Guest blog from my IFPRI colleague, Stuart Gillespie, with some reflections on enabling environments for nutrition.
“The microbe is nothing, the terrain everything” (Louis Pasteur, 1895)
“The microbe is nothing, the terrain everything” (Louis Pasteur, 1895)
"The objective of development is to create an enabling environment for people to enjoy long, healthy and creative lives." (Mahbub ul Haq, 1990)
We have learnt a lot about “enabling environments” in nutrition over the last few years -- about what they are, and why they’re important. In broad brush, an enabling environment is one in which there is a political commitment to address malnutrition, backed up by institutional commitment in the form of pro-nutrition policies, incentives and accountability. Nutrition-relevant data are generated, shared widely, and they inform action. Different elements of nutrition-relevant capacity are understood and strategies are pursued to address gaps and weaknesses. Nutrition champions build alliances and they work across sectoral boundaries to make the case for nutrition. The growing priority attached to nutrition is reflected in financing that is adequate, stable and flexible.
Such enabling environments (EEs) lie at the base of the
Lancet (2013) conceptual framework, and they have opened the door to a more
politically nuanced analysis of nutrition in recent years. EEs may be foundational
but they are also dynamic. They can change….for better or worse. In tracking
countries’ progress against four indicators, the SUN movement is monitoring the
development of EEs at the national level.
This is clearly important, but it’s not enough. Between
Pasteur and ul Haq, environments operate at
different levels. Think of the layers of an onion. At the core, a child’s
nutritional status represents an enabling (or disabling) environment for
her/his growth and well-being, Pasteur, and his compatriot Claude Bernard, did not
explicitly refer to nutritional status but it was
the stability of the “milieu intérieur” that was
believed to be “the condition for a free and independent life”. Nearly a
century later, when he launched the first Human Development Report, Mahbub ul
Haq was building on Amartya Sen’s capability
approach. Enabling environments were those that preserved the future capability
to act, that kept an individual’s set of life choices open. Human
development was about expanding the richness of human life, not the richness of
the economy.
Between the outer and innermost layers of the onion –
between macro and micro – there are district-level bureaucracies. A supportive
policy climate does not automatically guarantee effective subnational
implementation of nutrition-relevant programs. We need to move below the national
level to better understand meso-level environments for nutrition. We need to
pay more attention to vertical coherence (national to community) and go beyond
the politics of commitment-building to the politics of delivery.
Creating and sustaining EEs is not easy, and it takes
time. There are many moving parts, and there is no gold standard. Future research
and action needs to recognize such complexity. One way to do this, and to
foster sharing and learning across contexts, is to document real-world
experiences in developing EEs at different levels. Such “stories of change” – focusing as they
do on the lived experience of key actors -- can be powerful. Stories inform, but they also inspire.
1 comment:
Hi Stuart,
Thank you for this thoughtful blog.
Agree we need to pay attention and efforts to the politics of delivery.
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