1. The Maximising the Quality of Scaling up Nutrition Programmes Framework (MQSUN) is a DFID-funded consortium of partners, led by PATH, collaborating to scale up DFID nutrition programs globally.
MQSUN is a four year project spanning from February through February 2015
MQSUN aims to provide DFID with technical services to improve the quality of nutrition-specific and nutrition- sensitive programmes.
DFID has 17 priority countries including: *Bangladesh, Myanmar, Ethiopia, India, Kenya, Malawi, Mozambique, Nepal, Nigeria, Pakistan, Somalia, Sudan, Tanzania, Uganda, Yemen, Zambia, Zimbabwe
About MQSUN
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2. Our Partners Aga Khan University Agribusiness Systems International
ICF International
Institute for Development Studies
International Food Policy Research Institute
Health Partners International, Inc.
PATH
Save the Children UK
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3. MQSUN Calldown Activities
Nutrition Audits
Business Cases
Knowledge Management & Dissemination
Operations Research
Impact Evaluations
Governance and Political Economy Analysis
Capacity Building
Costing and Financial Tracking
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4. Supporting SUN Secretariat – History
MQSUN core activity
Review of National Nutrition Plans of 17 DFID* priority countries
Checklist tool for reviewing the National Nutrition Plans
Summary document of the review for 17 countries
Partners: HPI and PATH
Phase I – Supporting Movement of Scaling Up Nutrition
What would it cost to scale up nutrition working with SUN countries and networks
Development of costing tool – for standardizing the costing of national plans for scaling up nutrition
16 costed plans reviewed
Results presented in the Brussels SUN meeting (March 2013)
Partners: ICFI, HPI and PATH
Timeline: 2 months
Phase II – Country visits to get a better understanding of the plans and costing
Pilot testing of the costing tool – Kenya
Country visits – 8 countries (Nepal, Bangladesh, Indonesia, Sierra Leone, Burkina Faso, Madagascar, Malawi, Rwanda)
Continued desk reviews – 21 + countries
Results presented at the G8 Nutrition for Growth event in London, June 2013
Timeline: 8 months
*Bangladesh, Myanmar, Ethiopia, India, Kenya, Malawi, Mozambique, Nepal, Nigeria, Pakistan, Somalia, Sudan, Tanzania, Uganda, Yemen, Zambia, Zimbabwe
Aim of the study should be clearly written.
Where possible summarise using bullet points.
Do not cut and paste long paragraphs from documents/ trips reports. These are often too long and wordy for presentation formats.

5. Phase III – Supporting Movement of Scaling Up Nutrition
Technical support and assistance to the SUN countries (via SUN Secretariat) to accelerate action to tackle childhood undernutrition
Areas of support to the SUN countries:
Review of policy legislation and to develop plan summaries
Organization and implementation of the Common Results Framework (CRF) based on the country action plans
Financial tracking and resource mobilization
Aggregating and documenting the lessons learned
Disseminating the work at global events and with global networks
Timeline: 12 months
Aim of the study should be clearly written.
Where possible summarise using bullet points.
Do not cut and paste long paragraphs from documents/ trips reports. These are often too long and wordy for presentation formats.

6. Investigating Country Efforts in Scaling Up Nutrition in 20+ SUN Countries
Washington, DC
30 September 2013

7. MQSUN Technical Support and Assistance to the SUN Movement
Phase I
Policy review
Analytical framework
Methodology for country visits
Phase II
Remote support to countries and SUN Movement Secretariat (SMS)
Country visits
Support SMS at International events
Phase III
Policy, legislation, and plan reviews and summaries
Support effective nutrition-sensitive implementation around a Common Results Framework
Support financial tracking and resource mobilization

8. Phase I Develop an analytical framework and associated methodology
Aggregated Cost Tool (Standardized categorization)
Methods for cross-country review

9. Phase I – Analytical Framework
Aggregated Cost Tool (ACT)
Establishing a common set of measures based on submitted plans
Programme description
Programme classification
Target groups
Lead budget holder
Annual costs
Annual secured funding amounts
Funding source

10. Phase I – Support Methodology
Prepare draft methodology for country visits
Gain better understanding of existing plan
Which sectors were involved
How costs were calculated
How targets were selected
How donor networks/funds are incorporated into plan activities
Financial mapping and budget allocations

11. Phase II Desk support and analysis Targeted support
International event support

12. Phase II – Desk Support Cross-country Review (Desk Support)
Enter 21 submitted plans into ACT
Review plans in a standardized framework
Incorporate feedback and corrections from countries
Identify policy shifts to enhance scale up (e.g., inclusion of governance, nutrition-sensitive factors)
Review country and external funding, where available
Prepare summary documentation for dissemination

13. Phase II – Desk Support Analytical Support
Estimating external contributions
Defining the financing gap
Assist SMS with quantitative analysis and special requests

14. Phase II – Targeted Support
Selection of countries
Supplied a ratified plan
Full engagement of the focal point for the visit
Nutrition burden within the country is high
Plan is considered to be high quality or country has identified a specific short-term need for June Event
Purpose of visit
Work with focal points and stakeholders to help them understand and apply the analytical framework and methods
Develop an understanding of the elements, inputs, and calculations in the submitted cost plans
Both what is included and what is omitted
Identify the financial contributions and pledges of relevant stakeholders
Identify activity priorities
Identify financial gaps, where possible

15. Phase II – International Events
Scaling Up Nutrition Senior-level Meeting, Brussels, March 2013
Analysis of plans from 16 countries
Summary of methods and results
Reports with national and aggregated statistics
“Nutrition for Growth: Beating Hunger through Business and Science”, Pre-G8 Meeting, London, June 2013
Analysis of plans from 20 countries
Assist in development of country-specific two-page documents for countries to share policy priorities and advocate for financing requests
Provide intensive remote support to countries leading up to and during the event

16. Phase II Submitted Country Plans Bangladesh (2011 – 2015)
Benin (2012 – 2015)
Burkina Faso ( )
The Gambia (2011 – 2015)
Guatemala ( )
Haiti ( )
Indonesia ( )
Kenya ( )
Madagascar (2012 – 2015)
Malawi ( )
Mozambique (2011 – 2016)
Nepal (2013 – 2017)
Niger ( )
Peru ( )
Rwanda (2012)
Senegal ( )
Sierra Leone (2013 – 2017)
Tanzania (2012 – 2016)
Uganda (2012 – 2016)
Yemen (2013)
Red = countries visited

17. Overview of Submitted Plans
Key Considerations
Analytic Framework
Aggregated Results
Lessons Learned
Next Steps

18. Overview – Key Considerations
Plans reflect national commitments
inclusive consultation process between the government and in-country partners
Plans are used as reference for implementation
this implies (need for) more detailed planning and budgeting at sub-national levels

19. Overview – Key Considerations
Plan differences (caveats for comparison)
Inclusions/exclusions
Existing government inputs (labor, infrastructure)
New versus existing interventions
Stakeholder and sector involvement
Assumptions for scale-up
Percentage increase
District rollout
National coverage
Cost methodologies
Total intervention costs (ingredients)
Marginal budgeting
Program unit costs
Cost estimations
Program planning
Country budgets
External budgets

20. Political & Cultural Environment Disempowerment of women
Overview – Analytical Framework
Lack of good
CARE for mothers & children & support for mothers 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
Poverty

21. Applied Classification of Interventions in the Country Plans
Specific Nutrition Actions
Good Nutrition Practices
Vitamin and Mineral Intake
Acute Malnutrition Management
Enrichment of diet nutrient density for pregnant and lactating women and children months
Nutrition-sensitive Approaches
Food Security and Agriculture
Care Environment
Public Health and Water and Sanitation
Governance
Coordination and Information Management
Policy and Legislation Development
Advocacy and Communication
System Capacity Building

22. Overview - Plan Variety
Bangladesh, Sierra Leone, Uganda and Nepal have incorporated interventions from other sectoral plans

23. Specific Nutrition Actions
TOTAL COST: US$ 4.0 billion
(timeframe )
US$ 2.4 billion for good nutrition practices (61%)
US$ 650 million for acute malnutrition management (21%)
US$ 717 million for vitamin and mineral intake (18%)
US$ 198 million for nutrient dense diet for PLW and young children (5%).*
*Peru, Mozambique and Madagascar
Total annual: US$ 1.1 billion
Average annual (without highest or zeros): US$ million

24. Specific Nutrition Actions
Good nutrition practices include maternal, IYCF (38%) and healthy diet (31%).
Maternal and IYCF includes also advocacy and implementation of key legislation such as the BMS code and the maternity leave

25. Composition of Specific Nutrition Actions
Welcome emphasis on the prevention of malnutrition in all its forms through the promotion of good nutrition practices. Also Vitamin & Mineral intake is well reflected in most plans.
“Lower than expected costing” of acute malnutrition management is largely linked to the limited degree of scale-up within country plans. Similar consideration when reflecting on the low presence of nutrient-dense foods in the country plans. Out of the US$ 542 million for acute malnutrition, US$ 364 million is for Kenya and US$ 76 million is for Yemen

26. Nutrition-sensitive Approaches
TOTAL COST: US$ 28.9 billion
(timeframe )
US$ 19.6 billion for nutrition-sensitive food systems.
Note: Bangladesh alone is US$ 8.5 billion
US$ 89.5 million for interventions enhancing caring environments
US$ 9.2 billion for interventions in public health services, including reproductive health and WASH
Total annual: US$ 6.6 billion
Average annual excluding highest or zeros: US$ 1.3 billion

27. Nutrition-sensitive Food Systems
General strategies (1%) and supplemental feeding (2%) make up the remainder.
Diversified production includes small livestock (small ruminant, poultry)

28. Composition of Nutrition-sensitive Food Systems
Costed plans provide a useful guidance on the range of activities that can be included in guideline for definitions and selection of nutrition-sensitive approaches.
Supplementary feeding interventions do not specify the type of food

29. Diversified and Nutrient Dense Diet
Place smallholders, especially female farmers, and their needs for assets and services at the core
Diversify and intensify production (Agriculture)
Improve use of biodiversity (Agriculture)
Improve processing and storage (Agriculture, Industry and SMEs)
Ensure food safety (Health)
Distribute (Markets and Public Works)
Availability
Regulate or subsidize prices (Markets)
Ensure minimum income (Employment , micro-enterprise and SMEs)
Include in school meals (Education)
Include in employment schemes (Welfare)
Supplement to specific vulnerable groups (Welfare )
Accessibility
Promote and educate with a focus on maternal and IYCF (Health)
Utilization
Production of dairy, poultry, fishery, vegetable, fruit, legumes and oily seeds

30. Fortified Foods Accessibility Availability Utilization
Import and distribute (Markets)
Produce, fortify and distribute (Agriculture & Markets)
Regulate (Health)
Availability
Subsidize prices (Markets)
Supplement to specific groups (Welfare )
Supplement under special circumstances (Emergency)
Accessibility
Promote and educate as part of a diversified diet (Health, Markets)
Utilization

31. Nutrition-sensitive Public Health
Household water treatment
Water schemes maintenance
Community-led total sanitation
Sanitation campaigns
WASH in schools
Management and control of NCD
Management of malaria
Nutrition counseling of PLWHA

32. Governance TOTAL COST: US$ 2.3 billion
(timeframe )
US$ 1.5 billion for system-wide capacity building (66%)
US$ 629 million for coordination and information management (28%)
US$ 143 million for policy development, advocacy and communication (6%)
Total annual: US$ million
Average annual excluding highest or zeros: US$ 27.3 million

33. Nutrition Governance Multi-sectoral coordination at different levels
Quarterly monitoring meetings
Stakeholder mapping and other planning exercises
Capacity to plan, implement and monitor
Capacity for intra-ministerial coordination
Capacity for sub-national planning

34. 20 Countries At A Glance 99.9 million U5 Children (2013 proj.):
38 million stunted
average prevalence 39%
range
average annual reduction rate of 1.3%
3.2 million severely wasted
average prevalence 2.9%
range
7.0 million moderately wasted
average prevalence 6.2%
range )
Specific nutrition actions:
US$ 1.1 billion per year
US$ 71.6 million per country annually
Nutrition sensitive approaches:
US$ 6.7 billion per year
US$ 370 million per country annually
Governance for nutrition:
US$ 441 million per year
US$ 26 million per country annually
Note: 36 high-burden countries received from OECD ODA an annual average of US$ 218 million ( )
54% among sub-saharan African countries
Nutrition sensitive agriculture: If highest ranges are excluded the average annual is 3 million (very low)
Yemen: 57.7% stunting; Peru: 19.5% stunting
Benin: 7.9% severe wasting; Peru: 0.1% severe wasting

35. Messages from Country Visits
Elevate nutrition within governmental agendas
Centralize national planning and coordination processes
Position national task forces above ministerial level
Utilize Champions to enable national campaigns to reach wider and more influential audiences
Include stakeholders from multiple arenas in planning and coordination
Advocate and campaign for more domestic investment
Use this to leverage international funding
Issue of absorption

36. Messages from Country Visits
Develop multi-sectoral plans and innovative or pooled funding mechanisms
Decentralize the national costing processes to include sub-national managers, decision makers, and practitioners
Use the Aggregated Cost Tool to advocate for resources at the national level
offer guidance for definitional issues related to classification of activities

37. Continuing Needs Technical support
Finalise plans, costing, and M&E frameworks
Decentralise planning and costing
Advocacy
Build internal country support
Appeal to external donors
Financial mapping and funding gaps
Support peer learning to share examples, lessons, and successes
Support research to extend knowledge of what works

38. Next Steps – Phase III
Policy, legislation and plan reviews and summaries
Assess, evaluate and peer-review national sectoral documents
Support effective nutrition-sensitive implementation around a Common Results Framework (CRF)
Build and expand on knowledge base of effective interventions
Support financial tracking and resource mobilization
Establish systems for multi-sectoral planning, costing, financial tracking, assessment of budgetary shortfalls and completion of strategic plans and documentation
Aggregate and document the lessons learned from the work with countries
Disseminate lessons learned across the SUN global networks (Donor, UN agencies, civil society, and business).
Support the SMS in the preparation of briefs, presentations and reports to ensure information exchange and lessons learned