A. Nutrition Policies and Governance at the Global Level

There are examples of nations that have made steady, even rapid gains in reducing under nutrition. Examples are Bangladesh, Brazil, Ethiopia, India, Peru and Zambia.


There are examples of nations that have made steady, even rapid gains in reducing under nutrition . As noted earlier in this paper, the scientific evidence is clear as to what works especially at the immediate levels and there is a great deal of world-wide technical information on how interventions can be structured to best effect, although context still remains vitally important.

The challenge from global experience is making sure interventions are delivered through governance systems that work, and are cost effective and sustainable. There will be different pathways to maintaining political will and choices for nutrition improvement, but nutrition must receive funding and some priority if success is to be achieved.

Nutrition security will require a broad range of efforts (as identified by the conceptual framework in Section 2 of this review), and above all countries need to address the most vulnerable populations in society with an equitable, human rights based approach (IDS, 2012).

There are four key factors that all nations to some extent must develop in a framework to drive nutrition governance. These are:

i) intersector communication between government sectors and non government agencies;

ii) vertical coordination between different levels of government: national and local governments need legal frameworks, technical capacities and incentives to transfer resources, share information and remain accountable to each other; 

iii) sustainable funding to encourage policy coordination and implementation, particularly if national governments mobilize their own resources, and

iv) maintaining political commitment through monitoring and advocacy, with accurate indicators and timely reporting.

Experience from six countries (Bangladesh, Brazil, Ethiopia, India, Peru and Zambia) points to ten key findings and policy recommendations as being important ingredients:

  • The executive branch of government should be directly involved in the under nutrition reduction policy at the most senior level; this helps raise public awareness, coordinates the efforts of different line ministries and protects funding.​​

  • Establish effective bodies to coordinate nutrition actions across government ministries, with strong political support;

  • Frame nutrition as an integral part of the national development agenda, to generate public awareness so building in accountability;

  • Develop a single narrative about the severity of under nutrition, so contributing to clear policy goals, and targets as part of national campaigns;

  • Ensure that local governments have the capacity to deliver nutrition services; using decentralized services, and accompanied by active political parties and technical support from government ministries and donors. Training and capacity building will also be required.

  • Encourage local ownership of nutrition programmes and their outcomes; this will enhance accountability for politicians;

  • Support civil society groups to develop social accountability mechanisms; this enables groups to make under nutrition problems more visible and improve the scope and quality of service delivery;

  • Collect nutrition outcome data at regular intervals; this supports monitoring of progress and development of indicators; collecting data in a frequent and reliable manner is key to expanding political commitment, tracking progress and allocating the required funding.

  • Use centralized funding mechanisms to generate greater incentives to cooperate in the design, implementation and monitoring of nutrition interventions; this enhances accountability to internal sources of funding; and

  • Governments should create financial mechanisms to protect nutrition funding and use it in a transparent way. This could be, for example in the form of a levy.

 

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