Results for Development provides strategic support to change agents who are driving global, regional and country-level efforts to tackle malnutrition across sectors.
Governance & Multisectoral Coordination
The Challenge
Malnutrition is a complex problem that requires coordinated efforts across multiple actors operating in multiple sectors, including health, agriculture, WASH, social protection and education. Nutrition planning and programming — whether at the subnational, national, regional or global level — is not easy to achieve in traditional policy environments, where siloed decision-making within ministries (or other sector-specific units) is the norm and data for decision-making is often weak.
Our Approach
Results for Development provides strategic support to key change agents driving global, regional and national efforts to tackle malnutrition and improve nutrition outcomes. This work includes facilitating policy and strategy development, multisectoral planning and implementation; facilitating multisectoral action plan development and costing; strengthening the capacity of change agents based on their priorities and requests; ensuring financing information is available to budget holders for multisectoral planning and coordination; and developing and tailoring guidance on integrating wasting treatment into primary health care.
To support multisectoral policy planning, R4D facilitates highly intentional and well-structured engagements with the planning and budgeting departments of nutrition related sectors — including ministries of finance, planning and budgeting, health, agriculture, primary health care, women and children’s departments, local government, WASH, and social protection — alongside community representatives like traditional rulers, and technical officers from different agencies. Bringing these diverse stakeholders together around the same table and providing the appropriate tools for engagement can result in game-changing outcomes.
Examples of our Work
- Through the Sustainable Financing for Nutrition (SUSTAIN) project, R4D supports the governments of Nigeria, Ethiopia, Ghana and Malawi in their efforts to increase country-level financing for nutrition. We do this by strengthening the capacity of government and local partners to develop evidence-based sustainable financing strategies across sectors. In Nigeria, 17 states developed sustainable financing frameworks for nutrition. In Ethiopia, R4D supported the Ministry of Health to develop a Resource Mobilization Plan for the Seqota Declaration Scale Up and Expansion Phases, which the government used to mobilize domestic resources. In Ghana and Malawi, R4D supported the development of frameworks to guide sustainable financing for nutrition at the national level for both countries, and at the sub-national level for 17 districts in Northern Ghana and four districts in Malawi.
- R4D and UNICEF worked with country leaders to co-produce a novel 6-step guide for integrating early detection and treatment of child wasting into routine primary health care. In Ethiopia, R4D partnered with the Ministry of Health to adapt and apply this global evidence, creating a 3-year operational plan. While severe acute malnutrition treatment was already being integrated in most health facilities through Ethiopia’s Health Extension Program, the new plan expands services for moderate acute malnutrition, increases efficiency by utilizing the existing workforce and reducing reliance on parallel systems, and increases sustainability by strengthening health sector ownership and leadership.
- The Strengthening Economic Evaluation for Multisectoral Strategies for Nutrition (SEEMS-Nutrition) project, led by the University of Washington Department of Global Health, developed a common approach to address the global information gap on measuring costs, determining cost-effectiveness, and capturing benefits of multisectoral nutrition programs. Within the SEEMS-Nutrition partnership, R4D worked to ensure the common approach was responsive to decision makers’ needs. We convened the Policy Advisory Group bringing together global stakeholders to understand how evaluation data can support decisions to invest in, scale-up and set policy guidelines for nutrition programs. R4D also worked closely with the University of Washington to create a publicly available stepwise guide for applying the SEEMS common approach to costing studies.
- R4D developed a Nutrition Investment Toolkit for the Millennium Challenge Corporation (MCC) to support the design and implementation of nutrition-related activities within large MCC investments. The toolkit promotes a nutrition-smart approach that considers the impacts that investments in any sector may have on nutrition. It identifies nutrition-related activities with the best return on investment. It also recommends tools for measuring and modeling nutrition-related benefits from interventions that are intentionally designed to improve food systems, health, and nutrition outcomes. R4D continues to support MCC with training, dissemination, and application of the toolkit’s resources.
