Doctoral Degrees (Human Nutrition)

Permanent URI for this collection

https://scholar.sun.ac.za/handle/10019.1/100755

Browse

Browsing Doctoral Degrees (Human Nutrition) by Subject "Community-based child welfare -- Breede Valley, South Africa"

Now showing 1 - 1 of 1
  • Thumbnail Image
    Item
    Exploring stakeholder commitment and capacity to address infant and young child nutrition in the capital of the Breede Valley, Western Cape Province, South Africa
    (Stellenbosch : Stellenbosch University, 2015-12) Du Plessis, Lisanne Monica; McLachlan, Milla; Drimie, Scott; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.
    ENGLISH SUMMARY: There is experience with - and documented evidence on multi-stakeholder processes (MSPs) on a global - and national level and on how to build and assess commitment and capacity to address infant and young child nutrition (IYCN) at these levels. Little experience and documented evidence, however, exist for such processes at local level. In countries with a decentralised government system, part of the lack of experience and evidence on MSPs lies in the challenge of building commitment and capacity at various political and bureaucratic levels. There is, thus, a need to build an evidence-base of how to engage stakeholders at implementation level and to assess and advance their commitment and capacity to implement responses to address IYCN. There is also a call to better define enabling environments for successful action in this field. In this research, a qualitative study design and selected participatory research methods were used to explore a diversity of perceptions, willingness, abilities, relationships and powers of key stakeholders to address IYCN at sub-district level in the Breede Valley, Western Cape Province, South Africa. The study built on baseline research in the Community-based Nutrition Security Project (CNSP), which provided insight into maternal and child nutrition challenges in the Breede Valley. Stakeholders were identified and categorised during a focus group discussion (FGD) with individuals who knew the sub-district well. Subsequently, the researcher conducted semi-structured interviews with twenty seven key stakeholders to explore their perspectives, commitment and capacity concerning IYCN. Hereafter, they were invited to participate in a workshop to map stakeholder relationships and power related to IYCN governance. Lastly, FGDs were held to reflect on the research process and to explore elements of an enabling environment conducive to action on IYCN at implementation level. Main themes from the overall research findings include: the value of local knowledge and information; the appeal of the 1000 days message and its link to development; the urgent need for IYCN advocacy; the value of stakeholder engagement and seeing the broad IYCN stakeholder landscape; the need for multi-sectoral work, while recognising the difficulty in functioning across sectors; realising the capacity inherent in “people” as a resource, the need for a “whole of society approach” in advancing the IYCN agenda and the importance of strategic capacity in local forums, combined with national legislation, to advance action for IYCN. The study provides insight into the elusive concepts of commitment and capacity in relation to IYCN governance at local level. The personal and professional perspectives of key stakeholders involved at this level offered distinct information about the unique challenges they experienced as well as practical responses required to ensure action. The barriers to multi-sectoral work at the sub-district level hinged on narrow sector-specific focus areas, mandates and budgets leading to poor integration around the social determinants of health, lack of resources and lack of targeted advocacy. The core conclusion of the study is that a detailed exploration of initial stages of an MSP is a valuable practice - and research model to create awareness of IYCN as a development issue of crosscutting importance at implementation level. This process, though time and resource intensive, has supported the development of commitment and revealed collective capacity that could be unlocked to address IYCN at the sub-district level in the Breede Valley. Such an approach, appropriately adapted to local conditions, could be helpful in scaling-up efforts to improve IYCN at sub-district level elsewhere in the country. The next phase of the CNSP should involve joint planning and concrete action to improve IYCN in the Breede Valley. The proposed expansion of the definition of the enabling environment and adaptation of the nutrition governance framework could be introduced into international debates and agendas for continued deliberation, research and action to improve IYCN as a global, national and local priority.