Unleashing the ‘power of we’ in Southern Africa; regional support can help

Unleashing the ‘power of we’ in Southern Africa; regional support can help

At quick glance, the regional level appears to be invisible within the Scaling Up Nutrition (SUN) Movement, yet recent conversations with UN colleagues in Southern Africa paint a different picture. From senior management of the UN agencies to technical specialists servicing the Southern Africa region, UN joint programming is embraced as a means to improve effectiveness and achieve shared results, including the Sustainable Development Goals (SDGs). Understanding the triggers (and bottlenecks!) is crucial to pursuing UN joint programming on a larger scale. That means more joint projects in more countries and strengthened capacity of United Nations Country Teams (UNCTs) to do so. Here’s where the UN Network comes onto the scene.    

For the regional colleagues, the UN Network is a platform that is helping to change the nutrition narrative at country level, and along with it, stakeholder behaviour so that UN nutrition support increasingly takes the form of collective action. The COVID -19 pandemic, a vivid reminder of the interconnected nature of today’s world and the importance of acting together in a coordinated manner, is giving further impetus to joint approaches including nutrition-related programming.

Photo 1 - UNICEF Ashura Sala Lewis

The UN Network as an enabler

A team of three WFP nutritionists working at the regional level in Johannesburg unanimously agreed that the UN Network (UNN) platform was a motivating force for UN joint programming. Nutritionists from UNICEF were of that same school of thought, noting that this is particularly evident at the country level where UN colleagues rally around the SUN Government Focal Point and when funding is allocated to joint work. The word is out. UNN is helping actors − UN colleagues, government officials and other development partners − understand what multi-sectoral nutrition really means. Its portfolio of tools, such as the UN Nutrition Inventory and Nutrition Stakeholder and Action Mapping, and UNN knowledge products, such as the Compendium of Actions for Nutrition, unpack the nutrition landscape in its entirety and identify opportunities for increased synergies. Both the inventory and mapping exercises have been conducted or are underway in four countries[1] in the region and a fifth has recently come forward expressing interest in the latter.

Rose Craigue, former Senior Regional Nutrition and HIV Adviser, added that, “the UN Network chair most certainly plays a role to drive the joint efforts and influence the donors. It’s really about showcasing the value add in the different UN agencies coming together.” What do countries stand to gain? UN joint programming has the potential to confer a situation whereby increased operational efficiencies and investment in nutrition triumph, as actors see the comparative advantages and the benefits of collaboration. This, in turn, can lead to heightened impact directly improving the lives of women, children and other vulnerable populations. “Jointly delivering essential sexual and reproductive health services, such as antenatal care, supplementary feeding in maternity waiting homes, together with nutrition information and services to pregnant women in food-insecure regions, as we have witnessed in Zimbabwe is a sure win for better pregnancy outcomes for mothers and their babies,” said Dr. Julitta Onabanjo, UNFPA Regional Director for East and Southern Africa.

Photo 2 - UNFPA Namibia

Others acknowledged that UNN-REACH in Lesotho and Zimbabwe has also been a uniting force, helping to foster increased convergence among the UN agencies and bring new members into the UNN circle locally. For example, UNFPA opted to join the UNN in both countries thanks to the encouragement of the UNN-REACH facilitator and UN Nutrition Inventory exercise which helped colleagues see how their work in sexual and reproductive health was linked to nutrition outcomes.

Backing from UN leadership is essential

Encouragement from the Regional Directors of individual UN agencies, United Nations Resident Coordinators (UNRCs), UN Country Representatives of the agencies as well as UN reform factor into the equation. Christiane Rudert, UNICEF’s Nutrition Adviser based in Nairobi indicated that technical specialists from FAO, UNHCR, UNICEF, WFP and WHO in the region recently agreed to issue a single briefing note that will be shared with UNRCs and UN country teams to accelerate the prevention and treatment of wasting on the ground. The “involvement of the RC as advocacy platform is helpful, but we don’t yet have a lot of experience [doing so]” says Christiane. The note will highlight how the implementation of the Global Action Plan (GAP) on Child Wasting, a priority for the United Nations Secretary-General, is supported by the above five agencies, what is different from business as usual and how it contributes to the SUN agenda in the front-runner countries, such as Madagascar and Malawi.

Photo 3 - WFP, Badre Bahaji Nsanje Ir

For Nuha Ceesay, UNAIDS Country Director in Malawi, the Heads of Agencies also have an important role to play, a view shared by the regional UNICEF and WFP nutritionists. “The bulk of the work on joint programmes is carried out at the technical level, but the technical level is basically translating the vision of UN leadership,” explains Nuha. For this reason, identifying inter-agency collaboration as an organizational priority is key to empowering UN joint programming in the future. WFP Regional Director, Lola Castro, is another advocate for joint action. When speaking about nutrition, she spoke about the “need to go a bit beyond to ensure that we are working multisectorally and working in an integrated manner, paying attention to gender and climate change.” Lola was also quick to point out that “we are not starting from zero. At country level, there are a number of joint programmes, such as resilience activities in Malawi with FAO, IFAD and UNICEF.”

Partnership can also be promoted through agency-specific guidance. At UNICEF, nutrition partnerships are encouraged to extend across sectors and embrace multiple systems (e.g. education, food, health, social protection) with clear rules of engagement. In some cases, guidance is developed jointly such as the guidance note formulated by FAO, UNICEF and WFP on Mitigating the effects of the COVID-19 pandemic on food and nutrition of schoolchildren (April 2020). Colleagues from the UNICEF and WFP Eastern and Southern Africa Regional Offices later built on this foundation and a newly developed Framework for Reopening of Schools (June 2020), likewise developed by multiple agencies[2], by formulating a Multisectoral checklist about school re-openings and school-based nutrition in the context of COVID-19 (July 2020). The document underscores the importance of multi-sectoral considerations for nutrition, child protection, education, WASH and health services and outlines recommended measures to take both prior to and after school re-openings. “The joint nature adds a lot more oomph” and helps improve uptake of guidance materials, acknowledges Kudakwashe Chimanya, a nutritionist at the UNICEF East and Southern Africa Regional Office (ESARO). The push at WFP is towards colocation, which is echoed in its nutrition-sensitive programming materials. Still, further efforts are needed to enhance capacity for joint programming, particularly their implementation, monitoring and reporting, as shown by 2019 UNN global reporting data (see figure).

Figure 1

Unpacking the role of UN regional offices and platforms

The role of UN regional bureaus and offices is multi-tiered. In smaller offices, such as Eswatini and Lesotho, the regional colleagues tend to be more involved in country-level activities, including the formulation of UN Joint Programmes. Clearly, the line of support does not stop there. The regional offices can also play a catalytic role in strengthening ties between UN agencies. For example, regional engagement enabled UNICEF and WFP to come together in Zimbabwe to promote increased complementarity between the two agencies, including measures related to the COVID-19 response. UNICEF and WFP have teamed up in-country on SBCC regarding maternal, infant and young child feeding, which now includes COVID-19 related messaging and is disseminated through lean season food distribution points in 23 districts. UNFPA is also using this channel to distribute sexual and reproductive health commodities, drawing upon WFP logistics support. With that said, collaboration takes effort and a willingness to understand the other side ─ and compromise at times. The regional colleagues are also mobilized when there are challenges and the agencies ‘don’t get along’, encouraging country-level colleagues to work through the issues and resolve misunderstandings. Furthermore, UN regional staff can serve as matchmakers, connecting their nutrition colleagues in countries to the UNN Secretariat for technical assistance (e.g. on UNN analytics).

Regional platforms, such as the Food Security Working Group and Regional Nutrition Group in Southern Africa, co-led by UNICEF and WFP, also help foster increased collaboration between the agencies. This has ensured that partners in the region have a harmonized approach to nutrition in the COVID-19 response and are updated on the latest guidance. In addition, the working group has fueled nutrition advocacy, having developed a Call to Action in late July that highlighted the potential impact on nutrition outcomes in Eastern and Southern Africa due to COVID-19. Experience has also shown that these regional platforms can serve as incubators for new ideas, such as mother-led MUAC assessment in the face of COVID-19, which was conceived in this forum. A number of country offices, including Zimbabwe, have minimized malnutrition screening performed by Community Health Workers to reduce contact and are having mothers do it themselves. The underlying premise is that this adaptation is one way to minimize risk to the virus.

Joint action during the age of COVID-19

While the COVID-19 pandemic has presented a series for new challenges from how UN staff communicate to programming delivery, it has also increased the appetite for joint approaches. At the regional level, UNICEF and WFP have used the COVID-19 as a window of opportunity to develop a list of indicators for which it is relatively easy to collect data in order to get a snapshot of the situation without going to the field to reduce exposure to virus. The two agencies have also joined forces at the country level to safeguard nutrition during the COVID-19 pandemic. In Malawi, UNICEF developed jingles with key messaging on the prevention of COVID-19 that are being used by WFP and other partners to strengthen SBCC and awareness activities across different programmes. The two agencies are also providing joint support (technical and financial) to the government for district teams on ensuing programmatic adaptations from the use of personal protective equipment to frequency of distributions to curtail contagion. As part of these efforts, UNICEF and WFP supported the revision of the national standard operating procedure (SOP) on management of acute malnutrition in the context of COVID-19 as well as the implementation thereof. Colleagues from both agencies were quick to point out that these measures built on a rich history of inter-agency collaboration in support of the national nutrition emergency response from October 2015 to June 2017. This might suggest that collaboration breeds collaboration or that it is easier to execute where there is already a precedent.

Photo 4 - WFP, David Orr

A larger group of UN agencies (ILO, UNAIDS, WFP and WHO) are working together to strengthen nutrition education and advocacy, targeting PLHIV and TB patients to help ensure that their vulnerabilities are not further exacerbated in light of the COVID-19 situation. The UNAIDS Country Director, Nuha Ceesay, recognizes that “the willingness of the government to push for the UN to work together makes a huge difference.” He explained that the National Planning Commission continuously guides stakeholders in how they work together and support agreed programmes, setting the tone for collaboration.

Bottlenecks and challenges exist but can be overcome

Funding and personalities were identified as the main bottlenecks to UN joint programming in the area of nutrition. “Having a formal structure, like UNN, will help spur the individual technical leads to overcome personalities issues and make sure those collective objectives are met. One obstructive personality should not hold up collective action,” says Christiane at UNICEF. It’s about changing mindsets and being willing to see things from different perspectives. Nuha has a deep appreciation for this after years of joint work through UNAIDS. In his view, “It has to be a coalition of the willing. It requires a lot of patience and understanding and continuous engagement.” Training can also help people “look at the collective glory rather than individual success,” he adds. Potentially, the nutrition community can learn from the joint UN experiences accrued over the decades to combat HIV/AIDS. His colleague Narmada Acharya Dhakal, Regional Programme Adviser for Eastern and Southern Africa, unpacked this and pointed to the importance of coming together from the inception. “We have to be in a joint team mode and try to accommodate the team agenda, putting off our agency hats and defining the agenda together.”

Photo 5 - UNICEF, Ashura Sala Lewis

The funding environment also influences the extent to which UN agencies come together and collaborate on nutrition. In Kudakwashe’s experience, joint funding proposals can help show the comparative advantages of the respective agencies and are one way to mitigate some of these challenges, including different donor conditionalities and modalities to disburse funding. Recalling an example from Madagascar, Rosalyn Ford, WFP Nutritionist, noted that some donors want to see more collaboration between the UN agencies, which prompted the development of a joint proposal by FAO, UNICEF and WFP for the Japan International Cooperation Agency (JICA) blending nutrition-specific and nutrition-sensitive actions to reduce the country’s high stunting levels. Sometimes, it’s more complicated. Rose appreciates, that “We all have different priorities and interests and there is a small pot of money. [It] can be a struggle in trying to find convergence.” What can happen is that “a donor prioritizes a few districts which might align to the primary recipient agency but sometimes the other agencies are not really present there, so they need to look for supplemental funding,” she explains. This can lead to programming delays, which sometimes, can directly affect the impact of the programme.

Leveraging the SDG framework to galvanize UN collective action

The SDGs have raised the profile of nutrition, including among senior government officials in Member States. “The 2030 Sustainable Development Goals provide the framework for a collective response to: accelerate reduction in the numbers of malnourished children across the region; for a pathway to recovery from the effects of the COVID-19 pandemic; and opportunities to build resilience in nutrition to respond to future shocks”, says Mohamed M. Malick Fall, UNICEF Regional Director for Eastern and Southern Africa. Likewise, the United Nations Decade of Action on Nutrition, the SUN Movement and the Global Nutrition Report (GNR).

Similarly, the SDGs are helping to promote a wider understanding about nutrition so that it is perceived as a driver of sustainable development, not a mere technical intervention. The UNN Secretariat developed an infographic that depicts the links between nutrition and the respective SDGs to help bring those into focus, particularly for UN leadership and colleagues working in other technical areas (see figure). Pointing to that graphic during her travels in the region, the UNN Director/Global Coordinator has helped more UN agencies engage in the national nutrition agenda, such as IOM, UNDP and UNFPA in Zimbabwe.

Figure 2 - UNN SDGs and nutrition infographic

Increasingly non-nutritionists are talking about nutrition, the GNR, etc. with the understanding that “we won’t achieve the other SDGs if we don’t address nutrition,” says Rose. There is a place for everyone, and everyone must do their part. Rufaro Musvaire, WFP Nutritionist, summed it up well with a striking metaphor: “It’s like a car made up of different parts, some may appear more prominent than others. If one of them fails, you can’t move whether you have no fuel or your tire is flat.” Keeping this imagery in mind may help UN colleagues overcome institutional differences and other challenges to ensure that they are marching towards the same goals, particularly during these exceptional times.

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[1] The UN Nutrition Inventory has been completed in Eswatini, Lesotho, Mozambique and Zimbabwe, while the Nutrition Stakeholder and Action Mapping has been conducted in Lesotho, Madagascar (ongoing), Mozambique and Zimbabwe.

[2] UNESCO, UNHCR, UNICEF, WFP and The World Bank

Photo credits:

Photo 1 @ UNICEF/Ashura Sala Lewis

Photo 2 @ UNFPA Namibia

Photo 3 @ WFP/Badre Bahaji Nsanje Ir

Photo 4 @ WFP/ David Orr

Photo 5 @ UNICEF/Ashura Sala Lewis