Current Accountability Mechanisms

Do They Work?
Lawrence Haddad
International Food Policy Research
Institute

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Accountability
The glue that binds the
commitment to the result

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Simple model of accountability

identif
y

track

commitmen
ts
respon
d

results
levera
ge
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assess

Accountability is
intrinsically challenging
for nutrition
Many manifestations of
malnutrition are invisible
o Until clinical signs emerge
o Until later in life

Multiple sectors and actors

o Who owns responsibility for the
commitment?
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Current Accountability Mechanisms:

Outcome focused

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Current Accountability Mechanisms:

Action focused

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Strengthening Accountability in
Nutrition

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Identify commitments

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Nutrition budget commitments:

untracked, but not untrackable
Guatemala

Tanzania

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Zambia

Monitoring commitments

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49

% of countries dont have

enough data to assess if on/off course
for 4 WHA indicators

40 % of most recent

child growth surveys are

over 5 years old

Glaring Nutrition Data Gaps

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Tools for social

accountability
Participator
Citizen
y budgeting report cards

Community Social Audit

score card

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Assessing
Commitments

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A number of countries
are on course
for the WHA targets

69 - one or more
targets
31 - none of the
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Of the 168 Nutrition for Growth

commitments, % are..

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Leveraging commitments

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What have the MDGs done for

nutrition?
Underweight: one indicator in one
sub-goal of one MDG
Allowed development agencies to
justify an increased investment in
nutrition
Location in the MDG1 probably
helpful in supporting World Bank
leadership
Haddad, Lawrence. "How should nutrition be positioned in the post-2015 agenda?." Food
Policy 43 (2013): 341-352.
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Maharashtra

stunting fell from 37% to 24% in 7 years

Economic
Growth
Poverty
reduction

National
Nutrition
Mission

Frontline
nutrition staff
recruited

Improved Program
Performance

Nutrition
spending

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Responding
to
assessment
s

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Bilateral donor
response to
assessment
Number of
mentions of
nutrition, 2005-06
0 of 50 speeches
0 of 197 press
releases

Source: Sumner, Lindstrom and Haddad 2007.

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Citizen Report Cards: Useful in

nutrition?
RCT of community-based monitoring
of public primary health care
providers in Uganda
large increases in utilisation and
improved health outcomes
reduced child mortality by 33 per
Bjrkman, M and Svensson, J. (2009) 'Power to the People: Evidence from a Randomized
cent on Community Based Monitoring in Uganda, The Quarterly Journal of
Field Experiment
Economics, Vol 124: 2, pp 73569www.globalnutrtionreport.org

Role of research: stop doing

things that dont work

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Do
accountabili
ty
mechanism
s work?

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High level of post 2015 influencing

activity suggests we assume they do!

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But. the number of times

nutrition is mentioned in
169 SDG targets?

uno

one

un
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we need to intensify efforts to embed

nutrition more broadly in the SDGs

Conclusions
Accountability is the glue that binds
commitments to results
Identify-monitor-assess-leverage-respond
Outcome & action accountability mechanisms
exist
Mechanisms need to be strengthened
We cannot say definitively which work
Assume they do, but invest in finding out
more
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Thank you

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