21st Annual Martin J. Forman Memorial Lecture presentation by Abdoulaye Ka "Nutrition in Senegal -- Achievements & Prospects"

1. Un Peuple – Un But – Une Foi
PRIMATURE
NUTRITION IN SENEGAL…..
Achievements and prospects
October 2011
© Copyright CLM February 2011

2. SENEGAL’S NUTRITION SITUATION
Stunting rates by continent and countries over time
Senegal is an exception on the average trend in Africa
Text February 2011

3. SENEGAL’S NUTRITION SITUATION IN RELATION TO
ITS ECONOMIC DEVELOPMENT –
Comparison with India
Nutrition improved in Senegal in the past 10 years, despite weak economic
growth
By contrast, India’s malnutrition stagnated during this same period, despite
strong economic growth of around 6-7 percent/capita/year
9.00
8.00
7.00
6.00
5.00
4.00
GNI
3.00 Senegal
2.00
1.00 India
0.00
-1.00
-2.00
00 01 02 03 04 05 06 07 08 09 10
Year (20XX)
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4. Summary
What happened in Senegal?
What can we learn from the experience?
1. Institutionalization of nutrition policies and
programs
2. Creation of implementation platform
3. Prospects
Text February 2011

5. INSTITUTIONALIZATION PROCESS
1950-1970 1970-2000 Since 2000
“Techno “Crises “Proactive approach"
approach" management"
NO NO 1. Creation of the National
Committee for the Fight
against Malnutrition (CNLM)
Institutionalization
in the Office of the President
2. In 2002, creation of CLM, in
the Prime Minister’s Office
1. Policy letter on Nutrition
Nutrition policy NO NO 2. Strategic plans
3. Sectoral policy letters
1. Incorporation in DRSP and
DPES strategic planning
Prioritization NO NO documents
2. Inclusion of nutrition in the
national budget
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6. INSTITUTIONALIZATION PROCESS
How did we get to more than a decade of high-level institutional
placement?
1995 - 2001 Context
1. Social consequences of structural adjustment
policies
2. Devaluation of the national currency (CFA Franc)
3. Deterioration of living conditions and rise in
poverty
Institutional placement in
the Office of the President 4. Authorities pay attention to the consequences of
the situation on nutrition: political will
5. Nutrition identified as an alternative solution for
the mitigation of the impact of the crisis
6. Strong support from a development partner
(World Bank)
Text February 2011

7. INSTITUTIONALIZATION PROCESS
How did we get to more than a decade of high-level institutional
placement?
2001 - today Context
1. Senegal signed the MDG declaration
2. Closing of a successful nutritional project
3. Continued political will
4. Moving from a project approach to a
Institutional Placement in programmatic approach
the Office of the Prime 5. Advocacy from experts and partners to keep
Minister nutrition at the highest policy-making level
6. Broad consensus on the importance of the
multisectoral approach
7. Strong support from a development partner
(World Bank)
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8. INSTITUTIONALIZATION PROCESS
What are the risks and advantages of a high-level institutional
placement?
Advantages Risks
1. Enhances ownership of nutrition 1. Change of direction as a result of a
policy change in government
2. Facilitates the insertion of nutrition in 2. Resistance from traditional sectors in
sectoral policy and other key charge of nutrition
reference documents 3. Paris Declaration recommendations to
3. Facilitates the insertion of a budget reduce parallel coordination units in
line in the national budget favor of strengthening the sectors
4. Facilitates the implementation of
multisectoral policy
5. Enhances the credibility of nutrition
with development partners
Text February 2011

9. INSTITUTIONALIZATION PROCESS
What can we learn from this experience?
• The emergency situation was critical in our experience
• Leadership by those who introduced the reforms was essential to influence
government decisions
• Nutrition leaders have to seize opportunities to position nutrition at the center of
the economic and social development agenda of the country
• It is important to propose a concrete and actionable solution to decision-
makers.
Constraints for replication:
• It is not about the ideal position of nutrition in all countries
• Each country has to find its own way to mobilize stakeholders and resources,
and to ensure that each party takes ownership and responsibility
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10. EVOLUTION OF THE IMPLEMENTATION PLATFORM
1950-1970 1970-2000 Since 2000
“Techno “Crises “Proactive approach"
approach" management"
Involvement of NO NO All ministries represented
Line Ministries in CLM (health,
education, etc.)
Involvement of Implementation overseen by
NO NO
Local Governments Local Government
Involvement of Network of NGOs
civil society developing nutrition
NO NO
activities
Involvement of Private sector industries
the private sector NO NO involved in the fortification
component
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11. EVOLUTION OF THE IMPLEMENTATION PLATFORM
How did we involve so many stakeholders around the nutrition
theme?
- Development of standards and protocols on nutrition
by the different sectors involved
Involvement of Line - Integration of nutrition in sectoral policies
Ministries or partnerships
with public services
- Implementation of nutrition-specific or nutrition-
sensitive interventions at national and local level
- According to the Decentralization Policy, nutrition has
been decentralized to the level of Local Government
Involvement of Local - Integration of nutrition in Local Development Plans
Government considered
as a window of
- Financing of nutrition by Local Government
opportunity for nutrition - Local Government take responsibility for monitoring
and social mobilization
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12. EVOLUTION OF THE IMPLEMENTATION PLATFORM
How did we involve so many stakeholders around the nutrition
theme?
- NGO selection by local stakeholders
- Contractual Agreement Local Government and NGO
Involvement of civil
- Implementation of nutrition-specific or nutrition-
society or use of
horizontal structures for
sensitive interventions adapted to local contexts
implementation
- Discussions on application of norms and standards
(e.g. food fortification)
Involvement of the - Support to private sector industries for food
private sector to promote fortification with iron, vitamin A and iodine
social responsibility
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13. THE IMPLEMENTATION PLATFORM
What can we learn from the implementation platform?
- Facilitates coordination of sectoral
interventions
- Strengthens accountability of
stakeholders
- Facilitates the decentralization of the
results-based management of
interventions (planning and monitoring
implemented at community level
Limitations to its replicability:
- Political will to decentralize is not always available
- Capable horizontal structures have to be present at the national level to ensure
the success of nutrition interventions at community level
- Dependable financial support is needed to sustain the implementation and
support system
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14. PROSPECTS
The different crises have taught us that we need to keep building
and strengthening because gains are still fragile
Our challenge for the next five years:
- Consolidate the system, implementation and results
• Strengthen the stakeholders’ ownership and accountability (Local
Government, ministries, private sector)
• Adapt to stakeholders’ changing roles
• Strengthen CLM and its catalytic role
- Strengthen multisectoral activity
- Develop a more inclusive strategic document
• Strengthen dialogue among stakeholders
• Increase funding for pro-nutrition interventions
• Strengthen CLM
• Strengthen its ability to respond to emerging situations
• Stimulate and maintain CLM’s innovation capacity
• Overcome the difficulty of mobilizing public financing (in Senegal, the plan is
for an increase from $0.35 M per year between 2002-2006 to $7.8 M per year
in 2016)
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15. PROSPECTS
The different crises have taught us that we have to keep building and
strengthening because gains are still fragile
Our challenge for the next five years:
- Strengthen the SUN movement
• Intensify stakeholders’ involvement
• Develop strong partnerships in policy dialogue and financial support
• Strengthen accountability of the different actors
• Strengthen the monitoring and evaluation systems
• Strengthen and adapt the intervention strategies according to local contexts
• Strengthen the multisectoral implementation platform around key sectors
such as agriculture, education, environment, and health by initiating and
implementing nutrition-sensitive interventions
Text February 2011