ppwnov13- day 1 pm- p.menon- ifpri
DESCRIPTION
Day 1- afternoon session: Purnima Menon, IFPRI-New Delhi: “Enabling Policy Environments for Infant and Young child feeding and nutrition: the roles of actors, networks, narratives, and data,” Workshop on Approaches and Methods for Policy Process Research, co-sponsored by the CGIAR Research Programs on Policies, Institutions and Markets (PIM) and Agriculture for Nutrition and Health (A4NH) at IFPRI-Washington DC, November 18-20, 2013.TRANSCRIPT
Purnima Menon
IFPRI
Enabling policy environments for infant and young child feeding and nutrition: The roles of actors, networks, narratives, and data
Funding and contributors Funding:
Bill & Melinda Gates Foundation, through Alive & Thrive, managed by FHI 360 (www.aliveandthrive.org)
A4NH
Contributors IFPRI
Noora-Lisa Aberman Eva Schiffer Jody Harris Andrew Kennedy Neha Kohli Kuntal Saha Phuong Nguyen Disha Ali
Collaborators Nazneen Akhtar GMMB Edward Frongillo
The first 1000 days of life (pre-pregnancy to 24 months) are a crucial period for
nutrition
LAC
Europe & Central Asia
North Africa & Near East
Sub Saharan Africa
South Asia
INFANT AND YOUNG CHILD FEEDING
4
6-24 mo: Complementary feeding & Continued BF
Windows of Opportunity
Preconception through pregnancy
0-6 mo: Exclusive breastfeeding
http://www.marieclaire.com/cm/marieclaire/images/mcx0807FEIndia001-med.jpg
http://www.who.int/child_adolescent_health/documents/media/9241593431.jpg K Dewey
Guiding principles for complementary feeding (2003; 2005)
INFANT AND YOUNG CHILD FEEDING
Optimal IYCF practices at the household level also require an enabling policy environment Exclusive breastfeeding (EBF)
Agreements about critical need to provide policy support to EBF
Maternity leave and work place legislation Monitoring of compliance with the International Code of
Marketing of Breastmilk Substitutes (“the Code”) Investments in communications and awareness raising
campaigns Complementary feeding
Monitoring of compliance with the International Code of Marketing of Breastmilk Substitutes (“the Code”)
Investments in communications and awareness raising campaigns
Codex Alimentarius standards for production of complementary foods
Using data to drive program focus and results
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4
3
2
Alive & Thrive Program Framework
Elements of Alive & Thrive advocacy and policy engagement strategy
Policy Advocac
y
Messages and
materials
Data and evidence
Stakeholders and
partnershiips
Media engagement
Key objectives for policy advocacy evaluation led by IFPRI Understand and document shifts in the overall
policy environment for IYCF and nutrition in Bangladesh, Vietnam and Ethiopia Elucidate contribution of Alive & Thrive policy
advocacy engagement and interventions to the shifts in the policy environment (focus on issue ascendance)
Separate ‘deep-dive’ studies in each country Media engagement in Bangladesh Support to provincial planning for nutrition in
Vietnam Bringing attention to stunting and prevention of
stunting in Ethiopia
Illustrative example for today: overall policy environment in Bangladesh
Issue ascendance is one of the more “upstream” stages in the policy process
Menon et al., Food and Nutrition Bulletin, 2011
Framework for issue ascendanceShiffman and Smith (2007):
framework for issue ascendance in global health
Ideas
Issue Characteristic
s
Policy Dialogu
e
Political Contexts
Actor Power
Framework used because major policy and advocacy interventions in Alive & Thrive were initially focused primarily on getting and keeping the issue of IYCF on the agenda (rather than, say, getting a policy formulated)
2014 endline assessment of policy environment,
integrating analysis of event database and
program documentation.
2010 baseline assessment of policy
environment
Document A&T activities
through event database
Key components of policy process research
Data collection for policy environment assessment at 2010 and in 2014 (planned)Framework domain
2010 2014
Actor Power (actors, networks, leading institutions)
Net-Map (IFPRI, individual interviews)
Net-Map (planned by another research group; use of group interviews)
Ideas Opinion leader research by advocacy firm (2009)
Stakeholder interviews by IFPRI
Policy context Review of policy documents by IFPRI
Review of policy documents and A&T documentation by IFPRI
Issue characteristics
National level data from DHS (2007)
National level data from DHS (2011)
Event database developed to track and analyze advocacy strategies
Data based was coded based on advocacy best practices to identify strategies initially used, and shifts in strategies over timeMonthly project updates
Ideas
Issue Characteristi
cs
Issue ascendance on the policy
agenda
Political Contexts
Actor Power
Very complex, with many local and civil society players.. Strong central influence of some key government players and some individuals. The were was high level of central influence and lack of dynamic exchange across the network
Stunting levels remain high and stagnant in recent yearsExclusive breastfeeding was low, and stagnant over the years; complementary feeding is very suboptimal
Nutrition was seen as one of many issues that should be tackled by raising the economic status of the population and reducing poverty
Knowledge about stunting, the importance of IYCF, or solutions to the problems were variable across key actors
Global actions and strategies have entered into national policy discourses and actions but concerns remain about translating of guidelines into action on the ground.
Public health messages on IYCF are in danger of being eroded by persistent Code violations on the marketing of formula
Overall Bangladesh policy environment (2010)
What baseline findings meant for IYCF policy advocacy in Bangladesh
Ideas: Diverse views at the beginning; advocacy aims to shape a more coherent narrative
Policies: Having national strategy for infant feeding helped; A&T was able to take it to the next actionable level.
Issue characteristics: The situation was poor to start with; the data enabled good ‘story telling’. A&T focus on deepening understanding through data
People matter. In Bangladesh, the actor network for nutrition was complex and large. A&T’s
advocacy and policy engagement has been strategic
and systematic – slowly reaching all influential actors and ‘bringing them in’ over 4
years
Key insights from event analysis on strategic mix of advocacy activities
- Activities included: generating and framing evidence on IYCF, investing in capacity-building initiatives for communities and government quarters, and building communication materials at an early stage, training media and initiating media study circles to enhance media coverage and shape discourse via media
- A&T staff, in partnership with staff from other organizations, acted as policy entrepreneurs and champions using strategies such as alliance building, dialogues, and discussions as well as media and dissemination strategies.
- A&T and partners used or created policy windows that included award ceremonies, launch events, and special days or weeks.
- Extensive efforts to popularize the discourse via news coverage and dissemination, thereby providing external framing and advocacy of policy issues.
Methodological reflections Shiffman & Smith framework works well for assessing
factors related to issue ascendance; other aspects of policy process demand other frameworks and theories
Net-Map was useful to map actors and networks, but not perfect; major network characteristics well captured, but nature of participatory Net-Map interviews, time/availability or lack of knowledge of some stakeholders about others limits utility/accuracy
Event database requires continuous and diligent ‘data entry’ and continuity of research staff for coding and analysis; monthly updates possibly limited
Program itself has moved rapidly and advocacy and policy support interventions have gone beyond advocacy for “issue ascendance”!
Data challenges between 2010 and 2014 assessments: several other policy process issues and researchers, but similar methods, same stakeholders/interviewees
Any questions?