Stories of Change in Nutrition: A Tool Pool

Gillespie, Stuart; Bold, Mara van den

doi:10.2139/ssrn.2741912

Cited by 9 publications

(7 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Data and evidence for this article were drawn from our country case studies that were undertaken using mixed methods as described in Paper 2 of this series ( 21 ). As detailed in the article, our approach was informed by existing literature and published methodological approaches to study success stories ( 22 ). Initially, a systematic literature review of more than 15 published peer-reviewed and gray literature sources across all LMICs with an expanded search for exemplar countries was undertaken.…”

Section: Methodsmentioning

confidence: 99%

How countries can reduce child stunting at scale: lessons from exemplar countries

Bhutta

Akseer

Keats

et al. 2020

The American Journal of Clinical Nutrition

101

View full text Add to dashboard Cite

Background Child stunting and linear growth faltering have declined over the past few decades and several countries have made exemplary progress. Objectives To synthesize findings from mixed methods studies of exemplar countries to provide guidance on how to accelerate reduction in child stunting. Methods We did a qualitative and quantitative synthesis of findings from existing literature and 5 exemplar country studies (Nepal, Ethiopia, Peru, Kyrgyz Republic, Senegal). Methodology included 4 broad research activities: 1) a series of descriptive analyses of cross-sectional data from demographic and health surveys and multiple indicator cluster surveys; 2) multivariable analysis of quantitative drivers of change in linear growth; 3) interviews and focus groups with national experts and community stakeholders and mothers; and 4) a review of policy and program evolution related to nutrition. Results Several countries have dramatically reduced child stunting prevalence, with or without closing geographical, economic, and other population inequalities. Countries made progress through interventions from within and outside the health sector, and despite significant heterogeneity and differences in context, contributions were comparable from health and nutrition sectors (40% of change) and other sectors (50%), previously called nutrition-specific and -sensitive strategies. Improvements in maternal education, maternal nutrition, maternal and newborn care, and reductions in fertility/reduced interpregnancy intervals were strong contributors to change. A roadmap to reducing child stunting at scale includes several steps related to diagnostics, stakeholder consultations, and implementing direct and indirect nutrition interventions related to the health sector and nonhealth sector . Conclusions Our results show that child stunting reduction is possible even in diverse and challenging contexts. We propose that our framework of organizing nutrition interventions as direct/indirect and inside/outside the health sector should be considered when mapping causal pathways of child stunting and planning interventions and strategies to accelerate stunting reduction to achieve the 2030 Sustainable Development Goals.

show abstract

Section: Methodsmentioning

confidence: 99%

How countries can reduce child stunting at scale: lessons from exemplar countries

Bhutta

Akseer

Keats

et al. 2020

The American Journal of Clinical Nutrition

101

View full text Add to dashboard Cite

show abstract

“…These included Shiffman and Smith's work on political priority for health; Heaver and te Lintelo's on political commitment for hunger and nutrition; Pelletier et al on nutrition policy processes; and Fox, Reich, and Balarajan's on the political economy of nutrition . These are elaborated on extensively elsewhere . From these, we identified five forms of commitment: rhetorical, institutional, operational, embedded, and system‐wide.…”

Section: Methodsmentioning

confidence: 99%

“…36,37 These are elaborated on extensively elsewhere. 38 From these, we identified five forms of commitment: rhetorical, institutional, operational, embedded, and system-wide. We identified NAN effectiveness as an important determinant of nutrition commitment in much of this work and considered these networks worthy of additional focus.…”

Section: Phasementioning

confidence: 99%

Generating political commitment for ending malnutrition in all its forms: A system dynamics approach for strengthening nutrition actor networks

et al. 2019

View full text Add to dashboard Cite

Summary Generating political commitment for ending all forms of malnutrition represents a key challenge for the global nutrition community. Without commitment, the policies, programs, and resources needed to improve nutrition are unlikely to be adopted, effectively implemented, nor sustained. One essential driver of commitment is nutrition actor network (NAN) effectiveness, the web of individuals and organizations operating within a given country who share a common interest in improving nutrition and who act collectively to do so. To inform new thinking and action towards strengthening NAN effectiveness, we use a systems dynamics theoretical approach and literature review to build initial causal loop diagrams (CLDs) of political commitment and NAN effectiveness and a qualitative group model building (GMB) method involving an expert workshop to strengthen model validity. First, a “nutrition commitment system” CLD demonstrates how five interrelated forms of commitment—rhetorical, institutional, operational, embedded, and system‐wide—can dynamically reinforce or diminish one another over time. Second, we present CLDs demonstrating factors shaping NAN effectiveness organized into three categories: actor features, resources, and capacities; framing strategies, evidence, and norms; and institutional, political, and societal contexts. Together, these models generate hypotheses on how political commitment and NAN effectiveness could be strengthened in future and may provide potential starting points for country‐specific conversations for doing so.

show abstract

“…There are a plethora of policy process theories that have been applied to examine public health policy processes, the most commonly used being Multiple Streams Theory and the Advocacy Coalition Framework. 39,40 A description of these theories is beyond the scope of this paper, but see Sabatier and Weible, 41 John 42 and Gillespie and van den Bold 43 for detailed overviews. The Framework was adopted over the other policy process frameworks and theories because it is a synthesis of three other policy process frameworks, namely Multiple Streams Theory, Shiffman and Smith's Health Priority Setting Framework, and Heaver's work on political commitment for nutrition.…”

Section: Theoretical Frameworkmentioning

confidence: 99%

Generating Political Commitment for Regulatory Interventions Targeting Dietary Harms and Poor Nutrition: A Case Study on Sugar-Sweetened Beverage Taxation in Australia

Dry

Baker

2021

Int J Health Policy Manag

View full text Add to dashboard Cite

Background: Sugar-sweetened beverage (SSB) taxes are an effective public health policy intervention for improving nutrition and public health. Although implemented in over 50 jurisdictions worldwide, this intervention remains vastly underutilised, and in Australia political commitment for such a tax is low. The aim of this study is to understand the politics of SSB taxation in Australia, what factors have constrained political commitment for a tax, and what might enable such commitment in future. Methods: We adopted a case study design, guided by a theoretical framework developed from the political economy of nutrition literature. Data were collected from 16 interviews with informants from multiple sectors, supported by media articles, journal articles, and grey literature. Data were coded and organized by thematic analysis, and synthesised into the final results. Results: Nutrition actors have made significant progress in generating commitment for a SSB tax by producing relevant evidence, raising awareness, advocating for action, employing resonating frames, collaborating with civil society organisations, and forming coalitions increasing their overall cohesion. Nevertheless, political commitment for a SSB tax is low and was found to be impeded by the powerful influence of the food, beverage, and sugar industries, opposition from both major Australian political parties, ideological resistance to regulation, a low quality monitoring and surveillance system for food and nutrition, and limited public advocacy. The influence of nutrition actors was also impeded by weak connections to key policymakers and missed collaborative opportunities with pro-SSB tax organisations. Conclusion: The identification of several impediments provides an explanation for why political commitment for a SSB tax is low in Australia and reveals several opportunities for how it might be generated in the future. Political commitment may come about through, for example, actions to limit the influence of industry in policy decision-making, and by strengthening the existing pro-SSB tax coalition.

show abstract

Stories of Change in Nutrition: A Tool Pool

Cited by 9 publications

References 47 publications

How countries can reduce child stunting at scale: lessons from exemplar countries

How countries can reduce child stunting at scale: lessons from exemplar countries

Generating political commitment for ending malnutrition in all its forms: A system dynamics approach for strengthening nutrition actor networks

Generating Political Commitment for Regulatory Interventions Targeting Dietary Harms and Poor Nutrition: A Case Study on Sugar-Sweetened Beverage Taxation in Australia

Contact Info

Product

Resources

About