Scaling up Nutrition by Investing in our Nutrition Workforce

The development community is by now well aware that good nutrition is the bedrock of human well-being. In the critical window between conception and a child’s second birthday, good nutrition enables optimal brain and immune system development and functioning, which saves lives and equips a child to grow, thrive and reach his or her full potential. As the impact of nutrition is so far-reaching, achieving many of the Sustainable Development Goals will require scaling up proven nutrition interventions. This is where the challenge comes.

While we have broad agreement on the interventions, and commitments at the highest political levels, we are struggling with implementation—especially at the district level, where it counts most.

A recent article in Advances in Nutrition highlights the fact that capacity continues to be a serious limiting factor to scaling up the coverage, adherence, impact and sustainability of nutrition programs. Despite some progress, efforts to alleviate malnutrition in all its forms are hampered by a shortage not just in sheer numbers, but also in the skills and leadership capacity of our nutrition workforce. High-quality, appropriate training for front-line nutrition workers, program managers and even policy makers is often lacking. Also missing is enough effective leadership and advocacy skills training to make development efforts more nutrition-sensitive and skilled to deliver nutrition interventions at scale.

Today’s nutrition professionals need a complex set of technical and leadership skills required to both work in multisectoral teams and to address the multiple malnutrition burdens now faced by nearly half of all countries—such as when both stunting and obesity are found in the same household, or even experienced by the same individual.

And because nutrition outcomes depend on multiple sectors, leadership development needs to happen within multisectoral district teams, so that they have an aligned commitment when programs start and scale up. Nutrition professionals need to be fluent in discussing the concepts and constructs of other disciplines—such as agriculture, social protection and sanitation—and be able to advocate for the recognition of the importance of and need for nutrition to be included in a wide range of interventions and investments. We must effectively engage with both decision makers and implementers in these other sectors and seize opportunities to influence a wide range of policies and programs. It is up to the nutrition community to lead this effort.

Without investing in the capacities of people and systems, delivering nutrition at scale cannot happen.

What is leadership capacity development in nutrition? It’s the process through which individuals—and by extension the organizations they work for and the communities they live in—gain the orientations, knowledge, attitudes, skills and other capabilities needed to run scaled, effective, sustainable nutrition programs.

Being an effective leader is a learned behavior that is continually improved. This means that developing leadership capacity requires intensive and sustained interaction with the individuals involved. It is not a quick fix or a one-off training. It is hard work, and it takes meaningful financial investment. It has to happen.

We urgently need to build transformational leadership capacity where those most in need of interventions live and work—where program implementation takes place.

And it can be done. Scaling Up Nutrition Leadership in Africa (SUNLEAD AFRICA), the African Nutrition Leadership Program (ANLP) and UNICEF recently completed a successful pilot project aimed at building leadership capacity for effective multisectoral nutrition program implementation in the SUN countries Rwanda and Uganda. A series of workshops in the two countries, which took place over a period of four months and involved 45 individuals from diverse disciplines working at the district level to implement interventions, resulted in valuable learnings and aligned commitment to concrete action plans.

Highlights include:

• Participants came away with the important understanding that individual growth and development is linked to improved change leadership and therefore to effective program implementation.
• District teams established their individual critical success factors for scaling up nutrition, developed action plans to improve their teams’ functionality and identified limitations of existing activity-based program implementation strategies. It is clear that a one-size-fits-all approach, which is currently common, is not the solution—investments have to be tailored to be context-specific right down to the district level.
• Districts committed to monitoring their plans continuously and to eventually performing impact evaluations as part of their implementation strategies.
• Teams created basic plans for sustained growth and development at the individual and team levels.

Workshops like this—as part of a larger, sustained, well-financed push to increase leadership capacity in nutrition across sectors—will ultimately make a real difference in people’s lives. More people with the knowledge and skills to run more effective nutrition programs will mean a pregnant woman is able to receive the multiple micronutrient supplements she needs for a healthy baby. It will mean agriculture programs teach farmers not only how to better grow food, but also how to better prepare nutritious meals. It will mean a village has clean water to help prevent illnesses that rob residents of nutrients.

This is the future we envision—a world free from malnutrition. We have the knowledge and a good start on the financial commitments to get us there. What we’re missing is the empowered nutrition workforce. But by building truly transformational leadership capacity in the people who implement lifesaving nutrition programs, we can achieve our vision.

Authors:

Klaus Kraemer is the Director of Sight and Life.

Jessica Fanzo is the Bloomberg Distinguished Associate Professor of Ethics and Global Food and Agriculture at Johns Hopkins University and a member of the GNR Independent Expert Group.

Johann Jerling is the Director of the Centre of Excellence for Nutrition at North-West University in Potchefstroom in South Africa.