Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada.
Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Longueuil, Quebec, Canada.
Matern Child Nutr. 2019 Feb;15 Suppl 2(Suppl 2):e12728. doi: 10.1111/mcn.12728.
Nutrition issues are increasingly being addressed through global partnerships and multi-sectoral initiatives. Ensuring effective governance of these initiatives is instrumental for achieving large-scale impact. The Collective Impact (CI) approach is an insightful framework that can be used to guide and assess the effectiveness of this governance. Despite the utility and widespread use of this approach, two gaps are identified: a limited understanding of the implications of expansion for an initiative operating under the conditions of CI and a lack of attention to advocacy for policy change in CI initiatives. In this paper, a case study was undertaken in which the CI lens was applied to the advocacy efforts of Alive & Thrive (A&T), UNICEF and partners. The initiative expanded into a regional movement and achieved meaningful policy changes in infant and young child feeding policies in seven countries in Southeast Asia. These efforts are examined in order to address the two gaps identified in the CI approach. The objectives of the paper are (a) to examine the governance of this initiative and the process of expansion from a national to a regional, multilayered initiative, with attention to challenges, adaptations, and key elements, and (b) to compare advocacy in the A&T-UNICEF initiative and in typical CI initiatives and gain insight into how the practice of advocacy for policy change can be strengthened in CI initiatives.
营养问题越来越多地通过全球伙伴关系和多部门举措来解决。确保这些举措的有效治理对于实现大规模影响至关重要。集体影响（CI）方法是一个有见地的框架，可以用来指导和评估这种治理的有效性。尽管这种方法具有实用性和广泛应用，但仍存在两个差距：对在 CI 条件下运作的举措的扩张影响的理解有限，以及对 CI 举措中的政策变革倡导的关注不足。在本文中，进行了一项案例研究，其中应用了 CI 视角来审视 Alive & Thrive（A&T）、儿基会及其合作伙伴的倡导工作。该倡议扩展为一个区域运动，并在东南亚七个国家实现了婴儿和幼儿喂养政策的有意义的政策变革。这些努力旨在解决 CI 方法中确定的两个差距。本文的目的是：（a）从国家到区域、多层次倡议的角度，审查该倡议的治理和扩展过程，关注挑战、调整和关键要素；（b）比较 A&T-儿基会倡议和典型 CI 倡议中的倡导，并深入了解如何在 CI 倡议中加强政策变革的倡导实践。
