Mike Khunga, a Youth nutrition advocate from Malawi

By Mike Khunga

Mike Khunga, a Youth nutrition advocate from Malawi, exchanged thoughts and a handshake with Anne Peniston, Chief, Nutrition and Environmental Health Division at USAID, during the RESULTS International Conference in Washington, D.C.  in July.

Accountability is about the ways in which elected officials and policymakers are held responsible for carrying out the policies and programs they commit to, on the public’s behalf. It includes an obligation to provide an account or justify actions as well as ensuring that action is taken, and redress provided when accountability fails.

SUN Civil Society Network, a group of over 2,000 organizations in 39 countries, plays a critical watchdog role in promoting accountability among elected officials and policymaker by ensuring that policies, plans and pledges are implemented in the best interest of the people, particularly the population most vulnerable to malnutrition.

They also hold donors, private sector entities, United Nation agencies, and even CSO’s themselves accountable for their roles.

Civil society is therefore at the heart of the advocacy work to put nutrition on the national agenda and ensure sustainability and prioritization beyond political cycles. Building relationships with key players such as members of parliament and media is essential in this effort.

SUN Civil Society Networks actors promote accountability by participating in planning as part of multi-sectoral nutrition structure and by carrying out national budget analysis.

In Malawi, Nutrition Alliance (CSONA) and its members conducted a 2018/19 budget analysis which showed that government resource allocation to nutrition is 0.9% against the 3% stipulated in the Malawi Development Goals and strategy (MDGS3).

The analysis serves as the basis for advocacy for increased and sustained nutrition resource allocation in the country.

Apparently Malawi nutrition situation remain alarming with multiple burden of stunting, wasting and underweight at 37.1%, 3% and 11.7% respectively while the rate of exclusive breastfeeding  is 70%.

According to the cost of hunger study for Malawi, poor nutrition in early life results in low cognitive ability, low education attainment, poor immunity to infections, elevated risk of acute & chronic diseases, increased health care costs, ow productivity, high dependency on public resources and stagnant national development.

The study further shows that 23% of child mortality cases are associated with under-nutrition.

Total annual costs associated with child under-nutrition are estimated at USD 597 million which is an equivalent of 10.3% of GDP.

At policy level Malawi has recognised the need to combat malnutrition in all its forms through the Malawi National Multisector Nutrition Policy (2018-2022).

The Malawi Growth and Development Strategy (MGDS III) prioritises nutrition among other development issues emphasising the need to take proactive steps in addressing the root causes of the problem.

The mandate to respond to malnutrition is led by Department of Nutrition HIV and AIDS (DNHA) which play a critical role in coordinating all nutrition programming and implementation in Malawi.

At national level, the following are the structures: National Nutrition Committee, SUN Taskforce and various Technical Working group.

At district level and community level there is the District Nutrition Coordinating Committee (DNCC), Area Nutrition Coordinating Committee, and Village Nutrition Coordinating Committee.

Nutrition has been mainstreamed into all the relevant sectors and ministries, however these ministries have limited or no funding to carry out nutrition activities at district level and even the little fund that is available is poorly disbursed such that it cannot be tracked down.

According to the Organisation for Economic Cooperation and report, Donors contribute the most to nutrition investment in Malawi.

The country’s spending per child is US$ 2.45 compared to donor share of US$ 30.68 (OECD report 2015). With limited funding as well as poor nutrition structures to enhance accountability, nutrition situation in Malawi is not improving.

As Malawi is going to have elections in May 2019 one thing that has to be made clear by all the political aspirants is how they are going to enhance nutrition in the country considering that very few have talked of nutrition in their manifestos despite the country crippled with heavy burden of malnutrition.

The development of the country relies on people who are health and free from any form of mental retardation due to malnutrition. On the hand high levels of over nutrition

Citizen engagement is an essential component to ensure accountability and sustainability in nutrition interventions that address the immediate and underlying causes of malnutrition.

However, there is limited understanding among citizens of a human rights based approach to health and nutrition and mechanisms to demand these rights.

Despite recent data that show nutrition beyond a health issue, awareness of these developments among the citizens is very minimal as such communities do not perceive adequate nutrition as a fundamental human right that they can demand to be fulfilled from respective duty bearers.

Government on the other hand capitalizes on this lack of awareness of communities and fails to honor its nutrition commitments such as the nutrition for growth commitments where Malawi government pledged to accelerate budgetary support to nutrition.

Citizen Involvement during planning, implementation and monitoring helps them to keep track of quality and efficiency of services delivered and hold providers.

Unfortunately, citizen are not aware of information relating to budget, procurement resource allocation and standardization process and in the end, people are not empowered to demand nutrition from a right based approach and account those responsible for providing.

For better accountability during nutrition spending, project beneficiaries should be at the hub of the intervention and not viewed or treated as end users.

They is poor nutrition governance at district level due to uncoordinated and fragmented nutrition programming which makes it very difficult to retrieve data on nutrition financing and hold duty bearers accountable.

The challenge is also exacerbated by weak nutrition structures at community and district level.

To enhanced accountability at district level, nutrition should be prioritized in the key document like the District Development Plan a(DDP), District Implementation Plan (DIP) and Social Economic Profile (SEP).

On the other hand, government should prioritize nutrition within the national development framework to attract more resources for and government must create awareness in the public so that they can demand better nutrition support from the Constituency Development Fund.

Nutrition accountability by government needs to include commitments to international or national nutrition plans and monitoring frameworks.

During its planning process, government must identify what resources are available to fund the country’s nutrition goals and to establish clearly how those will be allocated.

Strong accountability framework should be built into the performance management process, including how to measure how service providers implement their plans and what actions should be taken in response to the abuse or misuse of public resource.

Overall, governments should have a clear oversight of the entire project and make sure that service providers are accountable for their performance.

 

Mike Khunga is a nutrition advocate in Malawi working with Nutrition Alliance in Malawi.  He is a nutrition and food science graduate from Lilongwe University of Agriculture and Natural Resources (LUANAR).

 

 

[1] Malawi Demographic Health Survey 2015-16, Department of Statistics, Government of Malawi

[2] Cost of Hunger Report (2012), Ministry of Finance, Organisation for Economic cooperation and Development report (2015)

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