Scaling up nutrition through multisectoral planning: An exploratory review of 26 national nutrition plans.

With a growing consensus on the need to address malnutrition in a comprehensive and multisectoral way, there has been increased attention on the processes and factors for multisectoral nutrition planning to be successful. To guide countries, the Scaling Up Nutrition (SUN) Movement developed a checklist that defined characteristics of good national nutrition plans. This exploratory review used the framework of the Checklist to assess 26 national multisectoral nutrition plans (MSNPs) developed between 2014 and 2020. The MSNPs were assessed against a subset of 31 Checklist characteristics defined as basic plan components. Although the level of detail varied across the reviewed plans, the majority included core components that are important to facilitate effective planning and implementation, such as an assessment of the nutritional status and determinants of malnutrition for children under 5 years of age, a commitment to global recommendations related to reducing malnutrition, actions consistent with global evidence and responding to identified issues/gaps, governance arrangements to facilitate coordination, and identification of capacity-building needs/actions to support effective implementation. Common gaps across plans included risk analysis and mitigation, defined responsible agencies for each action, an assessment of the financial gap and defined mechanisms for financial tracking and resource allocation, and mechanisms to coordinate operational research. These findings provide a high-level, multi-country review of multisectoral nutrition planning that can support future policymakers, technical assistance providers and regional and global stakeholders to consider the foundational elements of and further validate and address common shortcomings in developing such a plan.

Nutrition Embedding Evaluation Programme: An Evaluation Technical Assistance Model for Supporting Civil Society Organizations to Conduct Quality Nutrition Impact Evaluations.

The Nutrition Embedding Evaluation Programme (NEEP) was a global 4-year program (2013-2017) funded by the United Kingdom Department for International Development created to respond to gaps in the nutrition evidence base. The NEEP implementing agency-PATH-provided grants and evaluation technical assistance (ETA) to civil society organizations (CSOs) from 12 countries to conduct robust nutrition-related impact evaluations. The programmatic approach of having an intermediary agent to manage the funding and ETA mechanisms for nutrition impact evaluations is rare and therefore provides a unique opportunity to understand its effectiveness. Over the program duration, NEEP collected lessons learned that were analyzed and disaggregated into key themes considered critical for the completion of high-quality impact evaluations. From these lessons learned, NEEP provides an ETA program model that can be replicated or adapted to other international development sectors. This model highlights the key role of the three tiers (donor, ETA manager, and CSOs) in ensuring the best value for money and effective technical support for conducting impact evaluations and fostering the importance of knowledge uptake and evaluative culture for maximum knowledge diffusion. In this way, global research can be targeted to approaches that provide options to collaborate with the program implementers and contribute to a holistic evidence base to inform policy and programmatic decisions.

Use of a Nutrition Behavior Change Counseling Tool: Lessons from a Rapid Qualitative Assessment in Eastern Zambia.

The U.S. Agency for International Development Feed the Future Mawa Project - led by Catholic Relief Services - aims to improve food and economic security for farming households in Zambia's Eastern Province. Mawa employs social and behavior change (SBC) strategies with households and communities to improve nutrition and reduce stunting among children under two (CU2). To support these strategies, sub-partner University Research Co., LLC employed a participatory process to develop a series of 35 action cards, each illustrating one project-promoted behavior, that are used at household and community group levels. Caregivers of CU2 are given a full set of action cards to promote household dialogue and support for the promoted behaviors. As a final step in the action card tool development process, a qualitative rapid assessment was conducted 1 month after implementation to investigate preliminary ways action cards were being used, and if the methods of using the cards had the potential to impact behavior change. The research team conducted nine key informant interviews and four focus group discussions with Mawa staff and administered 41 qualitative interview questionnaires with project participants in the Chipata and Lundazi districts. Although not based on a representative sampling frame, the assessment produced valuable results for program improvement purposes. It also provided a feedback mechanism for community-based staff and project participants, a crucial step in the participatory tool development process. The assessment found that Mawa staff at every level use action cards combined with at least one other social behavior change tool for each nutrition intervention. Our results suggest that Mawa staff and project participants share a common understanding of the cards' purpose. Each group noted that the cards provide a visual cue for action and reinforce previous Mawa nutrition messages. Intended uses confirmed by the assessment include encouraging household cooperation, negotiating behavior change, telling stories, and integrating messages with other project sectors. Based on the findings, recommendations for future project activities include aligning efforts against a theory of change to optimize use of all SBC tools; leveraging action card use to strengthen cross-sectoral integration within Mawa; and specific ongoing monitoring of action card use to improve activity implementation.