I am a private practitioner in Medicine and Pediatric in Pakistan.I advise my patients, most of the time, about Nutrition and Healthy eating. I have conducted campaigns of hand washing and hygiene , Healthy eating and Oral hygiene for children.I have given presentations about "Mindful eating" and "Thriving at work "to name a few.
My focus is Prevention and it can only be implemented if we focus on our dietary habits. Malnutrition is both over and under nutrition. Stunting and childhood obesity are alarming and i am looking forward for new initiatives to work on the issues mentioned.

A young qualified Nutritionist currently volunteering with the Office Of the President, Department of Nutrition in Malawi. Our main focus is on the infant, young feeding and maternal nutrition as well as water hygiene and safety . We provide nutrition Education right in the communities.

I am a nutrition champion. I started this activity in 2007 when I was the Prime Minister of the Republic on Namibia. my interest in nutrition was triggered when Namibia reviewed its progress or luck thereof towards the MDBs. The review revealed that Namibia was facing a major challenge in reducing maternal deaths and infant mortality.
As a Prime Minister I was shocked by these findings. The Office of Prime Minister wanted to understand the major causes of maternal deaths and infant mortality. A survey was carried out by a civil society. The survey indicated that malnutrition contributed greatly to these conditions. For example, anaemia prevalence among pregnant mothers was quite high and stunting among the children bellow the age of five years was equally high. Anaemic pregnant women were at risk at the time of giving birth. Stunted children were vulnerable to opportunistic deceases.
It was against this background that the Namibia Alliance for Improved Nutrition(NAFIN) was born. NAFIN is multi-sectoral and multi-stakeholder. Its mission is to provide evidence based information to policy makers on the state of nutrition in Namibia; social mobilization in favour of balanced diets; promotion of breast feeding; awareness building among pregnant mothers about the need to visit ante-natal clinics; public hygiene such as good sanitation and hand washing.

I am founding Coordinator of SUN Civil Society Alliance Pakistan (SUNCSA,Pak) and SUN Academia and Research Network Pakistan (SUNAR,Pak). On the platform of SUNCSA,Pak we have organized sensitization sessions of Parliamentarians in all provinces of Pakistan and at Federal level. We believe that Parliamentarians can play an important role in implementation of Inter-sectoral Nutrition Strategies enactment/ enforcement of relevant legislation such as Protection and Promotion of Breastfeeding laws, mandatory food fortification laws etc. Parliamentarians can also be helpful for increasing budgetary allocations for nutrition specific and nutrition sensitive interventions.
As per our experience female MPs are more interested to work on malnutrition. Our key messages that worked well are:
(1).The current malnutrition crisis in Pakistan has been estimated to cost the economy 2-3% of GDP per year; Pakistan cannot afford to sustain this drain on the economy
(2)If prioritized, malnutrition can be ended in a generation in Pakistan! Addressing malnutrition is one of the best investments Pakistan can make in its future
(3).Improving nutrition is transformational—families become healthier, wealthier and better educated, because
- Children who are malnourished learn less at school, and earn less when they grow up.
- Iron and iodine deficiency in childhood reduces IQ by up to 25 and 13 points respectively.
- Malnutrition makes children more likely to acquire communicable diseases like measles and also develop complications. Malnutrition also reduces the effectiveness of certain vaccinations.
During our engagement with parliamentarian, we provided key statistics and updated about situation of legislation and policy environment. As a result, call attention questions were asked by parliamentarians in National and Provincial Assemblies. Meetings with members of relevant Parliamentary Standing Committees were also remained useful to promote accountability through parliamentary platforms. Currently, We are in process of developing policy briefs and provincial scorecards to equip them ready to reference information required for policy making and planning purpose.

Thank you all very much for the inspiring initial contributions shared.

Dr. Neelofur Malik - can you elaborate further on how others across different sectors can focus on the underlying determinants of malnutrition and what has been an effective example of your work in this area? Feel free to share any links to further information.

Sandra Salomy Phiri - has your positioning in the Office of the President helped to convene key sectors and how has this been achieved?

Right Honorable Nahas Angula - As the former Prime Minister of Namibia, based on your experience, what would you recommend for other nations who seek to increase political interest and commitment from their respective Heads of State?

Muhammad Irshad Danish - what has enabled you to engage with key parliamentarians as a starting point. You've shared key messages and future plans for scorecards - what ways would you recommend for others who wish to build the role of parliamentarians in their respective countries?

General question: How can the engagement of nutrition champions help to advance progress across key sectors - such as health, agriculture, water/sanitation, women's empowerment and education?

Please feel free to share links, tool and resources which can help to illustrate your excellent examples shared.

The Sierra Leone Alliance Against Hunger and Malnutrition is a civil society advocacy Nongovernmental Organization which is an alliance of over 150 networks, including women, youths and farmer based and school based organizations. The organization is also part and playing active role in SUN Civil Society Platform and other nutrition and food security working groups in the country.

We came together as an alliance after persistent reports identifying malnutrition as one of the major causes for the high maternal and infant mortality in our country; among the highest in the world. one of the key issues responsible for putting Sierra Leone the least country in the Human Development Index

To enhance government commitment to nutrition, the alliance is currently leading the efforts to include nutrition and food security issues in the National Constitution in the current constitutional review process.The effort has already yielded fruit; under Protection of Socio-economic Rights, this has been included including other enablers
c) to be free from hunger and to have food of acceptable quality;
SLAAHM is also using several platforms to bring Sierra Leone's voice to the global efforts to improve nutrition and food security for our malnourished children and women around the world
The alliance is currently hosting, on behalf of Sierra Leone, the Ecosystem Based Adaptation for Food Security Assembly which is a Pan African institution. As a result we are strongly involved in climate change issues and also encouraging other nutrition activists to include it in their nutrition activities.

The approach towards malnutrition is multi sectoral. The Government, Civil society,Private businesses even the show biz personalities should join together for this cause. The impact of malnutrition becomes obvious when its already too late. We need start the efforts now.
I had some teachers involved in an activity for healthy eating and importance of Oral hygiene and hand washing.The students were explainied and then later they practiced the habit. Now when i follow up with parents they update that there are very less episodes of sickness within that particular group of students.
Poor hygiene and sanitation is an underlying cause leading to malnutrition.

As an independent Consultant, with over twenty one years of relevant experience working for grassroots, numerous international and UN agencies including UNICEF & DFID with interventions on public health, nutrition, micro-nutrients, IYCF, CMAM and health sector reform programmes working in close coordination with the Govt. Departments as Programme Manager has given me the right experience to work further in Nutrition. Negotiating with the policy makers has been part of my work including new and innovative initiatives in nutrition and health working for the DFID supported TMST in India.

Working for the UNICEF in the Child Development & Nutrition section, Odisha for three years handling the statewide nutrition programme on Micro-nutrients in Odisha in coordination with the Dept. of Health & Women & Child Development and Food Supply Consumer Welfare Dept., Govt. of Odisha has further consolidated large scale nutrition programming. This involved extensive interaction with the Govt., non-Govt. and grassroots organisations to improve the nutrition & health indicators of the state. I was also actively involved in the roll out of the conditional cash transfer programme for pregnant & lactating mothers called MAMATA in the state. I’ve also prepared the document on Nutrition in Emergencies for UNICEF.

Worked for IPE Global as a Consultant to prepare an operational plan for nutrition and health based on impact assessment of the interventions of Govt. and bilateral agencies as well as field research as part of the core team of Maternal & Child Health with a publication on Nutrition in IDS, Sussex.

I am a breastfeeding and nutrition champion passionate in the area of maternal and early childhood nutrition and its impact on the future of the child. I feel that a lot has been done on the national level but unfortunately sometimes this information does not trickle down to the man and woman on the street. A lot of misinformation still exists and this affects rates of breastfeeding and proper complementary feeding habits. I offer talks, personal consultations, home visits to pregnant women; I also offer breastfeeding support and complementary feeding sessions, teaching these women on how they can use their usual family meals to feed their infants and young children the right way .

Initially we identified those parliamentarian who had history of working on different social and development issues. We received encouraging response from female parliamentarians at national and provincial level. The interesting fact is that both ruling and opposition MPs were ready to work together to address issue of malnutrition keeping away their political differences. We approached Political leaders through their party offices located at Federal and Provincial capitals. We also analysed manifestos of key political parties and then related them to development goals particularly around health and nutrition. We believe, political leadership can be mobilized through think-tanks of their own political parties.

I am a Deputy Director,working with National Primary Health Care Development Agency .I coordinate Maternal, Newborn and Child Nutrition. I possess MSC in Human Nutrition and have attended a short course on transformation of ideas,policy in Nutrition in the Institute of Development studies in 2015.The areas of focus are on Infant and Young childfeeding, Maternal Nutrition,Micronutrient Nutrition, including Nutrition commodities and suppliestc. The champion(s) I work with are Community Leaders who have been trained in Community Mobilization for demanding, accessing and utilization of integrated Primary Health Care services,of which nutrition is one of the components. Community Leaders are knowledgeable about the members of the community, they work with the Community Development Committee. The Community Leaders have this uniqueness of knowing the community members, health workers, available nutrition services. They exert great influence on community members and are close to members of the community where they live and work, mainly the rural dwellers which represent above 70 percent of Nigerian population. They have been very effective in working closely with Mother - mother care group for early initiation(with-in 30 minutes) at delivery, exclusive breastfeeding, complementary feeding, adequate meals for maternal nutrition, especially Nutrition in pregnance.These Community Leader champions are effective,but fraught with challenges which includes: Integrated PHC rarelly provides all essential package for Nutrition, access(economic,geographic). They understand the livelihood, seasonality issues, relating to food security (Nutrition Sensitive), as well as Health Systems issues, talking about Nutrition specific programme, but Community Leader champion does not have enough control of implementers. Areas of challenges with Community Leader champion need to be looked at for greater benefits in continuos with them.i suggest reorientation, linking nutrition with WASH,Education and other Development issues.

I am a Deputy Director,working with National Primary Health Care Development Agency .I coordinate Maternal, Newborn and Child Nutrition. I possess MSC in Human Nutrition and have attended a short course on transformation of ideas,policy in Nutrition in the Institute of Development studies in 2015.The areas of focus are on Infant and Young childfeeding, Maternal Nutrition,Micronutrient Nutrition, including Nutrition commodities and suppliestc. The champion(s) I work with are Community Leaders who have been trained in Community Mobilization for demanding, accessing and utilization of integrated Primary Health Care services,of which nutrition is one of the components. Community Leaders are knowledgeable about the members of the community, they work with the Community Development Committee. The Community Leaders have this uniqueness of knowing the community members, health workers, available nutrition services. They exert great influence on community members and are close to members of the community where they live and work, mainly the rural dwellers which represent above 70 percent of Nigerian population. They have been very effective in working closely with Mother - mother care group for early initiation(with-in 30 minutes) at delivery, exclusive breastfeeding, complementary feeding, adequate meals for maternal nutrition, especially Nutrition in pregnance.These Community Leader champions are effective,but fraught with challenges which includes: Integrated PHC rarelly provides all essential package for Nutrition, access(economic,geographic). They understand the livelihood, seasonality issues, relating to food security (Nutrition Sensitive), as well as Health Systems issues, talking about Nutrition specific programme, but Community Leader champion does not have enough control of implementers. Areas of challenges with Community Leader champion need to be looked at for greater benefits in continuos with them.i suggest reorientation, linking nutrition with WASH,Education and other Development issues.

I am a Deputy Director,working with National Primary Health Care Development Agency .I coordinate Maternal, Newborn and Child Nutrition. I possess MSC in Human Nutrition and have attended a short course on transformation of ideas,policy in Nutrition in the Institute of Development studies in 2015.The areas of focus are on Infant and Young childfeeding, Maternal Nutrition,Micronutrient Nutrition, including Nutrition commodities and suppliestc. The champion(s) I work with are Community Leaders who have been trained in Community Mobilization for demanding, accessing and utilization of integrated Primary Health Care services,of which nutrition is one of the components. Community Leaders are knowledgeable about the members of the community, they work with the Community Development Committee. The Community Leaders have this uniqueness of knowing the community members, health workers, available nutrition services. They exert great influence on community members and are close to members of the community where they live and work, mainly the rural dwellers which represent above 70 percent of Nigerian population. They have been very effective in working closely with Mother - mother care group for early initiation(with-in 30 minutes) at delivery, exclusive breastfeeding, complementary feeding, adequate meals for maternal nutrition, especially Nutrition in pregnance.These Community Leader champions are effective,but fraught with challenges which includes: Integrated PHC rarelly provides all essential package for Nutrition, access(economic,geographic). They understand the livelihood, seasonality issues, relating to food security (Nutrition Sensitive), as well as Health Systems issues, talking about Nutrition specific programme, but Community Leader champion does not have enough control of implementers. Areas of challenges with Community Leader champion need to be looked at for greater benefits in continuos with them.i suggest reorientation, linking nutrition with WASH,Education and other Development issues.

As one of the founder members of Kenya's SUN Civil Society Alliance (SUN CSA), I acknowledge the role played by nutrition champions in steering the scaling up nutrition agenda forward. Important steps in Kenya made by SUN networks included identifying criteria for identifying nutrition champions, working with other stakeholders to identify the champions, building capacity of the champions to understand their role and to use their influence in society to drive the SUN agenda.

Key lessons I learnt included: With the right nutrition champions SUN messages can reach and have an impact among our target audiences; the champions need updates on latest developments in nutrition in order to be relevant in their work; the champions can make great strides through the media - hence empower them to understand and use the media, introduce them to the media and work with them to identify themes/issues to advocate when addressing the media; and recognise their efforts if possible during annual nutrition days.

Here are links relating to work with nutrition champions in Kenya: A blog article http://www.ennonline.net/fex/52/mediacoverageofnutritionkenya and workshop report https://www.dropbox.com/s/7xdlhblik47cxbd/County%20Nutrition%20Champions%20Workshop%202015.pdf?dl=0%3Chttps%3A%2F%2Fwww.dropbox.com%2Fs%2F7xdlhblik47cxbd%2FCounty+Nutrition+Champions+Workshop+2015.pdf%3Fdl%3D0%3E&oref=e

I am a registered nurse/midwife by profession, currently a serving Member of Parliament for Dedza East and I chair the Parliamentary committee on health in Malawi. I am a nutrition champion. I have taken on this task looking at how nutrition remains to be such a silent subject with limited visibility despite its strategic mandate and importance towards the development of this country. Progress so far, much as my role as champion entails need for more policy level interaction, I have seen some disconnect to take the subject further. As such I am putting more focus at grassroots level where action happens.  That way I have a relevant and hands on experience to share when advocating for nutrition in Malawi. I want to make a case study for the work I am doing. Hopefully those within the SUN Movement at country level could vigorously and in a coordinated manner take nutrition to a higher level. My message is simple, nutrition is a very easy subject and a mandate with no controversy, we should never be behind in advancing nutrition at any level. There are subjects where globally we have registered tremendous results within a short period of time eg. HIV/AIDS and sexual reproductive health and how did we do it.....we used young people who have the energy and the louder voice to demand and make a subject visible. Let young people be involved in this Sun Movement.

Thank you to everyone who has contributed their personal stories of either working with champions or championing nutrition themselves.

Edward Jusu – can you elaborate further on how the Sierra Leone Alliance Against Hunger and Malnutrition was formed and who was instrumental to the effort? Can you give any advice to others who see the potential for organised collective action within their country but are unsure where to start?

Esther Kimani – how can more champions at the community level be identified, engaged and supported to ensure changes at the national level and lessons learnt are shared within the community?

Irshad Danish – can you elaborate further on the key messages you shared with the parliamentarians you had identified? Were the messages tailored to the social and development issues they had previously worked on?

Chinwe Joy Ezeife – can you share any information about the strategy adopted by the National Primary Health Care Development Agency for training Community Leaders? How were the champions identified and engaged with, and how have they been supported throughout the programme?

Titus Mung'ou – can you elaborate further on the process you used for identifying criteria for identifying champions? Which other stakeholders were engaged in the process? What are the steps that you followed and how would you recommend others approached this type of process?

Juliana M. Lunguzi – can you share any lessons from focusing your efforts at the grassroots level? Have you been engaging community champions and how have these individuals/groups been identified? As an MP, what inspires you to champion nutrition and what would compel more MPs to champion the issues?
We look forward to hearing your responses!

General question for additional contributors: How can champions be identified at the community level? How can they been engaged and supported?

I am a technical officer, nutrition. I desire and have great passion in nutrition and giving smile to the vulnerable.I work with Ghana health service at the Nadowli district health directorate and as substantive nutrition officer in the nadowli District hospital for three years now.
having service in the purely public health domain sector at the health directorate in implementation of nutrition programmes as CMAM, IYCF ,Community based growth monitoring and promotions,Growth monitoring and promotions,Vitamin and micro- nutrients supplementation among others.It is realised from supervision and monitoring activities that , most community members don't see the above services as health services, hence the need to engage community members on education on self building capacity towards nutrition actions.
Besides that, most health workers(Community nurses, Medical assistant, enrolled nurses etc don't have enough knowledge on the nutrition actions , indicators and interpretation of conditions hence pay less attention to nutrition related issues among individuals.as such specialized short programs on nutrition intervention which award certification of recognition with simplify monitoring tools and guide will help.most health workers as well as policy makers don't have attention for nutrition because most services rendered by health workers to clients don't earn direct money as compare to other health problems.
most of the interventions such as community based growth monitoring and promotions , etc have short term financial support for sustainability of nutrition programs and clear data management for continual comparison or establishment of facts couple with government poor financial support for nutritional interventions and activities. which should be made vital in allocating funds for running of specific nutrition activities to championing it.
most health care services related nutritional related problems such as malnutrition which need hospitalisation have the challenge of care,stigma and expense cost associated with care as most people in such conditions are very poor ,hence diverting their problems onto most care providers where some will not see interest of working with such "vulnerable-dependent".So working with the social welfare and ministry of Gender , other bodies etcto absorb health cost of such person and build the skills of the parent(s) is might be of good way in the aspect of CMAM and NACS(HIV) clients.
In the hospital certain which mostly see curative as key, must be supported financially and humanly with resources to champion nutrition actions.Baby-friendly hospital initiative, selective programming on impatient care management of severe acute malnutrition, nutrition assessment and counseling support with standard monitoring tools development across African countries will strengthen nutrition actions.
awarding of community members , nurses, doctors etc in leading nutrition action ll bring as far.by that champions of nutrition ll be identify in the community and various health facilities and supported in upgrading their knowledge in nutrition actions per the hope or interventions given to individual by various community.e.g a n award for and identifying a champion by the number of CMAM case identify or cure.MAM, NANCS for HIV persons as well as quality IYCF care practices and counselling successfully given .
strengthening the poverty line of and engaging parents at home in seeking nutrition will scale up nutrition quicker.the establishment of house heads lead persons in nutrition will be of great joy.Back yard poultry, High personalities and religious bodies involvement will also be of help.
family size, agric,economic strength and work force should be related in nutrition intervention
hopes these may be of help.
thanks

A response from Charif Said:

Chinwe Joy Ezeife - can you share any information on the strategy adopted by the National Development Agency of primary health care for the training of community leaders?
In my capacity as community health specialist Comoros, at the School of Medicine and Public Health of the University of the Comoros: This idea, where it is explored.....those responsible for this project must work deeply within the culture of the intervention area. The people will play a leading role in all stages. It is advisable to use the languages or the vernacular of the intervention area. The approach will be a systemic approach.

A young qualified Nutritionist currently volunteering with the Office Of the President, Department of Nutrition in Malawi. https://www.herbion.com/pk/shop/health-care/