What Can the United States Learn from the Scaling Up Nutrition (SUN) Movement?

Examining Country Leadership in Zambia, Kenya, and Bangladesh

Executive Summary

 

Country-led political and financial commitments to nutrition goals are widely recognized as critical to reducing malnutrition at scale. This report seeks to examine the relationship between country-level nutrition policy, implementation leadership, donor support and coordination, and nutrition outcomes at a national or subnational level. The analysis focuses on reducing the prevalence of stunting in countries targeted by the U.S. government global food and nutrition security initiative, Feed the Future. Drawing from progress of and lessons learned within the Scaling Up Nutrition (SUN) movement, it furnishes recommendations for Feed the Future to improve its engagement both with SUN and with broader country-level nutrition policies and aligned resources.

Drawing from emergent scientific evidence of both malnutrition’s social and economic burden and also the documented high returns on nutrition investments, the SUN movement was launched in 2010. From the outset, SUN focused on the harmful impacts of the global stunting burden and on interventions within the critical 1,000-day window from conception to a child’s second birthday. SUN now works in 59 countries to support nationally led strategies to combat malnutrition in a systematic way that accounts for its underlying causes. SUN promotes a multisectoral approach that engages multiple ministries or agencies as likely the most effective and comprehensive strategy to address undernutrition at scale.

During its first phase (2012–2015), the SUN movement sought to create an enabling environment for nutrition by uniting multiple sectors and stakeholders at the country level, with an emphasis on advocacy, partnership promotion, and unified nutrition commitments. The second phase (2016–2020) builds upon this foundation to demonstrate progress in investments and implementation that lead to measurable results.

The United States has a laudable history of tackling global malnutrition and has long been the largest nutrition donor in the world. Between Fiscal Years 2010 and 2016, the U.S. Congress provided nearly $1.5 billion for nutrition-specific activities; funding in 2016 was estimated at $229 million. The reduction of stunting prevalence is one of Feed the Future’s two highest-level goals and 18 of the initiative’s 19 focus countries are also members of the SUN movement. The first ever U.S. Global Food Security Strategy, submitted to Congress in October 2016, includes improved nutrition as one of three primary objectives. USAID has contributed to the SUN movement since its inception and acts as a coconvenor of donor networks at the national level in eight countries.

This report seeks to understand whether select countries that have more fully embraced and championed the SUN strategy have also witnessed greater progress in mounting a scalable and effective response to malnutrition. It explores whether multilateral coinvestments in nutrition policy and planning, in line with SUN aims and objectives, translate into change on the ground that sustains local ownership and leadership.

The discussion is presented in five chapters. Chapter 1 considers nutrition investments following the launch of the SUN movement in terms of policy and leadership, financial commitments, and improved data management. Chapter 2 examines the translation of these investments into multisectoral implementation through national systems, and investigates current evidence of impact. Chapter 3 provides an overview of the role of Feed the Future and its engagement with SUN, including profiles of its work in Bangladesh and Kenya. Chapter 4 presents a detailed case study that examines nutrition investments in Zambia and their subsequent impacts. Conclusions of the comparative analysis are summarized in Chapter 5.

The report suggests the following recommendations to the U.S. government:

At a global level:

  • Share Feed the Future country-level financial data with the SUN movement financial tracking system.
  • Improve communication of nutrition-sensitive technical expertise in agriculture and in private-sector engagement across donor networks, partner governments, and to the public. Collaborate with other stakeholders to better define what nutrition-sensitive interventions encompass and how their impacts are measured.
  • Approach participation within SUN working groups in a systematic way, with particular attention to the SUN business network given the U.S. government’s comparative advantages in private-sector partnerships.
  • Refocus attention on nutrition within Feed the Future portfolios. Ensure that activities are sufficiently tailored to translate into improved nutrition outcomes at scale.

At a national level with partner countries:

  • Work proactively to break down the stereotype of the U.S. Agency for International Development’s (USAID) disengagement from national government policies and the donor community.
  • Support systems that advance country-level leadership in high-level nutrition research and policy analysis to sustain political engagement and momentum for nutrition. The International Food Policy Research Institute (IFPRI) has led this type of work in countries such as Bangladesh, where it has embedded evaluation capacity within government ministries.
  • Consider reinforcing national data platforms and local analytical capacity. Centralized data systems support multiple actors to monitor nutrition and to trace causal pathways that reduce stunting. They simultaneously build local ownership and reduce redundancies. Move beyond a focus on data collection to target deficits that undermine the potential of data-driven decisionmaking.

Project Director

Rebecca Brown

Partner, NutritionWorks

Tamsin Walters

Partner, NutritionWorks

Jane Keylock

Partner, NutritionWorks