This section briefly describes why understanding context and causes is important and the common components required to do this. It provides links to a range of existing resources and tools that can be used to support context and causal analysis on the ground.
Step 1: Understanding the main causes of undernutrition in humanitarian contexts
It is critical that any response starts with an understanding of the prevailing local context to identify gaps and needs. The findings from this should be the foundation for programming. It will guide decisions on which interventions and activities to prioritise within a multisectoral response to ensure the most important drivers of undernutrition are addressed quickly so that the impact of the response is optimised. The analysis should start with forming an understanding of the reality for nutrition facing women, adolescent girls, infants and young children prior to any crisis and move on to document how the humanitarian situation has changed this reality across the spectrum of pathways to nutrition outcomes
(see Figure 1).
Disabled women and children or those from disadvantaged or minority groups, may be affected disproportionately by changes to the food security, health and care environment and their particular needs and vulnerabilities should also be understood.
Common components of understanding causes
Nutrition data and scenario assessment: It is important to have nutrition information, at national and sub–national levels, relevant to all population groups at an early stage. Wherever possible, data should be localised to ensure an accurate understanding is developed of the particular areas most affected by the crisis. Data from nutrition information systems, surveillance, surveys (from different points in time) and programmes that deliver essential nutrition actions, manage wasting or address micronutrient deficiencies can help to identify changes in nutrition indicators that require action.
Common indicators, both qualitative and quantitative, for which data is important (and may be available through existing/ ongoing data collection systems) include:
- Nutritional status (wasting, stunting, MNDs) of children and PBWG.
- Diet quality/diversity of children and PBWG.
- Household food security and household hunger.
- Mortality.
- Infectious disease.
- Infant and young child feeding (IYCF) practices (especially infant feeding).
- WASH practices and availability of infrastructure and access to facilities.
- Education, particularly access to education by girls.
Indicators should be disaggregated by sex and age and disability status wherever possible.
A full list of indicators relevant for multi–sector response planning can be found in the nutrition humanitarian needs analysis guidance developed by the nutrition cluster and also in the inter– cluster/sector collaboration (ICSC) project’s overview document ‘What is “Inter–Cluster / Sector Collaboration (ICSC)”?’.
Common platforms through which nutrition information is collected and analysed include national nutrition and health information systems, the integrated phase classification (IPC), nutrition and food security surveys using methodologies such as Standardised Monitoring and Assessment of Relief and Transitions (SMART) and Standardised Expanded Nutrition Survey (SENS) and Mobile Vulnerability Analysis and Mapping (mVAM).
It is important to note that in many humanitarian settings there may be considerable gaps in data availability and challenges with timeliness and quality of the survey and other data that exists. In these circumstances, developing a complete understanding of context and causes can be challenging. Adopting mechanisms, such as use of a mixed methods approach that combines any secondary data that is available with some primary data collected through surveys/ assessments and/or from key expert informants and focus groups, can help to fill knowledge gaps. Contextualising the data that does exist26 and use of proxies where possible can bridge data gaps and provide meaningful insights to inform decision–making, even in data–scarce environments, eg, changes in staple food prices relative to income levels may be useful as a proxy for food access. Triangulation of findings from different sources can improve reliability and certainty around findings. Collaboration with local authorities, community leaders and civil society to gather insights and ensure ownership of findings is critical for building an accurate understanding of the context and drivers of undernutrition. Use of ‘local knowledge,’ eg, rapid focus group discussions, can help to develop a reliable picture quickly.27 This approach is also being developed as part of the work of the Nutrition Determinants working group of the GNC
(see below).
Needs assessment
The inter–cluster/sector collaboration (ICSC) project28 has outlined the steps required for needs assessment to feed into a multisectoral response delivered by multiple partners and sectors. In summary these include:
- Agree roles and responsibilities and timeframe. Identify your core team. Agree who will be involved for the joint needs assessment and analysis, roles and responsibilities and timeframe for the analysis. These responsibilities may be adjusted as the plan evolves. Identify a wider group of key actors for consultation and feedback at different stages. Set the scope of the analysis and costing plan.
- Joint planning. Outline a basic framework for the information needed, agree on key indicators for each sector/cluster and collate and review existing data (secondary data) from respective sectors and identify critical information gaps.
- Only if required, plan joint data collection. Fill the information gaps identified and deepen the understanding of the situation and needs. Collectively select appropriate data collection and analysis methodologies, data collection tools and identify necessary resources. A practical plan should be developed, validated and implemented to collect complementary information.
- Jointly analyse and write up findings. Consolidate primary and secondary data and populate the analysis framework. Summarise findings and provide clear, actionable recommendations. Some recommendations may be common to all sectors while some may be sector–specific. One specific deliverable may be a joint chapter for the Humanitarian Needs Overview (HNO), or as a minimum, reflect ICSC commitments in the “Sectoral analysis” chapter of the HNO. When no space is provided in the HNO, a separate document can be prepared to highlight the joint analysis of needs and response strategy. Key requirements at this stage are an understanding of:
- Populations at risk.
- Main drivers of undernutrition among populations at risk.
- Gap analysis of programmes/interventions/services available to address main drivers.
- Prioritisation ie, a sense of what action will make the biggest difference to fill the biggest gaps.
- Share joint findings. Share the final findings as a whole with all relevant coordination groups, sectors and partners. Use different multi–sectoral platforms and groups.
Note this step may be informed by the Joint Intersectoral Analysis Framework (JIAF)29, which has recently undergone review and is being rolled out for the 2025 Humanitarian Programme Cycle.
Approaches and tools for context and causal analysis
Several tools/approaches exist that aim to support context and causal analysis for nutrition across different humanitarian contexts. These are briefly summarised in the linked and annexed text here.
The Nutrition Determinants working group of the GNC30 have recognised that there is a need for a simple and affordable toolkit, which will help to identify context–specific determinants of different forms of malnutrition and their influence (the degree to which they contribute to malnutrition) throughout an annual cycle, while facilitating community engagement, more efficient and effective use of existing data as well as programme solutions by programme implementers. This work is ongoing at the time of writing.
References
26 ie, redefining indicators to reflect the current realities and focussing on relative changes rather than absolute measures
28 What is “Inter-Cluster / Sector Collaboration (ICSC)”? V2, Sept 2023. What is inter-cluster / sector collaboration? | Global Nutrition Cluster
29 JIAF - HPC Collective Learning - OCHA Knowledge Base