About MQSUN
• The Maximising the Quality of Scaling up Nutrition
Programmes Framework (MQSUN) is a DFID-funded
consortium of partners, led by PATH, collaborating to
scale up DFID nutrition programs globally.
• MQSUN is a four year project spanning from February 2011
through February 2015
• MQSUN aims to provide DFID with technical services to
improve the quality of nutrition-specific and nutritionsensitive programmes.
• DFID has 17 priority countries including: *Bangladesh,
Myanmar, Ethiopia, India, Kenya, Malawi, Mozambique,
Nepal, Nigeria, Pakistan, Somalia, Sudan, Tanzania,
Uganda, Yemen, Zambia, Zimbabwe
Our Partners
• Aga Khan University
• Agribusiness Systems International
• ICF International
• Institute for Development Studies
• International Food Policy Research Institute
• Health Partners International, Inc.
• PATH
• Save the Children UK
MQSUN Calldown Activities
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Nutrition Audits
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Business Cases
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Knowledge Management &
Dissemination
•
Operations Research
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Impact Evaluations
•
Governance and Political Economy
Analysis
•
Capacity Building
•
Costing and Financial Tracking
Supporting SUN Secretariat – History
MQSUN core activity
Review of National Nutrition Plans of 17 DFID* priority countries
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Checklist tool for reviewing the National Nutrition Plans
Summary document of the review for 17 countries
Partners: HPI and PATH
Phase I – Supporting Movement of Scaling Up Nutrition
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What would it cost to scale up nutrition working with SUN countries and networks
Development of costing tool – for standardizing the costing of national plans for
scaling up nutrition
16 costed plans reviewed
Results presented in the Brussels SUN meeting (March 2013)
Partners: ICFI, HPI and PATH
Timeline: 2 months
Phase II – Country visits to get a better understanding of the plans and
costing
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Pilot testing of the costing tool – Kenya
Country visits – 8 countries (Nepal, Bangladesh, Indonesia, Sierra Leone, Burkina
Faso, Madagascar, Malawi, Rwanda)
Continued desk reviews – 21 + countries
Results presented at the G8 Nutrition for Growth event in London, June 2013
Partners: ICFI, HPI and PATH
Timeline: 8 months
*Bangladesh, Myanmar, Ethiopia, India, Kenya, Malawi, Mozambique, Nepal, Nigeria,
Pakistan, Somalia, Sudan, Tanzania, Uganda, Yemen, Zambia, Zimbabwe
Phase III – Supporting Movement of Scaling
Up Nutrition
Technical support and assistance to the SUN countries (via SUN
Secretariat) to accelerate action to tackle childhood undernutrition
Areas of support to the SUN countries:
▫ Review of policy legislation and to develop plan summaries
▫ Organization and implementation of the Common Results Framework
(CRF) based on the country action plans
▫ Financial tracking and resource mobilization
▫ Aggregating and documenting the lessons learned
▫ Disseminating the work at global events and with global networks
Timeline: 12 months
Investigating
Country Efforts in
Scaling Up
Nutrition in
20+ SUN
Countries
Washington, DC
30 September
2013
MQSUN Technical Support and
Assistance to the SUN
Movement
• Phase I
▫ Policy review
▫ Analytical framework
▫ Methodology for country visits
• Phase II
▫ Remote support to countries and SUN Movement Secretariat
(SMS)
▫ Country visits
▫ Support SMS at International events
• Phase III
▫ Policy, legislation, and plan reviews and summaries
▫ Support effective nutrition-sensitive implementation around a
Common Results Framework
▫ Support financial tracking and resource mobilization
Phase I
• Develop an analytical framework and associated
methodology
▫ Aggregated Cost Tool (Standardized
categorization)
▫ Methods for cross-country review
Phase I – Analytical
Framework
• Aggregated Cost Tool (ACT)
▫ Establishing a common set of measures based on
submitted plans
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Programme description
Programme classification
Target groups
Lead budget holder
Annual costs
Annual secured funding amounts
Funding source
Phase I – Support Methodology
• Prepare draft methodology for country visits
▫ Gain better understanding of existing plan
Which sectors were involved
How costs were calculated
How targets were selected
How donor networks/funds are incorporated into
plan activities
 Financial mapping and budget allocations
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Phase II
• Desk support and analysis
• Targeted support
• International event support
Phase II – Desk Support
• Cross-country Review (Desk Support)
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Enter 21 submitted plans into ACT
Review plans in a standardized framework
Incorporate feedback and corrections from countries
Identify policy shifts to enhance scale up (e.g.,
inclusion of governance, nutrition-sensitive factors)
▫ Review country and external funding, where available
▫ Prepare summary documentation for dissemination
Phase II – Desk Support
• Analytical Support
▫ Estimating external contributions
▫ Defining the financing gap
▫ Assist SMS with quantitative analysis and special
requests
Phase II – Targeted Support
• Selection of countries
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Supplied a ratified plan
Full engagement of the focal point for the visit
Nutrition burden within the country is high
Plan is considered to be high quality or country has identified a specific
short-term need for June Event
• Purpose of visit
▫ Work with focal points and stakeholders to help them understand and
apply the analytical framework and methods
▫ Develop an understanding of the elements, inputs, and calculations in
the submitted cost plans
 Both what is included and what is omitted
▫ Identify the financial contributions and pledges of relevant stakeholders
▫ Identify activity priorities
▫ Identify financial gaps, where possible
Phase II – International Events
• Scaling Up Nutrition Senior-level Meeting, Brussels,
March 2013
▫ Analysis of plans from 16 countries
▫ Summary of methods and results
▫ Reports with national and aggregated statistics
• “Nutrition for Growth: Beating Hunger through Business
and Science”, Pre-G8 Meeting, London, June 2013
▫ Analysis of plans from 20 countries
▫ Assist in development of country-specific two-page
documents for countries to share policy priorities and
advocate for financing requests
▫ Provide intensive remote support to countries leading up to
and during the event
Phase II
Submitted Country Plans
Bangladesh (2011 –
Mozambique (2011 – 2016)
2015)
Nepal (2013 – 2017)
Benin (2012 – 2015)
Niger (2012-2015)
Burkina Faso (2010-
Peru (2012-2013)
2015)
Rwanda (2012)
The Gambia (2011 –
Senegal (2013-2017)
2015)
Sierra Leone (2013 – 2017)
Guatemala (2013-2014)
Tanzania (2012 – 2016)
Haiti (2013-2017)
Uganda (2012 – 2016)
Indonesia (2011-2017)
Yemen (2013)
Kenya (2013- 2017)
Red = countries visited
Overview of Submitted Plans
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Key Considerations
Analytic Framework
Aggregated Results
Lessons Learned
Next Steps
Overview – Key Considerations
• Plans reflect national commitments
▫ inclusive consultation process between the
government and in-country partners
• Plans are used as reference for implementation
▫ this implies (need for) more detailed planning and
budgeting at sub-national levels
Overview – Key Considerations
• Plan differences (caveats for comparison)
▫ Inclusions/exclusions
 Existing government inputs (labor, infrastructure)
 New versus existing interventions
 Stakeholder and sector involvement
▫ Assumptions for scale-up
 Percentage increase
 District rollout
 National coverage
▫ Cost methodologies
 Total intervention costs (ingredients)
 Marginal budgeting
 Program unit costs
▫ Cost estimations
 Program planning
 Country budgets
 External budgets
Overview – Analytical
Lack of good
Framework
Insufficient access
to affordable,
nutritious
FOOD
throughout the year
Political &
Cultural
Environment
Inadequate access to
CARE
for mothers & children
& support for mothers
on appropriate child
feeding practices
ROOTED
IN
Poverty
HEALT
H sanitation
& clean water
services
Disempowerm
ent of women
Applied Classification of
Interventions
in
the Country
Specific
Nutrition Plans
Nutrition-sensitive
Actions
Approaches
• Good Nutrition Practices
• Vitamin and Mineral Intake
• Acute Malnutrition
• Food Security and Agriculture
• Care Environment
• Public Health and Water and
Management
Sanitation
• Enrichment of diet nutrient
density for pregnant and
lactating women and children
6-23 monthsGovernance
• Coordination and Information
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•
•
Management
Policy and Legislation Development
Advocacy and Communication
System Capacity Building
Overview - Plan Variety
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Specific
Sensitive
Governance
Specific Nutrition Actions
TOTAL COST: US$ 4.0 billion
(timeframe 2011-2015)
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US$ 2.4 billion for good nutrition practices
(61%)
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US$ 650 million for acute malnutrition
management (21%)
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US$ 717 million for vitamin and mineral
intake (18%)
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US$ 198 million for nutrient dense diet for
PLW and young children (5%).*
Specific Nutrition Actions
5%
Good nutrition practices
18%
Acute malnutrition
management
Vitamin & Mineral intake
21%
61%
Nutrient-dense diet
Composition of Specific
Nutrition
Actions
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Good nutrition practices
Acute malnutrition
Vitamin and mineral intake
Nutrient-dense diet
Nutrition-sensitive Approaches
TOTAL COST: US$ 28.9 billion
(timeframe 2011-2015)
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US$ 19.6 billion for nutrition-sensitive food
systems.
Note: Bangladesh alone is US$ 8.5 billion
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US$ 89.5 million for interventions enhancing
caring environments
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US$ 9.2 billion for interventions in public
health services, including reproductive health
and WASH
Nutrition-sensitive Food Systems
Food or cash for
work
Diversified
production
Income
generating
activities
Post-harvest
activities
46%
51%
School feeding
Quality and
safety of foods
Promotion of
school gardening
Food provision
for vulnerable
people
Improving availability
Improving accessibility
Composition of Nutritionsensitive Food Systems
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
no subcategory
Availability
Accessibility
Diversified and Nutrient Dense
DietPlace smallholders,
especially female farmers,
and their needs for assets
and services at the core
Accessibility
•Diversify and intensify
production (Agriculture)
•Improve use of
biodiversity (Agriculture)
•Improve processing and
storage (Agriculture,
Industry and SMEs)
•Ensure food safety
(Health)
•Distribute (Markets and
Public Works)
Availability
•Regulate or subsidize prices
(Markets)
•Ensure minimum income
(Employment , microenterprise and SMEs)
•Include in school meals
(Education)
•Include in employment
schemes (Welfare)
•Supplement to specific
vulnerable groups (Welfare )
• Promote
and educate
with a focus
on maternal
and IYCF
(Health)
Utilization
Fortified Foods
Accessibility
• Import and
distribute
(Markets)
• Produce, fortify and
distribute
(Agriculture &
Markets)
• Regulate (Health)
Availability
• Subsidize prices
(Markets)
• Supplement to
specific groups
(Welfare )
• Supplement under
special
circumstances
(Emergency)
• Promote and
educate as part
of a diversified
diet (Health,
Markets)
Utilization
Nutrition-sensitive Public Health
Household water
treatment
Management and
control of NCD
Water schemes
maintenance
Management of
malaria
11%
Community-led
total sanitation
Sanitation
campaigns
Nutrition
counseling of
PLWHA
74%
15%
WASH in schools
Public Health Services
Reproductive Health
Water and Sanitation
Governance
TOTAL COST: US$ 2.3 billion
(timeframe 2011-2015)
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US$ 1.5 billion for system-wide capacity
building (66%)
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US$ 629 million for coordination and
information management (28%)
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US$ 143 million for policy development,
advocacy and communication (6%)
Nutrition Governance
6%
Capacity to plan,
implement and
monitor
28%
Multi-sectoral
coordination at
different levels
Capacity for
intra-ministerial
coordination
Quarterly
monitoring
meetings
Capacity for subnational planning
Stakeholder
mapping and
other planning
exercises
66%
Coordination & Information Management
System-capacity building
Policy, advocacy & communication
20 Countries At A Glance
99.9 million U5 Children (2013 proj.):
• 38 million stunted
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average prevalence 39%
range 19.5-57.7
average annual reduction rate of 1.3%
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average prevalence 2.9%
range 0.1-7.9
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average prevalence 6.2%
range 0.3-11.6)
• 3.2 million severely wasted
• 7.0 million moderately wasted
Specific nutrition actions:
• US$ 1.1 billion per year
• US$ 71.6 million per country annually
Nutrition sensitive approaches:
• US$ 6.7 billion per year
• US$ 370 million per country annually
Governance for nutrition:
• US$ 441 million per year
• US$ 26 million per country annually
Note: 36 high-burden countries received from OECD ODA an annual average of US$ 218 million
(2009-2011)
Messages from Country Visits
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Elevate nutrition within governmental agendas
Centralize national planning and coordination
processes
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Position national task forces above ministerial level
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Utilize Champions to enable national
campaigns to reach wider and more influential
audiences
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Include stakeholders from multiple arenas
in planning and coordination
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Advocate and campaign for more domestic
Messages from Country Visits
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Develop multi-sectoral plans and innovative or
pooled funding mechanisms
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Decentralize the national costing processes to
include sub-national managers, decision makers, and
practitioners
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Use the Aggregated Cost Tool to advocate for
resources at the national level
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offer guidance for definitional issues related to
classification of activities
Continuing Needs
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Technical support
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Finalise plans, costing, and M&E frameworks
Decentralise planning and costing
Advocacy
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Build internal country support
Appeal to external donors
Financial mapping and funding gaps
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Support peer learning to share examples, lessons,
and successes
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Support research to extend knowledge of what
works
Next Steps – Phase III
1.
Policy, legislation and plan reviews and
summaries
• Assess, evaluate and peer-review national sectoral documents
2. Support effective nutrition-sensitive
implementation around a Common Results
Framework (CRF)
• Build and expand on knowledge base of effective interventions
3. Support financial tracking and resource
mobilization
• Establish systems for multi-sectoral planning, costing, financial
tracking, assessment of budgetary shortfalls and completion of
strategic plans and documentation
4. Aggregate and document the lessons learned
from the work with countries
• Disseminate lessons learned across the SUN global networks