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New report on Scaling Up Impact on Nutrition: What Will It Take?

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In July 2015, a new report was launched by the International Food Policy Research Institute to synthesize the critical elements required to improve nutrition impact at scale. The report recognises that whilst there is global consensus on the need to improve nutrition, little is known about how to operationalise the right mix of nutrition specific and nutrition sensitive actions that will generate impact.

Methods used by the researchers, Stuart Gillespie, Purnima Menon and Andrew L Kennedy, included a thorough literature review, consultation with experts, condensing of 36 theoretical frameworks and 19 programme experiences, and, in-depth case studies of four scaled-up programs.

Nine elements emerge as central to scaling up impact on nutrition:

  • having a clear vision or goal for impact
  • intervention characteristics
  • an enabling organizational context for scaling up
  • establishing drivers such as catalysts, champions, system-wide ownership, and incentives;
  • choosing contextually relevant strategies and pathways for scaling up
  • building operational and strategic capacities
  • ensuring adequacy, stability, and flexibility of financing
  • ensuring adequate governance structures and systems
  • embedding mechanisms for monitoring, learning, and accountability

The report identifies that in order to translate the current political commitment to fight malnutrition, attention will need to be focused on these nine elements.

The report is supported by the Transform Nutrition Consortium, with funding from the United Kingdom Department for International Development. The free access article, can be downloaded from Advances in Nutrition

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3 Comments
  • Claudioschuftan | Sep 4, 2015 at 10:40 am

    Let me comment on Stuart’s New IFPRI report on Scaling Up Impact on Nutrition: What Will It Take? Of June 2015 by looking at its conclusions only (in lower case):

    Scaling up has become something of a mantra within the international nutrition community in recent years, even though it apparently means different things to different people. ABSOLUTELY…AND THIS HAS DIVIDED THE NUTRITION COMMUNITY INTO THOSE THAT BACK AND PARTICIPATE IN SUN AND THOSE WHO DO NOT.

    There is a need for greater coherence and consistency with regard to the ends and the means of scaling up—its scope, purpose, and essential processes. PRECISELY. COHERENCE AND CONSISTENCY CAN ONLY MATERIALIZE IF WE CAN AGREE ON THE ACTORS AND MEANS; ON THE ENDS WE WILL HARDLY DISAGREE. WITHOUT BEATING AROUND THE BUSH, THE CONTROVERSY REVOLVES AROUND THE PARTICIPATION OF THE PRIVATE SECTOR IN MULTI-STAKEHOLDER PLATFORMS AND THE MYRIAD CONFLICTS OF INTEREST THIS BRINGS ABOUT. MUCH HAS BEEN WRITTEN ABOUT THIS, BUT TO LITTLE AVAIL SO FAR. AS IMPORTANT A CRITIQUE HAS BEEN THE FACT THAT SUN ONLY PLAYS LIP SERVICE TO USING A RIGHT TO FOOD APPROACH. NOT SURPRISINGLY, THE EMPOWERMENT OF CLAIM HOLDERS DOES NOT EVEN GET SCHORTSCHRIFT.

    The review identified 9 critical elements to guide actions for scaling up impact on nutrition: IS IT FAIR TO SAY WITH A TOP-DOWN BIAS? LE ME PLAY A DEVIL’S ADVOCATE ROLE HERE BY ASKING SOME PERTINENT QUESTIONS.

    Nine elements emerge as central to scaling up impact on nutrition:

    • having a clear vision or goal for impact. WHO IS TO HAVE A CLEAR VISION? THE PROFESSIONALS IN CHARGE OF SCALING UP? WHERE DO BENEFICIARIES HAVE AN INPUT?

    • intervention characteristics. AS DECIDED BY WHOM? WITH WHICH ACTORS INVOLVED AND WITH WHAT ROLE EACH?

    • an enabling organizational context for scaling up. INCLUDES CLAIM HOLDERS PROMINENTLY ENOUGH IN THAT ORGANIZATIONAL CONTEXT?

    • establishing drivers such as catalysts, champions, RECRUITED FROM WHERE? GOVERNMENT? ALSO REPRESENTATIVES OF CLAIM HOLDERS? system-wide ownership, WHAT IS SYSTEM-WIDE? COMMUNITY? and incentives; ECONOMIC?

    • choosing contextually relevant strategies and pathways for scaling up. WHO CHOOSES? CONTEXTUALLY RELEVANT TO CLAIM HOLDERS OR TO DUTY BEARERS?

    • building operational and strategic capacities. OF WHOM? INCLUDES EMPOWERMENT FOR THE SOCIAL MOBILIZATION OF CLAIM HOLDERS ON NUTRITION ISSUES?

    • ensuring adequacy, stability, and flexibility of financing. AGREE, BUT NOT WITH A ROLE FOR THE PRIVATE SECTOR (UNLESS THEY PROVIDE NON-EARMARKED FUNDS TO THE PUBLIC SECTOR FOR THE EFFORT).

    • ensuring adequate governance structures and systems. REQUIRES QUALIFICATION OF WHAT IS ADEQUATE, E.G., EFFECTIVE ACCOUNTABILITY AS PER BELOW?

    • embedding mechanisms for monitoring, learning, and accountability. IN THE SPIRIT OF HUMAN RIGHTS, MOSTLY THE LATTER, I.E., GIVING PUBLIC INTEREST CIVIL SOCIETY ORGANIZATIONS AND SOCIAL MOVEMENTS THE ROLE OF WATCH DOGS OF BOTH GOVERNMENT AND THE PRIVATE SECTOR.

    Successful large-scale nutrition programs have previously had several of these elements, but WHY ‘BUT’? have been mostly focused on nutrition-specific interventions, with good reason. I’D SAY WITH (PERHAPS!) NECESSARY BUT NOT SUFFICIENT REASON.

    But a new focus that also encompasses nutrition-sensitive development …A EUPHEMISM FOR WHAT IT REALLY IS: ADDRESSING THE SOCIAL DETERMINANTS OF MALNUTRITION (A LA SOCIAL DETERMINANTS OF HEALTH) and the role of leadership YES and enabling policy environments … A EUPHEMISM FOR HUMAN RIGHTS-BASED NEEDED STRUCTURAL REFORMS OF THE PREVAILING UNFAIR AND UNJUST SOCIAL, ECONOMIC AND POLITICAL SYSTEM is a new imperative for nutrition.

  • Stuart Gillespie | Sep 21, 2015 at 10:43 am

    Thanks to Claudio for these comments. It is not clear to me whether they derive from a reading of the whole paper, or just the conclusions that were posted on the SUN website? To clarify…..this review is focused on approaches to “scaling up impact on nutrition” (lower case). It is not in any way a review of the SUN Movement. Claudio focuses on the SUN Movement and the role of the private sector, which is not the main focus on the review. The 9 elements are all critiqued in such a way as to suggest that the agency and involvement of local communities/actors is ignored or downplayed. Again, it’s not clear if this a critique of the whole paper, or not – but it does not reflect the actual content of our review. Best, Stuart

  • Claudioschuftan | Sep 22, 2015 at 12:43 am

    As I say in the first para of my comment, the latter was based on the conclusions only. I acknowledge this again. I do understand Stuart’s paper does not review the SUN Initiative. But, when talking about scaling up impacts should his paper not have addressed the role of the private sector. Stuart implies that the answer is no. I cannot agree more with him on how the role of communities and claim holders has been mostly ignored. But/So my devil’s advocate questions above still stand. Best, Claudio cschuftan@phmovement.org