Nearly half of all deaths in children under five are attributable to undernutrition. Three million lives are lost each year to it (UNICEF 2016).
Undernutrition not only increases the frequency and severity of common infections and the risk of dying from them, but it also has long-term consequences on growth and development and is associated with impaired cognitive ability, reduced school and work performance, and increased risk of noncommunicable diseases later in life. In response, in its recent Global Nutrition Coordination Plan 2016–2021, the US Government (USG) committed to “improving nutrition throughout the world in order to enhance health, productivity, and human potential” through a coordinated multi-agency response (USAID 2016).
The equitable provision and utilization of high-quality nutrition-specific and nutrition-sensitive interventions is a global priority. Many of those interventions depend on the services of a range of providers, including community volunteers, health workers, teachers, agricultural extension workers, and other community actors. Services may include actions that directly affect nutrition, such as nutrition assessment, counseling, and care, as well as those that have a less direct relationship with nutrition, but are equally important. High-quality service delivery at scale requires a systematic and sustainable change process that considers the foundation underlying how services operate, provides adequate support to those service providers, and builds public demand for nutrition services.
USAID's Multi-Sectoral Nutrition Strategy 2014–2025 recognizes the need for increasing the equitable provision and utilization of high-quality nutrition-specific and nutrition-sensitive interventions. This guide provides government staff, USAID missions, and implementing partners with country examples, relevant resources, lessons learned, and key recommendations regarding this systematic and sustainable change process. JSI/SPRING Project. 2017.