title: Scaling up impact on nutrition: what will it take?
abstract: Despite consensus on actions to improve nutrition globally, less is known about how to operationalize the right mix of actions-nutrition-specific and nutrition-sensitive-equitably, at scale, in different contexts. This review draws on a large scaling-up literature search and 4 case studies of large-scale nutrition programs with proven impact to synthesize critical elements for impact at scale. Nine elements emerged as central: 1) having a clear vision or goal for impact; 2) intervention characteristics; 3) an enabling organizational context for scaling up; 4) establishing drivers such as catalysts, champions, systemwide ownership, and incentives; 5) choosing contextually relevant strategies and pathways for scaling up, 6) building operational and strategic capacities; 7) ensuring adequacy, stability, and flexibility of financing; 8) ensuring adequate governance structures and systems; and 9) embedding mechanisms for monitoring, learning, and accountability. Translating current political commitment to large-scale impact on nutrition will require robust attention to these elements.
authors.affiliation: International Food Policy Research Institute (IFPRI), Brighton, United Kingdom; s.gillespie@cgiar.org.
authors.forename: Stuart
authors.initials: S
authors.lastname: Gillespie
authors.affiliation: IFPRI, New Delhi, India; and.
authors.forename: Purnima
authors.initials: P
authors.lastname: Menon
authors.affiliation: IFPRI, Washington, DC.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Kennedy
mesh_terms: D003906:Developing Countries; D006266:Health Education; D006293:Health Promotion; D006801:Humans; D044342:Malnutrition / Q000517:prevention & control; D018673:Nutrition Policy; D009747:Nutritional Physiological Phenomena; D009752:Nutritional Status; D011203:Poverty / Q000517:prevention & control
keywords: capacity; enabling environment; evidence; financing; governance; impact; implementation; scaling up; strategy; undernutrition