Identifying nutrition policy demand and initial questions

  • STEP 1: Identify nutrition policy demand and initial questions

    Objectives:

    • To map the key opportunities for influencing policy, programming and investment decisions by identifying policy priorities of key nutrition-related sectors and time frames for decision making.
    • To identify initial questions of key nutrition-related sectors.

    Activities:

    • Activity A: Mapping key opportunities for influencing policy, programming and investment.
    • Activity B: Identifying initial questions for each priority.

    Outputs:

    • Matrix of key opportunities for influencing policy, programming and investment decisions and priority questions.
  • Scope of the question formulation process

    The NIPN country team will need to make certain strategic choices at the outset of the question formulation process.

    1. The NIPN approach is usually positioned to support a specific multisectoral nutrition policy or plan of action (MPPA). This focus is key to ensuring that the identified questions and subsequent analyses will respond to a specific need, that the appropriate decision makers are being engaged early on in the process, and that the answers to the questions are actionable and have the potential to influence a particular decision. For countries without a multisectoral nutrition policy or plan of action, it is recommended that a strategic decision is made on which nutrition policy, strategy, plan of action or possibly programme, the question formulation process will focus.
    2. Furthermore, the NIPN country team will need to make a strategic decision regarding whether to engage with all sectors contributing to the MPPA at the same time or whether to initially work with a subset of these, and subsequently engage the others. For countries without an MPPA, a similar choice needs to be made regarding whether to focus on all sectors that are likely to contribute to improved nutrition or only a few of them.
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    Example
    Guatemala decided to engage with a subset of the 20+ ministries contributing to the National Food Security and Nutrition Policy (PESAN 2012-2020). A focus on the four key ministries responsible for implementing actions of the revised Strategy for Preventing Chronic Malnutrition (ENDPC 2016-2020) seemed more manageable and more likely to provide tangible opportunities to turn NIPN findings into improved actions and decisions on ENPDC implementation.
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    This decision on which and how many sectors to engage in the NIPN operational cycle depends on several factors:

    • The existing structure of multisectoral coordination and the feasibility of engaging multiple sectors.
    • The capacity of the NIPN team to manage collaboration and data analyses with multiple sectors at the same time.
      This decision is likely to be a trade-off between bringing everyone on board to ensure a multisectoral approach and managing expectations around what can be delivered.
  • Activity A: Mapping the key opportunities for influencing policy, programming and investment decisions

    The mapping addresses the following questions:

    • What upcoming priority decisions are expected to be made in nutrition?
    • To which specific policy, programme or plan will they relate?
    • Who will make the decisions?
    • When will the decisions be made?
    • What evidence and information are likely to be needed?
    • Which administrative level is the focus of the decision (e.g. central or sub-national)?
      This information is gathered by the NIPN country team through a desk review of existing literature (see box below).
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    Examples of documents to review
    • Government resources such as: national policy, plans and programmes for nutrition (multisectoral and sector-specific with nutrition objectives).
    • Non-governmental resources such as:
      • Scaling Up Nutrition (SUN) movement UN Network online country reports and SUN country Joint Annual Assessments.
      • REACH supported documents: policy review, stakeholder and action mapping, common narrative or situation analysis overview and nutrition barometer.
      • Specific NIPN policy review
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The information should be verified and amended through stakeholder discussions with key government sectors, donors, UN and civil society groups, facilitated by the NIPN country team. The SUN platform may offer a good opportunity for these stakeholder discussions. The discussions may be in the form of focus groups or bilateral discussions and are particularly helpful in identifying the key opportunities to influence decision making.

The mapping aims to achieve the following:

  • Identify at which stage the MPPA is or sector-specific nutrition policy and plans are;
  • Assess coherence between the MPPA and sector-specific policies and plans (see country case study below);
  • Identify upcoming opportunities to influence decision making (next 12 months up to the platform’s duration);
  • Depending on the above, confirm which policy, plan or programme the NIPN cycle of ‘questions-analysis-findings’ will focus on;
  • Identify what types of information or findings are likely to be considered for these upcoming decision-making opportunities, and by when;
  • Ensure that the NIPN operational cycle will provide answers and recommendations in line with the decision-making calendar;
  • Define the target audience for the last step of the NIPN operational cycle regarding communication and dissemination of the answers to the policy questions.
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Window of opportunity
What are some examples of a “policy priority” that an NIPN operational cycle of ‘question-analysis-findings’ could inform?
  • a policy or plan under development, revision or implementation
  • an annual or mid-term policy review process
  • a budget prioritisation exercise
  • an annual planning exercise

For policies and plans, be mindful of which stage they are at: stakeholders’ priorities and interests will differ depending on the stage (evaluation, formulation or implementation), influencing the type of demand and information needs they may have.

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Case study
  • Activity A: Outcome of the mapping exercise

    The outcomes of the mapping exercise can be captured in a matrix summarising the key opportunities for influencing policy, programming and investment decisions (see Matrix Part I below).

    • Each row in the matrix relates to a specific piece of information that has been collected during the mapping.
    • Each column provides information relating to the policies, plans, programming and investments for one sector.
      The matrix example includes information from a fictional country. Only two columns have been filled (for multi-sectoral nutrition and agriculture). A full matrix would include further columns for all sectors that influence nutrition.
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    Matrix Part I
    PART I: OUTCOMES OF MAPPING BASED ON DESK REVIEW MULTISECTORAL NUTRITION AGRICULTURE
    Policy, plan or programmes National Nutrition Programme II (2016-2020) Nutrition-Sensitive Agriculture Strategic Plan (2016-2020)
    Stage in the policy cycle Year 2 into implementation – second implementation phase Year 2 into implementation
    Key changes/revision anticipated in the next 12 months and for the NIPN duration Evaluation in 2019 and revision of programme (phase II) by end of 2020 USAID planning to fund dietary diversity programme in vulnerable districts
    (funding from 2019)
    Window of opportunity for critical decisions January – March 2020 March – May 2019
    Key decision makers Ministry of Health
    Ministry of Agriculture
    Ministry of Agriculture
    USAID
    Key influencers Special Advisor for NNPII
    (in Ministry of Health)
    Food and Nutrition Advisor
    (in USAID)
    Key upcoming priority decision opportunities Year 3 will have a mid-term review Consultation workshop for USAID programme design – January 2019
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    Note
    Be mindful that that the ‘window of opportunity’ may be more or less strict depending on the strategic priority considered: a programme’s evaluation or reformulation leaves a larger window of opportunity while a specific event, such as a conference or consultation workshop (as in the above example for agriculture), has a fixed date, thus rendering the window of opportunity very narrow.
  • Five recommended exercises to help make a strategic decision

    The NIPN team can decide which exercises are most relevant in their respective contexts but all are helpful for framing the broad policy context overview and triggering the initial reflections and exchanges.

    1. Exercise 1: Start with understanding the magnitude and the trend of the undernutrition problem and the trends in relation to national targets.
    2. Exercise 2: Map out key multi-sectoral policies and plans of action in relation to undernutrition trends.
    3. Exercise 3: Gain a picture of the implementation time frame of the multi-sectoral policies and plans.
    4. Exercise 4: Identify which policies, programmes or investment decisions are more likely to be influenced and decide which administrative level to influence.
    5. Exercise 5: Identify and know your ‘decision makers’ at the various administrative levels.
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    Exercises
  • Activity B: Identify initial questions

    After having completed the policy review, the next activity will be to:

    • Engage with the sectoral government counterpart and request them to formulate one to two priority policy questions which they consider highly relevant to their sector
    • Capture these inputs in Part II of the matrix on key opportunities for influencing policy, programming and investment decisions (see example below)
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    Matrix Part II
    PART II: DRAFT POLICY QUESTIONS MULTISECTORAL NUTRITION AGRICULTURE
    Example question 1 Is the plan having an impact on stunting? How much impact have the nutrition-sensitive agricultural interventions had on stunting reduction?
    Example question 2 Will the plan meet its targets by 2020? At national and regional level? If not, which interventions need to be prioritised to accelerate progress? Which interventions should be prioritised to achieve the maximum impact on nutrition outcomes under the Nutrition-Sensitive Agriculture Strategic Plan?
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    The matrix exercise allows questions to be collected based on stakeholders’ priorities and sense of importance. At this stage, there is no need to apply other criteria; this will be done in the next steps.