Assessing DFID’s results in nutrition

The government has beaten its goal of reaching people in some of the world’s poorest countries with nutrition services – but with malnutrition set to rise as a result of the COVID-19 pandemic, it should do more to help the most vulnerable.

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Published
16 Sep 2020
Assessment
ICAI Green/amber score
Lead commissioner
Tamsyn Barton
Subjects
Nutrition
Related documents
Government response
Literature review
Approach paper

Relevant Sustainable Development Goals

  • Sustainable Development Goal 1: No poverty
  • Sustainable Development Goal 10: Reduced inequalities
  • Sustainable Development Goal 2: Zero hunger
  • Sustainable Development Goal 3: Good health and well-being
  • Sustainable Development Goal 6: Clean water and sanitation

Good nutrition is a fundamental prerequisite for the development of an individual and a country. It is essential for a healthy immune system and cognitive, motor and emotional development.

Worldwide, 820 million people are ‘chronically undernourished’ – 8.9% of the world’s population is believed to be hungry.  Low- and middle-income countries have the highest burden of undernutrition. The majority of the world’s stunted and wasted children live in Asia and Africa. Those already experiencing protracted crises, including in fragile and conflict-affected states, are more vulnerable.

Nutrition interventions are consistently identified as one of the most cost-effective development actions, with significant economic returns. In recent years, significant strides have been made to ensure that tackling undernutrition is a global priority. However, underlying factors, such as limited access to sufficient and nutritious food, inappropriate maternal and childcare practices and inadequate health services – all of which are affected by social, economic and political factors – means that progress towards reducing undernutrition is stalling in the poorest countries.

The coronavirus (COVID-19) pandemic is exacerbating the immediate and underlying causes of malnutrition and significantly threatens the potential for the global nutrition targets to be achieved.

This ICAI review assesses the accuracy of the results claimed by the former Department for International Development (DFID) from 2015 to 2019, and the robustness of the methodology used to calculate these results. It assesses the extent to which the nutrition portfolio targets and reaches the most vulnerable and hard-to-reach households, and the mechanisms used to understand their needs. Finally, the review assesses the impact of the nutrition programming that contributes to the reported results. This includes advocacy and technical assistance work at global and national levels, to foster action on nutrition.

Findings

Effectiveness: How valid are DFID’s reported nutrition results?

  • The measurement of reach is innovative and drives an increased focus on quality programming, although it does not reflect all goals within UK aid’s nutrition strategy.
  • DFID data shows that it met its global nutrition target (50 million people) early, despite taking a conservative approach to estimating its overall reach.
  • There have been inaccuracies and inconsistencies in the results measurement for some nutrition programmes. The nutrition portfolio has faced challenges in classifying intensity.
  • More than half of the nutrition programmes assessed by ICAI have achieved their immediate nutrition objectives.
  • Factors commonly influencing the effectiveness of the nutrition programmes include effective political leadership and coordination mechanisms, national and community-level delivery capacity, and systems for data and learning. External shocks are a major constraint.

Equity: Are DFID interventions reaching the most vulnerable and hard-to-reach women and children?

  • DFID targeted locations where people are highly vulnerable to undernutrition.
  • DFID made significant efforts to reach the most vulnerable households through its programmes.
  • The nutrition portfolio has been reaching vulnerable women and children under five, including in the most challenging environments.
  • DFID did not fully understand and always reach the most marginalised within its target group.
  • Wider barriers to reaching the most vulnerable include a lack of reliable data and coordination mechanisms, and capacity constraints on community workers and volunteers.

Impact: To what extent is DFID helping to reduce malnutrition?

  • DFID’s nutrition strategy and programmes were evidence-based with strong potential for impact.
  • The programmes are making progress on strengthening global and national leadership and action on nutrition.
  • The portfolio is likely to deliver longer-term impacts on undernutrition, although recent progress on reducing stunting and wasting has been mixed.
  • The multi-sector approach to nutrition is still under development particularly in food systems.
  • Efforts to improve coordination with partners did not achieve the required level of coverage and convergence of nutrition services on vulnerable households and communities.

Recommendations

Although this report looks back at the work of DFID, our recommendations are directed to the Foreign, Commonwealth and Development Office (FCDO) following the merger of DFID with the Foreign and Commonwealth Office. They are intended to strengthen the new department’s future approach to nutrition.

  1. FCDO should capture and communicate progress against all goals in its nutrition strategy, including strengthening systems and leadership for improved nutrition.
  2. FCDO should strengthen statistical capacity and quality assurance in-country and centrally, to support more accurate measurement of programme coverage and convergence, and to use the data to improve nutrition programming.
  3. FCDO should strengthen systems for identifying and reaching the most marginalised women and children within its target groups.
  4. FCDO should more consistently gather citizen feedback to help improve and tailor its nutrition programmes.
  5. FCDO should scale up its work on making sustainable and nutritious diets accessible to all, to help address the double burden of malnutrition, through nutrition-sensitive agriculture and private sector development.
  6. FCDO should work more closely with its partners to achieve the convergence of nutrition interventions, by aligning different sector programmes to focus on those communities most vulnerable to malnutrition.

Government response

The government’s response to our nutrition review is available to read online.

International Development Committee

We expect there to be an International Development Committee hearing into this review in due course.