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POSHANProcessresearch:Understandingprocessesthat

supportnutritionprogramimpacts

ShibaniGhoshNutritionInnovationLab AsiaandAfrica

TuftsUniversity

ResearchQuestions

Howandwhylargescale,multisectorpoliciesandprogramsachievenutritiongoals?

Howcanpolicyandprogramimplementationbeenhancedtosupportbothnutritionspecificandnutritionsensitiveactions?

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Leroy J L , Menon P J. Nutr. 2008;138:628-629

2008 by American Society for Nutrition

ProgramStepsandStakeholders

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5

WorldBank(2010)Whatcanwelearnfromnutritionimpactevaluations?Washington,D.C.

Legend

TeraiHillDistrictsMountainDistricts

SentinelSites 6

ServiceDelivery

SectorCoordination

Crossministrycoordination

CrossPolicyanddonorcoordination

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KeyIssuesinverticalandhorizontalcoherence

Individualcapacity:Skills,knowledge,training,experience,attitudestomultisectoractions,nutritiongoals,priorityproblems

Institutionalcapacity:Perceivedconstraintstomultisectorcollaboration,resourceuseefficiency,

Systemcapacity:Disincentivestocollaboration,innovation,venuesfordialogue,rolesandresponsibilities,

Gillespieetal.(2013)LancetSeries2Paper4

Questions

Perceivedconstraintsinworkingacrosssectors

Incentivesforcollaborationacrossinstitutionsandsectors

Expectedhurdlestomultisectorcoordination Knowledgeandtraininginnutrition

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Methods

Structuredopenendedquestionnaires ~700interviews(nationaldowntoward) Annualsurveys Firstsurveyconducted:FebruarytoJune2013 Dataentryinprocess Preliminaryfindings:September2013

Level Institution/Individual

National Policy makers, donors, INGOs, academics

Regional Administrator, RD Health, RD Agriculture, RD Livestock, RD Education, RD DWS, RD WD

District LDO, DHO/DPHO, Agriculture, Livestock, Education, DWS, Chamber of Commerce Program Office Social Dev Sec DDC, Planning Off, DDC, Chair NGO federation, NGOs

Ilaka Health, Agriculture, Livestock, Edu Resource Center

VDC VDC Secretary, Health, Agriculture, Livestock, Education (school teacher), NGOs

Ward FCHV, Representative Ward Citizen Forum, Representative MG, Representative Cooperative/Groups

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Analysis Degreeofverticalcoherencewithinsector

E.g.priorityproblems,interventionsneeded,importanceofmultisectoractions

MinistryofAgriculture,RegionalAgricultureofficedowntoward

Degreeofcollaborationacrosssectors(horizontalconcurrence) Withinregion,district,VDC,ward

Effectofconcurrenceandcoherenceonvariabilityofoutcomesontheground(community)

Changeinconcurrenceorcoherenceovertime(MSNPandprogramimplementation)