Assessing Multisectoral Coordination for Nutrition Policy Effectiveness
Assessing Multisectoral Coordination for Nutrition Policy Effectiveness: Analysis of Facilitators, Constraints and Solutions for Effective Implementation at the Woreda Level
This new research conducted during the first year of Growth through Nutrition was designed to follow up on the support provided under ENGINE, especially to model woredas in supporting the establishment and ongoing implementation of the woreda multisectoral coordination bodies and nutrition technical committees and to ascertain the factors that have enabled and sustained effective multisectoral coordination.
This study was conducted in September 2017 in four regions, SNNP, Oromia, Amhara and Tigray. The study was qualitative with purposing sampling of twelve woredas, three from each region. The woredas in each region represented one of three groups receiving different levels of interventions under the ENGINE program, identified as Model woredas (MW), non-Model woredas (NMW), and non-ENGINE woredas (NEW).
The data collection was done through Key Informant Interviews (KIIs) at the woreda and regional levels using a standardized and semi-structured questionnaire in the local language. For the purpose of analysis, respondents were grouped into three woreda groups: ENGINE Model, ENGINE non- Model, and non-ENGINE woredas. Coding and analysis were done using Atlas.ti 8.1.3.
Unlike the governance research conducted under ENGINE, the Growth through Nutrition research provides a better understanding of not simply “what” the situation is but also the “why.” This fine-tuned understanding has been facilitated by a combination of focus group discussions and individual interviews. For example, it became clear that awareness of the NNP and implementation of its structure and plan are complex issues challenged by high turnover, competing priorities, lack of leadership and understanding of roles and responsibilities. Therefore, different strategies need to be employed to create better awareness, ownership, understanding, and motivation for policy officials, technical experts, coordinating bodies, and supporting organizations.
A few highlighted recommendations from the study:
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Engagement of leaders at the highest levels is critical for maintaining visibility and awareness of the importance of the NNP II.
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Working with woreda sector heads to encourage more responsibility given to woreda technical committees to plan and implement joint nutrition activities. Also, working with woreda sector heads to ensure appropriate technical person assigned to participate in technical committees in a regular manner.
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Documentation of the status of coordinating bodies was weak in many woredas. Standardization and training in documentation of meetings, activities, and functionality is sorely needed. This could also help to fill some of the existing information gaps with the new staff joining the organizations. This support could be provided by Growth through Nutrition or other relevant partners.
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Sharing of experiences among the woredas would provide a practical forum for challenges and successes in implementing the NNP II. Growth through Nutrition could facilitate these discussions and work with woreda offices to ensure appropriate persons are targeted for different orientation and capacity building activities, and use existing platforms to facilitate these discussions.
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The current method of using a Scorecard at the federal and regional levels has been one way to ensure accountability. The results thus far look promising. Growth through Nutrition should explore methods for expanding the use of the Scorecard at the woreda level. The use of the 23 scorecard could facilitate the engagement and achievements in each sector in implementing the NNP II.
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Government Leadership above the woreda level should ensure that the Woreda leadership understand the NNP is government priority and plan. There needs to be clear government ownership of the program communicated at the regional level. Woredas should not associate the multisectoral coordination committee with ENGINE or Growth through Nutrition, but as a government plan and priority.
