Bridging barriers to advance multisector approaches to improve food security, nutrition and population health in Nepal

transdisciplinary perspectives

Santosh Gaihre (Corresponding Author), Janet Kyle, Sean Semple, Jo Smith, Debbi Marais, Madhu Subedi, Heather May Morgan

Research output: Contribution to journalArticle

Abstract

Background: Understanding stakeholders’ perceptions is crucial to the development and implementation of any intervention. However, a structured approach to eliciting stakeholder insights into complex, multisectorissues of food security, household environment and health islacking in many low and middle-income countries. This qualitative, workshop-based participatory study explores stakeholders’ experiences of developing and implementing multisector interventions to provide transdisciplinary lessons for future developments in low and middle-income countries. Methods: Participants were purposely selected based on their involvement in, or exposure to, the multisector intervention. Participants with interests in agriculture, nutrition, household air-quality, drinking water-quality and health from academic institutes, government and developmental organisations were brought together at a one-day workshop to participate in a series of discussions on issues relating to food security, nutrition, household environment and health in Nepal. All group discussions were audio-recorded and transcribed, and a thematic qualitative analysis performed to identify relevant themes. Results: The government’s ongoing Multisector Nutrition Plan, stakeholders’ willingness to work together, availability of local infrastructure for cross-institutional inputs and increasing global movement towards transdisciplinary approaches were identified by the 33 workshop participants, representing 23 organisations as key factors determining success of transdisciplinary work. Fragmentation, lack of research-based and practice-based evidence, limited transdisciplinary knowledge amongst sectoral stakeholders, short-term funding and lack of knowledge-sharing mechanisms were identified as barriers, often creating systematic problems for successful implementation. Stakeholders suggested methods to bring about success included: improved knowledge, both amongst policy-makers and implementers, of food security and its linkage with nutrition, household environments, health and hygiene; investment in collaborative practice-based research and evidence-based practice; and strengthened transdisciplinary collaboration between multi-stakeholders, such as researchers, implementers and beneficiaries, throughout the intervention development and implementation process. Conclusions: This study suggests that multisector approach needs to adapt to take into account the experiences and views of the stakeholders concerned. The paper offers recommendations for successful development and implementation of future multisector interventions in Nepal that can be extrapolated to other low and middle-income countries, and lays foundations for future transdisciplinary working to support realisation of the recommendations.
Original languageEnglish
Article number961
JournalBMC Public Health
Volume19
DOIs
Publication statusPublished - 18 Jul 2019

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Nepal
Food Supply
Evidence-Based Practice
Health
Education
Population
Organizations
Water Quality
Administrative Personnel
Agriculture
Hygiene
Research
Drinking Water
Air
Research Personnel

Keywords

  • Transdisciplinary
  • multisector
  • intervention
  • food security
  • nutrition
  • health
  • low and middle-income countries
  • Intervention
  • Nutrition
  • Health
  • Multisector
  • Food security
  • Low and middle-income countries
  • PUBLIC-HEALTH
  • INTERVENTIONS
  • PROMOTION
  • EXPOSURE

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Bridging barriers to advance multisector approaches to improve food security, nutrition and population health in Nepal : transdisciplinary perspectives . / Gaihre, Santosh (Corresponding Author); Kyle, Janet; Semple, Sean; Smith, Jo; Marais, Debbi; Subedi, Madhu; Morgan, Heather May.

In: BMC Public Health, Vol. 19, 961, 18.07.2019.

Research output: Contribution to journalArticle

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title = "Bridging barriers to advance multisector approaches to improve food security, nutrition and population health in Nepal: transdisciplinary perspectives",
abstract = "Background: Understanding stakeholders’ perceptions is crucial to the development and implementation of any intervention. However, a structured approach to eliciting stakeholder insights into complex, multisectorissues of food security, household environment and health islacking in many low and middle-income countries. This qualitative, workshop-based participatory study explores stakeholders’ experiences of developing and implementing multisector interventions to provide transdisciplinary lessons for future developments in low and middle-income countries. Methods: Participants were purposely selected based on their involvement in, or exposure to, the multisector intervention. Participants with interests in agriculture, nutrition, household air-quality, drinking water-quality and health from academic institutes, government and developmental organisations were brought together at a one-day workshop to participate in a series of discussions on issues relating to food security, nutrition, household environment and health in Nepal. All group discussions were audio-recorded and transcribed, and a thematic qualitative analysis performed to identify relevant themes. Results: The government’s ongoing Multisector Nutrition Plan, stakeholders’ willingness to work together, availability of local infrastructure for cross-institutional inputs and increasing global movement towards transdisciplinary approaches were identified by the 33 workshop participants, representing 23 organisations as key factors determining success of transdisciplinary work. Fragmentation, lack of research-based and practice-based evidence, limited transdisciplinary knowledge amongst sectoral stakeholders, short-term funding and lack of knowledge-sharing mechanisms were identified as barriers, often creating systematic problems for successful implementation. Stakeholders suggested methods to bring about success included: improved knowledge, both amongst policy-makers and implementers, of food security and its linkage with nutrition, household environments, health and hygiene; investment in collaborative practice-based research and evidence-based practice; and strengthened transdisciplinary collaboration between multi-stakeholders, such as researchers, implementers and beneficiaries, throughout the intervention development and implementation process. Conclusions: This study suggests that multisector approach needs to adapt to take into account the experiences and views of the stakeholders concerned. The paper offers recommendations for successful development and implementation of future multisector interventions in Nepal that can be extrapolated to other low and middle-income countries, and lays foundations for future transdisciplinary working to support realisation of the recommendations.",
keywords = "Transdisciplinary, multisector, intervention, food security, nutrition, health, low and middle-income countries, Intervention, Nutrition, Health, Multisector, Food security, Low and middle-income countries, PUBLIC-HEALTH, INTERVENTIONS, PROMOTION, EXPOSURE",
author = "Santosh Gaihre and Janet Kyle and Sean Semple and Jo Smith and Debbi Marais and Madhu Subedi and Morgan, {Heather May}",
note = "We are grateful to Mr Min Raj Gyawali, Program Officer (Nutrition), National Planning Commission and Mr Giri Raj Subedi, Chief, Nutrition Section, Child Health Division, Nepal Government for their kind support during the participant recruitment and transdisciplinary workshop delivery in Kathmandu, Nepal. We would like to thank Mr Naniram Timalsina and Miss Sirjana Devkota for their help during the workshop. We would also like to thank Professor Geraldine McNeill, University of Aberdeen for her insightful comments that improved the manuscript. We are grateful to all the participants for their active participation and contributions in group discussion. The authors accept full responsibility for this paper.",
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AU - Semple, Sean

AU - Smith, Jo

AU - Marais, Debbi

AU - Subedi, Madhu

AU - Morgan, Heather May

N1 - We are grateful to Mr Min Raj Gyawali, Program Officer (Nutrition), National Planning Commission and Mr Giri Raj Subedi, Chief, Nutrition Section, Child Health Division, Nepal Government for their kind support during the participant recruitment and transdisciplinary workshop delivery in Kathmandu, Nepal. We would like to thank Mr Naniram Timalsina and Miss Sirjana Devkota for their help during the workshop. We would also like to thank Professor Geraldine McNeill, University of Aberdeen for her insightful comments that improved the manuscript. We are grateful to all the participants for their active participation and contributions in group discussion. The authors accept full responsibility for this paper.

PY - 2019/7/18

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N2 - Background: Understanding stakeholders’ perceptions is crucial to the development and implementation of any intervention. However, a structured approach to eliciting stakeholder insights into complex, multisectorissues of food security, household environment and health islacking in many low and middle-income countries. This qualitative, workshop-based participatory study explores stakeholders’ experiences of developing and implementing multisector interventions to provide transdisciplinary lessons for future developments in low and middle-income countries. Methods: Participants were purposely selected based on their involvement in, or exposure to, the multisector intervention. Participants with interests in agriculture, nutrition, household air-quality, drinking water-quality and health from academic institutes, government and developmental organisations were brought together at a one-day workshop to participate in a series of discussions on issues relating to food security, nutrition, household environment and health in Nepal. All group discussions were audio-recorded and transcribed, and a thematic qualitative analysis performed to identify relevant themes. Results: The government’s ongoing Multisector Nutrition Plan, stakeholders’ willingness to work together, availability of local infrastructure for cross-institutional inputs and increasing global movement towards transdisciplinary approaches were identified by the 33 workshop participants, representing 23 organisations as key factors determining success of transdisciplinary work. Fragmentation, lack of research-based and practice-based evidence, limited transdisciplinary knowledge amongst sectoral stakeholders, short-term funding and lack of knowledge-sharing mechanisms were identified as barriers, often creating systematic problems for successful implementation. Stakeholders suggested methods to bring about success included: improved knowledge, both amongst policy-makers and implementers, of food security and its linkage with nutrition, household environments, health and hygiene; investment in collaborative practice-based research and evidence-based practice; and strengthened transdisciplinary collaboration between multi-stakeholders, such as researchers, implementers and beneficiaries, throughout the intervention development and implementation process. Conclusions: This study suggests that multisector approach needs to adapt to take into account the experiences and views of the stakeholders concerned. The paper offers recommendations for successful development and implementation of future multisector interventions in Nepal that can be extrapolated to other low and middle-income countries, and lays foundations for future transdisciplinary working to support realisation of the recommendations.

AB - Background: Understanding stakeholders’ perceptions is crucial to the development and implementation of any intervention. However, a structured approach to eliciting stakeholder insights into complex, multisectorissues of food security, household environment and health islacking in many low and middle-income countries. This qualitative, workshop-based participatory study explores stakeholders’ experiences of developing and implementing multisector interventions to provide transdisciplinary lessons for future developments in low and middle-income countries. Methods: Participants were purposely selected based on their involvement in, or exposure to, the multisector intervention. Participants with interests in agriculture, nutrition, household air-quality, drinking water-quality and health from academic institutes, government and developmental organisations were brought together at a one-day workshop to participate in a series of discussions on issues relating to food security, nutrition, household environment and health in Nepal. All group discussions were audio-recorded and transcribed, and a thematic qualitative analysis performed to identify relevant themes. Results: The government’s ongoing Multisector Nutrition Plan, stakeholders’ willingness to work together, availability of local infrastructure for cross-institutional inputs and increasing global movement towards transdisciplinary approaches were identified by the 33 workshop participants, representing 23 organisations as key factors determining success of transdisciplinary work. Fragmentation, lack of research-based and practice-based evidence, limited transdisciplinary knowledge amongst sectoral stakeholders, short-term funding and lack of knowledge-sharing mechanisms were identified as barriers, often creating systematic problems for successful implementation. Stakeholders suggested methods to bring about success included: improved knowledge, both amongst policy-makers and implementers, of food security and its linkage with nutrition, household environments, health and hygiene; investment in collaborative practice-based research and evidence-based practice; and strengthened transdisciplinary collaboration between multi-stakeholders, such as researchers, implementers and beneficiaries, throughout the intervention development and implementation process. Conclusions: This study suggests that multisector approach needs to adapt to take into account the experiences and views of the stakeholders concerned. The paper offers recommendations for successful development and implementation of future multisector interventions in Nepal that can be extrapolated to other low and middle-income countries, and lays foundations for future transdisciplinary working to support realisation of the recommendations.

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KW - Nutrition

KW - Health

KW - Multisector

KW - Food security

KW - Low and middle-income countries

KW - PUBLIC-HEALTH

KW - INTERVENTIONS

KW - PROMOTION

KW - EXPOSURE

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