Perspectives from UN leadership on how nutrition is gaining ground in Lesotho with support from His Majesty King Letsie III

Perspectives from UN leadership on how nutrition is gaining ground in Lesotho with support from His Majesty King Letsie III

Despite steady progress on the reduction of stunting levels, the triple burden of malnutrition ─ undernutrition, micronutrient deficiencies and overweight/obesity ─ remains persistent, compounding a host of social and economic challenges.[1] To gain a fuller picture of nutrition developments in Lesotho, we sought out the perspectives of two prominent UN figures. Salvator Niyonzima, United Nations Resident Coordinator (UNRC), and Mary Njoroge, World Food Programme (WFP) Country Director and former UN Network (UNN) Chair, are front-line advocates of cross-sectoral nutrition integration. Since 2017, Salvator’s role has been to oversee the coordination of all UN agencies in the country. Mary wears two hats. She oversees the alignment of seven UN agencies ─ FAO, UNAIDS, UNFPA, UNICEF, WFP, the World Bank and WHO ─ which have joined forces on nutrition through the UNN platform, drawing upon hands-on support from the neutral UNN-REACH facilitator. This, in turn, informs her role as WFP country director, working closer to the ground.

Engaging in discussions with both Mary and Salvator allows for a more complete picture than either one on their own. Here are highlights from the two interviews.

Question 1: How have government-led nutrition actions taken root in Lesotho in the past five years?

UNRC Lesotho photo

Salvator: A collaborative effort including UN agencies, civil society, academia, and the business [community] was based on a strategic analysis that brought together the latest available data. After that, we made sure that every agency would see themselves in the priorities we have lined up. Then work is divided according to our comparative advantages.

In terms of nutrition, there was a concerted effort building on the humanitarian intervention from 2015 – 2017, [to address the drought caused by El Nino.] Under the leadership of WFP, and with support from UNN-REACH, we developed in 2018 a Zero Hunger Strategic Review and a road map [to chart our progress]. Funding from the Irish government in 2017 [for UNN-REACH] allowed the UN to achieve a number of milestones.

One is improving data and evidence. We also conducted a Multi-sectoral Nutritional Overview [using the UNN tool] to see what was happening at district and community levels. The UNN developed an inventory that showed us what the various UN agencies are doing  such as UNICEF, FAO, UNFPA, WHO and the World Bank. This allowed us to see areas of duplication and avoid them. We discovered from using the UNN-REACH tools, for example, that cash top-ups were being duplicated by various agencies.

WFP Lesotho Country Director

Mary: Traditionally, nutrition has been perceived to fall into the women’s domain and only affect the vulnerable, children, women and the elderly. His Majesty King Letsie III, in his roles as African Union Nutrition Champion, FAO Nutrition Ambassador and World Bank Champion on Human Capital, has greatly helped to shift this mentality and elevate discussions regarding nutrition into the highest echelons of government. Additionally, His Majesty’s recognition of nutrition as one of the key elements in the socio-economic development of Lesotho and his unwavering passion and advocacy has led to men, at all levels, of society become more engaged in the discourse around nutrition.

In 2019, this included high-level events such as the official opening of the Regional Centre of Excellence against Hunger and Malnutrition (CERFAM) in Abidjan, the WFP June Executive Board Session in Rome and the Food Security and Nutrition Forum in Africa in Maseru. At each of these events, King Letsie III committed to firmly place Nutrition and Food Security on the continental and global agenda and encouraged increased investments to ensure that malnutrition issues are fully addressed and eliminated.

In the national context, His Majesty’s leadership role is supported by his government. Following the development of the food and nutrition strategy and costed action plan, the government of Lesotho will be convening a high-level stakeholders’ forum to discuss the applicability of crowdsourcing to fast-track the reduction of malnutrition, particularly stunting, and the achievement of nutrition targets. UNN-REACH Lesotho shall continue to engage with his Majesty King Letsie III to ensure improved nutrition governance through multi-sectoral, multi-stakeholder coordination in the country.

Question 2: How do communications and behaviour change factor into the equation?

Salvator: Malnutrition is driven by poor nutrition practices, from lack of information. The staple food here is maize and people eat porridge made from it. Households believe that if they eat that with vegetables and meat, that is enough variety in their diet. Over the years, maize production has fluctuated because of climate change, which means if there’s no maize, the staple food is destroyed. We want to give them a wider variety of options [to choose from]. Babies and lactating mothers need to be able to grow and cook other foods. Planting small gardens [also helps on this front]. There is currently a behavior change communication campaign underway. We are implementing funding from CERF (Central Emergency Relief Fund) as well as the EU and European Commission's Department for Humanitarian Aid and Civil Protection (ECHO) to increase better nutrition practices.

Mary: UNN-REACH, through [the] WFP Country Office and [the government’s] Food and Nutrition Office are at [the] final stage of the formulation of the Advocacy, Social Behavioural and Communication Strategy, which is key to communicating the interconnectedness of nutrition challenges and solutions. Additionally, UNN-REACH in partnership with government has commissioned a Maximum Intervention Programme to reduce stunting by promoting the empowerment of women and men to participate in a multi-sectoral approach of intervention convergence in the worst affected districts. Lesotho is also embarking on establishing the current status of nutrition investment and resource mobilization through [a] nutrition finance tracking exercise [with support from UNN-REACH and the UNN Secretariat] which in the future will form a full-fledged system that will identify gaps and inform the national nutrition budget and off- budget lines on annual basis.

Question 3: Coordination is fundamental for multi-sectoral interventions. How do you bring the various agencies together?

Salvator: There is a before and an after. Before the UN reform in January 2019, there wasn’t enough impartiality from the RC, even with the ‘firewall’, a mechanism put in place to avoid confusion between the two roles. There was a conflict of interest because this person was also the head of the UNDP.[2] The separation between the two posts freed up my time to focus on coordination. In the ‘after’, I have a much clearer understanding of what each agency is doing, which allows me to see synergies. We use a framework called UNDAF[3] to work with countries. In some cases, I’ve seen that the UNDAF wasn’t always used as a guiding document, but now it is my role to keep everyone on track.

Mary: UNN-REACH activities thus have a galvanizing effect on broader sustainable development by incorporating nutrition components into appropriate programmes for which nutrition is not a primary objective. Lesotho is on the path to ‘kicking out hunger and malnutrition’ by working together across sectors and stakeholder groups from the national to the community level. UNN-REACH has provided the country with a one-stop shop for nutrition, allowing different actors including the government, UN, civil society and other development partners  to draw on the data and visual outputs generated through their tools to understand the scope, magnitude and distribution of the country’s nutrition challenges. Specific achievements include the elevation of nutrition in the country’s National Strategic Development Plan (NSDP) II, a clear articulation of the UN’s approach to nutrition in the UNDAF and the validation of the Food and Nutrition Strategy and Costed Action Plan. This includes evidence-based studies related to the status of nutrition in Lesotho to inform policies.

Additionally, UNN-REACH Lesotho has made strides in providing localized solutions to nutrition challenges. The National Nutrition Awareness Campaign in 2019 was led and coordinated by multi-sectoral district teams. The campaign successfully produced context-specific solutions including the use of infant and young child feeding; micronutrient supplementation; food value chain and food systems analysis; a study called Fill the Nutrient Gap; and the impact of HIV/AIDS on family nutrition and WASH.

Recent conversations with other UN colleagues shed further light on how the Fill the Nutrient Gap (FNG) analysis was an avenue for joint UN engagement, led by WFP with the involvement of FAO, IFAD and UNICEF. It turns out that Salvator, in his capacity as the UNRC, delivered the opening speech at the launch of the FNG report, reaffirming the inter-agency dynamic and his commitment to the national nutrition agenda.  

Question 4: Finally, we know nutrition is a ‘maker and marker’ of sustainable development. What progress is Lesotho making to achieve the Sustainable Development Goals (SDGs) in 2030 and how can nutrition be leveraged to accelerate gains?

Salvator: Progress has been uneven. For SDG 4, Lesotho has made progress on primary enrollment, almost reaching universal levels. At the secondary level, it goes down to 43%, which means there are a lot of losses along the way. Another area of relative progress is gender equity [SDG 5]. The number of women who participate in political processes, such as female MPs, is 25 out of 120. It’s still low but shows progress. The wealth gap has widened. The Gini coefficient [SDG 10], a measure of inequality in an economy is 0.5, which is quite high. In a nutshell, Lesotho has made some relative progress, while other SDGs are still lagging behind. [Compared to] universal indicators, we are still quite low.

Mary: Currently, hunger and malnutrition in Lesotho is totally incompatible with the 2030 Agenda and the 2020 vision of Lesotho, achieving food and nutrition security accelerates progress towards the attainment of the Sustainable Development Goals particularly goal 2 and the development aspirations of Lesotho. UNN-REACH brings together the UN Agencies for planning and agreeing on areas of support to government initiatives meant to reduce the effects of malnutrition in the country. The multi-level National Coordination Structure on Sustainable Development has been established, the highest level being the National Oversight Committee that is chaired by the Right Honourable the Prime Minister.

Additionally, the UN Resident Coordinator leads the UN Country Team in consultations with the Government to define and agree on the UN strategic response to the Government’s development priorities with the view to make substantial progress towards achieving the global 2030 development agenda and its 17 Sustainable Development Goals. This response is captured in the UN Development Assistance Framework (UNDAF), which was prepared in collaboration with the government and other stakeholders, and informed by the Common Country Analysis, as well as innovative initiatives including foresight, scenario building, public engagement and other processes. This framework, with the Sustainable Development Goals (SDGs) at its core, contributes to the achievement of the National Strategic Development Plan II objectives and supports Lesotho Government’s aspiration to achieve the 2030 Agenda.

Photo credits @:

UN House/Thabiso Ntoanyane

WFP/Kathleen Mccarthy

[1] 2019 Global Nutrition Report. Lesotho country overview. Available at https://globalnutritionreport.org/resources/nutrition-profiles/africa/southern-africa/lesotho/#profile.

[2] UNDP stands for the United Nations Development Programme.

[3] UNDAF refers to the United Nations Development Framework.

[4] MICS 2018