Patrick Webb1,2, Shibani Ghosh3, Robin Shrestha3, Grace Namirembe3, Sabi Gurung3, Diplav Sapkota3,4, Winnie Fay Bell3, Dale Davis4, Eileen Kennedy3, Shailes Neupane5, Swetha Manohar6, Kedar Baral2. 1. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA patrick.webb@tufts.edu. 2. Patan Academy of Health Sciences, Patan, Nepal. 3. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA. 4. Helen Keller International, Patan, Nepal. 5. Valley Research Group, Kathmandu, Nepal. 6. The Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Abstract
BACKGROUND: Global commitments to nutrition have supported calls for better evidence to support effective investments at national level. However, too little attention has so far been paid to the role of governance in achieving impacts. OBJECTIVE: This article explores the ways by which the commitment and capabilities of policy implementers affect collaborative efforts for achieving nutrition goals. METHODS: Over 1370 structured interviews were held with government and nongovernment officials over 3 years in 21 districts. Coded responses supported quantitative analysis of stakeholders' knowledge, attitudes, and practices regarding policy implementation. RESULTS: Stakeholder commitment was already high in 2013 when a new national policy was adopted, but capabilities were weak. Only one-third of interviewed respondents had any nutrition training. Rollout of training focusing on districts targeted for early implementation of multisector programming. This raised levels of nutrition training among interviewed respondents to 57% in 2015, which raised demand for technical information to support actions. Better understanding of the complexity of cross-sector work led to calls for higher budgets and more effective cross-sectoral collaboration. CONCLUSION: Nepal offers an example of effective efforts to improve nutrition governance across sectors at all levels of administration. The promotion of awareness, capacity, and new ways of working shows promise. Trainings, information sharing, and management support led to growing willingness among civil servants to engage across sectors. Structured surveys offer a viable way to track change across institutions and sectors.
BACKGROUND: Global commitments to nutrition have supported calls for better evidence to support effective investments at national level. However, too little attention has so far been paid to the role of governance in achieving impacts. OBJECTIVE: This article explores the ways by which the commitment and capabilities of policy implementers affect collaborative efforts for achieving nutrition goals. METHODS: Over 1370 structured interviews were held with government and nongovernment officials over 3 years in 21 districts. Coded responses supported quantitative analysis of stakeholders' knowledge, attitudes, and practices regarding policy implementation. RESULTS: Stakeholder commitment was already high in 2013 when a new national policy was adopted, but capabilities were weak. Only one-third of interviewed respondents had any nutrition training. Rollout of training focusing on districts targeted for early implementation of multisector programming. This raised levels of nutrition training among interviewed respondents to 57% in 2015, which raised demand for technical information to support actions. Better understanding of the complexity of cross-sector work led to calls for higher budgets and more effective cross-sectoral collaboration. CONCLUSION: Nepal offers an example of effective efforts to improve nutrition governance across sectors at all levels of administration. The promotion of awareness, capacity, and new ways of working shows promise. Trainings, information sharing, and management support led to growing willingness among civil servants to engage across sectors. Structured surveys offer a viable way to track change across institutions and sectors.
Authors: Grace Namirembe; Robin Shrestha; Patrick Webb; Robert Houser; Dale Davis; Kedar Baral; Julieta Mezzano; Shibani Ghosh Journal: Int J Health Policy Manag Date: 2022-03-01
Authors: Helen Schneider; Maria van der Merwe; Beauty Marutla; Joseph Cupido; Shuaib Kauchali Journal: Health Policy Plan Date: 2019-07-01 Impact factor: 3.344