Development and testing of a "zero stunting" scorecard for use at provincial level : Bulawayo, Zimbabwe

Date
2021-12
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Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY: Introduction: High prevalence of stunting in children below five years of age poses a major threat to child development in Zimbabwe. Scorecards have been identified as instruments of choice for evaluating governments’ commitment towards reducing undernutrition. The aim of the study was to co-develop and test the usability and value of a “Zero stunting” scorecard at sub-national / provincial level in Bulawayo Metro Province, Zimbabwe. Methods: A draft “Zero Stunting” scorecard prototype was developed, based on the most recent evidence of the context, causes and consequences of childhood stunting. The Hunger and Nutrition Commitment Index (HANCI), developed by the Institute of Development Studies (IDS) at Sussex University, was used as a guide for the “Zero Stunting” scorecard development. HANCI consists of three domains: law, policy and finance. The draft “Zero Stunting” scorecard reflects the same domains and the following themes: food control, political economy, food systems, education, nutrition, water, sanitation and environment, health, social protection, finance and governance with relevant indicators linked to each theme. The draft scorecard was used as a tool during semi-structured interviews with key informants to assess the usability and value of the scorecard and to establish availability and relevance of provincial data that can be used to measure the proposed indicators at provincial level in the Western Cape province, South Africa. The study reported here, used the same tools and followed the same methodology during semi-structured interviews with officials in Bulawayo province, in Zimbabwe. Results and Discussion: A total of 10 participants consented to be interviewed. The results were viewed against the three linked elements of an enabling environment for nutrition, namely: 1) knowledge and evidence 2) politics and governance and 3) capacity and resources. Knowledge and evidence: Most participants did not have a good understanding of stunting. Some interventions for addressing stunting were known, but it was not comprehensive. The participants were receptive of the scorecard and indicated that it would be a powerful advocacy tool within the province and had a potential for raising the profile of nutrition within the province. Capacity and resources: The research highlighted the need for and importance of a high-level political nutrition champion within the province which is one of the core tenets of the scorecard as it seeks to tie different important actions together so that stunting may be eradicated. Lack of resources in general for addressing stunting was evident in Bulawayo Province. Politics and Governance: Relations between central government and local government were described as “informal with limited operational aims”. Participants did not feel comfortable to divulge certain information due to fear of victimization. Participants indicated that most of the datasets, to populate the scorecard indicators, are available on request. The challenge will be to access these due to security clearance required from the government. Conclusion: When viewed against the definition and the elements of an enabling environment, there is much work to be done at provincial level in Bulawayo province to ensure that nutrition, and more specifically stunting, will be effectively addressed. A “Zero Stunting” scorecard could be used as an advocacy tool and a way of initiating discussions around the multi-sectoral requirements for stunting reduction, bearing in mind the political economy situation in the country.
AFRIKAANSE OPSOMMING: Inleiding: ‘n Hoe voorkoms van dwerggroei in kinders jonger as vyf jaar hou ‘n groot gevaar in vir kinders in Zimbabwe se ontwikkeling. Telkaarte is geidentifiseer as instrumente van keuse vir die evaluering van regerings se toewyding om ondervoeding te verminder. Die doel van die studie was om ‘n “Zero Stunting” telkaart te ontwikkel en te toets vir die gebruik deur regerings op sub-nasionale / provinsiale vlak in Bulawayo Metro Province, Zimbabwe. Metodes: ‘n Konsep “Zero Stunting” telkaart prototipe is ontwikkel, gegrond op die mees onlangse beskikbare bewyse vir die konteks, oorsake en gevolge van dwerggroei in kinders. Die “Hunger and Nutrition Commitment Index” (HANCI), ontwikkel deur die Instituut van Ontwikkelingsstudies by Sussex Universiteit, is gebruik as ‘n gids vir die “Zero Stunting” telkaart ontwikkeling. HANCI bestaan uit drie domeine: wetgewing, beleid en finansies. Die konsep “Zero Stunting” telkaart reflekteer dieselfde domeine en die volgende temas: voedselkontrole, politiese ekonomie, voedsel sisteme, onderrig, voeding, water, sanitasie en omgewing, gesondheid, maatskaplike beskerming, finansies en bestuur, met relevante indikatore gekoppel aan elke tema. Die konsep telkaart is gebruik as ‘n data insamelingsinstrument gedurende semi-gestruktureerde onderhoude met sleutel informante om die potensiele waarde en bruikbaarheid van die telkaart te identifiseer en om beskikbaarheid en relevansie vas te stel van provinsiale data wat gebruik kan word om die voorgestelde indikatore te meet in die Wes-Kaap Provincie, Suid-Afrika. Die studie wat hier gerapporteer word het dieselfde instrumente gebruik en dieselfde metodiek gevolg gedurende semi-gestruktureerde onderhoude met regeringsamptenare in Bulawayo Provinsie. Resultate en Bespreking: ‘n Totaal van 10 deelnemers het ingestem tot ‘n onderhoud. Die resultate is teenoor die drie ineengestrengelde elemente van die ondersteunende omgewing vir voeding beskou, naamlik: 1) kennis en bewyse 2) politiek en bestuur en 3) kapasiteit en bronne. Kennis en bewyse: Meeste deelnemers het nie dwerggroei goed verstaan nie. Sommige intervensies vir die aanspreek van dwerggroei was bekend, maar dit was nie omvattend nie. Die deelnemers was ontvanklik vir die telkaart en het aangedui dat dit ‘n magtige instrument vir advokaatskap kon wees binne die provinsie en het ook die potensiaal om die profiel van voeding binne die provinsie te lig. Kapasiteit en bronne: Die navorsing het die noodsaaklikheid en belang van ‘n hoevlak, politiese voeding kampioen binne die provinsie belig, wat een van die kern uitgangspunte van die telkaart is, aangsien dit daarna streef om die verskillende belangrike aksies saam te vat sodat dwerggroei uitgewis kan word. Daar is ‘n duidelike tekort aan bronne in die algemeen om dwerggroei aan te spreek, in Bulawayo provinsie. Politiek en bestuur: Verhoudings tussen the sentrale en plaaslike regering was beskryf as “informeel met beperkte operasionele doelwitte”. Deelnemers het nie gemaklik gevoel om sekere inligting openbaar te maak nie as gevolg van die vrees vir viktimisering. Deelnemers het aangedui dat meeste van die datastelle, om die indikatore aan te vul, beskikbaar is op aanvraag. Die uitdaging sal wees om dit in die hande te kry as gevolg van sekuriteitsklaring benodig van die regering. Gevolgtrekking: Beskou teenoor die definisie en die elemente van die ondersteunende omgewing vir voeding, is dit duidelik dat daar baie werk is om te doen in Bulawayo Provinsie om te verseker dat voeding en meer spesifiek dwerggroei effektief aangespreek word. ‘n “Zero Stunting” telkaart kan gebruik word as ‘n instrument vir advokaatskap en ‘n manier om gesprekke te inisieer rondom die multi-sektorale behoeftes om dwerggroei te verminder, in ag genome die politieke ekonomie van die land.
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Thesis (MNutr)--Stellenbosch University, 2021.
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