Menu ENN Search

Inter-sectoral coordination for nutrition in Zambia

Summary of research1

Location: Zambia

What we know: The level of inter-sectoral coordination needed to address underlying causes of malnutrition is difficult to achieve and often lacking.

What this article adds: Concern Worldwide facilitated a unique initiative in a district of Zambia to improve multi-sectoral understanding and align activities on nutrition. A District Development Coordinating Committee (DDCC) was formed, focused on addressing stunting. Using this platform, a creative approach was used that has nurtured mutual supportive learning; several inter-sectoral developments have resulted and roll-out of the DDDC is now planned for 14 pilot districts. Upwards advocacy has strengthened the role of the National Food and Nutrition Commission (NFNC) as the national-level forum for experience-sharing to inform advocacy, planning and implementation. Facilitation, sustained support and commitment from an external agent have been instrumental in successes; there are lessons for the Scaling Up Nutrition (SUN) Movement.

The underlying determinants of nutritional status are adequate food, health and care. The goods and services related to these will be available from a range of sectors, which means inter-sectoral coordination is key to addressing malnutrition. However, the nutrition community in general has not yet managed to foster this necessary level of coordination. The authors of a recently-published paper suggest that several barriers exist, including low political commitment and space for new ways of working; limitations of existing routines and structures within sectors; weak coordinating bodies; lack of human resources; and inadequate strategic, management and technical capacity.

The authors present the example of Zambia, where the estimated national prevalence of stunting among children under five years of age is 45%. There is currently very little national or sub-national level inter-sectoral coordination for nutrition in Zambia. Against this backdrop, the non-governmental organisation (NGO) Concern Worldwide facilitated a unique initiative in the Mumbwa District of the country to coordinate ministries and NGOs involved in the provision of nutrition-related services. This paper describes the process of establishing this initiative, as well as subsequent learning and challenges.  

In February 2012, Concern Worldwide began bringing together relevant ministries and civil society organisations under the DNCC in order to improve understanding and align activities for nutrition at local level. To do this, the DNCC set out to build on the strengths of existing actors, systems and capacities to facilitate a shift in how stunting is understood and addressed, so that coordinated strategies and joint interventions for stunting prevention can occur. 

This process was strongly informed by ‘Theory U’, which promotes a creative, learning approach that moves from changing the perceptions of participating actors to experiential learning and sharing; to transforming actors’ sense of responsibility for change; and ultimately to acting on this. In practice, this has involved bringing together carefully selected, relevant actors in Mumbwa to share, understand and learn from each other’s experiences and perceptions. 

An important aspect of the coordination process was the acceptance of the DNCC meetings as a space for learning, sharing and reflection, and that multiple perspectives are something of value. As a result, a common understanding of stunting has emerged. This was exemplified when the DNCC developed a ‘problem tree’ analysis of stunting in Mumbwa, as seen from a multi-sectoral perspective, and a ‘solution tree’ to guide responses. The exercise revealed a number of overlapping themes that enabled the DNCC to identify areas of possible collaboration. Having reviewed and agreed this analysis, DNCC members travelled to a village two hours by road from Mumbwa town to engage with community members. This resulted in the DNCC adjusting the problem tree to reflect aspects of stunting that the community felt were important. This process helped DNCC members gain a deeper understanding of the realities of people most affected by stunting, and achieve a deeper engagement with one another about how to address these realities. 

Since its inception, the DNCC has participated in ‘upwards advocacy’. There is currently little inter-sectoral coordination in Zambia at national level. However, with the momentum created by the SUN Movement, the NFNC (as the national steering body for nutrition) is ideally located to become a force for nutrition advocacy, planning and implementation. Recognising this, the DNCC prioritised a national-level forum, whereby the emerging experiences from Mumbwa could be shared. Concern Worldwide facilitated a national meeting in October 2012 for this purpose, with support from the DNCC and engagement from the relevant national actors. The DNCC shared experiences from local level; as a result, the committee was identified as a possible model for coordination across Zambia. The NFNC now intends to replicate the committees in 14 pilot districts.

Several inter-sectoral programming developments have emerged through the DNCC. These include a clear commitment from actors to work together, share ideas and information, keep each other informed, and attend meetings. This type of commitment cannot be taken for granted as numerous disincentives exist within individual government ministries to avoid working outside their core mandates. Other developments include attempts to recognise and include new stakeholders in the district who may have a bearing on addressing undernutrition. For example, recognition among DNCC members of the importance of women’s land rights in addressing undernutrition led the DNCC to invite the Ministry of Lands to join the committee. Another tangible example of inter-sector collaboration was the sharing of vehicles, fuel and staff for cooking demonstrations, which each Ministry was undertaking separately but is now combining. There has been criticism that progress has been slow and more coordinated strategies and joint interventions should have taken place. However, the authors state that, as undernutrition is socially, dynamically and generatively complex, it will take time for effective solutions to emerge.

Another challenge is how to raise the issue of coordination and alignment to address undernutrition higher up the Government’s agenda. Part of the answer may lie with the SUN Movement, while another lies with securing high-level champions within the key line ministries to advocate for change. However, the experience of the DNCC shows that, while structures are important, sufficient attention must also be paid to the individuals involved in the coordination process and to the quality of relationships and interactions between them. In this example, the concerted support and commitment of an external agent (Concern Worldwide) from the outset was invaluable in making this happen. These will be key points to address as similar committees are replicated under the SUN Movement.

The authors conclude that the creation of a DNCC, while slow and difficult at times, was useful and sustained facilitation has built trust and mutually supportive learning between diverse stakeholders. While recognising that it will take time for fully effective and implementable solutions to emerge, the DNCC is a potentially durable and effective way of addressing undernutrition in Zambia in the long term.

Footnotes

Drimie, S., Chakrabarty, S.K., Dube, C., Smit-Mwanamwenge, M., and Rawat, R., Harris, J. (2014). Inter-sectoral coordination for nutrition in Zambia. In ‘Turning rapid growth into meaningful growth: Sustaining the commitment to nutrition in Zambia’, ed. Jody Harris, Lawrence James Haddad and Silke Seco Grütz. Pp. 1-9. Brighton: Institute of Development Studies (IDS).www.ids.ac.uk/publication/turning-rapid-growth-into-meaningful-growth-sustaining-the-commitment-to-nutrition-in-zambia 

More like this

FEX: Role of communication and advocacy in scaling up nutrition: lessons and plans from the Zambian experience

By Eneya Phiri Eneya Phiri is a seasoned advocate with four-and-a-half years' experience in nutrition advocacy and communications. He is a keen believer in communications for...

FEX: Experiences of multi-sector programming in Malawi

By Felix Pensulo Phiri Felix Pensulo Phiri is Director of Nutrition in the Department of Nutrition, HIV and AIDS, Ministry of Health, Malawi. He is responsible for providing...

FEX: Update on Scaling up Nutrition (SUN) and the ‘1000 Day’ movements

By Tom Arnold and David Beckmann Tom Arnold is CEO of Concern Worldwide and David Beckmann is President of Bread for the World. Recognised globally as non-governmental...

NEX: SUN en-net discussion

The SUN area of en-net includes questions and discussions that enable SUN country actors to share their experiences and learning openly. A recent question asked was: What are...

NEX: Building understanding and capacity for integrating food security and nutrition approaches to address widespread child undernutrition in Niger

Solange Heise Solange Heise is the Food Security and Nutrition Officer at the FAO representation in Niger. Background Niger, a landlocked country in the Sahel of West...

FEX: Assessing progress in implementing Uganda’s Nutrition Action Plan: District-level insights

Summary of Research1 Agaba E, Pomeroy-Stevens A, Ghosh S and Griffiths JK. Assessing Progress in Implementing Uganda's Nutrition Action Plan: District-Level Insights. Food and...

NEX: Scaling up nutrition: experiences from Balochistan, Pakistan

Muhammad Sheraz and Dr. Ali Nasir Bugti Muhammad Sheraz is the Nutrition Information Management Officer for the Department of Health within the Government of Balochistan. Dr....

FEX: Introduction to the special issue

The most recent Lancet series on maternal and child undernutrition (Bhutta et al, 2013) calculated that even with 90% coverage of specific nutrition interventions (addressing...

NEX: Unlocking Zambia’s Agricultural Potential for Nutrition Development

William Chilufya William Chilufya is a civil society advocate with 9 years of experience in championing pro poor development in Zambia. He is leading the Zambia Civil Society...

FEX: SUN Movement experiences in Indonesia

By Nina Sardjunani and Endang L. Achadi Nina Sardjunani is the SUN Lead Group member and was previously Deputy Minister of Ministry of National Development/National...

NEX: REACHing for the SUN: UN support for scaling up nutrition in Burkina Faso

Dr Doudou Halidou Maimouna and Ousmane Ouedraogo are the REACH co-ordinators in Burkina Faso. Bertine Ouaro is Head of the Nutrition Department at the Ministry of...

en-net: Nutrition Coordinator, Concern Worldwide Zambia, for the Female Youths Livelihood and Nutrition Enhancement Project

REQUEST FOR CURRICULUM VITAE’S FOR INDIVIDUAL CONSULTANTS (IC) COUNTRY/ GRANTEE: Concern Worldwide in Zambia NAME OF PROJECT: Zambia Female Youths Livelihood and Nutrition...

FEX: BabyWASH coalition planned to overcome development silos

By Peter Hynes, World Vision Actors from non-governmental organisations (NGOs), donors, academia, United Nations (UN) agencies and others met recently to consider forming a...

en-net: Nutrition Coordinator, Zambia Female Youths Livelihood and Nutrition Enhancement Project

COUNTRY/ GRANTEE: Concern Worldwide in Zambia NAME OF PROJECT: Zambia Female Youths Livelihood and Nutrition Enhancement Project Position: Nutrition Coordinator based in Lusaka...

en-net: Province level SUN platform

What are some good examples of where multisectoral platforms for SUN have been successfully established at province or county level ? Which actors have been involved in...

FEX: Bangladesh Nutrition Cluster: A case in preparedness

By Andrew Musyoki and Anuradha Narayan Andrew Musyoki is a Nutrition Specialist with UNICEF Bangladesh Anuradha Narayan is the Chief of the Nutrition Section, UNICEF...

FEX: From the editor

Rabia, seven months, with her mother at an OTP Aim and structure of this special issue This Field Exchange special issue on ‘Lessons for the scale up of Community-based...

FEX: Action Against Hunger/Action Contre la Faim: Promoting a comprehensive nutrition-security approach and organisational culture to enhance nutrition-sensitive programming

By Maureen Gallagher and Julien Morel Maureen Gallagher is Senior Nutrition & Health Advisor with ACF-USA Julien Morel is Senior Nutrition Security and Social Protection...

FEX: Hunger And Nutrition Commitment Index (HANCI)

The Hunger And Nutrition Commitment Index (HANCI) is a project of the Institute of Development Studies' (IDS) with funding from Irish Aid, UKAid and Children's Investment Fund...

FEX: Advocating for nutrition in West Africa: The role of SUN Civil Society Alliances

By Judith Kabore and Laure Serra Judith Kabore is an advocacy officer at the regional office of Action Against Hunger. A journalist by training, Judith worked in the Ministry...

Close

Reference this page

Editors (2016). Inter-sectoral coordination for nutrition in Zambia. Field Exchange 51, January 2016. p39. www.ennonline.net/fex/51/intersectoralzambia