4. The Added Value of Business
Business action on nutrition can take many forms. It can involve improving workplace conditions, supporting community programmes, mobilizing investment, or expanding the scope of compliance reporting.
Many businesses have the reach, expertise and resources to be a significant asset in global efforts to overcome malnutrition. Action may take many different forms, from workplace interventions to community initiatives to collaboration with third-party implementing partners. Below, we outline the key opportunities for business intervention across the four major drivers of malnutrition, as identified in a recent Lancet series: poor early-life nutrition, poor diet quality, the food environment, and socioeconomic drivers such as income and education.72
Figure 11: Indicative examples of company-level actions to address the four drivers of malnutrition
— N.B. The coloured dots indicate the principal drivers of malnutrition that may be addressed directly through a given intervention. The figure is intended to be indicative and does not capture the full range of channels through which interventions can indirectly tackle drivers of malnutrition (for example, the payment of fair wages directly tackles household economic insecurity as a driver of malnutrition but can, by boosting household income, also contribute indirectly to improved dietary quality among members of that household).
Source: Authors’ own research, drawing on analysis of common drivers of the double burden of malnutrition in Hawkes et al. (2019), ‘Double-duty actions: seizing programme and policy opportunities to address malnutrition in all its forms’.
Source: Authors’ own research, drawing on analysis of common drivers of the double burden of malnutrition in Hawkes et al. (2019), ‘Double-duty actions: seizing programme and policy opportunities to address malnutrition in all its forms’.
Figure 11: Indicative examples of company-level actions to address the four drivers of malnutrition
Source: Authors’ own research, drawing on analysis of common drivers of the double burden of malnutrition in Hawkes et al. (2019), ‘Double-duty actions: seizing programme and policy opportunities to address malnutrition in all its forms’.
4.1 Addressing the principal drivers of malnutrition
4.1.1 Improving early-life nutrition
There is compelling evidence that a core set of interventions targeting mothers, infants and young children can significantly reduce the risk of childhood stunting and wasting and yield enormous benefits in terms of lifelong nutrition and health.73 These include interventions that companies can implement themselves.
Breastfeeding support in the workplace (e.g. through on-site facilities such as private rooms and refrigerated storage for breastmilk pumping, and through maternity leave benefits to reduce the opportunity cost for mothers wishing to extend their leave to continue breastfeeding) has been proven to be effective.74 This can be complemented by initiatives targeting the wider community, including the provision of breastfeeding support clinics or innovative products such as mobile phone-based support services (Box 6). Food companies can also support greater access to nutritious food for infants, young children, mothers and women of reproductive age through the financing or delivery of community feeding programmes, such as school meal provision.75
A core set of interventions targeting mothers, infants and young children can significantly reduce the risk of childhood stunting and wasting and yield enormous benefits in terms of lifelong nutrition and health
Key nutrition interventions also include micronutrient supplementation for pregnancy and childhood. Companies can help to develop and implement these measures, and also have an important role to play through responsible marketing. Evidence also shows that in order to protect against increased risk of obesity in later life, the provision and promotion of energy-dense fortified foods and supplements in early childhood should be time-limited and should be accompanied by nutrition counselling on healthy eating.76 Nutrition education and healthy food provision in the workplace can play an important role in improving maternal nutrition and nutrition awareness.
Box 6: Example intervention | Technology to support expectant and breastfeeding mothers | Milk Stork, IBM and Vodafone
A number of companies sampled are supporting breastfeeding working mothers through the use of novel technology and services. Some offer their employees the use of third-party services, such as Milk Stork, to enable the shipment of expressed breastmilk while on work travel. Milk Stork has reportedly been used by more than 10,000 mothers since its inception in 2015.77 Other companies have developed app- and mobile phone-based information and support services. IBM, in collaboration with Nutrino, has developed the ‘Nutrino App’ to provide expectant mothers with evidence-based nutrition guidance, such as meal recommendations.78 Vodafone in South Africa (operating as Vodacom) has introduced a ‘Mum and Baby’ service, offering free content on maternal, neonatal and child health, together with well-being information and advice on breastfeeding, through weekly SMS messages.79 A 2019 KPMG review of the project found strong evidence of the usefulness of the Mum and Baby service in providing participants with reliable information relevant to their, and their children’s, health and well-being. The report also indicated that the content provided has influenced the behaviour of subscribers, leading them to take actions improving their family’s health: almost all users surveyed following the introduction of the information service agreed or strongly agreed that it had led them to take actions to improve their children’s health, with examples including the incorporation of more fruit and vegetables into the mother’s diet.80
4.1.2 Improving diet quality
For food and beverage companies, investments in more nutritious product ranges, biofortification, and agricultural productivity and diversification can all contribute to improved dietary quality among their own stakeholders and the wider population.
Food fortification is an important means through which the private sector can contribute to improved dietary quality.81 New technologies and innovation are another key tool in the arsenal of the private sector that can be deployed to improve access to diverse and nutritious diets. In food and agriculture, technologies to decouple food production from land use – for example, vertical farming and closed-loop agriculture such as hydroponics and aeroponics – offer new ways of minimizing and repurposing waste in the food system, and of producing nutritious food in areas where land or water resources are scarce.82
But many such technological advances come from outside the food sector. For example, genome-editing technologies such as CRISPR have the potential to boost production of so-called ‘orphan crops’ – nutritious crops whose production has fallen as global demand for maize, soybean and other commodities has risen – in low- and middle-income countries. This would help to diversify food production in support of more varied diets and improved productivity in regions where yield growth in main crops is stalling.83 Cold-chain logistics and storage, if deployed at scale, could significantly reduce food losses and enhance access to fresh and nutritious foods, particularly in remote communities where distances to market are great.84 Advanced sensor technologies, artificial intelligence, robotics, molecular printing, novel packaging materials and personalized nutrition monitoring – all have the potential, in their applications to the food system, to transform access to diverse, nutritious diets.85
At a more modest scale, all companies, regardless of sector, offering workplace canteens are in a position to influence, directly or indirectly, the quality of one or more daily meals among employees. And, through the integration of nutrition education and training into health and well-being programmes, companies can contribute to the embedding of healthier eating habits among these same groups. In 2005, the International Labour Organization identified food provision at work as central to delivering on the ‘decent work’ agenda, and advised that ‘enterprises are hurting themselves in not offering better meal options’.86
4.1.3 The food environment
Industry players – particularly in the food and beverage sectors – are pivotal in shaping the food environment. As food systems in low- and middle-income countries transform, with greater market penetration of global brands and rising demand for ‘Western’ diets, the private sector can help to drive this transformation in a direction that supports access to healthy and nutritious diets. Innovation and investment in food processing such as refrigeration, canning and pasteurization – and support for smallholders and SMEs to build their capacity in such processing – can prevent the loss of nutrients in foods and allow for safer and more ubiquitous access to fruit, vegetables and animal products, particularly in rural settings. Product reformulation – to reduce the salt and sugar content of foods, for example – can improve the healthiness of food options while meeting local preferences and without limiting choice.87
Companies from all sectors can help to support a diverse local food environment and sustain smallholder livelihoods by procuring local food where possible for use at their offices or other facilities
Companies from all sectors can help to support a diverse local food environment and sustain smallholder livelihoods by procuring local food where possible for use at their offices or other facilities. Other measures to shape the food environment include the use of ‘nudge’ tactics to build a healthy food environment in the workplace (Box 7), engagement with local food vendors to improve the healthiness of food on offer around the workplace, and responsible practices around the advertising of unhealthy foods and the use of nutritional claims on food products. Supply chain due diligence to ensure good practice among upstream suppliers can reduce the risk that a company is indirectly supporting a poor or harmful food environment.
Box 7: Example intervention | Nutritional scoring | Nestlé and BMW
A number of companies sampled are using nutritional scoring to enable consumers and employees to monitor their nutritional intake in a simplified way. One example is Nestlé’s Meal Nutritional Score (MNS), which scores recipes with a number between 0 and 100 based on the extent to which the meal aligns with national and WHO dietary recommendations.88 The MNS was piloted in the workplace at Nestlé Research in Lausanne, Switzerland, where, after two weeks of testing, the number of people selecting nutritionally balanced, higher-scoring meals increased by 10 per cent.89 Nestlé then extended the MNS system for public use, piloting it first in Mexico,90 via a recipe website which allows consumers to browse recipes and add them to their ‘menu’.91 The interactive platform also suggests starters, side dishes or desserts that will help the user ‘score higher’ and design a nutritionally balanced meal.92
Nestlé has developed a second nutrition score for use with children between the ages of six and 12 in the Philippines, creating a website called the ‘Tibay Calculator’.93 The website allows caregivers to monitor the diets of children by reporting on what the children have eaten in a given period. On the basis of this information, it calculates a score for diet diversity, assesses the probability of nutrient inadequacies, and provides food and product recommendations to address any suspected nutrient gaps.94
A simplified nutritional scoring system has also been used in the BMW Group’s staff canteens. A ‘traffic light’ labelling scheme indicates the meal’s calorific and nutritional value, factoring in the relative proportions of key ingredients and the method of preparation .95 Since the scheme was established in 2013, over 50 per cent of the group’s estimated 22,000 workers in Germany have been shown to change their eating habits, choosing healthier ‘green’ meals over other options.96
4.1.4 Socioeconomic factors
Nutrition education and health checks for employees and the wider community, the payment of fair wages to employees and responsible tax practices can help to tackle the underlying socioeconomic factors that drive malnutrition (Figure 1).
There is a wealth of evidence, both quantitative and anecdotal, around the impact of health and well-being education for workers on their health status and productivity. A study in the US found that, on average, healthcare costs to companies fall by $3.27 for every $1 investment in employee wellness programmes, while absenteeism costs fall by $2.73.97 Nutrition education, while insufficient in and of itself to overcome the multiple barriers to accessing and following healthy diets, is recognized as an important component of efforts to promote positive changes to eating behaviours.98 Evidence of the impact of per capita income increases in reducing child stunting, and in improving the food security and dietary quality of households, underlines the role that the payment of fair wages can play in supporting workers’ nutrition and that of their families (though higher wages need to be accompanied by interventions to improve nutrition education and create a healthy food environment, in order to avoid increased consumption of unhealthy foods as incomes rise).99 In addition, responsible tax practices can reduce fiscal leakages and, in theory, boost available public funds for government-led nutrition interventions.
Companies can also work in partnership – operationally and/or financially – with governments, other private-sector actors, civil society organizations (CSOs) and academia to support the implementation of nutrition interventions, generate best practice, raise awareness of the role that business can play in tackling malnutrition, and advance understanding of and research into novel and improved nutrition interventions.100
4.2 Nutrition-sensitive CSR programmes
While this report focuses on interventions directly aimed at improving nutrition, companies can also take ‘nutrition-sensitive’ action in other areas.101 Nutrition-sensitive approaches can be defined as those deployed in complementary sectors – such as public health, early child development, education, and water, sanitation and hygiene (WASH) – which have the potential to improve nutrition security through tackling the wider social determinants of malnutrition, including poverty and limited access to clean water and adequate sanitation (Box 8).102 Companies already implementing strategies in the community targeting these broader sustainability areas may, through integrating nutrition-sensitive elements, demonstrate positive action in support of tackling malnutrition and contributing to the achievement of SDG 2 and nutrition-centred targets.
The integration of nutrition into existing CSR activities, for example those targeting improved health, also applies to workplace policies and programmes. The HERproject, developed by the Business for Social Responsibility (BSR) initiative, focuses on improving women’s health among employees through multi-component workplace programmes, which often include nutrition (Box 9). A 2009 literature review – predominantly focused on North America and Europe – found ‘strong evidence’ that multi-component workplace programmes combining healthy food provision with other incentives for healthy living (e.g. prompts to use the stairs rather than the lift, space for physical activity, and cues such as labelling and price promotions for certain healthy canteen options) are effective in improving diets and preventing non-communicable diseases.103
Box 8: Nutrition-sensitive WASH interventions
Water, sanitation and hygiene (WASH) and nutrition are closely interconnected.104 Insufficient access to clean drinking water, poor hygiene practices and inadequate access to sanitation facilities are all significant risk factors for undernutrition. Poor WASH conditions are conducive to the spread of illness, most notably diarrhoea and pneumonia,105 which in turn can limit an individual’s ability to absorb essential nutrients. WASH programmes are recognized as critical in improving nutritional outcomes.106 As such programmes are often implemented on a large scale by development agencies, they offer important opportunities to engage beneficiaries on the issue of nutrition and to incorporate nutritional training and education into existing awareness campaigns around good food hygiene.107
WASH programmes can be made nutrition-sensitive in a number of ways, including through targeted efforts to support and promote good WASH practices among pregnant women and new mothers during the first 1,000 days of a child’s life, when good nutrition has a particularly critical impact on lifelong health and development.108 Training WASH programme implementers – including community outreach organizations and healthcare professionals – in basic nutrition can allow for the integration of nutrition monitoring and advice into existing WASH programmes without the need for additional staff or resources.109
Box 9: Example intervention | Tackling malnutrition among female workers | HERproject and Li and Fung Limited
The HERproject was launched by the Business for Social Responsibility (BSR) initiative in 2007. It connects multinational companies and their production factories to local NGOs to establish sustainable health programmes for low-income female workers in global supply chains. Since its inception, the HERproject has worked with more than 60 businesses in 850 workplaces across 14 countries with the objective of increasing the well-being, confidence and economic potential of more than 1,000,000 women.110 HERhealth programmes, under the HERproject, focus on addressing preventable health conditions such as anaemia by delivering healthcare services and improving understanding of good nutrition, among other health topics, through training and peer-to-peer learning. A review of health programmes under the HERproject in Egypt and Pakistan identified a number of positive outcomes among workers engaged in the programmes, including reductions in absenteeism, staff turnover and early-leave requests.111
Li and Fung Limited, a Hong Kong-based apparel and consumer goods company, introduced the HERproject to its suppliers in Bangladesh, Cambodia, India and Vietnam – targeting more than 175,000 female textile workers. In Cambodia, projects focused around health and nutrition have been shown to have tangible results, with interim project reviews indicating an 18 per cent increase in productivity and a 10 per cent decrease in resignations from female workers compared to at the start of the projects.112
4.3 Bridging the investment gap
Workplace and CSR programmes have important limits. The communities most severely affected by malnutrition may lie beyond the reach of companies, particularly MNCs. Many such communities will be marginalized, with workers engaged in the informal economy and populations living in settings too fragile for large-scale business investment. Research has found that children of temporary or migrant workers are particularly exposed to a poor food and nutrition environment, while the highest rates of childhood stunting are found in Burundi, Eritrea, Timor-Leste, Papua New Guinea and Niger,113 countries ranked as having among the least competitive business environments in the world.114
Underinvestment has hampered progress towards achieving the World Health Assembly targets and broader nutrition targets included under SDG 2. In 2017, the World Bank issued a warning that committed spending on nutrition interventions falls far short of the $7 billion-a-year additional investment required to meet the World Health Assembly targets on childhood stunting and wasting, exclusive breastfeeding and anaemia in women (targets which in 2015 were integrated into SDG 2 but which retain their 2025 deadline).115 Five years into the 10-year window for achieving the nutrition targets, the annual requirement for additional investment is now over $9 billion.116
Overall, just over 1 per cent of spending on official development assistance (ODA) goes to tackling undernutrition, and the total annual amount devoted to this area has increased only minimally since 2013.117 Obesity in low- and middle-income countries has been largely overlooked in ODA spending.118 Nutrition also accounts for a very low share of domestic government expenditure in high-burden countries, including those across sub-Saharan Africa and South Asia: just 0.1 per cent in these countries, according to a World Bank estimate.119 While philanthropic foundations such as the Bill & Melinda Gates Foundation and the Children’s Investment Fund Foundation have contributed significant sums, the majority of nutrition financing continues to come from a handful of international donors.120
Just over 1 per cent of spending on official development assistance goes to tackling undernutrition, and the total annual amount devoted to this area has increased only minimally since 2013
The full and transparent payment of taxes should be the first priority for companies looking to contribute to improved nutrition;121 tax avoidance deprives governments of revenue needed to support national development programmes and deliver basic services, including clean water and healthcare.122 Beyond this, blended funding mechanisms and development impact bonds offer a means for companies from all sectors to demonstrate a material contribution to improved nutrition, either in their countries of operation or among vulnerable populations, without taking responsibility for the design or implementation of specific nutrition programmes.123 The Power of Nutrition, a charitable foundation established in 2015 following the first Nutrition for Growth Summit (which took place in 2013), is an example of a blended financing mechanism for mobilizing private-sector investment in national programmes to tackle childhood undernutrition. The Power of Nutrition commits to doubling corporate contributions using donor or philanthropic funds and then doubling these amounts again with public and/or private funding raised by the implementing partners, thus acting as a ‘catalyst’ for investment in nutrition.124
Public–private partnerships and enterprises offer a further channel for private-sector investment in nutrition and nutrition-sensitive interventions, though there exist a number of sensitivities to be navigated.125 Under the Nutrition for Growth (N4G) framework to guide pledges and commitments, companies and investors are encouraged to ‘provide innovative private-sector financing to deliver integrated essential nutrition actions in country health plans’,126 and there already exist a wealth of examples of such arrangements targeting the double burden of malnutrition.127
4.4 Company action to date
In order to gauge the level and nature of action on nutrition already being taken by MNCs, we undertook a review of a sample of 180 companies and the information they publish on their websites. Our sample included the top five companies for each sector listed in the Fortune Global 500, and the top 100 non-financial transnational companies by foreign assets as compiled by the UN Conference on Trade and Development (UNCTAD). We reviewed all reports and literature available on the selected companies’ websites, and in particular material relating to corporate sustainability, workplace benefits and services, and supply chain governance.
In addition to looking for initiatives with a specific nutrition focus (for example, nutrition training or the development of nutritional products), we identified initiatives with a nutrition component (such as well-being programmes that include activities centred on healthy eating) and those with the potential to have positive indirect impacts on nutrition (such as WASH programmes).
Below we present an overview of the nutrition-related activities on which the companies sampled report (Table 2), before discussing these in more detail.
Table 2: Incidence of self-reported implementation of nutrition-related initiatives and programmes among 180 MNCs
|
Intervention area |
Example activities |
Share of companies reporting on activities |
|
|---|---|---|---|
|
In the workplace |
In the community |
||
|
Nutrition-focused partnerships in the community or at population level |
Partnerships with third parties – government bodies, civil society organizations or other businesses – which focus on delivering nutrition interventions such as school feeding programmes and emergency food aid. |
n/a |
30% |
|
Nutrition education or training programmes |
In-person or online courses and information sources for employees or for use in the community. |
34% |
19% |
|
Nutritional status monitoring |
Monitoring of the nutritional status of employees or members of the community through, for example, regular checks of BMI or blood glucose levels. |
7% |
6% |
|
Manufacture and/or sale of nutritional products and services |
The manufacture and/or sale of multivitamins, ready-to-use therapeutic foods, app-based nutrition monitoring services. |
n/a |
10% |
|
Breastfeeding support |
Support for workers or the wider community, for example, through information and support campaigns, the provision of private breastfeeding spaces and equipment, or support for the storage and transport of expressed breastmilk. |
18% |
6% |
|
Incentives for healthy eating |
Nutrition-based food labelling in the workplace and on proprietary products, awareness campaigns around healthy diets. |
44% |
13% |
|
On-site food provision and community feeding programmes |
Staff canteens and food voucher systems offering free or subsidized healthy food, community-based meal provision such as school feeding programmes. |
16% |
20% |
|
WASH interventions |
Programmes to provide or promote the use of clean water, drinking water and safe sanitation, including through workplace facilities, handwashing campaigns and support to third-party organizations implementing WASH programmes. |
6% |
33% |
|
Investment in agricultural production and value chains |
Programmes to support farmers to improve productivity and efficiency, either along the company’s value chain (classed as ‘in the workplace’ here) or in the wider community (classed as ‘in the community’ here). |
7% |
9% |
Note: n/a = not applicable.
4.4.1 Business engagement in nutrition-focused partnerships
Fifty-four companies reported working in partnership with other stakeholders – businesses, governments, CSOs and/or research institutes – on nutrition-related programmes in the community or at population level. Twenty-nine of the reported partnerships are with other businesses, either bilaterally or through business platforms such as the Global Alliance for Improved Nutrition (GAIN), the Scaling up Nutrition Business Network (SBN), the World Business Council for Sustainable Development (WBCSD), or the Consumer Goods Forum (CGF) (Box 10).
Twenty-six of the reported partnerships are with CSOs on initiatives including the distribution of nutrient supplementation, agricultural value chain development, and emergency delivery of ready-to-use therapeutic foods, while eight companies report working with donor agencies such as UNICEF and the World Food Programme. Fourteen of the reported partnerships are with governments in low-income countries, with such arrangements including school meal programmes and investments (through public–private partnerships) in food fortification and nutrient supplementation production facilities and supply chains. Of the 54 companies involved in a nutrition-focused partnership, only nine are not implementing another form of nutrition-centred programme or initiative (such as nutrition education or training in the workplace, or the manufacture and sale of nutritional products).
Box 10: Leading platforms supporting business action on nutrition
The Scaling Up Nutrition movement (SUN). SUN is a country-led initiative, involving 61 countries,128 aimed at coordinating multi-stakeholder efforts to tackle malnutrition in all its forms.129 The SUN Business Network (SBN) is an initiative convened by SUN, together with GAIN and the UN World Food Programme, aimed at mobilizing private-sector action and investment in support of improved nutrition. The SBN hosts a global network of 23 companies, mostly from the food, beverage, consumer foods and agribusiness sectors, which commit to implementing workforce nutrition policies, improving actions to address malnutrition in all its forms, and providing technical assistance to SBN country networks and their members (SMEs and national companies). The SBN supports businesses in identifying and capitalizing on opportunities to partner with other stakeholders, including governments and UN agencies, on nutrition.130
The Global Alliance for Improved Nutrition (GAIN). GAIN is an international organization headquartered in Geneva but operating across 13 countries in four regions. Launched in 2002, it aims to boost consumer demand for nutritious and safe food, increase the availability and affordability of nutritious and safe food, and change market incentives, rules and regulations to support nutritious and safe food production and consumption.131 GAIN works with governments, the private sector and consumers to provide technical, financial and policy support to make systems more nutrition-sensitive.132 GAIN co-convenes the SBN with SUN (see above) and the World Food Programme.
Food Reform for Sustainability and Health (FReSH). FReSH is an initiative of the World Business Council for Sustainable Development (WBCSD) and the EAT Foundation, and was launched in 2017 with the intention of driving business solutions for food system transformation.133 Working with over 20 companies, primarily in the food and beverage sectors, the initiative is focused on increasing the variety and diversity of healthy and sustainable foods, achieving nutrition security for supply chain workers, reducing food loss and waste, and developing strategies to reflect the true cost of food.134
The Consumer Goods Forum (CGF). CGF works with consumer goods retailers and manufacturers on issues relating to ‘food & non-food safety; environmental & social sustainability; health & wellness; and logistics & data flows in the end-to-end value chain’.135 CGF recently established an alliance with GAIN on workplace nutrition programmes. The initiative will provide guidance to employers on activities which can improve nutritional outcomes among their workers,136 and participating employers will be invited to sign a commitment register against which to report progress.137
4.4.2 Inconsistencies in reporting
Companies vary significantly in the type and depth of information they include in their sustainability reports, annual reports and company websites with regard to nutrition. There is often little consistency at company level from one year to the next, and the information provided is often limited in detail, particularly regarding the longevity and geographical scope of any programmes (our interviews indicate that certain workforce programmes are not implemented uniformly across a company’s countries of operation). Very few companies report on the effectiveness or impact of their programmes or activities.
Our interviews with company representatives suggest that a lack of data on the nutritional status of employees and local populations is a barrier to assessing and responding to the burden of malnutrition among stakeholders:
At headquarters level, we’re unlikely to have HR people who have an overview of absenteeism and the reasons for this.
Due to privacy laws, there is a limit to the data we can collect.
About two-thirds of the workforce are contractors. They do labour-intensive work. Their health status and data are opaque to us.
Governments in emerging market countries have their hands full, so we don’t want to rely on them too much as the data may be out of date.
In the absence of a standard practice or common reporting framework for action on nutrition, the lack of mention of any relevant activities in company sustainability and annual reports does not necessarily indicate that no such activities are ongoing, but simply that companies are not reporting on them. The language used to describe activities is often highly specific to each company, making it challenging at times to categorize activities according to the intervention areas above (see Annex IV for detail on the activities included under each area). In some cases, third-party literature indicates that a company is implementing a nutrition-relevant programme, but the company itself does not mention this in its reports or on its website (an indication perhaps of the lack of external interest in corporate reporting on the issue).
The lack of mention of any relevant activities in company sustainability and annual reports does not necessarily indicate that no such activities are ongoing, but simply that companies are not reporting on them
4.4.3 Divergence in approach within the company
In total, 150 of the 180 companies sampled report that they are implementing one of the initiatives or programmes listed above in Table 2. Sixty-nine companies say they are doing so in the workplace and in the wider community, while 41 report taking action within the workplace only. A further 40 report on community-focused programmes but indicate no parallel programmes in the workplace.
Discussions with interview participants indicated that outward-facing sustainability initiatives and inward-facing workforce initiatives are rarely linked up, though there were two notable exceptions. These two company representatives, both from the food sector, described a cross-company approach to promoting improved nutrition. The first spoke of combined efforts to assess and improve the affordability and quality of food on offer to employees, to assess and improve the nutrition security of suppliers and their families, and to mainstream improved nutrition and sustainability across the company’s policies, from CSR through to recruitment and internal HR policies. The second described integrated activities to promote healthy food choices in the staff canteen, to train all staff in the principles of a healthy diet, to invest in improved food availability and dietary diversity among farmers in sourcing locations, to build cooking skills among those farmers and their families, and to build local supply chains in sourcing locations for the valuing and redistribution of excess produce.
Responses to questions regarding company activities in addressing malnutrition frequently indicated a lack of coordination or consistency between parallel strands of work, with participants either unaware of or unable to attest to initiatives run by separate parts of their organization in different departments or locations:
Work at [our company] is pretty fragmented – there’s not a lot of joined-up thinking.
I would like to say that [the services we offer] are uniform, but it is likely that they’re not. The company isn’t a top-down company; the local organizations have a lot of autonomy.
Certain businesses will be leading the way while others don’t do anything on health and nutrition.
In the case of community or supply chain engagement, participants largely pointed to a handful of countries in which their company has active programmes, designed in response to specific identified needs. Workplace services such as subsidized food or health screenings were noted by participants as being contingent upon, and designed around, local needs, capacities or regulations.
We try to look at the barriers to sustainable growth in each of the countries and then identify in which ways we can connect more and support the government in overcoming these barriers.
In-country partners run the work on the ground with worker committees and with supply chains and identify where money should be invested.
We’re working on a cost–benefit analysis tool focused on workplace health interventions. This would identify the illnesses most costly to a given business and then identify the most cost-effective interventions to tackle those illnesses.
72 Hawkes et al. (2019), ‘Double-duty actions: seizing programme and policy opportunities to address malnutrition in all its forms’.
73 Bhutta Z. A., Das J. K., Rizvi A., Gaffey M. F., Walker N., Horton S., Webb, P., Lartey, A. and Black, R. E. (2013), ‘Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost?’, The Lancet, 382(9890): pp. 452–77, doi: 10.1016/S0140-6736(13)60996-4 (accessed 2 Apr. 2020); and Shekar et al. (2017), An Investment Framework for Nutrition.
74 GAIN (2019), ‘Workplace breastfeeding support’, Workforce Nutrition Programme Evidence Brief 4, https://www.gainhealth.org/sites/default/files/publications/documents/evidence-brief-4-workplace-breastfeeding-support-2019.pdf (accessed 2 Apr. 2020); and Walters, D., Dayton Eberwein, J., Sullivan, L. and Shekar, M. (2017), ‘Reaching the Global Target for Breastfeeding’, in Shekar et al. (2017), An Investment Framework for Nutrition.
75 Ruel, M. T. and Alderman, H. (2013), ‘Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition?’, The Lancet, 382(9891): pp. 536–51, doi: 10.1016/S0140-6736(13)6 0843-0 (accessed 6 Apr. 2020).
77 Milk Stork (undated) ‘Employers’, https://www.milkstork.com/employers.
78 IBM (2015), ‘Nutrino and IBM Introduce Watson-Powered Nutrition Recommendations for Expectant Moms-to-Be’, press release, 10 December 2015, https://www-03.ibm.com/press/us/en/pressrelease/48314.wss (accessed 1 Apr. 2020).
79 Vodafone (2019), Sustainability Business Report, https://www.vodafone.com/content/dam/vodcom/sustainability/pdfs/sustainablebusiness2019.pdf (accessed 1 Apr. 2020).
80 KPMG Public (2019), Vodacom’s Mum and Baby service in South Africa, a socio-economic impact assessment, https://www.vodafone.com/content/dam/vodcom/sustainability/pdfs/Vodacom_Mum_Baby_Service_Impact_Report.pdf (accessed 31 Mar. 2020).
81 Das, J. K., Salam, R. A., Mahmood, S. B., Moin, A., Kumar, R., Mukhtar, K., Lassi, Z. S. and Bhutta, Z. A. (2019), ‘Food fortification with multiple micronutrients: impact on health outcomes in general population’, Cochrane Database of Systematic Reviews, doi: 10.1002/14651858.CD011400.pub2 (accessed 23 May 2020).
82 Preston, F., Lehne, J. and Wellesley, L. (2019), An Inclusive Circular Economy: Priorities for Developing Countries, Research Paper, London: Royal Institute of International Affairs, https://www.chathamhouse.org/sites/default/files/publications/research/2019-05-22-Circular%20Economy.pdf (accessed 23 May 2020); and Bailey, R. (2017), ‘Disrupting dinner? Food for the future’, Hoffmann Centre for Sustainable Resource Economy, 18 May 2017, https://hoffmanncentre.chathamhouse.org/article/disrupting-dinner-food-for-the-future/ (accessed 23 May 2020).
83 Bailey, R. and Wellesley, L. (2017), Chokepoints and Vulnerabilities in Global Food Trade, Chatham House Report, London: Royal Institute of International Affairs, https://www.chathamhouse.org/sites/default/files/publications/research/2017-06-27-chokepoints-vulnerabilities-global-food-trade-bailey-wellesley-final.pdf (accessed 23 May 2020).
84 Bailey and Wellesley (2017), Chokepoints and Vulnerabilities in Global Food Trade.
85 Herrero, M., Thornton, P. K., Mason-D’Croz, D., Palmer, J., Benton, T. G., Bodirsky, B. L., Bogard, J. R., Hall, A., Lee, B., Nyborg, K., Pradhan, P., Bonnett, G. D., Bryan, B. A., Campbell, B. M., Christensen, S. et al. (2020), ‘Innovation can accelerate the transition to a sustainable food system’, Nature Food, 1: pp. 266–72, doi: 10.1038/s43016-020-0074-1 (accessed 23 May 2020).
86 Wanjek, C. (2005), Food at Work: Workplace solutions for malnutrition, obesity and chronic diseases, Geneva: International Labour Office, ISBN 92-2-117015-2.
87 Global Panel on Agriculture and Food Systems for Nutrition (2019), Improving diets in an era of food market transformation: Challenges and opportunities for engagement between the public and private sectors, https://www.glopan.org/wp-content/uploads/2019/08/Global-Panel_Abridged-Private-Sector-Brief_FINAL-WEB-VERSION.pdf (accessed 23 May 2020).
88 Prozorovscaia, D., Jacquier, E., Dudan, F., Mungkala, S. and Green, H. (2019), ‘A digital meal nutritional score may influence food choices in a workplace restaurant: A pilot study presented at FENS’, https://app.oxfordabstracts.com/events/696/program-app/titles/1?s=prozorovscaia (accessed 7 Apr. 2020).
89 Ibid.
90 Direct exchange with Nestlé.
91 Nestlé (2020), ‘Recetas’, https://www.recetasnestle.com.mx/ (accessed 27 Mar. 2020).
92 Ibid.
93 Nestlé (2020), ‘TiBay Calculator’, https://www.bearbrand.com.ph/tibay-calculator/plan (accessed 1 Apr. 2020).
94 Direct exchange with Nestlé. See also Mak, T.-N., Angeles-Agdeppa, I., Lenighan, Y. M., Capanzana, M. V. and Montoliu, I. (2019), ‘Diet Diversity and Micronutrient Adequacy among Filipino School-Age Children’, Nutrients, 11(9): 2197, doi: 10.3390/nu11092197 (accessed 1 Apr. 2020).
95 BMW Group (2020), ‘Health Initiatives’, https://www.bmwgroup.com/en/company/bmw-group-news/artikel/health-at-bmw-group.html (accessed 1 Apr. 2020).
96 Ibid.
97 Baicker, J., Cutler, D. and Song, Z. (2010), ‘Workplace Wellness Programs Can Generate Savings’, Health Affairs, 29(2), doi. 10.1377/hlthaff.2009.0626 (accessed 20 Mar. 2020).
98 GAIN (2019), Nutrition education, Workforce Nutrition Programme Evidence Brief 2, https://www.gainhealth.org/sites/default/files/publications/documents/evidence-brief-2-nutrition-education-2019.pdf (accessed 2 Apr. 2020); and Hawkes et al. (2019), ‘Double-duty actions: seizing programme and policy opportunities to address malnutrition in all its forms’.
99 Hawkes et al. (2019), ‘Double-duty actions: seizing programme and policy opportunities to address malnutrition in all its forms’; and Loopstra, R. and Tarasuk, V. (2013), ‘Severity of household food insecurity is sensitive to change in household income and employment status among low-income families’, The Journal of Nutrition, 143(8): pp. 1316–23, doi: 10.3945/jn.113.175414 (accessed 26 Mar. 2020).
100 Kraak, V. I., Harrigan, P. B., Lawrence, M. and Harrison, P. J. (2011), ‘Balancing the benefits and risks of public-private partnerships to address the global double burden of malnutrition’, Public Health Nutrition, 15(3): pp. 503–17, doi: 10.1017/S1368980011002060 (accessed 30 Mar. 2020).
101 Development Initiatives (2017), Global Nutrition Report 2017: Nourishing the SDGs, https://globalnutritionreport.org/reports/2017-global-nutrition-report/ (accessed 30 Mar. 2020).
102 Ruel and Alderman (2013), ‘Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition?’.
103 Chau, J. (2009), ‘Evidence module: Workplace physical activity and nutrition interventions’, Physical Activity and Obesity Research Group, University of Sydney, http://hdl.handle.net/2123/9073 (accessed 1 Apr. 2020).
104 WHO/UNICEF/USAID (2015), Improving Nutrition Outcomes with Better Water, Sanitation and Hygiene: Practical Solutions for Policies and Programmes, https://www.unicef.org/media/files/IntegratingWASHandNut_WHO_UNICEF_USAID_Nov2015.pdf (accessed 24 Apr. 2020).
105 Russell, F. and Azzopardi, P. (2019), ‘WASH: a basic human right and essential intervention for child health and development’, The Lancet Global Health, 7(4): e417, doi: 10.1016/S2214-109X(19)30078-6 (accessed 6 Apr. 2020).
106 Bhutta et al. (2013), ‘Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost?’; and Ngure F. (2014), ‘Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the link’, Annals of the New York Academy of Sciences, 1308: pp. 118–28, doi: 10.1111/nyas.12330 (accessed 6 Apr. 2020).
107 German WASH Network (2017), Linking WASH and Nutrition A Blueprint for Living SDG 17, http://www.washnet.de/wp-content/uploads/washnet17_linking-wash-nutrition_web_170721_jr.pdf (accessed 6 Apr. 2020); and Chase C. and Ngure F. (2016), Multisectoral Approaches to Improving Nutrition: Water, Sanitation, and Hygiene, The Water and Sanitation Program (WSP) Technical Paper: 102935, https://www.susana.org/en/knowledge-hub/resources-and-publications/library/details/2441 (accessed 6 Apr. 2020).
108 Mbuya, M. (2016), ‘Making water, sanitation, and hygiene programs nutrition sensitive’, Global Nutrition Report blog, 26 August 2016, https://globalnutritionreport.org/blog/making-water-sanitation-and-hygiene-programs-nutrition-sensitive/ (accessed 24 Apr. 2020).
109 World Bank (2019), Nutrition-Sensitive Water Supply, Sanitation, and Hygiene, Washington, DC: World Bank, http://documents.worldbank.org/curated/en/598771553098171805/pdf/135459-WP-P166089-PUBLIC.pdf (accessed 24 Apr. 2020).
110 BSR HERproject (undated), ‘Impact Numbers’, https://herproject.org/impact (accessed 2 Apr. 2020).
111 Yeager, R. (2011), HERproject: Health Enables Returns: The Business Returns from Women’s Health Programs, Levi Strauss Foundation, https://www.bsr.org/reports/HERproject_Health_Enables_Returns_The_Business_Returns_from_Womens_Health_Programs_081511.pdf (accessed 2 Apr. 2020).
112 Li and Fung Limited (2017), Annual Report: Our Supply Chains, https://www.lifung.com/wp-content/uploads/2017/03/LiFung_AR_our_supply_chain2017.pdf (accessed 1 Apr. 2020).
113 UNICEF/WHO/World Bank joint child malnutrition estimates, ‘Prevalence of stunting, height for age (% of children under 5’, https://data.worldbank.org/indicator/SH.STA.STNT.ZS (accessed 19 Jun. 2020).
114 Schwab, K. (2019), The Global Competitiveness Report 2019, World Economic Forum Insight Report, www3.weforum.org/docs/WEF_TheGlobalCompetitivenessReport2019.pdf (accessed 29 Mar. 2020).
115 Shekar et al. (2017), An Investment Framework for Nutrition.
116 Development Initiatives (2020), 2020 Global Nutrition Report.
117 Ibid.
118 Ibid.
119 Shekar et al. (2017), An Investment Framework for Nutrition.
120 Thacher, E., Borces, K., D’Alimonte, M., Clift, J. and Augustin F. (2019), Tracking aid for the WHA nutrition targets: Update on global spending in 2016, Washington, DC: Research for Development, https://www.r4d.org/wp-content/uploads/R4D_GlobalSpending_NutritionReport15-16_vf.pdf (accessed 2 Apr. 2020).
121 Strauss and Chlapaty (2018), ‘The State of Corporate Disclosure on Well-being’.
122 Bauer, J. and Sahan, E. (2020), ‘Business, development, and human rights’, in Lund-Thomsen, P., Wendelboe Hansen, M. and Lindgreen, A. (2020), Business and Development Studies: Issues and Perspectives, New York: Routledge, ISBN: 978-1-315-16333-8 (accessed 20 May 2020).
123 Nordhagen, S., Condés, S. and Garrett, G. S. (2019), ‘Blended Finance’, GAIN Discussion Paper Series No. 1, doi: 10.36072/dp.1 (accessed 6 May 2020); and Center for Global Development (2014), ‘Exploring Development Impact Bonds in Nutrition: Workshop Briefing Note’, 18 February 2014, https://www.cgdev.org/sites/default/files/DIB%20nutrition%20briefing%20note%20for%202.24.14workshop_0.pdf (accessed 30 Mar. 2020).
124 The Power of Nutrition (2020), ‘How we work’, https://www.powerofnutrition.org/what-we-do/ (accessed 6 May 2020); and Nutrition Connect (2020), ‘Innovative funding and partnerships to improve nutrition’, 3 April 2020, https://nutritionconnect.org/news-events/road-tokyo-2020-innovating-funding-and-partnerships-improve-nutrition (accessed 6 May 2020).
125 Hoddinott, J., Gillespie, S. and Yosef, S. (2015), ‘Public-Private Partnerships and the Reduction of Undernutrition in Developing Countries’, IPFRI Discussion Paper 01487, https://www.ifpri.org/publication/public-private-partnerships-and-reduction-undernutrition-developing-countries (accessed 13 May 2020).
126 Tokyo Nutrition for Growth Summit 2020 (2019), ‘Commitment-Making Guide’, https://scalingupnutrition.org/wp-content/uploads/2019/11/N4G-Commitment-Guide_web.pdf (accessed 6 May 2020).
127 Drewnowski, A., Caballero, B., Das, J. K., French, J., Prentice, A. M., Fries, L. R., van Koperen, T. M., Klassen-Wigger, P. and Rolls, B. J. (2018), ‘Novel public-private partnerships to address the double burden of malnutrition’, Nutrition Reviews, 76(11): pp. 805–21, doi: 10.1093/nutrit/nuy035 (accessed 13 May 2020).
128 SUN (2020), ‘Scaling Up Nutrition’, https://scalingupnutrition.org/ (accessed 22 May 2020).
129 SUN (2014), ‘An introduction to the Scaling Up Nutrition Movement’, http://scalingupnutrition.org/wp-content/uploads/2015/06/Orange_Internal_InOutline_ENG_20140415_web.pdf (accessed 22 May 2020).
130 SUN (undated), ‘SUN Business Network’, https://scalingupnutrition.org/sun-supporters/sun-business-network/ (accessed 30 Mar. 2020).
131 GAIN (2020), ‘Global Alliance for Improved Nutrition’, https://www.gainhealth.org/sites/default/files/publications/documents/gain-two-pagers-16-03-2020.pdf (accessed 21 May 2020).
132 GAIN (2017), ‘GAIN Strategic Plan 2017-2022’, https://www.gainhealth.org/sites/default/files/publications/documents/gain-organisational-strategy-17-22.pdf (accessed 21 May 2020).
133 WBCSD (2020), ‘FReSH’, https://www.wbcsd.org/Programs/Food-and-Nature/Food-Land-Use/FReSH (accessed 22 May 2020).
134 EAT (undated), ‘FReSH’, https://eatforum.org/initiatives/fresh/ (accessed 22 May 2020).
135 The Consumer Goods Forum (2019), The Consumer Goods Forum: Corporate Brochure, https://www.theconsumer
goodsforum.com/wp-content/uploads/2017/12/CGF-corporate-brochure.pdf (accessed 22 May 2020).
136 GAIN (2019), ‘CGF and GAIN announce new Alliance to roll out improved nutrition in the workplace’, 25 October 2019, https://www.gainhealth.org/media/news/cgf-and-gain-announce-new-alliance-roll-out-improved-nutrition-workplace (accessed 22 May 2020).
137 Ibid.