Special focus on nutrition-sensitive programming

Editorial
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ultimately joint planning and implementation.
In Zambia, a very active civil society network
has seen strong and innovative advocacy on
nutrition influence political commitments, spark
legislative change and influence relevant policy
(Phiri, 2015). However, despite greater commitments
to nutrition by the Government, coordination
of nutrition interventions across
sector ministries has been challenging. Experiences
around SUN in Indonesia reflect huge investment
and tenacity in engaging across multiple
ministries and greater nutrition profile in existing
national policies, plans and budgets. However,
sustaining commitment and translating policies
into programmes also remains a huge challenge
(Shaheen, 2015). Pakistan has had positive experiences
since joining the SUN Movement in
2011 (Sardjunani, 2015), although it is still too
early to say whether the multi-sector approach
is working. In India, nutrition-sensitive social
protection programmes are being implemented
and steered by government with some success
(Oxford Policy Management, 2015).
What all these articles have in common is
the finding that multi-sector programming is
easier said than done. An ENN-led review of
the Common Results Framework (CRF), as a
tool and construct promoted as part of the SUN
Movement, concluded that the development of
a national multi-sector CRF, with inclusion of
all its features, is a process that may take years,
rather than months (Walters, 2015). e processes
of galvanising political and key stakeholder interest
and ownership, development of multisectoral
approaches, and monitoring and evaluation
frameworks are complex and resourceintensive
activities. Sustained commitment of a
variety of different sectors and stakeholders is
required to establish a relevant, feasible and
workable CRF and deliver on it. ere is also an
important question about how multi-sector
CRFs resonate with fragile and conflict-afflicted
states (FCAS) and the particular challenges
FCAS face. e ENN CRF review asserts that
capturing experiences from more SUN countries
in FCAS contexts would assist in learning about
how the humanitarian perspective is incorporated
into the CRF process and how the humanitarian
approach can consider multi-sectoral, multistakeholder
processes.
Findings from a regional conference in West
Africa (Huré et al, 2015) highlighted that multi-sector
programming needs improved nutrition
management tools and enhanced targeting in
policies that recognise the priorities of each
sector, account for implementation capacity of
a given sector, and invest in decentralised multi-sector
governance. Development of impact
measures and strengthened evidence of effectiveness
of multi-sector interventions are also
necessary.
easier to implement multi-sector programming
when development partners are leading implementation
with limited government involvement.
is is not to suggest that planning without government
is the way forward, but to recognise the
particular complexities that governments face
and the need for joint planning and action. Furthermore,
might it be even more straightforward
in humanitarian contexts, where cluster and inter-cluster
coordination mechanisms are established,
or in FCAS, where there is oen weak national
governance and external stakeholders drive
programming? On the other hand, it may be
harder to plan and implement multi-sectorally
within the short financing and reporting timeframe
typical for humanitarian donors (Domniguez-
Salas et al, 2015 and Mwendwa et al, 2015). ACF
is one of the international agencies that has taken
a lead in integrated multi-sector programming
over a number of years. As described by the authors,
establishing multi-sector programming as
the model for ACF programming has been a
long and difficult process within the agency (Gallagher
et al, 2015). Outstanding challenges to
fully implementing a comprehensive nutrition
security approach across the agency’s sectors are
lack of evidence of effectiveness and cost-effectiveness;
complexities in measuring effectiveness;
limited time, energy and motivation to interact
across sectors; and inadequate time for analysis
within the humanitarian response cycle.
While the SUN Movement model is predicated
on multi-sector planning and programming
around nutrition, there are few examples of
scaled-up, multi-sector government implementation,
and where this has taken place, there is
limited documentation describing how it has
been achieved. ere is a need for greater understanding
of the political economy at various
levels of government, as well as administrative
and bureaucratic hurdles that need to be overcome
to undertake multi-sector and nutrition-sensitive
programming and to cater for weak or absent
governance in FCAS. is is also true of NGO-
NGO interactions, or even just departments
within organisations; there are always political
and institutional dimensions to distinct stakeholders
coming together. Processes therefore
need to be documented analytically and across
a range of contexts with a view to sharing learning.
As detailed lesson-capture is something ENN
specialises in, we will be doing our very best to
assist with this process in the coming years.
Ultimately, we do not yet have the evidence
to know whether it is actually worth the effort
(in terms of impact) to plan and programme
multi-sectorally as opposed to using scarce resources
to ensure wider and fuller coverage of
sector programmes like WASH, social protection,
etc., which are intrinsically (or indirectly) nutrition-sensitive.
We are working on intuition
that coordinated efforts are better. Given the
above call for evidence, the time seems particularly
ripe for constructing detailed case studies
across a range of countries and contexts to fully
understand how best to facilitate the inter-sector
planning and implementation process for nutrition-sensitive
work. Some of this is being
done under the Stories of Change initiative,
which will be reported on later in 2016 (see
www.transformnutrition.org)
Conclusions
is editorial has tried to bring a programmatic
lens to lessons learned and good practice, as
well as debates and challenges around nutrition-sensitive
interventions, including providing
a rationale for work on nutrition in non-traditional
sectors; clarifying definitions as they relate
to operations; and weaving together key international
evidence with field articles to provide
a snapshot of current knowledge and action.
Several key issues have emerged from this ‘reality-check’:
1) there remain questions around whether,
when, and how to work multi-sectorally for
nutrition;
2) there is a need for more rigorous research
on nutrition-sensitive interventions,
including appropriate research designs and
indicators; and
3) there is still work to be done on the detail
of definitions for nutrition-sensitive action
if they are to be usefully operationalised for
government and development partners.
Reflections on what is needed
Reflecting on the experiences shared in this
First, as reducing malnutrition requires the
issue, it seems legitimate to ask whether it is
work of several sectors, a key challenge to nu-
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WaterAid/ Panos/ Adam Patterson