Editing IPCC:AR6/WGII/Chapter-7 (section)

==== 7.4.2.6 Multi-sectoral Adaptation for Risks of Malnutrition ====

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''Adaptation to reduce the risk of malnutrition requires multi-sectoral, integrated approaches'' ( ''very high confidence'' ) ''.'' Adaptation actions include access to healthy, affordable diverse diets from sustainable food systems ''(high confidence)'' ; a combination of access to health—including maternal, child and reproductive health— and nutrition services, water and sanitation ( ''high confidence'' ); access to nutrition-sensitive and shock-responsive social protection ( ''high confidence'' ); and early warning systems ( ''high agreement'' ), risk sharing, transfer, and risk reduction schemes such as index-based weather insurance ''(medium confidence)'' ( [[#Mbow--2019|Mbow et al., 2019]] ; [[#Swinburn--2019|Swinburn et al., 2019]] ; UNICEF/WHO/WBG, 2019; [[#FAO--2021|FAO et al., 2021]] ; [[#Macdiarmid--2019|Macdiarmid and Whybrow, 2019]] ; [[#Liverpool-Tasie--2021|Liverpool-Tasie et al., 2021]] ). Common enablers across adaptation actions that enhance the effectiveness and feasibility of the adaptation include: education, women’s and girls’ empowerment ( ''high confidence'' ), rights-based governance and peacebuilding social cohesion initiatives such as the framework of the Humanitarian Development and Peace Nexus ''(medium confidence).''

''Nutrition-sensitive and integrated agroecological farming systems offer opportunities to increase dietary diversity at household levels while building local resilience to climate-related food insecurity'' ( ''high confidence'' ) ''( [[#Bezner%20Kerr--2021|Bezner Kerr et al., 2021]] ; [[#IPES-Food--2020|IPES-Food, 2020]] ; [[#Altieri--2015|Altieri et al., 2015]] )'' especially when gender equity, racial equity and social justice are integrated ( [[#Bezner%20Kerr--2021|Bezner Kerr et al., 2021]] ). Adaptation responses include a combination of healthy, culturally appropriate and sustainable food systems and diets; soil and water conservation; social protection schemes and safety nets; access to health services; nutrition-sensitive risk reduction; community-based development; women’s empowerment; nutrition-smart investments; increased policy coherence; and institutional and cross-sectoral collaboration ''(high agreement, medium evidence)'' ( [[#FAO--2018|FAO et al., 2018]] ; [[#Mbow--2019|Mbow et al., 2019]] ; [[#Pozza--2020|Pozza and Field, 2020]] ; [[#FAO--2021|FAO et al., 2021]] ; Table 7.7). Nutrition security can be enhanced through consideration of nutrient flows in food systems ( [[#Harder--2021|Harder et al., 2021]] ).This ‘circular nutrient economy’ perspective highlights the potential for adaptations throughout the food supply chain, including sustainable production practices that promote nutrient diversity and density, processing, storage, and distribution that conserves nutrition; equitable access and consumption of available, affordable, appropriate, and healthy foods; and waste management that supports nutrient recovery ( [[#Harder--2021|Harder et al., 2021]] ; [[#Boon--2020|Boon and Anuga, 2020]] ; [[#FAO--2021|FAO et al., 2021]] ; [[#Pozza--2020|Pozza and Field, 2020]] ; [[#Ritchie--2018|Ritchie et al., 2018]] ). Traditional, indigenous and small-scale agroecology and regional food systems provide context-specific adaptations that promote food and nutrition security as well as principles of food sovereignty and food systems resilience ( [[#HLPE--2020|HLPE, 2020]] ; [[#Bezner%20Kerr--2021|Bezner Kerr et al., 2021]] ; [[#IPES-Food--2020|IPES-Food, 2020]] ; [[#IPES-Food--2018|IPES-Food, 2018]] ).

A feasibility and effectiveness assessment was conducted for six adaptation strategies often used and recommended by the UN to respond to malnutrition risks that combined a literature review and expert judgment assessment of 80 peer-reviewed studies (UNSCN, 2010; Tirado et al. 2013; methods adapted from de Coninck et al. (2018) and Singh et al. (2020)). Nineteen indicators of six dimensions of feasibility (economic, technical, social, institutional, environmental and geophysical) were considered. The lead time to initiate and the expected longevity of each option were examined. Feasibility was defined as how significant the reported barriers were to implement a particular adaptation option. Highly feasible options were those where no or very few barriers were reported. Moderately feasible were those where barriers existed but did not have a strong negative effect on the adaptation option (or evidence was mixed). Low feasibility options had multiple barriers reported that could block implementation. Effectiveness ratings were based on expert consultation and reflected the potential of the adaptation option to reduce risk. The final effectiveness and feasibility scores were categorised as high, medium or low and reflect the combined results of all studies for a given adaptation option (Table 7.6).

'''Table 7.6 |''' Feasibility and effectiveness assessments of multi-sectoral adaptation for food security and nutrition.

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Adaptive social protection programmes and mechanisms that can support food insecure households and individuals include cash transfers or public work programmes, land reforms, and extension of credit and insurance services that reduce food insecurity and malnutrition during times of environmental stress ( [[#Carter--2018|Carter and Janzen, 2018]] ; [[#Johnson--2013|Johnson et al., 2013]] ; [[#Alderman--2016|Alderman, 2016]] ). For example, children from families participating in Ethiopia’s Productive Safety Net Program experienced improved nutritional outcomes, partly due to better household food consumption patterns and reduced child labour ( [[#Porter--2016|Porter and Goyal, 2016]] ). School feeding programmes improve nutritional outcomes, especially among girls, by promoting education, and by reducing child pregnancy and fertility rates ( [[#Bukvic--2017|Bukvic and Owen, 2017]] ). Adaptive social protection is most effective when it combines climate risk assessment with DRR and wider socioeconomic development objectives ( [[#Davies--2013|Davies et al., 2013]] ).

Transformative approaches towards healthier, more sustainable, plant-based diets require integrated strategies, policies and measures, including economic incentives for the agroecological production and equitable access to and consumption of more fruits, vegetables and pulses; inclusion of sustainability criteria in dietary guidelines, labelling and public education programmes; and promoting collaboration, good governance and policy coherence (Glover, 2019).

'''Table 7.7 |''' Summary of adaptation options for key risks associated with malnutrition.

{| class="wikitable"
|-
! '''Key risk'''

! '''Geographic region'''

! '''Consequence that would be considered severe and to whom'''

! '''Hazard conditions that would contribute to this risk being severe'''

! '''Exposure conditions that would contribute to this risk being severe'''

! '''Vulnerability conditions that would contribute to this risk being severe'''

! '''Adaptation options with high potential for reducing risk'''

! '''Selected key references'''

|-
| Malnutrition due to decline in food availability and increased cost of healthy food

| * Global, with greater risks in Africa, south Asia, Southeast Asia, Latin America, the Caribbean and Oceania

| * Substantial number of additional people at risk of hunger, stunting, and diet-related morbidity and mortality, including decreased mental health and cognitive function
* Micro- and macronutrient deficiencies
* Severe impacts on low-income populations from LIMICs
* Risks especially high for groups that suffer greater inequality and marginalisation

| * Climate changes leading to reductions in crop, livestock or fisheries yields, including temperature and precipitation changes and extremes, drought, and ocean warming and acidification

| * Large numbers of people in areas and markets particularly affected by climate impacts on food security and nutrition

| * High levels of inequality (including gender inequality) and substantial numbers of people subject to poverty or violent conflict, in marginalised groups or with low education levels
* Slow economic development.
* Ineffective social protection systems, nutrition services, and health services

| * Multi-sectoral approach to nutrition-sensitive adaptation and disaster risk reduction/management, including food, health and social protection systems
* Inclusive governance involving marginalised groups
* Improved education for girls and women
* Maternal and child health, water and sanitation, gender equality, climate services and social protection mechanisms

| [[#Glover--2019|Glover and Poole (2019)]] ; [[#Mbow--2019|Mbow et al. (2019)]] ; [[#Swinburn--2019|Swinburn et al. (2019)]]

|}

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