Advocacy,  Fortification,  Infant and Young Child Feeding

Measuring the Effectiveness of Nutrition Advocacy

What is advocacy for nutrition policy?

Many policy reforms emerge after sustained periods of advocacy. In the field of nutrition, advocates have played a critical role in raising awareness about the causes and consequences of malnutrition and which interventions governments should pursue to improve the health of their populations. Advocacy can be defined as “a continuous and adaptive process of gathering, organizing, and formulating information into argument, to be communicated to decision-makers through various interpersonal and media channels, with a view to influencing their decision towards raising resources or political and social leadership acceptance and commitment for development programs, thereby preparing a society for its acceptance” [1]. However, not all advocates exert equal influence on the policymaking process. To better understand the influence of advocacy on the policymaking process, DataDENT is leading a series of cross-country studies to examine which factors contribute to effective nutrition advocacy and how those factors could be operationalized for comparative purposes.

What are the key components of effective advocacy?

Different bodies of research collectively highlight that three main factors are relevant to effective advocacy (for example, Balarajan and Reich 2016 [2]; Di Gregorio et al. 2019 [3]; Gen and Wright 2013 [4]; Shiffman 2016 [5]; te Lintelo et al. 2016 [6]).

The first is the capacity of advocates, inclusive of sufficient staff with relevant knowledge about nutrition policy and the broader policy system, financial resources to sustain advocacy campaigns, and organizational vision demonstrated by time-bound objectives supported by action plans or a long-term strategy.

Strong networks represent a second key factor for effective advocacy. Such networks ideally are dense—meaning that they incorporate a diversity of skills and policy contacts—and have committed leadership and policy champions at high levels of government. In addition, a clear governance structure, such as one organization playing a leading role (e.g. UNICEF within the Scaling Up Nutrition movement network) or all organizations having an equal role, allows networks to be more resilient. 

Third, advocacy depends on external outreach activities. Such activities must rely on credible evidence that is viewed as legitimate by the communities in which advocates are operating. In addition, use of consistent messaging among network members is key to avoid confusion among policymakers. The visibility of advocates’ positions is enhanced via dissemination through multiple media outlets targeted at diverse audiences, while various modalities of policy engagement—parliamentary briefings, workshops, or journal training—can further assist with communicating complex nutrition messages.

How is DataDENT advancing metrics on nutrition advocacy?

Although the study of advocacy efficacy has grown in recent years with special attention to how advocacy organizations can refine their goals and strategies, there has been less attention to how advocacy organizations can be assessed in relation to one another and with respect to specific nutrition policy arenas.

To determine why some advocacy organizations are viewed as more effective at influencing nutrition policy than others, DataDENT is conducting comparative case studies in India and Nigeria – where child malnutrition remains stubbornly high despite longstanding advocacy efforts.

In 2019-20, we concluded a case study in Nigeria to understand advocacy efforts taking place in two key nutrition policy domains: Infant and Young Child Feeding (IYCF) and food fortification. We developed a standardized questionnaire and interviewed 67 stakeholders inclusive of advocacy organizations, government, donor, media, and research actors. The case study attempted to understand aspects of capacity, networks and outreach of advocates at both the federal level as well as within the states of Kano and Kaduna. In 2021, we are conducting a similar case study in India, both at the federal level as well as within the states Bihar and Uttar Pradesh. The objective is to derive metrics of effective advocacy that can be applied to a broader set of states and countries. The metrics can be used by decisionmakers, donors, and researchers to determine which advocacy organizations might be most effective in certain policy domains.

Findings from our two country case studies will be disseminated via various outputs, such as scientific papers, technical advice, slide decks, and webinars, to further conversations on effective nutrition advocacy. A companion set of outputs that examine metrics of the enabling environment for nutrition advocacy—focused on the same countries—will also soon be available.  

References:

[1] Pelletier, D, R Haider, N Hajeebhoy, N Mangasaryan, R Mwadime, and S Sarkar. 2013. “The Principles and Practices of Nutrition Advocacy: Evidence, Experience and the Way Forward for Stunting Reduction.” Maternal and Child Nutrition, 9(S2):83-100.

[2] Balarajan, Y, M Reich. 2016. “Political economy challenges in nutrition.” Globalization and Health, Vol.12(1): 1-8.

[3] Di Gregorio, M, L Faotrelli, J Paavola et al. 2019. “Multi-level governance and power in climate change policy networks.” Global Environmental Change, 54(April): 64-77.

[4] Gen, S, and AC Wright. 2013. “Policy Advocacy Organizations: A Framework Linking Theory and Practice.” Journal of Policy Practice, 12(3): 163–93.

[5] Schiffman, J. 2016. “Network advocacy and the emergence of global attention to newborn survival.” Health Policy and Planning, 31: i60-i73.

[6] Te Lintelo, D, N Nisbett, and K Pittore. 2016. “Multi-level advocacy for nutrition.” IDS Evidence Report No. 211. Brighton, UK: Institute of Development Studies, University of Sussex.  

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