REALIZING GENDER EQUALITY, ATTITUDINAL CHANGE AND TRANSFORMATIVE SYSTEMS IN NUTRITION (REACTS-IN)

Accelerating nutrition and gender equality for women, adolescent girls and children in Tanzania, Kenya, Somalia and India 2023 - 2029

REACTS-IN will support the strengthening of nutrition and health systems with a focus on the gender dimensions of malnutrition and contribute to achieving the World Health Assembly’s global nutrition targets. The program will implement integrated, multisectoral, evidence-based interventions that will address the key determinants of nutrition, gender inequalities and sexual reproductive health to improve the health and nutrition of women, adolescent girls and children under five in Tanzania, Kenya, Somalia and India.

The Need

COVID-19, conflict, climate change, economic shocks and more have threatened to undo years of hard-won development gains.

As the world approaches 2030, the timeline for achieving the ‘Zero Hunger’ target of the Sustainable Development Goals keeps widening. The unprecedented challenges posed by the COVID-19 pandemic, coupled with climate change and the impact of ongoing conflicts, including the war in Ukraine, have exacerbated the global malnutrition crisis and jeopardized years of hard-won development gains. Increasingly high levels of food insecurity in the target countries have exacerbated the susceptibility of women and adolescent girls to various forms of sexual and gender-based violence, as well as early and unwanted pregnancies. These factors contribute to a significant number of adolescent girls dropping out of school, which prevents them from reaching their potential and improving food and nutrition security for themselves, their families and their communities.

The situational analysis of REACTS-IN target countries revealed that these interrelated crises are projected to drive millions of people into high levels of acute, moderate and severe food insecurity across all four countries. In Kenya, approximately 942,000 children aged 6-59 months are affected by acute malnutrition, while a further 134,000 pregnant or lactating women urgently require treatment for acute malnutrition. Likewise, in Somalia, as of May 2022, an estimated 1.5M children under five, representing 45% of the total population of children, face acute malnutrition, including 386,400 who are likely to be severely malnourished. Furthermore, anaemia is a major public health problem in all target country, with prevalence rates of 56.1% among children under five in Tanzania respectively.

Combining forces to implement integrated, multisector interventions to address the key determinants of nutrition, gender inequalities and lack of access sexual reproductive health services and rights.
To reclaim the nutrition gains lost in the past few years, with a particular focus on the gender dimensions of the nutrition crisis we will work alongside our partners World Vision Canada, Nutrition International, HarvestPlus, the Canadian Association for Global Health and McGill University to promote the scale-up of gender transformative, evidence-based interventions that aim to remove the barriers that hinder women and girls from realizing access to good nutrition, health and sexual reproductive and reproductive health rights (SRHR).

Led by World Vision Canada, this project will:
• Ensure women and adolescent girls have equitable access to nutrition, health, WASH (Water, Sanitation, and Hygiene) and SRHR practices
• Enhance the availability and quality of gender-equitable and responsive nutrition, health and SRH services
• Strengthen the effectiveness of local stakeholders in realizing the nutrition and SRH rights of women and girls

YAWE will support the promotion of gender equitable decision making, control over household resources, and reduce SGBV; equip men to identify and reduce gender and sociocultural barriers that hinder adoption of gender equitable for improved nutrition, SRHR and WASH practices and will strengthen strategies to increase demand and utilization of Community-based and Family Planning method/ contraceptives. YAWE will apply different models to delivery effective gender-lens solutions on nutrition service both at individual, household and community level. Additionally, we will apply a comprehensive gender-responsive nutrition and health package designed for adolescent girls and boys. This package will engage teachers and student leaders to help facilitate access to nutrition and health services. To inform this package, evidence will be gathered through sex- and gender-based analyses to identify knowledge, attitudes, practices, gaps, challenges, and opportunities for improving adolescent nutrition and reducing anaemia.

REACTS-IN PROGRESS & ACHIEVEMENTS

From October 2023 to June 2024, YAWE has managed to do the following :

• Trained school teachers and community health workers on sexual reproductive health and rights, gender equality and child protection using Progam M & H Methodology as key community facilitators for adolescent girls and boys 10-19 years in schools and out of schools. Program M&H Methodology involves community-based education sessions and activities focused on gender, sexuality, reproductive health, parenthood and caregiving, violence prevention, emotional health, and HIV/AIDS. The program is adapted to each community’s gender norms, which are identified through a needs assessment. The program curriculum is also then integrated with other community action strategies. Activities and group education sessions which include youth being linked to community-based resources.
• Our application for Program M & H Program is an evidence-based program that has resulted in greater acceptance of domestic work as men’s responsibility, improved relationships with friends and partners, high rates of condom use, and lower rates of sexual harassment. Studies on Program H have shown increases in self-reported condom use, knowledge and communication about SRH, self-efficacy, decreases in self-reported STI symptoms and drug use, and more positive attitudes towards people living with HIV.
• Program H has been named a best practice in promoting gender equality and preventing gender-based violence by the World Bank and the World Health Organization and has been cited by UNICEF and the United Nations for its effectiveness. It has also been commended by the Pan-American Health Organization, UNDP, and UNFPA.