3. Scaling-up to reduce stunting requires a
discussion around the following questions
• Key nutrition stakeholders need to know
• What are the core nutrition actions addressing stunting (max. 20 multi-sectoral actions)?
• What is the scale of core nutrition actions today ?
• What actions have to be scaled up to reduce stunting in different regions of the country?
• What actions need to be scaled up to address particular stunting causes in (different regions
of) the country?
• Over time, are we making progress with scale-up against the targets defined in the plan?
• What needs to happen to make this happen? What are the bottlenecks, what are ways to
overcome them?
4. Output of Scaling Up Nutrition Planning & Monitoring tool
has 3 elements supporting a scale-up discussion
Recap nutrition situation*
and nutrition actions
Who does what where?
Coverage
What % of the target
group is covered?
Guidance for a
stakeholder dialogue
How & where to scale up nutrition?
Qualitative view Quantitative view Guidance for scaling up nutrition
What is the nutrition situation
of a country/ region?
Who are the key stakeholders?
What is their role?
Which stakeholders are doing
what where?
1
2
3
What % of the target group is
covered nationally; via which
delivery mechanisms?
What % of the
target group is covered
per region?
For each region, who is
reaching what % of the target
group?
4
5
6
What are the stunting levels
(e.g. prevalence)? What is the
action intensity per region?
Which regions are not
adequately addressed?
Which key problems are not
adequately addressed?
What are the action gaps for
regions with high problem
levels?
7
8
9
10
*Note: The REACH Stakeholder & Action Mapping tool uses outputs from the Nutrition Analysis.
5. What is the regional stunting prevalence? What is the
action intensity per region?
Stunting strongly prevalent in
<Region x> and <Region y>
Only few actions covered
in <Region x> and <Region y>
Tigray
Amhara
Afar
Benshangui-
Gumaz
Addis Ababa
Oromia
Southern Nations,
Nationalities
and Peoples
Gambela
Somali
Harari
Dire Dawa
0% - 20%
21% - 29%
30% - 100%
Stunting prevalence1
Tigray
Amhara
Afar
Benshangui-
Gumaz
Addis Ababa
Oromia
Southern Nations,
Nationalities
and Peoples
Gambela
Somali
Harari
Dire Dawa
0% - 25%
26% - 50%
76% - 100%
51% - 75%
# of actions with at least xx%2 of target
population covered
Illustrative
1. Among children 6-59 months old 2. To be determined based on country-specific situation
Guidance for a stakeholder discussion (scale-up conclusions) - Stunting
6. Anemia among women1: What are the action gaps for regions
with high problem levels?
Illustrative
0% - 4% 5% - 39%
Prevalence of anemia among women
1.Women 15-49 years
xx actions mapped addressing anemia among women1
National level at xx%
Target groups for anemia among women
with low coverage in <Region x> and <Region y>
1
Tigray
Amhara
Afar
Benshangui-
Gumaz
Addis Ababa
Oromia
Southern Nations,
Nationalities
and Peoples
Gambela
Somali
Harari
Dire Dawa
Related country
relevant actions
Target groups
Provide iron-folic acid /
iron supplements
Provide multiple micro-
nutrient supplements
30% - 100%
2
4
Pregnant women
15-49 years
Pregnant women
15-49 years
2
% of TG
covered
Provide insecticide
treated bednets
Pregnant women
15-49 years
3
Provide insecticide
treated bednets
Post-partum women
15-49 years
4
Provide deworming
tablets
Pregnant women
15-49 years
5
Carry out insecticide
spraying
Households6
Promote small-scale
horticulture / crop div.
Households7
Promote small-scale
animal husbandry
Households8
6
3
8
1
8
3
1
8
1
2
4
8
% of target group covered
Guidance for a stakeholder discussion (scale-up conclusions) - Other situation indicators
This overview is provided for each situation indicator
7. Conscious decision not to include financial
information in data collection
• REACH countries that have undergone stakeholder & action mappings in the past
faced two key challenges: collecting beneficiary coverage and financial information
• The mapping is regarded a very complex data collection exercise and we were urged
to make it as simple as possible
• Coverage information is crucial for a meaningful scale-up discussion; to understand
and address bottlenecks in scale-up, funding constraints as well as other resources
will naturally be a part of the discussion
• The only REACH country that successfully collected financial information is Ethiopia
– The information collected reflected only off-budget funds, not reflecting gov’t contributions
– Doubts about the accuracy/completeness of this information persist
– Organization (both gov’t & NGOs) are not eager to disclose this type of information
• To get a complete overview of funding of nutrition action in a country (on & off
budget), a separate financial management exercise that allows consistent tracking
over time would probably be more advisable; e.g. establishment of a common
nutrition budget code, governments requesting NGOs to report their funding etc.
