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8/9/2019 Quality for Governance for Nutrition, June 2014
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8/9/2019 Quality for Governance for Nutrition, June 2014
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2
The research base on nutritiongovernance,
“is limited to a handful of studies…[and]
systematic evidence about processesrelated
to intersectoral and multisectoralintegration
of actions is urgently needed.”
Gillespie et al. 2!"#$ Lancet paper 4
%e need to understand the barriers toactors
&or'ing at the interface of agriculture
and nutrition(
“)sing a variety of methods, &e need to*nd out
the follo&ing from these actors(
+o& much do they 'no& aboutnutrition
%hat do they thin' could be done”
8/9/2019 Quality for Governance for Nutrition, June 2014
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#
PoSHAN policy process studyquestions(repeat panels, ofce holders, 2013201!" #
in conte$t o% national &ultiSectorNutrition Plan
". %hat metrics eectively 0measure1 nutrition
governance
2. s stronger nutrition governance associated&ith better
nutrition outcomes over time
8/9/2019 Quality for Governance for Nutrition, June 2014
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4
5unaula +a3ar
6o5+78 research *eld sites 2"$
/ulti-5ector 8utrition 6lan
8/9/2019 Quality for Governance for Nutrition, June 2014
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9
5ource( 6o5+78 survey data 2!"
'evel nstitution)ndividual
8ational 6olicy ma'ers, donors, international non-governmental organi3ations 8G:s$,academics
;egional ;egional 7dministrator, /inistries of +ealth,7griculture, evelopment, implementing 8G:s
la'a :?ces of +ealth, 7griculture,
8/9/2019 Quality for Governance for Nutrition, June 2014
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E
hat is -easured.
Aommitment willingness to act $)nderstand and accept responsibility in multi-sector policy, senior management support, desire
to &or' across line ministries, incentives, etc.
Aapacity capacity to act $6osts *lled, adeIuate s'ills, purposive training,frustrations, resources available, disincentives,
bureaucracy, etc.
Aoherence horizontal and verticalcollaboration$
>egrees of agreement on nutrition problems,riorit actions needed, oint o&nershi of
8/9/2019 Quality for Governance for Nutrition, June 2014
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veryone see nutrition prole-s the sa-e a
&in
Agri
c
&in
Healt
h
&in
at
er
&in
4ducati
on
&in
'ocal
/ev
o-e
n in
/ev
5oodProductio
n
44K 42 #" 92 #F 4
/isease 4! 99 4E 4H #F "9lliteracy FH F H4 FH F2 H9Poor
6reast%ee
ding
! "H "9 E H "F
7ultural
taoos
22 22 "9 "9 "9 2!
8/9/2019 Quality for Governance for Nutrition, June 2014
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H
veryone see nutrition prole-s the sa-e a
High
levels
govern
8 (N9:;"
'oer
level
gov
8 (N2
8/9/2019 Quality for Governance for Nutrition, June 2014
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F
ncy o% vies on>o pro-ote crosssector collaoration %or nutr
Highe
r
levelgov
8
'oe
r
levelgov
8
:; F9KA 6-value
Strong
-anage-ent
support
F ".2# !.",
2."""
!.49"!
?oint
responsiility
#! "H ".F# ".#4E,
2.E!
!.!!!#
&andatory
-echanis-
#! F 4.#2 2.9,
E.#9
L.!!!"
7apacity "# "" ".22 !.E, !.#FH2
8/9/2019 Quality for Governance for Nutrition, June 2014
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"!
ncy o% vies on>
o pro-ote crosssector collaoration %or nutr
Health
sector
8
(n*12
3"
Non
health
sector
8 (n
:32"
:; F9KA 6-value
Strong
-anage-ent
support
H F !.H !.42F,
".94
!.EF#9
?oint
responsiility
2# 2E !.H9 !.944,
".#2E
!.4#2
&andatory
or@ing
-echanis-
"9 2# !.9H !.#4,
!.FE4
!.!#4!
8/9/2019 Quality for Governance for Nutrition, June 2014
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""
onal -ultisector nutrition plan rollout districts
8/9/2019 Quality for Governance for Nutrition, June 2014
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"2
istency o% vies on>
hallenges in -ultisector policy rollout&SNP
sites
8
(n*;:
"
All
other
sites 8
(n*;93
"
:; F9K A 6 value
Sufciently
consulted on
nutrition issues
4" 29 2."" ".2H!!,
#.4E#"
!.!!2
5req discuss
nutrition ith
colleagues
4! 24 2." ".24E,#.4""
!.!!#
nstitutional
hurdles aect
collaoration
4F 2H 2.4 ".9"49,4.!2"9
!.!!!2
7olleagues in 9H 4" ".F9 "."FHF, !.!!E
8/9/2019 Quality for Governance for Nutrition, June 2014
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"#
7onsistency o% vies on>
challenges to eective -ultisector or@on nutrition &SNP
sites 8
All
other
sites
8
:; F9K A 6
valu
e
'ac@ Bnancial
resources
# 4F !.E2 !.#",".!2"H
!.!4
Political
inter%erence
9 "9 !.## !.""H4,
!.F2F2
!.!
#'ac@
coordination
"4 F ". !.H2,
#.4HF4
!.!
4
Cely on
e$ternal aid,donor driven
"! "2 !.H2 !.#E2",
".H444
!.!
#
8/9/2019 Quality for Governance for Nutrition, June 2014
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"4
/istricts ithest and leastchanges in
stunting 200;2011
8/9/2019 Quality for Governance for Nutrition, June 2014
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"9
&osti-proved sites
8
'easti-proved
sites 8
:; F9K A 6 value
Beel unable to
respond
eectively
#4 9H !.#
!.2"!,
!.E4!
!.!!!4
>iscussed
stunting in pastmonth
29 "" 2.E
".24H,
9.EHH
!.!!F9
Trained in agD
lstoc' in past #y
"9 H 2.!
4
!.H#H,
#.!2#
!.""!F
Trained in
nutrition
F "F !.4
"
!."H2,
!.F#F
!.!#""
istency o% vies on>
llenges across est vs orst per%or-ing district
8/9/2019 Quality for Governance for Nutrition, June 2014
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Preli-inary conclusions
". Governance elements commitment, capacity,coherence$ vary across sectors, levels ofgovernment, and location /ust tailor incentives,information, training.
2. Be& even /o7$ claim that 0more food1 is the solution to
nutrition problems. Mut little agreement on 'ey
actions.
#. =Npression of &illingness to collaborate acrosssectorsO but
uncertainty on ho& to do that.
8/9/2019 Quality for Governance for Nutrition, June 2014
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"
ays %orard.
". 5tudy of nutrition 0governance1 still in itsinfancy. /ethods and methodologicalchallenges must be &idely shared.
2. =ncouraging *ndings( ts possible to measure policy processes
motivation, commitment to collaboration
across sectors, &illingness to act, capacity toact$. ;eal 0action1 is at sub-national level. Puality of nutrition governance lin'ed
measurably$ to impact. %orth eNploring
more.
8/9/2019 Quality for Governance for Nutrition, June 2014
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&any collaorators