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A Guideline for Developing Multisectoral
Nutrition Plans for Sudan
May 2022
1
Published by
Government of the Republic of the Sudan
Federal Ministry of Health
Telephone number: +249 11 774710 / 774
Fax Number: +249 11 778704
Email: info@fmoh.gov.sd Website: www.fmoh.gov.sd
P.O. Box 303 Khartoum
Year published: 2022
Cover Photos by: UNICEF, FAO and FEWSNET
Recommended citation: Federal Ministry of Health (2022). Guideline for Developing Multisectoral Nutrition
Plans: 2023-2030. Khartoum, Sudan.
2
ACKNOWLEDGEMENTS
The Guideline for Developing Multisectoral Nutrition Plans was developed by the SUN Movement
Secretariat in Sudan, under the Federal Ministry of Health with the support of the SUN Sudan Core
Group and Technical Advisory Group (TAG) members to facilitate the development and
implementation of the multisectoral nutrition plan.
The Federal Ministry of Health would like to thank Alem Hadera Abay, Senior International SUN
Adviser, for preparing this guideline, and Najlaa Osman Khidir, National SUN Coordinator, and
Matthew John Robinson, UNICEF International Consultant, for their immense and valuable
contributions.
Our appreciation also goes to all the members of the SUN TAG and SUN Core Group including, Federal
Ministry of Health Nutrition Program, High Council for Food Security and Nutrition in Sudan,
Humanitarian Aid Commission, UNICEF, WHO, WFP and Khartoum University for their valuable inputs.
The valuable inputs from other ministries and partners are also acknowledged.
The Federal Ministry of Health gratefully acknowledges the financial support of UNICEF in making this
guideline a reality and translating and printing this document for use by all nutrition stakeholders in
Sudan.
Dr Dalya Idris Hassan Eltayeb
Director of Directorate General of PHC
Federal Ministry of Health
3
FOREWORD
Recognising that nutrition is a humanitarian, development and human rights agenda, the government
of the Republic of Sudan have joined the SUN Movement in October 2015. The Federal Ministry of
Health, including the other 12 Federal Ministries, joined to support a multisectoral effort to address
the high levels of malnutrition Sudan is facing. Sudan has recently revised its Food Security and
Nutrition, Health and Nutrition policies to create an enabling environment for putting nutrition on the
national agenda.
The government of Sudan with its partners is making a concerted effort to address the burden of
malnutrition in the country. Sudan is on track to meet only 2 of the WHA targets. We have increased
exclusive breastfeeding from 41 per cent on baseline to 62.3 per cent in 2019 and childhood
overweight remains at 2.1 per cent below the global targets of 3.0 per cent for 2030. Sudan has also
made remarkable progress in reducing Child mortality from 128 per 1,000 live births in 1990 to 56.6
per 1,000 live births in 2020. However, such pace of progress could not be replicated in reducing
neonatal mortality. Despite such progress, Sudan is off track on many of the WHA nutrition targets,
including stunting (from 34.1% at baseline to 36.4% in 2019, wasting (15.4% at baseline to 13.6% in
2019) and anaemia among Women of Reproductive Age (36.8% in 2012 to 29.7%), which declined only
marginally.
Over the last three decades, the focus was put on the humanitarian and lifesaving components of
improving access to food and nutrition services. A well-deserved priority was given to the
circumstances that required a rapid response to this humanitarian crisis. However, unless we make an
effort to address the underlying causes of malnutrition, we may be bound to have chronic emergency-
like situations where people are on humanitarian handouts for extended periods and perhaps limiting
their potential to strive and transform their lives and become productive members of their
community. The SUN is best placed to facilitate a multisectoral nutrition response at the national and
subnational levels and ensure that nutrition is considered in our national, state and locality level plans
by actively engaging nutrition relevant sectors, including health, agriculture, education, water, social
development, industry, trade, justice, youth and sports, communication and media among other
sectors.
On behalf of the Federal Ministry of Health and in my capacity as SUN Focal Point, I am delighted to
reiterate our resolve to address malnutrition in all its forms and fully reactivate the SUN movement in
Sudan. I, therefore, request all nutrition relevant line ministries and sectors to make good use of this
guideline and ensure that we develop comprehensive multisectoral nutrition plans at all levels in an
effort to meet the SDGs and WHA targets.
It is my hope that line ministries and key stakeholders will use this guideline to facilitate the
development of effective multisectoral nutrition plans to achieve Sudan’s global and national nutrition
commitments and targets.
HE Dr Haythem Mohammed Ibrahim,
SUN Focal Point
Undersecretary Federal Ministry of Health
4
Contents
ACKNOWLEDGEMENTS 2
FOREWORD 3
ACRONYMS 5
1. INTRODUCTION 6
1.1. Background 6
1.2. Purpose of the Guideline 10
1.3. Conceptualising a Multisectoral Approach to Nutrition 10
2. SETTING THE STAGE FOR MULTISECTORAL PLANNING 13
2.1. Identifying Consensus Areas 13
2.2. Key considerations for multisectoral planning 15
2.3. Guiding Principles 16
2.4. Assessing the Country Nutrition Context 17
3. FORMULATING THE NATIONAL MULTISECTORAL NUTRITION PLAN 21
3.1. Responsibility for planning a multisectoral approach 21
3.2. Information to include in the multisectoral plan 21
3.3. Steps for formulating a multisectoral nutrition plan 22
4. OPERATIONALISING THE NATIONAL MULTISECTORAL NUTRITION PLAN 30
4.1 Governance and coordination structures/mechanisms operationalisation 30
4.2 Capacity development strategy 30
4.3 Advocacy and communication strategy 30
4.4 Resource Mobilisation 31
4.5 Sector annual planning for implementation at all levels of government 32
4.6 Operationalisation of the Multisectoral Plan at different levels 34
ANNEXES 35
Annex 1: Sudan Scaling Up Nutrition Movement Roadmap 2021-2025 35
Annex 2: Sudan global and national nutrition commitments 41
Annex 3: Nutrition Stakeholders Mapping: Donors in Sudan, 2019 43
Annex 4: Nutrition Stakeholders Mapping: Implementors & Catalysts in Sudan, 2019 44
Annex 6: Roles and Responsibilities of key sectors & actors 47
5
ACRONYMS
ARI Acute Respiratory Infection
BMS Breast-milk Substitutes
CF Complementary Food
CMAM Community-based Management of Acute Malnutrition
CRF Common Results Framework
CSA Civil Society Alliance
CSO Civil Society Organisation
FAO Food and Agriculture Organisation of the United Nations
HCFSN High Council for Food Security and Nutrition in Sudan
IFAD International Fund for Agricultural Development
ISF Improved Sanitation Facilities
MAD Minimum Acceptable Diet
MEL Monitoring, Evaluation and Learning
MIYCN Maternal, Infant and Young Child Nutrition
MNPs Micronutrient Powders
MNS Multi-nutrient Supplementation
MQSUN Maximising the Quality of Scaling Up Nutrition
NGOs Non-Governmental Organisations
N4G Nutrition for Growth
NSA Nutrition Sensitive Agriculture
RAN Research and Academia Network
RUSF Ready-to-Use Supplementary Food
RUTF Ready-to-Use Therapeutic Food
SBCC Social and Behavioural Change and Communication
SBN Scaling Up Nutrition Business Network
SDGs Sustainable Development Goals
SDN Scaling Up Nutrition Donor Network
SMART Specific, Measurable, Achievable, Relevant and Time-bound
SMEs Small and Medium Enterprises
SSMO Sudanese Standards and Metrological Organisation
SUN Scaling Up Nutrition
TAG Technical Advisory Group
TOR Terms of Reference
TWG Technical Working Group
UHC Universal Health Coverage
UN United Nations
UNDP United Nations Development Programme
UNFPA United Nations Population Fund
UNHCR United Nations High Commissioner for Refugees
UNICEF United Nations Children’s Fund
UNOCHA United Nations Office for the Coordination of Humanitarian Affaires
USI Universal Salt Iodisation
WASH Water, Sanitation and Hygiene
WHA World Health Assembly
WFP World Food Programme
WHO World Health Organization
6
1. INTRODUCTION
1.1.Background
Recognising malnutrition as one of the major public health, development and humanitarian
challenges, the government of Sudan is making concerted efforts together with its
humanitarian and development partners to address the high levels of malnutrition in the
country. Despite such efforts, progress to address all forms of malnutrition has been slow.
This has placed Sudan among the top 14 countries in the world experiencing high levels of
malnutrition with more than one in three children under five (36.4 per cent) too short for
their age. Close to half of all localities in Sudan have a stunting prevalence greater than 40 per
cent. The prevalence of wasting is also high at 13.6 per cent, with almost one in five localities
having a wasting prevalence greater than the 15 per cent threshold that is considered high by
WHO standards. Both stunting and wasting rates have only declined marginally in the last 15
years, with prevalence higher than the average for developing countries1. The first report on
the status of the country regarding malnutrition in 1987 reported that 32 per cent of children
under the age of five years were stunted, which is less than the current level of 36.4 per cent.
Similarly, micronutrient deficiencies are very high with 48.1 per cent of children under five
years old and 29.7 per cent of women of reproductive age anaemic and 57.8 per cent of
children suffering from vitamin A deficiency (Figure 1).
The level of childhood overweight and obesity is relatively low, with only 2.1 per cent of
children under five years of age overweight and 0.9 per cent obese. However, 28.3 per cent
of Sudanese adults are either overweight or obese with the percentage being much higher in
women (35.6 per cent) than men (22.6 per cent)2
. The trend among women clearly indicates
the need for more comprehensive nutrition programming that encompasses food-based
1
Federal Ministry of Health. Simple Spatial Survey Method (S3M II) Sudan Micronutrient Survey Report. Federal Ministry of Health,
General Directorate of Primary Health Care, National Nutrition Programme, Khartoum, Sudan. 2020
2
Federal Ministry of Health. Sudan Stepwise Survey for Non-Communicable Diseases Risk Factors 2016 Report. Federal Ministry of Health,
Khartoum, Sudan.
7
approaches aiming at dietary changes among women and children in addition to the nutrition
specific interventions mainstreamed though the health systems.
Globally, over 45 per cent of deaths in children under the age of five is attributed to
malnutrition. Stunting alone is associated with 37.7 per cent of all child mortality cases in
Sudan while stunted children achieve 1.6 years less in school education. It is estimated that
the associated economic cost of malnutrition to Sudan is over USD 2 billion per year
(equivalent to 2.6 per cent of GDP)3
. Clearly, malnutrition is not only a health sector
impediment but also one of the core national development challenges in Sudan.
Many factors have contributed to such high levels of malnutrition for over two decades.
Maternal malnutrition (8.6 per cent) perpetuates the inter-generational cycle of stunting
whilst micronutrient deficiencies are also intertwined with stunting. The poor quality of diet
contributes to high levels of malnutrition and makes children and women susceptible to
infections. The high levels of infection including diarrhoea prevalence among children (24 per
cent), acute respiratory infection (ARI) (23.7 per cent) and fever (23.1 per cent) are strongly
associated with malnutrition and in return contribute to high levels of malnutrition.
Inadequate dietary intake among infants, young children and women of reproductive age is
widespread – although 62 per cent of children up to 6 months old are exclusively breastfed,
only a quarter (25.4 per cent) of children 6-23 months of age receive a diversified diet. Poor
feeding practices are compounded by high levels of food insecurity with 10.9 million facing
high levels of food insecurity in 20224
. At the same time, less than 3 in 4 households (73.7 per
cent) have access to basic drinking water sources within 30 minutes of their home. Access to
health and sanitation services is also limited: Only 64 per cent of households have a health
facility within 30 minutes’ walk and only 37.4 per cent have access to improved toilet facilities.
Many cultural practices also undermine good nutrition, including limited knowledge of
undernutrition, lack of time for care and poor education levels among mothers (68.1 per cent
finish primary school)5
, and a high prevalence of early marriage at age 18 or earlier (60.2 per
cent). Furthermore, close to half (47 per cent) of Sudan’s population lives below the poverty
line6
, with poverty both a cause and a consequence of poor nutrition.
Many of these immediate and underlying factors affecting nutritional status are exacerbated
by socio-political and economic upheaval including recent high inflation rates (including for
staple food items) affecting household purchasing power, an economic crisis and the COVID-
19 pandemic, increasing pressure on already strained health systems, food systems and
livelihoods, with negative consequences for nutrition. Frequent climate related disasters add
to the complexity of the situation, with flooding and drought the main hazards.
The need for an integrated and comprehensive approach to address the formidable
humanitarian, development and peace related challenges in Sudan could not be more evident
than at this time in its history. The country is dealing with a complex humanitarian crisis that
has multiple drivers with over 1 million refugees and 3 million IDPs.7
Many of the internal
3
Cost of Hunger in Africa - The Social and Economic Impact of Child Undernutrition in Sudan, 2020.
4
Humanitarian Needs Overview Sudan 2022
5
Sudan MICS 2014
6
Central bureau of statistics, 2009
7
Sudan Humanitarian Needs Overview 2022 (Draft)
8
displacements are already prolonged for over two decades leaving many reliant on
humanitarian handouts, which is unsustainable. In many cases, people’s needs extend far
beyond immediate, life-saving support.
In 2022, an estimated 14.3 million persons need some form of assistance8
. The main support
is provided through a yearly multisectoral Humanitarian Response Plan, led by the
Government with support from partners, which includes key interventions by and large to
tackle the immediate causes of malnutrition and to a limited extent programmes that address
the underlying causes of malnutrition in such a chronic and complex emergency.
However, despite the ongoing efforts and due to the scale and complex drivers at work, Sudan
is far from being on track to meet the majority of the WHA Global Nutrition Targets (See Table
1). The lack of progress on improving nutrition also impacts Sudan’s ability to meet its SDG
commitments as nutrition is critical to achieving many of the 17 SDG Goals, including SDG1
(no poverty), SDG2 (zero hunger) and SDG3 (Good health), whilst other SDG Goals positively
impact nutrition.
Table 1: Sudan Progress towards the WHA Global Nutrition Targets 2030
WHA Goal Baseline a
Latest data b
Target
(2030)
Achieve a 50% reduction in the number of
children under-5 who are stunted
35% 36.4%
13.6%e
Achieve a 50% reduction of anaemia in
women of reproductive age
36.8%c
29.7% 18.4%
Achieve a 30% reduction in low birth
weight
32.3%d
32.3%d
22.6%
Reduce and maintain childhood
overweight to less than 3%
1.5% 2.1% 1.5%
Increase the rate of exclusive
breastfeeding in the first 6 months up to at
least 70%
41% 62.3% 70%
Reduce and maintain childhood wasting to
less than 3%
16.4% 13.6% <3%
a Source is Sudan Household Health Survey 2010 unless otherwise stated
b Source is S3MII 2018 unless otherwise stated
c WHO Global Health Observatory Data 2012
d MICS 2014
e Estimated based on WHO methodology
8
Sudan Humanitarian Response Plan 2021
9
The lack of progress to reduce all forms of malnutrition and the constant need for
humanitarian intervention is an indication of the need for a transition from health-focused
and humanitarian focused responses to a more comprehensive systemic multisectoral
approach along the continuum of the humanitarian and development nexus that would
oversee the lifesaving needs of the most vulnerable while also addressing the longer-term
drivers of vulnerability and crises to enable people to not only survive but also thrive.
The revised National Nutrition Policy (2021) and nascent efforts to develop a multisectoral
nutrition plan provide an opportunity to foster multisectoral work within the humanitarian
and development context. Even though the nexus of humanitarian and development work
has not been articulated well in the revised policy documents, it is important to create
continuity in the humanitarian-development nexus. The SUN Movement, with its vision of a
world free from malnutrition in all its forms by 2030, can be the driving force for this
continuity to ensure that the investment made under the humanitarian context continues to
help vulnerable households in their quest for recovery and to become more resilient.The SUN
5-year roadmap developed by the SUN Sudan Secretariate in close consultation with the TAG
members clearly articulates the strategic objectives of the SUN Movement and highlights the
key processes towards developing and implementing national multisectoral nutrition plan
(See Annex-1).
The National Nutrition Policy (updated in 2021) and the National Food Security and Nutrition
Policy (updated in 2020) reflect the governments’ commitment to create an enabling
environment for nutrition. Despite such improvements in the policy space, the country has
not yet put in place clear governance and accountability mechanisms with clear sectoral and
institutional mandates for nutrition or a robust mechanism to operationalise such policies and
strategies as it has not established operational modalities for multisectoral nutrition planning,
and joint monitoring and evaluation mechanisms at the national and subnational levels. There
are different coordination platforms in the health and agriculture sectors, but these are not
aligned and harmonised to leverage the impact through joint planning and monitoring of
programmes. More so, Sudan has not invested in nutrition in a systematic way across the
main systems including food, heath, water, education, resilience building, business and
legislative systems to address malnutrition in all its forms.
Multisectoral work requires systemic change including change in the human resources
structure and ways of working including joint planning, implementation coordination and
joint supervision and monitoring and evaluation. At present, Sudan does not have adequate
human resources especially at the grassroots level to deliver programmes. There is a structure
for one community health worker (CHW) per health facility but that is not even sufficient for
the different primary health care programmes. It is crucial to create robust primary health
care and community delivery channels to bring the nutrition response up to scale. SUN focal
person at the Federal, state and local levels can also be included in the new human resources
structure to ensure that the country is making progress towards attaining the national and
global nutrition targets. In the absence of such systemic and institutional changes, it will be
very difficult to meet the WHA and SDG targets for nutrition in Sudan within the remaining
time frame.
10
1.2. Purpose of the Guideline
The overarching purpose of this guideline is to help programme designers, planners,
managers and experts at all levels to develop and implement robust multi-sector nutrition
plans at the national and sub-national levels in order to successfully reduce malnutrition in all
its forms. Sudan is a member of the SUN Movement and a signatory to the 2012 World Health
Assembly Resolution 65.6 to meet six global nutrition targets by 2025 and the SDGs that aim
to end malnutrition in all its forms by 2030. Sudan has recognised malnutrition as a major
human and economic development challenge requiring multi-sectoral efforts in its revised
national nutrition policy and recent multi-stakeholder national consultations to develop
nutrition commitments as part of the global Nutrition for Growth (N4G) summit in 2021. Even
though Sudan recognised the multisectoral nature of nutrition in its policy, no costed national
multisectoral nutrition plan was developed to date that is aligned to the nutrition policy and
its global and national nutrition commitments.
There is no blueprint, applicable everywhere, at all times and under all circumstances for
undertaking multi-sectoral planning for nutrition. This guideline consolidates existing
knowledge and best practices, based on the experience of multiple countries, and lays down
a framework, which line ministries and nutrition partners can use to develop a comprehensive
and aligned national multisectoral nutrition plan and annual sectoral implementation plans
for nutrition. The guideline takes into consideration previous works that were undertaken
which are crucial components of the planning process. A situation analysis, as outlined in the
above section, and nutrition stakeholder and action mapping undertaken in 2019 are used in
contextualising this guideline and will enable line ministries and partners to carry out context-
based planning.
The sections below outline the key stages in developing national multisectoral nutrition plans
and implementation plans that can be considered when planning and designing nutrition
programmes at every level.
1.3. Conceptualising a Multisectoral Approach to Nutrition
A multisectoral approach creates opportunities for shared accountability to address very
complex social and development challenges that cannot be addressed by a single sector alone.
It creates opportunities to share knowledge and lessons learned in a common platform for
better collaborations and results. Multilevel interventions that seek to involve nutrition
relevant public and private sectors can also bring sustained change.
The multisectoral nature of nutrition was conceptualised in the mid-twentieth century, but it
was not until the 1970s that effort was made to address multiple causes of malnutrition as
part of a national plan in Thailand when malnutrition received national-level attention and a
national multisectoral nutrition plan was included in the Fourth National Economic and Social
Development Plan (NESDP) (1977–81)9
.
There is an increasing recognition that, while Ministries of Health have a critical role to play
in addressing malnutrition, there are equally other important sectors and systems that
contribute beyond the health sector and system. Recent studies show that health systems at
best can only reduce stunting by 20 per cent, while other sectors contribute the remaining.
9
Pattanee Winichagoon, Food and Nutrition Bulletin, vol. 35, no. 2 © 2014
11
Estimates show that even if nutrition-specific interventions are scaled up to cover 90 per cent
of the at-risk population, it would only address about 20 per cent of chronic malnutrition10
.
While the health system has an important role to play, focusing investments and efforts on
the health system alone will not allow countries to reach the WHA targets by 2025. The need
for concerted efforts across multiple sectors is now widely acknowledged by key stakeholders
as the only way to register meaningful results to attain these global targets.
This is because the key drivers of malnutrition (Figure 2)11
are complex, determined not only
by the situation at the individual or household level but also the broader societal context, and
cut across a number of sectors and systems beyond health, including agriculture, education,
water and sanitation and social protection.
Figure 2: UNICEF Conceptual Framework on the Determinants of Maternal and Child
Nutrition
10
The Lancet, Executive Summary of The Lancet Maternal and Child Nutrition Series, 2013
11
UNICEF, 2021. UNICEF Conceptual Framework on Maternal and Child Nutrition.
12
In order to foster the multisectoral response and move away from the sectoral nature of
development which characterises the funding and mode of operation of donors, governments
and NGOs, it is critical to ensure that non-health sectors perceive nutrition as directly relevant
to their work and understand the importance of becoming part of the response. The SUN
Movement is well-placed to bring together all stakeholders across the humanitarian and
development nexus and foster development of a multisectoral approach to nutrition in Sudan,
including the development and implementation of a national multisectoral nutrition plan.
Ensuring mutual accountability by putting in place a clear governance and accountability
framework is a key step towards ensuring the operationalisation of a multisectoral approach.
The hierarchical nature of working across the public and private sectors is a challenge that
needs to be tackled at the onset of the planning stage to create consensus around
multisectoral approaches to investing in nutrition with mutual accountability. Nutrition
programmes are commonly hosted under Ministry of Health, and it may not have the
mandate and leverage to directly engage other line ministries like agriculture, industry,
education, water, trade, environment, justice or social development and make them
accountable. Success is more likely if such a mandate is clearly delegated by the highest level
of government such as the Cabinet of Ministers. This governance challenge should be
addressed from the get-go with an agreed framework of governance and accountability to
ensure mandates and responsibilities are understood by all stakeholders.
13
2. SETTING THE STAGE FOR MULTISECTORAL PLANNING
2.1. Identifying Consensus Areas
Key to successful multisectoral planning and response at the national and local levels is the
recognition by all stakeholders involved that:
− Malnutrition is one of the top contributors to the national and global burden of
diseases and disability.
− Malnutrition is not just a health issue but multisectoral in nature.
− Investing in nutrition is cost-effective and one of the key pillars in the development
agenda.
− Government is the primary duty bearer and owner of nutrition matters primarily
accountable for its success or failures.
− Government at the highest levels should be accountable for nutrition within the
overarching mutual accountability for all stakeholders.
− Both the public and private sector including Civil Society has responsibilities and
accountability for nutrition.
− There should be commitment to allocate human, financial and technical resources to
meet the agreed targets by all the stakeholders.
− Consensus on clear global and national targets and the need for developing a
multisectoral plan aligned to the agreed targets is crucial in mobilising the necessary
resource at the national and global levels.
− Willingness of the current key actors, for example the Ministries of Health and
Agriculture, to share the responsibility and control together with the other public
sectors, businesses, civil society, academia and communities.
− Each sector must consider how it is going to contribute to the national nutrition
commitments and global WHA targets and develop sectoral plans of action that is
aligned with the national nutrition priorities.
− Finally, there are needs for fostering collaboration and agreement on new ways of
working within and among the sectors and with existing and new partners.
Consensus on Governance and Accountability Framework
The proposed model shown in Figure 3 below, depicting the recommended governance
structure for nutrition in Sudan, is expected to put in place a robust institutional mechanism
for developing multisectoral nutrition plans, coordinating programme implementation and
monitoring and evaluation and fostering evidence-based learning to scale up effective
implementation of nutrition programmes and interventions that would enable the country to
meet its nutrition targets.
The Federal Ministry of Health as a host of the SUN Secretariat and whose Undersecretary is
the government appointed SUN Focal Point provides an opportunity to foster multisectoral
14
work through the SUN Inter-ministerial Committee. The SUN Focal Point is answerable to the
SUN Inter-ministerial Committee and this committee is answerable to HE the Prime Minister.
The Inter-ministerial Committee is expected to meet on a quarterly basis while the SUN
Steering Committee, which is Chaired by the SUN Focal Point and Co-chaired by the
Undersecretary of Federal Ministry of Agriculture, is expected to deliberate on a monthly
basis. The SUN Secretariat led by the National SUN Coordinator, which oversees the
operationalisation of the SUN Movement by providing technical support and establishing
multisector and multistakeholder platforms is answerable to the SUN Focal Point, the
Undersecretary of the Federal Ministry of Health.
On technical matters, the SUN Technical Advisory Group (TAG), comprising representatives of
nutrition relevant sectors and stakeholders, will provide technical support to the SUN Steering
Committee and SUN Secretariat. The TAG meets on a monthly basis to ensure the country is
on track to meeting its national and global nutrition commitments. At the Federal level, each
nutrition relevant line ministry especially the core ministries like agriculture, health, water,
education, social development, industry and humanitarian sectors are expected to create a
Nutrition Focal Person position to ensure nutrition is taken up as national development and
humanitarian agenda.
Focal Persons will be assigned or named at the state and locality level to coordinate the
planning and implementation of a multisectoral nutrition plan. A multi-stakeholder platform
like the federal level TAG will be established and the existing ones strengthened to ensure the
full participation of nutrition relevant sectors and stakeholders.
The SUN Secretariat is tasked with coordinating SUN in Sudan on a day-to-day basis and
reports directly to the Undersecretary of Health. The Secretariate will work to elevate and
position nutrition as a development and humanitarian agenda requiring a multisectoral
response and facilitate the implementation of the 5-year Sudan SUN Roadmap. It will be
supported by a SUN Focal person in each nutrition-relevant Ministry and a Focal Point in each
state who will work closely with the SUN Secretariat to coordinate SUN activities at the state
and local levels. Five networks, made up of actors from different stakeholder groups (civil
society, UN, donor, business and academia), play a critical role in bringing together and
aligning contributions towards country nutrition priorities.
Overall, there is consensus at the SUN TAG level regarding the need to have a clear
governance and accountability framework for Sudan. Various models were considered for
discussion at the SUN Core Group and TAG consultation meetings and the below model is
recommended for the country to ensure that government at the highest levels are
accountable for nutrition.
15
2.2. Key considerations for multisectoral planning
When developing and implementing the multisectoral nutrition plan, the following
considerations need to be taken into account to ensure a successful process:
- The government must have the political will and commitment to take a leadership role
at the national level and create an enabling environment for leadership to emerge at
all levels. The government line ministries’ and other partners’ commitment to lead and
actively participate in the multisectoral response to nutrition is key to the success of
the multisectoral nutrition response.
- The government as a primary duty bearer needs to invest public funds into nutrition,
which has a high return. Budgetary allocation by Finance and Economic Planning needs
to be explicitly made as part of the annual budget allocations and financial gaps
transparently announced for the partners’ support.
- Leadership comes with accountability and ensuring the agreed governance. Putting in
place accountability frameworks is a critical element in a multisectoral response to
nutrition to strengthen institutional mandates and create a shared vision among the
partners.
- The magnitude of the problem needs to be well considered including identifying the
vulnerable, high-risk groups such as infants, children, adolescent and women.
16
- All nutrition relevant line ministries and sectors must be involved in the process from
the beginning, with each taking responsibility for their respective mandates.
- Sectors outside government need to be involved including UN agencies, donors,
business, civil society organisations and research and academia.
- Engaging empowering women and youth as key actors in the food system is crucial to
ensure sustainable and healthy diets.
- A successful multisectoral plan requires that the multisectoral approach to nutrition is
integrated into the planning process at all levels.
- Planning for the implementation and monitoring and supervision should include
community participation at the grassroots level. Particular attention should be given
to using and strengthening the existing community structures to sustain behavioural
changes.
- Roles and responsibilities should be defined based on the comparative advantage of
each stakeholder. It is not always necessary or appropriate for every sector to be
involved in all areas of nutrition, but systemic change can be brought forth with the
contribution of various relevant sectors.
- Financing of a realistic national plan by the government and donors is key to its
success. The necessary resources can be mobilised at the national and global levels if
the plan is well done with clear objectives and measurable indicators in a well-defined
time period.
- Creation of a platform conducive for multisectoral planning through the guidance of
the SUN Technical Advisory Group (TAG) chaired at an appropriate level and
formulation of multisectoral Nutrition Task Forces for key thematic areas comprising
experts are critical for successful planning.
- The potential emergency response activities or ongoing support to humanitarian
intervention should be adequately incorporated into the plan as a defined area of
focus, as Sudan is considered as a fragile country with a large humanitarian aid
operation.
- Build capacity at all levels to fully contribute and support effective coordination
including coordination with the nutrition cluster for emergency response and ensure
the continuity and institutionalisation of nutrition support as part of the recovery and
long-term interventions.
- Consideration for cross-cutting aspects in the planning including advocacy, gender,
capacity building, supply management and institutional arrangements and mandates.
2.3. Guiding Principles
Development and implementation of a multisectoral nutrition plan should be evidence-based,
aligned to agreed nutrition targets & commitments and guided by the following ten SUN
principles:
17
2.4. Assessing the Country Nutrition Context
The first phase of developing a multisectoral nutrition plan requires a good understanding of
the current nutrition challenges in the country and the overall context within which they can
be addressed. Assessing the country context will help to identify the priority nutrition issues
that Sudan needs to address, the status and gaps in the current response and the
sectors/stakeholders which are or need to be involved in addressing the priority nutrition
issues identified. There are three common core elements to assessing the country context
which include carrying out: i) a nutrition situation analysis; ii) a policy framework mapping and
analysis; and iii) a stakeholder and action mapping.
i. Situation Analysis
A nutrition situation analysis gives an overview of the context, highlighting the key drivers of
malnutrition and disparities between population groups, communities or regions of the
country. It helps to create a common understanding of the nutrition situation and highlight
the priority nutrition issues that need to be addressed through the multisectoral nutrition
plan.
The situation analysis is important for planning in the following areas: i) understanding and
estimating the needs of the key vulnerable groups, ii) providing information to identify cost-
effective and evidence-based interventions for each identified need, iii) understanding the
trends and the dynamics of the nutrition situation, and iv) providing evidence which can be
used for advocacy purposes to mobilise resources and increased commitment by all partners.
To develop the nutrition situation analysis, various assessments and surveys at the national
and locality level need to be properly analysed covering the following areas:
- Demography of the key target groups
- Current and trendline nutritional status of the key population groups (undernutrition,
overnutrition and micronutrient deficiencies)
- Underlying causes of malnutrition (Food, feeding and dietary practices, access to
services)
1. The human rights to good food and nutrition.
2. Be transparent about intentions and the impact.
3. Be inclusive: A broadly participatory process which will in many cases expand the scope of
the existing partnerships and include new ones.
4. Be willing to negotiate and open in stating objectives and expected results and reporting
back to the public
5. Be predictable and mutually accountable including mutual accountability for programme
decisions and funding allocations
6. Be cost-effective and avoid duplication
7. Be continuously communicative
8. Act with integrity and in an ethical manner
9. Be mutually respectful
10. Do no harm
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- Basic causes of malnutrition (access to resources, economic and social disparities,
political commitment, etc.)
A situational analysis might also include an assessment of:
- Shortcomings or perceived challenges/bottlenecks, including around demand for
nutrition-related services as well as social expectations.
- System performance (health system, food system, etc.) and performance gaps in
responding to needs and expectations.
- Capacity of the health, food, WASH, education and social protection systems to
respond to the needs and challenges in delivering nutrition sensitive programmes
including available resources (human, physical, financial, informational) and resource
gaps.
- Evaluation of the existing interventions and scalability of the
programme/interventions. Ranking of various interventions in focus group discussion
during programme reviews can be accessed from government and partners.
- Impact and cost-effectiveness of the programme/interventions. This kind of data is
available in published studies like the Lancet series and any other national impact
studies.
A proper triangulation of surveys and assessments with routine monitoring data can also be
undertaken to understand the current progress against international commitments as part of
the situation analysis. Sudan is a signatory to the WHA and SDG targets in 2025 and 2030,
respectively, and recently announced SMART nutrition commitments as part of the N4G
summit. All plans and activities need to contribute to such global and national targets and
commitments, as outlined in Annex 1.
ii. Policy Framework Mapping and Analysis
Policy framework mapping and analysis identifies the national policies, strategies and other
legal documents which already exist in support of nutrition. The purpose of the policy
framework analysis is to assess the current inclusion of nutrition across different sectoral
policies and strategies and inform the development of country priorities and alignment within
and across sectors towards addressing nutrition goals. When developing the country priorities
and the multisectoral nutrition plan, it should be based on existing policy frameworks as much
as possible to ensure that the priority interventions chosen are implemented. The findings
can also support advocacy and engagement for the updating of key policies, strategies and
laws which would strengthen the implementation of critical interventions in support of the
multisectoral nutrition plan.
iii. Stakeholder & intervention Mapping
Stakeholder and intervention mapping aims to identify key stakeholders’ interests, their
role(s) where they are currently working, capacities and potential influence to support the
development of the multisectoral nutrition plan.
The outcome of the mapping process should ideally cover the following areas:
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− Who are the major and supporting actors/organisations in the implementation of
nutrition-related activities and in governance bodies for nutrition and who should be
engaged in multisectoral planning for nutrition going forwards?
− The degree of interest and knowledge in nutrition across stakeholders, which helps to
identify advocacy, communication or capacity needs.
− The breadth of stakeholder nutrition-related programmes (geographic and population
coverage) and an indication of committed funding and resource gaps.
− An analysis of the strengths, opportunities and challenges to multisectoral planning
for nutrition stakeholders.
For more details, please refer to Module 1 of the MQSUN+ planning toolkit at the following
link: MQSUN-Multisectoral-Nutrition-Planning-Toolkit_Module 1_24Nov2020_final.pdf
(path.org)
iv. Engaging with all nutrition stakeholders
Getting the early involvement and buy-in of all the relevant stakeholders (government
ministries, UN agencies, civil society, private sector, academia, international donors) in all
sectors is critical to be able to develop and implement a truly multisectoral nutrition plan. This
is so that all stakeholders have a common understanding of nutrition, its relevance for the
country and for them to begin to appreciate their role in addressing the nutrition challenges
in the country thereby helping to ensure ownership of and commitment to the plan. Different
sectors and systems will have different levels of understanding about nutrition and the role
they could or should play. Likewise, the existing level of engagement in nutrition will also
differ, ranging from zero engagement where there are no sector nutrition objectives or
indicators in strategies or programmes, to strong engagement demonstrated through
relevant objectives, indicators and programmes which can contribute to an improved
nutrition situation.
There are several ways in which all potential partners can be identified and sensitised
including formal and informal meetings with partners/decision makers or a multi-stakeholder
workshop bringing all partners and decision makers together.
The focus of such occasions should be on ensuring that all the participants are on the same
page regarding nutrition by the end of the event and include:
- Explaining the key nutrition concepts and the critical role of nutrition
- Outlining the nutrition situation in the country, including key drivers
- Setting out the economic benefits of addressing nutrition
- Facilitating agreement on the importance of addressing nutrition and the need for a
multisectoral nutrition plan
The exercises carried out to understand the country nutrition context can provide a wealth of
information for such meetings/workshops. The stakeholder and intervention mapping and
contextual analysis in particular are likely to identify both actual and potential stakeholders
to engage in the process and is likely to bring new partners into the multisectoral nutrition
plan development and implementation – Ministries, private companies, state institutions and
communities that are key players but not yet taking part in nutrition design and programming.
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Continuous advocacy efforts may be needed from this point forwards to ensure that all
potential stakeholders become engaged and committed in the process of developing and
implementing the multisectoral nutrition plan, with more focus needed on those stakeholders
which cannot see their role clearly or perceive the importance of nutrition for their sector.
Table 2: Potential list of nutrition related sectors and partners in Sudan
Sectors Partners
Government Sectors Ministry of Finance and Planning, Labour, Gender/Women’s Affairs
Ministry of Health and appropriate directorates
Ministry of Agriculture and appropriate directorates
Ministry of Animal resource and appropriate directorates
Ministry of Water resources and appropriate directorates
Ministry of Labour and appropriate directorates
Ministry of GENERAL Education and appropriate directorates
Ministry of HIGHER EDUCATION
Ministry of Industry and appropriate directorates
Ministry of Trade and appropriate directorates
Ministry of Social Development and appropriate directorates
Sudan Central Bureau of Statistics
Ministry of Justice and appropriate directorates
Ministry of Environment
Ministry of Information and Communications
Ministry of Youth and sports sector
Research and academic institutions
Sudanese Standards and Metrology Organisation (SSMO)
Food Regulatory bodies
Chamber of Commerce and others relevant sectors
SUN Research & Academia Networks
Private Sector Consumer Associations
Millers, Salt producers, Oil producers, RUTF/RUSF & CF producers
associations
Workplace Nutrition programme organisers
Business clubs and associations
National and Multinational Private companies working on the food sector
Food marketing, packaging and labelling agencies
SUN Business Network
UN/NGO/Civil Society
Sector
UNICEF, WFP, WHO, UNFPA, FAO, IFAD, World Bank, UNDP, UNOCHA, UN
Women,
SUN, CSA, donor, and UN networks
INGOs
Local NGOs
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3. FORMULATING THE NATIONAL MULTISECTORAL NUTRITION PLAN
The analyses outlined in the previous section will provide nutrition relevant stakeholders with
most of the information necessary to formulate a strategic plan for a multisectoral approach
to nutrition. The Multisectoral Nutrition Plan should include identified priority areas,
programmes and interventions as well as the rationale for their selection, overall goals and
targets, including indicators (or benchmarks) and how they will be measured, a
responsibilities matrix, monitoring and evaluation framework, and an estimation of the
resources required (personnel, budget and funding sources).
3.1. Responsibility for planning a multisectoral approach
This usually falls to a government appointed/identified group. Many countries have done it
with the Ministry of Health taking the lead with clear representation by mandate from other
line ministries. Others have hosted the development and implementation of a national
multisectoral nutrition plan in the Ministry of Finance and Planning. As in many countries, in
Sudan, the Ministry of Health leads the nutrition programmes, particularly focusing on
emergency programmes and it has established a unit with adequate personnel at the Federal
level. Therefore, it would be appropriate that the Ministry of Health leads this process of
developing a national multisectoral nutrition plan as its undersecretary is also named as the
focal point for the SUN in Sudan. This responsibility comes with a need for a paradigm shift in
the way of working to engage all nutrition relevant line Ministries to include nutrition as part
of their national plan. It would also involve engaging the Cabinet of Ministers, which is the
highest government body accountable for nutrition work in Sudan. A higher-level government
official with the convening power to bring together different government ministries should
lead this process. The Cabinet of Ministers through its inter-ministerial committee should also
give a mandate to the SUN Secretariat office hosted in the Federal Ministry of Health to work
across all nutrition relevant ministries to develop the national multisectoral nutrition plan and
coordinate implementation at scale by using multi-stakeholder platforms. In addition, each
nutrition relevant line ministry in turn should nominate 2 to 3 high-level experts from
appropriate directorates to be permanent members of the SUN Technical Adviser Group
(TAG).
3.2. Information to include in the multisectoral plan
There is no set template for developing a multisectoral nutrition plan. However, at least the
multisectoral nutrition plan should include sections that refer to the following:
− Contextual analysis including reviewing the national and global commitments, and
alignment of the plan to the agreed targets. This may include analysis of capacity gaps
and opportunities and refer to previous plans and bottlenecks to achieve nutrition
goals
− Key nutrition priorities identified
− An overall goal and a set of key high-level targets and how they will be measured
− Strategic objectives/actions (includes major anticipated outcomes, output and
interventions across sectors).
− Governance and coordination structures/mechanisms
− Roles and responsibilities of all actors and sectors
− Risks and assumptions
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− An indicative budget and financing plan
3.3. Steps for formulating a multisectoral nutrition plan
To start formulating the multisectoral nutrition plan, it will be vital to bring together
stakeholders to identify the overall goal, priority areas and high-level targets of the plan. Once
this has been achieved, it is recommended that thematic technical working groups (TWG) are
set up, comprising sector experts from government and partners, to identify the evidence-
based, high impact interventions, target beneficiaries, outputs, outcomes and specific
objectives as well as the roles and responsibilities of stakeholders and indicators against which
to monitor progress.
3.3.1 Setting overall goal and high-level targets
If there is an existing multisectoral nutrition policy or strategy which already specifies an
overall goal for nutrition and/or targets, these can either be adopted or adapted for the
multisectoral nutrition plan. If these are not already agreed, then stakeholders can use the
contextual analysis information to formulate goals and high-level targets, including
information related to the SDGs, WHA targets and the N4G commitments.
3.3.2 Priority-setting
Developing an effective multisectoral nutrition plan will require priority-setting that takes into
account the magnitude of the nutrition situation, the evidence-base, cost-effectiveness, the
level and adequacy of the current programmes and response, the absorptive capacity of the
various systems (health, food, water, social protection, education, humanitarian and other
systems) and infrastructure to respond further, and the readiness of partners to fund,
implement and monitor the progress of the recommended priorities. Most of this information
will be available from the situation analysis and stakeholder and action mapping conducted
in the preparation phase.
There are globally recognised evidence-based nutrition specific and sensitive interventions
(See Figure 412
) and lessons learned at the national and subnational level that should be taken
in to account when identifying the nutrition priorities for Sudan. Emphasis on such priorities
can also differ at the subnational level depending on the context when developing the
operational action plan at the state and locality levels.
12
Black et al., 2013. Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet.
23
Figure 4. Framework for actions to achieve optimum foetal and child nutrition and
development
The determination of priorities will take into consideration:
− The magnitude and prevalence of the nutrition situation (e.g. wasting, stunting,
specific micronutrient deficiencies, overnutrition/obesity),
− Identification of most vulnerable groups,
− Geographical target areas,
− Disease, disability and mortality burden,
− Leadership and sector capacity for implementation,
− Potential and realistic resources to be allocated,
− Implementing partners and community readiness and ability to implement
evidence base interventions.
For more details, please refer to Module 2 of the MQSUN+ planning toolkit at the following
link: MQSUN-Multisectoral-Nutrition-Planning-Toolkit_Module-2_24Nov2020_final.pdf
(path.org)
3.3.3 Establishing Multisectoral Nutrition Thematic TWGs
To develop a Common Results Framework, it is recommended to set up TWGs across key
thematic areas. This would enable focused discussions and lay out in detail the objectives,
actions, targets and anticipated outputs and outcomes under each identified priority area.
When the TWGs are formed, the following needs to be considered:
− Forming a key thematic area consistent with the nutrition priorities and commitments
made by the country. Examples of thematic areas where technical task forces can be
formed to draft plans may include Community-based management of Acute
Malnutrition (CMAM), Maternal, Infant and Young Child Nutrition (MIYCN),
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Micronutrient Nutrition, Nutrition-sensitive Agriculture, WASH-Nutrition, SBCC for
nutrition, Social Protection and Education.
− Selecting appropriate experts for each task force. Each thematic area will have a group
of experts from different sectors to address malnutrition in all its forms in a more
systemic manner.
− Each task force will have clear ToR and will report its work to the TAG for feedback and
comments.
− Members of the task force need to have the right kind of experience and expertise to
significantly contribute to the planning processes.
3.3.4 Developing a Common Results framework (CRF)
A CRF is a single and agreed set of expected (or common) results generated through the
effective engagement of different sectors of government and the multiple nongovernmental
actors who have capacity to influence nutrition. A CRF lays out in detail the objectives, actions,
targets and anticipated outputs and outcomes under each priority area/strategic objective of
a multisectoral nutrition plan across a timeline, assigning clear roles and responsibilities. It is
a vehicle for stakeholders to translate policy into action and results.
Overall, the CRF should be based on the overall goal and high-level targets agreed on for
nutrition in the country and reflect the ways in which different sectors and actors can best
contribute to the achievement of these targets through their individual and collective actions.
A CRF is usually presented as a detailed logical framework, or log frame, which includes all the
nutrition actions identified by priority area and the anticipated results. The key steps in the
process are as follows:
Setting strategic objectives in priority areas to reach the overall goal and high-level targets
While there may be an overall goal for the national response, for each priority area there
should be strategic objectives set to be reached by the end of the period covered by the plan.
Often, the overall goal will only be reached only through achieving some specific objectives.
The existing strategic objectives outlined in the current nutrition policies or strategies can be
adopted or adjusted as appropriate.
Defining inputs, activities, outputs, outcomes and impact
The next step is identifying the inputs, activities, outputs and outcomes which will contribute
towards achieving the identified strategic objective. For each activity identified, the key target
group needs to be identified. Existing policies, strategies and plans relevant to the specific
sector can be used to support this process.
Assigning roles and responsibilities
Each activity identified and its outcome should be assigned to a key stakeholder(s) who bears
overall responsibility for implementation, achievement and reporting on the intervention.
This is typically the responsible ministry or ministries if it is a crosscutting intervention. Other
stakeholders that will contribute to achieving the outcome can also be included to ensure
there is clarity and accountability for all stakeholders engaged in each activity. It is also
25
important to consider and include broader roles of specific stakeholders and sectors as
appropriate. Example roles for different types of stakeholders and sectors can be found in
annex 3.
Specifying indicators, means of verification and sources of data
Strategic objectives, intermediate outcomes and their contributing inputs and outputs need
to be translated into a set of measurable indicators to establish whether progress is being
achieved. These should be based on existing data sources as much as possible such as national
level surveys or routine data. Such information will provide the basis for the development of
the M&E framework for the multisectoral nutrition plan.
Specifying the baseline and targets
Sudan, as a signatory to both the WHA and SDG goals, is using these targets to track progress.
The targets, as indicated in Table 1, as part of the nutrition situation analysis are extended to
2030 in line with the recently published WHO discussion paper. The justification behind the
2025 WHA targets is stipulated to ensure alignment with the 2030 SDG nutrition targets. We
are using 2010 as the baseline year against which progress will be tracked on an annual basis
using different national surveys.
Identifying critical assumptions and risks
It is important to identify assumptions related to external factors (e.g. political environment,
economy, climate change) that could carry risks. The situation analysis would have already
identified the reasons why some initiatives are not working and why priority areas are being
neglected. This will indicate the problems the projects have faced and the obstacles that have
prevented important issues from being raised and appropriately addressed. Stakeholders can
develop strategies to mitigate these risks.
For more details, please refer to Module 3 of the MQSUN+ planning toolkit at: MQSUN-
Multisectoral-Nutrition-Planning-Toolkit_Module-3_24Nov2020_final.pdf (path.org).
3.3.5 Putting in place and/or strengthening coordination platforms
Good governance and strong coordination within and across sectors are necessary for any
multisectoral nutrition plan to be implemented successfully. Governance mechanisms need
to be established and agreed at all levels with clearly defined roles and responsibilities. High-
level ministerial support that transcends the sectors (e.g. at the level of the Prime Minister or
Cabinet of Ministers) is the optimal position for establishing leadership in order to influence
and mobilise each sector and level of governance.
A key component of developing the multisectoral nutrition plan is to set out an agreed on
governance and accountability framework to facilitate the implementation. The key
considerations include the following:
− The governance and accountability framework should include a coordination platform
situated at the highest level possible within the government.
− The framework should outline the coordination platform and committee at each level,
the membership (including specific stakeholders) and their roles and relationship with
other related platforms.
26
− Each platform should involve a range of members and actors appropriate to the level
of the coordination mechanisms including ministers, deputy ministers and senior
officials or technical experts, representing all types of stakeholders and sectors.
− The framework should set out the relationships between each level, emphasising the
vertical relationships between the platforms at national level through to subnational
and local levels, how they will interact and how they will be accountable to each other.
− It is also critical to ensure that the necessary capacity is in place so that each platform
is functional, and the accountability structure is fit for purpose – ensuring it is
adequately staffed, empowered and government-led.
Section 1.1 set out the proposed governance and accountability framework for SUN in Sudan.
It is expected that this framework would be finalised as part of the development of the
multisectoral nutrition plan, once agreed with all stakeholders. In addition, as part of efforts
to develop broad-based nutrition coordination, the existing relevant coordination forums in
Sudan, which are by and large information sharing mechanisms, need to be mainstreamed at
all levels to facilitate multisectoral planning and tracking of progress against the agreed
targets. To avoid the duplication of efforts, the forums will be encouraged to revise their ToR
and facilitate more concerted action to achieve the agreed nutrition goals.
3.3.6 Putting in place a Monitoring, Evaluation and Learning (MEL) system
Monitoring and evaluation systems are an integral part of a multisectoral nutrition plan which
enable effective multisectoral strategic planning. They provide programme managers,
implementers and policymakers with timely information not only on the status of
implementation of programme activities but also, importantly, on the key issues and learning
of their effectiveness, efficiency and continued relevance. A robust MEL system, which builds
upon traditional monitoring and evaluation (M&E) to also foster learning and evidence-based
decision making, is required to be able to verify whether a multisectoral nutrition plan is on
track to achieve its targets and to enable evidence informed decision making (e.g. related to
resource mobilisation and resource allocation, service quality improvement, capacity
building, policy and plan formulation or revision). The evidence and information generated
can also be used for advocacy and resource mobilisation.
The MEL framework – which can also be described as a plan, strategy or matrix – is usually
developed as a distinct part of or separate document to the multisectoral nutrition plan but
is closely aligned with it. The MEL framework should consider any existing MEL system and
set out how this will be strengthened across various systems to be able to generate high
quality impact, outcome and routine programme output data. The budgeting for
operationalising the MEL Framework is usually done as part of the overall costing of the
multisectoral nutrition plan (see next section). Typically, at least 10 per cent of the activity
cost should be directed towards MEL, but the percentage can vary considerably depending on
what is needed to set up or strengthen the MEL system.
The key components to be included in the MEL framework include the following:
− Outline of the M&E framework.
27
− Overview of data sources and gaps for the selected indicators.
− A logical framework including the main goal, outcomes, outputs, activities, besides
assumptions, sources of data for verification and tools of verification.
− Defined data-collection mechanisms: source of data; frequency of data collection;
data collection tools; data-reporting mechanisms.
− Data coordination, management, analysis and interpretation plans: analysis
mechanism; data validation and verification (quality assurance); use of data at
different levels; data storage; data sharing.
− An evaluation plan and research agenda: annual reviews; midterm evaluation; final
evaluation; research and assessments to monitor progress and specific aspects of
programmes/the multisectoral nutrition plan.
− Data use – using generated data to inform planning and gauge progress towards goals.
− M&E capacity – including current capacity (may be some information available from
the contextual analysis) and capacity building approach to fill in identified gaps.
− Timeline of activities.
There should be an institutional base identified which will take the lead on assessments and
formative research that will be undertaken on a regular basis to track the progress and impact
of interventions. Usually, the M&E Directorate within the Ministry of Health together with
Nutrition and Research Institutes are responsible to lead such efforts. Partners like UNICEF,
WHO, WFP, World Bank, civil society and key nutrition donors often take part in such
assessments and studies.
For more details, please refer to Module 5 of the MQSUN+ planning toolkit at: Module 5:
Monitoring, Evaluation and Learning for Nutrition – MQSUN+ (path.org).
3.3.7 Costing the plan
Costing refers to determining the resources needed to implement an intervention or set of
interventions and related activities to achieve an objective. Accurate estimates of the financial
resources required to implement the multisectoral nutrition plan are essential for planning,
budgeting and resource mobilisation. A comprehensive costing should take into consideration
all the costs associated with implementing the multisectoral nutrition plan including human
resources, goods and services, capacity building, advocacy, creating the enabling environment
and MEL.
The critical elements needed to successfully carry out the costing will be available in the
multisectoral nutrition plan and include the following:
− Clear interventions and activities in the plan which are well understood.
− Implementation targets for each of the interventions and activities identified.
− Target coverage for each intervention and activity.
28
− Information on current spending including cost components (recurrent, capital and
indirect costs).
There are a variety of costing methods which can be used when costing a multisectoral
nutrition plan, depending on the context and the level of detail as well as the time and data
availability. Examples include:
− Top-down approach (less accurate, faster) – disaggregating total expenses for a
programme or activity into cost categories using defined formulae.
− Bottom-up approach (more accurate, take time) – identifying all the individual cost
elements (inputs) and the value of each for an activity or programme and aggregating
them, e.g. “ingredients approach”.
− Programme or experience-based approach – adjusting costs that exist for a similar
activity or programme.
Whichever method is chosen, it is important to document the overall approach, steps taken
and assumptions made for it to be well understood and to be replicated in the future. Costing
the plan should be done in close consultation with the respective sectors through engagement
of the SUN TWGs and focal points.
The costing is a critical step in the process of mobilising resources and can be supported by a
financial gap analysis and a resource mobilisation approach – a critical tool for advocacy for
the greater allocation of resources from domestic and other sources, whilst tracking the
investments informs ongoing advocacy and helps ensure that funds are used to best effect.
For more details, please refer to Module 4 of the MQSUN+ planning toolkit at: Module 4:
Costing and Financing for Nutrition – MQSUN+ (path.org).
3.3.8 Finalisation, official endorsement and launching
Once the multisectoral nutrition plan, including the MEL framework and costing, is completed,
there are several steps to take to finalise it and ensure that it is adopted. These include: i)
bringing the plan together into one coherent document; ii) validation workshop iii) launching
and endorsement of the plan; and iv) publication and dissemination.
i. Bringing the plan together in one coherent document
The focus at this stage is on bringing all the components of the document together and
ensuring a consistent narrative throughout the document to create a final draft of the plan.
ii. Validation workshop
The aim of a validation workshop is to ensure that all the national and state level stakeholders
(government ministries, UN agencies, civil society, private sector, academia, international
donors) are familiar with the multisectoral nutrition plan and have a final chance to raise any
issues of concern.
29
iii. Launching and endorsement
High-level representatives from each stakeholder, including the Prime Minister’s Office,
Government Ministries, HCFSN, donors, UN, CSA, private sector and research and academia
who are in a position to commit their organisation to support the implementation of the plan
and ensure accountability and ownership should be invited during the launch of the
Multisectoral nutrition plan launch and sign the document and provide guidance to all the
stakeholders. The launch at the national level should be followed by similar events at the sub-
national level to also receive endorsement from each state level Government and partners to
facilitate accountability for implementation of the plan.
iv. Publishing of the plan and dissemination
Any final inputs received during the validation process should be considered before the
multisectoral nutrition plan is published. The final draft document will need to be edited,
designed and printed. The formal endorsement of the Prime Minister, the Ministers of all
Government Ministries involved in the plan and the SUN Focal Point can be demonstrated
through their signing of the final document prior to printing. Once this process is completed,
dissemination of the final document at all levels is critical to support the implementation of
the plan itself.
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4 OPERATIONALISING THE NATIONAL MULTISECTORAL NUTRITION PLAN
4.1 Governance and coordination structures/mechanisms operationalisation
At the initial stage of implementation, it is critical to ensure that governance structures
established either before or during the development of the multisectoral nutrition plan are
formalised, functional, budgeted and adequately staffed to ensure accountability. This may
include needing to develop or update a TOR and the membership of each platform for the
implementation phase, developing links with other platforms within the governance
structure, securing support for running the platforms and securing domestic funding for
sustainable operation.
Key steps for establishing or strengthening national governance and coordination structures
include the following:
− Creating the governance structure in line with agreed approach
− Developing/revising TORs including roles and responsibilities
− Considering what capacities are in place or need to be developed
− Developing annual workplans as appropriate to the platform
− Embedding structures and staff into the public sector funding mechanisms
4.2 Capacity development strategy
To be able to successfully implement the multisectoral nutrition plan, a capacity development
strategy is needed for the national, sub-national and community levels which articulates in
detail and formalises the capacity building measures referenced in the plan. To help with the
development of the strategy, an in-depth capacity assessment and skills mapping exercise
may be carried out.
The capacity development strategy should include:
− Key capacity building activities at the national, sub-national and community levels and
the target groups for the activities
− Clear links between the capacity building activities and the intervention
areas/expected outcomes of the multisectoral nutrition plan
− Responsible entities for implementing each of the capacity building activities
− A timeline of the capacity building activities over the life of the multisectoral nutrition
plan.
4.3 Advocacy and communication strategy
Conducting advocacy is critical for the success of any plan but especially so for a multisectoral
nutrition plan that involves such many sectors and stakeholders. The purpose of an advocacy
and communication strategy is to enable all stakeholders to speak in one coordinated voice
to increase the political and social commitment to improve the nutrition situation, promote
accountability for nutrition and strengthen nutrition governance to support the goals of the
multisectoral nutrition plan. Specific objectives can include:
31
− Fostering buy-in and leadership for a multisectoral approach to nutrition
− Promoting a supportive policy, regulatory and operational environment
− Supporting the creation and/or accountability of a multisectoral governance structure
for nutrition
− Helping to mobilise the required government, human, technical and financial
resources required to implement the multisectoral nutrition plan and support long-
term sustainable financing for nutrition
− Promoting accountability of stakeholders to increase nutrition services and generating
demand for nutrition services by empowering communities, media and CSOs
− Raising public awareness on issues related to maternal and child nutrition and on
government and partner efforts/commitments to address these needs.
The advocacy and communication strategy should be developed in close consultation with all
the relevant stakeholders that engage in advocacy work, particularly at the policy level.
Ideally, the stakeholders would represent Government, UN, CSOs, donors, the private sector
and academia. The time frame for the advocacy strategy would usually be aligned with the
multisectoral plan, but the approach can be revised and extended as needed in line with a
future multisectoral plan or used beyond this period for continued engagement of partners
to implement multisectoral actions to improve nutrition.
4.4 Resource Mobilisation
Resource mobilisation refers to raising and leveraging financial (domestic public and external
funding) and non-financial resources to support the implementation of the multisectoral plan.
Resource mobilisation should be a collaborative process involving all nutrition stakeholders
and sectors, particularly planners and decision makers from each sector, the ministries of
finance, ministries of planning and development and external donors. Any resource
mobilisation strategy is very closely linked with an advocacy strategy.
Key steps to develop a resource mobilisation approach include the following:
− Develop situation analysis – set out the context and importance of the issues, identify
the gaps in funding (requires a mapping of available resources) and other aspects,
understand who all the stakeholders are – especially those which influence resource
mobilisation, map out the potential and actual financing mechanisms, and assess the
advocacy priorities.
− Develop relationship building strategies – set out strategies to develop partnerships
and identify all potential value-add partnerships to support resource mobilisation such
as Ministry of Finance, donors and the private sector.
− Make the case – develop advocacy approaches and key messages, identify
opportunities to convey key messages including the right audiences and who are best
placed to convey the key messages including nutrition champions, members of
parliament, donors, development partners, private sector, academia, CSOs and the
media.
32
− Monitoring and Evaluation – set out how the success of the approach will be
measured.
Implementation of both the advocacy and the resource mobilisation strategy require the
involvement of a wide range of stakeholders to ensure a broad base of support for the
multisectoral nutrition plan which can support all the aspects of implementation. Potential
roles of different stakeholders in supporting both strategies include the following:
− Nutrition Champions at the top level of government and in nutrition-related sectors
as well as well-known individuals in wider society to influence policy direction and
move nutrition up the political agenda.
− Members of parliament to influence the policy, planning and budgetary processes to
increase the visibility, importance of and resources for nutrition.
− Donors and development partners to increase and foster the alignment of external
funding and influence public sector nutrition policies and programmes.
− Private Sector to increase investment in nutrition-relevant areas such as food
fortification and promote good diets and breastfeeding.
− Media and CSOs to raise the visibility of nutrition as an issue, mobilise communities
and hold decision makers accountable for their commitment to nutrition.
− SUN Networks to support the process through convening and influencing their
respective groups in support of a multisectoral approach to nutrition.
Please refer to the Module 6 of the MQSUN + in this link for further information: MQSUN-
Multisectoral-Nutrition-Planning-Toolkit_Module-6_24Nov2020_final.pdf (path.org)
4.5 Sector annual planning for implementation at all levels of government
To successfully implement the multisectoral nutrition plan, there are several steps that are
recommended to be taken prior to and during the rollout of activities. These steps include: i)
ensuring that the coordination mechanisms outlined in the multisectoral nutrition plan are
put in place; ii) integrating the multisectoral nutrition plan activities into the planning process
at the national and state levels; iii) reviewing/developing guidelines and protocols; iv)
updating sector policies and plans; and v) reviewing/developing complementary sector-
specific laws and regulations.
i. Coordination
Due to the multisectoral nature of malnutrition and the multisector and multistakeholder
response encompassed in the multisectoral nutrition plan, the governance and accountability
framework not only needs to take into account coordination between sectors, outlined
earlier, but also how activities within a sector will be coordinated as there are often a variety
of departments involved in the process such as planning, programme units, and M&E as well
as many partners. Ideally, sector level coordination will use existing mechanisms at all levels
if present, rather than creating new ones.
33
ii. Planning process
To facilitate the implementation of the multisectoral nutrition plan, each activity needs to be
incorporated into the planning process at the national and sub-national level in the relevant
sector. It will be important to ensure that updated planning, policy guidance and capacity
building is completed prior to the annual planning process at the national and the subnational
level. In each Ministry, this planning process should be led by the planning unit with the
involvement of the relevant technical and programmatic departments.
Subnational governments, whether at the state or locality levels are responsible for the
delivery of services relevant or specific to nutrition which are outlined in the multisectoral
nutrition plan. Subnational governments, at least at the state level, should be involved in the
development of the multisectoral nutrition plan and, to facilitate planning, will also need to
be introduced to the final version along with key partners. Based on the multisectoral
nutrition plan, implementation plans will need to be developed at the state and locality levels,
led by the government, and involving all the stakeholders, as part of the regular planning
process. It may also be useful to carry out a brief contextual analysis to support planning at
the subnational level which could include a mapping of key interventions, the reach of the
interventions, the organisation’s involved and the capacity available.
The planning department in each sector should take the lead to bring all the units and partners
together to plan jointly for implementation, including budgeting, to take advantage of
synergies. To facilitate the planning process at the national and subnational levels, a workshop
or series of meetings can be set up with the participation of line ministry staff from
programmes, planning and M&E. Programme and technical staff should be included from
CSOs, the UN, private sector and academia, as appropriate. The subnational planning process
should consider the following:
− Prioritisation of actions, interventions or programmes and development of specific
objectives.
− Work plans and activity costing/budgeting
− Financial and nonfinancial resource needs
− Budget consolidation
− Monitoring and evaluating implementation
It is likely that these implementation plans will vary considerably by state and locality,
depending on the specific identified needs, but ideally there would be an identified core
package of services included in all the plans.
iii. Reviewing/developing guidelines and protocols
To support the implementation, it will be important for key stakeholders, including
Government Ministries and partners, to review the existing guidelines and protocols for all
the interventions included in the multisectoral nutrition plan to ensure that they are fit for
purpose. In the event that necessary guidelines and/or protocols do not exist, it will be
important for key stakeholders to come together to develop them.
34
iv. Updating sector policies and plans
In a similar manner to the review and updating of the sector guidelines and protocols, it is
critical to also review sector policies and plans to ensure that all sector-relevant interventions
in the national multisectoral nutrition plan are included. The purpose of this is to ensure that
these interventions are considered during each sector annual planning process. To do this, it
will be important to understand the timeline for updating sector policies and plans to
contribute to that process as it may not be possible to update them on an ad-hoc basis. The
situation analysis carried out at the start of development of the multisectoral nutrition plan
may provide information on all the relevant sector policies and plans or it may be useful to
also carry out a quick mapping.
v. Reviewing/developing complementary sector-specific laws and regulations
To support the implementation, there may be instances when updating or developing laws
could strengthen the implementation of specific interventions or programmes. An example
of this is introducing a mandatory food fortification law which will strengthen the prevention
of micronutrients deficiencies through fortification of staple foods including Universal Salt
Iodisation (USI) in the country.
4.6 Operationalisation of the Multisectoral Plan at different levels
National/Federal level:
− Putting in place governance and accountability framework and leading coordination
platforms at the national level.
− Developing/revising national policies and strategies
− Positioning nutrition as a national development agenda.
− Establishing a platform for joint planning, which is guided by the national TAG.
− Defining the planning process and inviting multi-sector partners to the planning forum.
− Establishes broad goals and objectives with smart performance indicators aligned to the
agreed national targets.
− Allocating national level budget and deploying appropriate human resources to
subnational levels.
− Developing the capacity of staff on planning, M&E and technical implementation at scale.
− Providing technical support to the implementation of the plan including supportive
supervision, joint monitoring and ensuring activities are aligned to the agreed results.
State/Locality level:
− Developing detailed implementation plans aligned with the national plan.
− Putting in place and leading coordination platforms at the state and locality level.
− Allocating budget and other resources (human resources, logistics etc).
− Facilitating training at the state and locality levels.
− Implementing the detailed action plan.
− Carrying out regular supervision of the programme implementation.
− Collecting and compiling data, timely tracking of results and providing progress
reports.
35
ANNEXES
Annex 1: Sudan Scaling Up Nutrition Movement Roadmap 2021-2025
Introduction
The global Scaling Up Nutrition (SUN) Movement, since its inception in 2010, has inspired a
new way of working collaboratively to end malnutrition in all its forms. With the governments
of SUN countries in the lead, it unites people—from civil society, the United Nations, donors,
businesses and researchers—in a collective effort to ensure every child, adolescent, mother
and family can realise their right to food and nutrition, reach their full potential and shape
sustainable and prosperous societies.
Sudan joined the SUN Movement in October 2015, with a letter from the Government
expressing its commitment to scaling up nutrition in the country. The recently developed SUN
Strategy 3.0 places a greater focus on nutrition results at the country level encompassing all
forms of malnutrition, a country-driven, country-led, country- owned approach and
empowering country teams to be able to lead, act at scale and accelerate progress.
Overview of the Roadmap
This document comprises the roadmap for Sudan SUN Movement’s operation over the next
five years. It sets out a systematic and methodological pathway to catalyse and scale up
efforts to reduce malnutrition in Sudan as well as make progress towards the shared SUN
vision of a world free from malnutrition in all its forms, the World Health Assembly (WHA)
global nutrition targets and the Sustainable Development Goals (SDGs). This roadmap builds
on the Sudan SUN Movement’s progress and achievements since Sudan joined the global SUN
Movement and is aligned with the SUN Strategy 3.0 strategic objectives.
The SUN vision:
By 2030, a world free from malnutrition in all its forms.
36
The roadmap sets out the broad framework of action for the Sudan SUN Movement,
organised by priority areas, over the next five years from 2021 to 2025. Under each priority
area, a set of broad activities are identified to be achieved by 2025 with the involvement of
all SUN stakeholders in Sudan. These broad activities will be the basis for developing more
detailed yearly implementation plans. The key themes of the roadmap, highlighted in the next
section on priority areas, are the re-operationalisation of the Sudan SUN Movement and the
development and implementation of a multisectoral nutrition action plan.
This roadmap is the guiding document for all SUN stakeholders in Sudan at the national and
sub-national levels, led by the government through the SUN Focal Person, SUN Coordinator
and secretariat, with the support of the SUN Networks (CSA, UNN, donor, business, and
academia). All SUN stakeholders are mutually accountable for ensuring the implementation
of the Roadmap. It should be regarded as a dynamic document that can respond to changing
needs and opportunities as well as lessons learned during the implementation period to
ensure its successful implementation. A mid-term review of the roadmap priorities will be
planned to assess the progress and any change in focus. This will be followed by a final review
near the end of the roadmap period to assess the overall progress and to inform priority-
setting for the next five-year roadmap.
The Roadmap Priority Areas
The SUN Movement Strategy 3.0 outlines four priority areas which SUN is accountable for at
the country level in order to accelerate action towards ending all forms of malnutrition and
to work towards the objectives of the Strategy:
● Leading inclusive development and review of country priorities
● Leveraging financial, political support and knowledge as well as evidence and technical
assistance to support country priorities
● Overseeing the execution of country priorities
● Ensuring the tracking of progress against priorities.
A fifth priority area was also identified in-country, which is re-operationalising the Sudan SUN
Movement, as its work was paused due to political changes and the impact of the COVID-19
SUN Strategy 3.0 Strategic Objectives 2021-2025
Strategic objective 1: Strengthen and sustain strong policy and advocacy environments at the
subnational, national, regional and global levels to position nutrition outcomes as a key maker
and marker of sustainable development.
Strategic objective 2: Develop and align shared country priorities for action.
Strategic objective 3: Build and strengthen country capacity to develop, prioritise, finance,
implement and track country actions through strengthened technical assistance and
knowledge management.
Strategic objective 4: Ensure governance of SUN that promotes country leadership and
responsibilities of government, aligns the resources of all Movement stakeholders behind
country priorities and strengthens mutual accountabilities.
37
pandemic in 2019 and 2020. This priority area will be the initial focus of the Sudan SUN
Movement.
The broad focus of each of the five priority areas is as follows:
1. The re-operationalisation of the Sudan SUN Movement
In order to be able to implement the four SUN country level priority areas, it is important to
ensure that the SUN Office, with supporting and oversight mechanisms and the SUN
Networks, are all fully operational, with clear guidance on roles and responsibilities. Ensuring
a revitalised and effective Sudan SUN Movement, including through developing strong links
with other nutrition-relevant multisectoral platforms, will provide a strong platform from
which to work towards the national and global nutrition goals.
2. Leading inclusive development and review of country priorities
This priority area focuses on the development of a comprehensive multisectoral nutrition
action plan for Sudan in order to more effectively tackle malnutrition and make rapid progress
towards the national and global nutrition goals. This will help to focus, catalyse and align
stakeholders and resources around a set of proven high impact nutrition interventions in line
with the context of Sudan, bring together sectors such as agriculture, education, social
protection and health to incorporate key nutrition-relevant interventions in their plans and
programmes, and institutionalise robust multisectoral coordination and accountability
mechanisms.
3. Leveraging financial, political support and knowledge as well as evidence and
technical assistance to support country priorities
To be able to successfully develop and implement a multisectoral nutrition action plan, it is
critical to move nutrition towards the top of the political agenda through demonstrating the
economic, development and human impacts of malnutrition, and positioning nutrition
outcomes as a key maker and marker of sustainable development. Ensuring that nutrition is
a top policy and institutional priority can help to unlock greater resources for nutrition and
generate additional political capital to accelerate nutrition improvement. Advocacy and
communication will be critical during the implementation phase to encourage all stakeholders
to do their part to improve the nutrition situation in the country. Likewise, ensuring that
technical assistance and knowledge management is increasingly organised around country
priorities will help to increase capacity and drive forward the implementation towards
nutrition goals.
4. Overseeing the execution of country priorities
In order to be able to successfully implement the multisectoral nutrition action plan, the
Sudan SUN Movement, as the principle entity for coordinating and leading accelerated
progress towards nutrition goals, has a critical role to play. This includes to ensure that all
nutrition stakeholders are aligned and committed to working together to implement the plan,
to provide proactive support to stakeholders and to ensure the inclusion of nutrition targets
in key development policies, legislation and sector plans so that each stakeholder can
contribute fully and accelerate progress towards nutrition goals.
5. Ensuring the tracking of progress against priorities
38
Strong assessment and learning mechanisms are critical to support the implementation of
country priorities and to foster accountability. Mechanisms commonly used for this purpose
include the tracking of resources for nutrition, developing strong information systems for
nutrition to track progress, carrying out periodic reviews of country progress towards national
and global goals, and carrying out a robust research agenda and using the findings to improve
programming. These mechanisms can also be used to understand the institutional and
systemic changes taking place, to assess capacity building needs and key challenges and
bottlenecks, and to evaluate the need for course corrections in implementing the multi-
sectoral nutrition action plan.
The Sudan SUN Movement Roadmap 2021-2025
Priority Area Activity Planned
year(s)
Expected key
contributors
Re-
operationalising
the Sudan SUN
Movement
Conduct a high-level SUN inception workshop to
announce the SUN movement re-activation, highlight
the nutrition context and advocate for a multisectoral
response in Sudan with prime minister, cabinet and
line ministries presence to get the political
commitment. Also leverage key events such as the
Food Systems Summit and N4G for this purpose.
2021 SUN Secretariat,
nutrition-relevant
ministries, SUN
Networks
Revise country SUN Operational Guidelines, setting
out how the SUN mandate will be operationalised in
Sudan, including its structure and links with other
nutrition-relevant coordination mechanisms.
Translate, print and distribute for SUN stakeholders at
the national and state levels.
2021 SUN Secretariat
Build the functional capacity of the SUN secretariat,
set up SUN oversight and support mechanisms,
activate coordination platforms at the national and
state levels, and establish the linkages with other
existing nutrition-relevant development and
humanitarian coordination platforms.
2021 SUN Secretariat
Conduct national advocacy workshops to relaunch
each SUN network, revitalise the membership, discuss
country priorities and commitment to the SUN
principles. Hold webinars with each global SUN
Network to determine the opportunities to support
the work of each network in Sudan.
2021 SUN Secretariat, SUN
Networks, Network
convenors
Update SUN Networks strategy documents, identify
potential members, set up/revise any governance
structures and develop initial workplans
2021 SUN Networks, SUN
Secretariat, Network
convenors
Review and
development of
country
priorities
Conduct a brief review of the current status of country
progress towards WHA, SDG and other nutrition
global targets. Identify priority actions required to
make faster progress towards global nutrition targets.
Update the nutrition situation analysis from 2019.
2021 SUN Secretariat
Review existing country nutrition related
policies/strategies/reports (e.g.: National nutrition
policies, COHA, zero hunger, Health policy, food
security policy, WASH strategy etc.) to identify any
2021 SUN Secretariat,
nutrition-relevant
ministries
39
Priority Area Activity Planned
year(s)
Expected key
contributors
strategic priorities/goals/commitments related to
nutrition and the current gaps.
Undertake a brief nutrition stakeholder mapping
analysis to understand who the major entities are and
their roles, understanding and capacity in terms of
nutrition, the focus and scale of their programmes and
funding, and views on the strengths, opportunities
and challenges to multisectoral planning for nutrition
in Sudan.
2021 SUN Secretariat,
nutrition-relevant
ministries, SUN
Networks
Engage with the ministries and stakeholders in each
sector on nutrition to identify and set goals, objectives
and sector priorities for nutrition as well as capacity
needs for inclusion in the multisectoral action plan
2022 SUN Secretariat,
nutrition-relevant
ministries, SUN
Networks
Develop the multisectoral nutrition action plan
accountability framework (outcomes, targets,
outputs, inputs) and costing in a consultative manner.
2022 SUN Secretariat,
nutrition-relevant
ministries, SUN
Networks, technical
support (costing)
Finalise the multisectoral nutrition action plan
including editing, design, printing, distribution,
launching and communication strategy
2022 SUN Secretariat,
technical support
(editing and design)
Leveraging
financial,
political
support,
knowledge,
evidence and
technical
assistance
Undertake a financial gap analysis for nutrition –
assessment of the resources available to achieve
progress towards multisectoral nutrition action plan
goals and strategic objectives (to achieve coverage
and human capacity required) relative to costing.
2022 SUN Secretariat,
nutrition-relevant
ministries, SUN
Networks, technical
assistance
Identify needs and explore opportunities for technical
assistance and south-south cooperation to support
implementation of the multisectoral nutrition action
plan.
2022 SUN Secretariat, SUN
Networks
Develop and implement an advocacy plan focused on
increasing support for the multisectoral action plan
and the maximum leveraging of resources in the
government and among all other stakeholders.
2022-2025 SUN Secretariat,
nutrition-relevant
ministries, SUN
Networks
Identify and work with Nutrition Champions at all
levels - including at the top level of government and in
parliament (including in budget committees) - to
ensure that nutrition is a national priority.
2022-2025 SUN Secretariat, SUN
Networks
Overseeing the
execution of
country
priorities
Advocate and work for the inclusion of nutrition
objectives and goals in the country development plan
and national level relevant sectors policies/strategies.
2022-2025 SUN Secretariat,
nutrition-relevant
ministries, SUN
Networks
Put in place and enforce a comprehensive legal
framework on nutrition (E.g.: mandatory food
fortification, BMS code, nutrition labelling, food safety
and food quality), in line with the national
multisectoral nutrition action plan priorities.
2022-2025 Nutrition-relevant
ministries, SUN
Networks, SUN
Secretariat
Develop SUN Network annual implementation plans
based on agreed goals and priorities in the
multisectoral nutrition action plan and in line with the
SUN Roadmap.
2022-2025 SUN Networks,
Network Convenors,
SUN secretariat
40
Priority Area Activity Planned
year(s)
Expected key
contributors
Develop/revise sector implementation plans based on
agreed goals and priorities in the multisectoral
nutrition action plan and ensure that associated
implementation guidelines and protocols are fit for
purpose.
2022-2025 Nutrition-relevant
ministries, SUN
Networks, SUN
Secretariat
Put in place and support a focal point for nutrition in
each nutrition-relevant ministry.
2022-2025 Nutrition-relevant
ministries, SUN
Secretariat, SUN
Networks
Assess and develop capacities on nutrition sensitive
programming: develop appropriate guidelines and
training materials as needed.
2022-2025 SUN Secretariat,
nutrition-relevant
ministries, SUN
Networks, technical
support
Tracking of
progress against
priorities
Establish and maintain the nutrition financial tracking. 2022-2025 SUN Secretariat,
nutrition-relevant
ministries, SUN
Networks, technical
support
Review and develop the nutrition information system
to ensure aligned with country nutrition priorities to
support the annual reporting/tracking of progress
against the goals set out in the multisectoral nutrition
action plan
2022-2025 SUN Secretariat,
nutrition-relevant
ministries, technical
support
Orient SUN stakeholders about the joint annual
assessments, focusing on achievements based on
country priorities, and implement yearly reporting
2022-2025 SUN Secretariat,
nutrition-relevant
ministries, SUN
Networks
Review country progress towards WHA, SDG and
other targets when new data becomes available.
2022-2025 SUN Secretariat,
nutrition-relevant
ministries, SUN
Networks
(particularly RAN),
technical support
Initiate the nutrition research agenda in collaboration
with all stakeholders, including researchers, academic
institutions and think tanks.
2022-2025 SUN Secretariat, SUN
Networks
(particularly RAN),
nutrition-relevant
ministries, technical
support
Create a repository of lessons learnt and new
knowledge and ensure that it is proactively exchanged
and used for advocacy and programming.
2022-2025 SUN Secretariat, SUN
Networks
(particularly RAN),
nutrition-relevant
ministries
Guideline for developing National Multisectoral Nutrition Plans for Sudan Final - English (1) latest version.pdf
Guideline for developing National Multisectoral Nutrition Plans for Sudan Final - English (1) latest version.pdf
Guideline for developing National Multisectoral Nutrition Plans for Sudan Final - English (1) latest version.pdf
Guideline for developing National Multisectoral Nutrition Plans for Sudan Final - English (1) latest version.pdf
Guideline for developing National Multisectoral Nutrition Plans for Sudan Final - English (1) latest version.pdf
Guideline for developing National Multisectoral Nutrition Plans for Sudan Final - English (1) latest version.pdf
Guideline for developing National Multisectoral Nutrition Plans for Sudan Final - English (1) latest version.pdf
Guideline for developing National Multisectoral Nutrition Plans for Sudan Final - English (1) latest version.pdf
Guideline for developing National Multisectoral Nutrition Plans for Sudan Final - English (1) latest version.pdf
Guideline for developing National Multisectoral Nutrition Plans for Sudan Final - English (1) latest version.pdf

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Guideline for developing National Multisectoral Nutrition Plans for Sudan Final - English (1) latest version.pdf

  • 1. A Guideline for Developing Multisectoral Nutrition Plans for Sudan May 2022
  • 2. 1 Published by Government of the Republic of the Sudan Federal Ministry of Health Telephone number: +249 11 774710 / 774 Fax Number: +249 11 778704 Email: info@fmoh.gov.sd Website: www.fmoh.gov.sd P.O. Box 303 Khartoum Year published: 2022 Cover Photos by: UNICEF, FAO and FEWSNET Recommended citation: Federal Ministry of Health (2022). Guideline for Developing Multisectoral Nutrition Plans: 2023-2030. Khartoum, Sudan.
  • 3. 2 ACKNOWLEDGEMENTS The Guideline for Developing Multisectoral Nutrition Plans was developed by the SUN Movement Secretariat in Sudan, under the Federal Ministry of Health with the support of the SUN Sudan Core Group and Technical Advisory Group (TAG) members to facilitate the development and implementation of the multisectoral nutrition plan. The Federal Ministry of Health would like to thank Alem Hadera Abay, Senior International SUN Adviser, for preparing this guideline, and Najlaa Osman Khidir, National SUN Coordinator, and Matthew John Robinson, UNICEF International Consultant, for their immense and valuable contributions. Our appreciation also goes to all the members of the SUN TAG and SUN Core Group including, Federal Ministry of Health Nutrition Program, High Council for Food Security and Nutrition in Sudan, Humanitarian Aid Commission, UNICEF, WHO, WFP and Khartoum University for their valuable inputs. The valuable inputs from other ministries and partners are also acknowledged. The Federal Ministry of Health gratefully acknowledges the financial support of UNICEF in making this guideline a reality and translating and printing this document for use by all nutrition stakeholders in Sudan. Dr Dalya Idris Hassan Eltayeb Director of Directorate General of PHC Federal Ministry of Health
  • 4. 3 FOREWORD Recognising that nutrition is a humanitarian, development and human rights agenda, the government of the Republic of Sudan have joined the SUN Movement in October 2015. The Federal Ministry of Health, including the other 12 Federal Ministries, joined to support a multisectoral effort to address the high levels of malnutrition Sudan is facing. Sudan has recently revised its Food Security and Nutrition, Health and Nutrition policies to create an enabling environment for putting nutrition on the national agenda. The government of Sudan with its partners is making a concerted effort to address the burden of malnutrition in the country. Sudan is on track to meet only 2 of the WHA targets. We have increased exclusive breastfeeding from 41 per cent on baseline to 62.3 per cent in 2019 and childhood overweight remains at 2.1 per cent below the global targets of 3.0 per cent for 2030. Sudan has also made remarkable progress in reducing Child mortality from 128 per 1,000 live births in 1990 to 56.6 per 1,000 live births in 2020. However, such pace of progress could not be replicated in reducing neonatal mortality. Despite such progress, Sudan is off track on many of the WHA nutrition targets, including stunting (from 34.1% at baseline to 36.4% in 2019, wasting (15.4% at baseline to 13.6% in 2019) and anaemia among Women of Reproductive Age (36.8% in 2012 to 29.7%), which declined only marginally. Over the last three decades, the focus was put on the humanitarian and lifesaving components of improving access to food and nutrition services. A well-deserved priority was given to the circumstances that required a rapid response to this humanitarian crisis. However, unless we make an effort to address the underlying causes of malnutrition, we may be bound to have chronic emergency- like situations where people are on humanitarian handouts for extended periods and perhaps limiting their potential to strive and transform their lives and become productive members of their community. The SUN is best placed to facilitate a multisectoral nutrition response at the national and subnational levels and ensure that nutrition is considered in our national, state and locality level plans by actively engaging nutrition relevant sectors, including health, agriculture, education, water, social development, industry, trade, justice, youth and sports, communication and media among other sectors. On behalf of the Federal Ministry of Health and in my capacity as SUN Focal Point, I am delighted to reiterate our resolve to address malnutrition in all its forms and fully reactivate the SUN movement in Sudan. I, therefore, request all nutrition relevant line ministries and sectors to make good use of this guideline and ensure that we develop comprehensive multisectoral nutrition plans at all levels in an effort to meet the SDGs and WHA targets. It is my hope that line ministries and key stakeholders will use this guideline to facilitate the development of effective multisectoral nutrition plans to achieve Sudan’s global and national nutrition commitments and targets. HE Dr Haythem Mohammed Ibrahim, SUN Focal Point Undersecretary Federal Ministry of Health
  • 5. 4 Contents ACKNOWLEDGEMENTS 2 FOREWORD 3 ACRONYMS 5 1. INTRODUCTION 6 1.1. Background 6 1.2. Purpose of the Guideline 10 1.3. Conceptualising a Multisectoral Approach to Nutrition 10 2. SETTING THE STAGE FOR MULTISECTORAL PLANNING 13 2.1. Identifying Consensus Areas 13 2.2. Key considerations for multisectoral planning 15 2.3. Guiding Principles 16 2.4. Assessing the Country Nutrition Context 17 3. FORMULATING THE NATIONAL MULTISECTORAL NUTRITION PLAN 21 3.1. Responsibility for planning a multisectoral approach 21 3.2. Information to include in the multisectoral plan 21 3.3. Steps for formulating a multisectoral nutrition plan 22 4. OPERATIONALISING THE NATIONAL MULTISECTORAL NUTRITION PLAN 30 4.1 Governance and coordination structures/mechanisms operationalisation 30 4.2 Capacity development strategy 30 4.3 Advocacy and communication strategy 30 4.4 Resource Mobilisation 31 4.5 Sector annual planning for implementation at all levels of government 32 4.6 Operationalisation of the Multisectoral Plan at different levels 34 ANNEXES 35 Annex 1: Sudan Scaling Up Nutrition Movement Roadmap 2021-2025 35 Annex 2: Sudan global and national nutrition commitments 41 Annex 3: Nutrition Stakeholders Mapping: Donors in Sudan, 2019 43 Annex 4: Nutrition Stakeholders Mapping: Implementors & Catalysts in Sudan, 2019 44 Annex 6: Roles and Responsibilities of key sectors & actors 47
  • 6. 5 ACRONYMS ARI Acute Respiratory Infection BMS Breast-milk Substitutes CF Complementary Food CMAM Community-based Management of Acute Malnutrition CRF Common Results Framework CSA Civil Society Alliance CSO Civil Society Organisation FAO Food and Agriculture Organisation of the United Nations HCFSN High Council for Food Security and Nutrition in Sudan IFAD International Fund for Agricultural Development ISF Improved Sanitation Facilities MAD Minimum Acceptable Diet MEL Monitoring, Evaluation and Learning MIYCN Maternal, Infant and Young Child Nutrition MNPs Micronutrient Powders MNS Multi-nutrient Supplementation MQSUN Maximising the Quality of Scaling Up Nutrition NGOs Non-Governmental Organisations N4G Nutrition for Growth NSA Nutrition Sensitive Agriculture RAN Research and Academia Network RUSF Ready-to-Use Supplementary Food RUTF Ready-to-Use Therapeutic Food SBCC Social and Behavioural Change and Communication SBN Scaling Up Nutrition Business Network SDGs Sustainable Development Goals SDN Scaling Up Nutrition Donor Network SMART Specific, Measurable, Achievable, Relevant and Time-bound SMEs Small and Medium Enterprises SSMO Sudanese Standards and Metrological Organisation SUN Scaling Up Nutrition TAG Technical Advisory Group TOR Terms of Reference TWG Technical Working Group UHC Universal Health Coverage UN United Nations UNDP United Nations Development Programme UNFPA United Nations Population Fund UNHCR United Nations High Commissioner for Refugees UNICEF United Nations Children’s Fund UNOCHA United Nations Office for the Coordination of Humanitarian Affaires USI Universal Salt Iodisation WASH Water, Sanitation and Hygiene WHA World Health Assembly WFP World Food Programme WHO World Health Organization
  • 7. 6 1. INTRODUCTION 1.1.Background Recognising malnutrition as one of the major public health, development and humanitarian challenges, the government of Sudan is making concerted efforts together with its humanitarian and development partners to address the high levels of malnutrition in the country. Despite such efforts, progress to address all forms of malnutrition has been slow. This has placed Sudan among the top 14 countries in the world experiencing high levels of malnutrition with more than one in three children under five (36.4 per cent) too short for their age. Close to half of all localities in Sudan have a stunting prevalence greater than 40 per cent. The prevalence of wasting is also high at 13.6 per cent, with almost one in five localities having a wasting prevalence greater than the 15 per cent threshold that is considered high by WHO standards. Both stunting and wasting rates have only declined marginally in the last 15 years, with prevalence higher than the average for developing countries1. The first report on the status of the country regarding malnutrition in 1987 reported that 32 per cent of children under the age of five years were stunted, which is less than the current level of 36.4 per cent. Similarly, micronutrient deficiencies are very high with 48.1 per cent of children under five years old and 29.7 per cent of women of reproductive age anaemic and 57.8 per cent of children suffering from vitamin A deficiency (Figure 1). The level of childhood overweight and obesity is relatively low, with only 2.1 per cent of children under five years of age overweight and 0.9 per cent obese. However, 28.3 per cent of Sudanese adults are either overweight or obese with the percentage being much higher in women (35.6 per cent) than men (22.6 per cent)2 . The trend among women clearly indicates the need for more comprehensive nutrition programming that encompasses food-based 1 Federal Ministry of Health. Simple Spatial Survey Method (S3M II) Sudan Micronutrient Survey Report. Federal Ministry of Health, General Directorate of Primary Health Care, National Nutrition Programme, Khartoum, Sudan. 2020 2 Federal Ministry of Health. Sudan Stepwise Survey for Non-Communicable Diseases Risk Factors 2016 Report. Federal Ministry of Health, Khartoum, Sudan.
  • 8. 7 approaches aiming at dietary changes among women and children in addition to the nutrition specific interventions mainstreamed though the health systems. Globally, over 45 per cent of deaths in children under the age of five is attributed to malnutrition. Stunting alone is associated with 37.7 per cent of all child mortality cases in Sudan while stunted children achieve 1.6 years less in school education. It is estimated that the associated economic cost of malnutrition to Sudan is over USD 2 billion per year (equivalent to 2.6 per cent of GDP)3 . Clearly, malnutrition is not only a health sector impediment but also one of the core national development challenges in Sudan. Many factors have contributed to such high levels of malnutrition for over two decades. Maternal malnutrition (8.6 per cent) perpetuates the inter-generational cycle of stunting whilst micronutrient deficiencies are also intertwined with stunting. The poor quality of diet contributes to high levels of malnutrition and makes children and women susceptible to infections. The high levels of infection including diarrhoea prevalence among children (24 per cent), acute respiratory infection (ARI) (23.7 per cent) and fever (23.1 per cent) are strongly associated with malnutrition and in return contribute to high levels of malnutrition. Inadequate dietary intake among infants, young children and women of reproductive age is widespread – although 62 per cent of children up to 6 months old are exclusively breastfed, only a quarter (25.4 per cent) of children 6-23 months of age receive a diversified diet. Poor feeding practices are compounded by high levels of food insecurity with 10.9 million facing high levels of food insecurity in 20224 . At the same time, less than 3 in 4 households (73.7 per cent) have access to basic drinking water sources within 30 minutes of their home. Access to health and sanitation services is also limited: Only 64 per cent of households have a health facility within 30 minutes’ walk and only 37.4 per cent have access to improved toilet facilities. Many cultural practices also undermine good nutrition, including limited knowledge of undernutrition, lack of time for care and poor education levels among mothers (68.1 per cent finish primary school)5 , and a high prevalence of early marriage at age 18 or earlier (60.2 per cent). Furthermore, close to half (47 per cent) of Sudan’s population lives below the poverty line6 , with poverty both a cause and a consequence of poor nutrition. Many of these immediate and underlying factors affecting nutritional status are exacerbated by socio-political and economic upheaval including recent high inflation rates (including for staple food items) affecting household purchasing power, an economic crisis and the COVID- 19 pandemic, increasing pressure on already strained health systems, food systems and livelihoods, with negative consequences for nutrition. Frequent climate related disasters add to the complexity of the situation, with flooding and drought the main hazards. The need for an integrated and comprehensive approach to address the formidable humanitarian, development and peace related challenges in Sudan could not be more evident than at this time in its history. The country is dealing with a complex humanitarian crisis that has multiple drivers with over 1 million refugees and 3 million IDPs.7 Many of the internal 3 Cost of Hunger in Africa - The Social and Economic Impact of Child Undernutrition in Sudan, 2020. 4 Humanitarian Needs Overview Sudan 2022 5 Sudan MICS 2014 6 Central bureau of statistics, 2009 7 Sudan Humanitarian Needs Overview 2022 (Draft)
  • 9. 8 displacements are already prolonged for over two decades leaving many reliant on humanitarian handouts, which is unsustainable. In many cases, people’s needs extend far beyond immediate, life-saving support. In 2022, an estimated 14.3 million persons need some form of assistance8 . The main support is provided through a yearly multisectoral Humanitarian Response Plan, led by the Government with support from partners, which includes key interventions by and large to tackle the immediate causes of malnutrition and to a limited extent programmes that address the underlying causes of malnutrition in such a chronic and complex emergency. However, despite the ongoing efforts and due to the scale and complex drivers at work, Sudan is far from being on track to meet the majority of the WHA Global Nutrition Targets (See Table 1). The lack of progress on improving nutrition also impacts Sudan’s ability to meet its SDG commitments as nutrition is critical to achieving many of the 17 SDG Goals, including SDG1 (no poverty), SDG2 (zero hunger) and SDG3 (Good health), whilst other SDG Goals positively impact nutrition. Table 1: Sudan Progress towards the WHA Global Nutrition Targets 2030 WHA Goal Baseline a Latest data b Target (2030) Achieve a 50% reduction in the number of children under-5 who are stunted 35% 36.4% 13.6%e Achieve a 50% reduction of anaemia in women of reproductive age 36.8%c 29.7% 18.4% Achieve a 30% reduction in low birth weight 32.3%d 32.3%d 22.6% Reduce and maintain childhood overweight to less than 3% 1.5% 2.1% 1.5% Increase the rate of exclusive breastfeeding in the first 6 months up to at least 70% 41% 62.3% 70% Reduce and maintain childhood wasting to less than 3% 16.4% 13.6% <3% a Source is Sudan Household Health Survey 2010 unless otherwise stated b Source is S3MII 2018 unless otherwise stated c WHO Global Health Observatory Data 2012 d MICS 2014 e Estimated based on WHO methodology 8 Sudan Humanitarian Response Plan 2021
  • 10. 9 The lack of progress to reduce all forms of malnutrition and the constant need for humanitarian intervention is an indication of the need for a transition from health-focused and humanitarian focused responses to a more comprehensive systemic multisectoral approach along the continuum of the humanitarian and development nexus that would oversee the lifesaving needs of the most vulnerable while also addressing the longer-term drivers of vulnerability and crises to enable people to not only survive but also thrive. The revised National Nutrition Policy (2021) and nascent efforts to develop a multisectoral nutrition plan provide an opportunity to foster multisectoral work within the humanitarian and development context. Even though the nexus of humanitarian and development work has not been articulated well in the revised policy documents, it is important to create continuity in the humanitarian-development nexus. The SUN Movement, with its vision of a world free from malnutrition in all its forms by 2030, can be the driving force for this continuity to ensure that the investment made under the humanitarian context continues to help vulnerable households in their quest for recovery and to become more resilient.The SUN 5-year roadmap developed by the SUN Sudan Secretariate in close consultation with the TAG members clearly articulates the strategic objectives of the SUN Movement and highlights the key processes towards developing and implementing national multisectoral nutrition plan (See Annex-1). The National Nutrition Policy (updated in 2021) and the National Food Security and Nutrition Policy (updated in 2020) reflect the governments’ commitment to create an enabling environment for nutrition. Despite such improvements in the policy space, the country has not yet put in place clear governance and accountability mechanisms with clear sectoral and institutional mandates for nutrition or a robust mechanism to operationalise such policies and strategies as it has not established operational modalities for multisectoral nutrition planning, and joint monitoring and evaluation mechanisms at the national and subnational levels. There are different coordination platforms in the health and agriculture sectors, but these are not aligned and harmonised to leverage the impact through joint planning and monitoring of programmes. More so, Sudan has not invested in nutrition in a systematic way across the main systems including food, heath, water, education, resilience building, business and legislative systems to address malnutrition in all its forms. Multisectoral work requires systemic change including change in the human resources structure and ways of working including joint planning, implementation coordination and joint supervision and monitoring and evaluation. At present, Sudan does not have adequate human resources especially at the grassroots level to deliver programmes. There is a structure for one community health worker (CHW) per health facility but that is not even sufficient for the different primary health care programmes. It is crucial to create robust primary health care and community delivery channels to bring the nutrition response up to scale. SUN focal person at the Federal, state and local levels can also be included in the new human resources structure to ensure that the country is making progress towards attaining the national and global nutrition targets. In the absence of such systemic and institutional changes, it will be very difficult to meet the WHA and SDG targets for nutrition in Sudan within the remaining time frame.
  • 11. 10 1.2. Purpose of the Guideline The overarching purpose of this guideline is to help programme designers, planners, managers and experts at all levels to develop and implement robust multi-sector nutrition plans at the national and sub-national levels in order to successfully reduce malnutrition in all its forms. Sudan is a member of the SUN Movement and a signatory to the 2012 World Health Assembly Resolution 65.6 to meet six global nutrition targets by 2025 and the SDGs that aim to end malnutrition in all its forms by 2030. Sudan has recognised malnutrition as a major human and economic development challenge requiring multi-sectoral efforts in its revised national nutrition policy and recent multi-stakeholder national consultations to develop nutrition commitments as part of the global Nutrition for Growth (N4G) summit in 2021. Even though Sudan recognised the multisectoral nature of nutrition in its policy, no costed national multisectoral nutrition plan was developed to date that is aligned to the nutrition policy and its global and national nutrition commitments. There is no blueprint, applicable everywhere, at all times and under all circumstances for undertaking multi-sectoral planning for nutrition. This guideline consolidates existing knowledge and best practices, based on the experience of multiple countries, and lays down a framework, which line ministries and nutrition partners can use to develop a comprehensive and aligned national multisectoral nutrition plan and annual sectoral implementation plans for nutrition. The guideline takes into consideration previous works that were undertaken which are crucial components of the planning process. A situation analysis, as outlined in the above section, and nutrition stakeholder and action mapping undertaken in 2019 are used in contextualising this guideline and will enable line ministries and partners to carry out context- based planning. The sections below outline the key stages in developing national multisectoral nutrition plans and implementation plans that can be considered when planning and designing nutrition programmes at every level. 1.3. Conceptualising a Multisectoral Approach to Nutrition A multisectoral approach creates opportunities for shared accountability to address very complex social and development challenges that cannot be addressed by a single sector alone. It creates opportunities to share knowledge and lessons learned in a common platform for better collaborations and results. Multilevel interventions that seek to involve nutrition relevant public and private sectors can also bring sustained change. The multisectoral nature of nutrition was conceptualised in the mid-twentieth century, but it was not until the 1970s that effort was made to address multiple causes of malnutrition as part of a national plan in Thailand when malnutrition received national-level attention and a national multisectoral nutrition plan was included in the Fourth National Economic and Social Development Plan (NESDP) (1977–81)9 . There is an increasing recognition that, while Ministries of Health have a critical role to play in addressing malnutrition, there are equally other important sectors and systems that contribute beyond the health sector and system. Recent studies show that health systems at best can only reduce stunting by 20 per cent, while other sectors contribute the remaining. 9 Pattanee Winichagoon, Food and Nutrition Bulletin, vol. 35, no. 2 © 2014
  • 12. 11 Estimates show that even if nutrition-specific interventions are scaled up to cover 90 per cent of the at-risk population, it would only address about 20 per cent of chronic malnutrition10 . While the health system has an important role to play, focusing investments and efforts on the health system alone will not allow countries to reach the WHA targets by 2025. The need for concerted efforts across multiple sectors is now widely acknowledged by key stakeholders as the only way to register meaningful results to attain these global targets. This is because the key drivers of malnutrition (Figure 2)11 are complex, determined not only by the situation at the individual or household level but also the broader societal context, and cut across a number of sectors and systems beyond health, including agriculture, education, water and sanitation and social protection. Figure 2: UNICEF Conceptual Framework on the Determinants of Maternal and Child Nutrition 10 The Lancet, Executive Summary of The Lancet Maternal and Child Nutrition Series, 2013 11 UNICEF, 2021. UNICEF Conceptual Framework on Maternal and Child Nutrition.
  • 13. 12 In order to foster the multisectoral response and move away from the sectoral nature of development which characterises the funding and mode of operation of donors, governments and NGOs, it is critical to ensure that non-health sectors perceive nutrition as directly relevant to their work and understand the importance of becoming part of the response. The SUN Movement is well-placed to bring together all stakeholders across the humanitarian and development nexus and foster development of a multisectoral approach to nutrition in Sudan, including the development and implementation of a national multisectoral nutrition plan. Ensuring mutual accountability by putting in place a clear governance and accountability framework is a key step towards ensuring the operationalisation of a multisectoral approach. The hierarchical nature of working across the public and private sectors is a challenge that needs to be tackled at the onset of the planning stage to create consensus around multisectoral approaches to investing in nutrition with mutual accountability. Nutrition programmes are commonly hosted under Ministry of Health, and it may not have the mandate and leverage to directly engage other line ministries like agriculture, industry, education, water, trade, environment, justice or social development and make them accountable. Success is more likely if such a mandate is clearly delegated by the highest level of government such as the Cabinet of Ministers. This governance challenge should be addressed from the get-go with an agreed framework of governance and accountability to ensure mandates and responsibilities are understood by all stakeholders.
  • 14. 13 2. SETTING THE STAGE FOR MULTISECTORAL PLANNING 2.1. Identifying Consensus Areas Key to successful multisectoral planning and response at the national and local levels is the recognition by all stakeholders involved that: − Malnutrition is one of the top contributors to the national and global burden of diseases and disability. − Malnutrition is not just a health issue but multisectoral in nature. − Investing in nutrition is cost-effective and one of the key pillars in the development agenda. − Government is the primary duty bearer and owner of nutrition matters primarily accountable for its success or failures. − Government at the highest levels should be accountable for nutrition within the overarching mutual accountability for all stakeholders. − Both the public and private sector including Civil Society has responsibilities and accountability for nutrition. − There should be commitment to allocate human, financial and technical resources to meet the agreed targets by all the stakeholders. − Consensus on clear global and national targets and the need for developing a multisectoral plan aligned to the agreed targets is crucial in mobilising the necessary resource at the national and global levels. − Willingness of the current key actors, for example the Ministries of Health and Agriculture, to share the responsibility and control together with the other public sectors, businesses, civil society, academia and communities. − Each sector must consider how it is going to contribute to the national nutrition commitments and global WHA targets and develop sectoral plans of action that is aligned with the national nutrition priorities. − Finally, there are needs for fostering collaboration and agreement on new ways of working within and among the sectors and with existing and new partners. Consensus on Governance and Accountability Framework The proposed model shown in Figure 3 below, depicting the recommended governance structure for nutrition in Sudan, is expected to put in place a robust institutional mechanism for developing multisectoral nutrition plans, coordinating programme implementation and monitoring and evaluation and fostering evidence-based learning to scale up effective implementation of nutrition programmes and interventions that would enable the country to meet its nutrition targets. The Federal Ministry of Health as a host of the SUN Secretariat and whose Undersecretary is the government appointed SUN Focal Point provides an opportunity to foster multisectoral
  • 15. 14 work through the SUN Inter-ministerial Committee. The SUN Focal Point is answerable to the SUN Inter-ministerial Committee and this committee is answerable to HE the Prime Minister. The Inter-ministerial Committee is expected to meet on a quarterly basis while the SUN Steering Committee, which is Chaired by the SUN Focal Point and Co-chaired by the Undersecretary of Federal Ministry of Agriculture, is expected to deliberate on a monthly basis. The SUN Secretariat led by the National SUN Coordinator, which oversees the operationalisation of the SUN Movement by providing technical support and establishing multisector and multistakeholder platforms is answerable to the SUN Focal Point, the Undersecretary of the Federal Ministry of Health. On technical matters, the SUN Technical Advisory Group (TAG), comprising representatives of nutrition relevant sectors and stakeholders, will provide technical support to the SUN Steering Committee and SUN Secretariat. The TAG meets on a monthly basis to ensure the country is on track to meeting its national and global nutrition commitments. At the Federal level, each nutrition relevant line ministry especially the core ministries like agriculture, health, water, education, social development, industry and humanitarian sectors are expected to create a Nutrition Focal Person position to ensure nutrition is taken up as national development and humanitarian agenda. Focal Persons will be assigned or named at the state and locality level to coordinate the planning and implementation of a multisectoral nutrition plan. A multi-stakeholder platform like the federal level TAG will be established and the existing ones strengthened to ensure the full participation of nutrition relevant sectors and stakeholders. The SUN Secretariat is tasked with coordinating SUN in Sudan on a day-to-day basis and reports directly to the Undersecretary of Health. The Secretariate will work to elevate and position nutrition as a development and humanitarian agenda requiring a multisectoral response and facilitate the implementation of the 5-year Sudan SUN Roadmap. It will be supported by a SUN Focal person in each nutrition-relevant Ministry and a Focal Point in each state who will work closely with the SUN Secretariat to coordinate SUN activities at the state and local levels. Five networks, made up of actors from different stakeholder groups (civil society, UN, donor, business and academia), play a critical role in bringing together and aligning contributions towards country nutrition priorities. Overall, there is consensus at the SUN TAG level regarding the need to have a clear governance and accountability framework for Sudan. Various models were considered for discussion at the SUN Core Group and TAG consultation meetings and the below model is recommended for the country to ensure that government at the highest levels are accountable for nutrition.
  • 16. 15 2.2. Key considerations for multisectoral planning When developing and implementing the multisectoral nutrition plan, the following considerations need to be taken into account to ensure a successful process: - The government must have the political will and commitment to take a leadership role at the national level and create an enabling environment for leadership to emerge at all levels. The government line ministries’ and other partners’ commitment to lead and actively participate in the multisectoral response to nutrition is key to the success of the multisectoral nutrition response. - The government as a primary duty bearer needs to invest public funds into nutrition, which has a high return. Budgetary allocation by Finance and Economic Planning needs to be explicitly made as part of the annual budget allocations and financial gaps transparently announced for the partners’ support. - Leadership comes with accountability and ensuring the agreed governance. Putting in place accountability frameworks is a critical element in a multisectoral response to nutrition to strengthen institutional mandates and create a shared vision among the partners. - The magnitude of the problem needs to be well considered including identifying the vulnerable, high-risk groups such as infants, children, adolescent and women.
  • 17. 16 - All nutrition relevant line ministries and sectors must be involved in the process from the beginning, with each taking responsibility for their respective mandates. - Sectors outside government need to be involved including UN agencies, donors, business, civil society organisations and research and academia. - Engaging empowering women and youth as key actors in the food system is crucial to ensure sustainable and healthy diets. - A successful multisectoral plan requires that the multisectoral approach to nutrition is integrated into the planning process at all levels. - Planning for the implementation and monitoring and supervision should include community participation at the grassroots level. Particular attention should be given to using and strengthening the existing community structures to sustain behavioural changes. - Roles and responsibilities should be defined based on the comparative advantage of each stakeholder. It is not always necessary or appropriate for every sector to be involved in all areas of nutrition, but systemic change can be brought forth with the contribution of various relevant sectors. - Financing of a realistic national plan by the government and donors is key to its success. The necessary resources can be mobilised at the national and global levels if the plan is well done with clear objectives and measurable indicators in a well-defined time period. - Creation of a platform conducive for multisectoral planning through the guidance of the SUN Technical Advisory Group (TAG) chaired at an appropriate level and formulation of multisectoral Nutrition Task Forces for key thematic areas comprising experts are critical for successful planning. - The potential emergency response activities or ongoing support to humanitarian intervention should be adequately incorporated into the plan as a defined area of focus, as Sudan is considered as a fragile country with a large humanitarian aid operation. - Build capacity at all levels to fully contribute and support effective coordination including coordination with the nutrition cluster for emergency response and ensure the continuity and institutionalisation of nutrition support as part of the recovery and long-term interventions. - Consideration for cross-cutting aspects in the planning including advocacy, gender, capacity building, supply management and institutional arrangements and mandates. 2.3. Guiding Principles Development and implementation of a multisectoral nutrition plan should be evidence-based, aligned to agreed nutrition targets & commitments and guided by the following ten SUN principles:
  • 18. 17 2.4. Assessing the Country Nutrition Context The first phase of developing a multisectoral nutrition plan requires a good understanding of the current nutrition challenges in the country and the overall context within which they can be addressed. Assessing the country context will help to identify the priority nutrition issues that Sudan needs to address, the status and gaps in the current response and the sectors/stakeholders which are or need to be involved in addressing the priority nutrition issues identified. There are three common core elements to assessing the country context which include carrying out: i) a nutrition situation analysis; ii) a policy framework mapping and analysis; and iii) a stakeholder and action mapping. i. Situation Analysis A nutrition situation analysis gives an overview of the context, highlighting the key drivers of malnutrition and disparities between population groups, communities or regions of the country. It helps to create a common understanding of the nutrition situation and highlight the priority nutrition issues that need to be addressed through the multisectoral nutrition plan. The situation analysis is important for planning in the following areas: i) understanding and estimating the needs of the key vulnerable groups, ii) providing information to identify cost- effective and evidence-based interventions for each identified need, iii) understanding the trends and the dynamics of the nutrition situation, and iv) providing evidence which can be used for advocacy purposes to mobilise resources and increased commitment by all partners. To develop the nutrition situation analysis, various assessments and surveys at the national and locality level need to be properly analysed covering the following areas: - Demography of the key target groups - Current and trendline nutritional status of the key population groups (undernutrition, overnutrition and micronutrient deficiencies) - Underlying causes of malnutrition (Food, feeding and dietary practices, access to services) 1. The human rights to good food and nutrition. 2. Be transparent about intentions and the impact. 3. Be inclusive: A broadly participatory process which will in many cases expand the scope of the existing partnerships and include new ones. 4. Be willing to negotiate and open in stating objectives and expected results and reporting back to the public 5. Be predictable and mutually accountable including mutual accountability for programme decisions and funding allocations 6. Be cost-effective and avoid duplication 7. Be continuously communicative 8. Act with integrity and in an ethical manner 9. Be mutually respectful 10. Do no harm
  • 19. 18 - Basic causes of malnutrition (access to resources, economic and social disparities, political commitment, etc.) A situational analysis might also include an assessment of: - Shortcomings or perceived challenges/bottlenecks, including around demand for nutrition-related services as well as social expectations. - System performance (health system, food system, etc.) and performance gaps in responding to needs and expectations. - Capacity of the health, food, WASH, education and social protection systems to respond to the needs and challenges in delivering nutrition sensitive programmes including available resources (human, physical, financial, informational) and resource gaps. - Evaluation of the existing interventions and scalability of the programme/interventions. Ranking of various interventions in focus group discussion during programme reviews can be accessed from government and partners. - Impact and cost-effectiveness of the programme/interventions. This kind of data is available in published studies like the Lancet series and any other national impact studies. A proper triangulation of surveys and assessments with routine monitoring data can also be undertaken to understand the current progress against international commitments as part of the situation analysis. Sudan is a signatory to the WHA and SDG targets in 2025 and 2030, respectively, and recently announced SMART nutrition commitments as part of the N4G summit. All plans and activities need to contribute to such global and national targets and commitments, as outlined in Annex 1. ii. Policy Framework Mapping and Analysis Policy framework mapping and analysis identifies the national policies, strategies and other legal documents which already exist in support of nutrition. The purpose of the policy framework analysis is to assess the current inclusion of nutrition across different sectoral policies and strategies and inform the development of country priorities and alignment within and across sectors towards addressing nutrition goals. When developing the country priorities and the multisectoral nutrition plan, it should be based on existing policy frameworks as much as possible to ensure that the priority interventions chosen are implemented. The findings can also support advocacy and engagement for the updating of key policies, strategies and laws which would strengthen the implementation of critical interventions in support of the multisectoral nutrition plan. iii. Stakeholder & intervention Mapping Stakeholder and intervention mapping aims to identify key stakeholders’ interests, their role(s) where they are currently working, capacities and potential influence to support the development of the multisectoral nutrition plan. The outcome of the mapping process should ideally cover the following areas:
  • 20. 19 − Who are the major and supporting actors/organisations in the implementation of nutrition-related activities and in governance bodies for nutrition and who should be engaged in multisectoral planning for nutrition going forwards? − The degree of interest and knowledge in nutrition across stakeholders, which helps to identify advocacy, communication or capacity needs. − The breadth of stakeholder nutrition-related programmes (geographic and population coverage) and an indication of committed funding and resource gaps. − An analysis of the strengths, opportunities and challenges to multisectoral planning for nutrition stakeholders. For more details, please refer to Module 1 of the MQSUN+ planning toolkit at the following link: MQSUN-Multisectoral-Nutrition-Planning-Toolkit_Module 1_24Nov2020_final.pdf (path.org) iv. Engaging with all nutrition stakeholders Getting the early involvement and buy-in of all the relevant stakeholders (government ministries, UN agencies, civil society, private sector, academia, international donors) in all sectors is critical to be able to develop and implement a truly multisectoral nutrition plan. This is so that all stakeholders have a common understanding of nutrition, its relevance for the country and for them to begin to appreciate their role in addressing the nutrition challenges in the country thereby helping to ensure ownership of and commitment to the plan. Different sectors and systems will have different levels of understanding about nutrition and the role they could or should play. Likewise, the existing level of engagement in nutrition will also differ, ranging from zero engagement where there are no sector nutrition objectives or indicators in strategies or programmes, to strong engagement demonstrated through relevant objectives, indicators and programmes which can contribute to an improved nutrition situation. There are several ways in which all potential partners can be identified and sensitised including formal and informal meetings with partners/decision makers or a multi-stakeholder workshop bringing all partners and decision makers together. The focus of such occasions should be on ensuring that all the participants are on the same page regarding nutrition by the end of the event and include: - Explaining the key nutrition concepts and the critical role of nutrition - Outlining the nutrition situation in the country, including key drivers - Setting out the economic benefits of addressing nutrition - Facilitating agreement on the importance of addressing nutrition and the need for a multisectoral nutrition plan The exercises carried out to understand the country nutrition context can provide a wealth of information for such meetings/workshops. The stakeholder and intervention mapping and contextual analysis in particular are likely to identify both actual and potential stakeholders to engage in the process and is likely to bring new partners into the multisectoral nutrition plan development and implementation – Ministries, private companies, state institutions and communities that are key players but not yet taking part in nutrition design and programming.
  • 21. 20 Continuous advocacy efforts may be needed from this point forwards to ensure that all potential stakeholders become engaged and committed in the process of developing and implementing the multisectoral nutrition plan, with more focus needed on those stakeholders which cannot see their role clearly or perceive the importance of nutrition for their sector. Table 2: Potential list of nutrition related sectors and partners in Sudan Sectors Partners Government Sectors Ministry of Finance and Planning, Labour, Gender/Women’s Affairs Ministry of Health and appropriate directorates Ministry of Agriculture and appropriate directorates Ministry of Animal resource and appropriate directorates Ministry of Water resources and appropriate directorates Ministry of Labour and appropriate directorates Ministry of GENERAL Education and appropriate directorates Ministry of HIGHER EDUCATION Ministry of Industry and appropriate directorates Ministry of Trade and appropriate directorates Ministry of Social Development and appropriate directorates Sudan Central Bureau of Statistics Ministry of Justice and appropriate directorates Ministry of Environment Ministry of Information and Communications Ministry of Youth and sports sector Research and academic institutions Sudanese Standards and Metrology Organisation (SSMO) Food Regulatory bodies Chamber of Commerce and others relevant sectors SUN Research & Academia Networks Private Sector Consumer Associations Millers, Salt producers, Oil producers, RUTF/RUSF & CF producers associations Workplace Nutrition programme organisers Business clubs and associations National and Multinational Private companies working on the food sector Food marketing, packaging and labelling agencies SUN Business Network UN/NGO/Civil Society Sector UNICEF, WFP, WHO, UNFPA, FAO, IFAD, World Bank, UNDP, UNOCHA, UN Women, SUN, CSA, donor, and UN networks INGOs Local NGOs
  • 22. 21 3. FORMULATING THE NATIONAL MULTISECTORAL NUTRITION PLAN The analyses outlined in the previous section will provide nutrition relevant stakeholders with most of the information necessary to formulate a strategic plan for a multisectoral approach to nutrition. The Multisectoral Nutrition Plan should include identified priority areas, programmes and interventions as well as the rationale for their selection, overall goals and targets, including indicators (or benchmarks) and how they will be measured, a responsibilities matrix, monitoring and evaluation framework, and an estimation of the resources required (personnel, budget and funding sources). 3.1. Responsibility for planning a multisectoral approach This usually falls to a government appointed/identified group. Many countries have done it with the Ministry of Health taking the lead with clear representation by mandate from other line ministries. Others have hosted the development and implementation of a national multisectoral nutrition plan in the Ministry of Finance and Planning. As in many countries, in Sudan, the Ministry of Health leads the nutrition programmes, particularly focusing on emergency programmes and it has established a unit with adequate personnel at the Federal level. Therefore, it would be appropriate that the Ministry of Health leads this process of developing a national multisectoral nutrition plan as its undersecretary is also named as the focal point for the SUN in Sudan. This responsibility comes with a need for a paradigm shift in the way of working to engage all nutrition relevant line Ministries to include nutrition as part of their national plan. It would also involve engaging the Cabinet of Ministers, which is the highest government body accountable for nutrition work in Sudan. A higher-level government official with the convening power to bring together different government ministries should lead this process. The Cabinet of Ministers through its inter-ministerial committee should also give a mandate to the SUN Secretariat office hosted in the Federal Ministry of Health to work across all nutrition relevant ministries to develop the national multisectoral nutrition plan and coordinate implementation at scale by using multi-stakeholder platforms. In addition, each nutrition relevant line ministry in turn should nominate 2 to 3 high-level experts from appropriate directorates to be permanent members of the SUN Technical Adviser Group (TAG). 3.2. Information to include in the multisectoral plan There is no set template for developing a multisectoral nutrition plan. However, at least the multisectoral nutrition plan should include sections that refer to the following: − Contextual analysis including reviewing the national and global commitments, and alignment of the plan to the agreed targets. This may include analysis of capacity gaps and opportunities and refer to previous plans and bottlenecks to achieve nutrition goals − Key nutrition priorities identified − An overall goal and a set of key high-level targets and how they will be measured − Strategic objectives/actions (includes major anticipated outcomes, output and interventions across sectors). − Governance and coordination structures/mechanisms − Roles and responsibilities of all actors and sectors − Risks and assumptions
  • 23. 22 − An indicative budget and financing plan 3.3. Steps for formulating a multisectoral nutrition plan To start formulating the multisectoral nutrition plan, it will be vital to bring together stakeholders to identify the overall goal, priority areas and high-level targets of the plan. Once this has been achieved, it is recommended that thematic technical working groups (TWG) are set up, comprising sector experts from government and partners, to identify the evidence- based, high impact interventions, target beneficiaries, outputs, outcomes and specific objectives as well as the roles and responsibilities of stakeholders and indicators against which to monitor progress. 3.3.1 Setting overall goal and high-level targets If there is an existing multisectoral nutrition policy or strategy which already specifies an overall goal for nutrition and/or targets, these can either be adopted or adapted for the multisectoral nutrition plan. If these are not already agreed, then stakeholders can use the contextual analysis information to formulate goals and high-level targets, including information related to the SDGs, WHA targets and the N4G commitments. 3.3.2 Priority-setting Developing an effective multisectoral nutrition plan will require priority-setting that takes into account the magnitude of the nutrition situation, the evidence-base, cost-effectiveness, the level and adequacy of the current programmes and response, the absorptive capacity of the various systems (health, food, water, social protection, education, humanitarian and other systems) and infrastructure to respond further, and the readiness of partners to fund, implement and monitor the progress of the recommended priorities. Most of this information will be available from the situation analysis and stakeholder and action mapping conducted in the preparation phase. There are globally recognised evidence-based nutrition specific and sensitive interventions (See Figure 412 ) and lessons learned at the national and subnational level that should be taken in to account when identifying the nutrition priorities for Sudan. Emphasis on such priorities can also differ at the subnational level depending on the context when developing the operational action plan at the state and locality levels. 12 Black et al., 2013. Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet.
  • 24. 23 Figure 4. Framework for actions to achieve optimum foetal and child nutrition and development The determination of priorities will take into consideration: − The magnitude and prevalence of the nutrition situation (e.g. wasting, stunting, specific micronutrient deficiencies, overnutrition/obesity), − Identification of most vulnerable groups, − Geographical target areas, − Disease, disability and mortality burden, − Leadership and sector capacity for implementation, − Potential and realistic resources to be allocated, − Implementing partners and community readiness and ability to implement evidence base interventions. For more details, please refer to Module 2 of the MQSUN+ planning toolkit at the following link: MQSUN-Multisectoral-Nutrition-Planning-Toolkit_Module-2_24Nov2020_final.pdf (path.org) 3.3.3 Establishing Multisectoral Nutrition Thematic TWGs To develop a Common Results Framework, it is recommended to set up TWGs across key thematic areas. This would enable focused discussions and lay out in detail the objectives, actions, targets and anticipated outputs and outcomes under each identified priority area. When the TWGs are formed, the following needs to be considered: − Forming a key thematic area consistent with the nutrition priorities and commitments made by the country. Examples of thematic areas where technical task forces can be formed to draft plans may include Community-based management of Acute Malnutrition (CMAM), Maternal, Infant and Young Child Nutrition (MIYCN),
  • 25. 24 Micronutrient Nutrition, Nutrition-sensitive Agriculture, WASH-Nutrition, SBCC for nutrition, Social Protection and Education. − Selecting appropriate experts for each task force. Each thematic area will have a group of experts from different sectors to address malnutrition in all its forms in a more systemic manner. − Each task force will have clear ToR and will report its work to the TAG for feedback and comments. − Members of the task force need to have the right kind of experience and expertise to significantly contribute to the planning processes. 3.3.4 Developing a Common Results framework (CRF) A CRF is a single and agreed set of expected (or common) results generated through the effective engagement of different sectors of government and the multiple nongovernmental actors who have capacity to influence nutrition. A CRF lays out in detail the objectives, actions, targets and anticipated outputs and outcomes under each priority area/strategic objective of a multisectoral nutrition plan across a timeline, assigning clear roles and responsibilities. It is a vehicle for stakeholders to translate policy into action and results. Overall, the CRF should be based on the overall goal and high-level targets agreed on for nutrition in the country and reflect the ways in which different sectors and actors can best contribute to the achievement of these targets through their individual and collective actions. A CRF is usually presented as a detailed logical framework, or log frame, which includes all the nutrition actions identified by priority area and the anticipated results. The key steps in the process are as follows: Setting strategic objectives in priority areas to reach the overall goal and high-level targets While there may be an overall goal for the national response, for each priority area there should be strategic objectives set to be reached by the end of the period covered by the plan. Often, the overall goal will only be reached only through achieving some specific objectives. The existing strategic objectives outlined in the current nutrition policies or strategies can be adopted or adjusted as appropriate. Defining inputs, activities, outputs, outcomes and impact The next step is identifying the inputs, activities, outputs and outcomes which will contribute towards achieving the identified strategic objective. For each activity identified, the key target group needs to be identified. Existing policies, strategies and plans relevant to the specific sector can be used to support this process. Assigning roles and responsibilities Each activity identified and its outcome should be assigned to a key stakeholder(s) who bears overall responsibility for implementation, achievement and reporting on the intervention. This is typically the responsible ministry or ministries if it is a crosscutting intervention. Other stakeholders that will contribute to achieving the outcome can also be included to ensure there is clarity and accountability for all stakeholders engaged in each activity. It is also
  • 26. 25 important to consider and include broader roles of specific stakeholders and sectors as appropriate. Example roles for different types of stakeholders and sectors can be found in annex 3. Specifying indicators, means of verification and sources of data Strategic objectives, intermediate outcomes and their contributing inputs and outputs need to be translated into a set of measurable indicators to establish whether progress is being achieved. These should be based on existing data sources as much as possible such as national level surveys or routine data. Such information will provide the basis for the development of the M&E framework for the multisectoral nutrition plan. Specifying the baseline and targets Sudan, as a signatory to both the WHA and SDG goals, is using these targets to track progress. The targets, as indicated in Table 1, as part of the nutrition situation analysis are extended to 2030 in line with the recently published WHO discussion paper. The justification behind the 2025 WHA targets is stipulated to ensure alignment with the 2030 SDG nutrition targets. We are using 2010 as the baseline year against which progress will be tracked on an annual basis using different national surveys. Identifying critical assumptions and risks It is important to identify assumptions related to external factors (e.g. political environment, economy, climate change) that could carry risks. The situation analysis would have already identified the reasons why some initiatives are not working and why priority areas are being neglected. This will indicate the problems the projects have faced and the obstacles that have prevented important issues from being raised and appropriately addressed. Stakeholders can develop strategies to mitigate these risks. For more details, please refer to Module 3 of the MQSUN+ planning toolkit at: MQSUN- Multisectoral-Nutrition-Planning-Toolkit_Module-3_24Nov2020_final.pdf (path.org). 3.3.5 Putting in place and/or strengthening coordination platforms Good governance and strong coordination within and across sectors are necessary for any multisectoral nutrition plan to be implemented successfully. Governance mechanisms need to be established and agreed at all levels with clearly defined roles and responsibilities. High- level ministerial support that transcends the sectors (e.g. at the level of the Prime Minister or Cabinet of Ministers) is the optimal position for establishing leadership in order to influence and mobilise each sector and level of governance. A key component of developing the multisectoral nutrition plan is to set out an agreed on governance and accountability framework to facilitate the implementation. The key considerations include the following: − The governance and accountability framework should include a coordination platform situated at the highest level possible within the government. − The framework should outline the coordination platform and committee at each level, the membership (including specific stakeholders) and their roles and relationship with other related platforms.
  • 27. 26 − Each platform should involve a range of members and actors appropriate to the level of the coordination mechanisms including ministers, deputy ministers and senior officials or technical experts, representing all types of stakeholders and sectors. − The framework should set out the relationships between each level, emphasising the vertical relationships between the platforms at national level through to subnational and local levels, how they will interact and how they will be accountable to each other. − It is also critical to ensure that the necessary capacity is in place so that each platform is functional, and the accountability structure is fit for purpose – ensuring it is adequately staffed, empowered and government-led. Section 1.1 set out the proposed governance and accountability framework for SUN in Sudan. It is expected that this framework would be finalised as part of the development of the multisectoral nutrition plan, once agreed with all stakeholders. In addition, as part of efforts to develop broad-based nutrition coordination, the existing relevant coordination forums in Sudan, which are by and large information sharing mechanisms, need to be mainstreamed at all levels to facilitate multisectoral planning and tracking of progress against the agreed targets. To avoid the duplication of efforts, the forums will be encouraged to revise their ToR and facilitate more concerted action to achieve the agreed nutrition goals. 3.3.6 Putting in place a Monitoring, Evaluation and Learning (MEL) system Monitoring and evaluation systems are an integral part of a multisectoral nutrition plan which enable effective multisectoral strategic planning. They provide programme managers, implementers and policymakers with timely information not only on the status of implementation of programme activities but also, importantly, on the key issues and learning of their effectiveness, efficiency and continued relevance. A robust MEL system, which builds upon traditional monitoring and evaluation (M&E) to also foster learning and evidence-based decision making, is required to be able to verify whether a multisectoral nutrition plan is on track to achieve its targets and to enable evidence informed decision making (e.g. related to resource mobilisation and resource allocation, service quality improvement, capacity building, policy and plan formulation or revision). The evidence and information generated can also be used for advocacy and resource mobilisation. The MEL framework – which can also be described as a plan, strategy or matrix – is usually developed as a distinct part of or separate document to the multisectoral nutrition plan but is closely aligned with it. The MEL framework should consider any existing MEL system and set out how this will be strengthened across various systems to be able to generate high quality impact, outcome and routine programme output data. The budgeting for operationalising the MEL Framework is usually done as part of the overall costing of the multisectoral nutrition plan (see next section). Typically, at least 10 per cent of the activity cost should be directed towards MEL, but the percentage can vary considerably depending on what is needed to set up or strengthen the MEL system. The key components to be included in the MEL framework include the following: − Outline of the M&E framework.
  • 28. 27 − Overview of data sources and gaps for the selected indicators. − A logical framework including the main goal, outcomes, outputs, activities, besides assumptions, sources of data for verification and tools of verification. − Defined data-collection mechanisms: source of data; frequency of data collection; data collection tools; data-reporting mechanisms. − Data coordination, management, analysis and interpretation plans: analysis mechanism; data validation and verification (quality assurance); use of data at different levels; data storage; data sharing. − An evaluation plan and research agenda: annual reviews; midterm evaluation; final evaluation; research and assessments to monitor progress and specific aspects of programmes/the multisectoral nutrition plan. − Data use – using generated data to inform planning and gauge progress towards goals. − M&E capacity – including current capacity (may be some information available from the contextual analysis) and capacity building approach to fill in identified gaps. − Timeline of activities. There should be an institutional base identified which will take the lead on assessments and formative research that will be undertaken on a regular basis to track the progress and impact of interventions. Usually, the M&E Directorate within the Ministry of Health together with Nutrition and Research Institutes are responsible to lead such efforts. Partners like UNICEF, WHO, WFP, World Bank, civil society and key nutrition donors often take part in such assessments and studies. For more details, please refer to Module 5 of the MQSUN+ planning toolkit at: Module 5: Monitoring, Evaluation and Learning for Nutrition – MQSUN+ (path.org). 3.3.7 Costing the plan Costing refers to determining the resources needed to implement an intervention or set of interventions and related activities to achieve an objective. Accurate estimates of the financial resources required to implement the multisectoral nutrition plan are essential for planning, budgeting and resource mobilisation. A comprehensive costing should take into consideration all the costs associated with implementing the multisectoral nutrition plan including human resources, goods and services, capacity building, advocacy, creating the enabling environment and MEL. The critical elements needed to successfully carry out the costing will be available in the multisectoral nutrition plan and include the following: − Clear interventions and activities in the plan which are well understood. − Implementation targets for each of the interventions and activities identified. − Target coverage for each intervention and activity.
  • 29. 28 − Information on current spending including cost components (recurrent, capital and indirect costs). There are a variety of costing methods which can be used when costing a multisectoral nutrition plan, depending on the context and the level of detail as well as the time and data availability. Examples include: − Top-down approach (less accurate, faster) – disaggregating total expenses for a programme or activity into cost categories using defined formulae. − Bottom-up approach (more accurate, take time) – identifying all the individual cost elements (inputs) and the value of each for an activity or programme and aggregating them, e.g. “ingredients approach”. − Programme or experience-based approach – adjusting costs that exist for a similar activity or programme. Whichever method is chosen, it is important to document the overall approach, steps taken and assumptions made for it to be well understood and to be replicated in the future. Costing the plan should be done in close consultation with the respective sectors through engagement of the SUN TWGs and focal points. The costing is a critical step in the process of mobilising resources and can be supported by a financial gap analysis and a resource mobilisation approach – a critical tool for advocacy for the greater allocation of resources from domestic and other sources, whilst tracking the investments informs ongoing advocacy and helps ensure that funds are used to best effect. For more details, please refer to Module 4 of the MQSUN+ planning toolkit at: Module 4: Costing and Financing for Nutrition – MQSUN+ (path.org). 3.3.8 Finalisation, official endorsement and launching Once the multisectoral nutrition plan, including the MEL framework and costing, is completed, there are several steps to take to finalise it and ensure that it is adopted. These include: i) bringing the plan together into one coherent document; ii) validation workshop iii) launching and endorsement of the plan; and iv) publication and dissemination. i. Bringing the plan together in one coherent document The focus at this stage is on bringing all the components of the document together and ensuring a consistent narrative throughout the document to create a final draft of the plan. ii. Validation workshop The aim of a validation workshop is to ensure that all the national and state level stakeholders (government ministries, UN agencies, civil society, private sector, academia, international donors) are familiar with the multisectoral nutrition plan and have a final chance to raise any issues of concern.
  • 30. 29 iii. Launching and endorsement High-level representatives from each stakeholder, including the Prime Minister’s Office, Government Ministries, HCFSN, donors, UN, CSA, private sector and research and academia who are in a position to commit their organisation to support the implementation of the plan and ensure accountability and ownership should be invited during the launch of the Multisectoral nutrition plan launch and sign the document and provide guidance to all the stakeholders. The launch at the national level should be followed by similar events at the sub- national level to also receive endorsement from each state level Government and partners to facilitate accountability for implementation of the plan. iv. Publishing of the plan and dissemination Any final inputs received during the validation process should be considered before the multisectoral nutrition plan is published. The final draft document will need to be edited, designed and printed. The formal endorsement of the Prime Minister, the Ministers of all Government Ministries involved in the plan and the SUN Focal Point can be demonstrated through their signing of the final document prior to printing. Once this process is completed, dissemination of the final document at all levels is critical to support the implementation of the plan itself.
  • 31. 30 4 OPERATIONALISING THE NATIONAL MULTISECTORAL NUTRITION PLAN 4.1 Governance and coordination structures/mechanisms operationalisation At the initial stage of implementation, it is critical to ensure that governance structures established either before or during the development of the multisectoral nutrition plan are formalised, functional, budgeted and adequately staffed to ensure accountability. This may include needing to develop or update a TOR and the membership of each platform for the implementation phase, developing links with other platforms within the governance structure, securing support for running the platforms and securing domestic funding for sustainable operation. Key steps for establishing or strengthening national governance and coordination structures include the following: − Creating the governance structure in line with agreed approach − Developing/revising TORs including roles and responsibilities − Considering what capacities are in place or need to be developed − Developing annual workplans as appropriate to the platform − Embedding structures and staff into the public sector funding mechanisms 4.2 Capacity development strategy To be able to successfully implement the multisectoral nutrition plan, a capacity development strategy is needed for the national, sub-national and community levels which articulates in detail and formalises the capacity building measures referenced in the plan. To help with the development of the strategy, an in-depth capacity assessment and skills mapping exercise may be carried out. The capacity development strategy should include: − Key capacity building activities at the national, sub-national and community levels and the target groups for the activities − Clear links between the capacity building activities and the intervention areas/expected outcomes of the multisectoral nutrition plan − Responsible entities for implementing each of the capacity building activities − A timeline of the capacity building activities over the life of the multisectoral nutrition plan. 4.3 Advocacy and communication strategy Conducting advocacy is critical for the success of any plan but especially so for a multisectoral nutrition plan that involves such many sectors and stakeholders. The purpose of an advocacy and communication strategy is to enable all stakeholders to speak in one coordinated voice to increase the political and social commitment to improve the nutrition situation, promote accountability for nutrition and strengthen nutrition governance to support the goals of the multisectoral nutrition plan. Specific objectives can include:
  • 32. 31 − Fostering buy-in and leadership for a multisectoral approach to nutrition − Promoting a supportive policy, regulatory and operational environment − Supporting the creation and/or accountability of a multisectoral governance structure for nutrition − Helping to mobilise the required government, human, technical and financial resources required to implement the multisectoral nutrition plan and support long- term sustainable financing for nutrition − Promoting accountability of stakeholders to increase nutrition services and generating demand for nutrition services by empowering communities, media and CSOs − Raising public awareness on issues related to maternal and child nutrition and on government and partner efforts/commitments to address these needs. The advocacy and communication strategy should be developed in close consultation with all the relevant stakeholders that engage in advocacy work, particularly at the policy level. Ideally, the stakeholders would represent Government, UN, CSOs, donors, the private sector and academia. The time frame for the advocacy strategy would usually be aligned with the multisectoral plan, but the approach can be revised and extended as needed in line with a future multisectoral plan or used beyond this period for continued engagement of partners to implement multisectoral actions to improve nutrition. 4.4 Resource Mobilisation Resource mobilisation refers to raising and leveraging financial (domestic public and external funding) and non-financial resources to support the implementation of the multisectoral plan. Resource mobilisation should be a collaborative process involving all nutrition stakeholders and sectors, particularly planners and decision makers from each sector, the ministries of finance, ministries of planning and development and external donors. Any resource mobilisation strategy is very closely linked with an advocacy strategy. Key steps to develop a resource mobilisation approach include the following: − Develop situation analysis – set out the context and importance of the issues, identify the gaps in funding (requires a mapping of available resources) and other aspects, understand who all the stakeholders are – especially those which influence resource mobilisation, map out the potential and actual financing mechanisms, and assess the advocacy priorities. − Develop relationship building strategies – set out strategies to develop partnerships and identify all potential value-add partnerships to support resource mobilisation such as Ministry of Finance, donors and the private sector. − Make the case – develop advocacy approaches and key messages, identify opportunities to convey key messages including the right audiences and who are best placed to convey the key messages including nutrition champions, members of parliament, donors, development partners, private sector, academia, CSOs and the media.
  • 33. 32 − Monitoring and Evaluation – set out how the success of the approach will be measured. Implementation of both the advocacy and the resource mobilisation strategy require the involvement of a wide range of stakeholders to ensure a broad base of support for the multisectoral nutrition plan which can support all the aspects of implementation. Potential roles of different stakeholders in supporting both strategies include the following: − Nutrition Champions at the top level of government and in nutrition-related sectors as well as well-known individuals in wider society to influence policy direction and move nutrition up the political agenda. − Members of parliament to influence the policy, planning and budgetary processes to increase the visibility, importance of and resources for nutrition. − Donors and development partners to increase and foster the alignment of external funding and influence public sector nutrition policies and programmes. − Private Sector to increase investment in nutrition-relevant areas such as food fortification and promote good diets and breastfeeding. − Media and CSOs to raise the visibility of nutrition as an issue, mobilise communities and hold decision makers accountable for their commitment to nutrition. − SUN Networks to support the process through convening and influencing their respective groups in support of a multisectoral approach to nutrition. Please refer to the Module 6 of the MQSUN + in this link for further information: MQSUN- Multisectoral-Nutrition-Planning-Toolkit_Module-6_24Nov2020_final.pdf (path.org) 4.5 Sector annual planning for implementation at all levels of government To successfully implement the multisectoral nutrition plan, there are several steps that are recommended to be taken prior to and during the rollout of activities. These steps include: i) ensuring that the coordination mechanisms outlined in the multisectoral nutrition plan are put in place; ii) integrating the multisectoral nutrition plan activities into the planning process at the national and state levels; iii) reviewing/developing guidelines and protocols; iv) updating sector policies and plans; and v) reviewing/developing complementary sector- specific laws and regulations. i. Coordination Due to the multisectoral nature of malnutrition and the multisector and multistakeholder response encompassed in the multisectoral nutrition plan, the governance and accountability framework not only needs to take into account coordination between sectors, outlined earlier, but also how activities within a sector will be coordinated as there are often a variety of departments involved in the process such as planning, programme units, and M&E as well as many partners. Ideally, sector level coordination will use existing mechanisms at all levels if present, rather than creating new ones.
  • 34. 33 ii. Planning process To facilitate the implementation of the multisectoral nutrition plan, each activity needs to be incorporated into the planning process at the national and sub-national level in the relevant sector. It will be important to ensure that updated planning, policy guidance and capacity building is completed prior to the annual planning process at the national and the subnational level. In each Ministry, this planning process should be led by the planning unit with the involvement of the relevant technical and programmatic departments. Subnational governments, whether at the state or locality levels are responsible for the delivery of services relevant or specific to nutrition which are outlined in the multisectoral nutrition plan. Subnational governments, at least at the state level, should be involved in the development of the multisectoral nutrition plan and, to facilitate planning, will also need to be introduced to the final version along with key partners. Based on the multisectoral nutrition plan, implementation plans will need to be developed at the state and locality levels, led by the government, and involving all the stakeholders, as part of the regular planning process. It may also be useful to carry out a brief contextual analysis to support planning at the subnational level which could include a mapping of key interventions, the reach of the interventions, the organisation’s involved and the capacity available. The planning department in each sector should take the lead to bring all the units and partners together to plan jointly for implementation, including budgeting, to take advantage of synergies. To facilitate the planning process at the national and subnational levels, a workshop or series of meetings can be set up with the participation of line ministry staff from programmes, planning and M&E. Programme and technical staff should be included from CSOs, the UN, private sector and academia, as appropriate. The subnational planning process should consider the following: − Prioritisation of actions, interventions or programmes and development of specific objectives. − Work plans and activity costing/budgeting − Financial and nonfinancial resource needs − Budget consolidation − Monitoring and evaluating implementation It is likely that these implementation plans will vary considerably by state and locality, depending on the specific identified needs, but ideally there would be an identified core package of services included in all the plans. iii. Reviewing/developing guidelines and protocols To support the implementation, it will be important for key stakeholders, including Government Ministries and partners, to review the existing guidelines and protocols for all the interventions included in the multisectoral nutrition plan to ensure that they are fit for purpose. In the event that necessary guidelines and/or protocols do not exist, it will be important for key stakeholders to come together to develop them.
  • 35. 34 iv. Updating sector policies and plans In a similar manner to the review and updating of the sector guidelines and protocols, it is critical to also review sector policies and plans to ensure that all sector-relevant interventions in the national multisectoral nutrition plan are included. The purpose of this is to ensure that these interventions are considered during each sector annual planning process. To do this, it will be important to understand the timeline for updating sector policies and plans to contribute to that process as it may not be possible to update them on an ad-hoc basis. The situation analysis carried out at the start of development of the multisectoral nutrition plan may provide information on all the relevant sector policies and plans or it may be useful to also carry out a quick mapping. v. Reviewing/developing complementary sector-specific laws and regulations To support the implementation, there may be instances when updating or developing laws could strengthen the implementation of specific interventions or programmes. An example of this is introducing a mandatory food fortification law which will strengthen the prevention of micronutrients deficiencies through fortification of staple foods including Universal Salt Iodisation (USI) in the country. 4.6 Operationalisation of the Multisectoral Plan at different levels National/Federal level: − Putting in place governance and accountability framework and leading coordination platforms at the national level. − Developing/revising national policies and strategies − Positioning nutrition as a national development agenda. − Establishing a platform for joint planning, which is guided by the national TAG. − Defining the planning process and inviting multi-sector partners to the planning forum. − Establishes broad goals and objectives with smart performance indicators aligned to the agreed national targets. − Allocating national level budget and deploying appropriate human resources to subnational levels. − Developing the capacity of staff on planning, M&E and technical implementation at scale. − Providing technical support to the implementation of the plan including supportive supervision, joint monitoring and ensuring activities are aligned to the agreed results. State/Locality level: − Developing detailed implementation plans aligned with the national plan. − Putting in place and leading coordination platforms at the state and locality level. − Allocating budget and other resources (human resources, logistics etc). − Facilitating training at the state and locality levels. − Implementing the detailed action plan. − Carrying out regular supervision of the programme implementation. − Collecting and compiling data, timely tracking of results and providing progress reports.
  • 36. 35 ANNEXES Annex 1: Sudan Scaling Up Nutrition Movement Roadmap 2021-2025 Introduction The global Scaling Up Nutrition (SUN) Movement, since its inception in 2010, has inspired a new way of working collaboratively to end malnutrition in all its forms. With the governments of SUN countries in the lead, it unites people—from civil society, the United Nations, donors, businesses and researchers—in a collective effort to ensure every child, adolescent, mother and family can realise their right to food and nutrition, reach their full potential and shape sustainable and prosperous societies. Sudan joined the SUN Movement in October 2015, with a letter from the Government expressing its commitment to scaling up nutrition in the country. The recently developed SUN Strategy 3.0 places a greater focus on nutrition results at the country level encompassing all forms of malnutrition, a country-driven, country-led, country- owned approach and empowering country teams to be able to lead, act at scale and accelerate progress. Overview of the Roadmap This document comprises the roadmap for Sudan SUN Movement’s operation over the next five years. It sets out a systematic and methodological pathway to catalyse and scale up efforts to reduce malnutrition in Sudan as well as make progress towards the shared SUN vision of a world free from malnutrition in all its forms, the World Health Assembly (WHA) global nutrition targets and the Sustainable Development Goals (SDGs). This roadmap builds on the Sudan SUN Movement’s progress and achievements since Sudan joined the global SUN Movement and is aligned with the SUN Strategy 3.0 strategic objectives. The SUN vision: By 2030, a world free from malnutrition in all its forms.
  • 37. 36 The roadmap sets out the broad framework of action for the Sudan SUN Movement, organised by priority areas, over the next five years from 2021 to 2025. Under each priority area, a set of broad activities are identified to be achieved by 2025 with the involvement of all SUN stakeholders in Sudan. These broad activities will be the basis for developing more detailed yearly implementation plans. The key themes of the roadmap, highlighted in the next section on priority areas, are the re-operationalisation of the Sudan SUN Movement and the development and implementation of a multisectoral nutrition action plan. This roadmap is the guiding document for all SUN stakeholders in Sudan at the national and sub-national levels, led by the government through the SUN Focal Person, SUN Coordinator and secretariat, with the support of the SUN Networks (CSA, UNN, donor, business, and academia). All SUN stakeholders are mutually accountable for ensuring the implementation of the Roadmap. It should be regarded as a dynamic document that can respond to changing needs and opportunities as well as lessons learned during the implementation period to ensure its successful implementation. A mid-term review of the roadmap priorities will be planned to assess the progress and any change in focus. This will be followed by a final review near the end of the roadmap period to assess the overall progress and to inform priority- setting for the next five-year roadmap. The Roadmap Priority Areas The SUN Movement Strategy 3.0 outlines four priority areas which SUN is accountable for at the country level in order to accelerate action towards ending all forms of malnutrition and to work towards the objectives of the Strategy: ● Leading inclusive development and review of country priorities ● Leveraging financial, political support and knowledge as well as evidence and technical assistance to support country priorities ● Overseeing the execution of country priorities ● Ensuring the tracking of progress against priorities. A fifth priority area was also identified in-country, which is re-operationalising the Sudan SUN Movement, as its work was paused due to political changes and the impact of the COVID-19 SUN Strategy 3.0 Strategic Objectives 2021-2025 Strategic objective 1: Strengthen and sustain strong policy and advocacy environments at the subnational, national, regional and global levels to position nutrition outcomes as a key maker and marker of sustainable development. Strategic objective 2: Develop and align shared country priorities for action. Strategic objective 3: Build and strengthen country capacity to develop, prioritise, finance, implement and track country actions through strengthened technical assistance and knowledge management. Strategic objective 4: Ensure governance of SUN that promotes country leadership and responsibilities of government, aligns the resources of all Movement stakeholders behind country priorities and strengthens mutual accountabilities.
  • 38. 37 pandemic in 2019 and 2020. This priority area will be the initial focus of the Sudan SUN Movement. The broad focus of each of the five priority areas is as follows: 1. The re-operationalisation of the Sudan SUN Movement In order to be able to implement the four SUN country level priority areas, it is important to ensure that the SUN Office, with supporting and oversight mechanisms and the SUN Networks, are all fully operational, with clear guidance on roles and responsibilities. Ensuring a revitalised and effective Sudan SUN Movement, including through developing strong links with other nutrition-relevant multisectoral platforms, will provide a strong platform from which to work towards the national and global nutrition goals. 2. Leading inclusive development and review of country priorities This priority area focuses on the development of a comprehensive multisectoral nutrition action plan for Sudan in order to more effectively tackle malnutrition and make rapid progress towards the national and global nutrition goals. This will help to focus, catalyse and align stakeholders and resources around a set of proven high impact nutrition interventions in line with the context of Sudan, bring together sectors such as agriculture, education, social protection and health to incorporate key nutrition-relevant interventions in their plans and programmes, and institutionalise robust multisectoral coordination and accountability mechanisms. 3. Leveraging financial, political support and knowledge as well as evidence and technical assistance to support country priorities To be able to successfully develop and implement a multisectoral nutrition action plan, it is critical to move nutrition towards the top of the political agenda through demonstrating the economic, development and human impacts of malnutrition, and positioning nutrition outcomes as a key maker and marker of sustainable development. Ensuring that nutrition is a top policy and institutional priority can help to unlock greater resources for nutrition and generate additional political capital to accelerate nutrition improvement. Advocacy and communication will be critical during the implementation phase to encourage all stakeholders to do their part to improve the nutrition situation in the country. Likewise, ensuring that technical assistance and knowledge management is increasingly organised around country priorities will help to increase capacity and drive forward the implementation towards nutrition goals. 4. Overseeing the execution of country priorities In order to be able to successfully implement the multisectoral nutrition action plan, the Sudan SUN Movement, as the principle entity for coordinating and leading accelerated progress towards nutrition goals, has a critical role to play. This includes to ensure that all nutrition stakeholders are aligned and committed to working together to implement the plan, to provide proactive support to stakeholders and to ensure the inclusion of nutrition targets in key development policies, legislation and sector plans so that each stakeholder can contribute fully and accelerate progress towards nutrition goals. 5. Ensuring the tracking of progress against priorities
  • 39. 38 Strong assessment and learning mechanisms are critical to support the implementation of country priorities and to foster accountability. Mechanisms commonly used for this purpose include the tracking of resources for nutrition, developing strong information systems for nutrition to track progress, carrying out periodic reviews of country progress towards national and global goals, and carrying out a robust research agenda and using the findings to improve programming. These mechanisms can also be used to understand the institutional and systemic changes taking place, to assess capacity building needs and key challenges and bottlenecks, and to evaluate the need for course corrections in implementing the multi- sectoral nutrition action plan. The Sudan SUN Movement Roadmap 2021-2025 Priority Area Activity Planned year(s) Expected key contributors Re- operationalising the Sudan SUN Movement Conduct a high-level SUN inception workshop to announce the SUN movement re-activation, highlight the nutrition context and advocate for a multisectoral response in Sudan with prime minister, cabinet and line ministries presence to get the political commitment. Also leverage key events such as the Food Systems Summit and N4G for this purpose. 2021 SUN Secretariat, nutrition-relevant ministries, SUN Networks Revise country SUN Operational Guidelines, setting out how the SUN mandate will be operationalised in Sudan, including its structure and links with other nutrition-relevant coordination mechanisms. Translate, print and distribute for SUN stakeholders at the national and state levels. 2021 SUN Secretariat Build the functional capacity of the SUN secretariat, set up SUN oversight and support mechanisms, activate coordination platforms at the national and state levels, and establish the linkages with other existing nutrition-relevant development and humanitarian coordination platforms. 2021 SUN Secretariat Conduct national advocacy workshops to relaunch each SUN network, revitalise the membership, discuss country priorities and commitment to the SUN principles. Hold webinars with each global SUN Network to determine the opportunities to support the work of each network in Sudan. 2021 SUN Secretariat, SUN Networks, Network convenors Update SUN Networks strategy documents, identify potential members, set up/revise any governance structures and develop initial workplans 2021 SUN Networks, SUN Secretariat, Network convenors Review and development of country priorities Conduct a brief review of the current status of country progress towards WHA, SDG and other nutrition global targets. Identify priority actions required to make faster progress towards global nutrition targets. Update the nutrition situation analysis from 2019. 2021 SUN Secretariat Review existing country nutrition related policies/strategies/reports (e.g.: National nutrition policies, COHA, zero hunger, Health policy, food security policy, WASH strategy etc.) to identify any 2021 SUN Secretariat, nutrition-relevant ministries
  • 40. 39 Priority Area Activity Planned year(s) Expected key contributors strategic priorities/goals/commitments related to nutrition and the current gaps. Undertake a brief nutrition stakeholder mapping analysis to understand who the major entities are and their roles, understanding and capacity in terms of nutrition, the focus and scale of their programmes and funding, and views on the strengths, opportunities and challenges to multisectoral planning for nutrition in Sudan. 2021 SUN Secretariat, nutrition-relevant ministries, SUN Networks Engage with the ministries and stakeholders in each sector on nutrition to identify and set goals, objectives and sector priorities for nutrition as well as capacity needs for inclusion in the multisectoral action plan 2022 SUN Secretariat, nutrition-relevant ministries, SUN Networks Develop the multisectoral nutrition action plan accountability framework (outcomes, targets, outputs, inputs) and costing in a consultative manner. 2022 SUN Secretariat, nutrition-relevant ministries, SUN Networks, technical support (costing) Finalise the multisectoral nutrition action plan including editing, design, printing, distribution, launching and communication strategy 2022 SUN Secretariat, technical support (editing and design) Leveraging financial, political support, knowledge, evidence and technical assistance Undertake a financial gap analysis for nutrition – assessment of the resources available to achieve progress towards multisectoral nutrition action plan goals and strategic objectives (to achieve coverage and human capacity required) relative to costing. 2022 SUN Secretariat, nutrition-relevant ministries, SUN Networks, technical assistance Identify needs and explore opportunities for technical assistance and south-south cooperation to support implementation of the multisectoral nutrition action plan. 2022 SUN Secretariat, SUN Networks Develop and implement an advocacy plan focused on increasing support for the multisectoral action plan and the maximum leveraging of resources in the government and among all other stakeholders. 2022-2025 SUN Secretariat, nutrition-relevant ministries, SUN Networks Identify and work with Nutrition Champions at all levels - including at the top level of government and in parliament (including in budget committees) - to ensure that nutrition is a national priority. 2022-2025 SUN Secretariat, SUN Networks Overseeing the execution of country priorities Advocate and work for the inclusion of nutrition objectives and goals in the country development plan and national level relevant sectors policies/strategies. 2022-2025 SUN Secretariat, nutrition-relevant ministries, SUN Networks Put in place and enforce a comprehensive legal framework on nutrition (E.g.: mandatory food fortification, BMS code, nutrition labelling, food safety and food quality), in line with the national multisectoral nutrition action plan priorities. 2022-2025 Nutrition-relevant ministries, SUN Networks, SUN Secretariat Develop SUN Network annual implementation plans based on agreed goals and priorities in the multisectoral nutrition action plan and in line with the SUN Roadmap. 2022-2025 SUN Networks, Network Convenors, SUN secretariat
  • 41. 40 Priority Area Activity Planned year(s) Expected key contributors Develop/revise sector implementation plans based on agreed goals and priorities in the multisectoral nutrition action plan and ensure that associated implementation guidelines and protocols are fit for purpose. 2022-2025 Nutrition-relevant ministries, SUN Networks, SUN Secretariat Put in place and support a focal point for nutrition in each nutrition-relevant ministry. 2022-2025 Nutrition-relevant ministries, SUN Secretariat, SUN Networks Assess and develop capacities on nutrition sensitive programming: develop appropriate guidelines and training materials as needed. 2022-2025 SUN Secretariat, nutrition-relevant ministries, SUN Networks, technical support Tracking of progress against priorities Establish and maintain the nutrition financial tracking. 2022-2025 SUN Secretariat, nutrition-relevant ministries, SUN Networks, technical support Review and develop the nutrition information system to ensure aligned with country nutrition priorities to support the annual reporting/tracking of progress against the goals set out in the multisectoral nutrition action plan 2022-2025 SUN Secretariat, nutrition-relevant ministries, technical support Orient SUN stakeholders about the joint annual assessments, focusing on achievements based on country priorities, and implement yearly reporting 2022-2025 SUN Secretariat, nutrition-relevant ministries, SUN Networks Review country progress towards WHA, SDG and other targets when new data becomes available. 2022-2025 SUN Secretariat, nutrition-relevant ministries, SUN Networks (particularly RAN), technical support Initiate the nutrition research agenda in collaboration with all stakeholders, including researchers, academic institutions and think tanks. 2022-2025 SUN Secretariat, SUN Networks (particularly RAN), nutrition-relevant ministries, technical support Create a repository of lessons learnt and new knowledge and ensure that it is proactively exchanged and used for advocacy and programming. 2022-2025 SUN Secretariat, SUN Networks (particularly RAN), nutrition-relevant ministries