SCN News No 36 - UNSCN

38
FEATURES
www.unsystem.org/scn
Commitment, Consensus and Strategic Capacity: An Evidence-Based Agenda
David Pelletier and the Mainstreaming Nutrition Initiative 1
The nutrition community may debate and disagree about many things, but we do agree on a few key points.
Malnutrition impairs human, social and economic development and is the major cause of the burden of
disease in the developing world. It generally does not receive the level of attention it deserves within
governments, international agencies and many other organizations, even though effective solutions are
available. We also tend to agree that our responses to the problem should be based on evidence.
Normally the evidence we seek relates to the efficacy and effectiveness of interventions. In contrast, the
Mainstreaming Nutrition Initiative (MNI) is an action research project that has gathered evidence on the
factors that help and hinder the movement of nutrition agendas at the country level. This is the type of
evidence required if nutrition is to receive the attention we feel it deserves. For the past two years MNI staff
from International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) and collaborating
institutions have partnered in various ways with governmental and non-governmental organizations in Bolivia,
Guatemala, Peru, Bangladesh, Pakistan, Vietnam, Uganda and Ethiopia. We have been participantobservers
in various phases of the nutrition policy process in these countries, from commitment-building to
implementation and evaluation. We also have interviewed a wide range of people from a number of other
developing countries and international organizations, participated in international meetings and examined
grey literature to understand the issues from diverse perspectives.
Although the Initiative is still underway and lessons are still being learned, it is timely to share some of the
findings with a larger audience. The findings that follow are based on experiences in nineteen countries: The
Philippines, Thailand, Bangladesh, Benin, Burkina Faso, Ethiopia, Kenya, Madagascar, Malawi, Mali,
Mauritania, Senegal, Tanzania, Uganda, Bolivia, Chile, Guatemala, Haiti and Peru, as reported by
government officials and staff from international agencies, NGOs and universities, or researcher institutions.
What shapes nutrition agendas?
The study identified a wide range of factors that influence the movement and shape of nutrition agendas, but
they can be grouped into the following categories: social conditions, catalytic events, structural factors, points
of contention, strategies and tactics (Figure 1 and Table 1).
Societal conditions and catalytic events
These two themes represent factors that have created opportunities and challenges to the national nutrition
agenda. Societal conditions refer to events and processes that tend to persist for many years and affect
many aspects of the development agenda in a country, with direct or indirect effects on the nutrition agenda.
Catalytic events are typically shorter in duration, and are more closely related to the nutrition agenda itself.
They are sometimes created by actors in the national nutrition system in the normal course of nutrition
research, testing of interventions, piloting or implementing of nutrition programs, responding to crises, or
conducting policy dialogue.
Societal conditions and catalytic events often provide opportunities for advancing the nutrition agenda. They
focus attention on conditions closely related to food security and nutrition (e.g., drought in Tanzania, Ethiopia,
Kenya, basic needs development and primary health care in Thailand, social inclusion in Bolivia and
Guatemala). They create not only a larger policy discourse within which nutrition can be strategically framed
by nutrition actors (e.g., currency devaluation in Senegal, results-based budgeting in Peru), but also venues
for policy discussions where nutrition actors can seek a seat at the table and position nutrition within the
larger policy issues of the day (e.g., MDG discussions in many countries, the HIV pandemic in Kenya,
Uganda and Malawi). Catalytic events which are more closely related to nutrition and more readily influenced
or used by nutrition actors. (e.g., publicizing a model community-based program in Thailand, attendance of
The Mainstreaming Nutrition Initiative (MNI) is World Bank-funded project of the International Centre for Diarrhoeal Diseases, Bangladesh and collaborators
at Cornell University, the International Food Policy Research Centre, the University of South Carolina and participating developing countries.
http://mainstreamingnutrition.org/default.aspx. Purnima Menon, Tien Ngo and Dominic Frongillo contributed to the study reported here. Tahmeed
Ahmed, Shamshir Ahmed (ICDDR,B) and Edward Frongillo (USC) also are core members of the MNI Team.
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