Reflections on the Evidence for Action in South Asia – By Patrizia Fracassi
It has been an incredible privilege to be part of the Transform Nutrition Consortium Advisory Group and to have participated in this Symposium in Kathmandu. The work carried out by Transform Nutrition shows that, in order for the research agenda to be cutting edge, opportunities have to be seized upon and worked with through engagement of key stakeholders, such as academia, research, policy makers, implementers and advocates.
The evidence for action in South Asia generated by Transform Nutrition will help to build bridges in the complex and evolving landscape of nutrition. It highlights with lessons from Bangladesh and India how essential it is to integrate nutrition into health systems. But it also demonstrates that the engagement of frontline workers remains challenging. As illustrated by Kavita Chauhan (PHFI), explaining the story behind the data is vital to increase synergies among people and bring delivery at scale. Findings by Shilpa Deshpande (IDS) were helpful to unravel the identity politics among service providers while the presentation by Rasmi Avula (IFPRI) clarified the incentives that are motivating frontline workers in India. If we want to improve the quality of nutrition services and address challenges of low utilization, we need to understand people and get more of this type of evidence.
We know that Governments invest in social protection programmes. But how do we make them work for nutrition? The results from a study in Bangladesh by Akhter Ahmed (IFPRI) confirm that adding intensive Behaviour Change Communication to cash transfer programmes provides the greatest gains for nutrition. Yet, more research is needed on how this can be replicated at scale. The diagnostic by Suman Chakrabarti (IFPRI) on how big drivers of social spending can be analyzed using a nutrition lens could be applied beyond India. If a large-scale programme fulfills its basic mandate, is it feasible to work with implementers and budget holders to incorporate nutrition goals and actions? This type of assessment is timely to explain the politics of financing and ensure that assumptions are studied before important decisions are made.
I had the privilege to chair the session on the Stories of Change together with Zivai Murira (UNICEF) and to hear from the evidence from Nepal, Bangladesh and the Indian State of Odisha. It was an inspiring and motivating session. The Stories of Change led by Stuart Gillespie (IFPRI) have the greatest potential to reach out to communities beyond nutrition. They link together and explain which factors are important in each context. These factors touch upon different sectors, calls for a variety of stakeholders to get engaged and show that multi-disciplinary teams can help to clarify lessons from the past and highlight future scenarios.
It is encouraging to see how the quantitative work by Derek Headey (IFPRI) to analyze the drivers of nutritional change has been applied and customized in the three countries. The presenters – Kendra Cunningham (Nepal), Masum Billah (Bangladesh) and Neha Kohli (India) – demonstrated that the right enabling environment was the required factor in each country but the triggers were specific to each situation. A key take away for me was that a committed and accountable leadership such as the one in Odisha State and Nepal brought together the evidence and the coherence required to enable the change. This would have not been possible, however, without the championship demonstrated by a wide range of stakeholders in moving the nutrition agenda forward.
Transform Nutrition shows that the evidence for action is there and that people can effectively work together to deliver nutrition. This is the time to reach out to all actors with a stake on nutrition. As highlighted throughout the Symposium, a better understanding of the people, be they mothers, caregivers, frontline workers, advocates or leaders, will enable us to act upon every opportunity and bring the change.
This blog was originally shared on the Transform Nutrition website. Transform Nutrition is a consortium led by the International Food Policy Research Institute (IFPRI). Click here to view the original version.
About the author: Patrizia Fracassi is a Senior Nutrition Analyst and Strategy Advisor for the Scaling-Up Nutrition Movement Secretariat and member of the Transform Nutrition Consortium Advisory Group.