Why is child malnutrition a problem?
Children’s chronic undernutrition is a problem affecting almost a quarter of all children under five years worldwide. Not only does it affect their cognitive development, weaken the immune system, and increase the risk of cardiovascular and respiratory disease, but it also undermines their economic potential and reproduces the cycle of poverty.
Currently, no country is on track to meet all of the 2025 Global Nutrition targets and only 8 of 194 countries are on track to meet just four of them. In Ecuador, more than 28% of children under five lacked the sufficient height for their age in 2018, but this figure is likely to be higher as a result of the COVID pandemic. In 2021, the new Lasso administration renewed the government’s commitment to reduce stunting by 6% by 2025.
How did you become involved in the policy-making process?
I had been invited to document Peru’s success in reducing stunted growths in 2008, and in collaboration with nutrition experts, we argued that success had less to do with the amount of government investment but the policy coordination and governance mechanisms between relevant stakeholders across different areas. The resulting research paper and policy briefs helped to better define the notion of political commitment and with it “changed the political dialogue in fundamental ways” with other development cooperation organisations such as the Scaling Up Nutrition Movement. The proposed nutrition governance framework has since been replicated to conduct several comparative studies worldwide for over a decade now.
How can governments and academics work together to translate research into policy?
The comparative research illustrates how the level of effective policy coordination varies according to the political and institutional variation in ten different countries and subnational territories. Building on comparative politics literature combined with extensive comparative fieldwork and dozens of expert interviews, the research argues there are four dimensions to ensure effective government interventions.
First, substantial horizontal coordination is needed at the highest executive level to ensure that different ministries, cooperation agencies and non-governmental organisations share and implement the same policy objectives. Vertical articulation is also needed to ensure that local authorities have the incentives to comply with national policies and constituency demands. Thirdly, the adoption of financing instruments, like results-based budgeting, enable better policy coordination and improved accountability in the allocation of nutrition finances. Finally, a strong element of monitoring and oversight is needed to ensure that researchers and civil society watchdogs keep track of policy progress and effective government responses.
How was this put into place in shaping the nutrition governance agenda in Ecuador?
Ecuador has been unable to overcome the burden of malnutrition for more than a decade and a half, despite generous investment of a progressive left-wing government and the fiscal abundance of a commodities bonanza. During the Covid pandemic, the previous government renewed its commitment to eradicate undernutrition and aligned the national strategy with the international convention of targeting interventions on the first 1000 days of a child’s life. My early work on nutrition governance was used by government advisors to inform some of their preliminary policy drafts and I later received an invitation to offer a governance perspective to the team of nutrition experts appointed by the new government administration. For several weeks, I had the privilege to work alongside public health experts, finance officials, cooperation agencies and civil society actors in crafting a common strategy to ensure prevention and eradication of children’s undernutrition. It was particularly rewarding to see how the four dimensions of the nutrition governance framework remained relevant to inform and organise the government’s national strategy.
What can others learn from this experience?
This experience has demonstrated how a theoretical framework for comparative research can still have a relevant policy impact almost a decade after its original publication. As a researcher, this work nicely connects and expands policy implications of my ongoing work looking at the Politics of Malnutrition in Brazil and Mexico.
As a university lecturer, I believe this policy experience will directly inform my teaching and supervision to show students how the political incentives and motivations of policy actors as well as structural and institutional constraints directly shape decision making and policy. As a dual British and Ecuadorian citizen, it has been fantastic to see that my UK based research on nutrition governance could contribute to improving children’s wellbeing in my native country.
Read Ecuador’s Intersectoral Strategic Plan for the Prevention and Reduction of Chronic Child Malnutrition (in Spanish).