Actors concerned with the governance, financing and coordination of the overall response (eg, SUN focal points, national nutrition response coordination bodies, cluster coordinators, donors) may find the following sections particularly useful:
- Rationale for a multisectoral approach to preventing undernutrition.
- Contexts and target populations .
- Oversight, coordination and collaboration of a multisectoral response to prevent undernutrition.
- Contextual analysis.
- Response design options.
- Principles and ways of working for prevention.
The prevention of undernutrition is not only an ethical imperative but a critical investment in long-term resilience and recovery. This tool translates evidence into practical guidance – not just what actions to take, but how to implement them effectively within a multisectoral response.
Actors concerned principally with the design and delivery of preventive interventions in specific sectors or a combination of sectors (including health, agriculture/food systems, water, sanitation and hygiene, social protection), such as government sector ministries, UN agencies, NGOs and Civil Society Organisations) may find the following sections most useful:
- Contexts and target populations.
- All sections under the decision tool including understanding causes of undernutrition, response design options and considerations for monitoring and evaluation.
- Principles and ways of working for prevention.
The ‘overarching’ sections listed above may also be useful to these actors in guiding the design of their specific component of the response and thinking through how it will ‘fit’ or ‘converge’ with other relevant components.
Aims and objectives of this tool
The objective of this decision tool and resource package is to support governments, donors and coordinating and implementing agencies working in food insecure humanitarian contexts to design and deliver a response that will support the effective prevention of undernutrition among pregnant and breastfeeding women and adolescent girls (PBWGs) and children under five years.
This tool aims to support the design of a complete multisectoral response delivered (most commonly) by multiple actors to address the most common and immediate drivers of undernutrition across diverse humanitarian settings. It is relevant for agencies involved in the design and/or coordination of a holistic multisectoral response as well as agencies covering one or two components. It will help to ensure prioritisation of key actions within a collective response, as well as giving options on interventions and the considerations that are important.
The tool does not aim to cover the detail of programme design which can be found in the large body of existing technical guidance and learning that are linked in the resource pages of this tool.
The tool is process–oriented: it covers the importance of understanding the main causes of undernutrition in a specific context as a first step; design of a holistic multisectoral response corresponding to this analysis and the oversight and coordination needed for implementing actors. The range of evidence–based nutrition–specific and nutrition–sensitive interventions that can be selected according to the context and target group is also presented with some guidance on the process of response design to ensure that the basic needs of those most vulnerable to undernutrition ie, PBWGs and children under five, are met.
Acknowledgements
This tool was commissioned and funded by Elrha’s Research for Health in Humanitarian Crises (R2HC) programme.
About Elrha
We are a global organisation that finds solutions to complex humanitarian problems through research and innovation. We are an established actor in the humanitarian community, working in partnership with humanitarian organisations, researchers, innovators, and the private sector to tackle some of the most difficult challenges facing people all over the world. Through our globally recognised programmes, we have supported more than 200 world-class research studies and innovation projects, championing new ideas and different approaches to evidence what works in humanitarian response. R2HC aims to improve health outcomes for people affected by humanitarian crises by strengthening the evidence base for public health interventions. Our globally-recognised research programme focuses on maximising the potential for public health research to bring about positive change and transform the effectiveness of humanitarian response.
Authors and Affiliations
Authors: Kate Sadler, Tamsin Walters, Rebecca Brown, Lena Cherotich, Rita Abi Akar
Affiliations: NutritionWorks (United Kingdom)
Elrha and NutritionWorks are grateful for the strategic and technical advisory support of our Steering Committee: Abigail Perry, World Food Programme (Italy), Brenda Lazarus, Food and Agriculture Organization (Kenya), Emma Massey, Foreign Commonwealth and Development Office (United Kingdom), Erin Boyd, USAID (United States), Dan Maxwell, Tufts University (United States), George Mutwiri, Save the Children International (Kenya), Gladys Mugambi, Ministry of Health (Kenya), Grainne Moloney, UNICEF (United States), Karima Al-Hada’a, Ministry of Planning & International Cooperation (Yemen), Mohamed Rashid, Food and Agriculture Organization (Kenya), Sonia Walia, Bureau for Humanitarian Assistance (United States), Zita Weise Prinzo, World Health Organization (Switzerland).
The project team would like to acknowledge and thank all stakeholders and contacts who supported the development of this tool, including those who provided case studies of prevention programming.
The views expressed in this paper are those of the authors and are not necessarily those of Elrha or Elrha’s donors.
This work is licensed under a Creative Commons AttributionNonCommercialNoDerivatives 4.0 International (CC BY-NC-ND 4.0).
Technical Advisory and Project Management: Gillian McKay, Elrha