Dear anonymous,

thank you for your reflection, it is indeed critical to question how a method continues to be helpful for practitioners. The Link NCA is known to be a resource intense process but more intricate than you outline above. I would definitely disagree comparing it to an extended SMART as that would mean disregarding its immense qualitative component, which cross-sectional surveys do not tend to have. In fact, I have never seen a SMART survey, for example, that would answer questions and bring insights that a Link NCA does.

That aside, I think it is important to clarify what Link NCA actually can do. The Link NCA is a method that allows stakeholders to triangulate different data sources and to identify plausible determinants of undernutrition in a particular context in order to adapt the programmatic response to most critical issues. Multi-sectoral programmes addressing most determinants of malnutrition would cost billions of dollars while organisations may not have the required funding. And this is where a Link NCA can be helpful - showing them which areas should be prioritised for the biggest impact. If you will, Link NCA allows organisations to look systematically at available secondary evidence for a particular context, layer it with primary data sources to build a strong evidence base for decision-making. Link NCA does not pretend to be a silver bullet as there are limits to what it can and cannot do and those limits are often well explained in the study limitations. In addition, Link NCA may not be the most appropriate tool for certain settings and therefore other tools could be used instead. However, Link NCA is currently the most robust method in the sector to study nutrition determinants and stakeholders choose to invest in it if conditions (objectives + resources) are met. In addition, one of key strengths of the Link NCA (that no cross-sectional survey can beat) is its community engagement as only through in-depth consultations with community members we can really seize the issues that concern them and develop strategies to tackle them.

If you would like to learn more about a Link NCA or other available methods, please do reach out bilaterally. Nutrition Determinants Working Group is compiling a list of methods and tools to study nutrition determinants, which will (hopefully) soon be transformed into a thorough toolkit to guide practitioners. Stay tuned for updates in Q1/Q2 2025.

Dear anonymous,

It's also important to recognize that the approach of engaging with communities to understand the root causes of malnutrition aligns with the principles of localization and anti-colonialism by involving deeply the communities we serve.

The core principle of Community engagement led by the Link NCA methodology (and other methods also involving in depth qualitative assessment with communities) can appear time consuming but it is crucial for several reasons:

1. It leads to an accurate diagnosis as malnutrition can result from a complex interplay of factors which might not be apparent if time is not invested in discussion with the community.
2. The time invested in understanding a community perspectives will help in creating mutual respect, this has been particularly observed within certain religious group who have shared that they needed the organisation to spend time with them to be able to respect the project.
3. As we are involving the community members in identifying their own problems and reflecting in potential solutions, they become active participants rather than passive recipients of aid, this leads to more sustainable and effective interventions.
4. We know that nutrition outcomes are often affected by cultural norms and practices which can only be fully understood through in depth qualitative studies.

Hope you will agree with the value of the points raised above...