What Does it Take to Change Your Mind?

By Marium Ibrahim

When evidence conflicts with strongly held beliefs, how easy is it for us to change our minds?

There may be many motivations behind why we hold certain beliefs, but what are these motivations, and in the event that evidence shows otherwise, how easy is it to change our point of view?

Let’s talk about…wheat flour fortification

By Haris Gazdar

Wheat flour chakki in Pakistan
Photo credits: Wikimedia Commons

1. What is food fortification?
Food fortification is the addition, usually at an industrial scale, of essential micronutrients to commonly consumed foods, to overcome nutritional deficiencies in vulnerable populations. It is a response to ‘hidden’ hunger – or the persistence of deficient diets in populations where hunger, as such, may not be obvious. Common examples of deficiencies are minerals (iron, zinc, iodine) and vitamins. Common examples of food fortification are salt iodisation, fortification of milk, condiments, cooking oils and staple foods with various micronutrients.

2. Why is it in the news?
Major stakeholders in the world of nutrition are supporting or taking part in fortification initiatives currently being launched. These are donor-supported programmes in various provinces to fortify wheat flour with iron and folic acid, salt with iodine, and cooking oil with Vitamin A. Mandatory regulation has been put in place in some provinces.

3. Why is food fortification so popular among stakeholders?
It seems like a low-cost response that can reach large numbers of those in need relatively easily through existing government and market systems. It does not require major economic uplift or poverty reduction – in fact it is best suited to addressing micronutrient deficiencies precisely in those populations which no long face extreme hunger and poverty.

4. So, does it really work?
Yes, no, maybe.

Salt iodisation has a good record globally and in Pakistan. Staple food fortification with folic acid has worked in many countries to address a foetal condition known as NTD. But there is little evidence that staple food fortification with iron reduces anaemia.

And in Pakistan the fortification of wheat flour with iron and folic acid has been tried several times without any publicly available evidence of success.

5. What is the hitch with wheat flour fortification?
There may be several, some technical others practical.

Technically, there is no clinching evidence that adding iron to staple food is an effective way of reducing anaemia. There are questions about quantities and absorption.

Practically, for fortification to be even considered, it should be applied to a food that is consumed by much of the target group through the year. In Pakistan there is no precise information on:

• What proportion of wheat flour that is consumed is milled industrially? Estimates range from 30 to 50 per cent. 
• What proportion of the population consumes milled flour all-year round, and what proportion of the population most vulnerable to anaemia consumes it? 
• Why do most rural households and many urban ones prefer chakki flour, and those that do use milled flour often opt for ‘fine’ varieties rather than regulated flour? 

6. Anything else?
Yes.

Around half of Pakistan’s population suffers from inadequate energy intake. One in three households say that they are vulnerable to hunger. So, Pakistan needs to urgently deal with actual hunger and not just hidden hunger.

7. What does that have to do with wheat fortification?
We need a serious reform of food security policies to ensure that no person is vulnerable to hunger. Current policies which aim to address food security are based on government wheat procurement and its subsidised supply to private sector mills who are then supposed to provide subsided flour to the population. This clearly does not work. The system has created adverse incentives and rent-seeking for capturing subsidies. Regulatory weaknesses in the sector arise from these rent-seeking opportunities.

Wheat fortification projects, by focusing on a technical solution around the same inefficient sector, are in danger of doing two things:

• Detracting from the need to address actual hunger, and not just ‘hidden’ hunger 
• Ignoring numerous sector analyses which call for a reform of the wheat system 

8. What needs to be done?
Policy and public debate must focus on ‘hidden’ hunger as part of a broader agenda of food security and combatting hunger – rather than imagining that stand-alone technocratic solutions are possible. And existing fortification programmes might avoid disappointment if they recognised some of the problems highlighted here, revised some of their expectations, and took on board existing critiques of the wheat subsidy system. 

This blog is a part of a new “Let’s talk about…” series that distils key research findings aiming to start a public conversation on emerging issues.

The Dairy Reform That Wasn’t

By Rashid Mehmood and Natasha Ansari

Modern, packaged milk still struggles to compete with the traditional alternative of loose, raw milk.
Photo credit: Fawad A. Najam, Flickr.com

There is a public debate about the quality and safety of milk sold to consumers. Most recently the Supreme Court took regulatory action with respect to some brands of packaged milk and also issued notices to companies regarding clearer labeling of whiteners as not being milk. Public attention on the dairy sector is welcome, but as government and courts gear up for action, it is important to understand the roots of current regulatory lapses, and to set out a broader agenda of reform that goes beyond consumer protection.

The Mystery of Political Will

by Kabeer Dawani

Political will is thought to be the solution to all development problems. But what is it?
Photo credit: Flickr.com

Along with corruption, the “lack of political will” is perhaps the most common lament among Pakistanis for public policy failures. For instance, a recent article in the Economic and Political Weekly argued, “many of the issues surrounding the recent census [in Pakistan] would have been solved had there been a political will.”

Teach a man how to fish? Social transfers in a “hungry” nation

by Hussain Bux Mallah

You can teach a man to fish, but does that ensure his household’s nutrition?
Photo credit: Pixabay.com

In the last two decades, there has been a lot of debate around social transfers, particularly cash transfer programmes. Do cash transfers give people dignity of choice, help them mitigate shocks and empower them, or do they “patronize” and provide an incentive for doing less work? Opponents almost always evoke the “teach a man to fish” proverb. However, there is an old joke built off this same proverb that says that even if one is taught how to fish it is likely that ‘he will sit in a boat and drink beer all day anyway.’ There is a grain of truth to this: with or without conditions, one can’t control what people choose to do with their time and resources. Still, many countries do try to ascertain the possibility that recipients spend cash transfers responsibly. In the United States, ten states require passing tests for drug use before one is eligible for welfare cash assistance or benefits.

Rest in power, Asma Jahangir

by Ayesha Khan

Asma Jahangir's funeral, 13th February 2018, Lahore, Pakistan
Picture credits: Rabia Mehmood

The untimely death of human rights defender Asma Jahangir has dealt a body blow to the Pakistani women’s movement and the peoples’ struggle for political empowerment. Most of those who attended her funeral yesterday in Lahore were less familiar with her international human rights profile and record as a Special Rapporteur for the United Nations in conflict-affected areas of the world. Those who came mourned her passing because she had fought for each one of their causes.

Extending agricultural policies to women

By Hussain Bux Mallah

Women picking cotton in Sanghar
Photo credit: Collective team

Pakistan’s employment trends show a steady feminization of the agricultural sector. Almost three-fourths of the female labour force is employed in agriculture, and the proportion of women working in agriculture has increased more than 10 percent from 2001-02 to 2012-13. However, the agriculture sector is not very friendly to women, especially to pregnant and/or lactating mothers. The health status of mothers working as agricultural labour and their children is alarming. Women who work in agriculture are far more likely to be underweight and to have children who are wasted and stunted than women who do not work in agriculture.  According to DHS 2012-13, out of all mothers who are working in the agriculture sector, 29 percent are underweight, 13 percent of their children are wasted and 52 percent are stunted.