Wasting and Stunting Project: Story of Change
Research Summary1
The Wasting and Stunting (WaSt) project2 began in 2014 with the establishment of the Wasting and Stunting Technical Interest Group (WaSt TIG) – a group of senior experts working on wasting or stunting coordinated by ENN. The project has subsequently been through three phases of work, resulting in multiple outputs by the TIG exploring the relationship between wasting and stunting. As part of ENN’s commitment to evaluating its work, a Story of Change (SoC) methodology was developed to explore the implementation and outputs of the WaSt project. The SoC aimed to examine and document the role of the WaSt project in creating a better understanding of the relationship between wasting and stunting and its ability to advance the uptake of findings in national policies, programmes and institutional architecture. The SoC also examined ENN's role as coordinator of the group.
To inform the process, 25 people were interviewed and asked to provide their views on the process, successes, challenges and lessons learned, as well as recommendations for the next phase of the project. Key informants were identified by ENN, including a mix of individuals who were heavily engaged in the project as WaSt TIG members (n=17) as well as those not involved but who may have been aware of or influenced by the work (n=8). Key informants included those working in academia, United Nations (UN) agencies, donors or non-governmental organisations (NGO).
Successes and achievements
A key theme emerging from the SoC was the success of the WaSt TIG in terms of it make up – a mix of expert individual members representing themselves rather than their agencies’ agendas – as well as the way that the group functions in an engaging, iterative and exploratory and yet task-oriented manner. The varied nature of the group’s membership (expertise spanning different areas related to wasting and stunting), its flexibility (allowing individuals to define their own level of engagement based on other commitments) and its open and collaborative manner were also identified as key features of its success. As one respondent noted, “It feels that it has been intelligently designed. It is not accidentally landing in the right place. All the activities have been thought through, resulting in the critical mass you want the project to generate.”
ENN was seen as an excellent facilitator, enabling and driving work forward in an effective and efficient manner, convening meetings and calls and organising workstreams while ensuring that directions were driven by group members and the work itself. The neutrality and independence of ENN was noted as key to enabling trust in the work and therefore uptake among the nutrition community and beyond. One respondent reflected these findings, noting, “Members were informed and included in the decision-making process and members felt empowered to give a direction … so [it is] not led [by ENN] but facilitated, and that made a difference.”
A key finding of the SoC was that, in the next phase of the work, as the key questions on the table become more about the implications of WaSt TIG findings on the ground, there is a need to engage more members from regional and national research entities and governments. There is also a need to further detail members’ roles and responsibilities (particularly as the group expands) and for the group to continue to be expertly facilitated in order to manage the diversity of perspectives, experiences and expertise represented within it.
Key achievements of the project so far, identified in the interviews, were:
- Contribution to a robust evidence base around the linkages between wasting and stunting.
- Contribution to a shift in research priorities, reflecting the need to understand more about the relationship between wasting and stunting.
- Contribution to an increase in awareness and understanding in the nutrition field around the linkages between wasting and stunting.
- Promotion of discussions and a shift in the narrative around wasting and stunting at policy level – identification of what is needed to address the links between these two manifestations of undernutrition at global level by donor agencies, UN agencies, NGOs and research institutions.
- Contribution to bridging the divide between the wasting and stunting communities (emergency and development).
The role of the group in influencing was noted to be impressive, even though only in its early stages. One respondent reflected that, “Everything we know about (the relationship between) wasting and stunting is a product of this group.” The WaSt viewpoint published in The Lancet3 was seen as a significant output of the project and considered a major success. However, there was a general reflection from the interviewees that, given the level of evidence produced so far, the project has not yet reached a stage where it can influence programming on the ground .
Future directions and activities
Reflecting on the next phase of the project, the SoC highlighted the general sense that ENN is best placed to continue leading the group, securing funding for activities and keeping the momentum going. Respondents noted the need to increase efforts to disseminate findings through simple communication packages to highlight the importance of the project and the potential implications to both technical and non-technical audiences. Recognising that the group has been successful in generating a valuable body of evidence, respondents noted that the next phase provides opportunities for an increased focus on translating that evidence into practice, including through the implementation of the WaSt study, and on influencing other research initiatives in order to develop clearer directions for programme and policy change.
Interviewees also identified the need to further engage governments and programmers in countries where the problems of wasting and stunting prevail. It was recommended that the TIG membership was expanded accordingly and for existing members of the group working directly with governments to take a more central role in disseminating project findings. Respondents also noted the need for the group to continue its exploration of the evidence, accessing longitudinal and prospective data in particular, to continue to fill outstanding gaps in key knowledge around the relationship between wasting and stunting.
For more information please contact Tanya Khara.