Scaling Up Nutrition Together, we can achieve what no single effort could, and make the world a healthier, stronger place for us all. Strengthening multi-sectoral coordination at country level as a basis to develop a Common Results Framework for Scaling Up Nutrition

Why nutrition? Because when.. Children receive proper nutrition and develop strong bodies & minds Girls & women are well-nourished and have healthy newborn babies Children receive proper nutrition and develop strong bodies & minds The world is a safer, more resilient & stronger place Adolescents learn better & achieve higher grades in school Communities & nations are productive & stable Families & communities emerge out of poverty Young adults are better able to obtain work & earn more

A smart investment Eliminating under-nutrition in young children has multiple benefits. It can: Boost gross national product by 11% in Africa and Asia. Improve school attainment by at least one year. Increase wages by 5-50%. Reduce poverty as well-nourished children are 33% more likely to escape poverty as adults. Empower women to be 10% more likely to run their own business

Experts agree The Copenhagen Consensus 2012 Expert Panel of world renowned economists identified the smartest ways to allocate money to respond to ten of the world’s biggest challenges. They agreed that fighting malnutrition should be the top priority for policy-makers & philanthropists. They found that every $1 invested in reducing under-nutrition results in a $30 return on investment in terms of increased health, schooling and productivity. “One of the most compelling investments is to get nutrients to the world’s undernourished. The benefits from doing so – in terms of increased health, schooling, and productivity – are tremendous,” -Nobel laureate economist Vernon Smith

The causes of malnutrition are interconnected Lack of good CARE for mothers & children & support for parents on appropriate child feeding practices Inadequate access to HEALTH sanitation & clean water services Insufficient access to affordable, nutritious FOOD throughout the year ROOTED IN Political & Cultural Environment Disempowerment of women Environmental Degradation Poverty

Specific Actions for Nutrition Nutrition-Sensitive Strategies Nutrition-sensitive strategies increase the impact of specific actions for nutrition Specific Actions for Nutrition Nutrition-Sensitive Strategies Agriculture: Making nutritious food more accessible to everyone, and supporting small farms as a source of income for women and families Clean Water & Sanitation: Improving access to reduce infection and disease Education & Employment: Making sure children have the nutrition needed to learn and earn a decent income as adults Health Care: Access to services that enable women & children to be healthy Support for Resilience: Establishing a stronger, healthier population and sustained prosperity to better endure emergencies and conflicts Feeding Practices & Behaviors: Encouraging exclusive breastfeeding up to 6 months of age and continued breastfeeding together with appropriate and nutritious food up to 2 years of age and beyond Fortification of foods: Enabling access to nutrients through incorporating them into foods Micronutrient supplementation: Direct provision of extra nutrients Treatment of acute malnutrition: Enabling persons with moderate and severe malnutrition to access effective treatment

The SUN approach – starting in 2010 The Scaling up Nutrition Movement relies on national leaders taking ownership and responsibility for delivering sustainable solutions to improve nutrition in their countries. Through country-led efforts that focus on equity and realization of rights, SUN countries are enabling women, families & communities to create stronger foundations for their people & transforming the future of our world. SUN enables countries to take a collaborative approach bringing together the people & resources needed to rapidly scale up nutrition-specific interventions as well as implement cross-sector strategies that are nutrition-sensitive.

Countries are at the center of scaling up nutrition Countries around the world have committed to making nutrition a priority & global partners are working together to support the efforts of SUN countries.

At the core of all efforts, Across all approaches – SUN supports equity for women At the core of all efforts, women are empowered to be leaders in their families and communities, leading the way to a healthier and stronger world.

The SUN approach Global Networks of stakeholders shift resources & align actions to support country efforts. With overall support and coordination provided by the SUN Secretariat and SUN Lead Group Country Network Civil Society Network United Nations Network Donor Network Business Network

Principles of Engagement Creating Political and Operational MS Platforms Principles of Engagement Be transparent about impact: all stakeholders to transparently and honestly demonstrate the impact of collective action. Be inclusive: through open multi-stakeholder partnerships that bring proven solutions and interventions to scale. act in line with a commitment to uphold the equity and rights of all women, men and their children. Be rights-based: Be willing to negotiate: when conflicts arise, as can be expected with diverse partners working together, hold the intention to resolve conflicts and reach a way forward. Be mutually accountable: act so all stakeholders feel responsible for and are held collectively accountable to the joint commitments. Be cost effective: establish priorities on evidenced-based analysis of what will have the greatest and most sustainable impact for the least cost. to learn and adapt through regular sharing of the relevant critical lessons, what works and what does not, across sectors, countries and stakeholders. Be continuously communicative:

National political commitment Processes that contribute to create an enabling environment for Scaling Up Nutrition Creating Political and Operational MS Platforms 1 Developing a coherent nutrition policy framework 2 Aligning Actions Across Sectors (MS Common Results Framework) Increasing Resources and Monitoring Implementation 3 4 National nutritional outcomes

multi-stakeholder platform At country level: A collaborative approach The Focal Point brings people together in a multi-stakeholder platform Technical Community Civil Society United Nations Donors Government Partners Business

Works to align and coordinate action across sectors. At country level: a multi-sector approach The multi-stakeholder platform Works to align and coordinate action across sectors. Social Protection Health Women’s Empowerment Agriculture Development, Poverty Reduction & Employment Education

Different ways for creating an enabling environment Multi-stakeholder platforms function at their best when there is agreement on: Common results and objectives Membership and Terms of Reference Organizational framework(s) Working procedures

Different ways for creating an enabling environment To ensure that multi-stakeholder platforms work for nutrition, it can be helpful to: Set a joint agenda to: Achieve common results and enable decisions to be taken across stakeholders on critical issues Ensure effectiveness of converged and integrated actions on the ground

Examples from countries Nutrition under supervision of the Head of Government or State (Tanzania, Uganda, Madagascar and Malawi) Presidential mandate linked to nutrition outcomes (Guatemala and Peru) Executive leaders acting as nutrition champions (Tanzania and Uganda, Indonesia and Sri Lanka) Balanced representation of stakeholders including civil society organizations and private sector (Tanzania, Uganda, Ghana and Bangladesh) Establishment of sub-national and district level multi-stakeholder platforms (Kenya, Rwanda, Uganda, Mozambique)

Building an enabling multi-stakeholder environment Consensus among representatives of different stakeholders by developing a shared understanding around nutrition issues Buy-in from all represented stakeholders by recognizing their specific contribution and by respecting their decision-making autonomy Alignment between individual stakeholders’ agendas around common results, including measurement of collective success

Establishing a Common Results Framework Sectoral POLICIES Sectoral STRATEGIES Engaging different parts in Government other stakeholders NEGOTIATION around a single set of results Several SECTORAL PLANS an IMPLEMENTATION PLAN which sets: results-based priorities responsibilities for implementation across Government sectors and partners target population + timeframes + baseline + targets a COSTING of the Plan and the contribution of different stakeholders   a M&E FRAMEWORK COMMON RESULTS FRAMEWORK includes:

Tracking and reporting impact Establishing targets to measure impact: Countries are encouraged to establish their own targets for nutrition goals in the following areas: Universal access to affordable nutritious food, clean water, sanitation, healthcare and social protection Increased adoption of practices that contribute to good nutrition (such as exclusive breastfeeding in the first six months of life) Optimal growth of children, demonstrated as reduced levels of stunting (low height for age) and wasting (low weight for height) Improved micronutrient status, especially in women and children, demonstrated as reduced levels of micronutrient deficiency Annual SUN Movement Progress Report: Released in September each year by the SUN Movement Secretariat, the report provides updates on progress in achieving the Movement’s goals and strategic objectives.

World Health Assembly 2012 Resolution: Supporting global impact Together, countries and supporting stakeholders are collectively working to reach the global targets set out by the World Health Assembly 2012 Resolution: 40% reduction of the global number of children under 5 who are stunted Target 1: Target 2: 50% reduction of anemia in women of reproductive age Target 3: 30% reduction of low birth weight Target 4: Increase exclusive breastfeeding rates in the first 6 months up to at least 50% Target 5: No increase in childhood overweight Target 6: Reducing and maintaining childhood wasting to less than 5%

How has stunting been reduced? How has stunting been reduced? In Peru Reduction in stunting adopted as national goal Major social programmes targeted to the poorest Comprehensive health insurance system implemented Increased Government budget allocated for nutrition In Nepal Political commitment and engagement by main sectors (Health, Education, WASH, Agriculture and Local Governance) Government budget for nutrition doubled In Ethiopia Large scale program to improve access to health posts in remote and drought- stricken areas Provision of safety nets for vulnerable families Treatment of severe acute malnutrition expanded

Challenges Competing parallel systems and structures Conflicting agendas and interests at different levels Lack of decision making authority accompanied by limited capacity to position nutrition outcomes at the core of the development discussion Limited coordination and capacity beyond the national level Limited engagement of local or community-based civil society organizations and private sector

together and make the world a healthier, stronger place for us all. we can achieve what no single effort could, and make the world a healthier, stronger place for us all.