient it's one of the possibilities so you need to produce and consume what you produce I'm Linda Chang from CRSK production alone how about the quality of the production there's more it's better I'm Don Brown I'm in the end of Endocrin I'm an ag economist and actually I agree with sort of Christine just having additional food doesn't mean the right people get it you have a whole question of the world education marketing systems a whole series of various sort of operations that have to go between the production and the actual consumption you mentioned the right people the people I think there's assumption that I mean the target is really people who do need more nutrition and those people often times are left out because they are not part of the system at all and so it is the need to put in place the sort of linkages between the production and the people who are really desperately need for the better nutrition so if you were to target those people to produce more would they eat more I don't think, you know the production a lot of times many people who really need the nutrition are not even in the farming sector and so one has to think beyond just the fact that if you produce it on the farm you consume it on the farm and that deals with your problem that's only a small part of it let me go over here whoever you are I'm Sophie Walker from ACDI Worker I think I come back to economic questions as well none of the statements are necessarily wrong but can you afford the asset of the livestock can you afford the asset of feeding the livestock before you can even then improve your nutritional status okay Celia, thoughts on this yes I agree production can lead to consumption and certainly it has a positive effect the more that it's produced the more that it's going to be consumed so on the whole it is a positive thing but it is not an absolute and inevitable thing and just to say also I think we do tend to look always for the silver bullet sometimes behavioral change communication is now it but it's very important again but it may not be enough we can't just rely on BCC either to deliver us good nutrition BCC that's something we do with an email right? sorry this is to be an an acronym free day behavioral change communication okay behavioral change all right Archie and Emmanuel are very good typers both disagree strongly with the statement Archie says foods derived from animals are an important source of nutrients to provide a critical supplement and diversity to keep them at base diet animal source foods provide more and higher quality protein than plants as well as important bio-available I think Archie is a nutritionist and is available including iron, zinc, micronutrients, calcium and vitamins A, C and B12 which are often deficient among poor and vulnerable populations Emmanuel completely disagree we need to first to educate the significance of taking animal source foods producing more without awareness will not have a greater impact education comes first followed by practice we're hearing again I have room for two more yes I'm in the middle I just want to I wanted to add that I think it depends on the animal source food do I agree with everybody else but it also depends on the life itself and the animals the goats are much different than the eggs and goat meat producing more goats animal food people I think arrangements are not always recognized because we may leave a lot of food I think that a lot of food but it's actually a lot of money for saving No more Yeah, we've got a lot of for more division and my argument here is why people Yeah, yeah. Yeah. Why I think these will help to improve is because why? Multiple don't access the animal because they are affordable. They are not accessible. So if you do the production to be cheap, you'll be affordable, and they will be able to access it. Thank you. Producing more makes it more affordable. Yeah? Okay. My name is, my name is, I'm in the middle. I am a gracious from Land-O-Lexish, and I believe that the production has no linear correlation with consumption. If you produce a high value animal food product, like milk or meat, does not mean it's affordable or accessible or is consumed more. So it depends on what value that product is. If it has more commercial value, it will not be consumed. Okay. We're going to go back to Jimmy and then John. Jimmy, what's your take away from this conversation? It's a very complex issue, obviously. And it is because we've done some studies on this many years ago. We've done the operation flood, for example, in India, and a couple of other cases. The economic argument is that people who spend a high proportion of their income on food, their most important need is disposable income. So anything of value they sell. So people sell whatever they have to get more disposable income, and they might buy food, but not necessarily animal sources. People's income rise, they come an inflection point when they begin to consume more at home because the demand for disposable income is not as strong as it would have been in the beginning. So it's a very complex issue, and it has to do with how much your need is for disposable income. If you don't have money, you will sell anything you have, even if you know it's good for you. So the common inflection point where your disposable income rises, and you begin to consume more at home. And this has been the studies that I know. So the studies. Is there some evidence behind all these points? Yes. I mean, the operation flood, probably the biggest dairy project ever had in India, that it gets a lot of acclaim for pulling a lot of people out of poverty and also addressing nutrition. A significant study was done on this issue. People did not consume more at the beginning, but they did later on. Yeah, the question was, producing more animal source food will result in better household nutrition? The question says, producing more animal source food will lead to better nutrition. The question does not say, producing more animal source food will lead to better household nutrition from animal food. Nutrition. I mean, it could be that you eat more, you consume more animal source food, but you have better nutrition. We're running out of time, so I'm going to go to John. John, the companies, the farmers that produce all your milk is a private company, not the international bit. Are they more nutritious because they produce more dairy? I'm sure that they are. Are the producers themselves? Is that your question? I would hope so. I don't know, perfect. I would assume that they are. My summary comment is, I think that this particularly the second question proves that there is a lot of strong opinion and that the topic of what has been discussed over the past year and will be discussed in the next few hours is a really worthwhile one because those are very rich and important areas to explore. Thank you very much everybody. Please go back to your seats on the way. Shake hands with everybody in the room. Shake their hand. If everybody in the room. Yes, yes. On the way to your seats. Shake the hands with every single person. You're the first speaker. Did you shake all the hands, Delia? A lot of hands. Make sure you shake all the hands, but you have to be walking toward your seat as well. Please shake and walk. Please shake and walk. Nice to meet you Joyce. Nice to meet you. Nice to meet you. It shouldn't be my question too tightly. Good. Okay. Thank you for that nice introductory session. The questions were designed really to try to elicit different perspectives and views. Question two was more successful I think than question one. Now we're going to shift and we're going to take you to Livestock for Nutrition 101. And we're going to start with Jenny, who's going to introduce Livestock for Nutrition 101, I think. And then right after that, Delia will come up and talk about the pathways. So, we need you to be doing some active listening. This is not just PowerPoint fatigue. You watch, you need to listen to presentations. I'm expecting you to ask questions and we'll come back on that. Jenny, over to you. Are you ready to go? I'm thrilled to be here. As Carmen and a few other people have alluded, this event has been a long time in coming. We've been planning it for over a year and through the whole series. I'm pretty clever at the end and thank you Peter for being such um, yay. And I don't know what I'm going to do off all my free time after this. Thank you to Ilri and especially Delia and Pala and Peter and Junie for hosting us. When I first found out about Ilri when I was back in veterinary school a long time ago, I always wanted to come. So, it's really exciting to be here and it's getting community people and I'm excited to meet everybody else here at the conference. And Atlanta Lakes are really great for any of you. Thank you very much. I'm here this morning to start things off by talking about animal source food and just how, just kind of how they can contribute to nutrition. And being in a room that has a lot of nutritionists in it, it's a little bit intimidating. But I'll tell you kind of my perspective as a veterinarian we explicitly know just how important animal source foods are to nutrition. He talked to Enfarmer who lost a cow. The mom a cow. And they have to raise a calf on milk or things or put that calf on feed really early. That calf does not grow well. They get sick. They get diarrhea. They are corduers. And we are also mammals and you're really not much different. So, this is, this session is really just going to cover briefly touch on childhood under nutrition in the first thousand days and then really get into why animal source foods are so good. I'm not going to be able to cover everything. But, and there's a lot of different arguments out there about, on the, again, arguments against livestock but it's just a lot of the rest of the day to talk about that. Just want to talk about the nutritional contribution of animal source foods to human diet. Briefly, the reason why we're here today is that globally malnutrition in all its forms is, it's still a major problem. Globally under nutrition reflected by planting, wasting, and micronutrient deficiencies persist, despite there's actually enough calories on this planet now to feed everybody. And almost a quarter of the total turnover from the world has attempted. So, that's 156 million children. And the total number of children in Africa is actually increasing. It's not decreasing. So, back in 2000 there was about 50 million attempted children and in 2015 that number is almost 59 million. And hidden hunger that Jimmy already mentioned is a really serious issue because those are micronutrient deficiencies and they're persistent problems. And almost one third of children around the world are vitamin A deficient. And close to 20% of children are immune X. Globally about 17% of the world is zinc deficient. And almost 30% of the world is iodine deficient. And micronutrients are essential for growth. Cognitive development and immune function. And they do all sorts of things at the cellular level. And we've really found through research and kind of through this progression of do we have enough food in the world, do we have enough protein in the world, do we have enough micronutrients and dietary diversity in the world diet quality and diversity as is as important as diet quantity. And just in perspective so globally around the world children under 5 deaths can be attributed to either directly or indirectly through contributing to other causes. It's still a major problem. The first thousand days, so just so we're all on the same page, the first thousand days is the time from conception to the child of two years old. Ladies and gentlemen the next stop on this service will be children of the child of one next age. Critical during this time period and then beyond during life. And it's a critical time period for development. And we know that diverse safe diets that contribute to adequate nutrition are vital to childhood growth and cognitive development and ultimately the economic trajectory of a country. So it's really important at the individual but also a very global level. Alright so how do animal source foods get involved into this picture? Animal source foods including meat which includes red meat, poultry, pork, fish and awful, as well milk and eggs are food based solutions to many under nutrition problems. And how do they do that? They provide high quality protein. They are calorie compact and they provide abundant and bioavailable micronutrients. And possibly they might be nature's perfect food. They were designed to feed other animals so they are pretty compact and they contain a lot of really good stuff in them. So it makes them so good. Animal source foods compared to plants they are rich sources of nutrients, fat, energy and protein. And plant foods are often higher in compounds like phytase and oxalase and fiber which inhibit absorption of some micronutrients. So while certain vegetables like spinach and legumes might have high content of certain micronutrients like iron or calcium they're also a lot harder to absorb. Those nutrients are a lot harder to absorb than the micronutrients are in animal source foods. Animal source foods are also the only dietary sources of vitamin B12 and vitamin D. And that doesn't just include fortified milk. There are sources like slivers you can find vitamin D in other animal source foods. When I was putting this presentation together I was googling for photos of B12 which is this compound up here. And a site came up and you know that kind of takes you down the rabbit hole. And I said what are the best vegetarian sources of B12? I said oh, let me see what this is. And they're all animal source foods right? It's cheese, milk, whey powder, eggs. I guess the vegetarian is not vegan right? But it just tells you they are critical to get these micronutrients. And animal source foods are also a great source of vitamin A, vitamin E, heme iron and heme iron is the type of iron that's easily absorbed and it's what's active in the blood cells zinc, calcium and riboflavin. And a lot of these animal source foods deliver many of these micronutrients in one compound package. Alright. So I thought it'd be really kind of nice to back up a little bit and actually just think about what's in actually some of these animal source foods. You just lump them in this one big pile but why is milk so wonderful? What's in milk that fits really good? Milk is a good supply of vitamin A, B12, riboflavin, folate and calcium. So vitamin A is really essential for sites and the function of your retina. Vitamin A is often known as there's a form of vitamin A called retinol. There's a reason why it's called retina and retinol. And it's also important for immune function. Vitamin B12 is required for metabolism in every cell of your body. And it's particularly important for brain and nervous system function as well as the formation of red blood cells. Folate is super critical for neural development and rapid cell growth so you can hear about women taking prenatal vitamins is often folate. It's important during growth so pregnancy and pregnancy are critical times for folate. Calcium is essential for bone growth. And milk consumption has also been found to stimulate growth factors in the body such as insulin like growth factor which is also very important for bone growth. What's an egg? I think this has already been mentioned but eggs might be one of nature's most perfect foods. They contain all the necessary nutrients to support the development of a chick. And they are a good source of protein and some have lots of fatty acids. They're also sterile when they're kept well. They're fairly shaped with shelf stable and they don't need any fancy storage. And they're also a really nice size right? It's like the perfect little snack full of protein and lots of really good stuff. Eggs are also a valuable source of choline which is gaining recognition for its importance in fetal and young child brain development. So among other things, choline is a precursor to something you might have heard of as a fetal colon esterase which is a neurotransmitter so you can imagine if it's a piece a part of a neurotransmitter it might be important for brain function. Meat is especially a dense source of animal source foods. It's an excellent source of protein. Team iron, zinc and B vitamins and around the world iron deficiency is one of the most common micronutrient deficiencies in the world over 30% globally are anemic and a lot of that is due to iron deficiencies which are then exacerbated by infectious diseases like parasites, HIV, AIDS and malaria infections and personal parasites. In developing countries it's estimated that 50% of all pregnant women and 40% of young children are anemic and anemia also contributes to 20% of maternal death so iron is really critical for red blood cell function and muscle function and zinc is also important for immune function and pregnant women and young children also have particularly high zinc requirements. So just as an example of how efficient a small amount of animal source food is to contributing to vastly increasing the nutrient content of a diet. So if you look at this to meet a young child's average daily requirements for iron or zinc they would only have to eat 60 grams of meat which is half the size of a duck of cards or 1.72 kilograms of maize and beans which is just way too much for the size of a small child's stomach which is impossible. So this chart is just a brief summary kind of going through why they're so invaluable and what in each one that I think is kind of good to think about not just lumping them all together but what you get out of each so what evidence is out there? There is not a whole lot that really shows that about animal source food the value and the consumption but it's growing and there is some and a lot of it is actually quite old. So back in the 80's researchers found that in the vegetarian diets of rural kids in Egypt, Kenya and Mexico those diets were deficient in vitamin A, vitamin B12 riboflavin, calcium, iron, zinc so micronutrients in animal source foods are all very rich in and there are a lot of other studies that there are some other studies not a lot that have looked at animal source foods consumption that have found significant improvements in growth cognitive development of children consuming animal source foods versus control groups that work and one interesting study was that a study in Kenyon Toddlers found that the best predictor of cognitive function at five years old when they were five was looking back with previous intake of animal source foods and that was even controlling for households, socioeconomic factors and duration of schooling and some interesting work that was presented at our event last fall is by Laura Iannotti coming out of Ecuador they found that daily egg consumption in children six to nine months old reduced stunting by 47% and that work is ongoing and I'm really excited to kind of see where that goes because there's a lot of really good stuff there so the million dollar question really and what you're all here to talk about today is we know and like our grandmother friend told us we know these foods are so valuable and have so much potential to improve nutrition but it's just how to do it better and that's why we are here so with that thank you and Shisha Wumba is the field of goodness campaign from a dairy project thank you good we're going to move straight into 101 the second part Delia is going to talk about the pathway so you set her up um my dear 15 minutes thank you and I'm very glad to be here my name is Delia Grace I'm here based at Illry I co-lead the program on animal and human health I'm a veterinarian and an epidemiologist by background and for the past 10 years I've been looking at the health effects of livestock the human health effects which has been mainly zoonosis emerging infectious diseases antimicrobial resistance and foodborne disease but an increasing part of the research interacts with nutrition so I'm not a nutritionist but I'm interested in nutrition and this presentation I'm going to talk about the pathways how the links between animal source food and nutritional outcomes some of the key messages are just why we need to think about pathways how pathways can add to our understanding of this issue a take home message there are many different pathways many different models for understanding pathways and at the end of the bibliography with some of the most widely used models however there is only one pathway which has ever been developed for animal source foods in particular which of course is our topic today and that was a pathway developed by Thomas Randolph myself and other colleagues and that's what I'm going to present on in most detail but a summary for these pathway models I would say is all are wrong and all are useful and we're going to hear a little bit about why that is the case an important message then is that the preferred model the chosen approach or model is very much dependent on the context and then going to just talk briefly about what's new what's happening in this research field and that will be a quick summary of the presentation so I think we're preaching to the converted here I don't need to tell you about how important livestock are to the poor and all the different roles they have and how common livestock keeping is among poor households and of course this has been known for many years and in the past decade there has been growing importance given to the question of nutrition so the whole area of human development encompasses many areas from livelihoods to income, to equity, to empowerment but in the past few decades there has been realisation that nutrition is pretty key to many of these things and that nutritional outcomes are often fixed in the first few years of life and good nutrition which is missed out at that stage has long-term impacts on earning and cognitive abilities on a host of other issues and also that one of the best ways of improving nutrition is animal source foods for the reasons which we've just had a quick summary on so that of course leads to a very clear and compelling logic that livestock keeping creates animal source food and animal source food improves health and nutritional wellbeing so livestock keeping therefore needs to better health and nutrition QED however when we actually look at the evidence and there have been many reviews on this in the last decade and these reviews, each review looks at many different papers so these are a relatively, these are a stronger form of evidence than any individual study and it's pretty clear that there is no overall evidence that agricultural interventions lead to nutritional outcomes and more recently there have been a couple of individual papers which have had a little bit more promising results but we must say that these are rather ambiguous and some say yes some say no and also most of them have had issues with design so we can still say that the best evidence is there isn't really a strong case to say that livestock keeping improves nutritional outcomes and of course we want there to be and we want our livestock program to improve nutritional outcomes so what can we do to make that happen and this is where the pathways come in so I mentioned that the sort of the most obvious and an important pathway is animals livestock keeping leads to animal source food leads to livestock eating leads to better health and nutrition and of course this is led to a whole area of research around the question are livestock keepers livestock eaters and the answer is it depends sometimes they are sometimes they aren't if they aren't they won't receive many benefits and they're more likely to be livestock eaters when they're producing eggs and milk than when they're producing meat but then that takes us to the next pathway the market linkages and this is when livestock keepers sell their livestock products and with the money they may do different things one is they may buy food and they may improve their nutrition some of that food may actually be livestock source food so they may get some back but another thing they can sell their livestock products and buy things which are not nutritious but otherwise contribute to household health but the other thing is that they may sell their livestock products and buy things which don't contribute to health and nutritional well being things like well beer is the example and often used when you sell your milk and buy beer that may not be very good or you sell your livestock products you buy things like televisions or other things which may be very important to you as a household but they may not improve your nutritional well being so here again it's very much it depends it depends on what you're selling what you're buying and there's a whole interesting area of research and what they call mental accounts which means that people in people's minds money doesn't come in and out it fits in different boxes and it very much depends on what you're selling and what you're buying to whether you get an nutritional outcome or whether you don't and then the last pathway which we're looking at is the one which we have been looking at particularly in Illry I would say of all the different pathways the Illry pathway is the one that gives most attention to this and I would argue that when you're looking at animal source food this is a pathway which needs a lot of attention and that is the pathway of zoonosis and foodborne diseases a recent study came out by the World Health Organization the burden of foodborne disease has been massively underestimated it is equivalent the health burden is equivalent to the burden of malaria or HIV AIDS or TB for every $100 spent on HIV AIDS or on TB there is maybe a scent spent on foodborne disease so foodborne disease is a massively underestimated problem and of all the foods which are most implicated in foodborne disease the single most important is animal source food so this third pathway can risk to undermine the good that you're getting by your livestock eating or your livestock selling and then the fourth issue is that none of these pathways positive and negative act in isolation but they're all in a combination in a complex system which involves all sorts of other issues around especially gender empowerment childcare equity inter-household distribution inter-household distribution crops what's going on in farms what's going on in ecosystems systems and then when you put it all together you end up with this is a said it was the early pathway which some unkind people have called the spaghetti approach to pathways because on the surface it is very complex but I tried to show you how it was built up and it's built up from simple elements and we believe that incorporating this complexity is actually essential the negative and the positive feedback loop understanding why or why not livestock keeping leads to nutritional and health outcomes which of course is the thing which we are ultimately interested in there are many other pathways these other pathways break it down in different routes different ways but basically they all sort of do the same job so the take away message is if you want your program to have a nutritional outcome you need a pathway which pathway you choose is probably not so important choose one which makes sense to you but think about if what are the problems in your context if you are in a context where there's a lot of maize you may want to think of acetoxins if it's a context where it's milk you may want to think of milkborne disease and zoonosis so I'm going to do a couple of slides just to finish up our kind of a quick update on the latest research on this as I said there is still one pathway which everyone can use in every circumstance if context specific there is still limited and ambiguous evidence I started off by saying that the big question does livestock keeping leads to nutritional outcomes the answer is no we haven't got to when you break it down to specific pathways there is still limited evidence but it is growing and it is clear that some pathways and some foods are more likely to lead to nutritional outcomes than others and that leads us to the benefit of picking what we might call winners and a recent finding from Isbury who is the center who leads a lot of this nutritional work and we work with quite closely it was quite nice to see that one of their recent findings was that animal source foods are the most promising for agricultural based intervention if you care about nutrition and among the animal source foods the milk and egg seems to be particularly promising but I would say a take away from this whole field which has been a hot topic El Fira which is a UK kind of agricultural institute has just done a big review of 150 active projects looking at how agriculture projects and research can lead to nutrition they've come to the conclusion of those 150 less than six will be able to show any impact by the way and I would say one of the findings from this is a sort of a feeling that agriculture is not enough and especially at Illry we are moving increasingly towards market based approaches we think farms are important, farmers are important but we think agriculture to nutrition is really only going to get as part of the way and we need a much bigger emphasis on markets if we're to go all the way. What's new and many of these pathways they were developed the first were developed more than a decade ago they've been updated over the last decade but many of them for example don't fully include some of the hot topics on nutritional outcomes especially the gut microbiome how keeping livestock some interesting papers from western Kenya the first to show how humans share gut bacteria with livestock it's been shown that in America and other places humans share with pets but this is the first one sort of showing it with livestock what does that mean this whole issue of aflatoxins could that directly insult the liver and gut resulting in stunting, sanitation huge in India you may have all the nutrients you want but if the sanitation is poor it's not going to work food safety my favorite topic and again to what extent can food safety negate. Pathways are being used in new ways the initial were mainly just descriptive how does this lead to that we're increasingly looking at interventions how we can develop pathways for interventions for generating testable hypotheses and also applying this very rich and very productive literature to other issues and again here at Illry we've been especially looking at can we develop pathways which are not linking livestock keeping to nutritional outcomes but linking for example unsafe food to nutritional outcomes and one of the key findings from this was that it wasn't so much the injection of hazards which was affecting nutritional outcomes it was even more importantly the food fears which changed people's consumption and purchasing behavior and these food fears were having effects on nutrition and that was published just last year by FAO so that was a quick summary of the pathways all of these notes will be circulated and all of the pathways discussed and mentioned will further information can be found in the bibliography so thank you for your attention thank you Delia and thank you Jenny so what we tried to do there was really I mean Jenny explain why why these animal source foods are so important and Delia shared the spaghetti of ways in which you can try to program nutrition outcomes into your intervention so after the coffee break we're going to come back and look at the different pathways what people are actually doing what some of the results have been what some of the research shows us what I want to do now is I ask you to actively listen we're dead on time but we have a couple of small things still so what I want you to do is before you leave the room talk to two neighbors and for three minutes what is the question that either of those ladies has to answer after the coffee the fun part in your pack you will also find a little white thing that looks like this it says name of dish so as we planned this event we were worried that we were going to overpower you with power points but we haven't done that so far so let's identify from the room if we can crowd source is there a dish or a food source that you think knee is a bit hidden is a bit lost is a bit under known less known than it should be that should be more known and then integrated into our program so the lander lace guy said we're looking for these fascinating no-magic bullets but we're looking for these new dishes yes so there's two assignments one is to fill in a card like this and I think I'm looking at Jenny now I don't know where do you put your recipe where do you put your dishes a bowl or a plate somewhere we'll have a bag at the back so sometime before lunch write down one of those under exploited less well known dishes it can be something really there's a bag there with a zebra on it so put them in there and there'll be a raffle and we want to just what are those interesting dishes and recipes that are under known so that's the fun part the hard part is talk to your neighbors for three minutes identify a question for Jenny or Delia and then you can have coffee and come back at 11 o'clock coffee is just outside toilets are there and there is a good start we come back at 11 o'clock why is there no evidence showing impact of animal source food on nutrition is it due to poor research so that's a nice question we'll come back on in the afternoon the person who wrote that has a name did he hear super do you get the prize it's very it's not a very difficult exercise do you have another prize or is that for later on yeah so there are some other questions I'm just going to share a couple of the flavor of some of the questions that came up and I think some are maybe still being discussed one is around what's the impact of or increased animal production on climate change is that going to have an impact on animal production and presumably the production of nutritious animal source foods what strategies are in place to improve the quantity and safety of animal source foods to increase consumption these are nice questions for this afternoon the panelists you will have some tough questions what are the consumption trends among producers of livestock and nonproducers of livestock do we know that is there a difference how do we achieve household behavior change to achieve better nutrition with animal source foods how do we achieve hopefully in this next session we're going to hear about some of the evidence some of the pathways so maybe we'll learn a bit of that how long does an intervention have to be implemented to note nutritional outcome change and what are the indicators might be for that so how long does it take for an intervention to actually have a nutritional outcome and do we have any indicators so there's a few but some of those questions are here if you have more questions I'd like to have them we will bring these back in the afternoon the same for the online people if they have questions burning questions that come up as we go along I'm looking for Edwin and for Armand I think are tracking the webinar if there are more please post them in the chat and we'll bring them back this afternoon good so now you know why it's useful to come back on time because you get a very I'm not sure I see a big piece of chocolate that doesn't look super nutritious it has milk in it okay Ruth was saying before the break that nutrition doesn't sell and obviously Toblerone sells but is Toblerone sell on its nutritional benefits I'm just wondering that was a nice comment we had okay we're going to move on now for the break we heard about we heard about the science the animal source foods what are the good things that they give us and we heard about those pathways spaghetti or pathways so now we're going to hear three presentations Sylvia will start off and she will report back on this study that Ilry did together with Chatham House looking at the influence of lifestyle derived foods the first thousand days and there's been a big review there and I hope we will hear about the different pathways that are being used to achieve some of those things and then Paula will talk through harnessing the potential of livestock to improve the nutrition of vulnerable populations not animal source foods of livestock and that's a deliberate choice of she changed her title and so we're looking at what are the guidance that people are coming up with again we're hoping this will give us insights into these pathways what are the specific pathways and finally we'll hear from Robin in household nutrition in Tanzania again an example of a specific project with evidence and research so those are the three pieces that go along we're going to do all three at once just do 50 minutes each 45 minutes listen carefully and then we're going to have some time to discuss what they told us so I think we start with Sylvia your presentation is here Sylvia is Spanish so you can use it you will use English right this one here please take it close and slow for the webinar and with no the strong accent I'll try my best ooh okay right well so good morning everyone my name is Sylvia I work for Illy and as has been already said by Peter I'm summarizing here some literature reviews we've done around the role of livestock that I food in the first thousand days and Peter was wondering why we're using livestock that I food to not animal source food as a term and this is because we deliberately excluded peach from our review so we are mostly working with the species animal species we call livestock right so obviously as you can imagine it's various authors I'm representing a bunch of them mostly joined the four between Illy and Chatham House so the first two presentations and all the debates and because I know what the audience is coming from I mean I think there's no need for me to go in depth into these concepts as Sylvia referred to in the first thousand days seems to be quite critical stage for even future nutritional and development outcomes so that's why it's important to look at the potential of using animal source food to leverage and to improve conditions in those years but even though we are a very old pro animal source food in my presentation I will also dig a little bit into the negative size of things and at the end of the day I think all this has to be a balance between what are the potential benefits and the potential risks of animal source food so yeah this is an upcoming report we published in July or August this year I have taken a very long time to get it ready because it's very very long and indeed it's very challenging to summarize 50 minutes like a 70 or 80 pages report so bear with me so this is the objective of the report just to synthesize the best current evidence on the influence of labs that I put on nutrition on the first thousand days in low and middle income countries there are two keywords in this report the thousand days and the low and middle income countries that's why I mean the question we want to answer not that we might get there actually but that's what we were trying to do so obviously the role of animal source food in diets and nutrition is very different in northern countries and low and middle income countries so the recommendations and the messages we are sending is what we believe is important for low and middle income countries and what we mean by that so the report is divided in six main chapters and I'm going to be covering a little bit superficially obviously because we don't have much time, five of those chapters because Delia already covered the pathways quite nicely it's all based on summarizing the available literature and including once with a multi literature review with on that there's some more details on this so the first chapter talks about the role of livestock that are put in diets in low and middle income countries now it's very hard there's not really much data when it comes to diets in low and middle income countries for the first thousand days so obviously we expanded our search and would rely on more generic data that we're looking at trends can tell us a little bit what is likely to be happening with the first thousand days so this is a graph I'm taking from information from a statistics from FAO that looks at what is relative contribution of different food products to the protein intake of people obviously it's an approximation from protein supply in those regions so obviously it's well in some places where you have big exports it might be a very rough approximation but anyway what we can see is that in northern America Europe, northern countries in China then the protein intake is very high, the protein supply is very high compared to what we consider in this report the low and middle income countries of our interest Southeast Asia Southern Asia and Sub-Saharan Africa so that is the first thing we can see here, the second thing is that if we look at the more orange colors we can see that that is the contribution, the role of left of the food is much much smaller in those regions of the world now this is I guess the first key sort of piece of data or information we get from there like in northern America and Europe up to even 60% of the protein supply comes from left of the food while in low and middle income countries it's about 20% now when we were doing the first exercise and there was that question about whether animals or foods had a luxury or not we were all bearing this agreement they are not a luxury, they are good, nutrition but then I wonder why then they are not making use of it because people say the poor have livestock but still what do they see, they are still not using it so they may actually be somehow a luxury, we can read that as that or maybe it's because not all the poor have livestock some people mention that not all the consumers are left for keepers so I think this is all very complicated if we want to disaggregate at different group levels and even if we want to look at a thousand days with this we cannot do much but this is what the data that is available but I think it's very interesting already to see this trend if we look at our ten trends we can see that again well overall in the world but in Europe you know a sort of representation of the developed world we can see that the demand and the supply of protein is increasing and it's been quite dramatically driven by livestock that I put while in places like southern Asia and sub-Saharan Africa the demand has been the increased demand for protein has mostly been met by vegetables which is the green color in the graph rather than by livestock that I put so even though we keep hearing that there's increased demand for livestock that I put in lower-mid and income countries well it might be that that is actually just because they are my increasing population but not because the food baskets are actually improving so again so that's sort of the message we get from this slide that actually most of the protein is being met currently in these countries by vegetables now the exception is southern eastern Asia where actually there is some increase on livestock that I put but nothing comparable to Europe obviously in North America we have the ground now in terms of regional trends of prediction so we can see that there's been somehow the suggestions that livestock that I put are being increased in growing in developing countries now as I said that that's not necessarily just relating to improved food baskets nobody really knows what is happening in the food baskets of the poor and also we can see that under and over wage are actually coexisting so that big suggestions that LDF demand is increasing is not telling us much about what is going on in terms of nutrition but I mean trying to put the focus on the first thousand days as I say there's no systematically collected data but we could access a few there's a few sort of localized studies, research studies, development projects that can give some suggestions this is for example the findings of a study in Uganda some colleagues of ours did this is a team of children under five if I remember correctly and this is sort of the diversity in different regions in Uganda so you can see that in terms of protein and fat intake sort of the big question of the diet was pretty low and that across many areas in the country so again I mean this is just one study but it's actually indeed suggesting that children must be as good as they should be there's no all the sources we have information from I cannot go into details but just summarizing what we can tell from all that those pieces of information I think is these four clear messages come out so first that the mother's education is very important when it comes to the diets of children also that obviously wealth is associated with consumption of laptop direct foods and there are regional differences and we tend to talk about laptop direct foods so generically and so you know anything will do but actually there are strong preferences in different places and a lot of cultural values associated with food so all that needs to be put in context and as Delia said also everything needs to be contextualized when we talk about what animals or food we should be promoting and then what some service found also is that under six months of age children may be getting more laptop direct foods that they should given that recommendation said they should only be getting breastfeeding so let me move into the second one the next section is the next one in the report talk about sort of trying to collect the evidence the real evidence of the effect of eating animal source food in the first thousand days the mothers and the infants in the second one of the last talk interventions and again nutritional outcomes so we did a systematic literature review on that and you know as you may expect we found very, very, very, very literature not only the topic wasn't there being covered in terms of research but I think most importantly the quality was not very good and remember we were not interested on studies conducted in lower middle income countries so we expanded the age range because if we had only targeted a thousand days I mean we had ended up with three studies only so we expanded up to 18 years but still we only included 13 papers and we reviewed almost a thousand seven hundred so that really shows what people were referring to there's little research now but what is now in Manobee of the greatest quality the other problem we face is because again last talk direct foods are many different ones and taken in many different forms those 13 studies are very diverse in terms of what interventions they implement, what products they use, what outcomes they measure with children what type of population they implement you know they're very hard to sort of pull the information together and do some sort of mental analysis or trying to find more robust evidence by putting different paper and data together so those are the challenges so it's very, it's very limited but what can we say what does all this seem to know what do we seem to know out of this so in general LDF seems to be better than bad in terms of contribution to nutritional outcomes and also Jenny I think referred to yeah there are some studies that indicate that milk is good for it's associated with high, with increased height and need more on cognitive functions but there's so much we don't know so again we don't know the context of specific effect, the different populations different population groups what type of, how different types of lactose direct foods contribute to nutrition and then something that we will be interested with and get to work on that but the literature will review seems to suggest that lactose direct food may actually be quite positive in the case of malnourished children now I'm not saying more on that because there's no more I mean we don't have solid findings on that but it might be that in that case it might be actually even more beneficial so anyway for practitioners you know I guess with all this information you can come up with your own messages somehow but I think that some people will say one of the questions that came up and Peter just read is why is there no evidence out there is that we are not doing research in a mixture of both but also because we are dealing with a complex issue with complex interventions different settings so I think that's something to bear in mind when we want to sort of set out to collect that evidence in terms of the real impact on nutritional outcomes right what happens with livestock interventions and really again refer to a little bit to that so there's even less data on this there's again these interventions are very very complex again normally interventions, livestock interventions like will be improving the productivity of livestock in a setting goes together with many other interventions normally they tend to be very holistic so it's very hard to really measure what is the effect on that derived from the livestock intervention itself so there are very recent reviews seem to suggest that indeed it seems that those agricultural interventions agricultural interventions do impact the pathways that relate those interventions with nutritional outcomes but it's not clear to what extent that translates into nutritional outcomes this is especially true for livestock interventions there's much less literature on that and from what we could read from different papers out there I think we concluded that livestock interventions certainly improve production incomes and expenditure if they are properly done they can improve nutrition in taken diets because they do impact those pathways but they may or may not improve nutritional outcomes in children and women which are the ones we're interested in so again a lot of uncertainties there a couple of interesting things that literature seems to be saying and that we shouldn't forget when we try to implement livestock interventions is that it seems that if you only target livestock productivity you are not going to have such a great impact in nutritional outcomes more positive impacts have been seen on interventions that target other types of capital so human capital financial social environment so not only livestock so that is something that we should be looking at what aspects are we actually impacting with this intervention in the lives of people and as many people refer to and there's a lot of nutrition education people here greater impact seems to be achieved if the livestock interventions are coupled with nutrition education interventions or targeting women because of those pathways that also really are referred to so what we don't know I mean we know nothing about the livestock interventions in thousand days and even beyond that interventions livestock interventions have barely looked at nutritional outcomes really and again as I said they are meagled with other interventions so it's very hard to tell what comes from the livestock itself so what do we need when it comes to livestock education what do we need when it comes to scientific livestock interventions that have explicit nutritional outcomes in their designs with better experimental designs and robust monitoring and analytical methods to study the impact so we need more targeted and better research studies impact evaluations to be able to draw conclusions right and now to the more negative side of livestock because we're talking we are also positive about it so there's two sort of main aspects that we also looked at is the health impacts of consumption of livestock that I put and also environmental impacts of promoting the production and the consumption of livestock that I put in terms of health impact these are just some of the pathways through which livestock that I put impact on health and I alluded to the putmon diseases which is probably the primary the most important one associated with diarrhea and all the types of illnesses but we have toxins, antibiotics and residues, chemical hazards full intolerances over consumption which is also a consumption of livestock that I put has been sort of implicated on that associated with that and then just increasing livestock the production of livestock that I put will result in more animals hanging around more production systems and perhaps more emerging diseases and panemics so those are concerns to think about this graph just shows that indeed when it comes to football illness which is probably one of the most clear health impacts that I put on consumption most of the football illness out there can derive from animals food compared to produce on the food another interesting finding that we already alluded to is that on that burden that putmon diseases has worldwide, most of that burden is actually buried by children under 5 in the forms of higher mortality and also obviously pregnant women which are part of that thousand days actually are more vulnerable to such diseases so why is it important to be looking at this when we look at thousand days foodborne illnesses in the area goes together very nicely and obviously the area can be linked to stanching also there's been some associations with the sharing of the material and interoperability interoperability there's also a ketoxin in the potential for that to be associated with stanching in some cases when we try to regulate that's on the other side of the coin when we try to actually improve food safety in many countries it's all about regulating and actually holding in certain forms of marketing which actually may decrease availability of livestock that I put and I feel the argument that can also decrease the consumption so these are all the little things that need to be balanced when we talk about the consumption of livestock that I put in health in our environment and I wish Jimmy was here because this will give him nice clues on how to discuss with the vegans and the vegetarians although again we don't have there's not a lot of evidence in lower middle income countries we rely still on all the evidence that has been produced in northern countries and yes it seems that production of livestock that I put has a much bigger than my nominal footprint than other products but some studies conducted in lower middle income countries very recently showed that it did the emissions and the level of emissions might be different and lower that we found in northern countries so we tend to sort of extrapolate what we find in northern countries and just say here is going to be the same maybe it's not as bad especially when we talk about the small holder production which are more sort of sustainable environmental is sustainable and again also sustainability is very broad it's not only environment socio-economic, social sustainability and very rarely we look at all those together when we think of the sustainability of livestock production and I guess a third key message here is that if you look at that graph that shows what is the the total the rent is what the world produces in terms of livestock that I put in blue you have the amount that will be required for the first thousand days so in reality we could easily preserve the needs of those thousand days and still reduce production a lot if people have concerns about environment and then I wonder who is sitting on that that is produced probably not the low middle income countries by the way so anyway to me these are the most sort of the key messages from this let me just before Peter shuts me down let me just do this slide with them it's very hard to draw key messages from all these and I really encourage you to read the report as soon as it out it would contain a lot of public explanations but I think these are the key facts so I think there's still room to improve the amount of LDF that people consume in low middle income countries and especially pregnant and taking women and children and youth and that is likely to be to have more positive than negative effects if we compare the diets in low middle income countries with some of the recommended diets this is still a way to go and livestock that I put can help a lot on filling that gap now whether all these translate into nutritional outcomes we yet don't know but it actually seems that it could easily could but we also need to balance the negative effects of it the health effects is one of it the other one is environmental but as I said we might need to consider that we might be able to increase consumption in low middle income countries and decrease it elsewhere perhaps so we need to get the right balance in terms of environmental sustainability good so that's all for me what's good for thought there I gave you an extra 5 minutes because I thought you were covered a lot in a few words let's move straight on Paola are you ready same idea we have extra minutes for you we're very biased here so same idea I give you a warning with an orange well I'm very happy that I'm after Sylvia because then you have a first mild exposure to Spanish accents and then I'm a bit I'm a bit wilder in terms of accents so it's good you are already prepared my name is Paola Dominguez and I well I'm a joint appointment with ILRI before with RBC and I just recently moved to LFHDM as a lecturer and what I'm gonna tell you about is the work that we've been doing for the last years in collaboration with FAO which has ended up in the production of this technical guidance for program planning which hadn't out there yet we still have to finalize the forward but it's pretty much there so I have two hats because I have a background as a vet I'm a vet originally but then I moved into human nutrition so as nutritionist we tend to visualize nutritionists always use this framework of nutrition and to see the multi-calcality the multiple causes of nutrition we start with in LILAC the inmediate causes which are the balance between intake expenditure and diseases and then there is a whole range in purple of underlying causes that touch on very different sectors so food security and agriculture, care practices water and sanitation and health etc and then there is the plastic causes which are more structural but then as we have seen from the pathways livestock touches has many entry points as a source of animal food which are nutritious as income as disease and has links in terms of natural human resources and physical activity etc and because of this multiple influences of livestock and the high nutrition value of animal source that Jenny has described before the health and growing interest from human agencies and donors and NGOs and then a couple of years ago Eco from the European Union funded this initiative and we organized FAO and RBC and Erie this regional workshop on livestock, livestock and human nutrition for program implemented in six French speaker countries in West Africa and our objective there was capacity in all these nutrition sensitive livestock all the linkages that Delia has been discussing and also discuss a little bit current barriers and challenges compilations learned and promote engagement between sectors so we did, we started doing a literature review and looking at all the available evidence we did a scope in a study talking to 50 or 60 different experts in the area and elsewhere talking about the preparation of the workshop and the relevant experiences and we conducted three days of workshop with experts of both nutrition and our livestock and it was three days of participatory work working on case studies etc and we end up building country action plans that were followed and at the very beginning of the workshop we asked the participants how they thought that nutrition was integrated into for the livestock sector into the interventions with five being the maximum we found that 83% didn't think that nutrition was really a priority and same thing on the nutrition sector and then that it was 73% that didn't think didn't really consider livestock and animal as a priority and given that we have seen all these interconnections it was a bit like we found there was a huge disconnect in West Africa and the countries where we were working but it's also supportable elsewhere so we were like okay so first let's put it all in order we've written a paper about this but then we said actually what can we do with all this information for practitioners and people who are on the film so basically from all those lessons learned we in particular me then at RBC with the nutrition department we drafted these guidelines and I'm going to summarize some of the key points and as Sylvia has very well explained we don't have answers we don't have like very clear like do this and the whole thing will improve but we have hints or things that can potentially work and so it's not prescriptive in any way it's just recommendations and actually one of the things is that if we do design for life-spec projects in a nutrition sensitive manner and we assess impact then we can bit by bit come up and contribute to building that evidence in terms of the general considerations a key thing would be assessing the local nutrition context and you would say yes but hey we are bet those who are bet yes when we are going to do a livestock project but I mean that information like almost everywhere there is government, there is UNICEF FAO, WFP NGOs working on that and they already have the information that you need as for what are the main nutrition problems which are the nutrients which have deficiencies, what are the dietary practices and taboos that can impair the success of a project and you just need to go and make friends and get all that information which is not always done apparently and otherwise I still have some kind of focus groups or interviewing key experts that can give you some of this information another very key thing is to have nutrition related objectives and activities and maybe even if your main objective is completely different and it's more livestock related but unless you have a nutrition and some nutrition sub-objectives you are not going to have specific activities that can promote that that actually happens and have a positive impact and what it's worth you won't measure it so you may just by like have some impact but you will, you won't really know so that's another very important thing. Also in terms of nutrition vulnerability when thinking of livestock projects you may think differently like the socio-economic vulnerability may be the same but in terms of biological terms like nutritionally vulnerable people as we have said people in the first 100 days but also elderly people or people with HIV or other diseases so those are things to think of if you want to maximize your effects of nutrition and also targeting women for livestock activities because there is evidence that improving empowerment on the access and control of women over resources is likely to result in better nutrition understanding the livestock nutrition impact pathways is stuff that really would be like no problem but then once you have designed your activities all those pathways many of them can work positively or negatively negatively and then once you have decided what you are doing you have to try to map them on your and to understand what is the course of action and then see whether you have to pay attention and monitor things that could go wrong because the do not harm principle is very important and a lot of people assumes that well you do this you increase production and it's fine and it's not like sometimes there's no there's no real effect and sometimes it can be even negative effect like we've discussed if you shift production towards being sold you actually may remove it from the consumption of the children or the household but also if you place a lot of burden for example in women then you may be removing them from practices which are important for nutrition such as breast feeding, hiker, etc so you need to think about all this and the nutrition related indicators people who are non-nutritionist tend to be a little bit stressed about that and say well we avoid it if we can and there is all kind of options and now there is a lot of different guidelines that kind of chew it for you before hand to make it easy when you need it but basically they have to be realistic in terms of the activities what you can achieve with your activities and also with time like a stunting is a general objective for all but if you choose a stunting which is a bit more term and you measure your intervention after 3 months or 4 months you may not see a lot of impact in a stunting so you have to choose again oops sorry again according to what are your pathways that you are using you can see which are your ideal indicators and the central ones and tropometry and biomarkers may not always be the easier and the more sensitive for your interventions but then you can look at things in the pathways such as I don't know if you are thinking of disease for example you can look at the prevalence of diarrhea or of zoonosis but then you have lots of things having to do with diet from dietary diversity to intake of animal foods or things like women empowerment or time use etc so you have to think of which pathways are you focusing in and then try to find you can find easier intermediate indicators in those pathways so for example an example that was presented in this workshop was from agronomist and veterinarian without borders working in Mali and what they did is like they were doing livestock and agriculture intervention and they did a baseline in which they were looking at dietary diversity scores that they desegregated by groups and then they found that the three groups were consumed by almost everyone were like starchy staples, dark green leaves legumes, nuts and seeds but then two sorts of the women wouldn't eat any animal and they repeated it at the end and they found that there had been substantial they included nutrition education nutrition education component but they found that like not all like significantly there has been significant increases in quantity and in quality in animal source foods and it was the first one that they were using nutrition indicators but they actually their feedback was that they were quite useful to be able to easy to use and then very useful to measure the impact or their intervention and they highlighted also something very important which is what why it was talking to the objectives is important if you want to see your impact you really need to take it on board from the very beginning and to add the nutrition component basic aspects have already been mentioned here or there so Yanny mentioned for example about the choice of species that in terms of nutrition may be different to what the livestock person looks at it so short cycle species like poultry may have better quicker impact but also milk and milk and eggs are likely to have more of a daily daily use than if you have meat cows and then you sell them every now and then and then you sell them you don't even you don't really use it for the household so those are important aspects gender for example there is the involvement of women with a different species is also different and it's something to consider and also actually diversity is better diversification is better in terms of protection against animal disease but also in terms of animal source foods availability then the seasonal variation in livestock production are clearly important for vets even more for nutrition where you have to eat every day so all the interventions having to do with feeding and for breeds that have more sustain production are really key for nutrition and animal health interventions for example there's no doubt that they decrease mortality and morbidity and that they improve animal production but then they sometimes neglect for example when working with pastoralists that go with a big herd somewhere then there is always some animal saying behind there are the ones who are covering the nutrition of the vulnerable members who are remaining behind and sometimes they don't receive too much attention so those are aspects that should okay that should be included other types of recommendations have to do more with after production to the value chain and the business approach that was very much but all the different experts that were involved that a business approach rather than a more humanitarian approach is much more likely to be sustainable and to have mid and long term impact in nutrition similarly value chain analysis which looks at governance equity opportunities and constraints throughout the chain is a good way to identify opportunities throughout the whole process and the use of livestock by products I personally wouldn't kill any animal but if you kill them then you can try to get the most out of that and in some settings maybe not here but in many settings they are under use and there was there was some advocates that were making sure that there was no use of them and then preservation and processing techniques are really important because even in some settings not all interventions and many of the interventions think of that but even in areas where there is no electricity and modern techniques are not very feasible there is a whole range of traditional interventions where there is a huge room for improvement and that have been used that are acceptable and feasible and that reduce the wastage improve the food safety of the product and and actually contribute to filling the seasonal gap and to have more of the same animals available throughout the year then in terms of nutrition education and behavior change communication interventions I think pretty much everyone here looks quite sensitized already with the topic and quite familiar but that's not always the case and for example there we had like in the workshop we had veterinarians who didn't have veterinarians who didn't have an exposure at all and think for example in animal foods only in terms of yeah, high protein but didn't see what the compact and rich product they are promoting and it's important first that the people working in the project are aware of that and then that gets because yes there's a lot of populations that are aware of how much more good but they are not aware for example of how much more good or how much more important they are for the children and their women and actually a lot of the taboos that relate to food many of them are focused on animal food and touch on women and children and all those need a very good understanding if you really want to be able to make a difference same thing with understanding better the food hygiene practices etc and the point of broader targets of nutrition education traditionally and even now more nutrition interventions are targeting women which is fine because they are the main curves but it's also like it's also father's responsibility and particularly when they are responsible or they take the final decisions from the resources so maybe we have to broaden our scope and make other members of the house to buy into or to be aware of that and that's very often left behind then also from producers the point from producers to consumers refers to the fact that again as I said before about some veterinarians who are promoting animal food production also people selling them or being involved throughout the value chain they are in contact with consumers and they are not always aware of those details so sensitization throughout the whole all the levels is likely to have a better result because social behavior changing behavior it's really difficult so you really need it's not easy it's not like you tell someone do this and tomorrow it's sorted so then you need really to build up on the information through different channels through different routes kind of different things that can be done in order of time I've deleted some slides to be able to make it I'm just in the final key messages so as Delia has said already there is not a fit all sizes solution and this both nutrition and possibilities for livestock production are very context specific so this has to be considered for each specific situation but be deal and thought through from the very beginning from the designer stage because as discussed effect impact in nutrition is not automatic it doesn't happen by default not necessarily and it's not always quick or easy but it's a good opportunity and then there is even if it's not like you have to take if you have a livestock intervention it's not that you have to have all the weight of improving nutrition on your shoulder but even if it's small contributions do have an important role and then also there is a need to assess impact properly and particularly integrating even if small nutrition indicators and then compile and disseminate all the good practices or bad practices also on the lessons need to strengthen the links between sectors so you are a vet is not expected to know everything about nutrition and a nutritionist about livestock but it's necessary to work together and to collaborate and then also with researchers or with different sectors that can help to build up that evidence for building up the adequate intervention and need to promote dialect between expert and expert and there is just some like right now there is a lot of resources like there is LFHTM, USAID, FAO have a lot of different training materials which are really useful and are really simplified to make it digestible and then there is a whole other that you can look at and I think that's all I have time to say thank you Thank you Paula as Delia said earlier we will be sharing the PowerPoints afterwards so these links and references will be available okay we are going to go to number 3 Robin taking us to Tanzania I think right? Thanks very much it's really wonderful to be here 30 minutes it's a tough gig 30 minutes it's a tough gig particularly to try and condense everything that we have learned and the first thing I want to say is that the title is possibly a little misleading it's talking about the impact of poultry interventions our project has been running for just over 3 years the data that I am going to show you is for the first 2 years and there is no way that you can expect the significant impact within a 2 year time frame to do with you is share what we have learned and basically share a lot about our lessons I want to acknowledge our partners clearly we couldn't have done this without support from the Australian Government and particularly our income free project partners and to those who are hosting our gathering today okay sorry right so this is our project and you can see that we have been listening to everything that has been written and tried to cram it all into a title so strengthening food and nutrition security through family poultry and crop integration in Tanzania and Zambia and there are 2 main aims here the first one was to reduce childhood under nutrition particularly looking at assets under the control of women so small hold of poultry and particularly small grains and indigenous vegetables but my main aim was really to see whether could we convince ministries of finance that a strategic intervention in animal health in particular would actually lead to positive outcomes for human health and to reduce the burden on health budgets so some of those who know me you know me I have spent a long time with village chickens I really think they are amazing and for those of you in villages you will recognize this little schematic here which is not to scale and don't take too much away from it but if we look at village chickens we know that in most places around once a year they will die off in big numbers usually they are dying off due to a disease called Newcastle disease preventable by vaccination we also know that in rain fed agriculture that supply of produce high supply just after harvest and with levels going down and then having that hunger period which can be very difficult for households so what I was interested in and my colleagues is if you introduce vaccination against Newcastle disease if you can try and stabilize poultry numbers what effect does that have at the household level in terms of food security and nutritional security simple question really hard to do so in terms about the approved project objective we needed to understand where we were working and I should say that most of this work focuses on Tanzania and it's really hard there are a lot of people out there doing nutritional projects so the first place that we selected to do our work by the time it came time to start somebody else had already arrived doing nutrition so we had to select again and we ended up in a place where nobody else wanted to go when we arrived there the people asked us are you lost are you sure you want to be here because they really hadn't seen many people and particularly lost white folk we came in with our Tanzanian colleagues but it's a pretty it's a challenging area to work in but an amazing group of people we wanted to look at appropriate interventions so the only pre-determined intervention was vaccination against Newcastle disease on the crop side that was all decided in association with communities through participatory workshops we wanted to be able to look at the role of women and to see whether our interventions were having an impact on nutrition and particularly to look at developing strategic linkages between the sectors and between disciplines and to build up the next generation of researchers our team is large because we've tried to cover the sectors, the different disciplines in Tanzania and Zambia we work with front line agencies, with research agencies we work with the Royal Veterinary College and also with Kaima Foundation still trying to build the skills space that we need within the University of Sydney we work with different faculty, from the medical faculty to the agriculture faculty to the veterinary faculty this being the greatest challenge of all to get three different academics from three different faculties with three different accounting systems all working together we do all come together under our new interdisciplinary centre which is called the Charles Perkins Centre which serves to try and break down barriers and get disciplines working together and with environmental design it's a five year project now with the way international development is going we were happy to get five years we all know that it's not long enough but your average project these days is two to three years and that's simply not long enough so we were happy to start with a five year project all of our human ethics approval started in country and then finally at the University of Sydney for those of you who have not worked with the human health side before do not underestimate how much time it takes to get ethics approval plus the randomised control trial now I have to say I've spent 20 years working with the control of new cancer disease and I've spent a lot of time in the field but we always worked more closely with the farmers who wanted to work with us so we may have offered vaccination to the whole community we may have had broad interaction with the whole community but in terms of working closely with folks we worked with those who wanted to work with us moving across and doing a randomised control trial has taught me a lot because we didn't choose who we work with we had done our census to find out all the different households but then participation was based around the age of the child and willingness to participate so it means that we're working from extremely poor households to households that are relatively better off and this is a great secret and it's partly the reason why all of the projects where we had great results with the early adopters were so difficult to translate we also have a really complex array of tools and that reflects the background of our team from qualitative methodologies through to quantitative methodologies for the students who have been involved with this project I don't think any of them trust questionnaires ever again I really can't say how much qualitative work is important from your response I think you understand why we're saying that you can see that we have a cross section of tools there I just want to mention the last one there which is two weekly collection of data and that's done by our community so we have folk from the community who are selected by their leaders who are active members of our team and they're reporting on status of children's health whether there was breastfeeding actively happening and also of course chicken numbers on a two weekly basis this is a terrible slide I'm sorry but it does reflect what we were dealing with so what we've got here is we decided that we would we're starting with the cluster design and within each community we've had four clusters and those four clusters are grouped around health centers can anyone suggest why we might have chosen health centers in the interest of time because this man is relentless I'll answer my own question it's because it's so hard there are so many confounding factors when you do this work and so what we tried it to do was to have the health center as a way of at least reducing some of those confounding factors because in some health centers women will have access to iron tablets they'll have access to advice in some health centers they may not so we're trying to take care of some of that the other difficult thing that we were dealing with you learned by doing so we have a staggered start we started in one word board first which was great we learned a lot there and we also have a staggered start around the introduction of intervention and it's really difficult from an ethical perspective we know from all the work that we've done that if you can introduce Newcastle disease vaccination and have the campaigns well done that the chicken numbers on earth you run a controlled trial where some communities get their chickens vaccinated and others don't ethically it's not acceptable so our only way out was to try and have a one year delay so at the level of our four communities leaders and representatives would come together for a meeting and we would have representatives from each community come to do a lottery draw in one envelope we had vaccinate in the year that you're in so two slips of paper with that two that had vaccinate in the following year and then in the other envelope we had the name of each community so they came, representatives and chose name of community when you start vaccinating and that was how we've done it they've sort of accepted it but it's certainly not straightforward but as I say the randomization is important and I'm going to say in terms of the talking points we've discussed a little bit about clustering, the ethics of delayed interventions I'm going to make a very maybe a controversial statement here we had our aims for our project but what I would say through having this randomization is that we simply don't know enough it's very hard to come up with a sound research question when you don't understand where you are and how people live so the randomization has been great and it's taught us a lot it's yielded some results that we might be able to get published yielded a lot of results that somebody should publish somewhere but it's not always easy so our project sites in Central Tanzania and in Zambia most of our work is in the central part of Tanzania in two different districts and across three wards so we've heard a lot about vulnerable households thinking about resource for setting important to think about this because we've focused today just on saying how important animal source food can be but we know that the circumstances in which these animals are raised are highly variable in most of our areas they're low rainfall areas tough climates 100 millimetres of rainfall and what's happened now we know with weather variability but it's extremely hard to know what's happening and if you've got poor soil you're up against it from the beginning in terms of household issues around who gets access to what information access and control are the resources who makes decisions communities around access to markets support for deep sanitation telecommunications are these very tricky and in terms of transient things around rainfall when it comes, when it doesn't long term changes and natural disasters setting you up for everything that we've encountered during the last three years so some of these are beyond our control some of these are absolutely made by us very interesting species that we are the other interesting thing coming in and moving from just really loving village chickens to start to focus a little bit on their owners and working with nutrition agencies everybody has the same problem in that it's easy to work in cities it costs money to go out and spend time with people and I say that because when we started our work we met with nutritional agencies we saw that they had a lot of material a lot of material suggesting what people should be eating and this looks great for a breastfeeding woman fantastic information about what women should access in order to be able to produce a regular supply of milk and then we went out to where we actually work so a huge difference in the availability of foods that are available huge seasonal variations so while you may have your beautiful pamphlet it would just be lost just be lost and almost to the point of being insulting in some cases so our key design elements I've spoken a little bit about randomization and I'm happy to talk about these things in more detail our social anthropologist really hammered us so our design is gender sensitive and we do use participatory methodologies all the way and when we talk about gender we're talking, speaking with both groups and also working across different language groups we've tried to take a nutrition sensitive approach to agriculture, to landscapes and to value change so that we're interested in what's in the food not just how much food or the volume of food and we made the unusual step of not working with research agencies so as if what we were doing wasn't complicated enough we used government ministry as our frontline agencies and as our direct partners because they inform us on what's possible we can do research and get beautiful finding but if what's required to realize those findings are just not feasible within current structures then what you've got is a paper that is of limited use to people our achievement to date is that the community still welcome us back and they've begun to think that maybe we did want to be there and that maybe we do learn a little bit each time we go our students have been fantastic because as we've gone along we've identified things that we didn't hadn't thought about, students come in and with small discrete projects can help us to understand better certainly our link with the community assistance and community vaccinators has been really invaluable our community assistance in particular provide that liaison that feedback as to what people are thinking how things are traveling I want to talk here a little bit about dietary diversity and just before I offend some people in the room how many people are vets here how many people have a public health background how many people have a public health nutrition background who works for UNICEF okay so I'm just apologizing in advance what I know is that it's really hard and particularly because I'm about to say to have some comments about DHS demographic health surveys and the templates that are used there it's designed for a specific purpose what we didn't understand was that we couldn't just translate it into our area so we've learnt the hard way particularly around dietary diversity how hard it is to be able to do that and to do that well so we had what was used in Tanzania as a broad national framework it did not fit where we were we've had to redo that and the other tricky thing here a lot of the dietary diversity look at the way the food group has done it's designed for plant people it really takes a lot of notice of plants, of the different vitamin A leafy rich green leafy vegetables who's mentioning liver in that category, it's not there and the other tricky thing about asking people in a questionnaire where they know even if you say it's the identified they don't trust you are you asking them to say what they really ate so maybe they ate a chicken maybe they ate a goat what if they ate an antelope in a country where it's illegal to do so so it's very difficult to get good dietary diversity scores it's also very difficult to work in settings where through certain prejudices I guess that eating certain foods is considered uncivilized or backward so who wants to say they ate a mouse, a field mouse and yet it's a great product as good as a sardine if you ask me but it can be hard for people to answer those questions when we've spent a long time telling people what is and isn't good food we spend a long time telling people you should plant and sell maize and yet it's been less than helpful in the long run in terms of nutrition so that was a long way around to say that we've all made mistakes and we're about to make more mistakes but by sharing them we hopefully minimize them doing this interdisciplinary research is really hard work I'm not sure that five years is long enough to create a team that functions well together but we're having a go and it is hardest I have to say for my colleagues from Australia who have had time in the field they don't understand and what they need are opportunities to sit down and listen but because of university calendars they can't spend the time in the field to understand so I apologize in advance for those of us who come in and think we know and don't hang around long enough to understand that we don't know key challenges that leads me on to this one and they teach in blocks that can't be changed that does not correspond to agricultural calendars so it means that people are not on the ground when they need to be to learn those lessons and to listen to farmers so it's a real challenge and I don't know it's something donors do have to grapple with about who should be on team and how they learn to listen from the people who know the situation better than anyone else we had a change of government and we had a delayed start to our project and we've had different governments and different leadership within ministries during the project really the rainy seasons are just all over the place and if it's not raining then it's flooding and it's been heartbreaking for communities traditional beliefs understandings around food it takes time to understand why they're there research design thinking about your sample size tools and time frame it can be very hard to do this so all you can do is do your best and do your best within the available budget public health folk tend to have more money than we do on the animal health side so you have to be realistic about what you can achieve or partner with those who tend to have a bit more money and once again interdisciplinary research think about it and use it at the right time now I like this one this is from Sons Award in Tanzania so my question is when is a chicken egg not a chicken egg so we have this is chips mayay for those of you who know it so egg and chips on the left we have it's a commercial egg from Tanzania on the right hand side we have a beautiful village chicken egg now part of what we did to try and say thank you to communities was that we wanted to give them little gifts on a regular basis and because we had a focus on eggs I came up with the great idea of giving out eggs unfortunately we didn't have enough village chicken eggs so we gave out commercial eggs some people who received them were very concerned once again I mean they've learnt to be a bit unsure about what white people do but they thought we were giving them snake eggs they had never seen an egg with such a pale yolk so it's tricky the rainfall pattern where we've been working we monitor rainfall in our areas it's been highly variable we know that for the first year we had very low rainfall even in the second year where we had better rainfall our rainy seasons are becoming shorter when it does rain you seem to get very heavy downfalls with poor absorption into the soil so it's tricky in these communities where rain-fed agriculture is so important didn't rain didn't rain and then it poured and it was going down the field trip these young men as you know own money by car and motorcycles so key messages is that this sort of work does require interdisciplinary research and if you need somebody to back you up you can quote nature because they now have kindly given us some tutorials here where we can try to start to explain how hard it is and that it does take longer and because it takes longer it needs a little bit more money but because of the complexity it really is we have to do it because doing short, poorly funded research it doesn't give you any good options now, with that build up just some quick findings of where we've got up to with our project right now so this is work largely done by Julia, the PhD student and research assistant with our project and we were all really happy for the first 18 months with what she was finding about what was turning out to be significant for those of you who like didn't show up significant in our study at this point in time what did show up as if it was around chicken ownership number of chickens owned cattle got a look in the first 18 months what's happened as we've added the next six months is that everything seemed changing we pushed out beyond the 0.5 level for chicken ownership it's hard to know why this is happening why it could be as we've talked about the multiple roles of livestock so that if you've had poor harvest you have to sell things so basically because of this long run of very poor rainfall possibly assets have had to have been mined, explored and exploited so that's one possible reason but it's still important to show that there would seem to be some linkage there even though this is now becoming a little tenuous sorry I should qualify for these Z scores does everyone know what a Z score is well for those of you who like me thought it was a very strange thing to say just a way of trying to look at the height of a child and you're looking to see how that's changed all the time so you measure young children up to two by lying down and once they're two and over you you get some sense and the Z score is a way of thinking how they're going against what you'd like for progression for healthy growth what was interesting here when Julia just looked at predicted means is that there just seemed to be some trend here around having chickens leading to less stunts the green children have grown well the children who had access to everything to be doing things that we had to learn about was trying to look at not only about chickens but it's about how those chickens roast and here you can see another really important thing which is about that time meaning so for me as a farmer growing up on chicken cattle property we take great care of nutrition of our animals for that period of time making sure that the young animals have access to what they need that's a critical concern what has been really badly done and I feel that we do need to say sorry to some of these communities children are largely being weaned on to cereal diet which is nowhere to compare so it must not have been that way your history here in New York where the bread needs Africa you must have weaned children on to better food before we started pushing some of our cash crops so it's not worth nutritionally understanding how that altered and how do we now because we make it sound as if it's a problem that these people are feeding the wrong thing but where did that idea come from where did that composition of what was raised on the farm and what was suggested as being the modern approach where did that come from we all play a role in where we are right now but for those of us coming from the veterinary science just to remember that we do start growth by age you tend to apparently part of the world often in many cases they've got their best length at birth and because of poor diet it just gets worse as you go along there is also a difference between gender so you will see that young girls tend to grow better than young girls that's surprising power I think it was we mentioned that there is now literature suggesting that close contact with animals can cause in terms of access to people contamination so that suggested that contact with poultry in New York can lead to something in children this work has been based on secondary documentation largely using data and doing calculations to look at that it's founded in some country not all countries what we have to say when we look at links between chicken ownership and restricted growth in our data we do not find that as I presented in the previous one in fact chicken ownership seems to have a lead to a better outcome for children so the next question that our data was able to answer for is does it depend on where these chickens are spending the night so if they are inside human dwelling would there be more potential for more contact and lead to problems so when we had a look at our two weekly data where we have been reporting incidents of diarrhea in children and their overall health status just on visual assessment by our community assessment what we found that there was no significant relationship between where chickens were held and what was happening in terms of incidents of diarrhea there was no pattern that was apparent there and as if you remember from the previous slide in fact the best outcomes the growth has been seen to be associated with chickens being kept inside why are we seeing different results from different countries it's complex and really the important and take home message that we need to get out to the public health community is that a chicken is not just a chicken they're not all the same they talk about poultry what species of poultry what breed of poultry and how is that bird raised we should not be having these discussions about animals or about different cropping systems without qualifying the production of the farming system because they're going to be different and going to lead to different outcomes one of our students animal and veterinary science student kindly was interested in the mothers not just in the children so she looked at data we've been recording data that allowed us to calculate body mass index in the mothers and what she found probably is not overly surprising but the time of taking that measurement really makes a difference so when women were measured in a number their BMI was much higher in May which if you think back to the time of the hunger season in this area that sort of matches water source BMI is higher with women that had access to real water sources have to squeeze in foul air still not that .05 cut off but close very close and toilet facilities some suggestions of association there we found no association with BMI and women with ownership of large ruminants small ruminants with their marital status and interestingly in educational level for any of our analyses educational level of the mothers has not with what we use there it hasn't come out as strongly associated that's probably because it's a very poor area and we need to use a finer way of assessing those who have not been to the community to assess the school at all maybe I just wanted to say thank you not us certainly looking at the way we use all of the egg so not just eating what's inside the egg but is it going to be possible to use crushed eggshell to deal with calcium deficiency that's the work in progress and we're dealing with the food safety part now and Haley's doing that we have a Tanzanian students who's looking at bacterial pathogens from poultry that are of interest looking at seasonal level and prevalence across production system aflatoxins we all know that aflatoxins are now a huge problem were they always a problem we don't necessarily have the data we know it's a problem now we know that with weather variability and stress on plants they're going to become increasingly a problem we know that certain varieties have more of a problem with aflatoxins and what happens with grains that don't look good for people to eat we give them to our animals but then accumulate the toxin that we then enjoy so this is what Godfrey's having a look at I've shown you some of the work by Sasha and Julia's work there as well so thank you to those students a bibliography for your enjoyment and I look forward to answering your question thank you Robin indeed it was 30 minutes not 15 as I thought so we're almost at lunchtime we have a couple of so what we're going to try to do is we have a couple of things we need to get to I've been told we have to have a group photo mandatory for all events right so we're going to try to do that before lunch because some people are leaving so just before lunch we go out for a photo we have about only three or four minutes so what I want you to do insects and birds and yeah so what do we conclude I'm going to head to your WS Paola is Paola still here so you're Illry's nutritionist right so you'll be able to say something on this from Illry's point of view I have a small flock of chickens and we harvest the termites and feed them termites once a week okay so you're okay we speed the people okay does Illry have any thoughts on insects, termites and I know if you pay or even Isabel you're the deputy head of the program responsible for nutrition and I'm French yeah yeah we have been considering we have I think Delia actually has one proposal on the pipeline about insects as we improve human conception we are considering as one of the options we should think about it in terms of understanding better and I think Delia is a better place I am not better place I'm going to pass the microphone to Paola but I think you know it doesn't really qualify as livestock at least for now yeah nutrition but I mean given that Illry yeah but given that Illry has focused on livestock production definitely for nutrition might be interesting but I'm not sure how much Illry wants to go into that direction that's all and if we start farming them which we could but I'm wondering insects for animal food similar to the chickens so mass production and etc yeah I mean we're looking here at protein protein sources for humans to improve their nutrition right so it sounds like there's bugs there's a lot of potential there sounds like okay Jenny is very good so blood guys what about blood bugs yeah so when we were going through all the bug questions I mean it struck me how many insects came up and I think we asked for crazy foods right but how many bugs are consumed all year round or is it much more of a seasonal thing right I mean and how you might get really steep peaks and valleys with bug availability and are people preserving them someone said cricket flower are people selling them are they making income are they proud that they eat it are they embarrassed that they eat it do we have time for more discussion around that okay does anyone have a comment about that I think these are foods that are broadly consumed and especially for Kenya in western Kenya and so they are widely consumed I was talking earlier to Rosa Pio who left and she said that just before she left for home she passed through the market and they have them locally sold in the market like the termites so they're easily available only that I think they're more available during the rainy season especially the termites so yeah yeah okay I would just like to add okay they are more available during the rain season but even off season they are produced traditionally there's a way of making them come out you create an environment where you're able to harvest them and they are sold off season they are very expensive in season they are much cheaper but they are rich in good essential fatty acids they are also very rich because they are eaten whole they are rich in calcium and also a good source of protein so they are used as a mean as a protein source and also they are eaten as a snack can I do a couple more yeah I have done one of the details of the Kenyan diet but I've spent some time in Senegal and Zaire now DRC and insects of all types are widely available in the market but they are primarily used as spices and supplements in a lot of the traditional food so I think they are very commonly used okay I don't need to belabor and me I'm back to the DRC example caterpillars were available during like three months of the year and they were the food at that time they were the source of income the major source of income for these poor women and they were the source of food they would even eat only caterpillars if there was nothing else available something about being proud or not I can remember it was held like 20-30 times back and forth and one time there was somebody can you take along a package for me and me, yes I can without knowing actually what was inside but then when I came home I realized that I was struggling with 5 kgs of caterpillars in my back so to say that people really do everything to access their food it's also linked with traditions some people really express their cultural identity by the things they are eating so and then to end this story how long can you keep them if they are well dried I've never found a person so after two years these caterpillars were still at my place and then a Congolese came to visit me and we still ate them so you can keep them quite low at least two years so any more quick thoughts on this are you going to move on? let's hear over here I've seen people eat caterpillars both the slender ones and the very fat ones I tried and they could not get through my tongue because I was imagining eating some some wadudu but the question I normally ask we normally look at things that come from the ground as all goods are there any safety risks that as you said they grow because there are a lot of toxic dumping going on right now would the environment of the soil lead to some toxic accumulation given they have a lot of fat that we can refer to ourselves so that we could have guidelines on where to harvest them from and where not to harvest them from safety issues probably we don't have an answer so we do not quite an answer but on daily we're developing some regulations, some guidelines for feed manufacturers or use insects as part of water content so if it can be done for animal feed then it can also be done for human consumption so that then those safety issues are under but as standard there's already been developed on those insects that will be used for feed from the nation any more points around anything else, do you want to talk about the blood or anything else or do you want to just leave these and you give your prizes you'll raffle off something and do it a bit later okay put them in the bin alright yeah yeah good so let's do that you'll pull a couple out and then people will have some prizes anything else I haven't heard people talk about grasshoppers but my experience in Uganda they are green grasshoppers called which are very popular during the season and they have been commercialized and they are packed in nice sandwich packages and it's a delicacy to the people who understand it for those of you not familiar and if you ever are in Uganda and go to Masaka during the season the lights in the town all have large cones underneath them so as the grasshoppers fly up they drop down and the people are down collecting them so there's an actual industry around it okay so I'm looking for Paola now so when you do your nutritional assessments are these sort of things included in those assessments in your guidelines step number one was some kind of a nutritional assessment or something which vets don't do very well yeah but nutritionists do do they also include all these bugs and things in their nutritional assessments you would normally do that yeah yeah that would be if you do a proper assessment on the dietary practices you would include everything from traditional foods, bush foods bugs so yeah it would be okay two more hands here from the UNICEF assessment for dietary diversity for ana fives that's one of the things like the food list insects bugs and all those is one of them that you ask about so it's included in the dietary diversity for children okay good I think we need to wrap the session up and move on to the next piece is that right Jenny? so thank you very much for that that was just kind of a fun thing to explore differences so what do we do next are you in charge? I'm handing over the microphone do I think yeah I'm in charge Edwin we need to change how do we change this at the power point in the morning? okay so Carmen we're getting to pass out the design no this is fine while this is getting set up I'm curious show of hands do people consider insects animal source foods so that's really not very many people in here so what are insects then? so are they animal source foods? the next session is meant to be a little bit more fun and interactive and we are going to how to do these nutrition sensitive livestock programs recognize that there is not there are not a lot of resources out there and they're kind of hard and that there might be a void or a need for kind of a quick design aid so this is building a little bit off of how this presentation that she was working on with FAO how to design these projects what's in them and this design aid is going to hopefully be complimentary to that report in that it walks practitioners through both for donors as well as for implementing organizations what are about livestock programs how do we do this? so you're a guinea pig this might be another American reference but so like 101 you might like what's the 101 it's a road or something so guinea pigs are typically used in scientific research so for you you're helping us guinea pigs today guinea pigs are also pretty tasty so this is building off of historically kind of this mixed evidence that livestock programs improve nutrition and the guide is trying to incorporate best practices and lessons learned from previous experience both published as well as kind of anecdotal just down in the trenches doing this work there are references to other resources and it's been really trying to align with existing FAOs spring and other multi-sectoral nutrition recommendations out there so what do we want to do? you guys all should have your this aid now in front of you and really would like to have you guys take some time to look at it read through it reflect on it everyone should have a pen if you don't have a writing utensil come find me we can get you one you can write on it scribble on it circle it explain what you don't understand and then within your table group kind of talk through it there on the next slide there are some questions kind of you can go through and in your folder you should also have a design aid feedback form that you can use to kind of guide your discussion what are we looking for feedback on what don't you understand etc and then we're going to once you have your small group after about 20 minutes or so and if people are done and this is boring we can move on and just have more discussion time that's fine but take one or two points from your table that you would like to share so what we didn't like what is missing, what's not intuitive what you think I should be there are there resources that we completely missed on does something make no sense do we need to elaborate on points and then we're going to go around and kind of share that feedback and then if you haven't finished filling in your feedback form you can work on that and then we'd like to have both feedback form as well as your aid given back to us because hopefully there might be some comments or questions or circles or whatever on that this is going to keep moving forward so I promise to give you the next version of this aid but it's not like you just get this one now and then you can keep on going we will share it once all of this pilot feedback has been implemented but please sit back so some questions to think about while you're going through I'm just going to leave these here what do you like, what doesn't make sense what's missing as an organization when you are designing these projects what other questions do you ask when you're thinking about this what would be important to have here and then there is a section of indicators what other indicators would you want to include and other just other feedback thank you everyone just to add on to what Jenny was saying we've talked a lot about Jenny and I as this was being developed on really who is the intended audience for such a guide and I think that for this room many of you are researchers but we also have a lot of implementing partners practitioners etc so this has a bit of a two fold audience one is that the true design team I work on a new business a lot designing for programs I know that I put things in there that may be questionable when you have to actually implement them and so what Jenny and I were discussing was that yes it can help you design the program but for those teams we were actually trying to implement the program that was designed that often end up in silos you have your market team you have your production team you have your nutrition team what we were trying to do is help them understand how they can maybe implement a little better or understand how they could break down some silos so as we go through this exercise what Jenny and I are asking you to do is wear that hat when I was helping start up a program would this be a helpful tool because in the end of the day what we are looking for is a tool that will get us to a better implementation of a program so thank you does anybody have any questions okay thank you for being our guinea pig yeah information there for both definitely design and start a little bit less technical stuff of start up but there is also things in there that would be useful for implementation and especially going into this adaptive stuff you know this is how it looks like in design but while we are in the implementation do we need to shift focus just one last announcement we have a missing registration pack that has someone's notes in it when they came in and reorganized the rooms that book went somewhere else so please take a look at your registration pack and see if there is notes in there that you don't recognize and then deliver them to this lady really digging deeper and saying what is the socioeconomic context who is who are the agents of change in the communities how do you identify them and how do you work with them gathering information from that level so that that builds your design and also reduces assumptions because we tend to bring in a lot of baggage as people from the outside and make a lot of assumptions something I remember is the mention of several other documents so maybe I link to those documents in case somebody needs more information on that can be given thank you we really to start with what we really like the first page is very straightforward helpful contains an enormous amount of useful information and the guiding questions overall are extremely useful and we imagine they could be used throughout the entire process just keep referring to them the key concepts are full of very densely packed information and we would have I think benefited more from them with each one or processed with why this piece of information would be important to you how you would use it and even perhaps the template to follow so for example explaining I think intuitively a calendar is a useful thing but here's the five key questions you should ask yourself while you're creating the calendar for your program in order to be able to capture information that would be most useful for a nutrition socialist program and then a template and any of the social behavior change communication are there some more resources that could help me that was I think the main points that we had come up with that they're so densely packed each piece could be elaborated a little more with how would you use this, why is it useful and here's some steps you could take from the calendar for your program additionally we looked at the theory of change and we feel there's a mix up of the level of production and availability for sale and consumption we feel we have been in the change the table please thank you generally from the discussion from this table the guide is appealing the the pictorial especially the introduction bit of it however we found that how to use the guide those numbered 1, 2, 3, 7 they are not followed in the way the guide format is so the formatting is it's a bit critical to be addressed number page 2 also we found that when we looked at the key concept the livestock the livestock fulfill many laws and what is written they are not starting together because what you are finding on the left is the asset the human natural and it is not coming in that it's not addressed it's not you get the word in the next paragraph this is where you read that livestock assets then it starts wondering where were they but they are up there but they are not available that pictorial bit of it clearly the bit on the calendar the seasonal calendar coming it's coming out very clearly it's nice and the pictorial bit of it gives a guidance however this should be formatted in the way that it should come in the right place so that it is guiding the person using the guide then another on page page page 5 that is where now we got a bit concerned about the pictorial it doesn't seem to be delivering the message it is meant to be delivering so there is need to be the organization on that one so that maybe it can come in the form of a chart not necessarily in this way it is put here as a diagram they are the bit on page 6 these guiding questions this is what should come initially from the first page it is the second rather than the size of the information so from the guide it's coming on the last page it's confusing where is it coming in and how is it to be used so if it can be organized it's informative and can be directly be used or be of use so I think that one and then again I think it has been mentioned by Table 2 about using this or refer to other manuals like I could say in page 1 like manuals the bit now it's not an attachment it can be improved I think the group can also share if they have something else to add thank you thank you on the guiding questions and one of the discussion we had was why we think about animal animals as a standalone issue of animal input it's better to look systematically including housing feed breeding and management because they are equally important at the same time they are interlinked and from nutrition perspective housing, animal housing might be a lot related to health so that was the point we discussed as well thank you very much the document has quite information that would be helpful in making decisions and formulating programs but we are feeling there would be a need to make it a bit much more focused so that it's an easy way to properly guide it it's a bit a mix up but it has very good information page 2 looking at the start yes it provides a range and what's happening for crops like sorg-dry season we not see the statistics so we can look at that then there was a table there on page 3 we were talking about nutritional content animals also and she did mention that camomilky you could include that then there's I thought there is a social and previous communication tool which is quite, you can't make anything out of it, you can't so it's not legible so we make it helpful then again probably a piece of numbering on page 5 we were looking at that, that decision making and we saw what at the end of the day is it the optimal decision that could have been made we saw what we're not able to bring out what the make it was when we read that then there was the sticks we were looking at that and we were still deriberating and we were saying that this guiding question when considering a nutrition life of project yes it is nutrition social causes animal health environmental market policy but economics was missing because we did mention here that life of contributing so that bit would be considered would this improve the income other than just culture that for something not quite agreed but we were discussing that so we can throw it broadly then we also the issue of life of product was kind of one thing life but not life of product that could also come my colleagues here thank you thank you for giving us a chance to help you with your free testing that's really appreciated that's all I think it definitely feels again and I think the challenges just saying that we didn't have complete agreement around something is the diversity of your target audience so some people here have an intimate knowledge and understanding whereas others of us are just parachuting in and understand so that's your challenge thank you as well as the reporter so we have some commonality with other groups so I won't repeat that I think what I have not heard so far that you felt that it would have been useful to have the pathway more explicit in that document and maybe possibly structure help use them as to structure the guide and of course we noticed as well that some of the pathway were actually anything in particular a bit clear on about woman empowerment and how it contributes to that relationship we were a bit unclear as well about the theory of change wondering whether it is useful because it can get quite complex and therefore do you want to have something that is simple and meet actually what could be useful for the theory of change which is to look at assumptions when you move from one block to the other when you don't see that the linkage is happening why is it so and this is the purpose of a theory of change I believe but that gets very complex so we were not sure whether we want to go into that anything else about more let's go back it's always good to be last because we said everything we wanted to say and maybe just to emphasize was on page 5 it was totally misplaced to the example because first season mathematically it wasn't making a change so we tried to calculate and it just didn't make sense at all including tables to buy other things consumption at the end of the day was totally lost along the way then the economic component was also we found it missing as one of our colleagues have mentioned the end result is also economic empowerment so that people can relieve the resources for other household items then the component we thought that it should flow using the value chain approach all the way from production to management of consumption and all that in a systematic way using color from after the introduction if you go the value chain approach it will flow there was a bit of a challenge with flow and then on the last page about the programming principle some of them we thought there should be more information regarding that target the vulnerable and improve equity there should be more information regarding the definitions you know because you want to empower community you also talk about empowering women but it should also be coupled with the other division which has written households because it should be the approach should be also bigger broader than just empowered women should be there but you know you're empowering the community I think there's 19 members have something else to say good thank you a huge thank you the feedback was very good and spot on I agree with most of it for us this is a zero draft so it's just the beginning and we'll be rolling it out hopefully in a few weeks or months Jennings do you have anything you want to say again no just thank you very much everybody I really appreciate feedback it's going to be really helpful as far as I'm going forward there are there are actually a lot of spare copies so if you do want to draft for them feel free to take a spare copy but please leave your scribbles on one here yeah just do it in the middle of people so you don't forget to leave a comment along with your feedback form and I think we're going to turn it back over to Peter so thank you everybody very much thanks guys give yourselves applause and your facilitators good okay we're entering the we're entering the last hour we're going to do a couple of things around around 3.30 we expect the USA to wake up so we think there will be more people on the webinar coming in so we're going to reopen the webinar around 3.30 what we're going to try to do is before that before lunch we had some presentations we didn't really have time to ask some of the critical questions we collected a lot of questions we're going to come back to some of those in a moment kind of interact with the speakers but we thought we would spend 10 minutes now with some of the questions so for example we collected quite a few questions that were very specifically for Robin and I don't want him to leave the room so what we thought to do was to collect any specific questions right before the coffee the lunch we have Robin we have Paola and we have Sylvia I don't know if you can remember so far back so are there any specific questions for those three we're going to come back afterwards and we'll have a more general conversation we have a very specific question for Robin, Sylvia or Paola that you really say I want to get a targeted chance to talk ask a question I'm not seeing a lot of yes good, say who the question is for please my question is from our farmer Robin she said she was a farmer in the morning yeah so in the presentation we noticed that there was no significant difference between the nutritional status for the households that had their livestock, their chickens staying in the house overnight and those that did not have chickens spending together with the humans in the house some evidence are shown that in households that with the livestock they have more contamination and they have more tunting do you have some explanation on that Robin yes, good in our group we were wondering whether there was nutrition education as part of the intervention yes two questions, is there one more? two more, yeah, okay I would like to know how the community vaccinators work, how they're incentivized and also whether vaccination is optional or somehow mandatory how it's encouraged at the household level in the village where they're working so we have the vaccinators in and out of the house sorry and Christian here was nutrition education, yep good and Christian and then we'll go on so my question is I've spoken with Robin before about the results of the research and I recall and again this was a couple of months ago but that in your experience and again this may not be documented with great data yet or whatnot but after about two years of the program you did see an increase in consumption of poultry products by households and so I was just wondering if you could comment on some of those preliminary results around actual consumption if possible good, okay we had a little bit of time Delia so we're giving the grilling Robin separately so four questions fantastic yes, thank you very much for your questions and I'm just amazed that you were listening so that's great, thank you chicken children housing community if you think about all the different breeds of chickens we've been raising them for over 8000 years they're very close association with us the finding or the suggested finding that having chickens inside may be causing problems with children is complex and it may be the case in some places it is not the case in our finding what we know and even in the days of avian influenza everyone was telling people chickens are bad, keep them out of your house but for those households who depend on their chickens you take the chicken outside maybe it's not there tomorrow so the reason why people have chickens in their house is about actual security financial security for their household some of the data that's been used to suggest linkages has not the formula approach has not yielded the same findings in every country that's been done and it's using secondary data and in some cases not data that was specifically designed to answer those questions and so one of the points that I made and maybe I didn't make it sufficiently clearly and I think for the public health community when you are documenting this type of information you need to be precise a village chicken that's raised extensively that lives in a closed environment that doesn't have regular contact with commercial chickens probably has a lower disease burden when they scavenge for their own feed and they don't consume a rich cereal based diet that microbiome is probably different so I think we need to be very precise commercial chickens where we have most of the data about the levels of salmonella, carnalabacter those food safety issues are very well studied there's very limited data on looking at the prevalence of those diseases under village conditions so we just need to be sure and so with all of this work read the literature and then make up your own minds because we always learn if the literature was always correct we could go home so it may be true in some cases it may not be the answer in all cases so in our data we found no association in fact the association that we found with birth and children was positive but the tendency was that it was higher where households had children so it's tricky nutrition education they only gave me 30 minutes so yes it's there but it's an evolving process as well so that when we do provide the education we do it in a way that is sensitive because you know and as I mentioned the difficulty of doing randomization walking into a home for a single mum where her husband walked away and to see the resources at her disposal it's really hard for me just to tell her to feed these to the child so trying to do things in a way it takes time to come up with the literature and the approach that seems feasible for community vaccinators I've been working for 20 years with Lily Stickens from trying to keep them alive and to prevent new couple disease we know the vaccine so that was not the issue and so the idea of giving the vaccine away free of charge was also not the issue our key question was is the investment in this control program going to make sense to a ministry of finance and so we took the hard option of saying community vaccinators get rewarded by the community so if you want your birth vaccinated you pay as a charge for vaccination and then the vaccinators also meant to go and buy their own vaccine because we really didn't have any more interest in showing that a donor funded project gives things away for free work and then to come back two years later to find there was nothing on the ground that was not of interest to us and for the question about two years we're only just, we're three years into this project the observation it taking two years to see a change is from previous work where we've done where we know that for communities to decide to decide to alter the way going on takes time and it's not about understanding what's going on it's about them having certainty that the vaccine is still going to come that all of these changes are going to hang around so it takes about two years for communities to decide that maybe this time the intervention is actually useful but they have some confidence that the vaccine is going to arrive when it's needed so lots of things for people to decide to make a change to what is a very finely balanced approach that they have to manage and guess an important option thank you thanks Robin okay I'll answer your question yes, everyone get an answer happy answer yes, follow up, very good yep, please I'm not sure on a today well you answer to the third question about I think the question was how sort of being incentivized to participate and your answer was like they were to pay the vaccinations yes, it's the secret if your vaccinators are happy and motivated so in that case I'm just trying to understand, so what did you do to make the vaccination come to visit them because if they are paying could that actually come to the village early on there'd been no training in these villages so we selected and moved to areas where vaccination had not been introduced but in many cases where you were working particularly closer to big cities there may have been vaccination campaigns that have been poorly introduced so sometimes what you have to do is overcome bad experiences when the vaccination arrived when the disease was already outbreak was underway and you just make it look like you're actually killing of those so there are all lots of stories out there make it look like the vaccines are getting the births, okay good I'm assuming that we have quite some questions for Paola Sylvia and Delia and Jenny as well but we have them collected, we're gonna have a bit of an exercise now so you have like one minute to organize yourself a little bit, you've been sitting for a while I recommend you stand up you swivel around and then you sit down again something like that just because we're gonna change the we're gonna change the dynamic a little bit yes, so I need yeah, so just stand up spin around, stretch an arm are you leaving us okay, thank you very much you left your things here, very good I will steal your chair then I need that good, so I hope you've had a chance to swing around thank you very much I know a couple of people are leaving we're missing you already as they say we're gonna do kind of a wrap up session if you can maybe move your chair over here for the next session we need them to be on the screen otherwise you'll be on the screen are they good okay, good I can see a few people sneaking out, are they going away or are they just going for a more break some are leaving okay Paula has to be there waiting for Sylvia to come up to her place there's a lot of a lot of people go outside, are they gonna, do you see them are people coming back in again do you think are they coming back in again do you think I know that, yeah so folks we're gonna do the last session if you're sitting far away you can come a bit closer if you like it's not nice or it's back table maybe you can come closer and just be a bit cozier there's a word in Dutch called gazelle which means being collectively friendly with each other close together cozy and friendly, good so we're gonna change the focus welcoming the webinar I think I'm looking for Edwin is Edwin hearing me upstairs, yes anybody online yes okay, are there very many people online one two three four I can't hear you you're early look at that one I don't want to okay I think it okay welcome to for the people on the Webex this is the animal source group livestock nutrition station workshop, we're at the last session we have one hour, we're gonna wrap up what we did my class now is very briefly that's all what we did today and the panel has come in on the Webex so basically we've been looking at animal source foods for nutrition impact and we just have a finger on evidence of good practices for better and we started off some welcome remarks that's why we're here and demonstrate how animal source can contribute to nutritional outcome and about digging evidence and how have we done that we started off with Jenny and all our speakers are sitting on the bench here a bench on a group of chairs and they should all be on the camera yeah, for the Webex we don't see it ourselves but they will be seeing you on the camera so don't do anything strange so we started off, Jenny from Land O'Lake basically reintroduced in a sense how animal source contributes to nutrition, the science the nutritional science and showed the importance of meat milk and eggs in our diets from a kind of scientific perspective Delia Grace from Illry she talked about the livestock nutrition pathway it's called Pathway on the agenda but it's Pathways we discovered there are many many different ways in which you can try to bring livestock nutrition together and she showed us a nice picture of a different pathway she said something like none of them work but they're all worth trying that's not a quote something like that so we spent some time after the break looking at different pathways so we had three presentations Delia started us off with a kind of a report back on a global literature review with an emphasis on lower middle income countries looking again at the influence of livestock derived foods on nutrition what I took away from that was that there is evidence there is not evidence there are significant positive relationships between livestock derived foods and children but there is no real evidence of nutritional outcomes however there is clear evidence of health risks and there seems to be some evidence of environmental issues so it wasn't all good news very little evidence could be found we then heard from Paula who took us through an evolving and emerging I think and one school of high genotropical medicine set of guidelines on how to improve program planning to meet nutritional outcomes and that for me the main message was really very much start with nutrition from the very beginning you're going to design and plan for nutrition make sure you do it properly pay attention to many all the different dimensions so it wasn't just have nutrition make it very very visible and then we heard from Robin about the impact of poultry intervention Robin Alders from University of Sydney who claims to be a farmer as well about the impact of poultry intervention on household nutrition in Tanzania and for me the big thing there was that it sounded like a totally new type of research had to be done insights from the research process itself and you gave us some preliminary insights and lessons from the the work but very much about the challenges we're trying to do real research evidence based research that really has you know meets all the ethical standards as well with human objects as well as animal objects so that's what we did after lunch we had an exercise about to design kind of a design guidance product that land of legs are working on and we got feedback on that and we're now in a session where we're going to synthesize what we got from the whole meeting so we're going to start with our five speakers once more I've given you a little bit of a flavor each of them has been asked to give us a two minute pitch yeah explaining the essence of their presentation for somebody who missed it yeah so we heard this morning the challenges are trying to present the work in 30 minutes you now have two so shall we start in the same reverse order or same order Jenny has the microphone so she's ready to go same order Jenny tell us, give us the essence in two minutes alright thank you so hi everybody out there in Webinar World I'm Jenny Lane I'm an animal health and livelihood technical advisor from land of legs and I spoke on the potential contribution of animal food to nutrition outcomes and my main take home message is that a small amount of animal source food can vastly increase the nutritional content of a mostly cereal based diet globally amounted nutrition is a giant problem still something wasting and hidden hunger of micronutrients deficiencies are very prevalent around the world still and animal source foods are rich food based solutions full of many micronutrients that can address a lot of the malnutrition under nutrition issues that we have in the world and I covered the content the special what's the good stuff in milk, meat and eggs and their nature super food I think thank you Jenny takeaways yes, super foods hello I'm Collie the animal and human health program here at Ilway so if livestock products are nature super foods, why don't we have any good evidence that livestock interventions can lead to nutritional outcomes one of the reasons is that the pathways between livestock intervention and nutritional outcomes are very complex, multiple and some of them go in the wrong direction taking it towards the worst health the good news is that there are a number of conceptual frameworks which help us understand these complicated links between livestock interventions and nutritional outcomes including one developed especially for animal source foods by early scientists we can say of these that they are just approximations to the truth, all of them are wrong and all of them are useful but if you want your project to have a nutritional outcome and to demonstrate it get one of these pathways, find one and use it in your planning impact assessment and reporting thanks Delia I have another microphone Sylvia I think you're next there will be a lot of from early scientists in the animal and human health team so not only we don't have enough evidence on the livestock interventions and nutritional outcomes but we have very limited evidence too on the effect of animal focused interventions and nutritional outcomes so all these come from the view of the literature with them for the report looking at the effect of livestock that I put products in the first thousand days but there's a few things that I think we can say from that like the poor are eating little livestock that I put for now especially that this applies to women and infants diets that they are in low and middle income countries that are very suboptimal so even though convincing scientific evidence on livestock that I put and nutrition is limited there is some room to improve the diets especially women and children in low and middle income countries to sort of make it more close to the recommended diets now we also need to be aware though of the risks of promoting livestock that I put consumption and health risks derived from foodborne diseases DCT and overconsumption and many other things need to be sort of looked at but still especially when it comes to food safety and foodborne diseases this is quite a fixable problem so we shouldn't shy away from sort of promoting livestock that I put consumption what is needed the other negative potential effect this environmental effect and all the big debate about the impact of livestock in the environment by what's going on in northern countries I think when it comes to low and middle income countries there is still room to preserve and improve even consumption and livestock that I put is still preserving the environment so all these and more in an upcoming report from Ilri and Chatham house that will be out in about in August 2017 so my name is Paula Dominguez and I'm a joint position between Ilri and the London School of Aging and Tropical Mixing and despite all these challenges and lack of evidence in some areas etc. there's also a good resource to believe that livestock and animal interventions have a lot of potential and the background work that we have done is that there is still a lot of disconnect in the field so because of that in a collaborative work which we did between FAO Royal Veterinary College and Ilri we drafted some FAO guidelines on program planning on livestock and nutrition that hopefully will be released in a few weeks hopefully and they give a little bit of ideas on how to make specifically livestock interventions nutrition sensitive and this is important because nutrition specific which are the opposite of nutrition sensitive so it's mainly conducted by nutritionists there has been estimation that even with a coverage of 80% it would only reduce something around 20% something which is good but it's not enough and actually the coverage for many of these interventions is far from being 80% even for 50% which means that given the huge problem that malnutrition is for individuals and for households and for countries we don't need to collaborate in one way or another so it's worth trying I really have a saying and those guidelines which we hope will be helpful will give an idea of how to because the thing with both nutrition and livestock production is that it's very context specific so it's not like you do this and that's it you have to assess in every situation which things can work better so those guidelines take you a little bit through what can be considered and how to think about how to think through the impact pathways to get the most useful intervention. Thank you and good morning my name is Robin Aldous and the University of Sydney kindly pays my salary and they are supporting my farming habit so I really am a farmer and might use our lambing as I sit here with you right now my task was to discuss impact of our work but I highlighted straight off that we're three years into a five year project and so and we've analyzed two years of those data so we're not really seeing the impact of our work we're understanding what was going on in those systems and we hope before the end of the fifth year that we can look at the impact of our intervention I spent a lot of time sharing what we've learnt along the way I think we all know that interdisciplinary work can be a great challenge and it really is as strong as it's weakest link so you really need to have people who are through disciplinary specialists involved and contributing and feeling comfortable about sharing what does and what does not work one of the great experiences for me with our current project has been the process of randomization I spent most of my time working with farmers where we may have made opportunity available at the community level to vaccinate chickens we chose to do follow up and work closely with the farmers who wanted to work with us with this project because we really want to understand our current project we wanted to understand what was happening across the community we took a randomized approach and it means you can't walk away from the household who don't adopt they're the ones from whom you learn the most they're often the most vulnerable and so it's been a great challenge understanding the ethical principles also moral principles which we need to take into account and the responsibility we have to the community who allow us to work with them doing work with human nutrition takes a long time and you need power for this idea of having sufficient sample size that you can do all these wonderful statistical calculations to come up with answers that mean something so that's the challenge I'm a great advocate of mixed methodology so you need to have lots of household but at the same time when you're doing your individual focus group discussions or key informant interviews what each person says is also powerful and sometimes it can be those who are brave enough to tell you something maybe that's just that one individual that makes a difference between understanding why things are not going well and the big difference so the idea of power and sample size can be hugely different depending whether you're talking about quantitative work or qualitative work I spent a little bit of time talking about what we've found so far in our project we started in February 2014 we've had very tough rainy season in the communities where we're working I guess for those people like me who like village chicken of the livestock species the only ones that have shown some association with improved outcome for growth in children has been chicken also with improved BMI in women we used the opportunity of working with households to track anthropometric indicators for both women and children if we had time and money in the household certainly the idea of focusing on women as children is the most vulnerable is crucial but everyone in the household should be able to be involved in some way so that's the main thing and I think the real lesson is for me is working with those communities they understand their circumstances they also understand why they may not be following and having a nutritious diet because they understand their limitations so far better than actually some of those pictures were a little longer than two minutes that's okay so what we're looking to do now is try to get a bit of a conversation among the folks sitting here but also amongst us as a group so we want you to come up with your questions I'm going to start a little bit with the questions we already shared this morning and we hope that some questions will come in during the webinar so Robin since you have the microphone I think still one of the questions that came in asked about what are the explicit nutrition indicators that can be built into agriculture related programs you just mentioned a couple can you tell us a little bit about what are the specific indicators in relation to animal source foods and nutrition that you used how did you come up with them how effective were they tell us about indicators an excellent question and the choice of indicators will depend very much on the timeframe of your project and your budget so if you have a short project anything under three years it's very hard to even contemplate looking at things like growth in children I would suggest that things such as dietary diversity and also people's understanding of the different role of the different types of food and the different components of food would be acceptable for short term projects even for a five year project I think while we are measuring length or height in children and BMI in women using biomarkers such as tracking vitamin A iron levels now that's something if you have the money you may be able to do that in a two year project and see improvements so there's no simple answer and you need to work with what's available in your area what your budget can come up with I'd just like to add to that because it's a trap which we've seen some projects fall into there's a wide variety of things which can be measured but if you want to prove a causal relationship as you're trying to do for example a randomized control trial and your objective is to show that your intervention has made a difference to nutritional outcomes it's important that you just choose one or two primary outcomes which are the things which your trial stands for followed by that is what you use to show whether or not you've had an impact on nutrition what we sometimes see in projects is they choose 9 or 10 different things it's A, vitamin A, it's stunting it's wasting it's mother's BMI it's varsity, it's total consumption of milk it's diarrhea episodes and sure enough they find that one of these is significant and then they say that they've shown that their project has nutritional outcomes it doesn't because if you don't choose one primary outcome and pre-specify it anything else you analyze is meaningless because you just go into what's called a multiple comparison problem can you pass the mic to Jenny everybody sitting here is a lot of scientists Jenny is working for an NGO is there a different perspective if you look at development projects I mean we've got two scientists now and a farmer give us the NGO perspective is there something different around the indicators yeah this is a pretty complicated topic actually and just to step back for a moment actually the very first session in this entire range was back in last June was on the success topic so if there's people out there interested in this I would refer them to that but to get to your question it is very complicated because often the donor where you're getting your money from determines what your project objectives are and they might also determine what indicators you're going to use and those indicators might not be the most effective in showing impact in what Celia is talking about and Robin's referring to so if you as a project want to add in indicators you have to have a very good reason because they cost more money so you are sometimes really limited by what's already been predetermined in both from donor as well as in project development stage so there needs to be a lot of feedback from what you're up what you previously learned what you're designing for and what you're looking for and understand why it's important why you're trying to co-opt something different we'll come back to that if anybody in the audience wants to say something about these indicators but I know that Celia has to leave us in a moment so before you go you reported on this study of the evidence literature review so one big question that came out of the audience why is there no evidence of the impact of AI test on nutrition the second question was is it due to poor research so what's your take on that I also alluded to this when I was talking I think what we find in the systematic literature review we did which is specifically look at projects that were doing interventions on providing livestock that are foods to children and then looking at the impact of that on nutritional outcomes out of a thousand and seven hundred we only managed to select 13 that made our inclusion and quality criteria so I think that says a lot there is a problem of quality of the studies and again goes back 15 13 sorry there was only eight individual studies because several papers were different outcomes for the same studies exactly but tell us why why is this so I think both Jenny and Villia referred to that a little bit we jumped into these studies with a really a time looking carefully whether an impact evaluation should look like and what is the most powerful way of detecting impact and effect and sometimes it's about choosing that one primary indicator primary outcome you are interested in and we try to perhaps I'm just trying to be too ambitious I wanted to look at many things and that compromises the power of the studies there are other things such as the money available for the project I mean this can be very expensive projects to run sometimes research studies cannot deal with that and then we might also say that the intervention is normally complicated when you even when you do feeding at school feeding programs at school you know what diet the children are having at home already how that food is being given to the children what is the compliance the coverage you manage to use those are very seems very difficult to monitor and capture so I think it's a combination of the interventions are complicated but also we need to you know take perhaps more seriously the impact evaluation part and you know try to spend quite good money into looking at one thing well I think it's a little bit it's a little bit part of that too I think sometimes the studies the research studies are not designed you know with sufficient power or with sufficient you know analytical methods that will help them demonstrate that impact I mean this room is full of people who have worked out more NGO's actually more than scientists perhaps is there another type of evidence that they have that you didn't look at well you will have to ask them I guess did you also look at the you referred to studies and literature and all that what about some of those studies actually were came from development projects so it's not always necessarily scientific studies set up to test hypotheses obviously I guess those that generate the type of evidence we were looking for are more likely to be going to be the physics studies you know the random mass control trials comparison groups and all that so that's much more likely to happen in the context of a research project that perhaps in the context of a development project but we included both we didn't necessarily exclude a development project if it was designed appropriately to measure impact we have a little time should we go back to the audience we have two questions one around indicators there's evidence does anybody in the room have an answer that Sylvia or Robin couldn't answer or Jenny anybody here share something about the indicators you use there's a good example over here we were talking earlier indicators they're running a development project right what sort of indicators are you using how did you come up with them not really answering your question but to your point Jenny about the indicators and outcomes frequently being demanded or restricted by the donor I think that's a huge problem it just makes me think having donors in this type of discussion is so important and influencing at that level because some of the indicators won't mention the donor or the initiative but with definitions that are four pages long even ensuring that everyone on a program team understands what we're measuring so what you're more or less saying is that these indicators are given to you you don't have much attitude to yourself to select indicators so being told we receive an RSA we submit a proposal we design a program but then we're also mandated to use certain indicators that don't necessarily align it's weird scientists have independence right so you guys can choose your indicators and see what the development projects are driven by the funder let's look at the evidence piece we heard about the scientific evidence and Sylvie said ask them so I'm looking for somebody here working for an NGO or a development project who's generating evidence why is there no evidence about nutrition and livestock does anybody have an answer everyone's looking away from me yes, Susan you're not an NGO it's a project tell us why is there no evidence no but I'm not a scientist either so it's a bit frustrating listening to all of this very important conversation looking for indicators looking for evidence when there must be some things we know right now and we knew 50 years ago and we knew 10 years ago that we just aren't putting in place and I don't hear that in the conversations today so instead of looking for more evidence and more indicators what about getting out the in-between stuff that is that is some evidence-based but also common common understanding and get that more into the world is that not part of researchers responsibility okay we'll come back to that, I'm walking in that direction before you answer Delia is there anybody in the audience here who says in my project we do collect evidence that isn't widely known and walking slowly yes I think there's a little bit of a disconnect in a donor funded project or which either NGOs and others are I guess it's the definition of what is evidence the standard set are of scientific studies they were the randomized controlled trial that's a very expensive process it's rarely unlikely that you have that funded so donors are demanding evidence there's evidence under their own criteria which are sort of preset indicators and these are oftentimes secondary data or a whole different level but it's not highly controlled or highly verified they put up verifications but it's a whole different standard it seems to me that there's a lot of work and a lot of knowledge maybe at that level but it doesn't meet the standard of a scientific study thank you Delia can you reply to some of those I think some of this is a moving target so many of the studies we reviewed were obviously done in the past and in the past standards of evidence were much lower people didn't have this focus on actual anthropometric nutritional outcomes necessarily or power calculations or primary outcomes so the demands for evidence are evolving very rapidly and I agree in a way with what people are saying we know these are super foods and are good so rather than spending so many million dollars on randomized controlled trials why not just divide that among 100,000 poor women and then they can go and feed bi-animal food for their kids it probably won't do them any harm but where it's coming from is this understanding that most of the high standards of evidence these sort of power calculations randomized controlled trials came originally from medicines and clinical medicine and that came about because people realized that when people were just going on what they judged was best what they saw around them what their anecdotal impressions were they often got things seriously wrong and they give examples how for decades there was a highly common condition called stomach ulcers many of you have heard of it and they had whole chunks of their stomach cut away and all sorts of other treatments and every surgeon who did it was convinced that he was doing good and then they found out it was caused by a bacteria and that the treatment was an antibiotic and again in development and I'm working especially in food safety and all around Africa and Asia we see monuments to good intentions gone wrong in these abattoirs and improved infrastructure and all these things that people thought were going to solve the problem and not only did they not solve the problem they often made it worse and I think this became more widely used and known donors, not all donors but a lot of donors started upping the game they wanted more and more better evidence they didn't want to invest money to actually see and they were surprised and we were surprised and shocked after having worked in livestock research to find that when people did the studies there was no evidence any of this had any benefit so that was a bit of a challenge so where it's coming from why I think it's good this emphasis and evidence and it's not going away but at the same time we shouldn't get so totally caught up with it that we don't do useful important things just because we don't have a total trial saying that we should ok thanks we're going to move on a little bit I want to get another question here so Paola you have the other mic so the question is how do we achieve behavior change within households to achieve better nutrition so we have the evidence we know what should happen how do we achieve that behavior change tell us you're both a vet and a nutritionist so what's your thoughts would your guidelines help us and I don't have the absolute the ultimate answer to that but what I would say is that well we've been discussing that before and for everything not animals or sports or and in low income countries everywhere like even you know people stop smoking when there is no it's quite clear that it's bad and there was lots of evidence a lot of money put and that that took ages that took years before that was properly integrated so I think the problem is when we believe that we do we go to the household we tell them ok so from now on you do that and then we are disappointed because they don't and I think that you have some good example where you say yes we've had some changes we've seen some changes why that happened you have some good practices there and a little bit of evidence perhaps I'm not I'm not so familiarized with that whole area of literature but my personal view is that it's something you build on slowly slowly so it has to be different channels it has to be common agreement and different interventions throughout time known and one off not on as I was saying before for example not just on women because then women may have their own barriers so we have to target different members of the household we have to target different members of the society like I don't know elderly religious leaders it has to be at many different levels and throughout time and I think that's how we get how we can get something we heard this morning quite a lot about DCC right so this isn't evidence what's the lowest level of evidence is they call an anecdote and anecdotes the plural of anecdotes is not data and you go all the way up to an RCT but one thing from a study we did in a part of Kenya which is very famous because there have been many many great runners have come from that area marathon runners and when we were doing focus group discussions about milk consumption one thing which came up was the men were saying we make sure our children drink milk because we want the next winner of the New York marathon so this was a way they changed their behavior because of something aspirational something they wanted for their children okay anybody else in the room have an answer on that it's a question that came from the room yes give us an example of something I think it much depends also on how you do the behavior change communication if it is done in a way that is really empowering communities then I think it has much better chance than just us coming with like you should drink milk and I think the example from the is great like the aspiration what is the vision of the people where do they want to go rather than looking at the problems we are used to make problems to use and see problems everywhere that we want to solve the vision of the people which is really empowering them and I really believe in participatory techniques and empowering people we have a project running in western Kenya also where we have let the community decide about what types of agricultural interventions they wanted to do and we combine that equally with nutrition education that was also designed by themselves like data, et cetera and we are currently analyzing the data so I can't say too much about it right now but one of the things that we saw is that my collaborator was telling me last week and he said like from the data what I am seeing is that the nutrition education as such seems to have higher impact than the agricultural interventions alone as well but I think a big deal of the success of that project has been the way communities have really taken how to say that they have developed their own needs and interventions et cetera it has really been empowering them very much I will take one over here and then come back to Jenny I think that effective behavior change communication finds its base in barrier analysis formative research into what the barriers are or understanding what the reasons the underlying drivers are in terms of why people make decisions in terms of the foods they consume and so a good behavior change process is looking at those social, economic influences that are affecting the decision making in any community and it is site specific it is culturally specific so they do require investment but it is very informative in terms of putting together the correct approach to the behavior change communication designing the messaging where to focus the messaging how to understand the leadership and the social dynamics in the community what is the best avenue for messaging to bring about the behavior change so as you say walking into a community and say we are going to do it this way now well no that won't happen without some sort of analysis of it so it sounds like there is probably quite a lot of examples of this these types of good stories right perhaps there are only anecdotes I don't know I just want to add that I agree with what she is saying that the issue of that delivery community education is very key and I'm borrowing this from an example from what I've seen in my community including my own mother she would go for this clinic normal clinic and she would come with a message and tell us the clinic is what you are told and she would give evidence that why do you think for example why should you pour water from boiling beans and when you pour them to the cows they put the water very fast because it reaches a little bit and because of that water for even when you are finding food you don't have to do that away I want to think that an example whereby Kenya has changed from a time when people were looking to kill which is the most convenient way in Kenya that is Kumawiki and in the way it was being sidelined when it was being enjoyed but because of the people being the extension is being very deliberate being very good in terms of demonstration in terms of impacting the message people should be gradual from eating original vegetables to eating kale and became like a household vegetable almost everywhere actually now the problem is taking people from eating kale to eating the indigenous vegetables again so what I am saying is that it is possible it is doable thank you okay so are these types of experiences documented and shared I mean are people aware of them how to do this there is not much evidence about some of the some practical things do you have a question from there one second I have to bring the mic then we are going to have to wrap this up very quickly I will bring you the mic and then this is a question or comment from the this is from Sarah great points from current speaker another consideration is that often messaging about child feeding has been targeted only to the mother some lessons from breastfeeding BCCs suggest that greater inclusion of fathers grandmothers and mother-in-laws can enhance maternal capacity for optimal child feeding practices we see Emanuel quite a tough question primary production might not be the best approach sorry we were having a side conversation okay a side conversation good I am going to come back we are going to have to wrap this up I want to bring one last question from the group there was a comment actually which said that for this agenda to go forward we need a convergence or a platform of some kind for nutritionists and livestock production systems people can talk to each other how do we do that I know but it sounds like they want something more did you mean perhaps so what are your thoughts on that I mean this is something in that line tell us a little bit how could this happen on a more structural basis do we turn rats into nutritionists like Paola well I think that the ball is shifting there are communities out there where agriculture is coming together there has been a series of agriculture for nutrition and health I think all that ideally I will talk a little bit more about that but it is changing shifting only 10 years ago nutrition sensitive wasn't even a term right the question here is really about livestock nutritionists well livestock is our agricultural so I think the first step is realizing that livestock is a part of agriculture you don't know that and then including livestock in the agricultural conversation after talking nutrition maybe this is actually given context there is something called the agriculture nutrition and health academy of which earlier members various other people here membership is free if you just google A&H academy online they do meetings every year the last one was in Ethiopia and you'll find lots of information and also a platform where agriculture nutrition is coming together and in the website there is regular posting of news updates of new documents coming up and projects there's one at the moment I mean the same point when Robin presented about her project talk about the challenges within the University of Sydney trying to get to different schools so I mean is it not a bit schizophrenic for you you're both a vet and a panel nutrition public health person but I wouldn't recommend it I'm on a typical I'm on a typical case because I decided to go in testing and then last minute I changed into veterinary and then this has been my way to go back to have both at the end so I'm not a good example I don't think it's necessary and I think despite yes there is challenges having to work with people who speak a different language than you in terms of discipline there is all sorts of challenges but that's the way forward I think Robin how did you cross those boundaries the main thing is that you actually have to have a common goal because it's just messy in that first time and then as information starts to come in people feel better but I do believe that the conversation that needs to be had is well beyond low or middle income countries I believe globally that ministries of health and ministries of agriculture need to work together agriculture is like a very important program I think that ministries of health that have less work so I think that's an example that needs to be to become a global paradigm shift absolutely absolutely and it needs to be as we face all the challenges in the world with the resources that go into producing food they need to be the best food targeted to the needs of the group for which that food is being produced okay we need to wrap up the very last comment yes because we're going to have to we're running out of time I would say at the program level for bringing it back to designing programs and projects having a person or a few people on the team actually serve as integration officers and really kind of can straddle this divide of agriculture and nutrition and see how they fit together and also bring in the wash piece and you don't have to be an expert you have to have a little bit of an understanding of them and know how those objectives might differ because I project teams really do struggle with integrating and end up in silos the team themselves have to understand how working together is going to help them achieve a bigger goal but they need guidance so do you have those integration officers in member lakes? I've been learning to be an integration officer oh you'll be becoming one okay one of my other colleagues is here and he works on a team on our grocery nutrition project in Ethiopia and I think he understands a lot of the other pieces too and they are maybe you can talk to Gizzo about it later offline maybe sorry to put you on the spot maybe you can share the terms of reference at some point with integration officers good guys we're going to have to call it a hold I think thank you very much for that thank you very much I'm going to hand over I think to Carmen Carmen has the job to tell us what happens next but also to reflect on the whole day and she has about 10 minutes she's being sidetracked thank you guys if you want to you can stay here if you like or you can go there wherever you feel comfortable so good good Carmen I'm going to give you the mic do you want to show something or is it just Dr. Ignatius Caius has a comment I would like to reflect on that integration issue and how we are segregating a veterinarian and a caches and nutritionist I am a veterinarian maybe from the old school but I spent a lot of time learning about animal nutrition and human nutrition I spent a lot of hours on public health which relates to meat and meat products water so when you say a vet is not a nutritionist then I'm not a veterinarian and I'm a gashore but I'm working from the animal field so when we dichotomize the science then we dichotomize the development project UNICEF wants to do health and nutrition somebody wants to do livestock and another wants to do water I think we are just messing up okay thank you everyone that's in the room in person I think today was a really good a lot of information was shared early in the morning for the webinar people on the webinar especially those who are joining much after the second half in the afternoon for us everything has been recorded from the morning session and those links will be shared out probably in the next week or two if you registered for the webinar or for the in person meeting well actually everyone who received an invitation to webinar or in person will receive an automatic link with all of the links about the copies of power point presentations that will all arrive in your inboxes give us around two to three weeks give us a little of the time to wrap up today summarize this I don't just going back to the early morning Jimmy Smith and John Ellenberger really emphasize the importance of animal source foods especially within the first 30 days they also raise important comments around the role of livestock both in nutrition and economically and how that plays and how that without investments into that people are unable to reach their full potential you need both the nutrition and the income coming from livestock to be able to reach your full potential as in my very quick summary of their conversation the next activity that we did was voting with our feet which I thought brought a lot of great conversation fun conversations although we were all compressed to one side of the room everyone felt very strongly that we were not a luxury item that went down to being a basic human right good nutrition is a basic human right but also that we shouldn't we shouldn't not address the issue of vulnerable households consuming animal source foods just because it's expensive or some people may consider a luxury everyone felt very strongly that there needed to be investment in this and then why and how people keep livestock is very complex so getting at the question of increasing production of animal source foods will result in improved household nutrition and every I think the majority consensus was that livestock keeping is very complex issue we have the various pathways for livestock to household nutrition and that households are juggling a lot of different issues and that they are making decisions on a day to day moment to moment basis in these vulnerable households moving on what we had for our introduction to nutrition to get everyone on the same page just the importance of animal source foods in human development eggs, milk, the perfect food Jenny's new super foods of eggs and milk I think they're going to what spirulina's out and goji berries are out it's now eggs and milk okay and does livestock keeping directly link improvement to nutrition getting into Delia's discussion major reviews major reviews on agriculture nutrition sounds not overall evidence for nutrition outcomes brought us into the afternoon's discussion there's not a lot of evidence out there and really why is there not a lot of evidence I don't know if we really answer that well the role of socioeconomic factors that's really the role of livestock and household is very context specific and the importance of looking at the context to know how to design a program or to work with people to improve that link between livestock and household nutrition was very important and you cannot just take a cookie cutter approach although the connection between production of eggs and milk is a little bit closer for improving nutrition directly you need to consider the context closely when you strive to strengthen strengthen a livestock pathway livestock to improve nutrition pathway constantly asking what are the socioeconomic factors factors but as well as what are some of the contaminations and safety issues that we need to factor in I really need glasses okay thank you I will get D for those at CRS I still need glasses you know I think there was a lot of common information between the different speakers really getting at this yes this is a very complex issue that you really need to look at the details of what's the situation that's happening on the ground but that the potential return on investment investing in livestock systems for improved household household nutrition is great the opportunity is great the risk of whether contamination and food safety issues those those are risks yes but they do not outweigh the benefits especially from birth nutrition human development perspective I think the strong consensus granted we are a livestock people in the room and of course we want to promote livestock but that we that really we want to see more investment in this area pretty close at time at any last key points that we think I have a few compelling statements that were said at the end oh I actually really enjoyed Robin's comments with the billions with the billions being spent on producing food we should ensure that that investment is going into the very best in nutritious food and with animal source food with Jenny Superfood but these are important again important investments that we should be making unless there's any other comments any everyone's clear as far as next up let me see if anything's coming into the webinar no okay so with that I were right on time one minute over I'm okay wrapping up if everyone's feel oh the raffle yes post quiz have a microphone okay so there is in your packet there is something there the quiz it will look similar if you took the quiz online it will look very similar maybe the same if you could just take a few minutes please to take our quiz for us and then we have one last raffle which we might do in three minutes to entice you to take your quiz we're oh it's the food card and you had to have submitted a food card to be in the raffle and I'm going to so I'm going to let Peter wrap up well I'm not going to wrap up I'm going to say thank you everybody for a nice day I'm going to hand over to Delia who was heavily involved in this from the early side from the very beginning just to close the meeting on behalf of Jimmy Smith our director general who was here this morning to welcome us thank you all for coming it's been a great debate discussion as has been said it's not a one-off it's part of a process and it's part of an ongoing community of practice so I hope to be in contact and we will be sending out information materials so you will certainly be hearing from us in the near future and we will also give you an alert as the different reports which you had mentioned today come online Delia good so raffle results who's pulling it out me oh my gosh so which this is the food this is the dish right and so what's okay so one of these it's called termites Hannah Hannah's here wow I don't know I just pulled one called termites it has Hannah's name on it so Hannah wins she wins some termites okay anything else you have to do guys from your side are you going to reward people for filling in the quiz as they leave is that the idea thank you right can you show us those chickens oh my god is that like is that like a stress chicken or something or is it a toy it looks like we missed the whole thing okay he's just talking about it it looked like they were wrapping up yes isn't that what you're hearing so I think that wraps the whole thing up as soon as you finish your forms you're free to go we're going to send you lots of follow up unless we've been there time they really have an awful way but she had just started talking about the animal Susan yeah yeah yeah we can do that yeah let's start with the follow up