Over the last five years or so, a broad-based consensus on the “what” questions in nutrition has solidified. We know a lot more about what is driving malnutrition and we know more about the type of interventions that are needed to respond. And yet, we continue to struggle with the “how” questions. We simply do not know enough about how to operationalize an appropriate mix of actions – nutrition-specific and nutritionsensitive – equitably, at scale, in different contexts.
The concept of “scaling up nutrition” is now so routinely espoused within the nutrition community, it has become a mantra. But it’s actually quite new – the main background paper for the first International Conference on Nutrition in 1992, for example, contained not one single mention of any of “scaling up”, “going to scale” or “mainstreaming” in its 279 pages. What do we mean by “scaling up”? Is there a shared understanding? And what do we know about success in nutrition-relevant scaling?
There is a need for greater coherence and consistency with regard to the “ends and the means” of scaling-up – its scope, purpose and its essential processes. This was the start point for this Transform Nutrition evidence review. Given the focus on scaling-up impact (rather than an intervention per se) we defined “scaling-up nutrition” as “a process aimed at maximizing the reach and effectiveness of a range of nutrition-relevant actions, leading to sustained impact on nutrition outcomes”.