Publication:
Operationalizing Multisectoral Nutrition Programs to Accelerate Progress: A Nutrition Governance Perspective

Loading...
Thumbnail Image
Files in English
English PDF (1.82 MB)
1,058 downloads
English Text (187.59 KB)
45 downloads
Published
2021-12
ISSN
Date
2022-01-06
Editor(s)
Abstract
Malnutrition continues to be one of the world's most critical health and human development challenges, threatening countries' Universal Health Coverage (UHC) goals and the achievement of the Sustainable Development Goals (SDGs). Given the complex, multifactorial, and interlinked determinants of nutritional status and well-being, multisectoral nutrition programming has been widely promoted as the most effective way to address the direct and indirect determinants of malnutrition and to improve nutrition outcomes. Robust governance systems are essential for implementing multisectoral nutrition interventions and creating cost-effective and sustainable programs. The objectives of this report are to (i) document and synthesize implementation experiences, challenges, and opportunities from seven countries supported by the World Bank and Global Financing Facility (GFF) in operationalizing large-scale multisectoral nutrition projects that emphasize and strengthen governance (Cambodia, the Democratic Republic of Congo, Guatemala, Indonesia, Malawi, Nigeria, and Rwanda); and (ii) facilitate cross-country learning. Given that the seven countries used as examples in this report are still implementing their multisectoral programs, the report focuses on documenting progress and lessons learned on implementation modalities and innovations, rather than highlighting impact at this stage. The report uses a multisectoral governance framework, adapted from Gillespie, Van Den Bold, and Hodge (2019), to synthesize the implementation experiences across the World Bank/GFF–financed multisectoral nutrition projects. The report provides eight lessons learned, organized under three broad categories: (1) Advocacy, leadership, and institutional support for multisectoral nutrition; (2) Management capacity and financing; and (3) Results measurement, monitoring, and accountability.
Link to Data Set
Citation
Subandoro, Ali Winoto; Holschneider, Silvia; Ruel-Bergeron, Julie. 2021. Operationalizing Multisectoral Nutrition Programs to Accelerate Progress: A Nutrition Governance Perspective. Health, Nutrition and Population Discussion Paper;. © World Bank. http://hdl.handle.net/10986/36802 License: CC BY 3.0 IGO.
Digital Object Identifier
Associated URLs
Associated content
Report Series
Other publications in this report series
Journal
Journal Volume
Journal Issue

Related items

Showing items related by metadata.

  • Publication
    Building High-Quality Health Systems to Improve Nutrition Services for Women and Children
    (World Bank, Washington, DC, 2022-08) Holschneider, Silvia; Subandoro, Ali Winoto; Ruel-Bergeron, Julie; Elder, Leslie
    A high-quality health systems approach that integrates nutrition is vital to accelerate progress in nutrition and meet the sustainable development goals by 2030.High-quality health systems for nutrition include integrated service provision and supplies, performance monitoring, strategic purchasing, and functioning referral services. Underpinning these components are political leadership and commitment, well-defined quality metrics and quality and timely nutrition data, and an accountability system that nurtures demand for quality services, among others. Several World Bank and Global Financing Facility (GFF) - co-financed projects are investing in building high-quality health system foundations to improve the quality of nutrition services and can serve as examples for improving quality of nutrition care.
  • Publication
    Positioning Nutrition with Universal Health Coverage
    (World Bank, Washington, DC, 2022-01) Subandoro, Ali Winoto; Okamura, Kyoko; Mehta, Michelle; Wang, Huihui; Ahluwalia, Naina; Finkel, Elyssa; Bulungu, Andrea L.S.; Dinsa, Girmaye; Okara, Latifat; Wilson, Shelby
    Achieving universal health coverage (UHC) is a top global priority, and nutrition actions are a critical part of meeting that goal. When delivered within key windows of opportunity to improve health throughout the life-course, essential nutrition actions play an important role in reducing the burden of disease and preventing permanent physical and cognitive impairments, ultimately staving off future health care costs for both individuals and health systems. Coverage and quality of nutrition service delivery remains low, despite robust evidence of cost-effective interventions. The health system, and most especially primary health care (PHC), is essential for delivering high-impact, cost-effective, nutrition-specific interventions at scale. There are gaps in knowledge on how to deploy resources more effectively to improve the delivery of nutrition services as part of preventive and promotive health care. A shift in focus is needed from the “what” and “why” of scaling-up nutrition to the “how” of improving nutrition services coverage and quality of nutrition services delivered through the health system, and especially PHC. Parts 1, 2, and 3 of this paper introduce the thesis that health financing arrangements can be optimized to ensure that distribution and utilization of health system resources are aligned with nutrition objectives. Parts 4, 5, and 6 of the paper explore the financing challenges and options to address key financing and service delivery challenges.
  • Publication
    Healthy Development : The World Bank Strategy for Health, Nutrition, and Population Results
    (Washington, DC, 2007) World Bank
    This paper updates the 1997 World Bank Health, Nutrition, and Population Strategy to enhance Bank capacity so that it continues to contribute to this virtuous circle in light of the momentous changes of the past decade in the architecture of development assistance for health (DAH) and of persisting HNP challenges worldwide. This 2007 HNP Strategy outlines the Bank vision for improving its own capacity to respond globally and with a country focus to the urgent issues posed by these changes and challenges.
  • Publication
    Fiscal Space for Health in Uganda
    (World Bank, 2010-03-01) Okwero, Peter; Tandon, Ajay; Sparkes, Susan; McLaughlin, Julie; Hoogeveen, Johannes G.
    This report reviews performance of Uganda's health sector and assesses options for increasing total health spending and improving efficiency of health spending to improve health, nutrition, and population outcomes. Although Uganda's health outcomes are improving, the country is unlikely to achieve its national targets for health as well as the health related Millennium Development Goals (MDG) Uganda is faced with a high disease burden from communicable diseases; in addition, the country is witnessing a growing epidemic of non communicable diseases. The main conclusion of the report is that while Uganda needs to continue exploring ways to mobilize funding for health it needs to improve the efficiency of its health spending to maximize the health benefits for its population. Uganda could reap significant savings by improving management of human resources for health; strengthening procurement and logistics management for medicines and medical supplies; and by better programming of development assistance for health. Besides, Uganda needs to take proactive steps to mitigate growing pressure to increase health spending.
  • Publication
    The Health Extension Program in Ethiopia
    (World Bank, Washington, DC, 2013-01) Workie, Netsanet W.; Ramana, Gandham NV
    Ethiopia has made substantial progress in improving health outcomes during the last decade and is on track to achieve some of the health Millennium Development Goals. Innovative strategies to improve household behaviors and coverage of basic health care services contributed to Ethiopia's achievements, and the Health Extension Program (HEP) remains the core of such innovations and provides a model for countries struggling to improve health outcomes in a resource-constrained setting. The program rests on an accelerated expansion of basic health infrastructure and local human resources with required skills to scale-up delivery of high-impact interventions focusing on improving the supply of and enhancing demand for a well-defined package of essential promotive, preventive, and curative health services. The objectives of the case study are to provide a detailed description of (a) the context for the introduction of the program; (b) the scope of the service package delivered under the program; and (c) the institutional arrangements and the links with the rest of the health system. The case study also summarizes and discusses the evidence of the program's achievements and the challenges to achieving universal primary health care coverage. The study also discusses the importance of political will and commitment in introducing such large-scale innovations in improving service delivery and mobilizing the community in a resource-constrained setting.

Users also downloaded

Showing related downloaded files

  • Publication
    Jobs in a Changing Climate: Insights from World Bank Group Country Climate and Development Reports Covering 93 Economies
    (Washington, DC: World Bank, 2025-11-05) World Bank
    The World Bank Group’s Country Climate and Development Reports (CCDRs) provide a crosscutting look at how countries’ development prospects, and the job opportunities they offer to their people, can be threatened by climate impacts and supported by climate policies. Climate change and policies affect jobs through impacts on productivity, energy and material efficiency, and physical, human, and natural capital. They can also transform employment opportunities, especially through complementary measures that help workers and firms adapt to and benefit from new technologies and production practices. Prepared by the World Bank, the International Finance Corporation (IFC), and the Multilateral Investment Guarantee Agency (MIGA), CCDRs integrate country perspectives, climate science and economic modeling, private sector information, and policy analysis to assess how countries can successfully grow and develop their economies and create jobs despite increasing climate risks and while achieving their climate objectives and commitments. Each CCDR starts from the country’s development priorities, opportunities, and challenges, and is developed in close consultation with governments, businesses, and civil society, ensuring the recommendations reflect national priorities. By combining evidence on adaptation, resilience, and emissions pathways, CCDRs highlight where climate action can reinforce development and job creation, and where targeted policies are needed to manage risks and smooth labor market transitions. Taken together, these elements can help create local jobs, ensure economic transitions are just and inclusive, and equip workers and firms to navigate the disruptions and opportunities of a changing climate and changing technologies.
  • Publication
    World Development Report 2025: Standards for Development
    (Washington, DC: World Bank, 2025-12-11) World Bank
    Standards make everyday life run smoothly. You rarely notice them: the credit card that works in any corner of the world, the Wi-Fi signal that connects a remote village to the cloud, or the vaccine vial that fits syringes from Dakar to Delhi. When standards work, they build trust. They free people and firms to focus on creating, trading, and innovating, confident that the systems around them will hold. When standards fail, the effects are immediate and draining. Payments are declined, signals drop, vaccines spoil—and instead of being productive, people spend their energy just meeting their basic needs. Standards, in short, are the hidden infrastructure of modern economies—and they have never been more important. Developing countries today must contend with a thicket of increasingly stringent international standards, a product of globalization and rapid technological change. Using standards—and shaping them—is now a prerequisite for export growth, technology diffusion, and the efficient delivery of public services. Yet standards are too often overlooked by policy makers, especially in developing countries. World Development Report 2025: Standards for Development provides the most comprehensive assessment of the global landscape of standards today and how they can be used to accelerate economic development. It offers a practical framework for countries at all stages of development. Countries at the earliest stage should adapt international standards to suit local conditions when needed, whereas at more advanced stages, they should aim to align domestic markets with international standards. Meanwhile, all countries should author international standards in priority areas.
  • Publication
    Digital Africa
    (Washington, DC: World Bank, 2023-03-13) Begazo, Tania; Dutz, Mark Andrew; Blimpo, Moussa
    All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.
  • Publication
    Impact Evaluation in Practice, First Edition
    (World Bank, 2011) Gertler, Paul J.; Martinez, Sebastian; Premand, Patrick; Rawlings, Laura B.; Vermeersch, Christel M. J.
    The Impact Evaluation in Practice handbook is a comprehensive and accessible introduction to impact evaluation for policymakers and development practitioners. The book incorporates real-world examples to present practical guidelines for designing and implementing evaluations. Readers will gain an understanding of the uses of impact evaluation and the best ways to use evaluations to design policies and programs that are based on evidence of what works most effectively. The handbook is divided into three sections: Part One discusses what to evaluate and why; Part Two outlines the theoretical underpinnings of impact evaluation; and Part Three examines how to implement an evaluation. Case studies illustrate different methods for carrying out impact evaluations.
  • Publication
    Business Ready 2024
    (Washington, DC: World Bank, 2024-10-03) World Bank
    Business Ready (B-READY) is a new World Bank Group corporate flagship report that evaluates the business and investment climate worldwide. It replaces and improves upon the Doing Business project. B-READY provides a comprehensive data set and description of the factors that strengthen the private sector, not only by advancing the interests of individual firms but also by elevating the interests of workers, consumers, potential new enterprises, and the natural environment. This 2024 report introduces a new analytical framework that benchmarks economies based on three pillars: Regulatory Framework, Public Services, and Operational Efficiency. The analysis centers on 10 topics essential for private sector development that correspond to various stages of the life cycle of a firm. The report also offers insights into three cross-cutting themes that are relevant for modern economies: digital adoption, environmental sustainability, and gender. B-READY draws on a robust data collection process that includes specially tailored expert questionnaires and firm-level surveys. The 2024 report, which covers 50 economies, serves as the first in a series that will expand in geographical coverage and refine its methodology over time, supporting reform advocacy, policy guidance, and further analysis and research.