Table 3

Factors identified as driving political commitment for nutrition

CategoryFactor and description
Actors(1) Nutrition actor network (NAN) effectiveness: effectiveness of NANs, the individuals and organisations operating within a given jurisdiction who shared common principles, causal beliefs and/or interest in tackling malnutrition and who acted collectively to do so.14 20 25
(2) Strength of leadership: presence of committed and politically savvy individuals, within or outside of government, recognised as strong champions for nutrition.7 14 20 26
(3) Civil society mobilisation: extent to which civil society groups mobilised to address malnutrition, including non-government organisations and social movements collectively representing the interests of citizens.7 14
(4) Supportive international actors: degree to which actors with an international scope of operations and/or membership initiated, championed and/or supported nutrition policy and programming responses.14 27
(5) Private sector interference: degree to which mobilised private interest groups undermined effective nutrition policy responses, including food producers, retailers, marketers and their representative peak bodies.28 74
Institutions(6) Strength of institutions: extent to which coordinating agencies and institutional systems mandated to address malnutrition were empowered to effectively coordinate multisector/multilevel responses and advocate for sustained attention and resources.7 14 53 60
(7) Effective vertical coordination: degree to which nutrition policies were effectively coordinated, implemented and monitored across levels of governance, particularly regarding the incentives of subnational actors to adopt, progress and benefit from central government policies.29 52 86 89
(8) Legislative, regulatory and policy frameworks: degree to which national nutrition policies, operational plans and enabling legislation were well-designed and enacted, and/or the alignment of nutrition objectives with broader policy agendas and regulatory frameworks.61 71 81
Political and societal contexts(9) Supportive political administrations: degree to which members of the executive (eg, head of state, ministers), legislative (eg, parliamentarians) and administrative (eg, agency heads, senior officials) branches of government initiated and championed nutrition responses.12 30 52
(10) Societal conditions and focusing events: extent to which changing societal conditions (long-duration phenomena) or focusing events (short-term processes) focused attention onto nutrition or closely related issues and presented opportunities or impediments to commitment-building.14 20 27 31 32
(11) Ideology and institutional norms: extent to which entrenched belief systems and practices predominant within political systems, policy-making institutions and/or in society-at-large, negatively skewed perceptions about malnutrition problems and undermined effective policy responses.15 20 25 28 48 94
Knowledge, evidence and framing(12) Credible indicators and data systems: availability of credible indicators and high-quality data systems for monitoring nutrition problems, informing policy design, tracking progress and empowering accountability systems.7 14 15 52 53
(13) Evidence: extent to which robust evidence on the causes, manifestations and consequences of malnutrition and the efficacy and cost-effectiveness of interventions was available, clearly communicated and accepted.14 28 75
(14) Internal frame alignment: degree to which NANs were aligned around a common interpretation and narrative of a given malnutrition problem including its definition, magnitude, causes and solutions for resolving it.14 25 27 29 31
(15) External frame resonance: degree to which NANs publicly portrayed (ie, framed) nutrition problems and solutions in ways that resonated with and motivated action by external audiences, and countered the frames deployed by opponents.14 20 27 28 31 52
Capacities and resources(16) Strategic capacities: degree to which NAN members possessed ‘soft-power’ skills including the capacity to generate consensus, resolve conflicts, respond to recurring opportunities and challenges, build strategic alliances, undertake strategic communications and related tasks.7 31
(17) Organisational capacities: degree to which NAN members possessed the technical knowledge and skills, administrative systems and human resources required to generate commitment, including through the effective management of nutrition policy and programming responses.7 15 24 31
(18) Financial resources: degree to which nutrition budgetary commitments and financing systems incentivised multisector/multilevel coordination, ensured successful policy implementation and created ownership and entitlements among political elites, policy-makers, citizens and other stakeholders.7 52