Chapter 01

The first global accountability framework for nutrition

Image by ©UNICEF Ethiopia/2014/Nesbitt

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Authors

Dr Renata Micha (lead author), Dimitra Karageorgou (supporting author)

Chapter 1 of 7
Contents
1.1 Share section

Key findings

  1. The Nutrition Year of Action spotlighted the urgent need for more action whilst ensuring that all stakeholders are held accountable for their commitments. Long-standing challenges with accountability have hampered progress, namely: accountability not built into commitments and streamlined across stakeholders; no central public platform for registering nutrition commitments and reporting on progress; no consistent way to characterise the type of nutrition commitments; and no clear criteria for SMART commitment-making and assessment.
  2. The Nutrition Accountability Framework (NAF) was launched by the GNR in September 2021 to strengthen accountability, building on work and learnings to date. The NAF is the world’s first global public platform for committing to and monitoring nutrition action, using comprehensive and transparent approaches. The NAF was endorsed by stakeholders and served as the official accountability mechanism for the Tokyo Nutrition for Growth (N4G) Summit, requiring that all N4G commitments are recorded through the NAF.
  3. The NAF cycle includes formulating and registering commitments in the NAF Platform, reporting on progress annually, and planning and taking further action when and where needed. The NAF helps to inform, shape and inspire strong commitments for nutrition through transparent, trusted and accessible sharing of data, evidence, tools and best practice. The GNR assesses commitments monthly and then publicly shares them through the interactive NAF Commitment Tracker.
  4. The GNR developed the standardised Nutrition Action Classification System to name, define and classify nutrition actions into action categories and sub-categories. Action categories are enabling, policy and impact, each broken down into four distinct sub-categories. The classification system maps nutrition commitments, thereby helping to identify the type of actions taken and gaps in action, and to inform, shape and inspire new action.
  5. The GNR developed the Nutrition Action SMARTness Index, which assesses and ranks the SMARTness of commitments into four levels: high, upper moderate, lower moderate, and low. The NAF Platform user sign up and registration forms include standardised data fields to enable the formulation of SMART commitments. Stakeholders are encouraged to work with the GNR to improve the SMARTness of their existing commitments, and they are invited to make new SMART ones.

If you would like to know more about any of the terms used in this chapter, you can visit the report glossary.

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Introduction

Poor diets and malnutrition in all its forms are among the greatest global societal challenges of our time,[1] requiring urgent and monitored action by stakeholders. The GNR created the Nutrition Accountability Framework (NAF) in the Nutrition Year of Action to strengthen stakeholder accountability. The NAF serves as the official accountability mechanism for Nutrition for Growth (N4G) commitments[2] and aspires to become the primary global public resource for monitoring nutrition action.

Recognising the need to tackle poor diets and malnutrition through more action and strengthened accountability, national governments and multilateral organisations have endorsed 2021 as the Nutrition Year of Action.[3] It was initiated in December 2020 by the Governments of Canada and Bangladesh, in partnership with the Government of Japan,[4] and was successfully concluded in December 2021 with the Tokyo N4G Summit. The NAF was launched by the GNR in September 2021 to ensure that all commitments are SMART (Specific, Measurable, Achievable, Relevant, Time-Bound) and can be accounted for. The framework builds on the GNR’s existing tools and expertise and further draws on elements from other accountability frameworks.[5] It is the world’s first independent and comprehensive accountability framework for nutrition action. The NAF comes with a wealth of standards and guidance to inform and inspire strong commitments for nutrition that result in greater progress in advancing nutrition globally and strengthened accountability.

This chapter introduces the NAF and the critical gap it fills to strengthen and drive accountability for nutrition.

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The need for strengthened global nutrition accountability

The world is faced with a global nutrition crisis that pre-dates the Covid-19 pandemic and was exacerbated because of it. Before the pandemic, one in seven premature deaths was attributable to child and maternal malnutrition and diet-related non-communicable diseases (NCDs), with most of this burden in low and middle-income countries.[6] This double burden of malnutrition – the coexistence of undernutrition[7] and diet-related NCDs – is the leading cause of poor health in the world.[8] With the worsening impacts of poor diets and climate change,[9] the need for more equitable, resilient and sustainable health and food systems has never been more urgent. The current nutrition challenges faced by countries worldwide, which continue to be stressed by Covid-19, are expected to worsen even further as the war in Ukraine has driven up food and fuel prices, with a large impact on food and nutrition security globally.[10] Countries faced with food and nutrition insecurity, and the most vulnerable, are threatened the most.

To address the global nutrition crisis, the 2020 GNR has called for stakeholders – including governments, businesses and civil society organisations (CSOs) – to step up their efforts and be accountable for their pledges.[11] The increased recognition that these stakeholders are accountable for people’s food and nutrition has been emphasised throughout the Nutrition Year of Action. National governments, multilateral organisations and the G7 leaders urged for more action and strengthened accountability,[12] which is critical to meeting the Sustainable Development Goals and the global nutrition targets set out by the World Health Assembly.[13] These were deemed even more urgent in light of Covid-19, which made evident the centrality of nutrition in building resilience[14] but at the same time de-prioritised nutrition in the policy agenda and hindered progress. In fact, GNR tracking of past N4G commitments revealed that the pandemic severely affected 43% of country goals; the main reason why it hindered progress was the lack of funding due to diversion of national revenue and resources towards Covid-19 mitigation.[15]

Furthermore, challenges in approaching accountability have hampered progress. GNR has identified the following challenges in tracking progress of past N4G commitments (i.e. 2013 and 2017 N4G summits), each informed by work and learnings to date.

  1. Accountability was not built into nutrition pledges. Accountability was not an inextricable part of previous pledging moments, with no formal registration and tracking process in place.[16] This meant that stakeholders were accountable at their own discretion, without motivation to report on their pledges, which contributed to low response rates in past N4G reporting.[17]
  2. There was no central public platform for commitment registration, whether part of or outside key pledging moments. This limited the ability to comprehensively capture and track any commitment made. This, to some extent, led to commitments being perceived as more relevant to certain stakeholder groups, for example donors making financial pledges or lower-income governments committing to address undernutrition at high-profile summits with their own focus.
  3. It was difficult to accurately map the type of action taken. Commitments were not comprehensively grouped into action categories, therefore not allowing for detailed assessment of the type of action taken and identification of gaps to inform priority setting. Four commitment types were previously used (‘financial’, ‘policy’, ‘programmatic’ and ‘impact’)[18] based on self-reporting, but the lack of a comprehensive classification system led to reporting errors.
  4. There were no clear criteria for SMART commitments. Although the need for SMART commitments has long been recognised, clear criteria for assessing the SMARTness of nutrition commitments have been missing. SMART commitments were encouraged but there was no guidance to support their formulation, assessment and tracking or overcome vague, repackaged or not trackable pledges. This limited assessment across commitments and the sharing of practical advice as to how they can be improved.
  5. There was no consistent approach to assessing progress, for example to identify variations between stakeholder groups (e.g. countries versus businesses) and action categories (e.g. policy versus impact). Despite GNR efforts to standardise progress reporting for past N4G commitments,[19] challenges in commitment formulation and limited information being made available precluded in-depth assessment of progress.
  6. Accountability was not streamlined across stakeholders, as there was no promotion and use of a unified approach in the registration, assessment and reporting of nutrition commitments made. As such, accountability for nutrition commitments was not potentially seen as relevant or beneficial for all.

Each of these challenges presented stakeholders, the nutrition community and GNR with opportunities to step up and strengthen accountability for nutrition. With the momentum generated by key nutrition events throughout 2021, and a climate of urgency, there were unprecedented opportunities to galvanise stakeholders in making new and strengthened commitments and establishing a global framework that allowed commitments to be SMART and trackable (see Box 1.1).

The NAF, developed by the GNR, seeks to address each of the above challenges and provide an independent and robust accountability platform to monitor nutrition actions based on common principles, standards and methods.

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Box 1.1 The creation of the NAF and its contribution to the success of the Tokyo N4G Summit

Authors: Dimitra Karageorgou, Charlotte Martineau and Dr Renata Micha

The need to strengthen accountability was reiterated ahead of the 2021 Tokyo N4G Summit by the GNR and the N4G accountability working group convened by the Government of Japan (the summit organiser).[20] Building on efforts and recommendations to date, the Government of Japan led the way in bringing accountability to the forefront of the Tokyo N4G Summit. They called for commitments to be SMART and impactful, and promoted data-driven accountability as a cross-cutting theme. The Government of Japan worked closely with the GNR and named the NAF the comprehensive and transparent accountability mechanism for the Tokyo N4G Summit, requiring that all N4G commitments are registered through the NAF and reported on annually.[21] The NAF has since been endorsed[22] by major stakeholders, such as the World Health Organization, the Scaling Up Nutrition (SUN) Movement, Save the Children, the Government of Canada and the United States Agency for International Development (USAID).

Throughout 2021 the GNR promoted stronger accountability by developing and publicly sharing relevant resources online and actively engaging with commitment-makers.[23] A registration process that supports SMART commitments was put in place (see How the GNR assesses the SMARTness of commitments), requiring N4G commitments to be registered and tracked – a major step forward from past N4G summits. Moreover, the GNR developed the NAF Commitment Tracker, through which the general public and all stakeholders can publicly access and explore commitments made.

Overall, the Tokyo N4G Summit led 191 stakeholders to register 416 commitments with 859 goals (Figure 1.1); of these, 20 commitments with 50 goals were registered after the Compact was published.[24] Stakeholder engagement led to US$42.6 billion[25] being committed to; of this, US$40.7 billion was committed to up until the Compact and US$2.6 billion was committed to between the Compact and the 15 March 2022 (see Chapter 2 for more data on commitments made, including findings on SMARTness).[26] Looking at past N4G summits, in 2013 108 stakeholders pledged 357 commitments with 416 goals, securing up to US$22.9 billion to tackle undernutrition. In 2017, 18 stakeholders made 34 commitments with 40 goals and committed US$5.3 billion. Overall, in 2013 over two-thirds of goals were made by governments (168, 40%) and the private sector (127, 31%), whereas in 2021 governments made half of the goals (459, 53%), followed by CSOs (197, 23%).

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Figure 1.1 At the 2021 Tokyo N4G Summit stakeholders registered 859 commitment goals through the NAF

Commitment goals made at the Nutrition for Growth summits by stakeholder type

Figure 1.1 At the 2021 Tokyo N4G Summit stakeholders registered 859 commitment goals through the NAF
Commitment goals made at the Nutrition for Growth summits by stakeholder type
N4G
Summit 		Governments Civil Society Private Sector Donors International
organisations 		Academia Other Total
Tokyo, 2021 459 197 92 59 34 18 0 859
Milan, 2017 20 2 7 11 0 0 0 40
London, 2013 168 41 127 44 28 0 8 416

Source: Global Nutrition Report: Nutrition for Growth Commitment Tracker. Bristol, UK: Development Initiatives. https://globalnutritionreport.org/resources/nutrition-growth-commitment-tracking. Accessed on 15 November 2022.

Notes: The figure shows the absolute numbers of commitment goals registered by stakeholder type across the N4G summits. Academia is a stakeholder type that was added in 2021 as part of the NAF and for the Tokyo summit. In all three summits, international organisations included only UN agencies. The NAF introduced a formal registration process for the Tokyo summit that included standardised data fields for each commitment and its goals. The total amounts committed to are derived from financial commitment goals, and do not differentiate between nutrition-specific and nutrition-sensitive financing. Amounts were not reported for all financial goals, and as such total amounts reported may underestimate the full magnitude of financial investments.

The NAF provides a unique structure to measure the extent of stakeholder mobilisation and provide data-driven accountability for pledges made.

“The NAF contributed to the success of the Tokyo N4G Summit 2021 by supporting stakeholders to make SMART nutrition commitments. The NAF has fostered significant international momentum with the active participation of a wide range of parties.” – Takeshi Akahori, Government of Japan

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How the NAF strengthens accountability

A fundamental principle of the NAF is transparency in all developed processes, data and findings.[27] Transparency builds trust by allowing stakeholders and the public to understand how the framework works and the extent to which stakeholders are addressing nutrition issues. This principle further creates a continuous learning process that enables stakeholders to identify, refine and steer priority nutrition actions to address changing needs at national, regional and global levels.

The NAF was designed to address, over time, each of the six critical challenges identified as barriers to accountability. Specifically, the NAF:

  1. Provides an infrastructure for building accountability into nutrition pledges. The NAF allows nutrition commitments made as part of any pledging moment to be accounted for and tracked over time. In the case of the 2021 Tokyo N4G Summit, all commitments linked to this event were required to be registered through the NAF to ensure standardised and built-in accountability. Similarly, the NAF can be used for any other nutrition pledging moment.
  2. Provides a central platform for registering and sharing nutrition commitments. The NAF Platform allows a user (stakeholder) to sign up and register nutrition commitments, using evidence-based tools and guidance (see How the NAF works), at any time whether or not linked to key pledging moments.[28] The GNR assesses all commitments on a monthly basis and publicly shares them through the interactive NAF Commitment Tracker. The NAF does not replace existing country-level data and reporting systems; yet, it is the go-to place for exploring nutrition commitments made worldwide and their progress, success stories and lessons learned across different contexts.
  3. Identifies and characterises types of nutrition commitments. The GNR uses the Nutrition Action Classification System (see How the GNR maps nutrition actions) to name, define and classify nutrition actions into standardised categories and sub-categories. This system overcomes potential challenges and errors in self-reporting, provides a concrete basis for reporting and analysis by type of action, and enables gaps in action to be identified. The NAF does not prescribe nutrition actions to be taken or assess if nutrition actions are evidence based or align with national priorities.
  4. Assesses the SMARTness of nutrition commitments. The GNR established principles, clear criteria and rigorous methods for evaluating the SMARTness of nutrition commitments.[29] The NAF Platform sign up and commitment registration forms include standardised data fields, based on the SMART criteria, that enable the formulation of SMART commitments.[30] The GNR takes the information provided and assesses and quantifies the SMARTness of the commitments using the Nutrition Action SMARTness Index, which ranks commitments into four levels of SMARTness (see How the GNR assesses the SMARTness of commitments). The GNR, through verifying the self-reported data with stakeholders (not validating this against other sources), aims to help stakeholders to improve the SMARTness of their commitments.[31]
  5. Provides a central platform for reporting progress towards meeting commitments. Work is underway to expand the platform to facilitate stakeholders reporting annually on progress made. Stakeholders will be expected to report against indicators deemed essential to ensure trackability of commitments (see How the GNR assesses the SMARTness of commitments). As such, the NAF Platform will be expanded to include the commitment progress form (early 2023), which will support reporting on progress and its assessment.
  6. Streamlines transparent nutrition accountability across stakeholders. The NAF promotes a shared culture of accountability[32] across stakeholders to ensure commitments are more than promises, and that they translate into impact. The unified approach to commitment registration, assessment, progress reporting and dissemination enables stakeholders to make SMART, publicly shared commitments to improve nutrition. All developed methods, materials, self-reported commitment data,[33] progress made and findings of any analysis performed are made publicly available. Although the NAF does not directly advocate for nutrition action with specific stakeholders or build their capacity, this level of transparency increases general understanding of accountability, while the rigorous NAF methods can be leveraged to support data-driven accountability for any nutrition pledge made worldwide.
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How the NAF works

Who can register commitments in the NAF

The NAF aims to attract commitments from all stakeholders worldwide with an interest and capacity to commit to nutrition action, including governments, CSOs, international organisations, philanthropies, the private sector and academia (Figure 1.2). Any stakeholder can be considered a ‘donor’ if they commit to actions outside their own national boundaries, entity or workforce, for example a government supporting another country financially or non-financially.

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Figure 1.2 Stakeholders can register their nutrition commitments through the NAF at any time

Stakeholders that can register commitments to the NAF

Figure 1.2 Stakeholders can register their nutrition commitments through the NAF at any time

Graphic outlines different categories of stakeholder that can be considered make commitments to the NAF. This includes governments, philanthropies, international organisations, civil society, private sector actors and academia. Any stakeholder can be considered a Donor if they commit to actions outside their own national boundaries. These definitions are further elaborated in the glossary.

Notes: For a detailed description of stakeholder types please see the Glossary.

The report presents findings across each of the above stakeholder groups: governments (Chapter 3), CSOs (Chapter 4), private sector (Chapter 5), donors (Chapter 6) and international organisations (Chapter 7).[34]Academia is discussed in Chapter 2 (Box 2.1).

Which commitments are included in the NAF

The GNR has developed eligibility criteria to determine which commitments can be included in the NAF. These criteria reflect the NAF principles of independence, collaboration, excellence, accessibility, integrity, transparency, inclusivity, recognition and commitment.[35] They ensure that the NAF collects and reports on standardised granular data (see commitment data cleaning and standardisation) that has been derived independently using rigorous methods.[36] The eligibility criteria applied to all commitments registered are:

  1. Commitments are registered in the NAF Platform to ensure these are assessed and reported on with standardised approaches. As such, commitments sent as pdf, email text or presented in summits are excluded.[37] The forms used are designed to support the formulation of SMART commitments[38] and their tracking (see How the GNR assesses the SMARTness of commitments). Commitments are not excluded based on their SMARTness; they are assessed so that stakeholders can improve their ranking.
  2. Pledges represent commitments. The NAF accepts only commitments, defined as pledges that are explicitly expressed written statements including both the intention to act and the commitment to a certain measurable deliverable.[39]
  3. Commitments are related to improving nutrition. The NAF accepts only commitments that are nutrition related, according to the Nutrition Action Classification System (see How the GNR maps nutrition actions).[40] Commitments should improve nutrition and not go against the shared vision of ending malnutrition in all its forms, or do harm.[41]
  4. Commitments are new. Only new commitments are accepted.[42]
  5. Stakeholders commit to report on progress towards commitments, fully and publicly on an annual basis through the NAF Platform.
  6. Commitments are reported in English, because both the registration form and the commitment verification process are currently supported only in English.[43]
  7. Commitments are included whether or not they are linked to a pledging moment, ensuring that all commitments registered receive equal visibility.

The following eligibility criteria were additionally applied for N4G commitments:[44]

  1. Commitments are linked to the N4G summit (the Tokyo summit for the present report), as indicated by stakeholders.
  2. Commitments align with national priorities. This is based on self-reporting and not validated.
  3. Commitments align with the N4G Principles of Engagement.[45] Of those self-reported principles, compliance of breast milk substitute (BMS) manufacturers with the International Code for BMS marketing was verified by the Access to Nutrition Initiative (ATNI)[46] on behalf of the summit organisers.[47]

All eligible commitments are publicly shared through the NAF Commitment Tracker. Commitments initially deemed as ineligible are not published in the tracker, until the GNR contacts stakeholders to verify the information submitted.

The NAF virtuous cycle of accountability and action

The full NAF cycle is summarised in Figure 1.3. It includes eight steps involving the active engagement of stakeholders (orange boxes) with the GNR (blue boxes).

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Figure 1.3 The NAF informs, shares knowledge and builds trust and collaboration among stakeholders, inspiring more action

The NAF virtuous cycle of accountability and action

Figure 1.3 The NAF informs, shares knowledge and builds trust and collaboration among stakeholders, inspiring more action

Graphic depicts the NAF cycle with eight steps, half performed by stakeholders, half by the GNR. These include two steps where information is verified by the GNR. The clockwise cycle: develop commitments (stakeholder action); register commitments (stakeholder action); review commitments (GNR action); publish commitments (GNR actions, involving GNR verification of information); report on progress (stakeholder action); review progress (GNR action); publish progress (GNR action, involving GNR verification of information); make more commitments (stakeholder action).

Notes: This graphic summarises the collaborative cycle of the NAF, from developing and registering nutrition commitments to reporting on progress and taking more action. Orange steps are those taken by stakeholders, and blue steps are taken by the GNR. All commitments, after being assessed for eligibility, are assigned to standardised action categories (Nutrition Action Classification System) and SMARTness Index levels (Nutrition Action SMARTness Index) and publicly shared through the NAF Commitment Tracker. ‘SMART’ refers to Specific, Measurable, Achievable, Relevant and Time-bound commitments.

  1. Stakeholders develop commitments. The NAF cycle starts with the stakeholders developing nutrition commitments using the NAF supporting guidance[48] on the formulation of SMART commitments.
  2. Stakeholders register commitments. Stakeholders sign up to the NAF Platform and sign in to register their commitments, at any time and irrespective of whether these are linked to a pledging event, using the online forms that support SMART reporting.
  3. The GNR reviews registered commitments. The GNR reviews on a monthly basis all newly registered commitments for eligibility (see How the NAF works), which are subsequently assigned to nutrition action categories using the Nutrition Action Classification System (see How the GNR maps nutrition actions) and assigned to SMARTness Ievels using the Nutrition Action SMARTness Index (see How the GNR assesses the SMARTness of commitments).
  4. The GNR publishes eligible commitments. All eligible commitments are published in English[49] through the NAF Commitment Tracker.[50] The tracker allows for individual commitments to be searchable against a range of criteria and is updated monthly as commitments are being verified and/or new ones are added.[51] At the same time, through the newly introduced verification process, the GNR contacts stakeholders to clarify inconsistencies and retrieve missing data; commitments are re-assessed (per previous step) as clarifications are received. The verification process aims to improve the SMARTness of the commitments, ensure that the reported information is accurately recorded and derive a fully standardised and complete dataset.[52]
  5. Stakeholders report on progress. Stakeholders use the NAF Platform and the commitment progress form to report on an annual basis progress made towards their commitments (starting in 2023).
  6. The GNR reviews progress made. The GNR reviews the reported progress and assesses it through standardised criteria, developed and published as part of the progress assessment methods. Reported data on progress are similarly verified to ensure these are as complete and accurate as possible.
  7. The GNR publishes progress. The GNR publishes the reported progress through the NAF Commitment Tracker, celebrating success and identifying gaps in action. Achievements, based on transparent selection criteria (to be developed), and best practices will be shared online or as case studies in press releases and future GNR publications. Stakeholders receive recognition for making progress and gain knowledge on how to further improve their commitments, potential gaps in action, as well as priorities that could be considered.
  8. Stakeholders take more action. The NAF cycle closes with stakeholders learning from published data, evidence and guidance, further strengthening existing commitments and making new ones.

The NAF is expected to evolve as more commitments are registered, leading over time to strengthened tools and processes. Lessons learnt, both in the implementation of the NAF and engagement with stakeholders, will continue to inform this evolving and dynamic global framework.

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How the GNR maps nutrition actions

The Nutrition Action Classification System was developed by the GNR in 2021 as part of the NAF. It provides the basis for efficient tracking and reporting of nutrition commitments and their goals across three action categories each broken down into four subcategories, thereby enabling analysis of where actions are focused and where more commitments might be needed (Figure 1.4).

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Figure 1.4 A system to comprehensively name, define and classify nutrition actions

The Nutrition Action Classification System

Figure 1.4 A system to comprehensively name, define and classify nutrition actions

Graphic answers questions relating to the Nutrition Action Classification System, a classification system developed by the GNR to map nutrition action. It identifies the type of nutrition action in a consistent and standardised manner by classifying nutrition actions into three categories (enabling, policy, impact). Each is further divided into four sub-categories. It clearly defines nutrition action types and allows for consistent reporting, enabling informed priority setting.

Note: The Nutrition Action Classification System was developed by the GNR as part of the NAF and is available online.

The Nutrition Action Classification System names, defines and classifies nutrition actions based on common principles and shared characteristics. The system is used to assign nutrition actions under three mutually exclusive categories: enabling, policy and impact (Figure 1.5). Each of these categories is further divided into four action sub-categories.[53]

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Figure 1.5 The system classifies nutrition actions into standardised categories and sub-categories

Structure of the Nutrition Action Classification System

Figure 1.5 The system classifies nutrition actions into standardised categories and sub-categories

• Stakeholders register their commitment(s) • Each commitment may have one or more goals • The GNR categorises each goal into one of three action categories, and then into an action sub-category o Enabling actions, which aim to establish an enabling environment for nutrition  Sub-categories: leadership and governance; financial; operational; research, monitoring and data. o Policy actions, which aim to implement nutrition strategies, policies, interventions or programmes  Sub-categories: food supply chain; food environment; consumer knowledge; nutrition care services. o Impact actions, which aim to achieve improved nutrition outcomes in the population  Sub-categories: diet; food and nutrition security; undernutrition; obesity and diet-related NCDs.

Notes: The assignment of the goals into action categories and sub-categories is performed independently by the GNR based on self-reported data. For a complete description of each of the action categories and sub-categories, including examples of relevant actions, please see the Nutrition Action Classification System.

The GNR classifies goals based on self-reported data, mainly informed by the goal description. Commitments can have multiple goals of different action categories (Figure 1.6). Through this process, non-nutrition-related goals are also identified (see How the NAF works).

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Figure 1.6 One commitment may have multiple goals spanning multiple categories of action

How the Nutrition Action Classification System is used to identify nutrition actions

Figure 1.6 One commitment may have multiple goals spanning multiple categories of action

Example: • A government registers a commitment entitled ‘Improve childhood malnutrition’ • This commitment has three goals o Goal 1: Form a multisectoral body for the regulation of breastmilk substitutes marketing by the end of 2023  Action category: enabling • Action sub-category: financial o Goal 2: Implement legislation on breastmilk substitutes marketing by 2025  Action category: policy • Action sub-category: food environment o Goal 3: Increase exclusive breastfeeding for the first 6 months from 15% in 2022 to 25% in 2030  Action category: impact • Action sub-category: undernutrition

Notes: The assignment of the goals into action categories and sub-categories is performed independently by the GNR based on self-reported data. For a complete description of each of the action categories and sub-categories, including examples of relevant actions, please see Nutrition Action Classification System.

The classification system maps commitments and their goals and helps to inform gaps in action and priority setting. The current iteration of the classification system does not include guidance to stakeholders on which actions to develop and prioritise. However, when considering priorities specific to their context, stakeholders can use the classification system to identify possible nutrition actions that can be considered to improve the nutrition situation and current state of the food and health systems. Over time, the classification system will allow the GNR identify gaps in action and provide evidence-based recommendations for action.

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How the GNR assesses the SMARTness of commitments

The Nutrition Action SMARTness Index is a ranking system that assesses and reports on the SMARTness of nutrition commitments. It was developed by the GNR in 2022 as part of the NAF (Figure 1.7). It is based on a comprehensive methodology that assesses and quantifies the SMARTness of commitments and their goals and addresses past challenges (see The need for strengthened global nutrition accountability) by providing clear criteria for SMART commitment-making.

Findings are publicly reported on the NAF Commitment Tracker, so the SMARTness Index encourages better performance as stakeholders can learn how to improve their assessment. Using NAF resources and guidance on SMART formulation and registration, and through the verification process, stakeholders can improve the formulation of their existing and future commitments. At the same time, the GNR uses the SMARTness assessment results to identify ways to improve and refine the online forms and accompanying guidance.

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Figure 1.7 An index to assess and report on the SMARTness of nutrition actions

The Nutrition Action SMARTness Index

Figure 1.7 An index to assess and report on the SMARTness of nutrition actions

Graphic answers questions about the SMARTness index, a ranking system developed by the GNR to assess and report on the SMARTness of nutrition act in a consistent and standardised manner. The index ranks nutrition actions into four levels of SMARTness – high, upper moderate, lower moderate and low – by taking into account three performance criteria: SMARTness score, trackability and completeness. It allows for consistent reporting of the SMARTness of nutrition actions and provides practical guidance for stakeholders to improve the formulation of existing and future commitments.

Note: The Nutrition Action SMARTness Index was developed by the GNR as part of the NAF and is available online.

When developing the Nutrition Action SMARTness Index, the GNR first identified the ingredients (information) required for a commitment to be SMART and mapped these to each of the five SMART dimensions (Figure 1.8).[54] The 20 identified ingredients were then embedded in the online sign-up and commitment registration forms as compulsory fields to ensure that they are collected for all registered commitments in a standardised manner.[55]

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Figure 1.8 The GNR identified 20 ingredients as essential for a nutrition commitment to be considered SMART

Information needed for a commitment to be SMART

Figure 1.8 The GNR identified 20 ingredients as essential for a nutrition commitment to be considered SMART

Graphic outlines the ingredients of a SMART commitment by dimension (specific, measurable, achievable, relevant, time-bound). Specific: stakeholder name, stakeholder type, additional stakeholders, description of each commitment goal, type of each goal, target population of each goal. Measurable: primary indicator to measure progress of each goal, baseline level/value of the indicator of each goal, year the baseline level was assessed, target level/value of the indicator of each goal, monitoring plan for the indicator. Achievable: total commitment costs, funder(s), funding mechanisms, amount of total costs secured. Relevant: alignment with global nutrition targets, thematic area for N4G commitments. Time-bound: start and end date of each goal.

Note: Commitments are not excluded on the basis of their SMARTness. The aim is for the GNR to work with stakeholders to support them in improving the SMARTness of their commitments.

The Nutrition Action SMARTness Index ranks the goal(s) of each commitment into four SMARTness levels: high, upper moderate, lower moderate and low (Figure 1.9). The SMARTness Index factors in and jointly evaluates the following three performance criteria:

  1. SMARTness score. Gives a numerical score, between 0 and 5, to each goal, reflecting the completeness and coherence of the 20 ingredients. A score of 5 indicates that all 20 ingredients have been provided, and are clearly and consistently described – as such the goal is also trackable and clear.
  2. Trackability. Indicates whether the six ingredients (S4, M1, M2, M4, T1 and T2) used to determine whether progress can be tracked for a goal have been provided and clearly described.
  3. Completeness. Indicates for how many ingredients the GNR needed to go back to the commitment-maker and ask for clarifications.[56]

The GNR assesses the SMARTness of each goal based on self-reported data. The aim is that all goals reach the high SMARTness level through the verification process; the SMARTness Index of each goal is updated in the NAF Commitment Tracker as clarifications are received.

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Figure 1.9 Goals are ranked as high, upper moderate, lower moderate or low in SMARTness

Structure of the Nutrition Action SMARTness Index

Figure 1.9 Goals are ranked as high, upper moderate, lower moderate or low in SMARTness

Graphic depiction of the described ranking system. Shows that: • A goal which is trackable and required only minor clarifications, with a SMARTness score of 4.5 and above would have a high final SMARTness index level. • A goal which is trackable and required only minor clarifications, with a SMARTness score of 3.5 to 4.5 would have an upper moderate final SMARTness index level. • A goal which is trackable and required more than minor clarifications, with a SMARTness score of 4.5 and above would have an upper moderate final SMARTness index level. • A goal which is trackable and required more than minor clarifications, with a SMARTness score of 3.5 to 4.5 would have a lower moderate final SMARTness index level. • A goal which is trackable and required more than minor clarifications, with a SMARTness score of below 3.5 would have a low final SMARTness index level. • A goal which is not trackable and required only minor clarifications, with a SMARTness score of 4.5 and above would have a lower moderate final SMARTness index level. • A goal which is not trackable and required only minor clarifications, with a SMARTness score of 3.5 to 4.5 would have a lower moderate final SMARTness index level. • A goal which is not trackable and required only minor clarifications, with a SMARTness score of below 3.5 would have a low final SMARTness index level. • A goal which is not trackable and required more than minor clarifications, with any SMARTness score would have a low final SMARTness index level.

1.8 Share section

Conclusion

The world remains off track in its effort to meet almost all global nutrition targets.[57] The need to tackle poor diets and malnutrition in all its forms is ever pressing, with increased recognition that stakeholders are accountable for people’s food and nutrition. The Nutrition Year of Action presented stakeholders with unprecedented opportunities to step up and take more action, whilst highlighting the need for strengthened accountability. To date, there has been no robust accountability infrastructure to comprehensively record and monitor all new commitments for nutrition and ensure that stakeholders are held accountable for the pledges they make.

The GNR played a central role in addressing past challenges and strengthening accountability by developing the NAF, the world’s first public accountability framework for nutrition. Its aim is to create a shared culture of stakeholder accountability, communication, information sharing and trust, to achieve the shared vision of ending malnutrition in all its forms. The NAF served as the formal accountability mechanism for the 2021 Tokyo N4G Summit and created a wealth of standards and resources to support SMART commitment-making. It provides a transparent, consistent and systematic approach to positive stakeholder accountability, and has the potential to transform stakeholder engagement and the nutrition actions they take. The NAF can be used by all stakeholders at any time to commit to new and strengthened nutrition action and receive recognition for the efforts they make.

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Key recommendations

  1. Nutrition commitments should be SMART, public and acted upon. To achieve the global nutrition targets and the shared vision of ending malnutrition in all its forms, we need to ensure that all nutrition commitments are SMART, publicly shared, monitored and strengthened via common standards and processes. The NAF provides the most comprehensive global platform to support stakeholders in doing so and hold each other to account.
  2. Stakeholders should leverage and benefit from the NAF and commit to a shared culture of accountability. Being endorsed by multiple governments and international organisations, the NAF is the first global public resource for consistently monitoring all new commitments for nutrition. Promoting and streamlining its use across countries and stakeholders will allow, over time, the most comprehensive and independent assessment of nutrition action taken and its corresponding impact.
  3. Trustworthy accountability mechanisms require rigorous and transparent standards and processes. Within just its first year of existence, the NAF has published several resources, including methods and tools, and engaged with stakeholders to support strengthened commitment-making. This basis is fundamental for building trust with stakeholders and the global nutrition community. Such mechanisms need to be well-resourced, adaptive and continuously monitored to ensure that they remain as relevant as possible.
  4. Pledging moments for nutrition should follow the lead of the 2021 Tokyo N4G Summit. The success of the Tokyo summit is paving the way for all future events, highlighting the importance of active stakeholder engagement and data-driven accountability. With the Nutrition Year of Action and the Tokyo summit signifying a reset in stakeholder accountability, it is crucial that the NAF continues to serve and further evolves to support new pledges for nutrition. The sustainability of the NAF should be preserved to establish the trust of all stakeholders in its purpose and ensure systematic and continuous monitoring of nutrition action.
  5. All nutrition commitments should be registered, reported and monitored. The NAF is the official accountability mechanism of N4G commitments. Yet, it has been developed to enable the recording of any nutrition commitments worldwide and across diverse stakeholders and pledging moments, so that these can be strengthened and become more impactful over time. Commitments don’t have to be linked to specific events to be registered and get recognised. Stakeholders are encouraged to use the NAF to commit to nutrition and transform how we work together to jointly fix the global nutrition crisis.

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Footnotes

  1. Global Nutrition Report. 2021 Global Nutrition Report: The state of global nutrition. Bristol, UK: Development Initiatives. Available at: https://globalnutritionreport.org/reports/2021-global-nutrition-report/; and Global Nutrition Report. 2020 Global Nutrition Report: Action on equity to end malnutrition. Bristol, UK: Development Initiatives. Available at: https://globalnutritionreport.org/reports/2021-global-nutrition-report/.

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  2. The term ‘commitment’ is used to describe a pledge that is a written statement with an intention to act and a commitment to a measurable deliverable.

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  3. Nutrition Year of Action Launch Event Recap. Nutrition for Growth. https://nutritionforgrowth.org/nutrition-year-of-action-launch-event-recap/. Accessed 24 October 2022.

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  4. N4G 2021 Vision and Roadmap. Nutrition for Growth. 2020; published online 14 December. https://nutritionforgrowth.org/resources/vision-and-roadmap/. Accessed 24 October 2022.

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  5. Global Access to Nutrition Index 2021. Methodology. Development, structure, scope, contents, scoring and results presentation. Utrecht, Netherlands: Access to Nutrition Initiative. Available at: https://accesstonutrition.org/app/uploads/2020/06/Global-Index-2021-Methodology-FINAL.pdf; Global nutrition monitoring framework: Operational guidance for tracking progress in meeting targets for 2025. Geneva, Switzerland: World Health Organization and UNICEF, 2017. Available at: https://www.who.int/publications/i/item/9789241513609; Sustainable Energy for All. Accountability Framework. Vienna, Austria: United Nations, Department of Economic and Social Affairs, 2014. Available at: https://sustainabledevelopment.un.org/content/documents/1644se4all.pdf; Guidelines for the Development of a Criteria and Indicator Set for Sustainable Forest Management. New York, US, and Geneva, Switzerland: United Nations and Food and Agriculture Organization of the United Nations, 2019. Available at: https://unece.org/DAM/timber/publications/DP-73-ci-guidelines-en.pdf; SENDAI Framework. Voluntary Commitments. UN Office for Disaster Risk Reduction. Available at: https://www.undrr.org/implementing-sendai-framework/voluntary-commitments; and EU Platform on Physical Activity and Health. Monitoring Framework. European Commission, 2005. Available at: https://ec.europa.eu/health/archive/ph_determinants/life_style/nutrition/platform/docs/eu_platform_mon-framework_en.pdf.

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  6. GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396: 1223–49.

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  7. Undernutrition is a diet-related condition resulting from insufficient food intake to meet needs for energy and nutrients, including stunting, wasting, underweight and micronutrient deficiencies.

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  8. Popkin BM, Corvalan C, Grummer-Strawn LM. Dynamics of the double burden of malnutrition and the changing nutrition reality. Lancet 2020; 395: 65–74.

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  9. Global Nutrition Report. 2021 Global Nutrition Report: The state of global nutrition. Chapter 2: What we eat matters: Health and environmental impacts of diets worldwide. Bristol, UK: Development Initiatives; and Swinburn BA, Kraak VI, Allender S, et al. The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report. Lancet 2019; 393: 791–846.

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  10. Osendarp S, Verburg G, Bhutta Z, et al. Act now before Ukraine war plunges millions into malnutrition. Nature 2022; 604: 620–4. Available at: https://media.nature.com/original/magazine-assets/d41586-022-01076-5/d41586-022-01076-5.pdf; and No author listed. The war in Ukraine is exposing gaps in the world’s food-systems research. Nature 2022; 604: 217–8.

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  11. Global Nutrition Report. 2020 Global Nutrition Report: Action on equity to end malnutrition. Bristol, UK: Development Initiatives. Available at: https://globalnutritionreport.org/reports/2020-global-nutrition-report/.

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  12. Tokyo Nutrition for Growth (N4G) Summit 2021 & UN Food Systems Summit 2021. Available at: https://nutritionforgrowth.org/wp-content/uploads/2021/09/N4G_UN_FoodSysSummit_9.23-1.pdf; and Carbis Bay G7 Summit Communiqué. Our Shared Agenda for Global Action to Build Back Better. Cornwall, UK, 2021. Available at: https://www.consilium.europa.eu/media/50361/carbis-bay-g7-summit-communique.pdf.

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  13. Global Targets 2025: To improve maternal, infant and young child nutrition. World Health Organization. Available at: www.who.int/teams/nutrition-and-food-safety/global-targets-2025. Accessed 24 October 2022; and Set of nine voluntary global NCD targets for 2025. World Health Organization. 2022; published online 4 June. Available at: https://www.who.int/multi-media/details/set-of-nine-voluntary-global-ncd-targets-for-2025. Accessed 24 October 2022.

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  14. Global Nutrition Report. 2020 Global Nutrition Report: Action on equity to end malnutrition. Bristol, UK: Development Initiatives. Available at: https://globalnutritionreport.org/reports/2020-global-nutrition-report/; COVID-19 continues to disrupt essential health services in 90 per cent of countries. Geneva, Switzerland: UNICEF, 2021. Available at: www.unicef.org/press-releases/covid-19-continues-disrupt-essential-health-services-90-cent-countries; OECD Policy Responses to Coronavirus (COVID-19). COVID-19 and global food systems. Organisation for Economic Co-operation and Development, 2020. Available at: www.oecd.org/coronavirus/policy-responses/covid-19-and-global-food-systems-aeb1434b/.

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  15. Global Nutrition Report. 2021 Global Nutrition Report: The state of global nutrition. Chapter 4: From promise to action: Progress towards the 2013 and 2017 Nutrition for Growth commitments. Bristol, UK: Development Initiatives. Available at: https://globalnutritionreport.org/reports/2021-global-nutrition-report/.

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  16. Nutrition for Growth Accountability Working Group. Final Paper. Tokyo Nutrition for Growth Summit 2021. Available at: https://nutritionforgrowth.org/wp-content/uploads/2020/10/Accountability-WG-Final-report-designed-VF_Compressed.pdf.

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  17. Global Nutrition Report. 2021 Global Nutrition Report: The state of global nutrition. Chapter 4: From promise to action: Progress towards the 2013 and 2017 Nutrition for Growth commitments. Bristol, UK: Development Initiatives. Available at: https://globalnutritionreport.org/reports/2021-global-nutrition-report/.

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  18. Nutrition for Growth Commitment Tracker. Global Nutrition Report. Available at: https://globalnutritionreport.org/resources/nutrition-growth-commitment-tracking/. Accessed 24 October 2022.

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  19. Nutrition for Growth Commitment Tracker methodology. Global Nutrition Report. Available at: https://globalnutritionreport.org/resources/nutrition-growth-commitment-tracking/methodology/. Accessed 24 October 2022.

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  20. Nutrition for Growth Accountability Working Group. Final Paper. Tokyo Nutrition for Growth Summit 2021. Available at: https://nutritionforgrowth.org/wp-content/uploads/2020/10/Accountability-WG-Final-report-designed-VF_Compressed.pdf.

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  21. The Nutrition Accountability Framework: Endorsements. Global Nutrition Report. 2021; Available at: https://globalnutritionreport.org/resources/naf/. Accessed 24 October 2022.

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  22. These organisations have declared their public approval and support of the NAF.

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  23. The GNR’s participation has been determinant in ensuring that N4G outreach, mobilisation and communication included clear and coordinated guidance on the accountability process. The GNR, in addition to developing the NAF, provided guidance on how to register SMART nutrition commitments via online resources and presentation on events, responded to stakeholder questions via emails and in events, reviewed registered commitments and collaborated with the summit organisers to generate the Compact Annex (https://www.mofa.go.jp/files/100275456.pdf) which included all commitments registered in the run up to the Tokyo N4G Summit (registered until 9 December 2021, 23:59 GMT). All the above resulted in building trust and collaboration among stakeholders.

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  24. Tokyo Compact on Global Nutrition for Growth Annex: Commitments. Tokyo Nutrition for Growth Summit 2021, 2021. Available at: https://www.mofa.go.jp/files/100275456.pdf. The Compact is the outcome document of any N4G summit. It summarises the commitments made by all stakeholders in the summit and provides context for stakeholders to develop new commitments leading up to the next N4G summit. The annex of the Compact lists all commitments made in a given N4G summit.

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  25. All financial goals registered were linked to the Tokyo N4G Summit.

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  26. Financial amounts are based on the data submitted. Amounts were converted to US$ based on the 2021 yearly official exchange rate (local currency units relative to the US$) set by the International Monetary Fund.

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  27. About the Nutrition Accountability Framework: Key principles of the Nutrition Accountability Framework. Global Nutrition Report. 2021. https://globalnutritionreport.org/resources/naf/about/. Accessed 24 October 2022.

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  28. The registration is currently available in English with plans to translate into other languages over time, subject to available resources.

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  29. SMARTness and the NAF. Global Nutrition Report. 2021. https://globalnutritionreport.org/resources/naf/about/smartness-of-nutrition-commitments/. Accessed 25 November 2022.

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  30. Developing the NAF Platform's Commitment Registration Form. Global Nutrition Report. 2021. https://globalnutritionreport.org/resources/naf/developing-registration-form/. Accessed 24 October 2022.

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  31. The SMARTness Index assesses the completeness and coherence of each commitment goal against predefined criteria. It does not factor in or assess the potential importance, scale or impact of a commitment; for example a commitment could be low in SMARTness but high in potential impact (and vice versa). As the work evolves and stakeholders report on progress made, the GNR will consider methods to assess this.

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  32. The NAF provides a platform for self-reporting of nutrition commitments by various stakeholders. It does not prescribe nutrition priorities or have a regulatory nature with regards to validating the self-reported data, including holding stakeholders accountable for actual delivery of commitments.

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  33. Personal and contact information of the stakeholders, as well as commitment data indicated as confidential, are not published.

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  34. The order of the chapters is based on the number of commitments registered by each stakeholder group.

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  35. About the Nutrition Accountability Framework: Key principles of the Nutrition Accountability Framework. Global Nutrition Report. 2021. https://globalnutritionreport.org/resources/naf/about/. Accessed 24 October 2022.

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  36. As the work evolves, additional eligibility criteria might be considered, such as alignment with international standards and evidence-based actions.

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  37. The GNR actively follows up with stakeholders in all such cases to request them to register their commitment through the NAF platform, and it supports them in doing so.

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  38. Developing the NAF Platform's Commitment Registration Form. Global Nutrition Report. 2021. https://globalnutritionreport.org/resources/naf/developing-registration-form/. Accessed 24 October 2022.

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  39. Of the 440 commitments registered until 15 March 2022, seven single-goal commitments were excluded for stating visions and intended actions, or the willingness to act, without committing to a certain deliverable (these are available upon request and were all submitted using the temporary registration process prior to the launch of the NAF).

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  40. All 433 eligible commitments had at least one nutrition goal; one goal was excluded for not being nutrition related (to improve school performance); nine of the 897 eligible goals were included in the analysis and classified as ‘enabling’, ‘policy’ or ‘impact’, but could not be further classified in an action sub-category as it was unclear if they were nutrition focused (one was to increase physical activity and eight for broad social protection measures).

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  41. After reviewing the full formulation, goals and action plan of each commitment, we excluded three single-goal commitments and one goal of a two-goal commitment, all made by breast milk substitute (BMS) companies. The excluded commitments and goals were addressing infant and young child feeding and concerned marketing practices that are in contradiction to the International Code of Marketing of Breastmilk Substitutes

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  42. We consider any unique commitment that is registered to the NAF Platform that was launched in 2021 as ‘new’. This may include commitments with an earlier starting year (before 2021) as long as they have not been previously registered in GNR’s N4G tracker.

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  43. Of the 433 commitments, 29 (6.7%) were registered in a language other than English (23 in French, four in Spanish and two in Portuguese). These were translated into English, at the GNR’s expense, to include in the analysis and published to the NAF Commitment Tracker. However, the GNR does not currently have the resources to offer translation as an official service.

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  44. Commitment-Making Guide. Tokyo Nutrition for Growth Summit 2021, 2021. Available at: https://nutritionforgrowth.org/wp-content/uploads/2021/04/CommitmentGuide_4.27.21.pdf.

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  45. N4G Principles of Engagement. Tokyo Nutrition for Growth Summit 2021. Available at: https://nutritionforgrowth.org/wp-content/uploads/2021/09/N4G-Principles-of-Engagement.pdf

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  46. Access to Nutrition Initiative. https://accesstonutrition.org/. Accessed 24 October 2022.

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  47. [13] The GNR shared the names of all commitment-makers with ATNI. ATNI reviewed these and identified four BMS companies within the 30 private sector businesses that registered commitments. Of these four, two wished to be linked to the Tokyo summit but did not fully meet the BMS criteria of the N4G Principles of Engagement whereby BMS companies must commit to achieve full compliance with the International Code of Marketing of Breastmilk Substitutes and all subsequent World Health Assembly resolutions (collectively referred to as ‘the Code’) in both policy and practice by 2030; one did not wish to be linked to the Tokyo summit; and the fourth registered their commitments post-summit, hence they could not be assessed against the N4G Principles of Engagement. The BMS companies’ commitments to the Code are continuously tracked and reported on by ATNI’s Indexes as well as the BMS Call to Action. For the present analysis, the commitments made by BMS companies were not considered as N4G commitments; they were included, however, in the overall analysis unless excluded based on other eligibility criteria (see footnote 41).

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  48. A guide to the NAF Platform's Commitment Registration Form. Global Nutrition Report. 2021. https://globalnutritionreport.org/resources/naf/about/platform-guide/. Accessed 24 October 2022.

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  49. Commitments registered in languages other than English were translated into English for publication at the GNR’s expense; however, the GNR does not currently have the resources to offer translation as an official service. The original language data can be downloaded from the tracker.

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  50. The NAF Commitment Tracker data and the corresponding codebook can be downloaded in csv format.

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  51. The NAF Commitment Tracker will have additional functionalities in the future.

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  52. For stakeholders to make changes to their commitments they need to directly contact the GNR.

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  53. The current classification system does not include broad social protection/equity measures that are not directly relevant to nutrition (e.g. increase the income of women). As the NAF evolves, including such actions will be explored to further refine and expand the classification system.

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  54. The SMARTness of nutrition commitments. Global Nutrition Report. 2021. https://globalnutritionreport.org/resources/naf/smart-commitments/. Accessed 24 October 2022.

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  55. Developing the NAF Platform's Commitment Registration Form. Global Nutrition Report. 2021. https://globalnutritionreport.org/resources/naf/developing-registration-form/. Accessed 24 October 2022.

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  56. Through the commitment registration form, stakeholders have committed to work with the GNR post-registration to provide required clarifications.

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  57. Global Nutrition Report. 2021 Global Nutrition Report: The state of global nutrition. Bristol, UK: Development Initiatives. Available at: https://globalnutritionreport.org/reports/2021-global-nutrition-report/.

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