Multisectoral nutrition planning in Nepal: Evidence from an organizational network analysis

Abstract

Multisectoral approaches are central to the global Scaling Up Nutrition (SUN) movement and the Sustainable Development Goals. Nepal joined SUN in 2011 and approved the first 5-year Multisectoral Nutrition Plan (MSNP) in 2012, covering 2013-2017. This mixed methods study draws on organizational network analysis (ONA) and qualitative interviews with a sample of 22 organizations to examine (1) levels of engagement and network dynamics among government sectors and development organizations and (2) milestones and processes in the development and implementation of Nepal's MSNP. Findings suggest that the development of the MSNP was related to the high density of organizational connections; the leadership role of the Nepal's National Planning Commission and the National Nutrition and Food Security Secretariat; and the bridging roles played by a few government ministries and UN agencies that linked organizations that did not have direct relationships with each other. Specialized roles were observed for the three types of working relationships: policy dialogue, strategic planning and implementation. Partners were less connected on MSNP implementation than for policy dialogue and strategic planning, which may have constrained collaborative scale-up efforts. The Ministry of Agricultural Development, in particular, was the conduit for connecting non-health sectors into the broader network. Our study offers insights into the structure and dynamics of multisectoral planning in Nepal. It also contributes to a small but growing literature that illustrates how ONA can be applied to measure and use network results to elucidate the processes for strengthening multisectoral planning and implementation of nutrition-specific and nutrition-sensitive interventions.

Nutrition in Nepal: Three decades of commitment to children and women

“…Although iodized salt has public health benefits for the entire population, it is particularly important for Although the case for multisector planning for nutrition is clear, documented evidence on how to design, plan and scale-up multisectoral approaches is rare (World Bank, 2013). In this issue, Ruducha et al (2022) (2) the introduction of nutrition coordination structures at all administrative level; and (3) the high degree of organizational connectivity across sectors and stakeholders that supported a unified understanding and potential for joint action.…”

“…Although the case for multisector planning for nutrition is clear, documented evidence on how to design, plan and scale‐up multisectoral approaches is rare (World Bank, 2013 ). In this issue, Ruducha et al ( 2022 ) use organizational network analysis and qualitative interviews to explore the governance processes that underpinned the development of Nepal's first MSNP. Prior to MSNP, nutrition programming in Nepal was primarily driven by the health sector, with little engagement from other sectors.…”

Reflections on benefits and challenges of longitudinal organisational network analysis as a tool for health systems research and practice

“…), increased efficiency or effectiveness in achieving a shared objective or bringing together diverse stakeholders that may not have otherwise come together in a planned or coordinated manner. 12 13 Organisational network analysis has also been used to assess network structure and/or coordination of services, 14 15 to identify opportunities for integration of services, 16 17 to refine internetwork and intranetwork resource exchange 18 19 and planning in multisectoral environments, 20 to monitor and evaluate capacity building 21 22 and to study policy advocacy. 23 Despite the encouraging findings from this research, the application of network analysis to organisational networks seems to be lagging behind that for networks of individuals.…”

Using social network analysis to understand multisectoral governance in district-level tobacco control programme implementation in India

“…23 More recently, its application has been tested to understand levels of engagement and network dynamics among participating sectors and organisations in the planning of multisectoral nutrition programmes. 24 Thus, SNA provides distinctive methods to map, measure and analyse how social relationships within a network are established and evolve. 25 26 This study focuses on multisectoral policy implementation and governance, using the case of tobacco control policy at the district (local) level in Karnataka, a southern Indian state.…”

“… 23 More recently, its application has been tested to understand levels of engagement and network dynamics among participating sectors and organisations in the planning of multisectoral nutrition programmes. 24 Thus, SNA provides distinctive methods to map, measure and analyse how social relationships within a network are established and evolve. 25 26 …”