A4NH researchers at the International Food Policy Research Institute (IFPRI) recently partnered with the United Nations World Food Programme (WFP) to develop nutrition-sensitive guidance which is being used to design and re-design WFP programs globally. Deanna Olney, Senior Research Fellow at IFPRI, and WFP nutrition-sensitive program advisors Kathryn Ogden and Sarah Piccini and Chief of the Nutrition Integration team Mutinta Hambayi discussed the process the two organizations went through, what they learned from it, and next steps for moving the work forward.
The work is detailed in the paper "Leveraging an Implementation– Research Partnership to Improve Effectiveness of Nutrition-Sensitive Programs at the World Food Programme," published in Food and Nutrition Bulletin, and will be further explored during the 2020 Micronutrient Forum sponsored session "Nutrition-Sensitive Approach: A Critical Link."
Q: What was important about this process?
Kathryn Ogden, Sarah Piccini, and Mutinta Hambayi (WFP): This partnership is very important as it draws on the expertise of two prominent organizations - one in global research and one in implementing humanitarian operations worldwide. Our shared goals and interests were recognized from the beginning: we brought together research experts, programme experts and WFP management.
Together we recognized that a globally influential nutrition-sensitive agenda and approach could not be developed in silos. From the WFP point of view, the resulting process allowed us to link our wide operations with the global thinking for better nutrition and cutting-edge knowledge on what works.
Deanna Olney (DO): I think three things were really critical in this process. First, having the partnership between a research organization and a program organization working closely together to improve nutrition and health outcomes. Second, having people on both sides with a range of backgrounds and areas of expertise, so you really brought all sides to the table. From there, we could develop an understanding of how things are supposed to work, map these processes and their expected outcomes and then figure out where there were opportunities to improve program impacts on health and nutrition outcomes across a range of programs. Third, essential to making this happen was high-level support from both IFPRI and WFP senior leadership. The high-level backing of the partnership and the process gave it some weight throughout the process and then looking ahead for further support.
Q: Why do you think this kind of partnership hasn’t happened before, or isn’t more common?
WFP: Historically, WFP’s primary role as a humanitarian agency means we move quickly to save lives.
The emergency response cycle, program design, and time frames meant to help the most vulnerable do not necessarily match up to those of a research agenda. As a result, these kinds of partnerships were less common.
However, when WFP began to rethink how to contribute to 2030 agenda, particularly on ending all forms malnutrition, the organization decided to make a shift to capitalize on the different programs we implement, hoping for greater impact on nutrition. We set the goal of bringing robust, globally recognized nutrition-sensitive programs to scale, and we recognized that we needed to seek out specialized external expertise.
As an organization, we needed to start with a solid conceptual foundation that would allow us to see the impact of WFP programmes - from general food assistance through to school feeding, resilience, small-holder market support and social protection. Our decision to take a longer-term approach across the organization, rather than a project-based approach, provided the enabling environment for an operations-research partnership.
DO: At IFPRI, we do some of this type of work, but it tends to be project-specific, not more generally looking across a range of programs and co-creating systemic change. I believe this is the first time we’ve done so at this scale. There are two reasons, I think, for why this doesn’t happen more often. One, there’s generally limited funding for this type of work. While donors may be interested in a specific topic or project, they may be less interested in funding this type of organizational collaboration across a broad range of projects over a longer period of time. Two, the very different priorities and approaches between researchers and program implementers are often competing in terms of timelines, complexity of evaluation, and more. We are finding value in it, however, and people are willing to invest the time in working through those challenges if they know the funding is there to see it through. Right now, this is still internally driven, and though we plan for a ten-year process that includes development, testing, and reviewing guidance, we’ll see if we can secure that commitment of resources to enable us to continue.
Q: How did the decision to pursue this come about?
WFP: After the 2013 Lancet series on maternal and child nutrition and with the SDGs, WFP’s nutrition work was strategically elevated to the Division level in 2015. The Nutrition Division drives the organization’s contribution to end all forms of malnutrition. With this goal in mind, we sought IFPRI’s expertise to help us review the existing evidence on programming effectiveness for improved nutrition outcomes across WFP programme areas.
At the same time, since 2012, WFP had been working on a corporate “proof of concept” for stunting prevention which included multisectoral programming and highlighted the importance of a corporate enabling environment with more emphasis on nutrition and SDG 2.2. end all forms of malnutrition. We wanted to build on that good work across the whole organization.
DO: When IFPRI was approached by WFP to work with them on this, I saw an opportunity to use an approach we’d used at a single-program level with Helen Keller International and apply it more broadly with an organization that has a global reach. We wanted to know, can we improve our potential to use research for impact in nutrition?
Q: On the IFPRI side, what was the biggest surprise in this?
DO: It has been surprising to see how hard it has been to get funding to test the theories. We came up with a well-appreciated guidance that’s been taken up and identified pathways and opportunities to create impacts. With this type of large-scale organization, it’s a great opportunity for donors to get the most bang for their buck with impact. The collaboration has been a real success – from headquarters to country level. Seeing the country office in Sri Lanka, for example, take up the guidance and take ownership – coming back to us to show us how they have used it and are building on the lessons we’ve shared – that has been very impressive. It’s great to see how the work is being used practically.
Q: What do you think it was on the WFP side?
WFP: The complexity of what we were trying to do given the global level of evidence.
We expected to have relatively simple actions to integrate nutrition, but this was not the case. Eventually, this complexity was translated into a framework that we could apply across different program areas. In the end, we co-developed tools to understand the pathways to impact, and the right indicators that could track our progress – whether those be process, results, outputs or outcomes.
This conceptual clarity allowed us to be clear on the guidance countries needed to operationalize this relatively new area of nutrition-sensitive programming.
Q: Were there challenges you didn’t expect?
WFP: There were big challenges in the early phases of setting up the impact evaluations. A number of factors had to come together – a suitable country that was sufficiently stable and fit the research priorities, the buy-in and operational funding from the country office to support the evaluation, and the right early-phase programme that was funded for a long enough period of time for us to see the outcomes or impact.
DO: Funding remains a challenge, and we found that having a pool of funding set aside from the beginning is essential. It has to be flexible so you can be responsive and draw on it when the opportunities come up, rather than having to find it after things are under way, when it will probably be too late to align the research with a funded program.
Q: What do you think were the most critical parts of the process?
WFP: It was very important to define the requirements – what were basically the pre-requisites for robust nutrition-sensitive programming - and the entry points across each program area where nutrition-sensitive activities made sense and were feasible. With this we could bring the right people to the table. It was also critical to define the right research questions and develop the impact pathways to make the case for the investments.
DO: Having both sides, and all sides, at the table, was key. This gave us the background to co-create the requirements and opportunities and pathways that could be systematically applied. It was very helpful to have joint missions to specific country offices to implement guidance, identify research opportunities, and secure buy-in from the country offices themselves. This created a feedback loop and helped the regional and country representatives and program teams understand why we were taking this approach, that we were there for support and to answer questions. This created serious engagement and ensured it resonated and people understood the how and why.
Q: Do you feel like you can see differences/improvements from these processes already?
WFP: Yes. Country offices often report on at least one nutrition sensitive indicator, making the organization more accountable. The consultation across programs created awareness on a new topic and how every program could contribute to nutrition.
To give a specific example, the Sri Lanka country office took the nutrition-sensitive programming guidance and outlined how they could meet the requirements and what the specific opportunities were. From this the country office devised their own country-specific program pathways. They were able to shift the mindset of leadership and program colleagues who became champions for improved nutrition.
Q: What does this project mean for nutritionally vulnerable people?
WFP: We are seeing that programs such as those related to school feeding, asset creation or smallholder market linkages have included nutrition objectives and outcomes. These programs achieve not only their primary aims in education, poverty alleviation and resilience, but also aim to support better diets and nutrition for vulnerable populations, who are not necessarily receiving nutrition-specific assistance, thereby increasing the likelihood of greater wellbeing.
DO: We’re still learning what the impacts will be! There is a lot of potential for this type of project to improve the health and nutrition of people, but now that we’ve created hypotheses grounded in previous research, we need to test them to find out.
Q: How do you bring others into the process?
WFP: The technical working group set up at the outset brought program colleagues together. We were able to build a network of champions, then work with them and move the nutrition-sensitive agenda forward by contributing to different programme strategies. The resilience programming and school feeding teams were two of our early supporters. Externally, we have spoken together at events to promote the work, also within the support of the Rome-based agencies work. There have also been joint missions to country offices with program colleagues to operationalize nutrition-sensitive interventions and explore research opportunities.
DO: We’re also presenting this approach at different forum so others can learn from our experiences. The publication is another avenue for that outreach, as well. As we share it with partners and in different places, we see who it resonates with and how we can grow the community interested in taking this approach.
Q: Who else would you want to include from IFPRI’s point of view? What other perspectives?
DO: It would be great to bring donors in – understanding the investment perspective would be very helpful. I also think involving more local NGOs and community-based organizations would help, because we could get their perspective on the approach and how it fits with their work – does it resonate on the ground? Does it make sense in their country? Could it inform policy processes at the national level? These are all questions that would be valuable to answer.
Q: What advice would you give someone considering this approach?
WFP: Think through what might be feasibly achieved, in what time frame and at what cost at the outset. Bring everyone together at the beginning to limit the risks of not being able to start or complete the work because of lack of buy in, budget or operational constraints. Be collaborative and proactive from the beginning, and move quickly from theory to application, even on few countries. Nutrition sensitive is process oriented. Each step matters.
DO: Bring everyone to the table, identify a broad enough funding base to at least get things up and moving in the evaluation and research – there’s a lot of energy in the process, and you want harness and sustain it, and hopefully drive additional funding as a result
Q: What comes next?
WFP: Next steps include documenting experiences and learning, sharing, and scaling what works. Undertaking research and publishing results is part of the way forward to build evidence of what works.
DO: We continue trying to find opportunities to test the hypotheses in the guidance. This is going on in Sri Lanka, and it would be helpful to identify a few others and then refine the guidance based on the WFP-specific evidence. It would also be useful to bring other people into the process, to see if this is applicable across other types of organizations and can be adapted or replicated in other contexts.
Q: What do you most want people to know about this work?
WFP: “Nutrition-sensitive” is a process not a product. It takes time to bring people on board, find the right opportunities, and implement them. The value of nutrition-sensitive champions cannot be underestimated. Nutrition is everybody’s business.
DO: The importance of close partnerships between program implementers and researchers can’t be understated if we want to improve nutrition and achieve the SDGs. Implementers, researchers, and donors need to come together and trust one another, to test things, learn together, and make iterative changes and adapt that learning as we go. We all have something to bring to the table, and this systematic approach will require everyone.
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