Greater DFID and EC Leadership on Chronic Malnutrition: Opportunities and Constraints

This report assesses the commitment currently demonstrated by DFID and the EC – two of the largest aid agencies – to reducing chronic malnutrition. In doing so the paper reviews the drivers and impediments to changing the status quo. The report was commissioned by Save the Children UK.

The goal of the paper is to give the agencies pause for thought. Do they have common views of what malnutrition is? Do they realise what is at stake in improving nutrition status? Are their assumptions correct as to the priorities they are currently giving malnutrition reduction? Are their assumptions correct about the bigger picture on donor investments in malnutrition? Are there opportunities for sensibly increasing investment? Are there impediments that are not as insurmountable as they at first seem?

The key findings are as follows:

Our assessment is that DFID and the EC assign chronic malnutrition a medium level of priority although much of this assessment depends on just how nutrition-friendly the indirect nutrition interventions are. Chronic malnutrition is widely recognised by both DFID and EC as crucial to reducing child mortality, morbidity and in promoting learning in school and economic productivity in the labour market. However, nutrition is seen by the EC and DFID as a supporting investment rather than a foundational one. We identify ten reasons for this.

1. Chronic malnutrition does not fit neatly into the developing country sectoral silos that donor agencies are increasingly linking up with;
2. Chronic malnutrition is seen as everybody’s business and nobody’s responsibility – there are few institutional champions;
3. Chronic malnutrition has not been seen as linked to the governance agenda, although there are clearly opportunities for it to be;
4. Within DFID and the EC there are few institutional incentives to pay attention to nutrition;
5. International agencies are not seen as capable or willing to support or put pressure on DFID or the EC to do more;
6. Parliamentary bodies have no particular incentive to pressure DFID or the EC on nutrition;
7. Tracking spending flows on nutrition is difficult;
8. Attributing impact on nutrition status of indirect nutrition interventions is difficult;
9. There are some clear direct interventions but these are seen as involving too much or too little behaviour change to be sustainable;
10. The move to direct budget support and SWAPs means these direct nutrition programmes will be underfunded in the absence of champions.

We are optimistic that DFID and the EC could do more on nutrition within the constraints under which they currently operate. In addition, there seem to be several opportunities for SC UK to support DFID and the EC in this regard.