What drives nutrition policy reform in Africa? Findings of a Three-Country Case Study Comparison...
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Transcript of What drives nutrition policy reform in Africa? Findings of a Three-Country Case Study Comparison...
![Page 1: What drives nutrition policy reform in Africa? Findings of a Three-Country Case Study Comparison (Malawi, South Africa, and Zambia)](https://reader031.fdocuments.in/reader031/viewer/2022030319/58ec9f6a1a28ab666b8b4645/html5/thumbnails/1.jpg)
What Drives Nutrition Policy Reform in Africa?
Findings of a Three-Country Case Study Comparison
Malawi, South Africa, and Zambia
Sheryl Hendriks
![Page 2: What drives nutrition policy reform in Africa? Findings of a Three-Country Case Study Comparison (Malawi, South Africa, and Zambia)](https://reader031.fdocuments.in/reader031/viewer/2022030319/58ec9f6a1a28ab666b8b4645/html5/thumbnails/2.jpg)
Slow Progress but Way Off Targetfor Some Micronutrients
• Iodine fortification: Same solution but different timing and impact
• Addressing Vitamin A deficiencies: Different vehicles and differing outcomes
• Iron: What is the sticking point?
• Multi-mixes in fortification: Complex decisions
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Nutrition Re-emerges on Policy Agendas
(1) A relevant problem in all 3 countries, but real action after 1990
(2) International focusing events played a major role in initiating change with supporting evidence, ready solutions, targets, and binding agreements focusing on rights
(3) Supported by powerful advocates and coalitions– both international and local
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Consideration of Design Modalities
(4) International best practice informed and shaped policies but not always interpreted in the same way
(5) A few incidences of ideas, ideologies, and beliefs
(6) Cost-benefit was a deciding factor in choice of fortification vehicle, but not a major constraint.
• Costs shifted to private sector
• Coverage is more important with supplementation programmes
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Transforming Proposals into Adopted Policies
(7) Powerful opponents - especially from private companies and millers
(8) Implementing veto players played a role in fortification programmes –presidents, private sector, and health professionals
(9) Propitious timing played a role in South Africa as well as with regular UN reporting cycles on children’s rights
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Ensuring Implementation on the Ground
(10) Budgets typically came from donors initially and support continues in various ways but fortification costs transferred to the private sector
(11) Institutional capacity is a major constraint for supplementation rolled out through health systems; private-sector fortification compliance; and coverage
(12) Implementation veto players are essential due to high levels of coordination among multiple stakeholders
(13) The commitment of policy champions is not strong in this phase
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Evaluating, Reconsidering, and Reforming
(14) Constantly changing information and beliefs trigger the need for review and revision of policies
(15) Changing material conditions do not really affect private-sector fortification programmes, but are a problem with supplementation
(16) Institutional shifts seldom influence micronutrient policies
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Conclusions and Recommendations
• Except for iodine, suboptimal progress in addressing micronutrient deficiencies.
• The Kaleidoscope Model was useful in identifying the drivers of and constraints on change in micronutrient policies in the developing world.
• Common drivers included– the global knowledge base;
– call for action and international targets;
– national leadership; and
– the champions and support of the development partners.
• Differences were seen in – the level of engagement with various stakeholders;
– design and funding considerations;
– the institutional and regulatory infrastructure; and
– long-term investment in sustainable solutions.
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We wish to acknowledge the co-authors of the six initial
field studies:
Suresh Babu, Nicolette Hall, Jody Harris, Nicole Mason, Elizabeth
Mkandawire, David Mather, Stephen Morgan, Flora Nankhuni, David
Ndyetabula, Dorothy Nthani, Nic JJ Olivier, Nico JJ Olivier, Phillip
Randall and Hettie C Schönfeldt.
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For More Information, Please Visit
http://foodsecuritypolicy.msu.edu/
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