Leveraging the Scaling Up Nutrition Movement to Operationalize Stunting Prevention Activities: Implementation Lessons From Rural Malawi

Kodish, Stephen; Farhikhtah, Arghanoon; Mlambo, Trust; Hambayi, Mutinta; Jones, Vanessa; Aburto, Nancy

doi:10.1177/03795721211046140

Cited by 4 publications

(5 citation statements)

References 41 publications

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“…Uganda and Senegal have implemented multisectoral nutrition coordination bodies with convening powers at the national level ( 56 , 57 ) . Finally, Malawi is in the process of implementing multisectoral financial and programme indicator tracking mechanism which intends to enhance commitment and accountability for nutrition financing and results ( 58 ) . In summary, there are various experiences and lessons that countries in Africa can learn from the planning and operationalising of various components of MNG for improved nutrition outcomes.…”

Section: Resultsmentioning

confidence: 99%

Utilising emerging perspectives at the global and regional level to frame multisectoral nutrition governance landscape in Kenya

Korir,

Oldewage-Theron,

Mugambi

et al. 2024

Public Health Nutr.

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Objective: Multisectoral Nutrition Governance (MNG) is a vital enabling determinant of improved nutrition outcomes. Despite this, it remains to be a complex phenomenon that lacks adequate understanding, especially in developing countries like Kenya. This narrative review aims to discuss the evolution of MNG, the current state of MNG, barriers and challenges, and based on these identify entry points for improvement within the complex governance structure in Kenya. Design: The Peer Review of Electronic Search Strategies (PRESS) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to ensure rigorous and transparent identification of literature and interpretation. Setting: Kenya and developing countries with similar contexts. Participants: The review included 45 documents (peer-reviewed articles and grey literature) that reported on MNG in developing countries. Results: We acknowledge that MNG is a complex and evolving determinant of better nutrition outcomes. The paper highlights challenges Kenya and other developing countries face such as inadequate leadership, inadequate coordination, insufficient capacity, inadequate monitoring and evaluation systems, and limited financial resources, among others. For Kenya in particular, there is inadequate understanding of what MNG is, and how it can be effectively operationalized and tracked. Conclusions: To enhance understanding of MNG in Kenya, a country-specific assessment of MNG processes and impact outcomes using standard tools and defined metrics is vital. Such assessment will generate evidence of progress, successes, and challenges that will compel the government and stakeholders to invest more in multisectoral nutrition approaches to achieve its’ nutrition goals.

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Section: Resultsmentioning

confidence: 99%

Utilising emerging perspectives at the global and regional level to frame multisectoral nutrition governance landscape in Kenya

Korir,

Oldewage-Theron,

Mugambi

et al. 2024

Public Health Nutr.

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“…All these variables were often mentioned by literature related to stunting cases or stunting reduction programs, that is, program budget, 26,27 stakeholder's cooperation, 28–31 water supply, 8 human resources to execute program, 32 and WASH behavior. 33 Based on the literature, we argue that stunting reduction programs have a high chance of success if all those variables exist in the community.…”

Section: Methodsmentioning

confidence: 99%

“…The 5 selected variables were: (a) the district budget for the stunting reduction program (representing financial), (b) stunting-related stakeholder's cooperation and coordination (institution), (c) sufficient water supply (environmental), (d) skill or ability of related stakeholders or officers to execute the program (technical), and (e) WASH-related behavior (social). All these variables were often mentioned by literature related to stunting cases or stunting reduction programs, that is, program budget, 26,27 stakeholder's cooperation, [28][29][30][31] water supply, 8 human resources to execute program, 32 and WASH behavior. 33 Based on the literature, we argue that stunting reduction programs have a high chance of success if all those variables exist in the community.…”

Section: Group Model Building Workhopmentioning

confidence: 99%

Interactions of Factors Related to the Stunting Reduction Program in Indonesia: A Case Study in Ende District

Daniel

Qaimamunazzala

Prawira

et al. 2023

International Journal of Social Determinants of Health and Heal

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Previous stunting-related studies focus more on causes or determinants of stunting. Little is known about factors contributing to the success of stunting reduction programs. This study aims to fill those gaps using a case study from Ende District, Province of Nusa Tenggara Timur, Indonesia. A group model-building workshop with stunting-related stakeholders was conducted in November 2021. The system dynamic approach in the form of a causal loop diagram was used. Five variables related to the stunting reduction program were included in the analysis: the budget for the stunting reduction program; stunting-related stakeholder's cooperation and coordination; sufficient water supply; the ability of the related stakeholders to execute the program; and water, sanitation, and hygiene-related behavior. We found that the budget for the program and the cooperation and coordination between stakeholders were the most influential variables in the system. The feedback loop between these 2 variables was also the most prominent in the system, suggesting that sufficient funding and strong collaboration between stakeholders could lead to successful stunting reduction programs. Finally, this study implies that the stunting reduction programs in developing countries should be seen holistically and improvement should be conducted in all aspects, including financial, institutional, environmental, technical, and social.

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“…HSAs also perform other tasks within communities related to health education and sanitation and hygiene 6 7. Though outside of the formal health system, within many communities, Care Groups composed of volunteers and mothers play an important role in spreading health information and mobilising communities 8 9…”

Section: Introductionmentioning

confidence: 99%

Using community-based, participatory qualitative research to identify determinants of routine vaccination drop-out for children under 2 in Lilongwe and Mzimba North Districts, Malawi

Powelson,

Kalepa,

Kachule

et al. 2024

BMJ Open

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ObjectiveIn recent years, full childhood routine immunisation coverage has fallen by 5% to levels not seen since 2008; between 2019 and 2021, 67 million children were undervaccinated. We aimed to identify and describe the determinants of vaccination drop-out from the perspectives of caregivers and health workers in Malawi.DesignWe used a community-based participatory research approach to collect data through photo elicitation, short message service exchanges, in-depth interviews and observations. We used a team-based approach for thematic analysis, guided by the Behavioural and Social Drivers of Vaccination framework.SettingThe study was conducted in Lilongwe and Mzimba North Districts in Malawi, representing urban and rural settings, respectively.ParticipantsParticipants included caregivers of partially vaccinated (n=38) and fully vaccinated (n=12) children between 25 and 34 months and Community Health Workers (n=20) who deliver vaccines. Caregiver participants were identified through health facility vaccination registers and with the assistance of community health volunteers.ResultsWe identified five principal drivers of routine vaccination drop-out: (1) poor caregiver knowledge of the vaccine schedule and how many vaccines are needed for full vaccination; (2) caregivers’ fear of repercussions after not following vaccination guidelines; (3) rumours and concerns if vaccines are repeated or new ones are introduced; (4) high opportunity cost of health facility visits, exacerbated by wait times, stockouts and missed opportunities and (5) limited family support and vaccination burden placed largely on mothers. Key differences between rural and urban settings related to practices around health cards and vaccine wastage, wait times, migrant and tenant communities, and social support systems.ConclusionsImmunisation interventions should be tailored to address drivers of drop-out in the community, the health facility and beyond. Service quality, timeliness and reliability need to be improved, and tailored messaging and education are needed, especially in response to COVID-19-related misinformation and introductions of new, routine vaccines.

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Leveraging the Scaling Up Nutrition Movement to Operationalize Stunting Prevention Activities: Implementation Lessons From Rural Malawi

Cited by 4 publications

References 41 publications

Utilising emerging perspectives at the global and regional level to frame multisectoral nutrition governance landscape in Kenya

Utilising emerging perspectives at the global and regional level to frame multisectoral nutrition governance landscape in Kenya

Interactions of Factors Related to the Stunting Reduction Program in Indonesia: A Case Study in Ende District

Using community-based, participatory qualitative research to identify determinants of routine vaccination drop-out for children under 2 in Lilongwe and Mzimba North Districts, Malawi

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