Operationalising multi-sectoral coordination and collaboration for improved nutrition

Summary of Report

SPRING. 2016. Operationalizing Multi-sectoral Coordination and Collaboration for Improved Nutrition: Recommendations from an in-depth assessment of three countries’ experiences. Arlington VA: Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING).

Reducing undernutrition requires a commitment from multiple sectors, yet there is little documentation on how to collaborate across sectors to reach global goals. The Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) project investigated approaches to multi-sectoral collaboration for nutrition through a three-country assessment and literature review.  A recent report highlights lessons learned by USAID and its implementing partners, and provides a series of recommendations to guide the design, implementation and monitoring of future collaborations.

Building on earlier research on cross-sector working in Senegal, Nepal and Burkina Faso, SPRING worked with three Feed the Future USAID Missions and their implementing partners in Guatemala, Bangladesh and Rwanda to strengthen their vision, plans and approaches for coordination and collaboration around nutrition. Researchers used document reviews, workshops and more than 50 interviews to identify the challenges and opportunities faced by countries in encouraging stakeholders to work together. Despite being at different stages and using various approaches, the countries shared similar obstacles in implementing structures, processes and practices. The report provides both country-specific recommendations and lessons that can be applied to other countries’ efforts to strengthen multi-sectoral collaboration to improve nutrition outcomes. ‘Coordination’, ‘collaboration’ and ‘integration’ are used interchangeably, but this report used the term collaboration throughout, with the understanding that coordination is inherent in the term.

SPRING identified six common multi-sectoral collaboration strategies across the countries related to leadership, strategy, communication, accountability, documentation and reporting that also align with key stages in the programme development and implementation cycle.

1. Prioritise collaboration to address nutrition

Collaboration should be inclusive, but leaders have an important role in overseeing the process and are an integral part of an initiative’s success. All three countries had champions within the Mission who took the lead in developing the approach. In Bangladesh, one USAID staff member created the working group and documented collaboration efforts. In Guatemala, one initial leader established the Western Highlands Integrated Programme (WHIP), set up monthly meetings and documentation so that only a small amount of operational guidance was needed from USAID. Rwanda’s Mission Director prioritised nutrition by driving the creation of the Community Health and Improved Nutrition (CHAIN) project, so nutrition and community health partners could work together for greater effect. However, implementing partners reported that they do not always understand where they fit in the ‘big picture’ and, instead, focus on their separate work plans; USAID has an important role in helping the partners see how they can better connect to other activities.

2. Develop a practical strategy

All three countries were struggling to develop a strategy that defined roles and responsibilities across participants, including a system for monitoring and feedback. Observations across the countries suggest that a collaboration strategy for nutrition should be inclusive, understandable, measurable and responsive.

• A strategy should be inclusive, encouraging participation from all stakeholders to generate consensus from the beginning and foster meaningful engagement.

In Guatemala, the WHIP held a workshop to finalise a two-year action plan during which participants agreed on common language to include in the strategy, vision and objectives, and defined the roles and responsibilities of the various stakeholders. Convening people at the outset also generated support for the design and implementation of collaboration across and among activities.

• A strategy should define terminology and expectations.

Confusion over terminology for coordination, collaboration, cooperation and integration was reflected in differing perceptions of how various activities were working together in Guatemala, and what stakeholders believed they were expected to do.

• A strategy should impose a time limit and result in a realistic outcome(s).

An ideal collaboration strategy includes a combination of easy wins to sustain momentum, as well as more ambitious, long-term outcomes. CHAIN partners in Rwanda identified a number of short-term goals, including increased adaptation and use of each other’s materials and messages.

• A strategy should include learning objectives and an understanding of the context in which collaboration is being promoted to guide current and future approaches.

Interviewees across the countries stated that they felt as though new activities had been designed separately from existing portfolios, and without a sound assessment of where the gaps were and how the new partners would best fit. By incorporating context assessment and evidence from past evaluations, USAID and other designers may develop collaboration strategies that capitalise on partners’ combined strengths.

3. Communicate the strategy’s goals and expectations at all levels

Communication at the national level between chiefs of party and Mission staff in the three countries was strong and regular meetings well attended. District-level interviews in Bangladesh and Rwanda revealed that several stakeholders had not heard about initiatives to collaborate, despite structured meetings between senior staff. Many interviewees across all the countries are often unaware of the collaboration challenges that staff in other locations face, suggesting weak communication between central and district levels; there were no formal structures for communicating the purpose of Bangladesh’s Agriculture-Nutrition Linkages Group and Rwanda’s CHAIN objectives. In contrast, the monthly departmental meetings in Guatemala (there are WHIP coordinating bodies in five geographic departments) are a venue for decentralized collaboration with department-level staff indicating a high level of understanding about what other stakeholders were doing.

4. Hold all stakeholders accountable for achieving the strategy

All stakeholders need clear, documented roles and responsibilities to facilitate commitment and promote effective collaboration.

• Ensure that collaboration responsibilities are central to everyone’s work

Collaboration requires resources, time, and committed staff to initiate and maintain efforts over time. USAID Rwanda has initiated structures to manage the implementation of CHAIN, which has a project manager who oversees the coordination of the project management team (PMT) and all the activities. Recently, collaboration responsibilities have been included in job descriptions and incorporated in newly awarded activities.

• Provide autonomy

In Guatemala, each departmental WHIP committee has the power to institute its own plans which has empowered some committees to take the initiative. In one department, the committee selected a pilot community where a number of partners work, and created a joint one-year work plan, working closely to collaboratively implement project interventions.

5. Share learning & adjust during implementation

A common finding in all three USAID Missions was that partners are working on similar activities simultaneously (e.g., duplicative evaluations, separate social and behavior change materials for nutrition, repeated or overlapping mapping exercises and tools), often duplicating efforts and not working in a cost-effective way. In Rwanda, stakeholders decided to form a technical working group to share tools that could be adjusted to serve others. In Guatemala, the Mission made deliberate efforts to coordinate the monitoring and evaluation processes across partners. Similarly, in Bangladesh, one activity is responsible for organising indicators across the activities.

6. Report on collaboration efforts 

Many of the partners in all three countries did not have specific deliverables, objectives, or metrics related to collaboration, resulting in a conflict between their contracts and the request from their donor to collaborate. The discrepancy between mandatory activity targets and a request for collaboration leaves implementers reluctant to allocate time and resources to collaboration. The Missions agreed that it was important to recognise stakeholders’ work on collaboration and requested assistance in monitoring their efforts. One opportunity for providing information that would ensure they achieve their collaboration goals is through evaluating joint trainings, common across all countries. The trainings themselves (number of trainings and people trained) are sometimes measured, but rarely are attempts made to measure additional outcomes. Certain benefits of collaboration, like participant satisfaction, are infrequently captured in traditional monitoring systems that focus on quantitative outcomes, but combining qualitative and quantitative methods may more effectively capture the dynamic nature of collaboration.

Conclusion

While collaboration strategies, goals, and models vary, they often follow a similar life cycle that can be systematically designed, implemented and monitored. The authors suggest that incorporating the recommendations highlighted by this assessment may lead to more successful and sustained collaboration for nutrition. However, well-designed indicators measuring the process and outcomes of collaboration still need to be developed to demonstrate the level of impact that is possible through multi-sectoral collaboration for nutrition.

The authors suggest that incorporating the recommendations highlighted by this assessment may lead to more successful and sustained collaboration for nutrition. However, well-designed indicators measuring the process and outcomes of collaboration still need to be developed to demonstrate the level of impact that is possible through multi-sectoral collaboration for nutrition.