Carrots and Sticks : The Political Economy of Nutrition Policy Reforms

Natalicchio, Marcela; Garrett, James; Mulder-Sibanda, Menno; Ndegwa, Steve; Voorbraak, Doris

Carrots and Sticks : The Political Economy of Nutrition Policy Reforms

Autores

Natalicchio, Marcela

Garrett, James

Mulder-Sibanda, Menno

Ndegwa, Steve

Voorbraak, Doris

Editor

World Bank, Washington, DC

Descripción

The World Bank and other development partners have been involved in the implementation of nutrition programs for over 30 years. While a number of these programs have become successful and sustainable large-scale operations, many others have been hindered by political and administrative obstacles. The disparate results of these nutrition programs suggest that generating technically sound knowledge about nutrition and providing it to policymakers is not enough to ensure good results. It is also crucial to understand the political context, and the constraints and motivations of politicians, public officials, and other relevant players to initiate, implement, and sustain sound policies. In May 2007 the World Bank held an international workshop on these issues to help increase the impact of nutrition programs and policies at the country level. This paper summarizes the results of that workshop. Drawing from the political economy literature, it presents two frameworks for understanding how to undertake action to put nutrition on the agenda and move it forward, as well as insights on how and why political factors derail reforms and how to keep that from happening. These frameworks are accompanied by a discussion of the politics of nutrition policies, including typical obstacles to policy development and implementation, and possible solutions. To complement the political economy approach, the paper also draws on the insights that management and organizational fields offer regarding change promotion. Experiences from Senegal, Madagascar, Ghana, Tanzania, Benin, and India are discussed, sketching out the history of nutrition policies and the factors that promoted change, main obstacles and challenges. The paper closes with an attempt to encapsulate all elements presented in a single analytical framework, and provides plans of action for specific countries as prepared by some of the participants.

Palabras clave

ACCOUNTABILITY, ACCOUNTABILITY MEASURES, ADVOCACY EFFORTS, AGRICULTURE, ASSETS, BANKS, BREAST-FEEDING, CAPACITY BUILDING, CHILD DEVELOPMENT, CHILD SURVIVAL, CITIZEN, CITIZENS, CIVIL SERVANTS, CIVIL SOCIETY, CIVIL SOCIETY ACTORS, CIVIL SOCIETY ORGANIZATIONS, COMMUNITY BUILDING, CONFIDENCE, CORRUPT, DECENTRALIZATION, DEVELOPING COUNTRIES, DEVELOPMENT STRATEGIES, DISCRETION, ECONOMIC GROWTH, EFFECTIVE POLICIES, ELDERLY, EMERGENCY SITUATIONS, ENFORCEMENT MECHANISMS, EQUIPMENT, EXISTING CAPACITY, FISHERIES, FOOD SECURITY, GOOD GOVERNANCE, HEALTH POLICY, HEALTH REFORM, HEALTH SECTOR, HEALTH SECTOR REFORM, HEALTH SYSTEMS, HEALTH WORKERS, HUMAN CAPITAL, HUMAN DEVELOPMENT, HUMAN NUTRITION, HUMAN RIGHTS, IMPACT OF POLICIES, INFORMATION SYSTEM, INITIATIVE, INSTITUTIONAL CAPACITY, INSTITUTIONALIZATION, INTEGRATION, INTERNATIONAL ASSISTANCE, INTERNATIONAL CENTER FOR RESEARCH ON WOMEN, INTERNATIONAL COMMUNITY, INTERNATIONAL CONFERENCE ON NUTRITION, INTERNATIONAL FOOD POLICY RESEARCH INSTITUTE, IRON, ISOLATION, LAWS, LEADERSHIP, LIVESTOCK, LOBBYING, LOCAL COMMUNITIES, LOCAL GOVERNMENTS, MEDIA, MILLENNIUM DEVELOPMENT GOALS, MINISTER, MINISTRY OF EDUCATION, MINISTRY OF HEALTH, MODERNIZATION, NATIONAL COMMITTEE, NATIONAL DEVELOPMENT, NATIONAL POLICY, NATIONAL POLICY MAKERS, NATIONALS, NATURAL RESOURCES, NGOS, NUTRITION, NUTRITION POLICIES, NUTRITION PROGRAMS, NUTRITIONISTS, PARADIGM SHIFT, PATRONAGE, PERSONAL COMMITMENT, PERSONAL COMMUNICATION, PERSONALITY, PLANS OF ACTION, POLICY ANALYST, POLICY CHANGE, POLICY DEVELOPMENT, POLICY DIALOGUE, POLICY DOCUMENT, POLICY FORMULATION, POLICY GOALS, POLICY PROCESS, POLICY PROCESSES, POLICY RESEARCH, POLITICAL ACTION, POLITICAL CHANGE, POLITICAL LEADERS, POLITICAL POWER, POLITICAL PROCESS, POLITICAL SUPPORT, POLITICAL SYSTEMS, POLITICAL TURMOIL, POLITICIANS, POOR HOUSEHOLDS, POOR PEOPLE, POTENTIAL CONTRIBUTION, POVERTY REDUCTION, POVERTY REDUCTION STRATEGY, POWER RELATIONS, PRACTITIONERS, PRIVATE SECTOR, PROGRESS, PUBLIC ATTENTION, PUBLIC FUNDS, PUBLIC OFFICIALS, PUBLIC SERVICE, QUALITY OF SERVICES, REMEDIES, REMEDY, RESEARCH ORGANIZATIONS, RESPECT, RURAL COMMUNITIES, SANCTION, SANCTIONS, SCIENTIFIC EVIDENCE, SERVICE DELIVERY, SERVICE PROVIDERS, SOCIAL MARKETING, SOCIAL SECTOR, SPONSORS, SUSTAINABLE FINANCING, TECHNICAL CAPACITY, WARS, WORLD HEALTH ORGANIZATION