A theory of change for scaling up integrated nutrition best practices

Maternal and child undernutrition is a direct or indirect cause of millions of childhood deaths and other adverse health outcomes annually. Undernourished children are more likely than well-nourished children to die before reaching age five, and those that survive face long term negative impacts on mental and physical well-being. High-impact best practices in nutrition have been well documented by the 2008 Lancet Series, but in many countries, program implementation has fallen short of goals. While the best practices are known, many of these are behavioral, and programmatic strategies to bring about behavior change are less well known. Further, there is growing interest in the intersection of health sector approaches with agriculture and other sectors, but successfully implementing integrated programs across sectors and at scale has proven challenging. The Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) Project is working to enhance the global evidence base on nutrition policies and programs across multiple sectors, and improve program implementation in low-income settings. An initial activity to accomplish this is the development of a “theory of change” (TOC) model delineating pathways of activities that influence underlying causes of undernutrition and improve long-term outcomes such as stunting, anemia, and others. SPRING is also developing a research agenda to fill knowledge gaps related to how programmatic interventions can improve nutrition, and the TOC will evolve over time as research fills those gaps. In this poster, the authors will present the TOC, describe pathways of impact on nutrition determinants, and discuss remaining research gaps.