Experiences of multi-sector programming in Malawi

An ENN article by Felix Pensulo Phiri, Director of Nutrition in the Department of Nutrition, HIV and AIDS, Ministry of Health, Malawi. He is responsible for providing nutrition multi-sector oversight function and coordination for the National Nutrition Response and is the SUN nutrition focal point in Malawi.

What we know: Malawi has made strong progress in reducing stunting and other forms or malnutrition, despite challenges of frequent flooding and food insecurity related to climate change. Malawi joined the SUN Movement in 2011.

What this article adds: There is strong political will and commitment by leadership to address hunger and undernutrition: nutrition is a priority area in the national development agenda; there is a nutrition coordinating office; and multi-sector nutrition platforms at national, district and sub-district levels have been established. The National Multi-sector Nutrition Policy and Strategic Plan guides the national nutrition response. The National Nutrition Education and Communication Strategy (NECS) includes both nutrition-specific and nutrition-sensitive programming, the latter catalysed by the SUN Movement and involving multiple sectors in planning and district technical support. Strengths of the SUN/NECS programme include strong leadership at all levels; a clear, consistent (globally and within country) guideline for action; heightened nutrition profile through new district structures; due attention and openness to ongoing learning; alignment of the donor network to support coordinated resource mobilisation; and a well organised civil society network. Challenges relate to fragmented rollout and funding; monitoring and accountability; inadequate consideration of maternal nutrition; conflicted interests of partners; and limited participation of the private sector. Continued support of the District Nutrition Coordination Committees (DNCC) is required; a comprehensive evaluation of NECS rollout would greatly inform future activities.

Background

Malawi is one of the poorest countries in the world, currently ranked 174 out of 187 countries in the 2014 Human Development Index. Life expectancy at birth is estimated at 54.8 years, which is a reflection of persistently high rates of poverty and the severe effects of the HIV/AIDS crisis and other health issues. Additional problems include over-dependence on subsistence production and rain-fed maize production and consumption, which contributes to diets that lack diversity and are poor in micronutrient-rich foods. In recent years, Malawi has been experiencing the effects of climate change, which has led to food insecurity and contributes to widespread poverty among the population and persistently high rates of undernutrition.

Nutritional situation

Child undernutrition is one of the major problems in Malawi, with a national stunting prevalence of 47%. The double burden of malnutrition is on the increase, with an estimated 5.1% of children under five years old overweight (NSO, 2014), while according to the Global Nutrition Report, 22% of adults are overweight and 5% are obese (IFPRI, 2015). Despite the many challenges, Malawi has made some progress in combating undernutrition and in improving food security for its population.

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The Emergency Nutrition Network (ENN) and support to the SUN Movement

ENN is a UK registered charity which was set up to improve practice and strengthen the institutional memory of agencies involved in the emergency food and nutrition sectors. ENN focuses on communities in crisis, typically humanitarian emergencies. ENN enables nutrition networking and learning to build the evidence base for nutrition programming in three ways:

• Field Exchange (FEX), an online and print publication on nutrition and food security in emergencies and high burden contexts. Field Exchange is printed three times per year.
• Nutrition Exchange (NEX), is an online publication of short, easy to read articles on nutrition programme experiences and learning. Nutrition is summarised information from the flagship publication, Field Exchange.
• en-net, a free and open resource that helps practitioners access technical advice for operational challenges through the online forum. A specific area for SUN en-net was launched in 2015. Visit SUN en-net ►

ENN is part of the DFID funded Technical Assistance for Nutrition (TAN) programme under which ENN is providing knowledge management services to the SUN Movement in Phase Two (2016-2020). ENN is focused on capturing, curating and disseminating knowledge and learning about nutrition scale up with a focus on high burden and fragile and conflict affected states. Three regional specialists and a Knowledge Management Coordinator are working with country level SUN actors (government, UN, donors, civil society, business and academia) to capture what is being learnt about the scale up of nutrition specific and sensitive activities.