focus on accountability is not designed to “name and shame”; it is about focusing scarce resources that have alternative uses.
At present, accountability of all stakeholders in nutrition is weak. The Nutrition for Growth (N4G) tracking process showed a community with highly variable capacities to respond to accountability prompts. In addition, there are few national data on domestic resource flows designed to improve nutrition status. Presently, country-level progress can only be assessed for four of the six WHA indicators. The nutrition community needs to be more deliberate about building accountability. Investing in civil society is likely to be key, as highlighted in several panels throughout the report.
Recommendations
• As a matter of urgency, the Joint Child Malnutrition Mon- itoring group (UNICEF, WHO, and the World Bank) should establish rules for determining whether countries are on or off course for meeting global goals on low birth weight and exclusive breastfeeding.
• Targets for nutrition spending should be developed in both domestic budgets and donor budgets and accompanied by better tracking data on spending to ensure that the quantity and quality of spending are improved. The 2015 Global Nutrition Report will include new work in this area.
• N4G signatories need to see themselves as champions of ac- countability—investing in accountability mechanisms within their own organizations and helping others to become more accountable.
• The development, piloting, and evaluation of new account- ability mechanisms by all nutrition actors should be encour- aged and supported. Approaches that engage citizens and national civil society organizations are particularly important.
• The 2014 Global Nutrition Report places insufficient empha- sis on business and private sector accountability. The 2015 Global Nutrition Report will rectify this shortcoming.
MESSAGE 8: Tracking spending on nutrition is currently challenging, making it difficult to hold responsible parties accountable.
Few countries have transparent and comprehensive systems for tracking nutrition spending, with Guatemala appearing to be one notable exception. Tracking of donor resources is improving, but many reporting differences remain. Civil society organizations, multilateral agencies, and businesses also need to do more to track nutrition resources.
Recommendations
• Countries should be supported by a wide range of stake- holders to undertake basic data-gathering exercises on nutrition-relevant budget allocations. The data can then be categorized into nutrition-specific and nutrition-sensitive categories using national or international definitions and published in an open data format. The 2015 Global Nutri-
tion Report will aim to provide a platform for countries to highlight their work in this domain.
• Other nutrition actors—such as UN agencies, large civil society organizations, intergovernmental organizations, and large companies—should be encouraged to undertake similar financial tracking exercises and to make the data freely available.
MESSAGE 9: Nutrition needs a data revolution.
The world has committed itself to meeting six WHA global nu- trition targets, yet more than half of the countries in the world do not have the data to assess their progress. It is, moreover, a problem in all regions: of the 94 countries that are missing WHA tracking data, 38 are in Europe and 1 is in North America. In addition, nearly 40 percent of the countries that do have tracking data for four of the six WHA targets are using survey data that are five to nine years old.
In addition to data gaps on WHA progress, intervention cov- erage, and financial tracking, there are important gaps in data on food consumption, program costs, low birth weight, micro- nutrient status, capacity to scale up interventions, and impact. We also have few data on the natural resource use intensity of different nutrition actions.
Recommendations
• Because there are many data gaps, it is vital to prioritize which gaps to fill. Given the imminent finalization of the SDGs, we need to be prepared for a possible increase in spending on data gathering. A series of regional workshops should be held in the next 12 months to identify key data gaps to be filled.
• Nutrition investors—both domestic and international— should be prepared to invest in capacity to conduct consis- tent and comparable national nutrition surveys so that they are available every three to four years.
• High-income countries need to do more to make their WHA data internationally comparable. Future Global Nutrition Reports will track the rates of inclusion of data from these countries, which are mainly in Europe.
• Too little is spent on updating and maintaining national and global databases on nutrition. Governments and donors must start investing more in this essential component of ac- countability. The 2015 Global Nutrition Report will attempt to analyze current levels of investment in relation to need.
MESSAGE 10: National nutrition champions need to be
recognized, supported, and expanded in number. Effective large-scale action on nutrition requires the existence of sufficient numbers of dedicated, trained, and properly motivat- ed individuals with adequate resources, working in conditions that support their efforts. Examples of the importance of these champions are plentiful: the Maharashtra case study in Panel 2.3, for example, shows how important it is to fill frontline
ACTIONS & ACCOUNTABILITY TO ACCELERATE THE WORLD’S PROGRESS ON NUTRITION 73
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