Sheryl Hendriks POLICY SEMINAR What Drives Policy Change? Insights from the Kaleidoscope Model of Food Security Policy Organized by IFPRI, Michigan State University and University of Pretoria, Consortium partners- Food Security Policy Innovation Lab

1. What Drives Nutrition Policy Reform
in Africa?
Findings of aThree-Country Case Study Comparison
Malawi, South Africa, and Zambia
Sheryl Hendriks

2. Slow Progress but Way Off Target
for Some Micronutrients
• Iodine fortification: Same solution but different timing and
impact
• Addressing Vitamin A deficiencies: Different vehicles and
differing outcomes
• Iron: What is the sticking point?
• Multi-mixes in fortification: Complex decisions

3. Nutrition Re-emerges on Policy Agendas
(1) A relevant problem in all 3
countries, but real action after
1990
(2) International focusing events
played a major role in initiating
change with supporting evidence,
ready solutions, targets, and binding
agreements focusing on rights
(3) Supported by powerful advocates
and coalitions– both international
and local

4. Consideration of Design Modalities
(4) International best practice
informed and shaped policies but not
always interpreted in the same way
(5) A few incidences of ideas,
ideologies, and beliefs
(6) Cost-benefit was a deciding factor
in choice of fortification vehicle, but
not a major constraint.
• Costs shifted to private sector
• Coverage is more important with
supplementation programmes

5. Transforming Proposals into Adopted Policies
(7) Powerful opponents - especially
from private companies and millers
(8) Implementing veto players played a
role in fortification programmes –
presidents, private sector, and health
professionals
(9) Propitious timing played a role in
South Africa as well as with regular UN
reporting cycles on children’s rights

6. Ensuring Implementation on the Ground
(10) Budgets typically came from
donors initially and support continues in
various ways but fortification costs
transferred to the private sector
(11) Institutional capacity is a major
constraint for supplementation rolled
out through health systems; private-
sector fortification compliance; and
coverage
(12) Implementation veto players are
essential due to high levels of
coordination among multiple
stakeholders
(13) The commitment of policy
champions is not strong in this phase

7. Evaluating, Reconsidering, and Reforming
(14) Constantly changing information and
beliefs trigger the need for review and
revision of policies
(15) Changing material conditions do not
really affect private-sector fortification
programmes, but are a problem with
supplementation
(16) Institutional shifts seldom influence
micronutrient policies

8. Conclusions and Recommendations
• Except for iodine, suboptimal progress in addressing
micronutrient deficiencies.
• The Kaleidoscope Model was useful in identifying the drivers of
and constraints on change in micronutrient policies in the
developing world.
• Common drivers included
– the global knowledge base;
– call for action and international targets;
– national leadership; and
– the champions and support of the development partners.
• Differences were seen in
– the level of engagement with various stakeholders;
– design and funding considerations;
– the institutional and regulatory infrastructure; and
– long-term investment in sustainable solutions.

9. We wish to acknowledge the co-authors of the six initial
field studies:
Suresh Babu, Nicolette Hall, Jody Harris, Nicole Mason, Elizabeth
Mkandawire, David Mather, Stephen Morgan, Flora Nankhuni, David
Ndyetabula, Dorothy Nthani, Nic JJ Olivier, Nico JJ Olivier, Phillip
Randall and Hettie C Schönfeldt.

10. For More Information, Please Visit
http://foodsecuritypolicy.msu.edu/

11. www.feedthefuture.gov