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Decentralised multisectoral coordination of nutrition in Senegal

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At the beginning of this year, I attended a Nutrition International (NI) mission in the village of Amadou Bellinaoude-Santhiago, in the Kolda region to visit the Integrated Nutrition Project at Kédougou and Kolda (PINKK) implemented by NI.

For me this visit was interesting for several reasons. Not only was I able to see first-hand the activities and implementation methods of the PINKK project but also, and especially, the decentralised governance mechanism of nutrition at the regional, departmental, communal and village level in Senegal. 

Image shows sign that reads, "Cellule De Lutte Contre La Malnutrition."

 

The main objective of PINKK is to improve the nutritional security of populations, especially women and young children, in the Kedougou and Kolda regions through an innovative, integrated and multisectoral approach. PINKK is implemented by Nutrition International (formerly the Micronutrient Initiative), in partnership with World Vision, Desjardins International Development and the Fight Against Malnutrition Unit (CLM) 1, the Government of Senegal's supreme authority for coordinating nutrition.

The national coordinator of the CLM is also the national focal point for the SUN movement. For this role it provides multi-stakeholder nutrition coordination with the various SUN networks in Senegal, particularly from civil society, donors and United Nations agencies. The CLM is therefore a multisectoral and multi-stakeholder nutrition coordination framework at the national level. To ensure the implementation of community nutrition interventions in the 14 regions it covers, the CLM has set up a National Executive Office (BEN) to manage programs and projects. The BEN relies on the Regional Executive Offices, which are responsible for monitoring and coordinating community nutrition activities in partnership with local authorities.    

The Kolda REO that we visited covers the regions of Kolda, Sédhiou and Ziguinchor.  It is this office which is one of the main interlocutors of the regional PINKK team, which is implementing the project in this region. During our visit we had a preparation and briefing meeting with this team in the REO premises in Kolda, which also houses the PINKK project team. There is therefore a high level of collaboration between the PINKK team and the REO of the CLM in Kolda. However, PINKK does have a high degree of autonomy and a separate team. 

Image shows mother presenting baby to be examined.

 

The CLM has 6 REOs which each cover 2 to 3 regions and are managed by regional officials. They are responsible for monitoring and coordinating nutrition interventions at the regional level, as well as coordinating all nutrition-sensitive sectors. To this end, there is a regional coordination framework called the Regional Monitoring Committee (RMC). This committee, which meets once every six months, brings together all the regional technical frameworks of the sectoral ministries related to nutrition at the regional level. It is chaired by the governor of the region.

In Senegal, the regions are composed of departments headed by prefects. At the departmental level, coordination of nutrition initiatives is carried out by the Departmental Monitoring Committee (DMC). After the departmental level, comes the communal (local authority) level. The local authority, through the local advisers, is one of the three main institutions constituting the strategic framework of the CLM described above.  At local (commune) level, nutrition initiatives are coordinated by the Local Monitoring Committee.  Finally, at the village level, there is the Local Steering Committee, chaired by the Village Chief or the Neighbourhood Leader. This committee also includes community relays and local leaders.

On our tour of PINKK activities, the team was accompanied by representatives from the departmental council and from the town hall, as well as by Kolda's BER manager, each of these representing a sphere of responsibility in the supervision of nutrition in Senegal.  During this visit we were shown the complete range of activities that have been implemented within the PINKK project to combat nutritional insecurity in the Kolda region. The PINKK project operates in 300 villages in the Kolda region, where a number of multisectoral nutrition activities based on the mother-child relationship are carried out among households, in order to reach the most vulnerable populations. Therefore, the activities that have been implemented within the PINKK project cover areas that are both specific and sensitive to nutrition2.

In addition to these direct activities, the PINKK supports the supervision of nutrition at a regional level through the strengthening of the capacity of governmental and local structures to integrate nutrition in local community plans and programs. This support for supervision aims not only to facilitate current PINKK implementations but also to allow the improvement and sustainability of nutrition intervention, in particular of community nutrition initiatives, for the benefit of the most vulnerable in the targeted regions. Another of PINKK's strategies for sustainability is the continuation of the activities set up within the framework of the project by the beneficiary populations, in particular backyard gardens, small livestock farming, hygiene practices and the practice of income-generating activities by organized women's groups. These actions must, of course, be supported and accompanied by the appropriate public services associated with this project.

Image shows adults helping child wash their hands at washing station.

 

It should be noted that, as regards the CLM, there is already a decentralised coordination mechanism consisting of the following bodies:

  • The Regional Monitoring Committee organised by the CLM REO at regional level
  • The Local Monitoring Committee organised by local authorities,
  • And the Local Steering Committee which plans activities at the village level.

In addition to the CLM coordination frameworks, there are other PINKK-supported consultation and coordination frameworks where nutrition issues are discussed, in particular:

  • The nutrition review of partners at regional level,
  • Quarterly review meetings organized by medical region.

Thus, Senegal has put into place a complex  architecture of decentralised multisectoral coordination of nutrition interventions at the national level. However, it should be noted that the stakeholder alignment mechanism is not clearly visible. For example, the private and academic sectors at the regional level are not always invited to the discussions.

After the country joined the SUN movement in 2011, a multi-stakeholder platform was created, bringing together stakeholders from the government as well as from civil society, donors and non-governmental agencies. It would be interesting to set up a similar SUN platform at the regional level. This platform could be created using existing coordination frameworks, notably by complementing them with various stakeholders put forth by the SUN movement: donors, the United Nations, civil society, academia and the private sector, as well as government institutions.

Over the next year, ENN will take a closer look at the programming and implementation of nutrition at the subnational level. In particular, we will focus on how changes at the national or political level have "overwhelmed/impacted" its implementation. We will also diagnose the multisectoral coordination mechanism from the regional to the district level.

The aim of this exercise is to contribute to the documentation and sharing of examples of "best practices" and of structures for the supervision of nutrition that work well and that may be of interest to other agents working in similar contexts in other countries.

 


The CLM was created in 2001 by decree of the President of the Republic and is now under the authority of the Prime Minister in order to ensure the definition and implementation of the National Nutrition policy. The CLM is fundamentally composed of 3 types of institutions:

  • Sector ministries (Agriculture, Health, Industry and Trade, Economy, Education and Decentralisation),
  • The association of local elected representatives,
  • Civil society organisations.

The main activities carried out within the framework of the project are as follows:

  • The promotion of good nutritional practices including health and hygiene through the monitoring and promoting of growth, nutritional education, the provision of hand-washing facilities and the distribution of micronutrient powders for children of 6 to 23 months
  • The production of foods rich in micronutrients from backyard gardens, family fruit trees and the breeding of short-cycle species such as guinea fowl, chickens, ducks, pigeons, etc.
  • Giving women financial education in order to sustain the production of micronutrient-rich foods

Awareness sessions for pregnant women using circles of solidarity with other pregnant women.