Day 1- afternoon session: Purnima Menon, IFPRI-New Delhi: “Enabling Policy Environments for Infant and Young child feeding and nutrition: the roles of actors, networks, narratives, and data,” Workshop on Approaches and Methods for Policy Process Research, co-sponsored by the CGIAR Research Programs on Policies, Institutions and Markets (PIM) and Agriculture for Nutrition and Health (A4NH) at IFPRI-Washington DC, November 18-20, 2013.

1. Enabling policy environments for infant and young
child feeding and nutrition: The roles of actors,
networks, narratives, and data
Purnima Menon
IFPRI

2. Funding and contributors

Funding:


Bill & Melinda Gates
Foundation, through Alive
& Thrive, managed by
FHI 360
(www.aliveandthrive.org)
A4NH

Contributors

IFPRI

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


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Noora-Lisa Aberman
Eva Schiffer
Jody Harris
Andrew Kennedy
Neha Kohli
Kuntal Saha
Phuong Nguyen
Disha Ali
Collaborators



Nazneen Akhtar
GMMB
Edward Frongillo

3. The first 1000 days of life (pre-pregnancy to
24 months) are a crucial period for nutrition
INFANT AND YOUNG
CHILD FEEDING
Europe &
Central Asia
LAC
North Africa &
Near East
Sub Saharan Africa
South Asia

4. Windows of Opportunity
INFANT AND YOUNG CHILD FEEDING
Preconception through
pregnancy
0-6 mo: Exclusive
breastfeeding
6-24 mo: Complementary
feeding & Continued BF
Guiding principles
for complementary
feeding (2003; 2005)
4
http://www.marieclaire.com/cm/marieclaire/images/mcx0807FEIndia001-med.jpg
http://www.who.int/child_adolescent_health/documents/media/9241593431.jpg
K Dewey

5. Optimal IYCF practices at the household level
also require an enabling policy environment

Exclusive breastfeeding (EBF)

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Agreements about critical need to provide policy support to
EBF
Maternity leave and work place legislation
Monitoring of compliance with the International Code of
Marketing of Breastmilk Substitutes (“the Code”)
Investments in communications and awareness raising
campaigns
Complementary feeding



Monitoring of compliance with the International Code of
Marketing of Breastmilk Substitutes (“the Code”)
Investments in communications and awareness raising
campaigns
Codex Alimentarius standards for production of complementary
foods

6. Alive & Thrive Program
Framework
1
2
3
4
Using data to drive program focus and
results

7. Elements of Alive & Thrive advocacy and
policy engagement strategy
Messages
and
materials
Media engagement
Policy
Advocacy
Stakeholders
and
partnershiips
Data and evidence

8. Key objectives for policy advocacy
evaluation led by IFPRI

Understand and document shifts in the overall
policy environment for IYCF and nutrition in
Bangladesh, Vietnam and Ethiopia

Elucidate contribution of Alive & Thrive policy advocacy
Illustrative example for today: overall policy environment in
engagement and interventions to the shifts in the policy
Bangladesh
environment (focus on issue ascendance)

Separate ‘deep-dive’ studies in each country



Media engagement in Bangladesh
Support to provincial planning for nutrition in Vietnam
Bringing attention to stunting and prevention of stunting
in Ethiopia

9. Issue ascendance is one of the more
“upstream” stages in the policy process
Menon et al., Food and Nutrition Bulletin, 2011

10. Framework for issue ascendance
Shiffman and Smith (2007): framework
for issue ascendance in global health
Actor Power
Issue
Characteristics
Policy
Dialogue
Political
Contexts
Ideas
Framework used because major policy and advocacy
interventions in Alive & Thrive were initially focused
primarily on getting and keeping the issue of IYCF on the
agenda (rather than, say, getting a policy formulated)

11. Key components of policy process research
2010 baseline assessment of
policy environment
Document A&T
activities through
event database
2014 endline assessment of
policy environment, integrating
analysis of event database and
program documentation.

12. Data collection for policy environment
assessment at 2010 and in 2014 (planned)
Framework domain
2010
2014
Actor Power (actors,
networks, leading
institutions)
Net-Map (IFPRI,
individual interviews)
Net-Map (planned by
another research
group; use of group
interviews)
Ideas
Opinion leader
research by advocacy
firm (2009)
Stakeholder interviews
by IFPRI
Policy context
Review of policy
documents by IFPRI
Review of policy
documents and A&T
documentation by
IFPRI
Issue characteristics
National level data
from DHS (2007)
National level data
from DHS (2011)

13. Event database developed to track and
analyze advocacy strategies

Monthly project updates
Data based was coded based on advocacy
best practices  to identify strategies
initially used, and shifts in strategies over
time

14. Overall Bangladesh policy environment
(2010)
Stunting levels remain high and
stagnant in recent years
Exclusive breastfeeding was
low, and stagnant over the
years; complementary feeding
is very suboptimal
Issue
Characteristics
Nutrition was seen as one of
many issues that should be
tackled by raising the economic
status of the population and
reducing poverty
Knowledge about stunting, the
importance of IYCF, or solutions
to the problems were variable
across key actors
Very complex, with many local and
civil society players.. Strong central
influence of some key government
players and some individuals. The
were was high level of central
influence and lack of dynamic
exchange across the network
Actor
Power
Issue
ascendance
on the policy
agenda
Ideas
Political
Contexts
Global actions and strategies have
entered into national policy
discourses and actions but concerns
remain about translating of guidelines
into action on the ground.
Public health messages on IYCF are
in danger of being eroded by
persistent Code violations on the
marketing of formula

15. What baseline findings meant for IYCF policy
advocacy in Bangladesh


People matter. In Bangladesh, the
actor network for nutrition was
complex and large. A&T‟s advocacy
and policy engagement has been
strategic and systematic – slowly
reaching all influential actors and
„bringing them in‟ over 4 years

Ideas: Diverse views at the
beginning; advocacy aims to
shape a more coherent
narrative
Policies: Having national
strategy for infant feeding
helped; A&T was able to
take it to the next actionable
level.
Issue characteristics: The
situation was poor to start
with; the data enabled good
„story telling‟. A&T focus on
deepening understanding
through data

16. Key insights from event analysis on
strategic mix of advocacy activities
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Activities included: generating and framing evidence on IYCF,
investing in capacity-building initiatives for communities and
government quarters, and building communication materials at
an early stage, training media and initiating media study
circles to enhance media coverage and shape discourse via
media
A&T staff, in partnership with staff from other organizations,
acted as policy entrepreneurs and champions using strategies
such as alliance building, dialogues, and discussions as well
as media and dissemination strategies.
A&T and partners used or created policy windows that
included award ceremonies, launch events, and special days
or weeks.
Extensive efforts to popularize the discourse via news
coverage and dissemination, thereby providing external
framing and advocacy of policy issues.

17. Methodological reflections

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Shiffman & Smith framework works well for assessing factors
related to issue ascendance; other aspects of policy process
demand other frameworks and theories
Net-Map was useful to map actors and networks, but not
perfect; major network characteristics well captured, but nature
of participatory Net-Map interviews, time/availability or lack of
knowledge of some stakeholders about others limits
utility/accuracy
Event database requires continuous and diligent „data entry‟
and continuity of research staff for coding and analysis; monthly
updates possibly limited
Program itself has moved rapidly and advocacy and policy
support interventions have gone beyond advocacy for “issue
ascendance”!
Data challenges between 2010 and 2014 assessments: several
other policy process issues and researchers, but similar

18. Any questions?