The politics of reducing malnutrition: building commitment and accelerating progress

The politics of reducing malnutrition: building commitment and accelerating progress

How can enabling environments and processes for scaling up nutrition be cultivated, sustained, and translated into results?

In the past 5 years, political discourse about the challenge of undernutrition has increased substantially at national and international levels and has led to stated commitments from many national governments, international organisations, and donors. The Scaling Up Nutrition movement has both driven, and been driven by, this developing momentum. The main challenges are to enhance and expand the quality and coverage of nutrition-specific interventions, and to maximise the nutrition sensitivity of more distal interventions, such as agriculture, social protection, and water and sanitation. But a crucial third level of action exists, which relates to the environments and processes that underpin and shape political and policy processes.

The authors of this paper in the 2013 Lancet Series on Maternal and Child Nutrition focus on this neglected third level. They address several fundamental questions:

  • how can enabling environments and processes be cultivated, sustained, and ultimately translated into results on the ground?
  • how has high-level political momentum been generated?
  • what needs to happen to turn this momentum into results?
  • how can we ensure that high-quality, well-resourced interventions for nutrition are available to those who need them, and that agriculture, social protection, and water and sanitation systems and programmes are proactively reoriented to support nutrition goals?

The authors use a six-cell framework to discuss the ways in which three domains (knowledge and evidence, politics and governance, and capacity and resources) are pivotal to create and sustain political momentum, and to translate momentum into results in high-burden countries.

Key messages from the paper include:

  • emerging country experiences show that rates of undernutrition reduction can be accelerated with deliberate action
  • politicians and policy makers who want to promote broad-based growth and prevent human suffering should prioritise investment in scale-up of nutrition-specific interventions, and should maximise the nutrition sensitivity of national development processes
  • political commitment can be developed in a short time, but commitment must not be squandered—conversion to results needs a different set of strategies and skills
  • leadership for nutrition, at all levels, and from various perspectives, is fundamentally important for creating and sustaining momentum and for conversion of that momentum into results on the ground
  • acceleration and sustaining of progress in nutrition will not be possible without national and global support to a long-term process of strengthening systemic and organisational capacities
  • the private sector has substantial potential to contribute to improvements in nutrition, but efforts to realise this have to date been hindered by a scarcity of credible evidence and trust. Both these issues need substantial attention if the positive potential is to be realised
  • operational research of delivery, implementation, and scale-up of interventions, and contextual analyses about how to shape and sustain enabling environments, is essential as the focus shifts toward action.

Please note: This paper is accessible upon free registration to The Lancet.

  1. How good is this research?

    Assessing the quality of research can be a tricky business. This blog from our editor offers some tools and tips.