Towards the Next Horizon for Nutrition - Capacity Development

No one can deny that the Millennium Development Goals have focused the world’s attention on critical issues and have saved lives. But most of the successes have been unrelated or indirectly related to achievements in improving the nutritional status of the worlds’ most vulnerable—and improving nutrition is one of the most powerful ways to advance health and development. As global leaders move toward the Sustainable Development Goals, we need to invest in leadership and capacity development for improved nutrition.

In the forward to the 2014 MDG Report, Dr. Ban-Ki Moon writes “The likelihood of a child dying before age five has been nearly cut in half over the last two decades. That means that about 17,000 children are saved every day.” We celebrate this, but also have to ask the tough question: will those 17,000 children have better lives or will they become the one out of six children (roughly 100 million) in developing countries who are underweight, the one in four who are stunted or the 66 million primary school-age children who attend classes hungry?

We can give these children better lives. To do so, we need to deliver proven nutrition interventions—at scale. To scale up nutrition, there is an urgent need in the global health community for both capacity development and leadership development.

Scaling up nutrition requires a move away from efficacy and effectiveness testing and pilot programs and towards new leadership with the support of implementation (delivery) science. The challenge we now face is how to best deliver nutrition interventions within existing health systems or large-scale programs, where the delivery of an intervention is a complex web that involves many different disciplines and role players and the balancing of agendas and priorities. We now know that the ability to develop and then convert well-constructed plans into action at the programme implementation level is a critical success factor. To address this, a shift in thinking and working is required – and we need to broaden our horizons from efficacy research to implementation research.

We also need to rethink the concept of ‘capacity development.’ For some, capacity development is a useful umbrella term that provides a home for a number of often nebulous ‘needs.’ For others, capacity development, is about imparting ‘know-how’ (predominantly technical skills) to individuals and institutions. Often people create a checklist of skills that are considered necessary to develop a specific competency, and then emerges the necessary course/training program to develop those skills. As delegates complete the course, they are determined to have developed the capacity.

Yet it is our belief at Sight and Life that capacity development is and must be so much more. A neglected element of capacity development is leadership development. We need to develop leadership for change. It is transformational leadership where the leader creates successful teams. It is not developing the traditional manager-leader who leads the planning, organizing, directing and controlling of work activities. Rather, it is about the individual who can create an aligned commitment among a diverse group and unlock people’s potential so as to improve their performance and productivity towards achieving a united vision. In the words of the writer Lewis Lapham, “Leadership consists not in degrees of technique but in traits of character; it requires moral rather than athletic or intellectual effort.”

Developing strong leaders requires a large, sustained financial commitment over time. It involves a fundamental change in the way leadership is still viewed in many of the environments where we need to be making a difference. It means creating self-awareness, developing a new orientation, creating self-belief and then walking alongside these new leaders, mentoring and supporting them. Leadership development is not about a two-year grant or a short course. It does not have neat metrics for determining success. Perhaps that is why many avoid it.

The Africa Nutrition Leadership Programme (ANLP) is a great starting point for this revolution and has now trained and networked over 300 nutrition leaders from some 33 African countries, many of whom are making a significant difference leading from where they stand. However it is our view that the ANLP needs greater investment to grow to a new level. The time has come to be able to offer its thinking and training to a wider group, such as teams leading SUN in countries, as well as investing in on-going mentoring and follow-up support to further strengthen the capacity of the Alumni to continue to grow and take up the leadership of nutrition initiatives across the continent. But this is a long term invest that does not offer a quick or easy to measure return on investment. We need a brave sponsor to step up to the plate.

If we are to meet the challenges of scaling up nutrition and truly improving the lives of the world’s most vulnerable children, the time has come to take a fresh look at the concept of capacity and leadership development.