Improving Multi-SectoralCollaboration for Scaling up

Nutrition-Specific and Nutrition-Sensitive Interventions in

BangladeshDr. Malay Mridha

and Dr. Tanvir Hasan

BRAC James P Grant School of Public Health, BRAC University

Presentation outline• Factors associated with nutrition

• What are the nutrition specific and nutrition sensitive interventions?

• Who are the actors in scaling-up the nutrition specific and sensitive intervention?

• Why do we need multi-sectoral collaboration?

• How can we improve multi-sectoral collaboration?

Factors associated with nutrition

Nutrition specific interventionsExamples of nutrition specific interventions

Adolescent, preconception, and maternal health and nutrition

Dietary supplementation

Maternal dietary or micronutrient supplementation

Diversification and micronutrient supplementation or fortification for children

Promotion of optimum breastfeeding

Treatment of severe acute malnutrition

Complementary feeding and responsive feeding practices and stimulation

Disease prevention and management

Nutrition in emergencies

• Nutrition specific interventions are effective in addressing immediate causes of malnutrition and some of the underlying causes such as inadequate foods, feeding and caring practices

Source: LANCET 2013

Nutrition sensitive interventions

Examples of nutrition sensitive interventions

Agriculture and food security Child protection

Social safety nets Education

Early child development Water sanitation and hygiene

Maternal mental health Health and family planning services

Women’s empowerment

• Nutrition sensitive interventions are effective in addressing some of the underlying and basic causes of malnutrition such as household food insecurity and inadequate access to services

Source: LANCET 2013

More on nutrition sensitive and specific interventions

Source: REACH

More on nutrition sensitive and specific interventions

Source: LANCET 2013

Actors for scaling-up nutrition specific and sensitive interventions

Source: REACH

Collaboration is everything

Source: REACH

Coordination, collaboration, integration

Why multi-sectoral collaboration

Source: SPRING

Improving multi-sectoral collaboration: Key actions from a roundtable on September 7, 2013

Summary of key actions• Strengthen nutrition goals, design, and implementation. It should be a priority at

the directorate and ministry levels to ensure that all programmes carefully consider opportunities and submit proposals to become more nutrition-sensitive.

• Coordinate between ministries and partners for effective design, implementation and evaluation. Effective linkages should be established between government, development partners, non-governmental organizations, and the private sector.

• Utilize targeting, timing, and duration of exposure to make interventions more nutrition sensitive. Programmes should be targeted to families with pregnant and lactating women and children between 0 and 24 months of age.

• Increase focus on women's nutrition and empowerment. When programmes, increase women's decision-making power, it increases investments in nutrition for the whole family.

• Develop effective monitoring and evaluation. This includes using nutrition indicators, like child growth and food diversity indicators.

Improving multi-sectoral collaboration: SPRING collaboration life cycle

Source: SPRING

Key element along the cycle: Design

Source: SPRING

Key element along the cycle: Implement

Source: SPRING

Key element along the cycle: Monitor

Source: SPRING

Multi-sectoral collaboration: REACH Framework

Source: REACH

Improving multi-sectoral collaboration: practical ideas….1• Plan multisectorally, implement sectorally

• Current multi-sectoral committees: BNNC, Steering committee of Nutrition (MoHFW), Food Policy Monitoring Committee (MoFood)

• A single coordination committee and role clarification: prevent overlap of interventions, generate integrated approach for resource allocation, track performances, joint targeting, coordinate capacity building, coordinate BCC messages

• National nutrition policy and NPAN guide overall implementation plan. Each ministry implement part of the action plan.

• Develop evidence-based policy, strategies, programs and support research

• Document the contribution of each sector in the improvement of nutrition and cost-effectiveness

Improving multi-sectoral collaboration: practical ideas….2• Address common governance challenges

• Low capacity, low staffing, low coverage, inequity and weak accountability

• Collaborate to implement both nutrition sensitive and nutrition specific programs: National Nutrition Services and Country Investment Plan at national and sub-national level.

• Frontline health workers can take part in nutrition sensitive programs e.g. WASH/Homestead gardening, teachers can play role in the adolescent nutrition programs etc.

• Monitor and evaluate programs of each ministry using nutrition indicators

• Conduct focused national and local advocacy

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Thank You!!!!!!!