Developing an Effective Nutrition Sector in Malawi
Malawi has the highest rate of chronic malnutrition in Africa. To improve the lives of millions of Malawians and fight malnutrition, the government is scaling up nutrition interventions and making these programs central to development. However, Malawi needed to build capacity for effective implementation and policy leadership, as well as mechanisms for multi-sector coordination. The government also needed to learn about different nutrition interventions before launching the World Bank-financed project to fight malnutrition. Senegal had extensive and successful experience with nutrition intervention, especially in decentralization and community involvement. Senegal had also implemented several Bank-funded projects in the area. Bank staff therefore connected Malawi with Senegal to learn about strategies for making nutrition more effective.
During the expert visits and study tours, the Malawian knowledge exchange participants learned about the importance of inclusive approaches for community participation, decentralized management structures, and downstream communication. They also improved their understanding of results-based management and monitoring and central-level coordination, guidance, and resource mobilization. The Malawian government’s positive attitude and strong motivation to fight malnutrition attracted further donor commitment and interest in the projects. The eye-opening visit also allowed the Malawian beneficiaries to effectively engage in the preparations of the World Bank’s Country Assistance Strategy, which includes US$30 million nutrition investment component.
“Preparations [for the nutrition component] went smoothly and [was] consensual as a result of the learning event,” said Menno Mulder-Sibanda, Senior Nutrition Specialist at the World Bank. “The learning event created a much better understanding of the stakes, the expectations, the roles and responsibilities of the various stakeholders and took the ‘politics’ out of the discussions.”
Beneficiaries / Participants
The government of Malawi aims to reduce the burden of chronic malnutrition—the highest in Africa—which is stunting the lives of millions of Malawians.1 The government wanted to reposition nutrition interventions as central to the development of the country by building capacity for multi-sector coordination, effective implementation frameworks, and policy leadership. In 2004, after years of discussions on how to curb the high chronic malnutrition rates, Malawi established the Department of Nutrition, HIV, and AIDS (DNHA) in the Office of the President and Cabinet (OPC) to provide greater visibility and leadership for two national nutrition programs, approved in December of 2007 and January of 2010. Translating policies into implementation, however, requires effective coordination, leadership, and management of multi-sector actors – issues the World Bank addressed in its two most recent Country Assistance Strategies for Malawi, covering Fiscal Years (FY) 2007-10 and FY2011-14. The latter includes a nutrition investment of US$30 million in FY12.2
Through its la Cellule de Lutte contre la Malnutrition (CLM) program, Senegal has managed to reduce chronic malnutrition in the past decade. This success is due to Senegal’s decentralized management system, effective communications, and community involvement in all nutrition interventions. Local governments and communities have set up 1,900 community nutrition sites and mobilized over 4,300 community nutrition volunteers, reducing underweight malnutrition rates in the intervention areas by 4 percent. The World Bank’s nutrition enhancement project contributed to this success; it has reached more than 1 million children under age five with low-cost, high-impact measures to improve nutrition. Capturing the opportunity, the World Bank connected Malawi with Senegal to learn about arrangements to address malnutrition levels and increase the impact of the national nutrition enhancement programs.
The learning event was strategically positioned to have maximum impact. The knowledge exchange took place at the start of preparation of a World Bank-funded project. Other donors are also providing support or are anticipated to provide support to the program. In addition to the immediate application of new knowledge, Malawi is now also in a position to continue South-South relations and learning with Senegal and other developing countries.