Siekmans Kendra, Bose Sujata, Escobar-DeMarco Jessica, Frongillo Edward A
Independent Consultant, Guelph, Ontario, Canada.
Alive & Thrive, FHI 360, Washington, DC, USA.
Matern Child Nutr. 2025 Apr;21(2):e13711. doi: 10.1111/mcn.13711. Epub 2024 Oct 3.
Alive & Thrive (A&T) provides strategic technical assistance (TA) to develop effective policies; improve maternal, infant, and young child nutrition (MIYCN) programme design and implementation and enhance system capacity to sustain quality MIYCN service delivery at scale. A qualitative assessment was conducted using document review and stakeholder interviews (n = 79) to describe a selection of A&T's TA in six countries and systematically assess the contextual and TA process-related factors that influenced the results achieved and document the lessons learned about MIYCN TA design and implementation. To facilitate the selection of different types of TA, we classified TA into two levels of stakeholder engagement and intensity. Under the Technical Advisor TA category, we assessed A&T's support to strengthen national policy formulation, monitoring, and implementation of the International Code of Marketing of Breast-milk Substitutes. For Capacity Development TA, we assessed A&T support to scale-up maternal nutrition services and to increase strategic use of data. Factors important for TA provision included identifying and engaging with the right people, using evidence to support advocacy and decision-making, using multiple ways to strengthen capacity, developing packages of tools to support programme scale-up, and reinforcing feedback mechanisms to improve service provision and data quality. Challenges included shifts in the political context, poorly functioning health systems, and limited resources to replicate or sustain the progress made. Continued investment in evidence-based and practical TA that strengthens the institutionalization of nutrition across all stakeholders-including government, medical associations, civil society and development partners-is essential. Future TA must support governments to strengthen system capacity for nutrition, including financial and human resource gaps that hamper full scale-up.
“活力与成长”（A&T）提供战略技术援助（TA），以制定有效的政策；改善孕产妇、婴儿和幼儿营养（MIYCN）项目的设计与实施，并提高系统能力，以便大规模持续提供高质量的MIYCN服务。通过文件审查和利益相关者访谈（n = 79）进行了定性评估，以描述A&T在六个国家的部分技术援助情况，并系统评估影响所取得成果的背景因素和与技术援助过程相关的因素，记录在MIYCN技术援助设计和实施方面吸取的经验教训。为便于选择不同类型的技术援助，我们将技术援助分为利益相关者参与程度和强度的两个级别。在技术顾问技术援助类别下，我们评估了A&T在加强国家母乳代用品销售国际守则的政策制定、监测和实施方面的支持。对于能力发展技术援助，我们评估了A&T在扩大孕产妇营养服务以及增加数据的战略使用方面的支持。提供技术援助的重要因素包括确定并与合适的人员合作、利用证据支持宣传和决策、采用多种方式加强能力、开发支持项目扩大规模的工具包以及加强反馈机制以改善服务提供和数据质量。挑战包括政治环境的变化、卫生系统运作不佳以及复制或维持所取得进展的资源有限。持续投资于基于证据且切实可行的技术援助，以加强包括政府、医学协会、民间社会和发展伙伴在内的所有利益相关者的营养制度化至关重要。未来的技术援助必须支持各国政府加强营养系统能力，包括弥补阻碍全面扩大规模的资金和人力资源缺口。
