Multisectoral Nutrition: Feasible or Fantasy?

Undernutrition has received unprecedented attention, financing and policy focus in recent years. One example is the Scaling Up Nutrition (SUN) movement, with over fifty countries engaged and pursuing a multisectoral nutrition (MSN) approach. This presentation describes the extraordinarily high requirements for MSN to achieve impact and assesses the likelihood of countries achieving impact under current conditions. It is based on the results of a two‐year, prospective study of the challenges, strategies and accomplishments in implementing a multisectoral approach to stunting reduction in four of the African SUN countries: Burkina Faso, Ethiopia, Mali and Uganda. The requirements for effective MSN include various forms of commitment, coordination and capacity at individual, organizational and system levels, involving multiple government organizations, donors, implementing agencies, civil society organizations and the private sector, extending from national to community levels. Few of these requirements were met in the four study countries, yet each of them made significant progress in four major areas: Strengthening the enabling environment, cascading MSN to sub‐national levels, aligning stakeholders and the practice of adaptive management and learning. While this progress is encouraging, these countries remain at fairly early stages of building the MSN system and continue to face many challenges. Most of these challenges can be addressed by placing a high priority on three high leverage system investments: strengthening human resources in the MSN coordinating unit, creating a small but full‐time implementation team and ensuring that accurate information on critical bottlenecks is conveyed and acted upon in a timely fashion by high level decision makers in government and partner organizations. In the absence of such investments it is uncertain whether or how MSN can become effective or sustainable within a time frame that is acceptable to politicians and international donors. Support or Funding Information UNICEF Regional Offices in Western/Central Africa and Eastern/Southern Africa.