Division of Human Nutrition, Department of Global Health, Faculty of Medicine and Health Sciences, Tygerberg Campus, Stellenbosch University, Cape Town 8000, South Africa.
International Institute of Tropical Agriculture, Ibadan 200001, Nigeria.
Int J Environ Res Public Health. 2024 Feb 2;21(2):175. doi: 10.3390/ijerph21020175.
In Nigeria, varying levels of malnutrition across states present a critical challenge to public health, demanding tailored policy responses. This paper delves into the specific issues and dynamics influencing nutrition programs in the country. Advocating for nutrition-sensitive actions requires analyzing context-specific political commitment. This article presents a case study on two Nigerian states with varying malnutrition profiles to explore the political economy of nutrition. The study used stakeholder analysis, in-depth interviews, and semi-structured interviews through workshops, incorporating the Political Commitment Rapid Assessment Tool. The objective was to measure political commitment, the window of opportunity for action, and stakeholder analysis. The results showed that despite having a significant child malnutrition problem, Kebbi State received a high political commitment to nutrition, with proportions ranging from 0.67 to 1 in each of the six domains measured. On the other hand, Anambra State, where malnutrition was less severe, had varying commitment levels. Institutional commitment was marginally high (0.67), expressed commitment was high (0.71), and budgetary commitment was lower at 0.33. Kebbi had better support for programs dependent on foreign donors than Anambra. Both states need to use media to increase awareness about nutrition issues. When the nutrition situation is severe, foreign donors' influence grows. In conclusion, there are opportunities for strategic framing and advocacy of the nutrition profile of the states. Local state media can be effective, and institutional coordination committees that include various sectors already facilitate commitment to nutrition actions. However, individual, uncoordinated sectoral action can counterbalance the benefits of these committees. Further possibilities to generate political commitment for nutrition in the states are available. This study not only offers insights into the effectiveness of political strategies in addressing malnutrition but also lays the groundwork for future research and provides actionable recommendations for government policymaking.
在尼日利亚，各州不同程度的营养不良对公共卫生构成了严峻挑战，需要制定有针对性的政策应对措施。本文深入探讨了影响该国营养计划的具体问题和动态。倡导对营养有敏感认识的行动需要分析具体国情下的政治承诺。本文以两个具有不同营养不良特征的尼日利亚州为例，探讨了营养的政治经济学。该研究采用利益攸关方分析、深度访谈和通过研讨会进行的半结构化访谈，并结合政治承诺快速评估工具。目的是衡量政治承诺、行动的机会窗口和利益攸关方分析。结果表明，尽管 Kebbi 州存在严重的儿童营养不良问题，但该州获得了高度的营养政治承诺，在所测的六个领域中，每个领域的比例均在 0.67 到 1 之间。另一方面，Anambra 州的营养不良程度较轻，承诺程度也各不相同。机构承诺略高（0.67），表达的承诺较高（0.71），预算承诺较低，为 0.33。Kebbi 州比 Anambra 州更支持依赖外国捐助者的方案。两个州都需要利用媒体提高对营养问题的认识。当营养状况严重时，外国捐助者的影响力会增加。总之，为各州的营养状况进行战略框架和宣传提供了机会。当地州媒体可以发挥作用，并且已经包含各个部门的机构协调委员会有利于对营养行动的承诺。然而，个别、不协调的部门行动可能会抵消这些委员会的好处。进一步为各州提供增加营养政治承诺的可能性。本研究不仅为解决营养不良问题的政治策略的有效性提供了见解，还为未来的研究奠定了基础，并为政府决策提供了可行的建议。
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