Publication: Political Economy of Nutrition Policy in Senegal
Loading...
Published
2018-06
ISSN
Date
2019-09-30
Author(s)
Editor(s)
Abstract
Senegal has a reputation for having one of the most effective and far-reaching nutritionservice delivery systems in Africa. Chronic malnutrition has dropped to less than 20 percent, oneof the lowest in Sub-Saharan Africa. The reduction in stunting in particular has been deemed a success in Senegal with the prevalence of child stunting one of the lowest in Sub-Saharan Africa in absolute terms (Nene 2017). This success has at least in part been attributed to broad-based government commitment to nutrition, which has grown from US$0.3 million per year in 2002 to US$5.7 million per year in 2015, increasing from approximately 0.02 percent to 0.12 percent of the national budget. Yet concerns remain regarding whether the level of government support for nutrition is sufficient and the degree to which nutrition has been as effectively “mainstreamed” across major line ministries, such as agriculture, education, water and sanitation, socialprotection and health, to support both nutrition-specific and nutrition-sensitive interventions. Moreover, the nutrition field as a whole is characterized by a myriad of actors (international donors, NGOs, and technical support agencies) whose interventions are not well coordinated, leading to duplications of effort and inefficiencies in the provision of services. A series ofexternal shocks, including food shortages stemming from drought, the global financial crisis, and the instability of prices for local foodstuffs since 2007, has revealed the continued need for additional investment in nutrition and better intersectoral coordination of activities to counter cyclical attention to nutrition and a predominant focus on food insufficiency rather than abroader focus on nutrition. To this end, the government of Senegal, through the CLM, is in the process of drafting the new PSMN to develop a reform agenda for the sector. The PSMN will lay out a framework and timeline for the development of a nutrition financing strategy that will requirespecific analysis of the sector spending and financial basis, linking it to the coverage and quality of nutrition services and assessing the contribution of different sectors and actors to the budget. As part of the Analysis & Perspective: 15 Years of Experience in the Development of Nutrition Policy in Senegal series, the World Bank commissioned this report to elaborate the specific political challenges to and opportunities for further raising the profile ofnutrition on the government’s agenda and secure a sustainable effort to reduce maternal and child malnutrition. The nutrition agenda is often prone to political economy challenges when it competes for government support, as the impact of nutritional intervention is neither immediate nor tangible. Though the benefits of proper nutrition are life-long and are foundational to proper growth and development, nutrition can fall by the wayside in policymakers’ inevitably shorter-termoutlook. With this in mind, the objective of this report was to identify the policy and political levers that can be used to foster government leadership and galvanize intersectoral coordination that mainstreams nutrition into government policies and programs and effectively, efficiently, and sustainably delivers nutrition interventions in Senegal.
Link to Data Set
Citation
“Fox, Ashley M.. 2018. Political Economy of Nutrition Policy in Senegal. © World Bank. http://hdl.handle.net/10986/32471 License: CC BY 3.0 IGO.”
Digital Object Identifier
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Political Economy Analysis for Food and Nutrition Security(World Bank, Washington, DC, 2012-12)The overall goal of this paper is to promote the use of political economy analysis in advancing more effective food and nutrition policies. The paper reviews the field of applied political economy for the food and nutrition sector, and offers practical guidance on how to conduct political economy analysis to better navigate the policy reform process. The paper is presented in three parts. Part I reviews the literature on political economy analysis (PEA) and its application in the food and nutrition fields, focusing on the applied literature in development. Three kinds of PEA are discussed: In-depth, Stakeholder, and Rapid Assessment PEA, which serve different purposes. The paper then introduces a structured qualitative method for conducting an in-depth PEA, based on four stages of the policy cycle: agenda-setting, policy design, policy adoption, and implementation. Part II provides an illustrative case study of an in-depth PEA for a specific food and nutritionrelated policy of India, the Integrated Child Development Services scheme. The analysis explains how the agenda was set and its consequences. Part III presents a newly developed tool to conduct a rapid assessment PEA for food and nutrition policy. This tool uses a questionnaire approach to evaluate the level of political commitment for food and nutrition security and opportunities for change, and can be used to monitor change in political commitment over time.Publication Carrots and Sticks : The Political Economy of Nutrition Policy Reforms(World Bank, Washington, DC, 2009-02)The World Bank and other development partners have been involved in the implementation of nutrition programs for over 30 years. While a number of these programs have become successful and sustainable large-scale operations, many others have been hindered by political and administrative obstacles. The disparate results of these nutrition programs suggest that generating technically sound knowledge about nutrition and providing it to policymakers is not enough to ensure good results. It is also crucial to understand the political context, and the constraints and motivations of politicians, public officials, and other relevant players to initiate, implement, and sustain sound policies. In May 2007 the World Bank held an international workshop on these issues to help increase the impact of nutrition programs and policies at the country level. This paper summarizes the results of that workshop. Drawing from the political economy literature, it presents two frameworks for understanding how to undertake action to put nutrition on the agenda and move it forward, as well as insights on how and why political factors derail reforms and how to keep that from happening. These frameworks are accompanied by a discussion of the politics of nutrition policies, including typical obstacles to policy development and implementation, and possible solutions. To complement the political economy approach, the paper also draws on the insights that management and organizational fields offer regarding change promotion. Experiences from Senegal, Madagascar, Ghana, Tanzania, Benin, and India are discussed, sketching out the history of nutrition policies and the factors that promoted change, main obstacles and challenges. The paper closes with an attempt to encapsulate all elements presented in a single analytical framework, and provides plans of action for specific countries as prepared by some of the participants.Publication Republic of Mozambique : Evaluation of the Poverty Reduction Strategy Paper Process and Arrangements Under the Poverty Reduction and Growth Facility(Washington, DC, 2004-07-06)The International Monetary Fund (IMF) and the World Bank introduced the Poverty Reduction Strategy Paper (PRSP) process in 1999 to strengthen the poverty alleviation focus of their assistance to low-income countries. At the IMF, the introduction of the PRSP was accompanied by the transformation of the Enhanced Structural Adjustment Facility (ESAF), the concessional lending window, into the Poverty Reduction and Growth Facility (PRGF), with a view to giving a more central role to poverty reduction and pro-poor growth considerations in the design of IMF-supported programs in low-income countries. The rest of the report is organized as follows. Part two provides background information on poverty incidence in Mozambique, as well as on political and economic developments since the early 1990s. The relevance of the PRSP approach to Mozambique s situation, application of the underlying principles, and preliminary evidence on results, are examined in part three. The effectiveness of IMF assistance, including alignment of the PRGF and technical assistance to PRSP objectives is assessed in part four. Part five considers the effectiveness of World Bank support, also including alignment of that support to the objectives of the PRSP approach. Part six reviews IMF-World Bank collaboration in relation to the PRSP process, and part seven presents the main conclusions and lessons.Publication Nutrition Policy and Programs in Ghana(World Bank, Washington, DC, 2010-06)Although Sub-Saharan Africa has some of the worst nutrition indicators in the world, nutrition remains a low priority on the policy agendas of many African governments. This despite the fact that proven interventions are known and available and that investment in them is considered a cost-effective strategy for poverty reduction. This case study is one in a series seeking to understand (1) what keeps African governments from committing fully to reducing malnutrition, and (2) what is required for full commitment. It documents how the Ghanaian government has addressed the issue of malnutrition since Independence, examines what political and institutional factors have prevented full commitment, and identifies what conditions have moved the nutrition agenda forward at different points in time. The primary objective of this study as well as the series as a whole is to help African governments, development partners, and nutrition and health practitioners identify, understand and address the political and institutional obstacles preventing sustainable progress in nutrition.Publication Improving Effectiveness and Outcomes for the Poor in Health, Nutrition, and Population : An Evaluation of World Bank Group Support since 1997(Washington, DC: World Bank, 2009)This evaluation aims to inform the implementation of the most recent the World Bank and International Finance Corporation (IFC) health, nutrition, and population (HNP) strategies to enhance the effectiveness of future support. It covers the period since fiscal year 1997 and is based on desk reviews of the portfolio, background studies, and field visits. The evaluation of the HNP support of the World Bank focuses on the effectiveness of policy dialogue, analytic work, and lending at the country level, while that of IFC focuses on the performance of health investments and advisory services before and after its 2002 health strategy. The themes it covers are drawn from the two strategies and the approaches adopted by international donors in the past decade. Independent Evaluation Group (IEG) has previously evaluated several aspects of the Bank's HNP support. IFC's support for the health sector has never been fully evaluated. Many lessons have been learned over the past decade about the successes and pitfalls of support for health reform: First, the failure to assess fully the political economy of reform and to prepare a proactive plan to address it can considerably diminish prospects for success. Political risks, the interests of key stakeholders, and the risk of complexity- issues the evaluation case studies found to be critical are often neglected in risk analysis in project appraisal documents for health reform projects. Second, reforms based on careful prior analytic work hold a greater chance of success, but analytic work does not ensure success. Third, the sequencing of reforms can improve political feasibility, reduce complexity, ensure that adequate capacity is in place, and facilitate learning. When implementation is flagging, the Bank can help preserve reform momentum with complementary programmatic lending through the Ministry of Finance, as it did in Peru and the Kyrgyz Republic. Finally, monitoring and evaluation are critical in health reform projects-to demonstrate the impact of pilot reforms to garner political support, but also because many reforms cannot work without a well-functioning management information system.
Users also downloaded
Showing related downloaded files
Publication The World Bank Group in Tanzania, Fiscal Years 2012–22(Washington, DC: World Bank, 2025-07-22)This evaluation assesses the relevance and effectiveness of the World Bank Group's support to Tanzania between Fiscal Years 2012 and 2022. Over the past decade, Tanzania has experienced resilient growth, with an average annual per capita GDP increase of 2.2%. However, poverty remains widespread and slow to decline, underscoring the need for more inclusive growth. The report examines the Bank Group's strategic and operational approaches during this period, which were aligned with Tanzania's development priorities and focused on industrialization, human development, and public sector reforms. The evaluation includes thematic chapters on the Bank Group's support for private sector-led growth and spatial transformation, as well as lessons to inform future support to the country.Publication FY 2025 China Country Opinion Survey Report(Washington, DC: World Bank, 2025-08-04)The Country Opinion Survey in China assists the World Bank Group (WBG) in better understanding how stakeholders in China perceive the WBG. It provides the WBG with systematic feedback from national and local governments, multilateral/bilateral agencies, media, academia, the private sector, and civil society in China on 1) their views regarding the general environment in China; 2) their overall attitudes toward the WBG in China; 3) overall impressions of the WBG’s effectiveness and results, knowledge work and activities, and communication and information sharing in China; and 4) their perceptions of the WBG’s future role in China.Publication FY 2024 Seychelles Country Opinion Survey Report(Washington, DC: World Bank, 2025-01-27)The Country Opinion Survey in Seychelles assists the World Bank Group (WBG) in better understanding how stakeholders in Seychelles perceive the WBG. It provides the WBG with systematic feedback from national and local governments, multilateral and bilateral agencies, media, academia, the private sector, and civil society in Seychelles on: (1) their views regarding the general environment in Seychelles; (2) their overall attitudes toward the WBG in Seychelles; (3) overall impressions of the WBG’s effectiveness and results, knowledge work and activities, and communication and information sharing in Seychelles; and (4) their perceptions of the WBG’s future role in Seychelles.Publication Digital Africa(Washington, DC: World Bank, 2023-03-13)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 The World Bank Group in Georgia, 2014-23(Washington, DC: World Bank, 2025-07-30)This Country Program Evaluation assesses the performance and effectiveness of the World Bank Group’s support to Georgia in achieving the country’s development objectives. In the decade leading up to the evaluation period, Georgia pursued economic reforms to attract critical investments for becoming a regional trade and transport hub. Ambitious economic reforms went hand in hand with efforts to improve human development and strengthening social protection systems. Growing geopolitical tensions and internal political polarization have challenged Georgia’s reform progress in recent years. The Bank Group’s strategy adapted well to Georgia’s development needs and was well coordinated with other development partners. It successfully employed a range of instruments to help increase competitiveness, growth, and job creation, and effectively contributed to improved infrastructure and increased trade by using programmatic and innovative approaches. The Bank Group’s regular investments in analytical work and the switch to results-based programmatic support helped improve the efficiency and effectiveness of education and health care systems. The IEG offers the following lessons based on the evidence and analysis in the Country Program Evaluation: (i) Prioritizing Bank Group support around the move towards deeper regional integration was an effective anchor for key economic reforms for economic convergence. (ii) Pursuing a selective and adaptive approach in a country with high implementation capacity and institutions, strong coordination among development partners, and access to a wide range of external resources can allow the Bank Group to exercise significant influence in areas of comparative advantage and global expertise. (iii) A stronger focus on outcome-based programmatic approaches helped to build local capacity and crowd-in partner financing.