Monitoring, Evaluation, Accountability and Learning (MEAL)

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Over the past decade, global and country recognition of the threat that malnutrition poses to health and future development of children has grown exponentially. The importance of a concerted approach is now widely accepted.  The Movement’s theory of change is that when multiple stakeholders from multiple sectors and at multiple levels work together, in a country-led force, we will achieve results.

The first phase of the SUN Movement (2012-2015) focused on creating an enabling environment for nutrition and bringing multiple sectors and stakeholders together at country level. The main emphasis was on advocacy, promoting partnerships and calling for commitments for nutrition. In the second phase (2016-2020), the Movement continues to have multi-stakeholder and multi-sectoral approaches at its core.

However, there is a growing expectation that countries in the Movement can demonstrate how effective partnerships can lead to progress in spending and implementation and contribute to results and impact. Subsequently, the Movement’s support system is expected to step up and support countries’ demands, especially from those countries that are lagging behind with their progress.

Therefore, in 2017 the SUN Movement Secretariat stepped up efforts to define a system that would provide access to data and information for different purposes and audiences.  In February 2017, an Advisory Group was established to develop, test and implement a new system. As of September 2017, the Monitoring, Evaluation, Accountability and Learning (MEAL) Advisory Group is composed of 33 people from SUN Networks, technical support providers and academia.

The Monitoring, Evaluation, Accountability and Learning (MEAL) system

Assessing progress towards the Movement’s objectives and the Sustainable Development Goals for a world without hunger and malnutrition requires the alignment of globally agreed monitoring frameworks and initiatives. The SUN MEAL system will be the means for measuring the extent to which the SUN Movement is achieving results and impact.

MEAL primarily relies on secondary data complemented by primary data collected by the SUN Movement Secretariat and SUN Networks. Sources include the SUN Movement Joint-Assessment – an Exercise undertaken by many SUN Countries each year – in addition to results from a range of other Exercises including financial tracking, surveys and stakeholder mapping and reports.  This information from different sources is integrated into a database managed by the SUN Movement Secretariat.

The Theory of Change step-by-step

Step 1 – How do multiple stakeholders from different sectors come together?

Answering this question has been at the core of the SUN Movement’s monitoring efforts since 2010.

  • The SUN Movement Secretariat maintains information on Multi-Stakeholder Platform’s (MSP’s), SUN Government Focal Points, stakeholder representation in MSPs and engagement of MSPs with media, parliamentarians and champions.
  • The SUN Movement Global Network Secretariats – CS Networks, UN Network, Donor Network and Business Network – maintain information on the existence and composition of their networks. The UN Network Secretariat has completed a review on the functionality of the UN Network for SUN in 57 SUN Countries, the SUN Donor Network is implementing a Donor Convener review, the Civil Society Network continues to conduct annual surveys (since 2015), and the SUN Business Network is working with country-level networks to develop performance metrics and to establish an annual review mechanism.

Publicly available documents such as Terms of Reference, meetings’ minutes, reports, Decrees are available in the relevant places of the SUN Movement website and can also be shared upon request.

Step 2 – How do multiple stakeholders from different sectors change their behaviours?

Answering this question has been at the core of the SUN Movement monitoring efforts since 2012.

Monitoring and Evaluation of the Four SUN Movement Processes

The SUN Movement M&E Framework was developed and tested in 2013. Countries joining the SUN Movement are asked to fill a baseline template that is organized around the key elements of the SUN Movement M&E Framework.

The SUN Movement M&E Framework was developed and tested for the first time in 2013. Today, countries that join the SUN Movement are asked to complete a baseline template that is organized around the key elements of the SUN Movement M&E Framework. Each year between April and July, Multi-Stakeholder Platforms conduct Joint Annual Assessments on four SUN Movement processes:

  1. Bringing people together;
  2. Ensuring a coherent policy and legal framework;
  3. Aligning actions around a common results framework and,
  4. Tracking finance and mobilizing resources.

Four Joint Annual Assessments have been completed since 2014 with an annual average response rate of >75% of all member countries. The SUN Movement Secretariat analyses data from the Joint Annual Assessments and this is used to inform a large part of the SUN Movement Annual Progress Reports. Key findings from the Assessments are presented in country profiles and summarized in the main body of the report to show the overall progress of the SUN Movement. Since 2016, Multi-Stakeholder Platforms were asked to identify their annual priorities and to determine if these priorities could be responded with in-country capacity or if this required external technical assistance. In the latter case, SUN Government Focal Points are asked to convey a written request to the SUN Movement Secretariat to ensure that global providers can be mobilized through the Networks or through a dedicated technical assistance mechanism.

Commons Results Frameworks and Checklist for Quality National Plans

One of the key functions of the Multi-Stakeholder Platforms is the development and revision of national action plans (also recognised as a Common Results Framework). Published and endorsed planning documents are accessible from the SUN Movement website or upon demand.

From November 2016, a Checklist for Quality National Plans (English | Français Español) was launched for SUN Government Focal Points and partners who are in the process of reviewing or developing their multi-sectoral nutrition action plans. The Checklist is also equipped with links to tools and guidelines to review how well nutrition is mainstreamed in development strategies and sectoral plans. Interested countries can access support to use the Checklist by contacting the SUN Movement Secretariat and the UN Network at country level and its secretariat.

Public Commitments

SUN Countries that made public commitments during the 2013 Nutrition for Growth London event are reporting on an annual basis to the Global Nutrition Report. The Decade of Action on Nutrition (2016-2025) encourages Member States to make SMART commitments and to register them in an open-access Commitment Repository managed by WHO/FAO. These commitments are expected to be tracked on a regular basis by country self-assessment.[1]

Information Systems for Nutrition

Accessing and using data is essential for improved decision-making and coordination. A mapping of information systems in 57 SUN countries was completed by Nutrition International at the end of 2016.

[1] PowerPoint presentation dated 15th March 2017 – shared by Dr Francesco Branca (WHO)

Step 3. How do multiple stakeholders mobilize resources and align their implementation?

Answering this question has been at the core of the SUN Movement’s monitoring efforts since 2013.

In preparation of the Nutrition for Growth (N4G) London event in 2013, SUN Countries shared costed estimates for nutrition interventions included in their plans. In the same year, the SUN Donor Network started to track their own spending based on a commonly agreed methodology. Building on their methodology, the SUN Movement Secretariat worked with partners to provide countries with a feasible approach to monitor their spending using national budgets as the main publicly available documents.

Tracking nutrition investments

Since 2015, Multi-Stakeholder Platforms  have been engaged in the analysis of national budgets to gain insights into their spending for nutrition. By 2016, over 40 SUN countries have shared the results from their budget analysis providing insights into spending by programmes, sectors and, in some cases, sources of funding. 22 countries have undertaken a budget analysis for the second time and 19 have done it for the first time. Countries that have done the budget analysis for the first time find it easier to repeat the exercise in the subsequent years.

The SUN Movement Secretariat maintains two types of finance datasets based on data received from countries. The first dataset was initiated in 2013 and collates all cost estimates of interventions and plans shared by countries (available online at CRF Planning Tool). The second dataset compiles all data shared by countries that have completed their budget analysis. Results from the budget analysis are presented in ‘budget analysis’ country profiles and are available for 36 countries and 1 Indian State. Aggregated data were shared with the Global Nutrition Report in 2015, 2016 and 2017 and have been used for the estimation of current spending as part of the development of An Investment Framework for Nutrition (World Bank 2016).

Costing nutrition efforts

Finance data is crucial to get an understanding of nutrition specific and sensitive spending across SUN countries and, where possible, to compare current spending with cost estimates. In 2016, Results for Development completed an analysis of nutrition-specific spending based on the DAC/CRS. Data are available for 57 SUN countries and can be access through the website InvestinNutrition.

Mapping nutrition actions

Since 2011, REACH and most recently the UN Network for SUN have supported SUN Countries with the mapping of stakeholders and their actions at sub-national level. Governments, civil society organizations, UN agencies and donors were supported with the mapping of core nutrition actions, including analysis of geographic and beneficiary coverage and delivery mechanisms. Detailed data is available for at least 20 SUN countries. The SUN Movement Secretariat is working with SUN Networks to make the mapping exercise available to all SUN Countries by 2019.

Monitoring Coverage of Key Interventions and Food Supply

Most data for nutrition and health interventions are available from health facilities and/or from nutrition-related programmes and are maintained in global databases by UNICEF and WHO. UNICEF has developed a global portal called NutriDash, which provides an overview of data collected on the reach and quality of nutrition programmes. Data on food supply are regularly collected and maintained by FAO.

Step 4. How does aligned implementation show effective results?

Answering this question has not been the core of the SUN Movement’s monitoring efforts during 2012-2015. However, it represents the core business of key partners of the SUN Movement (e.g. Global Nutrition Report, UN agencies, etc.) and is critical to assess the Theory of Change of the SUN Movement Strategy and Road Map (2016-2020).  

Prioritised indicators have an established methodology for data collection, are standardized at international level and are available from existing data sources for the majority of SUN countries. The alignment and close correspondence with the 2030 Agenda for Sustainable Development, the Global Nutrition Report, the Decade of Action for Nutrition, the ICN2 Framework For Action (FFA), Every Women Every Child and other major strategies and monitoring efforts for nutrition is critical. This alignment is intended to minimize the monitoring and reporting burden. Almost all prioritized indicators are part of global monitoring frameworks such as the Sustainable Development Goals, the Maternal, Infant and Young Child Nutrition (MIYCN framework) and the Global Reference List for 100 Core Health Indicators 2015.

A mapping of the prioritized indicators against data sources shows that the majority of indicators are available from household surveys. Household surveys are critical because they provide disaggregated data for almost all indicators, although there might be issues with sampling that need to be considered when analyzing age-based data. The data can be disaggregated by sex, age, wealth and education. Geographical variables can also be stratified at sub-national level, mostly at regional and provincial level. A mapping of information systems conducted by Nutrition International in 2017 show that nationally representative surveys (i.e. DHS, MICS and national-level SMART surveys) are widely available in SUN countries.

The 2030 Sustainable Development Agenda put emphasis on equity, mostly known with the statement of “leaving no one behind”. SDG 17 calls for countries to increase the availability of disaggregated data. Disaggregated information is limited to household surveys and provides reliable information about the vulnerability of population groups based on gender, age, ethnicity, wealth and residence (urban/rural). However, most population-based surveys do not have sample data that allow going beyond provincial and regional level. Small-scale surveys and data from facilities or programmes could provide information at district and local level provided that the data quality issues are addressed.  Countries often lack data on migrant populations, minorities and other marginalized population. In addition, disaggregation by humanitarian settings at the sub-national level should be undertaken to provide relevant information.

Step 5. How do effective results contribute to better nutrition status?

The SUN Movement’s first phase (2012-2015) focused on the World Health Assembly (WHA) Global Nutrition Targets. The SUN Movement Strategy and Roadmap (2016-2020) incorporates the diet-related Non-Communicable Diseases (NCD) to take into account multiple forms of malnutrition that co-exist in the same populations, households and sometimes individuals.

Prioritized indicators are all aligned with the WHA Global Nutrition Targets, the diet-related NCD Targets, the Sustainable Development Goals, the Maternal, Infant and Young Child Nutrition (MIYCN framework) and the Global Reference List for 100 Core Health Indicators 2015.

A mapping of prioritised indicators against data sources shows that the majority of indicators are available from household surveys including DHS, MICS and national-level SMART surveys. The data can be disaggregated by sex, age, wealth and education. Geographical variables can also be stratified at the sub-national level, mostly at regional and provincial level. It is crucial to apply an equity lens to the analysis of the nutrition status in SUN Countries with a special attention to vulnerable populations and humanitarian settings.

Step 6. How does better nutrition contribute to key SDGs by 2030?

The SUN Movement Strategy and Roadmap (2016-2020) aims to demonstrate that by purposively incorporating nutrition objectives into development efforts, all sectors and parts of society will be able to show how this has contributed to the achievement of the Sustainable Development Goals.

The Global Nutrition Report in 2015 and 2016 has built the evidence to substantiate the argument that nutrition is a cornerstone of sustainable development. This evidence builds on economic studies such as the work done by Horton and Hoddinott (2014) and the Cost of Hunger studies. The evidence clearly demonstrates that a country not investing in nutrition will lose significantly in terms of human development.

The contribution of malnutrition to mortality is well known and documented. Countries can access the Lives Saved Tool to estimate the number of lives saved among children less than five years of age based on a core set of nutrition-specific interventions.

Nevertheless, a systematic way to measure how nutrition contributes to the Sustainable Development Goals is the subject of current studies and research.

Latest update on SUN MEAL

The baseline document of the SUN MEAL Framework with a list of indicators, data sources and alignment with internationally agreed frameworks and monitoring initiatives is now available!

The SUN MEAL system provides the backbone for measuring the SUN Movement Theory of Change with each step supported by indicators that give an appreciation of progresses and results from a baseline of 2016 and subsequent years. Prioritized indicators are not comprehensive for each SUN Country, however, they enable the SUN Movement to track changes across a large number of countries using standardized data that allow for comparability. With thanks to the support of Nutrition International and advice from the MEAL Advisory Group.

Download: MEAL Baseline Document 2017 (English/ Français / Español)

 

The Country Dashboards aim to help users to identify performance patterns and inform strategic decisions. The Dashboard can be adapted for use at sub-nation­al level and complemented with additional indicators based on data availability. These materials has been shared by the SUN Movement Coordinator with all country teams to invite them to actively participate in the MEAL plenary session at the SUN Movement Global Gathering in Abidjan. Each Country Dashboard will be available after the 2017 SUN Movement Global Gathering.

Country Dashboard Guidance Note: (English / Français / Español)
Anonymous Country Dashboard: (English / Français / Español)

 

The 2016 MEAL Baseline Comprehensive Report provides a detailed and comprehensive analysis for all MEAL indicators and is accompanied by a 10-page Executive Summary of key findings and implications for actions.  Available in English

The Executive Summary is a 10-page documents that provides key findings from the 2016 Baseline Report and implications for action
Available in English / Français / Español

 

The All SUN Countries Dashboard Colour-coded Excel file compares all MEAL indicators for 59 SUN countries. It also provides an overview of the Performance by Country and of the Overall Scoring by Country based on a subset of MEAL indicators for which at least 75% of countries have data coverage.

All SUN Countries Dashboard English

The MEAL baseline dataset includes all key indicators reported in the Country Dashboards (year of data, data point and performance classification). Additional variables are: the Annual Average Reduction Rate (AARR), on/off track variables and male data for all nutrition status indicators.

MEAL Baseline dataset: English

Advisory Group Consultations

This MEAL Advisory Group is engaged in key moments for the development and finalization of frameworks and operational guidance across the SUN Movement. Throughout 2017, the SUN Movement Secretariat and facilitators from SUN Networks are conducting direct consultations with representatives and experts from SUN Countries. Within SUN Countries, the consultation will be coordinated through SUN Government Focal Points who are responsible for convening government ministries and development partners.

With innovation and inclusivity in mind, the consultations aim to enable stakeholders at all levels to contribute to creating a more efficient and impact driven Movement. This work will be informed by the principles of the SUN Movement.