Development of a conceptual framework, approach, and assessment tools for mainstreaming nutrition in MCH programs

CornellUniversityhas taken the lead in developing a framework and assessment tools that will provide guidance for effectively mainstreaming nutrition into MCH activities.

The MNI framework considers three major dimensions of the nutrition-related context in a country:  the technical, implementation and sociopolitical dimensions.  In any context, considerations related to these three dimensions need to converge to inform the development of a strategy to move the nutrition agenda forward.

To develop strategic action plans for specific countries/contexts, it is intended that in any context, there will be four broad phases of activities that will help a country team to develop a strategic action plan for mainstreaming nutrition.  The four phases include:

• A strategic assessment of the opportunities and needs for mainstreaming (including institutional and stakeholder analysis)
• Decision-making about key mainstreaming priorities and actions (including the integration of technical, implementation, and sociopolitical considerations).
• Development of action plans for implementation
• Development and implementation of monitoring and evaluation plans for the mainstreaming process and outcomes.

In addition, several assessment tools were developed for use in a given country.  These include three tools to map program implementation & evaluate program implementation capacity.  The first tool maps current and ongoing nutrition activities for identifying opportunities for mainstreaming.  The second tool assesses whether nutrition interventions are integrated or delivered as stand alone programs.  The third tool assesses the quality of nutrition interventions using a table of critical capacity needs for various nutritional interventions intended for use in key-informant interviews with program managers as well as on field visits that include observations of program activities.

A second set of tools were developed to assess the sociopolitical dimension.  These include:

• Questions for key-informant interviews to assess the challenges to moving nutrition forward in a country (developed and used in Vietnam)
• Assessing Problems, Solutions and the Sociopolitical Environment: Some Guiding Questions (developed to help the assessment team broaden its perspectives on the types of factors that may affect the nutrition agenda at the national level)
• Review of Policy Processes and Capacity Issues Related to Undernutrition (developed as a generic initial assessment at national level)

Testing of the assessment tools in different countries took place. Now refining of MNI approach is in progress. A technical guide is being developed for the country level mainstreaming process.   The guide will address the four phases of activities that are essential for any country team to be able to engage in and/or facilitate in collaboration with other country stakeholders.