Coordinating nutrition in Mali: Interview with the SUN focal point

* Originally published by ENN Online – Nutrition Exchange 11 – January 2019

Mali is facing high levels of malnutrition (including 38.5 per cent stunting prevalence and 15.3 per cent wasting among children under five years old), driven by factors such as climate change and conflict. This has triggered an increase in political momentum within the country and Mali has made progress in strengthening nutrition governance since joining the Scaling Up Nutrition (SUN) Movement in 2011, particularly with the creation of a Nutrition Coordination Cell (Cellule de Coordination).

ENN’s Ambarka Youssoufane interviewed Dr Djibril Bagayoko, Head of the Nutrition Coordination Cell (housed in the Mali Ministry of Health (MoH) since 2016) and the country’s SUN focal point, on the country’s progress in nutrition governance and coordination. Dr Bagayoko has over 20 years’ experience in the health sector, especially in programme management and system development and strengthening.

1. Has there been a change in how nutrition is coordinated in Mali since the country joined the SUN Movement?

Joining the SUN Movement has been very important for Mali, as it has motivated the government to develop a multi-sector nutrition policy and action plans with cost and performance indicators, with institutional responsibility for each sector. The Coordination Cell fills an important gap in terms of multi-sector coordination of nutrition actors and interventions. Before this unit was set up there was a nutrition counsellor at the MoH (without the convening power for multi-sector coordination or a dedicated team) and a SUN focal point. The new Coordination Cell is under the Prime Minister’s authority but hosted in the MoH, making it easier to strengthen the multi-sector nutrition agenda in the country.

2. Have SUN Movement networks been set up in Mali?

Mali has been [dealing] with the SUN Movement since 2011, and the SUN architecture works quite well within the institutional arrangements set up. The civil society, academic and research, donor and private sector networks are all operational. The parliamentarian network has worked with us to integrate the right to food and nutrition into the constitution. The Coordination Cell oversees the performance of all SUN networks and submits quarterly reports to the government. All of these networks have annual plans and each of them has developed an institution to organise nutrition activities. However, difficulties remain, notably the overlap of SUN networks with a number of other existing coordination frameworks, such as the food security coordination framework, etc.

3. Are there any key nutrition platforms or stakeholders outside the SUN Movement architecture (i.e. nutrition cluster, other emergency-focused platforms, agriculture platforms, etc)?

There are a number of other frameworks that exist outside the government’s networks, notably the cluster networks set up by UN agencies such as those for nutrition, food security and health, or for emergency response. Even though these additional coordination frameworks are sometimes set up for specific purposes or themes, there is also duplication with SUN networks, since they are coordinating the same institutions. The government is trying to bring all the institutions under the same coordination framework to avoid duplication and ensure multi-sectorality. It makes my role more challenging to have different levels of coordination and I have advocated for greater alignment, particularly with UN partners.

4. When and how was the coordination unit set up? Does this function as the main multi-stakeholder platform in the country? What are its main responsibilities? How is it being funded?

The Coordination Cell was created in March 2015 to take over the role filled by REACH following its closure. Its mandate is to strengthen governance around nutrition. This is done with four levers: communicate with all the sector groups; facilitate coordination around the political vision; facilitate collaboration by activating multi-stakeholder, multi-sector platforms; and monitor the implementation of the national nutrition plan.

The Cell acts as the government’s focal point for all networks at the central level. At the decentralised level, we also have a mandate to facilitate the activity of three different coordination frameworks operating at the regional, department and commune level (see Figure 1). Operating costs are mostly funded by the government, but the Cell is also being supported by the World Food Programme for four years.

5. What are the key activities in which the coordination unit and the SUN networks have been involved? What activities are planned for the next year?

We have four to five permanent staff, but the Cell is also composed of nutrition focal points in all relevant ministries (18-20 line ministries) and we organise capacity building via training on the basic concepts of nutrition, etc. The Cell doesn’t have programmes of its own, but we are involved in integrating nutrition in all relevant policies. For example, the Cell is part of the group revising the national water policy and we are lobbying to make it more nutrition-sensitive. Key activities highlighted in the unit’s own action plan are to operationalise coordination meetings between different platforms, continue capacity building of government nutrition focal points and strengthening of the country SUN networks.

6. What have been the challenges in operating the Cell?

One of the difficulties with this unit is that it has an atypical structure because it’s organised by the Prime Minister’s office but delegated to the level of the Ministry of Health, which makes it less powerful than it’s supposed to be. It also lacks adequate funding to play its role; for example, to motivate staff on civil servant wages.

Coordination at the sub-national level is one of the most important challenges the Cell is facing. National-level and even regional-level meetings are organised regularly, but coordination meetings are not being held at the operational (commune) level. In order to make these coordination frameworks work we need to provide them with simple tools for self-assessment of their needs (these tools are being developed at the Cell level) – but we need support for this.

7. Can you share some lessons learned in your role as nutrition and focal point coordinator?

The main lesson learned from running the unit is that it needs three types of leadership: political leadership; institutional leadership; and staff leadership. The most important thing to change in terms of Mali is data availability. Implementing functional monitoring systems would allow us to [obtain] data from the lowest level – and this will allow for better coordination and [better] programme management to eventually change the nutrition situation in Mali.

8. In your opinion, has the SUN Movement been a source of significant energy and change in the country, or was the country already taking on a long-term, multi-sector agenda in nutrition?

Joining the SUN Movement has been very important for Mali. It has motivated the country to develop a multi-sector nutrition policy which is also budgeted. The SUN movement has supported experience-sharing through participation in various meetings. At the country level, SUN stakeholders including donors and UN agencies have met with Mali’s Secretary General to advocate for putting nutrition at a higher institutional level. This kind of advocacy cannot be done by lower institutions, but only by partners.