Scaling Up Impact on Nutrition: What Will It Take?

Despite consensus on actions to improve nutrition globally, less is known about how to operationalize the right mix of actions—nutrition-specific and nutrition-sensitive—equitably, at scale, in different contexts. This review draws on a large scaling-up literature search and 4 case studies of large-scale nutrition programs with proven impact to synthesize critical elements for impact at scale. Nine elements emerged as central: 

1. having a clear vision or goal for impact; 
2. intervention characteristics
3. an enabling organizational context for scaling up
4. establishing drivers such as catalysts, champions, systemwide ownership, and incentives
5. choosing contextually relevant strategies and pathways for scaling up
6. building operational and strategic capacities
7. ensuring adequacy, stability, and flexibility of financing
8. ensuring adequate governance structures and systems
9. embedding mechanisms for monitoring, learning, and accountability. 

Translating current political commitment to large-scale impact on nutrition will require robust attention to these elements.