A spirit of collaboration in Nepal

A spirit of collaboration in Nepal

From the beginning, the partnership between Nepal and UNN-REACH was symbiotic. The Nepali government has made steady progress on the nutrition front since 1970, when the National Nutrition Policy Coordination Committee and the institution of the Joint Nutrition Support Program (JNSP) were established [1]. This history, along with a willingness to develop more structured nutrition governance, would set the stage to make UNN-REACH intervention a productive endeavor.

Nutrition stakeholders in Nepal

As one of the world’s poorest countries [2], Nepal made a significant leap in reducing child stunting between 2001 and 2011, dropping about 15 percentage points [3]. Even so, by 2011, the year before UNN-REACH entered the country, the figures were still daunting. According to the Demographic and Health Survey (DHS) of 2011, 41 percent of children under five years of age were stunted and 11 percent were wasted. By 2016, the end of UNN-REACH’s tenure in the country, 36 percent of children under age 5 were stunted and 10 percent were wasted, still exceeding prevailing thresholds that signal a public health problem. As this article goes to print, under-five stunting hovers at 36 percent and under-five wasting remains just below 10 percent [4].

Arguably, the above statistics do not reflect a marked impact in recent years. The kind of institutional change UNN-REACH supports typically takes time to translate into impact. Stunting is a more long-term indicator, not only reflecting nutrition gains but also broader development. What is harder to measure is how various structures have been designed and operationalized that help the government to continue to monitor and chart their progress on this issue, bringing together a wide spectrum of players to contribute to continuous improvement.

Initial steps

UNN-REACH was first established in 2008 by FAO, UNICEF, WFP and WHO, and repositioned under the broader UN [nutrition] Network (UNN) in 2015. As it was in Nepal in 2012, the initiative continues to be a support mechanism for improving nutrition governance, working in close collaboration with SUN networks, including the UNN.

Along with the National Planning Commission, UNN-REACH lead the SUN Joint Annual Assessment in Nepal bringing together networks that included the Civil Society Alliance (SCANN), academia, development partners, and others. In 2014, they organized meeting on resource mapping and cost estimation with participation from all national stakeholders. 

“The REACH facilitator played an important role in bringing the senior government officials from the relevant ministries together to plan and implement nutrition activities in Nepal,” commented Dr. Geeta Bhakta Joshi. As a member of the National Planning Commission in Nepal, he is recognized for his outstanding achievements in promoting nutrition in his country.

Close-up

The objective of NNFSS was to support policymaking and improve the food security and nutritional status of the Nepali people. According to the UNN-REACH Facilitator Neu, government was so pro-active about multi-sectoral planning because a member of the Secretariat was a ‘champion of nutrition’, who pushed the nutrition agenda for this body, coordinating the five ministries from a platform with slightly more authority than previously.

Savita Malla, a Nepali nutrition expert who worked on communication strategy during this period and now serves as a policy specialist at the global SUN Movement Secretariat reflected, “REACH’s most important contribution was to help the Government of Nepal establish the multi-sectoral multi-stakeholder platforms. We were part of the implementation of the multi-sectoral nutrition plan (MSNP) 1 and development of MSNP 2, both of which were costed. Without REACH, it would not have developed as quickly or in such an organized way.”

The power of collective action

Generation one REACH tools were less standardized and automated than the current generation. As a result, the multi-sectoral mapping exercise did not capture coverage data for beneficiaries or geography as it did in other countries. However, the process of collaboration was so participatory that it still yielded this collective action, even without sophisticated data. In fact, Nepal was a testing ground for the development of the UNN tool on nutrition capacity assessment.

The successful integration of the programme was largely due to local ownership of the tools, which were used as a means of building government capacity in nutrition governance. According to Neu, what mattered most when UNN-REACH was working on nutrition governance was not the coordination of the UN within its various offices, but the extent of collaboration with local government. Neu elaborated, “In Nepal, the government wanted REACH to establish a NNFSS within the government. They decided it should be staffed by eight people in total and tasked with coordination for all actors and stakeholders. Five ministries, along with projects, NGOs, and broader society including academia and civil society took part.”

Scaffolding local nutrition governance architecture

Referring to how meetings were organized, Neu explained, “you can’t just mix them all up – government, NGOs, and academics, or it will become a waste of time. We focused on structure, objectives, output, and deliverables, and a work plan. Groups were organized according to technical areas, with terms of reference.”

To support the implementation of the MSNP, high-level committees were established in addition to technical multi-sectoral groups that focused on capacity development, monitoring and evaluation, as well as advocacy and communication. The participation of academics, the private sector and donors was an integral part of the process. “Multi-stakeholder architecture brought about a massive change in how nutrition governance progressed,” Neu added. “There were monthly meetings, a regular forum with three working groups: capacity building; monitoring and evaluation and information management; and advocacy and communication. A capacity development master plan led the way to implement parts of the advocacy strategy. For the first time, partners had one guiding document for this.”

UNN-REACH always adapts tools to the local context, but in Nepal this was taken one step further. When the mapping exercise was conducted in 2013, data points were connected to government policies and strategies, not just nutrition. In a separate document, the Policy Overview, an additional stream focused on whether the multi-sectoral approach was mentioned by the policy in question, while a fourth stream looked exclusively at government commitment, demonstrated by funding.

Policy Overview excerpt

When earthquake Gorkha struck, UNN-REACH was there

The extent of UNN-REACH’s value became clear when the Gorkha earthquake struck in April 2015, and the government asked Neu, the international facilitator, to play the role of inter-cluster coordinator. Drawing on the relationships he had forged with the UN, civil society, NGOs, donors, ministers, and more, Neu oversaw clusters for nutrition, health, protection, food security and others. His appointment was a vote of confidence that attests the value of the UNN-REACH facilitator, and evidence of how UNN-REACH helped to strengthen the humanitarian-development nexus. “Since we were the neutral body that worked within the government, we had a certain ‘clout’ that helped us organize other agencies for the relief effort,” Malla commented. “REACH staff were on the ground in the immediate aftermath. We also helped the government develop their National Disaster Assessment report.”

A new way to share information: the Nepal Nutrition & Food Security Portal (NNFSP)

One of the most significant outcomes of UNN-REACH’s intervention was the establishment of a web-based portal that all stakeholders could use for reference. This included updated contact information, reports, mapping and other outputs from the analytical tools. Every organization working on nutrition would enter information about their projects, including what groups they were targeting and what types of interventions they had tried. From there, all uploaded information was mapped so data could be visualized. The portal was user-friendly, so stakeholders could upload their information in less than 45 minutes.

Looking back, Malla reflected on some of the challenges the group faced. “At first, the portal was difficult to develop, because different organizations were committed to their own websites, but after it was up and running, the UN and NGOs noticed this was one platform where all resources were available as a government-owned initiative. Sometimes, when documents were not available, people would contact us, asking for them.” This portal was key in supporting knowledge brokering among a wide range of actors and fostering a climate of trust and transparency.

Milestones

As a knowledge broker – a person or organization who facilitates the access, interpretation, adaptation and utilization of information to meet the needs of implementers or policy makers [5] – Neu was able to establish strong ties with government from the start, and move capacity building quickly towards concrete outcomes.

Here are some of them, across a range of sectors:

  • On the communication front, jingles, a nutrition logo, talk shows and more were developed. Journalists were trained in twenty-one districts and created a Media Network. The National Advocacy and Communication Strategy was endorsed and launched.
  • The nutrition monitoring and evaluation framework was updated and implemented with ownership by all relevant ministries.
  • To improve capacity, a pool of trainers from various public institutions were deployed to spread their new skills. Six districts were supported in developing annual, costed multi-sectoral plans, with additional allocation of funds.

Joyce Njoro, former Senior Programme Officer at the UNN Secretariat, who oversaw the UNN-REACH engagement in Nepal, commented, “What was unique in Nepal was that the Secretariat was headed by Ingo Neu, whereas in many other countries, the Secretariat would be headed by local staff. The bigger concern was, how do we sustain this?”

Four years later, the NNFSS is still operational and a model that other countries learn from and emulate. The sustainability of the ‘governance architecture’ such as NNFSS and the portal is further testament to the trust-building, facilitation and incremental capacity development that UNN─REACH undertook while in-country.

Footnotes:

[1] https://journals.sagepub.com/doi/10.1177/0379572116674555

[2] https://statisticstimes.com/economy/poorest-countries-by-gdp-capita.php

[3] https://dhsprogram.com/pubs/pdf/FR257/FR257%5B13April2012%5D.pdf

[4] Global Nutrition Report, 2019

[5] UN Network website. Knowledge Management webpage. Available at https://www.unnetworkforsun.org/knowledge-management

Photo credits @ NNFSS/Sagar Shrestha