Mapping exercise fuels multi-sectoral action to account for nutrition results in Mali

* Interview originally published by the UN Network for SUN 

Mali continues to face high levels of malnutrition driven by multiple factors that are exacerbated by the effects of climate change and conflict. Child wasting is estimated at a whopping 10.7 per cent (SMART 2017) although national statistics masque notable regional disparities. At the same time, 25.5 per cent of women 15-49 years old are overweight or obese (SMART 2017), indication of the country’s double burden. An extensive mapping exercise is being undertaken in Mali, led by the Head of the national nutrition coordination cell (Cellule de Coordination), Dr. Djibril Bagayoko. The Coordination Cell availed the neutral facilitation services of REACH and technical mapping assistance from the UN Network for nutrition Secretariat throughout the process. Among other applications, the mapping is being used to track the implementation status of the country’s national nutrition plan (2014–2018). The multi-stakeholder, multi-sectoral mapping is helping to paint the full picture of the nutrition situation in the country, giving consideration to both humanitarian and development actions.

Staff at the Coordination Cell, where the SUN Focal Point is based, have teamed up with colleagues in the Nutrition Division within the Ministry of Health to gather data on 30 actions from 48 institutions. In addition to key actors from the Government, the exercise has mobilized the six UN agencies engaged in the UN Network in–country (FAO, UNFPA, UNICEF, UN WOMEN, WFP and WHO) as well as the other SUN networks (Academic and Research, Business, Civil Society and Donor). It has also seized the opportunity to engage Inter-Agency Standing Committee (IASC) Clusters – Nutrition, Food Security, Health and WASH – in view of the fragile context as part of efforts to close the gap between humanitarian and development work streams. This also consistent with the mapping’s aim to foster partnerships and synergies on nutrition. Read more about the mapping exercise in the below interview with the SUN Focal Point, Dr. Bagayoko, including how it is changing the way nutrition is addressed in Mali. Dr. Bagayoko is supported by the staff at the Coordination Cell, who helped him prepare for the interview.

© Cellule de Coordination / S. Togo

Question (Q): What is the overall goal of Mali’s mapping exercise?

Answer (A): To improve nutrition governance by improving accountability in order to meet the needs of target groups, such as pregnant and lactating women, children under five years old and adolescent girls. The mapping also seeks to animate multi-stakeholder, multi-sectoral approach to nutrition, including coordination platforms, as envisaged by the National Nutrition Policy and the Scaling Up Nutrition Movement.

Q: What do the findings tell us about the nutrition stakeholder landscape and coverage of nutrition actions in Mali?

A: The preliminary results of the mapping exercise were presented during a validation workshop, held on 27 June 2018, which was moderated by the Coordination Cell. The UN Network’s REACH Facilitator provided instrumental support, including on the workshop preparations. The workshop was attended by a multitude of actors, including: representatives of government technical structures (e.g. the Planning and Statistics Unit of the Ministry of Health and Ministry of Rural Development respectively, National Centre of School Feeding), UN agencies, civil society as well as those from the donor community (e.g. the Canadian Embassy).

In general, the mapping exercise indicated that nutrition-specific interventions, such as the management of acute malnutrition, iron and folic acid supplementation, tend to have higher coverage than nutrition-sensitive actions, particularly those related to agriculture and social protection (e.g. conditional cash transfers). A mapping expert from the UN Network Secretariat added that this is largely consistent with trends observed in other countries, where the UN Network has supported multi-stakeholder nutrition mapping. The Director and Global Coordinator of the UN Network Secretariat, Purnima Kashyap, also noted that this underscores the need to further mobilize non-traditional nutrition actors, who carry out many nutrition–sensitive actions to support nutrition gains on a societal and individual level.

Q: In your opinion, what are the main benefits of the mapping?

A: The mapping invoked strategic reflection around nutrition actions, demystifying the multi-sectoral approach. It provided an avenue to sensitize and mobilize different stakeholders, which has helped them understand their respective roles, particularly those actors who are supporting nutrition–sensitive actions. Eight sectors (agriculture, fisheries, food security, health, livestock, social protection, WASH and women’s empowerment) are partaking in the exercise. For some, this is the first time they are engaging in the nutrition arena. This is often the case for actors supporting nutrition–sensitive actions, such as fish farming. Consequently, the mapping has helped us include gender perspectives and reach out to other sectors, including: agriculture; WASH; education and social protection. It has also enabled the Coordination Cell to identify coverage gaps, particularly those efforts related to the prevention of malnutrition. Actors in–country are embracing this newly available coverage data and pointing to it as a key input for improving the service delivery of nutrition–specific and sensitive programmes alike.

The mapping highlighted the need to involve targeted populations in the design of behaviour change communication activities to improve uptake of existing nutrition-related services. In addition, it identified opportunities for increased collaboration among related sectors and stakeholders, recognizing that this is also vital for improving intervention coverage. The mapping exercise is helping to instil a culture of data–driven decision–making in Mali which will help us optimise the use of scarce resources. This is directly enhancing the monitoring and evaluation of the our current multi-sectoral nutrition policy and plan (2014–2018) as well as shaping the next national nutrition plan, which will cover the 2019–2023 period.

Q: Is multi-sectoral engagement where you would like it to be?

A: While eight sectors are participating in the exercise, most of the actions mapped are oriented towards two sectors. This illustrates the need for further efforts to engage some sectors, reminding them how their work is supporting positive nutrition outcomes and sustainable development, more broadly.

Q: Tell us about the challenges you encountered when executing the mapping exercise and how they were overcome.

A: One of the main challenges was to establish a local team with the requisite technical and managerial skills to carry out the exercise. This was overcome by strengthening the individual capacity of local actors in an effort to increase the sustainability of the mapping. Here, the UN Network’s support was instrumental to training the mapping team and providing guidance in successive phases. The learning-by-doing approach employed proved to be another challenge, particularly since Mali was one of the first countries to use the new web-based version of the mapping tool. To the extent possible, our mapping team leveraged lessons learned from other countries where the mapping was successfully completed. It also documented the Mali experience to support the continuous improvement of the mapping– tool and process.

Q: Based on your experience, what would you consider to be the ‘critical success factors’ for executing the mapping exercise?

A: Taking stock of existing data for key sectors during the preparatory phase and the validation workshop at the end of the exercise highly facilitated the mapping process and were crucial for rolling out an inclusive approach. Not only did this help us obtain stakeholder buy-in from the onset, but it also helped sustain momentum throughout the exercise. These efforts were backed by regular, dynamic communications with all participating institutions. The technical support of the UN Network and the Mali’s active engagement in the SUN Movement were also pivotal to the success of the mapping.

Q: Is there anything that you would do differently the next time?

A: Good question. Here are some thoughts/tips that I would bear in mind (and encourage others to do the same) for a successive round of mapping.

1. Advocate for direct access to relevant, sector-specific databases, particularly those of non–traditional nutrition actors
2. Decentralize data collection to improve the response rate to the mapping questionnaire and correct inconsistent data during field visits
3. Prepare posters that illustrate the key findings to support dissemination, including among SUN networks, and reinforce the roles of the different sectors in nutrition. The posters could be shared at annual multi-sectoral nutrition reviews and perhaps at the SUN Global Gathering.

Q: Now that you have conducted the exercise, how are the findings being used to support transformative change in nutrition?

A: The mapping is a decision–making tool that all actors can use to guide prioritization exercises, advocacy and resource mobilization for nutrition at all levels– decentralized, national and global. It enables the Government, particularly nutrition collaboration mechanisms, to monitor nutrition–specific and sensitive programmes in a holistic and systematic manner.

The specific population and geographic coverage gaps unveiled by the mapping are informing concrete action on the ground from decentralized nutrition planning to the articulation of priorities around which stakeholders will align for increased coherence. It has also highlighted the interrelationships between nutrition actions and insights about strategic partnerships, which are helping to better adapt these actions to the Malian context and to improve operational efficiency. The mapping has also improved communication across institutions. Furthermore, it is calling upon stakeholders to boost coverage for hard-to-reach populations and increase participation of targeted populations, reinforcing an equity approach. Similarly, it is guiding efforts to attract investment in nutrition as well as capacity strengthening activities required for good nutrition governance. As I previously mentioned, these efforts are enhancing nutrition coordination, providing valuable inputs to and thus helping to animate the multi-stakeholder, multi-sectoral nutrition coordination platforms, including the Coordination Cell.

Efforts are currently underway to migrate the mapping data to a government server to complement data gathered through the District Health Information Software (DHIS2) so that the government system includes indicators from all sectors related to nutrition. Essentially, this means embedding the mapping metrics into the government information system. We are already working to plan the next wave of data collection, using the government information system. The intent is to regularly collect coverage data on the ‘core nutrition actions’ in this fashion at the municipal level, and then aggregate it to district and regional levels each semester. While we will initially be conducting this in a few regions, it will later be adopted by all regions. Ultimately, this will enable us to draw upon the mapping as a tool to monitor changes in nutritional status of the Malian population through regular updates over the course of the multi–sectoral national nutrition plan.