UNIVERSITY OF BOLTON

An Investigation of Nutrition Security Projects Implementation in Local Councils during Malawi Growth and Development Strategy II, the Case of Zomba District Council, Malawi

BY

NICHOLAS MWISAMA

SUBMITTED TO UNIVERSITY OF BOLTON (UK) IN PARTIAL FULFILMENT OF THE

REQUIREMENTS FOR THE AWARD OF MASTER OF PUBLIC ADMINISTRATION DEGREE

APRIL 2019

Art by YUMA Signs, Zomba, Malawi, instructed by Author

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Abstract

This paper is based on a research study with an aim to establish how decentralization

programme in the local councils of Malawi can promote implementation of nutrition

security projects. The study was carried out through a case study of Zomba district council

amidst a growing body of knowledge suggesting that stunted growth, caused by

malnutrition, especially among the under-five years children is a national crisis in the

country. Research evidence show that stunted growth deters mental and physical

development such that there is negative impact on ability to excel in school and other

physical activities hence unproductive human capital which is a recipe for slow economic

growth. The study focussed on the governance side of nutrition security projects having

noticed that there was little information to show how these projects were implemented.

Semi-structured questionnaire was used to collect data through focus group discussions

and in-depth interviews. Purposive sampling, coupled with snowball sampling, was used

to identify respondents and data was analysed through thematic area analysis.

It was disclosed, among other issues, that implementation of nutrition security projects in

the local councils was not using governance structures and there was no nutrition

component in the district development plan. Precisely, implementation of nutrition projects

in the council was found to be a sole responsibility of non-state actors.

The study recommends, among other measures, instituting a standalone ministry

responsible for nutrion affairs and early childhood development to put up a vibrant

coordination and implementation framework that will guide a holistic approach to the

crisis.

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Acknowledgement

First of all, the researcher would like to register profound and sincere gratitude to Ron

Smith at University of Bolton in the UK who was supervisor for this study. In particular,

Ron has been amazing with credible and time sensitive feedback throughout the study.

Alex Chanza who was local supervisor for the study also deserves extraordinary

recognition for providing rich and diverse feedback.

The researcher, also, wishes to submit with humility and gratitude to Rev. Bishop George

Tambala of The Catholic Diocese of Zomba for his support in many ways during the study.

The lecturers for the entire program, in particular, Prof. Mustaf Hussein, Dr. Rabecca

Ward and Chris Grant should receive gratitude for their great inspirations.

The Disctrict Commissioner for Zomba District Council, Mr. Emmanuel Bambe should

also be highly acknowledged for kindly approving that key staff in the disctict council

should participate in the study.

Finally the researcher is very thankful to all participants in the study; councillors for Zomba

District Council (2014-19), the council secretariat, departments of health, agriculture and

education under the council as well as non-governmental organizations which

participated.

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Declaration

I declare that: An Investigation of Nutrition Security Projects Implementation in

Local Councils during Malawi Growth and Development Strategy II, the Case of

Zomba District Council, Malawi is my own work with guidance from my supervisors and

that all sources of information and data have been well acknowledged and indicated with

complete referencing.

Nicholas Mwisama ………………………………………

STUDENT’S NAME SIGNATURE

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Dedication

To my beloved late mum, Efeta Naphiri Mwisama, the thesis is dedicated to you for being

a great and exceptional inspiration of my life through your unconditional love and

undivided commitment to raise and educate me over thick and thins of cultural barriers.

May your soul continue resting in eternal peace.

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Abbreviations and Acronyms

ADCs Area Development Committees

CDF Constituency Development Fund

DC District Commissioner

DDCs District Development Committees

DDP District Development Plan

DEC District Executive Committee

DNCC District Nutritioin Coordinating Committee

DNHA Department of Nutrition, HIV and AIDS

ECD Early Childhood Development

EU European Union

FGDs Focus Group Discussions

FUM Farmers Union of Malawi

GDP Gross Domestic Product

ICN International Conference on Nutrition

LDF Local Development Fund

LGFC Local Government Finance Committee

MEPD Ministry of Economic Planing and Development MGDS Malawi Growth Development Strategy

MP Member of Parliament

NACSMS Nutrition Advocacy Communication and Social Mobilization Strategy

NAP National Agriculture Policy

NCDs Non-Communicable Diseases

NGOs Non-Governmental Organization

NU Nutrition Affairs

OPC Office of President and Cabinet

PED Performance Enhancement Department

RE Research Ethics

SDGs Sustainable Development Goals

SNIC Support for Nutrition Improvement Component

SUN Scaling Up Nutrition

TOC Theoy of Change

UNGA United Nations General Assembly

VDCs Village Development Committees

ZAO Zomba Agriculture Office

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Table of Contents

Abstract ........................................................................................................................... ii

Acknowledgement .......................................................................................................... iii

Declaration ..................................................................................................................... iv

Dedication ....................................................................................................................... v

Abbreviations and Acronyms .......................................................................................... vi

Table of Contents .......................................................................................................... vii

LIST OF TABLES ............................................................................................................ x

LIST OF FIGURES .......................................................................................................... x

1.0 CHAPTER ONE: INTRODUCTION AND STUDY BACKGROUND .......................... 1

1.1 Introduction ............................................................................................................ 1

1.2 Study Background ................................................................................................. 1

1.3 Problem Statement ................................................................................................ 2

1.4 Significance of the Study ....................................................................................... 3

1.5 Research Purpose ................................................................................................. 3

1.6 Objectives .............................................................................................................. 3

1.7 Research Questions .............................................................................................. 4

1.8 Structure of the Paper ............................................................................................ 6

1.9 Summary of Chapter one ....................................................................................... 6

2.0 CHAPTER TWO: LITERATURE REVIEW ................................................................ 7

2.1 Introduction ............................................................................................................ 7

2.2 Decentralization Policy and Malawi’s Socio-economic Growth .............................. 8

2.3 Nutrition Security from Grobal perspective ............................................................ 9

2.3.1 Governance in Nutrition Interventions .................................................................. 11

2.4 Nutrition Security in Malawi ................................................................................. 13

2.5 Conceptual Underpinnings .................................................................................. 16

2.5.1 Theory of nutrition and education promotion ....................................................... 16

2.5.2 Theory of Change (TOC) ........................................................................................ 16

2.6 Gap in Knowledge ............................................................................................... 18

2.7 Conceptual framework ......................................................................................... 19

3.0 CHAPTER THREE: METHODOLOGY OF THE STUDY ......................................... 21

3.1 Introduction .......................................................................................................... 21

3.2 Research Philosophy ........................................................................................... 22

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3.3 Main Research Philosophies ............................................................................... 23

3.3.1 Positivism................................................................................................................... 23

3.3.2 Realism ...................................................................................................................... 24

3.3.3 Interpretivism............................................................................................................. 24

3.3.4 Pragmatism ............................................................................................................... 25

3.3 Research Approach ............................................................................................. 25

3.4 Research Method ................................................................................................ 26

3.5.1 Survey ........................................................................................................................ 28

3.5.2 Grounded Theory ..................................................................................................... 29

3.5.3 Case Study ................................................................................................................ 29

3.6 Time Horizon ....................................................................................................... 30

3.7 Technique and Procedures .................................................................................. 30

3.7.1 Data Analysis ............................................................................................................ 32

3.8 Interview Questions and Justification ................................................................... 33

3.9 Sampling and Sample Size .................................................................................. 33

3.10 Research Ethics ................................................................................................. 37

3.11 Limitations of Research Method Used ............................................................... 38

3.12 Summary of Chapter Three ............................................................................... 39

4.0 CHAPTER FOUR: RESEARCH FINDINGS AND DISCUSSION OF FINDINGS .... 40

4.1 Introduction .......................................................................................................... 40

4.2 Findings ............................................................................................................... 40

4.2.3 Detailed Findings ...................................................................................................... 49

4.2.1 Stakeholder understanding on linkages between decentralization program .. 49

and implementation of nutrition projects ......................................................................... 49

4.2.2 Factors affecting implementation of nutrition projects .................................... 51

4.2.3 Community participation in nutrition security programming and ................... 53

productivity .......................................................................................................................... 53

4.2.4 Gaps in decentralization program affecting sustainable nutrition security .. 54

4.3 Discussion of research findings ........................................................................... 56

4.4 Summary of Chapter Four ................................................................................... 62

CHAPTER FIVE: CONCLUSIONS AND RECOMMENDATIONS ................................. 64

5.1 Introduction .......................................................................................................... 64

5.2 Conclusions ......................................................................................................... 65

5.3 Recommendations ............................................................................................... 67

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5.4 Study limitations ................................................................................................... 68

5.5 Areas proposed for further research .................................................................... 69

References .................................................................................................................... 70

Appendices ................................................................................................................... 77

FGDs transcripts ........................................................................................................ 77

Consent form ............................................................................................................. 91

Research Ethics Checklist ......................................................................................... 92

A photo during one of the FGD sessions ................................................................... 94

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LIST OF TABLES Page Table 1: Checklist for FGDs Interviews 35

Table 2: Sampled key projects staff for In-depth interviews 36

Table 3: FGDs Data Analysis 41

Table 4: In-depth Interviews Data Analysis 44

LIST OF FIGURES Page

Figure 1: Global Nutrition targets and targetted NDCs 10

Figure 2: Kenya’s Nutrition Advocacy Communication and 12

Social Mobilization Strategy

Figure 3: Concept Framework 19

Figure 4: The Research Onion 23

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1.0 CHAPTER ONE: INTRODUCTION AND STUDY BACKGROUND

1.1 Introduction

This study sought after establishing how Decentralization policy powered by Local

Government Act of 1998 can promote implementation of nutrition security projects in the local

councils of Malawi through a case study of Zomba district council during Malawi Development

Strategy phase two which ran from 2011 to 2016. The study came at a time when stunted

growth due to malnutrition was at a high prevalence rate of 41% (USAID, 2014). The Local

Government Act is popularly known as the Decentralization Act hence in this report these

terms will be used interchangeably.

Therefore, this chapter, dwells on background of malnutrition and stunted growth levels in

Malawi and how it links to decentralization, problem statement of the study, objectives of the

study, research questions, significance of the study and structure of this paper.

1.2 Study Background

Malawi as a country, relies on agriculture sector as a key driver of economic growth since the

dawn of independence in the mid-60s. According to Farmers Union of Malawi (FUM) (2018)

and Wood et al (2013), agriculture sector contributes to 30% of the country’s Gross Domestic

Product (GDP). Since independence, government priority was on agriculture production for

industry development (OPC, 1987). Consequently, agriculture production focused on tobacco

and maize production for industry and food security respectively, and this was at the expense

of nutritious food production through livestock, legumes and other nutritious food items.

When non-state actors on nutrition found their way into public discourse following change of

regime, they proceeded advancing malnutrition as a key issue for government policy

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direction. Research studies were conducted and papers presented on stunted growth due to

malnutrition in terms of causes and effects until government adopted nutrition into its policy

framework. Hence the decentralization policy from Decentralization Act of 1998 recognized

nutrition security as one of the proponents of socio-economic growth in the country.

Therefore, nutrition interventions would be effected through decentralization structures in

local councils where citizens’ participation in decision making on issues affecting their lives

was guaranteed. FAO (2015) and UNSCN (2014) contend that countries focusing on nutrition

security register notable economic growth. However, a number of research studies including

USAID (2014), European Commission (2018) and WFP (2015) established that nutrition

insecurity is very high in Malawi such that half of under-five years children and at worst 54%

of under-two years children were stunted. Pollitt et al (in Bhargava, 2014) and Barker (in

Wood et al, 2013) found out that stunted growth prevents mental and physical development.

Hence a fertile environment for unproductive human capital.

1.3 Problem Statement

Nutrition insecurity, also referred to as malnutrition, is one of the outstanding challenges

draining more than 10% of GDP (WFP, 2015). OPC (2007) states that malnutrition causes

most of the deaths in the country. Signs of chronic under nutrition resulting into stunted growth

are very common in Malawi (WHO & UNICEF, 2009). MoAFS (2010) established that stunted

growth prevalence rate was above 43% while USAID (2014) European Commission (2018)

pointed that the rate was at 41%. It is not surprising, therefore, that the country’s nutrition

policy documents of 2007-12 and 2018-22 describe malnutrition as a national crisis, and the

Malawi Growth Development Strategy (MGDS) III (2017-22) recognizes it as an issue which

requires urgent action.

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Different programmes and interventions have been designed and implemented based on

research findings on preventive and curative aspects of malnutrition but stunted growth still

remains high according to research evidence presented earlier. It is common knowledge

traced back to mid-60s that government looks at nutrition and food security as one thing.

However, IFPRI (2015) and Smith et al (2003) revealed that malnutrition cases in Malawi are

mainly due to household food utilization. Engel (2014) wondered whether malnutrition cases

were common due to gaps in knowledge or in implementation of known solutions. Therefore

the researcher developed ontological and epistemological assumptions around

implementation of nutrition security projects where issues of governance are key hence this

study.

1.4 Significance of the Study

The study stands to contribute to knowledge at national policy making level where

malnutrition cases can be minimized through governance and implementation frameworks

which are being investigated. With malnutrition cases minimized, prevalence rate for stunted

growth is expected to drop and the nation will be assured of building a mentally and physically

fit generation which is key to socio-economic growth.

1.5 Research Purpose

The main purpose of this study was to establish effective and efficient approach to

implementation of nutrition security projects in the local councils of Malawi through existing

structures created by policy documents.

1.6 Objectives

The following were the research objectives;

i. To establish the understanding of key stakeholders regarding the role and benefits

of decentralization program in achieving ideal nutrition security

ii. To identify factors affecting implementation of nutrition security projects

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iii. To determine community participation in nutrition security programming and

productivity

iv. To establish gaps in decentralization program affecting sustainable nutrition

security for an improved programming content

1.7 Research Questions

Based on the research purpose and objectives, the research study was pursued through

the following key questions;

i. In relation to implementation of nutrition security projects, what is your view on

the decentralization program which the district council is empowered to

implement through the Decentralization Act of 1998?

ii. What are the factors affecting implementation of nutrition security projects?

iii. How do you rate awareness and participation of Zomba district communities

regarding nutrition security projects especially during MGDSII?

iv. What could you change at planning level and in the community to achieve higher

rate of awareness and participation in implementation of nutrition security

projects?

v. What is your perception towards decentralization program in promoting nutrition

security in communities under the council?

vi. How can the council achieve nutrition security and sustain it?

These questions pulled out diverse issues such that the study will contribute to knowledge

clearly, as indicated earlier, by demonstrating that effectiveness and efficiency in dealing with

malnutrition to minimize stunted growth cases in the country can be achieved using existing

policy frameworks with structural reforms focussing on the governance side of nutrition

interventions.

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1.8 Structure of the Paper

This thesis is arranged in five chapters. Chapter one introduces the reader to the key issues

being pursued in the study before presenting study background. Further, the chapter covers

research problem, significance of the study, research purpose,research objectives, research

questions, structure of the thesis and finally a section summarizing the chapter.

Chapter two covers a detailed literature review on the subject matter being investigated in

the study. The review includes a critical look at Decentralization policy in relation to Malawi’s

socio-economic growth, nutrition security from grobal perspective, governance in nutrition

interventions and nutrition security in Malawi. Two theories that underpinned this study are

also presented after the literature review section and at the end a concept framework

projecting on the overall assumptions of the study is presented.

Chapter three discusses research philosophy, research approach, research method, and

research strategy where various options along these units have been analysed before settling

for one option with a justification. Time horizon indicating the applicable time frame for this

study has been discussed. Technique and procedures which includes data analysis model

have also been covered. Furthermore, sampling and sample size, research ethics and

limitations of research method used have been presented before a summary section for the

chapter.

Chapter four pulls out study findings. In addition, the chapter analyses and interprets the

findings.

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Chapter five presents conclusion of the paper with key issues of the findings. The chapter

makes recommendations based on the findings and then study limits are highlighted before

winding up with proposed areas for further studies.

1.9 Summary of Chapter one

The chapter has introduced the reader to the main issue being pursued in the study before

presenting the outline of the chapter. Among the key issues discussed in this chapter are

background to the study and problem statement where issues leading to conducting this

study have been exposed and justified with research evidence. The following chapter looks

at literature review on the subject matter where a clear gap in knowledge is established

thereby justifying the need for this study.

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2.0 CHAPTER TWO: LITERATURE REVIEW

2.1 Introduction

The main aim of this research study was to establish viable approach and strategies in

achieving effective and efficient implementation of nutrition security projects under the district

councils of Malawi through a case study of Zomba district council. The researcher was

interested to appreciate the linkages between implementation of nutrition security projects

under the council in line with decentralization policy which was rolled out following enactment

of Local Government or Decentralization Act of 1998. The Policy of the Act highlights among

other key issues the implementation of nutrition security projects as a catalyst for economic

development. This chapter, therefore, looks at what other scholars have established on the

subject matter through review of secondary data in forms of books, academic journals,

websites, magazines, working papers, policy documents and implementation frameworks

before the researcher proceeds with primary data collection from targetted institution. This is

a literature review stage which is integral to any scientific research. Onwuegbuzie et al (2012)

underscores that literature review represents the most important stage of research study

because among other key issues, it leads to a clear distinction between what has been

studied before and what needs to be studied, identifies variables applicable to the study, and

establishes contradictions, inconsistences and gaps in the area of interest. In qualitative

research, literature review mainly helps to identify knowledge gaps and justify the need for

research while in quantitative research it mainly helps to develop research questions

(Creswell & Plano Clark, 2007). This explains why qualitative research may have a brief

literature review as opposed to quantitative research.

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In particular, this chapter will cover existing literature on ideal governance of nutrition projects

implementation in the local councils of Malawi, nutrition security from global perspective

focussing on governance and the real situation on governance of nutrition security projects

in the local councils.

2.2 Decentralization Policy and Malawi’s Socio-economic Growth

The adoption of decentralization policy in 1998 by the government of Malawi was widely

regarded as a game changer in terms of paradigm shift from top-down to bottom-up approach

towards public service delivery especially in the agriculture sector which is the main stay of

the country’s economy and a key sector advancing food and nutrition security. Hussein (2013

and 2017) reveal that decentralization entails involvement of the citizenry in decision making

by the central government, and as stipulated in the Decentralization Act (1998), local councils

would be at the centre of implementation following devolution of powers from the central

government. Hussein (2005), established that sustainable economic growth links positively

with citizen participation facilitated by government hence the agriculture sector was one of

the sectors which pioneered implementation of the decentralization policy. However, Chiweza

(2010) established that implementation of nutrition security projects under the agriculture

sector still remained under central government control. Meanwhile, more than 10% of

Malawi’s GDP continued to be spent due to malnutrition (WFP, 2015). According to National

Multi-sector Nutrition Policy of 2018-22, malnutrition is mainly understood as a mismatch of

food intake to body dietary needs. The policy acknowledges that malnutrition has negative

impact on physical and mental development of under five years aged children. Also, Pollitt et

al (in Bhargava, 2014) and Barker (in Wood et al, 2013) argue that malnutrition affect both

physical and mental development from human conception and this deters social and

intellectual development. It is well documented regarding causes of malnutrition, which in

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most cases is discussed in terms of under-nutrition due to its significant negative impact, that

there are immediate causes, underlying causes and basic causes. These include lack of food

and proper breast feeding for immediate causes, lack of hygiene, water and sanitation for

underlying causes, and incoherent policy frameworks for basic causes (Nutrition Policy,

2007-12 and 2018-22).

2.3 Nutrition Security from Grobal perspective

The UN General Assembly (UNGA) of 2015 had one of the key resolutions to put in place

sustainable food systems that will promote nutrition security, thus, member states were

challenged to prioritize nutrition interventions (Branca et al, 2017). This was against a

background of alarming prevalence rate in stunted growth where 155 million children of

under-five years and 640 million adults were malnuorished. GIZ (2017) states that about 800

million people in the world are undernourished and 2 billion people suffer from malnutrition

globally. The Global Panel on Food Systems for Agriculture and Nutrition 2016 (in Hawkes,

2017) also reveals that millions of peole in the world are challenged in terms of their physical

and health growth. In Europe, European Union (EU) member states formulated an

implementation plan which aimed at dealing with high prevalence rate of malnutrition through

prioritizing among other key thematic areas; enhancing political and policy dialogue and

identifying viable interventions (Lein, 2013). The International Conference on Nutrition (ICN2)

of 2014 (in Branca et al, 2017) strongly recommended countries to come up with effective

implementation plans in a bid to achieve six nutrition targets which includes 40% reduction in

stunted growth for children under five years of age, and deal with three diet-related

noncommunicable diseases (NCDs) targets by 2025. The figure 1 below shows a summary

of adopted global nutrition targets and the targetted three NDCs.

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Source: Adopted from Branca et al, (2017) and extracted from https://ecdpm.org/great-

insights/sustainable-food-systems/sustainable-food-systems-who-nutrition

Nonetheless, it has been established by a number of studies (Lein, 2013; Engel, 2014;

Hawkes, 2017; Mugambi et al, 2017; Nutrition Policy, 2007-12) that countries continue to

struggle in making anticipated strides in the fight against malnutrition. For example, Engel

(2014) refers to the situation in Netherlands and wonders whether the absence of meaningful

progress in addressing malnutrition is due to lack of nutrition knowledge or faulty

implementation of known solutions. According to Hawkes (2017), one of the key barriers to

winning the fight is lack of evidence-based policies. In Zambia, for example, it was noted that

government was concentrating on production of maize at the expense of other diverse dietary

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food products. In Kenya, according to Engel (2014), nutrition remains one of the biggest

threats to realize the country’s vision by 2030 in accordance with Kenya Constitution which

prescribes the right to basic nutrition for all children. However, it is worthy noting that Kenya

registered significant progress in terms of reducing stunted growth for under five children from

35% in 2009 to 26% in 2014 although 1 in 4 children remained malnourished (Engel, 2014).

This success is attributed to how they planned and executed implementation of nutrition

interventions and reviewed for further programming through a multi-sectoral approach which

ensured that there was a strong political will.

2.3.1 Governance in Nutrition Interventions

There is an increasing body of knowledge which is pointing to many countries in the world

realizing that nutrition is a cross-cutting issue and it requires strong coordination (Nutrition

Policy 2018-22). Nutrition security is a broad and complex issue which can only be dealt

through a holistic approach by means of specific targets such that business as usual could

yield little or no results (Mugambi et al, 2017; Ngwenya, 2015; FAO,2015). However,

implementation and coordination of nutrition interventions vary from one community to

another, from one country to another and from region to another because of geographic,

demographic, economic and political frameworks which create different institutional

environments (Engel, 2014). Therefore an in-depth analysis of implementing institutions is

important to establish weak links in the implementation frameworks. In the case of a notable

success story of Kenya as earlier discussed, Mugambi et al (2017) highlight on nutrition

advocacy communication and social mobilization strategy which was developed to facilitate

institutional coordination. Branca et al (2014) also recommend the need to strengthen

communication in the governance as well as implementation and coordination structures.

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The figure 2 below shows Kenya’s Nutrition Advocacy Communication and Social

Mobilization Strategy which can be adopted to enhance implementation and coordination

activities.

Source: Kenya Nutrition Advocacy Communication and Social Mobilization Strategy 2016-2026

This model puts emphasis on 3 strategic pillars of governance, capacity to deliver, and behaviour

and practices. It follows that an institution in the implementation of nutrition security projects

ought to collaborate well through these pillars in order to deliver.

In Malawi, there are a number of stakeholders implementing nutrition security projects which

includes the government as a key stakeholder through the Ministry of Agriculture and other

concerned ministries. Linking to the issue of governance, there are clear implementation

frameworks in all line ministries guided by different Acts and policies. The Decentralization

Act (1998) which was operationalized through decentralization policy (1998) is clear in terms

of how central government would proceed with implementation and coordination of various

projects through district or local councils. It puts much emphasis on citizen participation at all

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decision making levels, although Reddy (2015) reveals that smallholder farmers have no

voice in the production value chain. Thus, they are never given a voice at any level of decision

making hence implementation of nutrition related interventions are dragging.

2.4 Nutrition Security in Malawi

Like the G20 member countries according to FAO (2015) and UNSCN (2014), the constitution

of Malawi also recognizes the importance of nutrition in the socio-economic development of

the nation. Chapter IV section 13 (b) states; “The state shall actively promote the welfare and

development of the people of Malawi by progressively adopting and implementing policies

and legislation aimed at achieving adequate nutrition for all in order to promote good health

and self-sufficiency.” By the same token, both of the main policy documents in nutrition

security of the country acknowledge that malnutrition is a silent crisis at national level

(Nutrition Policies 2007-12 and 2018-22). A number of studies reveal that nutrition challenges

in the country contribute to high levels of stunted growth. According to USAID (2014) and

European Commission (2018), stunted growth for under five children in Malawi is at 41%.

This is one of the most pressing areas for effective policy intervention because there are

enduring effects of stunted growth in children. The Office of President and Cabinet – OPC

(2011) accepts that stunted growth in children has negative impact in mental and physical

development. Thus, nutrition insecurity or malnutrition is one of the exceptional challenges

Malawi government is struggling with. According to OPC (2007), malnutrition is accountable

to most of the deaths among various population groups in the country. This can be described

as a fertile environment for drastic drop in human development index. On the one hand, the

MGDS II (2011-16) aimed to improve the human development index among other key

strategic goals through scaling up implementation of nutrition security projects and on the

other MoAFS (2011), describes prevailing nutrition insecurity as a hidden hunger which

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deters the country’s economic development. One of the districts with higher prevalence rate

in stunted growth is Ntchisi with an average rate of 53 % (WFP, 2013). The situation requires

nutrition specific interventions urgently. In Zomba district, stunted growth is considerably high

from 52% in 2006 (Nutrition Policy 2007-12). It is argued that the situation in Malawi is

contributed by policies that do not focus on productivity and production of nutritious foods

although government identifies nutrition security as an important component in social

economic development of the country (UNSCN, 2014). However, IFPRI (2018) demonstrates

that nutrition security is beyond production because having enough food does not translate

into sound nutrition. Issues of hygiene, water and sanitation which are referred to as

underlying factors also contribute to malnutrition as indicated earlier. IFPRI (2015) and Smith

et al (2003) argue that food utilization is the most important aspect of household nutrition,

subsequently the National Agriculture Policy (NAP) (2016) recommends nutrition education

on food utilization as one of the key priorities for government. Further, Fan (2017) argues that

food loss and wastage is key to end undernutrition by 2025 especially in the Sub-Saharan

region where the loss and wastage have significant implications on household income and

nutrition. According to Mphwanthe et al (2016), 25% of food served to children in Malawi is

wasted and this leads to 23% loss of energy and micronutrients. It is stimulating to note that

the National Agriculture Policy (NAP) of 2016 points out the need to streamline nutrition

education in order to register meaningful progress. These are clear indicators begging for a

comprehensive and robust nutrition security implementation framework where nutrition

education and communication to the general public form key priorities alongside strong

political will and capacity building.

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It is important to note that the current Nutrition Policy (2018-22) points to a comprehensive

approach towards implementation of interventions. Among other key issues, it recommends

streamlining multi-sectoral approach having realized that nutrition has many faces but the

policy is short of a clear implementation framework. It is only referring to implementation

frameworks of line ministries some of which put nutrition interventions in the peripherals of

their projects. Although MGDS II (2011-16) and MGDS III (2017-22), highlight nutrition

security as one of the interventions to propel economic growth and one of the priority areas,

again there is no clear or tailor-made implementation framework considering that nutrition is

a national crisis. Nevertheless, both documents Nutrition Policy (2018-22) and MGDS II

recognize the use of local structures, as stipulated in decentralization policy, such as District

Nutrition Coordination Committees (DNCCs) which will work closely with community

structures to coordinate implementation. However, it should be pointed that policy documents

are available and implementation structures are also available, for example, through local

councils but there is almost no literature indicating how effective and efficient these structures

are in dealing with nutrition security.

Thus, governance issues towards implementation of nutrition security projects have not been

explored enough to appreciate how policy documents and frameworks on the issue are being

translated on the ground. For example, FAO (2015); USAID (2014); European Commission

(2018); IFPRI (2018); IFPRI (2015); Smith et al (2003) and Fan (2017) referred to earlier,

offer a wonderful causal explanation on high prevalence rate of stunted growth but with no

substantial reference in terms of implications due to governance aspects. WFP (2013);

UNSCN (2014) and Mphwanthe et al (2016) focussed on stunted growth prevalence rate

statistics, the demographic impact and food nutrient loss statistics respectively. These studies

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present clear statistics while suggesting implicitly that methodological approaches and

strategies in the studies did not give room to explore issues behind the figures. Therefore, in

all these studies there is no clear direction touching on governance part of nutrition security

projects especially on implementation. Hence this study comes at an opportune time.

2.5 Conceptual Underpinnings

This study is guided by two theories, namely; theory of nutrition education and promotion,

and theory of change.

2.5.1 Theory of nutrition and education promotion

This theory looks at a holistic view of food and nutrition dynamics where food quality and

quantity form key components to achieve intended results and, in 2005, this theory led to

enactment of Food Education Basic Law in Japan which is popularly known as “The Basic

Law on Shokuiku,” (Adachi, 2008). The law defines Shokuiku as acquisition of knowledge

about food as well as the ability to make appropriate food choices. Adachi (2018) explains

that Shokuiku is a Japaneses term for food education, and metions that following the basic

law on shokuiku, nutrition education program was introduced in schools where quality and

quantity of various foods necessary for body needs are key modules.

2.5.2 Theory of Change (TOC)

The theory focusses on developing, managing and evaluating interventions (Mayne, 2015).

According to Project Oracle (2014), TOC articulates how to achieve project aim and

assumptions involved, and describes and explains project impact from beneficiary point of

view. Thus, TOC is interested in effective and effecient planning and implementation of

projects or interventions.

17

2.6 Implications and Assumptions

These two theories connect directly to ontological and epistemological assumptions of this

study in a sense that existing literature on implementation of nutrition security projects in the

local councils of Malawi suggest that the gaps ought to be tackled through adopting a model

and identify technical tools to implement the model. In other words, the theory of nutrition

education and promotion can contribute to addressing prevailing knowledge gap by means

of TOC. According to Mayne (2015), TOC prescribes the following technical tools;

i. Designing/Planning Interventions

- Understanding and agreeing on interventions with stakeholders

- Identifying and addressing equity, gender, and empowerment issues

- Ex ante evaluation of proposed interventions

ii. Managing Interventions

- Designing monitoring systems

- Understanding implementation, managing adaptively and learning

iii. Assessing Interventions

- Designing evaluation questions, methods, and tools

- Making causal claims about impact

- Reporting performance

iv. Scaling

- Generalizing to the theory, to other locations and for scaling up and out

The model of technical tools discussed above was adopted from Mayne, J. (2015) Useful Theory of Change models. Canadian Journal of program evaluation, (30), 2, pp142

18

2.7 Gap in Knowledge

There is abundant knowledge suggesting that nutrition links positively to socio-economic

development of any country in the world. This is why world leaders continue to put in place

measures to address undernutrition which is the main cause of stunted growth leading into

deterred physical and intellectual development. Fan (2017) reveals that the international

community has agreed to put nutrition target 12.3 on Sustainable Developmt Goals (SDGs)

with focus on food loss and wastage by 2030. In Sub-Saharan region, stunted growth due to

undernutrition account for a large population. In particular, as established in this literature

review, studies show that Malawi prevails at 41%.

There are various factors leading to undernutrition and they differ from one region to another,

country to another and community to another. Literature reveal that among key issues

contributing to stunted growth in the country are lack of nutrition knowledge and also lack of

coherent implementation frameworks, thus, effectively suggesting that governance issues

surrounging nutrition security projects are key to malnutrition fight hence the need for depth

understanding. It is not necessarily due to the absence of nutritious food. The revelation of

these gaps in knowledge prompted the researcher to undertake the study which proceeded

from existing policy documents on the subject matter.

Thefore, the concept framework below presuposes a structual or governance model on how

nutrition knowledge gaps can be addressed in terms of institutions, processes and tools that

can be used to achieve intended results. Having established that malnutrition as a cause of

stunted growth is a national crisis in the country, the proposed structural model in the concept

framework focuses on structures and tools from national level to communities.

19

Central

Government

Local councils forming

nutrition technical

working groups

Ministry forming

national team of

technical experts

Formulating nutrition

education and

promotion strategy

Designing customized

implementation

framework

Devolving powers to manage nutrition at

local councils through standalone

ministry

-Dissemination and orientation of strategy

and framework in local councils by national

technical team

- Setting aims and objectives, and drawing

action plan by local councils

-Submission of budget estimates by local

councils

-Review

-Impact Evaluation

-Scaling up

Activity Monitoring

& Evaluation Reporting

IMPLEMENTATION

Comprehensive Report to

Central Government and

copy to Ministry of Nutrition

Affairs and Early Childhood

Development for policy

review

2.8 Conceptual framework

This study presuposes a conceptual framework which is presented in the figure 3 below.

20

The above concept framework proposes a model of tackling implementation of nutrition

security projects in the local councils of Malawi guided by the two theories underpinning this

study.

2.8 Summary of Chapter Two

This chapter has covered key issues that have shaped a definite direction for this study. In

particular, the chapter has presented and discussed the available literature on the issue of

nutrition security project implementation from global perspective to the local context. This

chapter has established that malnutrition is not only a local problem but also a global concern

affecting socio-economic development of countries. The international community is putting in

place measures through a multi-sectoral approach to decrease undernutrition cases which

cause stunted growth leading into enduring effects on human development. As a country,

Malawi recognises that stunted growth due to malnutrition has reached a crisis level hence

putting in place policies to guide interventions through a number of structures.

However, the chapter has unearthed that among the key gaps that needs to be addressed in

the fight against stunted growth in Malawi connects directly to governance issues on

implementation such as lack of nutrition knowledge and effective implementation frame

works. Therefore, this study offers to establish details and depth of the phenomenon so that

recommendations can be drawn to facilitate solutions. The study is underpinned by the theory

of nutrition education and promotion, and the theory of change through which a conceptual

framework has been drawn to provide an overrall strategic picture of the study.

21

3.0 CHAPTER THREE: METHODOLOGY OF THE STUDY

3.1 Introduction

This study aims to arrive at effective and efficient approaches in the implementation of

nutrition security projects in line with decentralization policy in the local councils of Malawi.

Thus, this chapter centres on how data collection for the study was structured and executed

thereby demonstrating validity and reliability of the study findings.

Research scientists have mixed views regarding research methods and designs hence some

apply them interchangeably. Bryman & Bell (2007) show that research method is how a

research study is conducted in terms of data collection while research design represents a

structure to guide how the entire research will be conducted from data collection to analysis.

This forms part of primary research methodology while some general issues such as sample

size, sampling and others form secondary part of methodology (Thomas, 2013). Methodology

is defined as “more about attitude to and your understanding of research and the strategy

you choose to answer research questions,” (Greeners, 2008 :10). Bryman & Bell (2007)

simplifies it as a techinique for data colletion and Sarantakos (2012) breaks it into pieces as

a way through which a researcher makes sense of what is being investigated.

Therefore, under this chapter, the researcher discusses research methodology according to

research onion steps as recommended by Saunders et al (2009). The researcher will only

consider widely used steps of the research onion and adopt steps that are suitable for this

study. Consequently, the researcher will demonstrate exposure to key modules which are

considered in a research study and subsequently present justification for adopting a particular

module in the study process. Saunders et al (2009) recommends that a researcher should

adopt the best step to use in a research after discussing the other alternative steps to avoid

22

a crash with own beliefs and assumptions. Therefore the researcher will discuss and adopt

best steps guided by ontological and epistemological assumptions for this study. According

to Ali & Birley (1998) and Saunders et al (2009), Ontology refers to what is considered as

real and can be studied while epistemology regards acceptable knowledge in a study.

3.2 Research Philosophy

Research philosophy, sometimes referred to, as research paradigm is widely difined as “a

fixed set of assumptions about the way inquiry should be conducted,” according to Kuhn (in

Thomas, 2013). It is imperative to take note why a philosophy or paradigm is significant in

scientific research studies such as this. Leech & Onwuegbuzie (2009) and Robson (2011)

argue that research philosophy helps to guide the researcher on what specific tools and

approaches to use in conducting a study. Thus, it is research philosophy preferred, influenced

by research ontological and epistemological assumptions, which determines the researcher’s

approach whether to attach or detach from the research process in terms of being subjective

or objective (Onwuegbuzie et al, 2012). Therefore, it is noteworthy, that some research

studies may combine both approaches at different times or at the same time depending on

needs and design (Davies 2007). The researcher will discuss more on approaches later in

this report.

Figure 4 below is a reseach onion adopted from Saunders et al (2009). Among other steps,

the onion presents tools and approaches for different reseach philosophies. As indicated

earlier, the researcher will discuss key steps before adopting a step which will be applied in

this study.

23

The Research Onion

The research ‘onion’ Source: Saunders et al (2009)

3.3 Main Research Philosophies

The figure 4 above shows that there are four main research philosophies which researchers

use based on study design. These are positivism, realism, interpretivism and pragmatism.

3.3.1 Positivism

Postivism describes the nature of reality as independent of human behaviour such that reality

exists regardless of human knowledge (Collins &Hussey 2003). In other clear terms, reality

cannot be affected by human behaviour. This suggests that ontological and epistemological

assumptions for this philosophy point to reality and acceptable knowledge as independent

from researcher. Therefore, a research study with postivism philosophy is described as an

24

objective research because the researcher’s beliefs and behaviour are detached from it. This

is quantitative research which seeks to test existing theory to add on it or challenge it, and

uses large amount of data to extraporate findings to the general population (Biernacki &

Waldorf, 1981).

3.3.2 Realism

This philosophy argues that reality exists and takes place in the real world which is outside

situations and laboratories (Robson 2011). It advocates that reality is independent of human

experiences. Saunders et al., (2009:114) difines experiences as “sensations, the images of

the things in the real world, not the things directly.” This is a similar view with positivism i.e.

regarding reality as objective.

3.3.3 Interpretivism

Interpretivism stands in sharp contrast with positivism. In fact, these two philosophies are

exclusive of each other. Saunders et al., (2012) shows that interpretivism advocates study of

reality through objects and phenomena in their natural environment. Hence, reality can be

fully captured by not only studying objects but also by understanding the environment in which

the objects exist, therefore, can be affected by human beliefs and behaviour. This is a clear

indicator that interpretivism is subjective in nature. Weber (in Bryman & Bell, 2007) contends

that interpretivism philosophy guides the researcher to understand fully the causal

explanation of situations. In other words, interpretivism helps the researcher to explore and

explain depth of a phenomenon by means of reference to human behaviour towards a similar

phenomenon. It is therefore qualitative. Biernacki & Waldorf (1981), Glaser (1978) and

Strauss (1967) reveal that qualitative studies are shy of a big sample size because few people

would have knowledge in what is being investigated, and that the purpose of qualitative

studies is to build a theory and not to test it.

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3.3.4 Pragmatism

This philosophy can be described as a care-free ride. It projects that there are multiple ways

to study and arrive at reality such that researchers can freely design a study and offer an

interpretation to reality without being chained by philosophies (Suanders et al., 2012).

According to Robson (2011), pragmatism is action centred and does not consider philosophy

as a big thing in a reseach study. It “prefers action to philosophizing. It is, in a sense an anti-

philosophy,” Johnson & Onwuegbuzie (in Robson 2011:28). Nonetheless, Robson (2011)

strongly argues that pragmatism is but impatient because a good research study ought to

model itself on accepted theories.

Therefore, the researcher opts for interpretivism philosophy for the sake of this study because

it is qualitative and offers an opportunity to explore and explain. The researcher seeks to

establish how nutrition security projects are being implemented under Zomba district council

and, explore existing gaps and explain their reasons. According to Saunders et al (2012),

interpretivism philosophy is suitable for research studies that seeks to establish depth of a

phenomenon. Also, as earlier discussed, this study does not intend to test a hypothesis or

theory, rather, it seeks to build on a theory that can help in understanding and predicting on

the phenomenon under study.

3.3 Research Approach

There are three research approaches presented in the Saunders’ research onion. These are

deduction, induction and abduction. However, deduction and induction are main approaches

widely used by many researchers. Abduction approach is associated with discovery of new

things or seeks to explain surprising phenomenon, and may connect well with grounded

theory research strategy, therefore opposed to case study and other strategies (Robson

26

2011). According to Ochis (1998), abduction cannot be treated as a traditional and classical

means of drawing conclusions, rather it is a method not yet fully accepted into formal logic.

Deductive approach is largely associated with quantitative research studies because they

involve large amounts of data through surveys and experiments, and their conclusions are

extrapolated to the general population (Biernacki & Waldorf, 1981). Unlike deductive

approach, inductive approach is aligned to qualitative research studies because they can

make conclusion using smaller amounts of data and does not seek to project conclusions

onto the general population (Straus, 1967). According to Creswell & Plano Clark (2007),

qualitatative research gather data through observation, interviews and document analysis.

Trochim (in soiferman, 2010), argues that inductive approach moves from specific to general

while deductive approach begins from the general and ends with the specific. Trochim further

contends that arguments based on experience and observation are inductive in nature while

those based on laws, rules or other widely accepted principles are deductive in nature.

In this study, the researcher settles for inductive approach because the study is qualitative in

nature as it seeks to establish depth of the issue being investigated. Also, the study does not

use large amount of sample to impose the conclusions on the general population. Thus, the

study aims not to negate or affirm a theory, rather it seeks to contribute to knowledge and

therefore building a theory regarding the subject matter in a given environment.

3.4 Research Method

As argued earlier by Bryman & Bell (2007) that research method is how a research study is

conducted in terms of data collection, Saunders et al (2009) in the research onion shows that

there are a number of methodological choices such as mono-method qualitative, multi-

27

method qualitative, mono-method quantitative, multi-method quantitative, mixed methods

and etc. The term multi-method refers to “the mixing of methods by combining two or more

qualitative methods in a single research study or by using two or more quantitative methods

in a single research study" Hesse-Biber (2010). It follows that mono-method and multi-

method qualitative involve use of single method and a number of methods respectively in a

single qualitative study.

Therefore, this study adopts mono-method qualitative by means of interviews through in-

depth sessions and Focus Group Discussions (FGDs). Collins & Hussey (2009:144,155)

defines an interview as “a method for collecting primary data in which a sample of

interviewees are asked questions to find out what they think, do or feel,” while FGDs are

defined as “a method for collecting data whereby selected participants discuss their reactions

and feelings about a product, service, situation or concept under the guidance of group.”

These two methods are similar in nature for they involve a researcher asking open-ended

questions for participants to answer. Precisely, in-depth sessions and FGDs are interview

based. Interviews are the best fit in this study because they provide an opportunity to explore

and explain thereby establishing depth of the subject matter.

3.5 Research Strategy

The concept of research strategy is broad and researchers define it in a number of ways.

According to Koppa-info (2010), research strategy is a set of rules directing a research

project, and that the focus can be either broad or narrow depending on the research method

direction. Similarly, Dinnen (2014) argues that research strategy is a step by step of action

that provides direction in conducting a systematic research study. Saunders et al (2009:90)

summarises with a brief and clear definition; it is “general plan of how the researcher will go

28

about answering the research questions.” These definitions point to a common

understanding. Research strategy can be described as a vehicle gear box. It determines how

the vehicle will go about covering distance in a given direction. Datt (2016) demonstrates that

research strategy enables researcher to answer research questions which controls flow and

structure of the study, and that the extent of existing knowledge and availability of time are

important aspects of research strategy. These aspects proceed from research assumptions

being pursued.

Thus far, there are eight research strategies according to Saunders’ research onion.

Nonetheless, for the sake of this study, the researcher discusses three strategies which are

widely used and one of the three is adopted.

3.5.1 Survey This strategy is mainly associated with large amount of samples and data which points to

quantitative research underpinned by positivism philosophy. Visser et al (2013) describe

survey research strategy as type of study that involves collection of data from a sample drawn

from specific population through use of questionnaire as opposed to interviews. Interviews

are more compartible with qualitative research underpinned by interpretivism philosophy

(Collins & Hussey, 2009). Therefore, in scientific research studies such as this, the idea of

questionnaire method is exclusive to that of an interview method. On the one hand, Visser et

al (2013) warns that surveys are more expensive and require a lot of time while on the other

Leeuw et al (2008) and Biernacki & Waldorf (1981) disclose that surveys require data

collection from large samples because results are imposed onto the general public. Hence

numbers are paramount in surveys and therefore quantitative.

29

3.5.2 Grounded Theory

This is a strategy defined by Bringer et al (2006) as an iterative process which involves the

researcher to move between data collection and analysis. It connects directly to Gibbs (2010)

who underscores that, with grounded theory strategy, data collection and analysis are done

simultaneously. Consequently, it focuses on generating ideas to build on a theory from the

collected data and refine the ideas with new data being collected and analysed. This points

to inductive approach for qualitative studies. Corbin & Strauss (2008) highlight that grounded

theory strategy derives inductively from the study of phenomena which it represents.

3.5.3 Case Study

The stratedgy is similar to grounded theory because they are both qualitative and inductive

in nature. They both seek to establish depth of a phenomenon as opposed to a sweeping

statistical survey (Gibbs, 2010, Koppa-info, 2010, and Shuttleworth, 2008). However, in a

case study strategy data collection and analysis are not handled simultaneously. The process

in a case study starts with data collection then data analysis. According to Garson (2008)

case studies do not consume more time than surveys because few variables are studied

through smaller samples but with more details uncovered thereby making statistical controls

impossible. This suggests that case studies are less expensive because they do not require

large samples of elements or participants and also they are done within specific short period

yet they boast about ability to uncover rich details towards a particular situation hence helpful

in generating theories to generalize and predict on a phenomenon.

In this study, therefore, the researcher settles for case study strategy because it is not only

less expensive and that it has to be concluded within a space of four months according to

school calender, but also that it allows the researcher an opportunity to establish depth of the

case being studied. This will satisfy ontological and epistemological assumptions of the study.

30

3.6 Time Horizon

Time horizone is defined by www.businessdictionary.com/definition/time-horizon.html as

“estimated length of time for a plan, program, or project to complete.” Basically, this is time

frame for an activity or project to complete. Researchers have two accepted options regarding

time horizone to conduct research studies. These options are cross-sectional and

longitudinal. Johnson (2010) provides a clear distinction between these two options by

pointing that cross-sectional studies are quick, inexpensive and able to suggest areas for

further research while longitudinal studies are time consuming, expensive and difficult to

establish causality.

The dictates of this study leaves the researcher with no other option than considering cross-

sectional study because it is not expensive and should be completed within a space of four

months. Best of all, the study should be in a positiong to suggest areas for further research.

3.7 Technique and Procedures

In terms of techique and procedures for this study, the research onion prescribes data

collection and data analysis. The researcher used semi-structured questionnaire to conduct

interviews through in-depth and FGDs sessions. The questions focussed on key issues

which the study was investigating to answer the main question and the nature of questions

were exploratory hence open-ended.

The opening to the questions focused on respondent’s views on decentralization program

which the district council is empowered to implement through the Decentralization Act of 1998

in relation to implementation of nutrition security projects. This was to establish an open

understanding of respondents between decentralization program and nutrition projects

31

implementation. In other words, respondents had to discuss how they connect the idea of

decentralization and nutrition security projects implementation. Precisely, the researcher was

interested to capture how nutrition projects implementation were governed by existing

structures of decentralization as stipulated in the policy document.

Another example of the questions focused on how respondents rated awareness and

participation levels of Zomba district communities regarding nutrition security projects. These

questions aimed to establish an overall picture and attitude of the people in communities

regarding nutrition projects. So, respondents were free to rate in terms of percentages and

follow up questions to know reasons behind their rates were asked.

Further, a key question in the ending section of the questionnaire sought to gather on how

the council can achieve sustainable nutrition security. This question provided an opportunity

to respondents to suggest ways and means of improving governance in terms of

implementation of nutrition security projects in the local councils. It should be noted that this

question attracted a lot of comments which signifies that respondents were concerned with

existing gaps in the governance of nutrition projects at the district council.

Therefore, this study was designed to appreciate the depth of status quo on the subject matter

which is why semi-structured questions were the best fit as opposed to structured questions

which are closed-ended in nature and could not satisfy the demands of the study. Collins &

Hussey (2009) recommend the use of semi-structured questionnaire in a qualitative study

because the questions are open-ended thereby creating room for probing and establish

depth. Conducive environments to conduct these sessions were arranged and the researcher

was presentable and organized. This was in order to provide participants with confidence to

offer quality information. Cassell (2005) stongly encourages researchers to be conscious of

32

their identity when conducting interviews because identity can attract negative or positive

attitude from participants and this has an impact on collection of quality data. Kamper et al

(in Onwuegbuzie & Collins, 2007) also stress that researchers must strive not to

inconvinience sampled members in a research study. For in-depth sessions, all interviews

were done in the comfort of participants’ offices while FGD sessions were conducted at the

comference room of Zomba District Council offices where all participants usually meet for

their regular group meetings.

3.7.1 Data Analysis

The researcher opted for manual analysis of the study themes by means of entering and

transcribing data into Microsoft word particularly because the study is qualitative in nature

and does not include a large sample of participants. Then an open coding system adopted

from Grounded Theory data analysis was employed. According to Gibbs (2010), this model

of analysis is by far the most popular technique for qualitative analysis because it is

exhaustive. In other words, this system boasts about data saturation where all relevant

information is analysed until no new themes emerge. There are three stages in the open

coding system which are shown and explained below:

1. Open Coding: Developing categories of information

2. Axial Coding: Interconnecting the categories

3. Selective Coding: Explaining connected categories and produce theoretical

propositions.

Stages of open coding system above were adopted from Gibbs, G. R. (2010) Grounded Theory; Core elements. University of Huddersfield

33

It is important to note that the researcher engaged a well experienced note-taker, who is also

well trained in transcription, to assist in taking notes during FGDs to supplement recordings

of the sessions. This was to ensure that everything which participants discussed was well

captured. Later, the note-taker transcribed the recordings while liaising with the notes.

Transcription can be dictated by researcher’s theories and values hence constraining the

process of capturing what was exactly discussed thereby affecting data interpretation

(Lapadat & Lindsay, 1999). The researcher was therefore compelled to hire services of an

independent expert to take notes and transcribe.

3.8 Interview Questions and Justification

The interview questions for this study were formed guided by an interpretivism approach

through the four objectives presented earlier where the suject under investigation would be

clearly understood in terms of social and psychological aspects as well as their causes. In

view of the same, the questions were open ended to explore and explain (Collins & Hussey,

2009).

3.9 Sampling and Sample Size

There was a total of 36 participants who were sampled purposively from an initial proposed

total number of 32 participants. In other terms, the researcher used nonprobable or targetted

sampling which came into effect by means of snowbow sampling. The term snowbow

sampling refers to “a nonprobability sampling technique where existing study subjects recruit

future subjects from among their acquaintances…sample group is said to grow like a rolling

snowball,” (Goodman, 1961). According to Exloplorable.com (2009), Snowball sampling “is

a non-probability sampling technique that is used by researchers to identify potential subjects

in studies where subjects are hard to locate.” In this case the number of targetted key staff at

Zomba district council secretariat increased from 11 to 15 following the researcher’s notice

34

that other staff would provide much needed information. This is acceptable in a scientific

research study as echoed by Gibbs (2010) who contends that in a purposive or targetted

sampling, participants or samples can be added so long as they are meant to provide relevant

data which would not be provided by available samples. However, it was difficult to reach

out to all targetted staff in the absence of engaging the head of the institution who is the

District Commissioner (DC). The DC assisted in motivating the staff who later accepted to

participate in the study. Subsequently, there were 18 ward councillors, 15 key staff under the

district council and 3 senior chiefs who operate under the stewardship of the district coucil,

forming sample size for this study i.e 18 for FGDs interviews and 18 for in-depth interviews.

Nevertheless, in the due course of conducting interviews, the researcher noted that there

was need to include participants from key Non-Governmental Organizations (NGOs) who

were implementing nutrition security projects in Zomba district for the sake of balancing up

data through appreciating their side of the matter especially on objectives 2 and 3 of the

study. Further, the researcher noted that including senior chiefs and councillors would be

duplicating source of information because both councillors and chiefs deal with grass-root

communities directly. After some enquiries, it was revealed that councillors were better

placed to provide quality information because they were always in touch with people on the

ground, and that they were less likely to be influenced by political pressure because they held

elected positions and could not be fired unlike chiefs who were controlled by politicians.

Hussein (2017) confirms that councillors in Malawi reside with people in their wards and

aware of issues that affect the people much better than government agencies.

35

Therefore, one participant holding a senior position in project planning and implementation

was sampled from each of the key NGOs who were implementing nutrition security projects

in Zomba district. The NGOs were Project Concern International (PCI), Emmanuel

International and Save the Children. These three participants replaced the three senior chiefs

proposed earlier. The table 1 below shows details of sampled participants for FGDs

interviews.

Table1 Checklist for FGDs interviews

As indicated in the table above, the plan was to have 9 participants in each of the two FGD

sessions but it turned out that the first session had 8 participants while the second session

had 6 participants. This means a total of 14 members participated out of the proposed 18

members. It shows that participant numbers in all the two sessions were representative. A

standard FGD session require a minimum of 4 participants and maximum of 12 participants

(Carlsen & Glenton, 2011). However, Morgan (1997) recommends that where numbers have

36

reached the maximum, there should be strict moderation to maximize participation of all

members because others may dominate. The table 2 below shows details of sampled

participants for in-depth interview sessions.

Table2: Sampled Key Projects Staff in Zomba District Council for In-depth interviews # Participant Name Gender Position Department Status/Remarks

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

The table 2 above shows that 4 out of 18 proposed members for in-depth interviews did not

participate in the study. This reveals that 78% of proposed members participated which can

Sampled Key Projects Staff from the NGO sector under Zomba District Council

37

be described as representative of the intended sample especially considering that all key

stakeholder institutions involved in nutrition security projects implementation under Zomba

district council participated in the study through their projects key staff. Thus, in total, 28

participants took part in the study through FGDs and in-depth interviews out of 36 proposed

participants.

3.10 Research Ethics

Research ethics is an important part of any scientific study especially if the suject being

investigated involves human interaction in a given environment. Blumberg et al (in Gray,

2014:130) defines research ethics as “sets of moral principles or norms that are used to guide

moral choices of behaviour and relationships with others.” Similarly, Resnik (2015) describes

research ethics as conduct norms that distinguish acceptable and unacceptable behaviour.

It follows that research ethics are regulations that control execution of research study through

its design. According to Resnik (2015), ethical standards in a research study promote values

such as trust, accountability, mutual respect and fairness between the researcher and the

researched. University of Gloucestershire (2018) emphesises that research participants

should be made aware of their rights to refuse participation or withdraw from participating at

any time and the researcher ought to address issues of confidentiality and anonymity

accordingly. These measures ensure that interaction between the researcher and the

researched remains neutral hence, in this study, the researcher made available an informed

consent form to all participants. It should be noted that some participants refused to

participate while some withdrew. This was as a result of a clear explaination to all participants

who freely made decision regarding participation or not at any stage. Those who participated

were also asked to sign the consent form at will. Subsequently, some participants opted not

to sign. However most of participants signed the informed consent form. For example out of

38

a total sample of 28 participants who participated, 21 of them signed the consent form while

7 of them opted not to sign although they participated fully. (A copy of signed consent form

for one of the participants appears under appendices section).

It should be mentioned that the consent form assured participants of confidentiality and

anonymity, which is highly ethical in the interest of protecting rights and job safety of

participants. The form clearly indicates that participant name would not appear anywhere in

the study report. However, for academic purposes, participant names have been included in

this report but are not attached to their individual answers such that any participant would not

be held responsible for discussing a specific issue.

It is also worth-noting that, the researcher submitted Research Ethics (RE1) form to study

supervisor at University of Bolton who approved it thereby giving the researcher a go ahead

to collect data. Further, the researcher obtained an approval from the head of the institution

which was being investigated in this study. These stages were very important because the

university research ethical standards were supposed to be met and that in the absence of

approval from the head of investigated institution, participants would not be free to provide

quality information since some issues discussed had political implications which in most

cases workers of government institutions such as Zomba district council would avoid for fear

of compromising their job security. (Copy of RE1 form appears under the appendices

section).

3.11 Limitations of Research Method Used

Interviews were the only method used to collect data for this study. According to Saunders et

al (2009), the method is branded mono-method qualitative because it only uses a single

method of data collection. While this method is the best fit for the study because it offered

39

the researcher an opportunity to establish social and psychological aspects of the

phenomenon, it is never short of drawbacks. Esterberg (2002) and Gibbs (2010) contend

that interviews rely on respondent’s accuracy to recall and report, and that sometimes people

do not say exactly what they do. To address this shortfall, the researcher could also use

observations as an additional method but this was not possible because the research time

horizon was cross-sectional where timeframe was limited to participants’ knowledge of

nutrition security projects implementation during MGDS II, which was way back from the time

of the study i.e. 2011 to 2016.

3.12 Summary of Chapter Three

In this chapter, the researcher presented and discussed methodology used when conducting

the study. Saunders’ research onion was adopted and the key components of the onion were

discussed before the researcher made a choice for a specific component and justified it.

Thus, the researcher made sure that while peeling off the onion layers, some of the layers

were spared for use in this study. Consequently, interpretivism philosophy, inductive

approach, mono-method qualitative method, case study strategy, cross-sectional time

horizon were used. In addition, the chapter presented and discussed techniques and

procedures used to collect and analyse data. For example, the researcher ensured that the

study was conducted in a conducive environment where issues were discussed freely without

affecting flow of information. Later, open coding data analysis was used. The study sampled

a total number of 36 participants through purposive sampling method coupled with snowball

sampling and 28 participants took part in the study because others igonored to participate,

while others withdrew on the way.

40

4.0 CHAPTER FOUR: RESEARCH FINDINGS AND DISCUSSION OF FINDINGS

4.1 Introduction

This study was grounded in establishing how Malawi’s dececentralization policy powered by

the Decentralization Act of 1998 can contribute to minimizing cases of stunted growth due to

malnutrition through a case study of Zomba district council. The Act is clear in terms of

facilitating socio-economic growth through creating enabling environment where citizens

would be allowed to participate in decision making on development affairs affecting their lives.

This was branded as a hallmark of sustainable development because evidence, according to

Zafarullah et al (in Sarker, 2006), shows that where people participate in decision making for

development, there is no social and cultural inertia hence they own such development and

help in sustaining it. The narrative in the decentralization policy is explicitly pointing to among

other important issues streamlining nutrition security as a means to attain meaningful socio-

economic growth because sound nutrition leads into an effective human capital. Precisely,

the policy answers directly to the country’s constitution which prescribes the right to nutrition

security for all to arrive at good health and self-sufficiency as revealed in the literature review

section. Similarly, the country’s nutrition policy documents of 2007-12 and 2018-22

acknowledge that nutrition security links directly to socio-economic growth but the status quo

has reached national crisis. Therefore streamlining nutrition security is unnegotiable for it is

constitutional. The findings of this study are therefore speaking directly to national policy

direction.

4.2 Findings

This section presents results of the study based on the main question which underpinned the

study; how can decentralization policy promote implementaton of nutrition security projects

through the local councils of Malawi? Tables 3 and 4 below present data analysis out of data

41

collection exercise for this study and later details of the data in the table are presented before

discussing them in subsequent sections.

4.2.1 Table 3: FGDs Data analysis

DATA ANALYSIS

PART A: FOCUS GROUP DISCUSSIONS

THEMES VARIABLES RESPONSES REASONS / REMARKS

Understanding of key stakeholders on roles and benefits of decentralization program in achieving ideal nutrition security

General view on Decentralization Programme

-Devolving of power from central government to communities through councils where citizen participate in decision making

-Decentralization is only existing on paper because government is not willing to share powers with district structures

Decentralization impact in various sectors of Zomba district communities

-People are now able to hold their leaders accountable through following up project details such as funding amount and quality of works and services delivered through structures such as DDCs, ADC and VDCs

-Government overlooking decentralization structures - There are no trainings for DDCs, ADCs and VDCs and they lack direction

Describing the implementation of nutrition security projects during MGDS II

-People receive Likuni Phala and micronutrients powder when they go to hospitals

Curative measure by

ministry of health

Impact of Nutrition security projects in Zomba District -The impact is very minimal

because there is lack of information from central government regarding nutrition matters

Lack of or inadequate nutrition education

Satisfaction level on designing implementation of nutrition security projects due to decentralization

-Very dissatisfied -Partly satisfied

Factors affecting implementation of nutrition security projects

Measures to achieve intended projects results

-Development fund controlled by member of parliament for the area through unilateral choices of projects which does not include nutrition -The council prioritizes physical structures such as roads and school buildings

-NGOs who come with nutrition projects do not consult the council, they go through District Executive Committee (DEC) which is not a council. So there is lack of inclusiveness at planning level. Lack of coordination and poor planning

42

Awareness about malnutrition as major cause of stunted growth in Malawi

-Partly aware but department of nutrition no longer focusing on nutrition interventions like in the 70s and 80s where nutrition officers trained people.

-Given a chance, I would among other projects suggest to establish an orchard in my area- koma pano ma khansala angokhala ngati chipatala chopanda mankhwala (As it is, councilors are like a clinic without drugs, they are not useful)

Nutrition security projects implemented by Zomba district council

-No nutrition security projects have been implemented under initiative of the council

Council not prioritizing nutrition

Nutrition security projects implemented by NGOs under Zomba district council

-Support for Nutrition Improvement Component (SNIC)

Challenges and Problems involved

-Lack of project sustainability -NGOs use incentives to entice people to participate -Use of Soda in relish removes nutrients

Lack of nutrition education and unsustainable planning

How they were dealt with -Participants could not recall

Collaboration between the council and key stakeholders

-NGOs not using valid channels, only consult DEC and not the council according to procedures and they plan in isolation

Lack of coordination and inclusive planning

Community participation in nutrition security programming and productivity

Estimated % of awareness and participation of communities on nutrition security projects in the district

- Around 20% awareness and participation -Around 80% awareness and participation based on NGO interventions

The 80% awareness and participation is due to some NGO implementation model of using incentives. People will pay attention and participate only to get the incentives but will not understand and willing to do something about it after the donor leaves

Satisfaction level with estimated %

-Dissatisfied

There are only opportunistic interventions at council level

How important is Nutrition at household level for communities

-People in communities do not consider nutrition as important. They simply don’t care.

Most people eat to fill their stomachs. Lack of nutrition education

Commitment of Key players such as central government and NGOs in nutrition security projects

They do not make consultations with important stakeholders before implementation.

Lack of inclusive planning on the part of NGOs

What needs to change at planning and in communities on nutrition

-The council should improve on sharing of information regarding nutrition and coordination of activities through the council should be reviewed. Most of the

Need for Nutrition policy dissemination and use of existing structures for implementation NGOs accused of encouraging the culture of

43

decisions made are forced through to communities - NGOs should adopt using existing structures in the communities. They should avoid creating their own structures because when they leave, it is difficult to sustain their interventions. -NGOs should stop providing incentives

handouts through providing incentives

Gaps in decentralization program affecting sustainable nutrition security

Perception towards promoting nutrition security in communities of the district

-People are able to follow development issues in their areas although issues of nutrition are far behind. Leaders are mainly to blame for not reaching out to people with targeted interventions in various programs.

Lack of coordination at council level and lack of political will to devolve power from central government

Available knowledge in managing implementation of nutrition security projects No training offered

Needed support for the council to do better

Political will to incorporate nutrition into programmes and adequate funding

Needed support towards key project staff to do better Sensitization and training of

staff in nutrition modules High vacancy rate of key positions at the council

Capacity Building need

How can the council sustain effective implementation of nutrition security projects

-There should be a body to focus and deal with nutrition issues exclusively and should have strong coordinating and bargaining power across all ministries. -Community nutrition schools should be reintroduced -The council should prioritize nutrition interventions -There should be effective dissemination of nutrition information to all stakeholders - Members of parliament should be lobbied to recognize nutrition as key issue in development -LDF should have a percentage to be used on implementation of nutrition projects

Demand for a body with horizontal powers with other government ministries to champion nutrition issues through nutrition education and information dissemination Demand for political will to draft nutrition into key priority areas

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4.2.2 Table 4: In-depth interviews Data analysis

IN-DEPTH INTERVIEWS DATA ANALYSIS

THEMES VARIABLES RESPONSES REASONS / REMARKS

Understanding of key stakeholders on roles and benefits of decentralization program in achieving ideal nutrition security

General view on Decentralization Programme

-This is citizen participation on government decisions regarding development affairs; So far Zomba district council is on the right truck, structures are put in place. Council is able to deliver some services centralized at the council such as payroll management, mobilizing own resources. There is also partial devolution of development funding through District Development Fund. People must participate, it is constitutional therefore unnegotiable

Few services and functions delivered through decentralization system, 20 years down the line. Decentralization secretariat dissolved after establishing structures. No new efforts to enhance the system.

Decentralization impact in various sectors of Zomba district communities

Service delivery improved. Local innovations implemented due to devolution of development budget i.e. direct funding from development partners such as World Bank and MASAF

-solar power irrigation schemes, construction of market structures and etc

-In 6 key priority areas for MGDSII there is litle to do with nutrition. --Constitution is clear that 5%of national budget should go to councils but this is not being implemented. No meaningful participation of citizens to foster development as stipulated and anticipated; only political participation during elections

45

Describing the implementation of nutrition security projects during MGDS II

Nutrition projects have been implemented as opportunistic interventions, integrated in HIV and AIDS interventions. There has been no standalone nutrition project from within the council. Only development partners such as World Vision, Save the Children, Emmanuel International and others have been implementing nutrition focused projects. -There is no direction in nutrition projects, keeps on shifting from department to another. It is not clear in terms of who is mandated to coordinate nutrition projects in the country

-Health department doesn’t concentrate on nutrition security. It deals with curative intervention i.e. dealing with clients already affected

Lack of funding Need for strong and well-focused coordination structure; standalone ministry with horizontal powers with other ministries

Impact of Nutrition security projects in Zomba District

Stunted in 2010, at national level, 47% and Zomba 48% Now (2018) nation 37% - although other sources such as USAID suggests that it is at 41%, Zomba 36.4% (source: Zomba Agriculture Office)

-But there were serious gaps in coordination of activities among key players -Impact not yet measured (source: District council secretariat office) This suggests lack of coordination and collective planning on the same theme under the same council

Satisfaction level on designing implementation of nutrition security projects due to decentralization

Only satisfied

Not satisfied

-Not yet there due to poor planning which are not inclusive and with supporting budget -Council does not have dedicated nutrition projects. Only development partners do - There is no clear implementation plan for nutrition projects

46

Factors affecting implementation of nutrition security projects

Measures to achieve intended projects results

-By using existing structures and planning modalities -Strengthening of structures at district and community levels, and adoption of care group model which prioritizes activities directly affecting nutrition and the affected -Creation of care groups

Care group model has been

widely applauded because it

deals with nutrition issues

directly; Households are

grouped and form a cluster

where a leader is chosen.

They are trained to know

about health and nutrition

Awareness about nutrition as major cause of stunted growth in Malawi

-Very much aware unfortunately there is no focus on nutrition

Development strategies not on nutrition

Nutrition security projects implemented by Zomba district council

Agriculture and food security with some components on nutrition in passing.

No focus on nutrition

Nutrition security projects implemented by NGOs under Zomba district council

-Support for Nutrition Improvement Component (SNIC)-Supported by DNHA -Scaling Up Nutrition (SUN) -Micro Nutrient Powder (Ndisakanizeni)

SNIC ended abruptly although it was meant to be a model project for the government, funds were abused

Challenges and Problems involved

-Misappropriation of funds

for SNIC project

-Poor planning due to lack of

inclusiveness

-Lack of comprehensive

social and behaviour change

interventions to support the

project

-High levels of illiteracy which

affected uptake of

interventions

Inadequate resource

- Nutrition has no budget at

council level

Lack of Nutrition education

and political will

body such standalone

ministry as suggested by

many

How they were dealt with Lobbying of NGOs to come

and implement

Collaboration between the council and key stakeholders

- NGOs only come to give

notice of their interventions in

the district. -No specific

interventions directly dealing

with the council

-No collaboration with

academia

-No proper coordination

except that NGOs make

presentation of their

interventions at the District

No coordination and planning

47

Executive Committee for the

council to know what they are

doing

Community participation in nutrition security programming and productivity

Estimated % of awareness and participation of communities on nutrition security projects in the district

Around 50%

-Largely left as NGO responsibility but the NGOs have their own focus or impact area -Nutrition regarded as

women issue but at the

same the women

participation in decision

making in the communities

is very low –

Satisfaction level with estimated % Dissatisfied

Because nutrition is a crisis, needs more focus

How important is Nutrition at household level for communities

Not very important

-Lack of knowledge which

starts from those learned,

those holding strategies

position – Need for nutrition

education at different levels

-They only respond to NGO intervention with no intention to continue on their own - There are disjointed and uncoordinated interventions -Household don’t regard

nutrition as a priority.

People concentrate on what

they are seeing such as the

effects as opposed to the

causes of malnutrition –

connects with witchcraft

beliefs, need for nutrition

education

Commitment of Key players such as central government and NGOs in nutrition security projects

-Central government is committed by training people in nutrition but when they finish training they never go to work in the same field. Other than training, there are no particular interventions by central government -NGOs are very committed but they do not include the council in their planning and implementation

Lack of coordination

What needs to change at planning and community levels on nutrition

-Perception about

development should be

renewed, things that matter

Need for collective approach, comprehensive awareness campaign,

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most such as nutrition should

be prioritized

-Village development

committees should be

highlighted to know about

nutrition.

-Stakeholder collective

planning is very important for

coordination

-This requires a strong unit or

structure which has

horizontal powers with other

ministries

political will to prioritize nutrition Demand for standalone ministry for nutrition

Gaps in decentralization program affecting sustainable nutrition security

Perception towards promoting nutrition security in communities of the district

-Decentralization has only managed to put some system in place without sustaining their functions -Central government not ready to devolve resource management

Available knowledge in managing implementation of nutrition security projects

Project management Care Group model

Needed support for the council to do better

-Creation of vote for nutrition in budget – Political will -Need to zero-down to define what nutrition is? What elements are there? -develop strategies

Pressing need for nutrition education, planning and implementation; and adequate funding

Needed support towards key project staff to do better

-Training of key personal in project management – -Development partners should come to implement interventions with sustainability component

Capacity Building

How can the council sustain effective implementation of nutrition security projects

-Decentralization structures should be empowered to function according to primary purpose -There should be a vibrant framework to guide and coordinate nutrition interventions

– The DDP has no nutrition

as a key component, it is

only a section under HIV and

AIDS interventions.

-In the absence of full decentralization as the case is, creation of a stand-alone ministry is inevitable

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4.2.3 Detailed Findings

The following section seeks to expound on the data analysis presented in the tables above.

4.2.3.1 Stakeholder understanding on linkages between decentralization program and implementation of nutrition projects

The study noted that all key implementation stakeholders under Zomba district council were

aware that decentralization entails citizen participation in decision making on development

affairs affecting their lives but requires central government devolving powers to local councils,

which was not the case. It was reported that as a result of decentralization programme there

were some improvements on service delivery as implementation of some locally initiated

projects were possible, and people were able to hold their leaders accountable through

following up project details such as funding amount and quality of works and services

delivered. The programme had implementation structures such as District Development

Committees (DDCs), Area Development Committees (ADC) and Village Development

Committees (VDCs) which formed a full community where action was centred to serve the

masses. Project implementation in various interventions including nutrition security projects

were supposed to be done through these structures. It was therefore well recognized that

nutrition security interventions were no exceptional to use the decentralization structures for

effective implementation.

In particular, stakeholders recalled that the council was able to deliver services such as

payroll management, staff recruitment and construction projects from within itself as opposed

to being controlled by central government. However, it was established that the central

government would not devolve most of the services as stipulated in the decentralization

policy. For example, stakeholders discussed that the responsibility to choose projects to

implement at district level was still in the hands of central government. In most cases,

50

communities were advised to implement construction projects for structures such as roads

and schools following directive from central government.

Further, the study revealed that Zomba district council had no component of nutrition security

projects implementation in its District Development Plan (DDP). The DDP prioritized

infrastructure development in various sectors with nutrition projects implemented as

opportunistic interventions, integrated in HIV and AIDS projects. Thus, the council had never

implemented a standalone nutrition project from within its budget. Stakeholders felt that there

was no visible direction in nutrition projects because central government appeared wandering

about the issue as evidenced by shifting of nutrition programme from OPC to ministry of

health although the ministry of health was mainly mandated to deal with curative interventions

of malnutrition cases as opposed to preventive interventions. Nonetheless, other ministries

such as Agriculture and Education were also reported to have nutrition programmes. As a

result, stakeholders reported that it was confusing regarding which entity was responsible for

coordination of nutrition security matters in the district and the country as a whole. Meanwhile,

implementation of nutrition security projects in the district was left as a sole responsibility of

Non-Governmental Organizations (NGOs) such as Emmanuel International, Save the

Children and others. Most of stakeholders held that there was still minimal impact from

nutrition security interventions in the district due to little commitment from central government.

Surprisingly, the agriculture office under Zomba district council reported from their records

that in 2010, stunted growth prevalence rate at national level was at 47% and 48% for Zomba

district. At the time of this study in December 2018, the Zomba district agriculture office said

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that the national prevalence rate was at 37% and 36.4% for Zomba district suggesting a 10%

and 12% drop respectively in a space of eight years.

4.2.3.2 Factors affecting implementation of nutrition projects (i) Lack of Political Will

The study gathered that the council would be distributing funds for community projects

through Local Development Fund (LDF) which is segmented into Constituency Development

Fund (CDF) and the Member of Parliament (MP) representing that constituency would decide

which projects to implement. All participants in this study could not recall any nutrition project

which an MP in the whole district of Zomba considered to implement. This was linked to

influence by the council through directives from central government to prioritize physical

structures such as roads and buildings and subsequently having no nutrition budget lines in

the council. This issue came out strongly from participants who pointed that the absence of

political will has created unconducive environment for nutrition projects in the council.

(ii) Lack of Consultations

Almost all participants mentioned that unilateral decisions by MPs was not helping matters

because laid down procedures in the decentralization policy require that councillors and

community structures should to be consulted. One of the participants who was a councillor

said “If councillors were given a chance to suggest what type of projects to implement, I would

among other projects suggest to establish an orchard in my area- koma pano ma khansala

angokhala ngati chipatala chopanda mankhwala (As it is, councillors are like a clinic without

drugs, they are not useful).” Also, as indicated earlier, the council relied on NGOs to

implement nutrition security projects in the district and some participants in the study reported

that the NGOs would come and start implementing nutrition projects without consulting the

52

council. They would go through District Executive Committee (DEC) which used to work on

behalf of the council at the time when councillors were not there.

(iii) Poor Planning

Other study participants described the NGOs as not encompassing in their planning and

execution. It was pointed out that the NGOs lacked inclusiveness in their programming. Most

of them would proceed with implementation on their own after reporting to the DEC. There

were only two NGO projects which participants applauded because the council was involved

in all the stages and these were Scaling Up Nutrition (SUN) and Support for Nutrition

Improvement Component (SNIC).

(iv) Lack of Coordination

It was well reported that when NGOs report at the DEC, they were left to implement without

tracking their progress. They would report at their own pace and sometimes they would not

report until end of their project. Also, there was no sharing of information in terms of

interventions and success stories. For example the adoption of care group model by Malawi

government where households are grouped and form a cluster, then get briefed on health

and nutrition was widely commended to have noticeable impact but stakeholders took time

to appreciate it before adoption because most of them operated in isolation.

(v) Lack of Household Knowledge

Some participants mentioned that due to lack of knowledge in nutrition, households regarded

malnutrition issues as effects of witchcraft. They would resort to remedies associated with

witchcraft thereby worsening the situation. Also, some men perceived nutrition issues as

meant for women and this was contributing to slow progress in dealing with stunted growth.

The use of soda substances in cooking relish and other food for most of women in villages

53

was discouraged by participants who argued that soda removes nutrients from food.

Therefore, participants suggested the ban of soda in food preparation. Additionally, it was

reported that high levels of illiteracy were contributing to lack of understanding during

implementation of available interventions.

(vi) Misappropriation of funds

It was also discussed that some nutrition project funds were abused. This was the SNIC

project which was well funded and had an inclusive approach where the council was part of

implementation team. However, the donors pulled out following discovery of unaccounted

expenditure hence the project ended abruptly.

4.2.3.3 Community participation in nutrition security programming and productivity

The study was also interested to appreciate levels of community participation in the available

nutrition projects and the following issues emerged;

(i) Incentive based participation

It was established that some of the NGOs engaged communities by enticing them with

incentives to participate in their interventions. For example, communities would be requested

to attend certain interventions in their areas with a message of receiving food items in return.

In this case, almost the whole village would go out for the activities and most of them would

only wait for the food items without participation or attention to issues being presented. This

approach would later affect other NGOs who do not use incentives. Attendance of their

interventions by communities turned out very low. As a result, participants in the study had

mixed feedback in terms of their levels of satisfaction regarding community awareness and

participation. Some mentioned that they were somehow satisfied while others were very

dissatisfied.

54

(ii) Lack of Intervention sustainability plan

Almost all study participants reported that organizations implementing nutrition projects in the

district had no measures to ensure continuation of their interventions beyond projects

implementation deadline. It was mentioned that communities would not benefit much from

most of the projects because they were not prepared to self-help and participation. Thus, they

would see no reason to continue activities initiated by the projects in the absence of the

implementing organizations.

(iii) Lack of Knowledge on the part of community leaders

Most of community leaders were reported to have little or no knowledge regarding nutrition

matters and it became difficult for them to mobilize their subjects to participate in activities.

This was attributed to lack of deliberate efforts on the part of the council to conduct civic

education about nutrition. However, it was also noted that the council officials lacked

knowledge on nutrition matters and it was difficult for them to plan accordingly although there

was nutrition coordinator who led the DNCC.

(iv) Perception on Development

The issue of perception towards development also took centre stage during the study. From

the officials in strategic positions at the council down to communities, development was

looked at from a hardware perspective. Since nutrition projects would not require putting in

place physical structures, it was not considered as meaningful development to the people.

4.2.3.4 Gaps in decentralization program affecting sustainable nutrition

security

As prescribed by decentralization policy, nutrition projects would be promoted through laid

down structures in the district councils. It was important to look at some of the gaps in the

55

decentralization set up affecting implementation of sustainable nutrition projects. The study

pulled out the following gaps;

(i) Dissolving of Decentralization Secretariat

It was discovered that during operationalization of decentralization policy, a secretariat was

formed to establish structures from the ministry to district councils and down to communities.

However, the secretariat was dissolved before the structures were made functional and

monitored. In addition, there were no clear implementation frameworks through which the

established structures would operate.

(ii) Key Staff Capacity Building

Most of the key staff at the council required formal training in project management. For

example, there was only one key staff who was formally trained in project management and

this was by all means not fertile for effective and efficient service delivery. It was not surprising

to note that there was no clear implementation framework to guide and coordinate project

implementation.

(iii) High vacancy rate in key positions

The study gathered that almost 50% of key positions at the council were vacant. It was

therefore difficult to plan and implement activities with effectiveness and efficiency.

(iv) Inadequate Funding to councils

It was reported that the constitution demands that 5% of annual national budget would be

allocated to councils for their projects but this was not being fulfilled. As a result some of the

key functions at the council including communication and civic education on nutrition were

idle.

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4.3 Discussion of research findings

The findings of this study as presented above reveal sticky issues surrounding

implementation of nutrition security projects in line with decentralization policy in the district

councils of Malawi, through a case study of Zomba district council. As established in the

literature review and subsequently integrated into the concept framework, the findings

ascertained that dealing with malnutrition as a main cause of stunted growth in Malawi

requires, among other key issues, scaling up nutrition education and putting in place a vibrant

implementation framework to coordinate activities. This effectively confirms the two theories

underpinning this study as applicable. The other issues emerging from the findings and not

explicit in the literature review are lacks of political will, consultations, household nutrition

knowledge, resources and capacity building; poor planning and high vacancy rate on key

strategic positions.

Lack of political will came out with strong emphasis as a contributing factor in terms of

consideration of projects and use of existing structures in the council. This is consitent with

existing theories on performance of local councils in Malawi (Hussein, 2005, 2013 and 2017).

More discussion on the findings will now take on the direction of objectives which undepinned

this study for the sake of addressing the main research question.

i. To establish the understanding of key stakeholders regarding the role and

benefits of decentralization program in achieving ideal nutrition security

Stakeholders noted that decentralization programme created well established structures

capable of reaching out to people on the ground with efficiency and effectiveness regarding

nutrition and other sector interventions and that some locally initiated projects were being

implemented. However, it was underscored that coordination of nutrition projects was

57

disjointed and the existing decentralization structures were not being used because the

central government could not keep focus on the importance of nutrition. By observing from

the administration trends of the central government, it confirms stakeholders’ assertion. The

government has never considered nutrition as a key development issue despite featuring

high on UN general assemblies to which Malawi subscribes. This is why Zomba DDP had no

nutrition component as a key development theme. It was only around 2004 when the then

administration created a department known as Department of Nutrition and HIV and AIDS

(DNHA) and housed it under OPC with a principal secretary who was specialized in nutrition.

This was a bold step towards streamlining nutrition by government administration of that time.

Nonetheless when the administration changed in 2012, there was little focus on nutrition as

compared to HIV and AIDS. Later the department was moved to ministry of health. This was

a clear indication that government had less interest in nutrition matters despite abundant

evidence pointing to a vibrant human capital as human development from conception

requires specific nutrition requirements through to five years of age. The first five years of

human development are decisive in terms of physical and mental development for the rest of

life and it is irreversible. This could be a contributing factor to poor performance of the

country’s national football team as argued by sports analysts that most of players in the

national team are of short heights and not fit hence not at par with international standards of

football.

According to EU (2016), DNHA coordinates nutrition interventions from central government

through structures of line ministries and district councils but the EU report is quick to point

out that sector coordination has been largely disconnected. This is not surprising because,

as the findings revealed, ministry of health focuses on curative interventions as opposed to

58

preventive interventions which are at the centre of nutrition programming. This approach at

central level trickled down to local councils as established that coordination issues on nutrition

were more of a problem than a challenge. Inversely coordination of other development issues

such as physical infrastructures was treated with top priority attention. This is where TOC

becomes an integral part. There is need to approach implementation activities as prescribed

by TOC under literature review (pg17). Nevertheless, a country which has all required

infrastructure development with malnourished population would never reach self-sufficiency

and would remain trapped in poverty because, as revealed in this study, research evidence

shows that countries continue to spend a fortune of their national budget on malnutrition

cases.

It was therefore a surprise for this study to learn, according to Zomba Agriculture Office

(ZAO), that stunted growth due to malnutrition dropped by 10% at national level and 12% for

Zomba district in a space of eight years. This is a significant improvement which needs to be

explored further. However, it should be noted that other departments of the district council

such as the council secretariat, education and health were not aware of this development.

ii. To identify factors affecting implementation of nutrition security projects

In terms of issues affecting implementation of nutrition projects, they included lacks of political

will, consultations, household nutrition knowledge, resources and capacity building; poor

planning and high vacancy rate on key strategic positions. On the part of central government,

as indicated in the findings, some degree of political will on the matter was noticed through

the presence of nutrition department and two policy documents of 2007-11 and 2018-22

although there was no clear guidance in terms of implementation framework as pointed in the

literature review. In addition, central government adopted care group model where

59

communities are briefed on health and nutrition, as indicated in the findings, which has been

traced with positive feedback although the impact is not yet assessed to measurable levels.

In a way, it is not entirely lack of nutrition knowledge or education, rather it is lack of adequate

knowledge. This is another indicator for lack of political will. The main issue is that the

available political will is not practical because structures and models were only created and

imposed on other stakeholders such as NGOs to use and not for the government itself. The

presence of a practical political will on the matter would be a break through because

resources such as funding and capacity building on the part of staff in councils would be

attended to with due priority. Best of all, practical political will would end in establishing a

vibrant body to coordinate nutrition from nation level down to communities through existing

local council structures and models. This can be in form of a standalone ministry to deal with

nutrition gaps which have led into a national crisis as acknowledged by government policy

documents. In fact this would be a great altenative in the presence of slow devolution of

services from cetral government to district councils. However research evidence warns,

according to Christensen & Laegreid (2011), that interventions administered by a ministry

with no horizontal coordinating power to other ministries would be challenging to succeed. It

occurred at some point in Malawi government where according to OPC (2013) Performance

Enhancement Department (PED) was commissioned in 2012 because it was noticed that

Ministry of Economic Planning and Development (MEPD) which was responsible to

coordinate reforms lacked bargaining powers.

The new ministry responsible for nutrition affairs would be prioritized as a government arm

which deals with national crisis hence adequate funding and human resources comprising of

experts in nutrition and project management should not be in short supply. The use of soda

60

in households during food preparation which was dicouraged by participants could be

integrated in nutrition education module facilitated by the new ministry and this would form a

benchmark to look into other practices which lead to nutrient loss during food preparation

both in households and the entire food value chain. Thus, the ministry will have to take a

comprehensive holistic approach on nutrition education as suggested by ‘Theory of nutrition

education and promotion’ discussed under literature review (pg16). For example, the ministry

could lobby for an Act on nutrition education drawing from the “law on Shokuiku” model in

Japan as revealed in the literature review.Then through TOC model the ministry will design

programmes at national level and implement them through the local council structures. Thus,

issues of poor planning and high vacancy rate will be taken care of accordingly by the new

ministry.

iii. To determine community participation in nutrition security programming and

productivity

Community participation in nutrition security interventions also trickles up to disjointed

coordination by central government via the absence of a practical political will. With the

proposed model of a new ministry responsible for nutrition affairs, this issue can be

approached holistically by means of adopting Kenya’s Nutrition Advocacy Communication

and Social Mobilization Strategy (NACSMS) presented in figure 2 of this report under

literature review. This strategy is translated into three pillars of governance, capacity to

deliver and, behaviour and practices where among key deliverables all stakeholders are

guided with one model. Therefore, issues of lack of sustainability plan by implementing

organizations and erratic participation as reported in the findings would be dealt with by

featuring these components into the strategy taking into consideration social and cultural

inertia aspects as advised by reseach evidence (Zafarullah et al in Sarker, 2006).

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iv. To establish gaps in decentralization program affecting sustainable nutrition

security for an improved programming content

It is worth noting that after twenty years of decentralization programme, only a handful of

services were done through district councils. In particular, the study established that central

government was unable to perform constitutional obligation of devolving services to district

councils as indicated in the 1998 decentralization policy document. There was only partial

devolution of services through allowing councils to manage their own payroll sytem,

recruitment of staff and resource mobilization among others, and decentralization

secretariate was only setup to put in place structures that would never be used fully. Further,

the study pointed that councils were allocated funds less than the established 5% of annual

national budget. Section 150 of the Constitution and section 44 subsection 4 of the

Decentralization Act empowers Local Government Finance Committee (LGFC) to ensure that

councils are funded adequately. It is understood clearly that central government is in conflict

with its own constitution.This can be associated with the absence of practical political will.

While this is the case on the one hand, it should be appreciated on the other as indicataed

earlier, that the study discovered that citizens were now able to hold their leaders accountable

especially on quality of service delivery and amount of funds invested. However, citizens were

denied meaningful participation in decision making except during national elections. This is

the key reason why development issues reflect on the ground, mostly, according to central

government perspective and with almost no consideration from communities or other

stakeholders thereby defeating the essence of the Local Government Act. It should also be

mentioned that misappropriation of project funds as reported contributed to deceleration of

efforts in dealing with malnutrition at the council. While this could not occur regularly, the

impact turned out very severe as the council was unable to sustain the SNIC project following

62

the pulling out of donor amidst a crisis in malnutrition cases. These gaps can be dealt with

through engagement of stakeholders including the local councils and central government to

discuss and adopt the importance of upholding the rule of law, transparency and

accountability which are key preliquisites for good governance (OECD, 2005). Also, citizens

should request central government to be faithful to constitutional obligations.

4.4 Summary of Chapter Four

This chapter has presented study findings and discussed them. The key gaps revealed in the

literature review, which loop on governance, i.e. lack of or inadequate nutrition education and

a vibrant implemetation framework in the implementation of nutrition security projects through

the local councils were confirmed by the findings. The other issues which emerged from the

findings and not explicit in the literature review were lacks of political will, consultations,

resources and capacity building; poor planning and high vacancy rate on key strategic

positions. It has been exposed that coordination of nutrition interventions from national level

was disconnected across sectors. In particular, central government enacted Decentralization

Act and operationalized it in decentralization policy where vibrant structures through which

implementation of nutrition security projects could be effective, were established by a

secretariat, but later government could not make use of the structures as intended. The

moving of nutrition department from OPC to ministry of health could only help worsening the

situation because ministry of health does not focus on preventive measures which are key to

dealing with malnutrition and this is confusing stakeholders. Some commitment on the subject

matter from central government was also noted in the findings and discussion sections

through formulation of policies and adoption of care group model for nutrition projects

implementation. Altenative views have been discussed, offering solutions to the gaps

identified and effectively answering the main question of this study. The following chapter will

63

make conclusion of the study and offer recommendations to the government of Malawi for

possible consideration. The chapter will also highlight on proposed areas for further study

based on the findings of this study.

64

5.0 CHAPTER FIVE: CONCLUSION AND RECOMMENDATIONS

5.1 Introduction

This study investigated implementation of nutrition security projects in local councils of

Malawi through a case study of Zomba district council and it was centred on how can

decentralization policy promote implementation of nutrition security projects through the local

councils of Malawi. The issue caught the researcher’s attention because studies have shown

that malnutrition is the main cause of stunted growth which affects mental and physical

development resulting into an unproductive human capital which deters socio-economic

development. This is a global challenge and in Malawi prevalence rate for stunted growth is

currently at 41% as revealed in the literature review section. The UNGA continues to call

upon countries in the world to put nutrition issues as one of the key development priorities

due to its direct bearing on human wellfare and economic growth. Meanwhile, as shown in

the literature review, more than 10% of Malawi’s GDP is spent on malnutrition cases. The

government of Malawi has put in place policy documents to promote nutrition having

recognised it as a national crisis and the Local Government Act of 1998, through

decentralization policy, targets nutrition as one of the themes to be tackled through

decentralization structures. This is a clear recognition that the governance part of nutrition

issues is very important. However, literature expose that much has been done regarding

causes and effects of malnutrition but litle is known regarding the governance part of it

especially in the implementation of related projects. This is where the study came in to bridge

the gap.

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5.2 Conclusions

The study has established that Zomba district council registered some improvements in terms

of service delivery due to decentralization policy because the council was now able to

implement certain initiatives from within itself as stipulated in the policy. Structures such as

DDCs, ADCs and VDCs have been put in place in communities to facilitate citizen

participation and implementation of various projects. Nonetheless, through Chiweza (2010)

in the literature review, and the study findings, it was noted that government was very slow

to devolve powers to the local structures on various develoment projects including nutrition

security projects (pgs 8 and 49). Precisely, the council could not recognize nutrition as one

of the key priorities. For example, study findings reveal that DDP for Zomba council had no

component regarding nutrition security projects, and nutrition interventions were

implemented as opportunistic activities embedded in HIV and AIDS programme (pg 50). In

addition, the findings point that responsibility for nutrition security projects was entirely in the

hands of NGOs who were accused of planning and implementing projects in isolation i.e. not

involving the council except reporting at DEC before commencing their implementation

activities (pg 50). Some participants, as captured in the findings mentioned that due to

inadequate funding into the councils, nutrition projects were not considered but the nutrition

policies of 2007-12 and 2018-22 in the literature review established that the issue at hand is

a national crisis (pgs 55 and 13).

Further, the study revealed that central government lacked practical political will to prioritize

nutrition as one of the key development issues. For example, the findings reveal that central

government continued to decide on projects to be implemented by councils as opposed to

decentralization procedures where such decisions were supposed to come from communities

(pg 51). The findings also noted that priority projects for government were on construction of

66

roads and public buildings such as schools (pg 54). Further, the findings show that when

funding is released for constituency development under the council, members of parliament

representing constituencies make unilateral decisions in terms of choosing what project to

implement and nutrition has never been chosen by any (pg 51). For the NGO nutrition

interventions, the findings have it that a number of challenges such as lacks of inclusive

planning and sustainability plan detered meaningful progress for desired impact (pgs 52 and

54). At central government level, literature review established that coordination of nutrition

interventions was disjointed and the findings confirmed where stakeholders reported that the

situation was confusing them (pgs 15 and 50). Furthermore, the findings show that lack of

nutrition knowledge exists in most of stakeholders including councils and communities (pg

54). In particular, the findings indicate that due to lack of nutrition knowledge during food

preparation, most of households in villages use soda substances which remove nutrition

value in the food (pg 52). This is consistent with IFPRI (2015) and Smith et al (2003) as

argued in literature review (pg14). These studies contended that food utilization forms the

most importat part of nutrition value chain.

The study recognized that government has demonstrated efforts to deal with malnutrition in

the country although not with a holistic approach. For example, as indicated in literature

review, there are policy documents in place and the findings recorded that government

adopted care group model which all stakeholders in nutrition are asked to use (pgs 13 and

52). The care group model was applauded with positive and visible impact but was yet to be

assessed or measured. Communities were reported, as captured in the findings, that they

were not well conversant with nutrition issues hence their participation was erratic (pg 52). At

worst, some NGOs enticed communities with incentives to attend to their intenvetions and

67

this was discouraged by study participants because people lacked ownership of the projects

and were unable to take initiatives when NGOs end their projects (pg 53).

Additionally, the study established that most of the issues experienced at local councils in

terms of decentralization gaps affecting implementation of nutrition projects were structual

and governance based. For example, as shown in the findings, Zomba district council was

reported to have almost 50% vacancy rate in key strategic positions (pg 55). It was also noted

in the findings that most of the available key staff required training in project management as

part of capacity building (pg 55). The dissolving of decentralization secretariat was described

by participants as premature because it only fulfilled to set up structures without capacitating

them to deliver.

5.3 Recommendations

The following section presents recommendations emerging from the study findings for

possible consideration by stakeholders including the government of Malawi.

i. Central government should consider adopting a practical political will by committing

itself to devolve its functions fully to local councils and the local councils should be

funded adequately. These are constitutional obligations which are unnegotiable.

ii. Central government should also demostrate commitment to the dictates of UN

resolutions by considering nutrition as one of the key priorities to accelerate

development. A new ministry responsible for nutrition affairs should be put in place

to address governance issues surrounding nutrition from national strategic level to

communities. In particular, the ministy should focus on scaling up nutrition

education and putting in place a vibrant implementation framework coupled with

an effective communication strategy. A national crisis should not be left as a

68

responsibility of non-state actors such as NGOs who could play a supplementary

role. As a matter of suggestion, the new ministry can combine Nutrition Affairs (NA)

and Early Childhood Development (ECD) as indicated in the concept framework

because research evidence provided in the study background section shows that

population group of under-five years children are affected by malnutrition in large

numbers.

iii. Stakeholders such as NGOs and others should on the one hand continue engaging

central government on the serious implications of malnutrition with emerging

evidence and on the other they should adopt best practices of good governance

through being inclusive in their project planning

iv. In the short term, local councils should engage NGOs in nutrition interventions and

provide them with guidance in terms of procedures to implement projects under the

council where among other key issues, they should include sustainability plan and

budget.

5.4 Study limitations

Research studies are never short of limitations and this one was no exceptional. Two

limitations in this study are worthy taking note as shown below.

i. Data collection exercise took place during rain season and it was difficult to

convene a meeting with some participants in the study at the district council offices

where the environment was most convenient for them. For example, participants

for FGDs were councillors and most of them reside in rural areas which required

local means of transportation such as a bicycle to reach main roads and connect

to the district council offices. As a result, interviews were rescheduled two times.

69

However, the DC’s office was very supportive. Space for the interviews at the

council premises was readily availbale in all attempts.

ii. The study was done through personal funds and it was challenging to meet some

costs such as transport refunds for all participants of FGDs. The researcher applied

less-cost measures hence all planned activities which required funds were done.

5.5 Areas proposed for further research

Based on the findings of this study, the following areas are proposed for further research;

i. Stunted growth in Zomba district was reported to have dropped by 12% in a space

of eight years. This is a significant drop and achievement worthy exploring and

confirmed to draw lessons for corrective measures.

ii. The Care group model adopted by Malawi government and recommended it to

stakeholders dealing with nutrition was recorded with visible positive impact. It is

important to know why this is the case and draw lessons. Also, there is need to

assess the positive impact for the sake of establishing the extent of the impact

which will inform future programming.

iii. A study on the use of soda substances should be done to determine the extent to

which soda destroys nutrients in food and the study should further ascertain why

most of the households in the villages use soda substances in food preparation.

The study should also focus on other possible substances which reduce or remove

nutrition value during food prepartions. The findings will inform households and the

industry on how to improve food utilization and maximize nutrition benefits.

70

References

Adachi, M. (2008) Theories of Nutrition education and promotion in Japan. Enactment of the “Food Education Basic Law.” Asia Pac J Chin Nutri, (17), 1, pp 180-184

Ali, H. A. & Birley, S. (1998) Integrating Deductive and Inductive Approaches in a study

of New ventures and customer perceived risk. Cranfield University, Imperial College of Science, Technology and Management. Working Paper

Bhargava, A. (2014) Diet Quality, Child Health, and Food Policies in Developing

Countries. World Bank Policy Research Working Paper No. 7072. Biernacki, P. & Waldorf, D. (1981) Sociological Methods & Research, (10), 2, PP141-163 Branca, F., Phelps, H., Mahy, L. (2017) Why are sustainable food systems paramount to

the World Health Organization’s nutrition mission? GREAT Insights Magazine, (6), 4, September/October.

Bryman, A., Bell, E. (2007) Business Research Methods. 2nd Ed, Oxford University Press. Business Dictionary. [On line]. Available on

http://www.businessdictionary.com/definition/time-horizon.html. Accessed; 11 February 2019.

Carlsen, B., & Glenton, C. (2011). What about N? A methodological study of sample-size

reporting in focus group studies. BMC medical research methodology, (11), 26, doi:10.1186/1471-2288-11-26

Cassell, C. (2005) Creating the Interviewer: identity work in the management research

process. Qualitative Research, (5), 2, pp 167-79 Chiweza, A.L. (2010) A Review of The Malawi Decentralization Process: Lessons from

selected districts: A joint study of the Ministry of Local Government and Rural Development and Concern Universal. Chancellor College.

Christensen, T. & Lægreid, P. (2011) Democracy and administrative policy: contrasting

elements of New Public Management (NPM) and post-NPM. European Political Science Review, 3 (1), pp 125 – 146.

Collis, J. and Hussey, R. (2003) Business Research: A Practical Guide for Undergraduates

and Postgraduate Students, 2rd Ed, Basingstoke: Palgrave Macmillan. Constitution of the Republic of Malawi. Lilongwe. Malawi Government Corbin, J.M & Strauss, A.L. (2008) Basics of Qualitative research. Techniques and

procedures for Developing Grounded Theory. 3rd Ed, Thousand Oaks. Sage.

71

Creswell, J.W., & Plano Clark, V.L. (2007) Designing and Conducting mixed methods research. Thousand Oaks, CA: Sage Publications.

Datt, S. (2016) Defining research strategy in a research paper on business studies. [On

line]. Available on https://www.projectguru.in/publications/research-strategy-business-studies/. Accessed; 30 January 2019

Davies, M. B. (2007) Doing a Successful Research Project; Using qualitative or

quantitative methods. New York. Palgrave Macmillan. Department of Nutrition HIV and Aids, (2009) Malawi National Nutrition Policy and

Strategic Plan 2007 -12. Lilongwe. Malawi Government. Department of Nutrition HIV and Aids, (2018) National Multi-Sector Nutrition Policy 2018–

2022. Lilongwe. Malawi Government. Dinnen, J. (2014) Clearly Define Your Research Strategy [On line]. Available on

https://www.mackenziecorp.com/phase-2-clearly-define-research-strategy/. Accessed; 30 January 2019

Engel, P. (2014) Why a new Dutch Food and Nutrition Security Policy should invest

more in improving governance. ECDPM, [On line]: Available on https://ecdpm.org/talking-points/new-dutch-food-nutrition-security-policy-invest-improving-governance/ Accessed; 30 November 2018

Esterberg, K. (2002) Qualitative methods in social research. McGraw Hill. Boston. European Commission. (2018) Nutrition Dashboard for Malawi. [On line]: Available on

http://ec.europa.eu/europeaid/malawi-nutrition-country-fiche-and-child-stunting-trendsen Accessed; 8 October 2018.

European Union. (2016) Action Document for AFIKEPO Nutrition programme in Malawi.

Lilongwe. Explorable.com (2009) Snowball Sampling. [On line]. Available

on https://explorable.com/snowball-sampling. Accessed; 11 February 2019. Farmers Union of Malawi (FUM). (2018) Nutrition Sensitive Agriculture Pilot Project,

Environmental & Social Management Framework. FUM Working Paper No. P163923. Lilongwe.

Fan, S. (2017) Reducing food loss is key to end hunger and undernutrition by 2025. IFPRI

Newsletter. [On line]. Available on http://www.ifpri.org/blog/reducing-food-loss-key-end-hunger-and-undernutrition-2025 Accessed; 5 February 2019

FAO. (2015) Implementation Plan of the G20 Food Security and Nutrition Framework.

72

Discussion Paper. Rome Garson, G.D. (2008). Case Studies. Qualitative Research in Public Administration. North

Carolina State University. Gibbs, G. R. (2010) Grounded Theory; Core elements. University of Huddersfield. [On

line]. Available on https://www.youtube.com/watch?v=4SZDTp3_New. Accessed; 29 January 2019.

GIZ, (2017) Malawi: Food and Nutrition Security. Deutsche Gesellschaft fu r. Goodman, L.A. (1961) “Snowball Sampling.” Annals of Mathematical Statistics, 32, (1),

pp148 – 170 Graser, B. (1978) Theoretical Sensitivity: Advances in the Methodology of Grounded

Theory. Mill Valley, CA; Sociology Press. Gray, D. (2014) Doing Research in the Real World. London. Sage Greener, S. (2008) Business Research Methods. London: Ventus Publishing. Hawkes, C. (2017) Policy coherence across the food system for nutrition: From challenge

to opportunity? GREAT Insights Magazine, 6, (4) September/October. Hesse-Biber, S. N. (2010). Mixed methods research: Merging theory with practice. New

York. Guilford Press. Hussein, M.K. (2005) Good Governance and The New Local Government System in

Malawi: Challenges and Prospects. PhD in Public Governance. University of Johannesburg. Available from: http://www.ujdigispace.uj.ac.za› ... › Department of Political Studies (ETDs).

Hussein, M.K. (2013) Decentralization and Management Reforms on the Death Bed?

Obstacles Facing Malawi's District Councils. Africa Review, 4, (1) pp 33–47. Hussein, M.K. (2017) Local Governance in Malawi – sighs and sobs in District Councils?

The International Journal of Social Sciences and Humanities Invention, 4, (1) pp 3222-3230

IFPRI. (2018) Nutrition-sensitive programs: How can they effectively tackle Malawi’s

nutrition problems? [On line]: Available on http://massp.ifpri.info/2018/05/25/nutrition-sensitive-programs-how-can-they-effectively-tackle-malawis-nutrition-problems. Accessed; 2 December 2018

International Food Policy Research Institute – IFPRI. (2015) Report on Mapping Linkages

Between Agriculture, Food Security and Nutrition in Malawi. Lilongwe. IFPRI

73

Johnson, S.L. (2010) A Question of Time: Cross-sectional versus Longitudinal Study Designs. Pediatrics in Review, (31), 6, pp 250-251

Koppa-info. (2010) [On line]. Available on

https://koppa.jyu.fi/avoimet/hum/menetelmapolkuja/en/methodmap/strategies Accessed; 28 January 2019.

Lapadat, J. & Lindsay, A. (1999) Transcription in Research and Practice: From

Standardization of Technique to interpretive positionings. Qualitative Inquiry, (5), 1, pp 64-86

Leech, N.L. & Onwuegbuzie, A. J. (2009) A Typology of mixed methods research designs.

Quality and Quantity, 43, pp265-75 Leeuw, E.D, Hox, J.J., & Dillman, D.A. (2008) International Handbook of Survey

Methodology. European Association of methodology series. Routledge. Lein, B. (2013) Between policy and practice: the EU Food and Nutrition Security

Implementation Plan, ECDPM, ACP-EU cooperation [On line]: Available on https://ecdpm.org/talking-points/policy-practice-eu-food-nutrition-security-implementation-plan/ Accessed; 30 November 18

Malawi Government. (1998) Local Government Act, 1998. Lilongwe. Malawi Government Malawi Government. (2017) Malawi Growth and Development Strategy III 2017-22,

Building a Productive, Competitive and Resilient Nation. Lilongwe. Malawi Government.

Malawi Government, Department of Nutrition, HIV and AIDS. (2018) National Multi-Sector

Nutrition Policy 2018-22. Lilongwe. Malawi Government Mayne, J. (2015) Useful Theory of Change models. Canadian Journal of program

evaluation, (30), 2, pp142 Ministry of Agriculture and Food Security – MoAFS. (2011) Malawi Agriculture Sector Wide

Approach: A Prioritized and Harmonized Agricultural Development Agenda: 2011 – 2015: Malawi Government.

Ministry of Agriculture and Food Security – MoAFS. (2010) The Agriculture Sector Wide

Approach (ASWAp) Malawi’s prioritised and harmonised Agricultural Development Agenda. Government of Malawi.

Ministry of Agriculture, Irrigation and Water Development- MoIWD. (2016) National

Agriculture Policy. Lilongwe. Government of Malawi.

74

Ministry of Finance and Development Planning Department of Development Planning. (2012) Malawi Growth and Development Strategy II 2011-16. Lilongwe. Malawi Government.

Ministry of Finance and Development Planning- MoFDP. (2011) Malawi Growth and

Development Strategy II 2011-2016. Government of Malawi. Ministry of Justice. (2004) The Constitution of the Republic of Malawi. Lilongwe. Malawi

Government. Ministry of Local Government and Rural Development – MoLGRD. (1998) The Malawi

National Decentralization Policy. Lilongwe. Malawi Government. Morgan, D. L. (1997) Focus Groups as Qualitative Research; Planning and Research

Design for Focus Groups. SAGE Research Methods, pp 32-46 Mphwanthe, G. , Kalimbira, A.A, & Geresomo, N.C. (2016) Consumption and wastage of

home-fortified maize flour products in northern Malawi. South African Journal of Clinical Nutrition, (29),1, pp 23-26

Mugambi, G., Volege, M., Gichohi, G. (2017) Co-ordinating sectors: Kenya’s Food and Nutrition Security Bill. Nutrition Exchange, (7) p11

Ngwenya, S. (2015) COMESA fully behind CAADP Vision 2025 ECDPM interviews.

GREAT Insights Magazine, 4, (2) February/March. Ochs, P. (1998) Peirce, pragmatism, and the logic of Scripture. Cambridge. Cambridge

University Press. Office of President and Cabinet – OPC. (2013) Organization Performance Assessment

Report. Malawi Government. (July 2012 – March 2013). Office of President and Cabinet- OPC. (2007) National Nutrition Policy and Strategic Plan.

Lilongwe. Government of Malawi. Office of President and Cabinet- OPC. (2011) National Nutrition Education and

Communication Strategy for Preventing Child Stunting in Malawi. Lilongwe. Government of Malawi.

Office of President and Cabinet- OPC. (1987) Statement of Development Policies 1987 –

1996. Zomba: Government Printer. Onwuegbuzie, A. J. & Collins, K.M.T. (2007) A Typology of mixed methods sampling

Designs in Social Science Research. The Qualitative Report, (12), 2, pp 281-316 Onwuegbuzie, A. J., Leech, N.L., & Collins, K. M. T. (2012) Qualitative Analysis

Techniques for the Review of Literature. The Qualitative Report, 17, (56) pp1-28.

75

Organization for Economic Corporation and Development - OECD. (2005) Modernizing

Government: The Way Forward. Paris: Grands-Augustins. Project Oracle. (2014) Developing a Theory of Change for your project. London. London

Metropolitan University Reddy, S. (2015) Smallholders need a seat at the table too. GREAT insights Magazine, 4,

(2) February/March. Resnik, D. B. (2015) What is Ethics in Research & Why is it Important? National Institute of

Environmental Health Sciences. US Government. Robson, C. (2011) Real World Research. 3nd Ed, West Sussex. John Wiley & Sons Ltd. Sarantakos, S. (2012). Social Research, Palgrave Macmillan. Available

on https://books.google.com/books?hl=en&lr=&id=IjUdBQAAQBAJ&pgis=1. Accessed; 24 January 2019.

Sarker, A. E. (2006) New Public Management in Developing Countries; An Analysis of

Success and Failure with Particular reference to Singapore and Bangladesh. International Journal of Public Sector Management, 19 (2), pp 180 – 203.

Saunders, M., Lewis, P. & Thornhill, A. (2009) Research Methods for Business Students,

5th Ed, Pearson Education UK. Saunders, M., Lewis, P. and Thornhill, A. (2012) Research Methods for Business

Students. Pearson Education Ltd. Harlow. Sheahan, M. & Barrett, C. B. (2017) Food loss and waste in Sub-Saharan Africa. Food

Policy, (70), pp1-12 Shuttleworth, M. (2008) Case Study Research Design. [On line]. Available

on https://explorable.com/case-study-research-design. Accessed; Jan 25, 2019 Smith, L.C., Ramakrishnan, U., Ndiaye, A., Haddad, L. & Martorell, R. (2003) The

Importance of Women’s Status for Child Nutrition in Developing Countries. IFPRI Research Report no. 131. Washington DC.

Soiferman, L. K. (2010) Inductive and Deductive Approaches. University of Manitoba. Strauss, A. (1967) The Discovery of Grounded Theory. Strategies for qualitative Research.

Chicago. Aldine. Strauss, A. (1967) The Discovery of Grounded Theory. Strategies for qualitative Research.

Chicago. Aldine.

76

Thomas, G. (2013) How to do your Research Project: A Guide for Students in Education and Applied Science. 2nd Ed, Sage.

University of Gloucestershire Research Committee. (2018) Research Ethics: A Handbook

of Principles and Procedures. England. University of Gloucestershire. UNSCN. (2014) Country Policy Analysis: Nutrition Impact of Agriculture and Food Systems

Malawi. UN System Standing Committee on Nutrition country study for the second International Conference on Nutrition. Geneva, Switzerland.

USAID. (2014) Malawi: Nutrition Profile [On line]: Available on

http://www.usaid.gov/sites/default/files/documents/184/USAID-Malawi-Profile.pdf Accessed; 8 October 2018.

Visser, P.S., Krosnick, J.A., & Lavrakas, P.J. (2013) Handbook of Research methods in

social psychology. 2nd Ed, Stanford University. WFP. (2015) Malawi: New Study Reveals Huge Impact of Hunger on Economy of Malawi

[On line]. Available on http://allafrica.com/stories/201505131124.html. Accessed; 25 June 2015.

WFP. (2013) Using Monitoring and Evaluation to Maximize Impact for Stunting Prevention

in Malawi [On line]. Available on https://documents.wfp.org/stellent/groups/public/documents/manual_guide_proced/wfp286275.pdf Accessed; 10 March 2019.

WHO & UNICEF. (2009) WHO child growth standards and the identification of severe

acute malnutrition in infants and children. Geneva, Switzerland. Wood, B., Nelson, C., Kilic, T., & Murray, S. (2013) Up in Smoke? Agricultural

Commercialization, Rising. IFPRI Discussion paper No. 6650. Washington DC.

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Appendices

FGDs transcripts

Group One

Objective 1: To establish the understanding of key stakeholders regarding the role and benefits of decentralization program in achieving ideal nutrition security a) What is your view on the decentralization program which the district council is empowered to implement

through the Decentralization Act of 2010?

1st R: Decentralisation we take it like a song. This programme is not reaching out the people it was supposed to serve. We would say we have decentralisation in Zomba but people in the village have not seen the benefits of decentralisation. I am saying this because we are supposed to have the project which the people in the village are supposed to do. The work which the villagers were supposed to benefit the authority brings their own contractor. Decentralisation is there by name but the central government still run all the undertakings. People not being involved in decision making as prescribed by decentralization. The central govt is still controlling projects. Decentralization is only there as a song not action.(decentralization only existing on paper) 2nd R: we decentralisation in Zomba the only challenge is that people in the village do not know What it means when we say decentralisation. When we say decentralisation we mean the the council and the people in the village have been empowered to run their projects. The problem we have is the empowerment which the council have been empowered; it’s a challenge for the same council to empower the people on the ground. People don’t know about decentralisation, the normal procedure is supposed to be the projects are supposed to come from the people in the community to the council then to the central government But most of the projects are failing at the council. So the people in the village have not received the information enough to know more about decentralisation. People in the communities do not understand their role in decentralization because government through the council is not doing enough to involve people in making decisions for various projects. (people do not understand their role due to not being involving by govt)

3rd R: Decentralisation I understand it in the way that any citizen of Malawi has the power wherever they maybe to make a decision to decide what they want. They might be in the villages or town. They have a right to decide what they want and their decision is what is supposed to be happening. They are supposed to use the resources that will respond to their needs which they are lucking in the area not for the central government or the council deciding for them. Decentralization means that the citizens must have power to decide what they want in terms of development and how to use available resources as opposed to government or the council deciding for the citizens.(citizen participation) 4th R: Decentralisation the way we understand it, is that people are empowered to make decisions on what they want. But the authorities seem to hold on to release the empowerment to the people. Probably they think there positions will cease. People in the village they may have the project but when they are approved they always have guidelines. So the people questions where is decentralisation. Decentralization is when people are empowered to make decisions regarding desired activities and projects in their area but authorities are not willing to empower people in communities. (citizen participation though govt not involving people) b) How do you describe the program in terms of impact in various sectors of Zomba district communities

especially during Malawi Growth Development Strategy (MGDS) II (2011-16)?

1st R: Things on the ground here and there have changed because previously it was difficult for an ordinary person to find out about the projects from the authority, the case which is happening today. People are free to check on the projects happening in the area about the cost of the project and who is funding the projects. There is notable improvement in a sense that ordinary citizens are now free to follow up on what is happening on projects in their area i.e. cost of project and funding organization.

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2nd R: Decentralisation is working and people have been empowered, good examples are that when a contractor is working and people have noticed that he is not mixing well cement. People able to stop such projects and seek the way forward by discussing with the contractor. It applies the same in the hospitals when people are not satisfied with the service they are able to call the authorities for discussions. So people on the ground are responding well they are knowing some of the things. Citizens are now free to engage service providers of projects in their areas to appreciate quality of their work. For example building contractors can be stopped to work if people note that they are doing sub-standards c) One of the key issues which the MGDS II was mandated to address, was to improve nutrition security

because of its direct relevance in the country’s social-economic growth, how do you describe the implementation

of nutrition security projects during this period?

Participants could hardly recall d) What roles did you play in these projects?

1st R: Our role is to encourage the people to participate in the programme and also helping the implementers to find the resources they want in the community. The role of a councillor is to encourage people to participate in projects implementation

e) What is your view in terms of impact from these projects due to decentralization program at the level of

Zomba district council?

1st R: MGDS II is one of the policy document that gives you a guide but when we ask each other if we have seen MGDS II or read about it. You will find that none of us has done that. So I wanted you know as you are referring to MGDS, we will responding to something that we don’t know. Why we don’t know, as councillors we make roles and it is the secretariat that implements and they are supposed to give guidance. Like the situation of nutrition, they are supposed to tell us the status in Zomba and what the policy document are saying. So there if good information that we could have been answering this referring to data on the ground. There are supposed to be reports for state of Nutrition in Zomba, this could be constituency by constituency. This could help me as a councillor to enlighten my community that things are not and this is what we are supposed to do to improve because they will have impact on our children intelligence. There is serious lack of information from the central govt via the council. As councillors we do not have guidance regarding state of nutrition in Zomba as such it is difficult to guide our communities on specific activities, so the impact is minimal. f) Using a Likert scale of 1 to 5, how do you rate designing of nutrition security project implementation in

reference to decentralization policy?

I: You are highly satisfied with Nutrition issues, Very satisfied, satisfied, Dissatisfied and Very dissatisfied 1st R: Very dissatisfied 2nd R: Very dissatisfied 3rd R: Very dissatisfied 4th R: Very dissatisfied 5th R: I will say I am partly satisfied because there has been information which has been coming and people have received the information. There has been interventions like now there is food for asset (FFA) there are receiving maize, beans and cooking oil all this they are targeting Nutrition. 6th R: In my ward there is an organisation World Vision it has taken part in teaching the people to plant vegetables which is also helping in nutrition. So I am somehow satisfied. 7th R: In my area I have also seen organisation giving people goats so that when give birth they would another person. This is all the part of nutrition.

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Some are partly satisfied because of interventions such as Food for Asset program where people receive maize, beans and cooking oil. NGOs such as World Vision motivate people to grow vegetables and other organizations distribute goats to families who will pass on to other families after reproducing. Objective 2: To appreciate factors affecting implementation of nutrition security projects

a) What measures did you put in place to achieve intended results within allocated time for implementation

of projects under the district council during MGDSII?

1st R: The projects were to come from the ground (Village) to the council. Then when there is response they return from the council to the village. The problem which is there, the projects when coming they are attached with conditions which is contrary to what people have been thinking. So people work because they wanted the project but with no satisfaction. For example people wanted Road project with ring beam, the project could be funded but with no ring beam which people wanted. When things happen like this it means the desires of the people has not been achieved. Because in this case the road gets damaged again. That desired projects would come from the communities to the council, when funding come, the council goes back to the communities for implementation. However, projects are changed at the council and implementation is done with conditions. For example, a community would propose public buildings constructed with ring beam but when implementation begins there are instructions that the building would not have a ring beam. It means what people desired to have a long lasting structure is not considered. I: So in your areas do you have procedures on how the projects can come on the ground? 2nd R: When the project has come here on the council, from VDC to ADC and when it is decided at the council the project goes back through ADC. It is at ADC where they direct the project to an area and they put condition attached to the project. For example the issue of nutrition they would say those who have back yard garden should be in the project and those who do not have should not be part of the project. So the condition is the protection for the implementation of other projects. The ADC acts like the over seer of the projects in all the areas and they report back to the council. Other condition discourage people to participate. For example on nutrition projects, those who do not have back yard in their homes do not have opportunity to grow vegetables funded by an organization. 3rd R: Sometimes we are told to bring the projects that the people wants in the villages. The area may decide on the school blocks but when the decision come here at the council we are told there is no funding for school blocks but roads. We do roads very year and when the rains come they are damaged. Priority projects here at the council go to construction of roads every year although communities want other projects such as school blocks yet the roads are never sustainable. They require maintenance every year. I: As councillors your term is going to the end. From the time you started work where would say most project came from on the ground from the people or from the council? 3th R: We would say half would go back to the ground and half would not. Like we would want a school block and planting trees. What will come will be planting trees in a certain area and making roads and the road may need the covert, they will not be there. Half of the projects that communities desired did not pass. The council concentrates on roads which are done with no expertise such that in the following year, the roads are damaged and should be worked on again. 4th R: In the village they have projects that they want, which have been presented to ADC and the response has come back like in Zomba we want eleven school blocks but we will look at which area has a need for the school block and we would acknowledge that the area should have the school block. But the problem is that when the projects are coming they already have a focus to which area they will go. Sometimes the problem is that specific projects are allocated to certain areas for unknown reasons. People from those areas may not want school blocks but they are forced to accept school blocks instead of other community priorities b) What were the priority projects considered by the council?

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1st R: CDF has brought school, bridges and roads but not nutrition projects. 2nd R: CDF has different work and it concerns much on the desires of the MP that he accepted to have a school block in the area. But it’s not in all areas to happen like that. CDF seems is for the MP who makes decisions over it so what works is what he has decided. Community development fund is controlled by the sitting member of parliament in the area. The MP prioritises projects that he or she feels will be visible on the ground so that he is voted back into power. (no political will by members of parliament probably due to absence of political will by central government) 3rd R: There is no councillor here who can say CDF was used for a Nutrition project, there is no one. c) Why? - already discussed above

d) Are you aware of malnutrition as a major cause of stunted growth in Zomba district and Malawi as a

country?

1st R: Yes but The nutrition department is not working, previously there used to be schools which would teach the women about nutrition and there was also Farm Institute. With this things were ok even in the villages they were eating nutritious food because at every EPA there was a Nutrition extension worker. The phase out of that which now only on RDP there is a Nutrition Officer has caused a lot of problems, there is no one at EPA and in the community as a result information flow is a challenge. Yes but nutrition department is no longer focussing on nutrition as compared to decades of years ago as in 70s and 80s. There used to be community nutrition schools facilitated by nutrition extension workers and people benefited a lot through preparation of nutritious foods.(nutrition education was once given priority and it benefited people) 4th R: My area is close to the EPA and nutrition programme take place only around the EPA not any further. They don’t take people which are from a distance for a cooking demonstration. There is some efforts towards nutrition in terms of cooking demonstration in my area but it is only involving a handful people. e) To what extent in terms of percentage has the council considered implementation of nutrition security

projects? Almost none, only NGOs come with nutrition projects but not directly from the council

f) What nutrition security projects do you remember being implemented during MGDSII?

Growing of vegetables in back yards through World Vision fund but now it is no longer there g) What were the challenges and problems involved?

1st R: The challenge is the dishonest of those in authority because there is this information at Agriculture but they don’t want to tell people. We would say the people in the village are failing but there are no people to teach them. There is serious lack of information from the Agriculture department. People do not know what to do exactly to improve and sustain their nutrition.(lack of nutrition education) 2nd R: Things are not done in order say if you tell the MP to do a Nutrition project they would take that of no importance. The result is that as time goes things a dying naturally and at the end there will be no nutrition department. There is no political will to streamline nutrition. If you suggest to Member of Parliament to implement nutrition projects, he or she will not consider it because they don’t feel it is important for their votes. They want physical things on the ground 3rd R: I want to talk about poverty which I think affects us so much. People get one thousand if they luck on a piece work per day. But people eat more than one thousand kwacha in a day. On the same money he has to pay school fee for his children and dress his family. So I think poverty is what is failing us because with such money he cannot afford to get nutritious food. Sustainability has been a challenge because the organisation that come in the villages are using the same people who are now there for the benefits, they know this organisation has money. When they NGO has phased out they know there benefits are over they will go a sit down. They will not continue with it because all they wanted were the benefits. They are doing business not that they knowledge they have received they should help there areas. Poverty is also a contributing factor to achieve household nutrition because it is not easy to acquire nutritious food when a family can only raise a thousand kwacha or below in a day. They have other

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needs such as school fees, clothes and other household needs. The other problem is that NGOs come with nutrition projects without sustainability plan. The moment their project comes to an end, people stop there. So people perceive their projects as a onetime intervention to benefit from. 4th R: The rain also have contributed to reduce people’s capacity as they are not producing enough to sustain themselves. 5th R: The NGOs when going in an area they should be implementing their programmes together with the government so that continuity should not be a challenge. It is a challenge now because the NGOs go on ground on their own as such people know the period the NGO will be around and during the period the NGOs gives the people the incentives. This becomes a challenge when the government takes over because they don’t give incentives and people do not participate. I think there a lot on money allocated to Nutrition in the councils in Malawi, but it’s not utilized well. There are NGOs that brings people Goats in the villages but you will see the goats die before they distributed. They give seed like beans, soya, and cow peas when the rains are almost gone. How can we progress in this case? NGOs should be working hand in hand with government when implementing their nutrition projects so that government should take over when the project comes to an end. Some NGOs give incentives of money to people to participate in their projects and when they go government does not do the same, which is challenging to continue motivating people in the community although the projects are for their own good. NGOs should avoid going to communities and implement projects on their own without government.(lack of coordination on the part of NGOs in nutrition and government) 6th R: In the villages most areas they use soda to prepare they meals which at the end kill the nutrients in the meals. I don’t what soda benefits our bodies but I would have loved the company that makes soda to close up. Also preparations of food in the villages does not help to gain nutrition values from our food. For example there is heavy use of Soda in almost every relish cooked in the villages. Soda does not keep nutrition in relish. People need to know these things.(preparation of food by use of Soda, which is very common in villages of Malawi, cause loss of nutrients value) h) How were they dealt with?

Participants could not recall how the outlined challenges were dealt with although they would suggest if given a chance. i) How did the council relate and collaborate with other key players such as Non-Governmental

Organisations (NGOs) and Academia on implementation of nutrition security projects?

1st R: When we talk of Zomba Council its where there is the presence of the Councillors if there are no councillors that is not council. So the NGOs are not in working relation with the council but they work well with DEC. When the NGO come and meet DEC they are released to go and work in the areas they want. So when they have jumped the council here it’s rare to find a councillor working with the NGO.In 2015-2016 we had almost 42 (Forty-two) NGOs but only 15 (Fifteen) were active on the ground and DEC was aware of that. So the NGOs here in Zomba they work with DEC not Council. A council cannot exist without us councillors which means we are an important part of decision making as a council. Unfortunately NGOs here in Zomba deal with District Executive Committee (DEC) and not us as councillors. It is therefore difficult to see a councillor collaborating with NGOs although we are on the ground with the people (lack of coordination on the part of technical stakeholders) I: Does this mean between DEC and Council there is no collaboration? 1st R: Yes, there is nothing. 2nd R: There other NGOs that we know and we are involved in their programmes but there is no good collaboration with the NGOs. 3rd R When NGO has come to DEC with their work and preference area. The DPD would make arrangements to meet the DEC and when this is done the NGO is allocated. The right order according to the laws it’s supposed

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to be when the NGO meets come and meet DEC, the DPD should call for council meeting through Development Committee and the Development Committee should present to the Full Council that there is an NGO which will do this, in a area. So in this order it will mean all the councillors in Zomba will know about the NGO and the area they are working. But if the arrangement ends at DEC it means council does not know. It happens that things are happening in TA Chikowi but the chief knows nothing of what is happening in his area. According to procedures, when NGO comes and meet DEC, the director of planning and development is supposed to call for a full council meeting and discuss the NGO objectives and their targeted communities. This could encourage a working relationship between councillors and the NGOs. Unfortunately the arrangement ends at DEC and excludes the council. Sometimes, even the chiefs do not know about NGO activities in their areas. I: so planning of intervention to go in a particular area, you are saying DEC makes the decision? 3rd R: Yes. 4th R: They are using the old procedure where there were no councillors. Then when an NGO meets DEC they were allocated. So it’s a challenge for the councillors to work with the NGOs which they have not be informed through the council. The DEC is killing the role of the councillors in the areas because we have the power to stop the projects which are not in order but in this case it is a challenge. The council operates as if there are still no councillors like in the past years. As councillors we have the mandate to make decisions including stopping a project in an area if certain measures are not followed but we cannot do this now, it is challenging. Objective 3: To understand community participation in nutrition security programming and productivity a) In terms of percentage, how do you rate awareness and participation of Zomba district communities

regarding nutrition security projects especially during MGDSII?

1st R: Awareness 20% Participation: 20% 2nd R: Awareness 25% Participation: 10% 3rd R: Awareness 25% Participation: 20% 4th R: Awareness 20% Participation: 20% 5th R: Awareness 30% Participation: 20% b) Please state how you feel about your ratings on the scale below?

0=Dissatisfied 1=Neither satisfied nor dissatisfied 2=Satisfied 3=Highly satisfied All R: We are not satisfied c) Why? -already discussed above

d) Did communities regard nutrition as one of the important household need?

1st R: They don’t care about nutrition. 2nd R: and some they don’t even know about nutrition. 3rd R: Most people they just eat to fill there stomach and some consider nutrition to be for the rich that can afford.

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4th R: At list something is happening on the ground hence we were able to mention the percentage. Like now there are back yard gardens that are people have in the village where they grow vegetables and them the organisations are giving the people beans and cooking oil. The remaining thing is for them to find fish then they have eaten a variety of food. It is important to acknowledge that something is happening on the ground that is why we able to mention the percentages; for example distribution of beans and cooking oil in communities, but there is a long way to go. 5th R: These things my colleague has mentioned are happening in specific areas. This is because the authority decides who to attend to probably because they do not agree with the councillor, or they don’t like the area. The problem is that distribution of food items as my colleague has mentioned do not take place in all areas. They target specific areas probably for political reasons. e) Why? – already discussed above

f) What is your view regarding commitment and programming content of key players such as NGOs in

nutrition security projects including the central government? - already discussed above

g) What could you change at planning level and in the community to achieve higher rate of awareness and

participation in implementation of nutrition security projects? The council should improve on sharing of

information regarding nutrition and coordination of activities through the council should be reviewed. Most of the

decisions made are forced through to communities. (lack of information sharing and effective coordination)

Objective 4: To establish gaps in decentralization program affecting sustainable nutrition security

a) What is your perception towards decentralization program in promoting nutrition security in communities

under the council?

1st R: People are able to follow development issues in their areas although issues of nutrition are far behind. Leaders are mainly to blame for not reaching out to people with targeted interventions in various programs. Central government is happy to hold on to power in most of these issues.(lack of coordination and political will) 2nd R: Some people know what to do in terms of nutrition needs for the household but they are lazy to do what they know while others cannot do anything due to poverty

b) What training did you receive or attend on management and implementation of these projects?

1st R: No 2nd R: No 3rd R: No, there was SNC which just briefed as about the nutrition needs of an expectant woman. But it was not a training.

c) What sort of support does the council require to advance implementation of nutrition security projects?

1st R:The council should have enough funding that will be channelled to nutrition interventions 2nd R: People should be allowed to participate through their leaders such as councillors

d) How would you like to be supported as one of the key officers under the council to contribute better

towards implementation of projects? N/A

e) How can the council achieve nutrition security and sustain it?

1st R: There should be a department specifically for Nutrition that will be looking on issues in the villages and it should be attached to Community Development. (Implicitly suggesting ministry responsible for nutrition) There should be schools that women will go and learn about nutrition and how to prepare food. There should also be farm institute (Nutrition education) 2nd R: We already have department of nutrition but what I would love this should extend to the wards. The councillor should be part of the community nutrition councillors. And there should be a leader who will be over seer of nutrition in a particular community. There should also be clubs which will enable proper management.

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Councillors should be involved in nutrition interventions and there should be community leaders to oversee nutrition interventions. Community nutrition clubs should be formed and enabled 3rd R: There is department of Nutrition in Agriculture and community Development. I would love them to coordinate and work together, in this case people on the ground will be able to benefit. We have extension workers for Community development and Agriculture in the areas but they are not working together it thy could work together about nutrition which they advocating Zomba would change. Alternatively they should give each other chance to implement the programme which have come in the areas. The department of nutrition should be grounded into the community and should coordinate activities at district level. There should not be duplication of efforts with other departments because this confuses the people on the ground (lack of coordination on nutrition interventions by govt) I want to thank you that you have empowered us where nutrition is concerned and we can now look into it when we are planning the budget. 4th R: We should have documentation centre in the areas where they will show the projects that have taken place in the areas and which areas have been left behind. There should a Nutrition representative in the VDC because that is where the projects come from and the representative will be able to enlighten on nutrition matters and the projects required in particular area on Nutrition. ADC should also be vibrate to monitor the projects in Nutrition and other projects. The council should document and disseminate all information regarding projects and their communities of intervention. A nutrition representative should be there in village development committees and that one should be the liaising point for nutrition interventions. There should be a vibrant monitoring framework for nutrition related activities Organisation should teach well the councillors about budgeting and expenditure tracking. This will able the to follow well the proceeding of the allocations and be able to advice the areas of need. There should be an NGO to train councillors on budgeting and expenditure tracking so that they are able to follow implementation of projects properly (interesting suggestion worthy exploration?) 5th R: The council knows about the Nutrition issues but they need to put the right order in their priorities. DEC, service committee and full council in this order empowerment on nutrition will reach the people. The council must prioritise nutrition in their projects 6th R: This Nutrition should be under one Ministry because the percentage you have given us of 36.4% in Zomba is from Agriculture. But we see the people in this sector we will find that they don’t know about it. This will apply to Health and all that are dealing with nutrition. The department if can belong to one ministry it will help where we can go and ask or find information. The department of nutrition should be under one ministry. As it is, it is confusing. The ministry of Agriculture and health have nutrition departments and they do not seem to collaborate well on the ground. (implicitly suggesting a ministry responsible for nutrition which will not focus on other ministry issues) Information should not be hidden here in Zomba about issue like nutrition, everyone should have access. There should be effective dissemination of nutrition information to all key stakeholders (nutrition information sharing and education) Finally I would like to know how we will have access to what we are discussing. 7th R: The Zomba council should put empower the committees that are in the areas this will help. People should be taught about ownership so that when they have been taught with the organisations things should continue. People should not look at hand outs. Communities should stop looking for handouts. Zomba district council should empower communities to own projects that are for their own good. This will ensure continuity of nutrition projects even when NGOs have rounded up their projects. We want to thank you although you have come at the end of our term as councillors, we would have loved to meet you earlier. We would love also to see the results of this study.

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8th R: I would love to see there is a group of people looking into Nutrition and a certain allocation for them to be using for transport. It is important to have a grouping that will specifically look into nutrition issues across the board. This grouping should be allocated all required resources to deliver (explicitly suggesting a ministry responsible for nutrition) 9th R: The ministry of Health and Agriculture have their people who are working in the communities. These are supposed to work together so that they reach and disseminate the required information on Nutrition. This should start at DEC level, before they start working in the community they should call and inform the extension workers under Health and Agriculture what they want to do in the area. At the end these extension will help in implementation of the programme because they stay within the community. Ministry of health and agriculture should plan and work together to reach out to communities on nutrition issues (need for proper coordination) We thank you that you have empowered us with information through this discussion.

Group Two Objective 1: To establish the understanding of key stakeholders regarding the role and benefits of decentralization program in achieving ideal nutrition security a) What is your view on the decentralization program which the district council is empowered to implement

through the Decentralization Act of 2010?

1st R: Decentralisation It is the capacity that the people in the village (ground) have to decide of the programme that they want in their area. When they decide they take this to the authority, this is different from it used to happen in the past where programmes would come from the authority to the ground. People in communities should decide what development needs to be done (citizen participation) 2nd R: Decentralisation is the empowerment that the central government has given to the council that they can do everything in corroboration with the people on the ground. In this case like in my case it is the people of my area Thondwe who will decide the project they want in their area and bring it to the council. Central government enabling councils and people on the ground to decide what projects they want (citizen participation – councils and the people)

b) How do you describe the program in terms of impact in various sectors of Zomba district communities

especially during Malawi Growth Development Strategy (MGDS) II (2011-16)?

1st R: I would say things are working on paper but on the ground there is a challenge. A good example is LDF is not achieving its purpose, like in my area the problem that the people had they are still the same problems until now. Our problem in the area could be the bridge or clinic, but when the money comes from central government they are attached with particular projects for the money which in most cases they are not what the people want in the area. So the people do the project because they want to the money. So on decentralisation the central government still controls the projects. Things only working on paper. People come up with their list of needs but they end up being told to do projects that they do not desire. The central government controls which projects should be done 2nd R: Central Government has just empowered the council or the people on the ground on paper but Central Government is driving all the activities. Like every funding that comes on the district has project attached to it. Central government controls all activities regarding projects to be done and how. The government has only empowered people on paper. I:But in the villages we hear there are Village Development Committees and Area Development Committees?

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2nd R: Yes there are there but they do not work, they would plan that this year CDF we want to use on these project but what the VDC or ADC have agreed on when they come here they are told there procedure do not allow them to do what the VDC and ADC have agreed on which is contrary to the people on the ground need. At the district again they fear the authority from the Central Government if the district had no fear of the central Government decentralisation would have been working well. Even the DC when you tell him that this is what the people on the ground want, he would to ask first from the central government he cannot make a decision on his on. There are such structures as VDCs and ADCs but what they choose and plan to do is always changed by central government. Even the district council, the DC always refers to central government if certain projects can take place or not. (Government heavily controlling choice of projects and how they should be run) I:So you are saying there is nothing mention or discuss on the ground due to decentralisation? ALL. R: Yes, there is nothing. 3rd R: Some VDC and ADC do not understand decentralisation they are just working without being trained.it would be better as the source of the projects to be trained so that they understand what they are supposed to be doing. No proper guidance and training of ADCs and VDCs hence they lack direction. c) One of the key issues which the MGDS II was mandated to address, was to improve nutrition security

because of its direct relevance in the country’s social-economic growth, how do you describe the implementation

of nutrition security projects during this period?

1st R: On nutrition at list so far so good people they work so that they receive money through LDF so there is different now and in the past because malnutrition has reduced and in the hospitals there are programmes of peanut distributions and Likuni Phala, so things are better unlike before. There is something to refer to regarding nutrition. People receive peanut and Likuni Phala which is rich in nutrition when they go to hospital. 2nd R: In addition these days there are organisation which when they come here at the council they are allocated which area they are supposed to work, this is also helping. But when nutrition projects have come on the ground through organisation people in the area depends that the NGO will do everything and they will just be receiving. Most people go into the project to benefits themselves and when the project ends there is no continuation. There are organizations working in nutrition but they do not have continuation plan. When their projects end people stop regarding nutrition as an important issue in their homes. (lack of sustainability plan for NGOs interventions) 3rd R: These projects when they come they fail to teach people what will be part of their life but what is happening is that, the programme has phased out and everything also ends. No continuation plan d) What roles did you play in these projects?

We did not play any role e) What is your view in terms of impact from these projects due to decentralization program at the level of

Zomba district council? No tangible impact. We are only told that children’s health is now improving due to food

received in hospitals but it is difficult to see it on the ground

f) Using a Likert scale of 1 to 5, how do you rate designing of nutrition security project implementation in

reference to decentralization policy?

1st R: Around 20% or 25% but we would want things to be better more than the way things are now. 3rd R: Yes, maybe more than 25% because most women now understand the reason for going to under five clinic where they also get information on nutrition. Objective 2: To appreciate factors affecting implementation of nutrition security projects a) What measures did you put in place to achieve intended results within allocated time for implementation of

projects under the district council during MGDSII?

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1st R: Most projects that they come are under LDF. On LDF most funding is allocated to the roads and not the roads that will last no, we will work on them this year and the following year too just for people to get paid. So you would find that on LDF there is no component of Nutrition. And in Agriculture we have been contracting dams and planting tree which are not even there, they all died. I feel the authorities find roads projects easier than other projects. Projects come under Local Development Fund (LDF) where people ought to discuss priorities, but in most cases the council prioritises maintenance of roads. Unfortunately most of these roads are only worked on to get paid. Every year they get maintenance. No nutrition components under LDF. 2nd R: All in there is no funding that the authorities would say let’s discuss what we should do with this funding. For example we have CDF which is controlled by the MP but as a counsellor I don’t have a say that on this let’s start with this project as a priority. Constituency/community development fund (CDF) is heavily controlled by Member of Parliament in that area and councillors are never consulted. (Absence of political will on MPs) I: So communities have no chance to implement their desired projects? 3rd R: Some are followed but they always have question mark. The people on the ground would decide what they want and when we bring it here, they already have a programme (project) Like this LDF they specifically said we should not construct dams yet the people on the ground wanted dams. Or we wanted to plant vertiver and they would say there is no money for that. Almost all projects suggested by communities do not pass. Some projects may be considered but on condition that when funding would be available. I: What percentage would you rate the projects that were considered from the ground/Communities? 1st R: about 10% 2nd R: about 5% 3nd R: But when you bring road projects in your area even fifteen roads they will be funded but not other projects like if we want a clinic. (why are roads more preferred? For transactional payments and therefore to achieve sense of care from govt?) b) What were the priority projects considered by the council?

1st R: Only roads

2nd R: In my area there are Dams which were constructed in 2014-2015 but they have no fish. They were projects from the council. c) Why?

1st R: Councillors have no powers to advise or suggest what projects are needed on the ground. If we had the power to do so, it was easy to implement nutrition related projects. For example I would buy 20 trees for Mango, 20 for Avocado pair, so that we can have an orchard. The councillor does not have a say on CDF its all for the MP. Ma khansala angokhalatu ngati chipatala chopanda mankhwala, alibe ntchito! (Councillors are like a clinic without drugs, they are useless) MPs decide what should be implemented without consulting the councillors. 2nd R If we look at Zomba the malnutrition due to lack of nutrition food is very high which shows that as a district we do not consider nutrition aspect as important.

I: How are you working with non-governmental organisations that are found in your areas? 1st R: There are many organisations that are doing Nutritional programmes in the areas but there is no good connection with the councillors. Most of the organisation that were there could not want us to work together because they were not doing what they are supposed to do on the ground but buying luxurious cars. Most of these organizations want to operate the way they want in terms of targeted communities and they do not consult us. I: Do you mean the NGOs when coming in the area they do not pass through the council. 2nd R: They pass through the DEC but they do not meet the Service Committee and the DEC do not call us to brief us about the NGOs coming in our area. Since we started our term I have only seen one organisation

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coming to inform the councillor their purpose in the area. There are many organisation doing Nutritional programmes but we have not been informed. They do not come and collaborate with councillors who form the council instead they rely on the DEC just like it was happening when there were no councillors. (Lack of coordination between NGOs and community structures) 3rd R: You find an NGO has come in my ward but as a counsellor I am not informed but people are going to attend. When you go there you find what they are doing is contrary to what they are supposed to be doing.

d) Are you aware of malnutrition as a major cause of stunted growth in Zomba district and Malawi as a country?

ALL: Yes, through this discussion. We did not know about it before (Interesting!) e) To what extent in terms of percentage has the council considered implementation of nutrition security

projects?

ALL: Mmmmmm! One R: Palibe chilipo (there is nothing on the ground)

f) What nutrition security projects do you remember being implemented during MGDSII?

One R: SNIC project

g) What were the challenges and problems involved?

Participants Could not recall h) How were they dealt with?

N/A i) How did the council relate and collaborate with other key players such as Non-Governmental

Organisations (NGOs) and Academia on implementation of nutrition security projects? – Discussed above

Objective 3: To understand community participation in nutrition security programming and productivity

a) In terms of percentage, how do you rate awareness and participation of Zomba district communities

regarding nutrition security projects especially during MGDSII?

1st R: Awareness 95% Participation: 55% 2nd R: Awareness 90% Participation: 45% This is happening because there is enough information in the hospitals and food items distributed by NGOs. 3rd R: Awareness 95% Participation: 75% 4th R: Awareness 90% Participation: 50%

b) Please state how you feel about your ratings on the scale below?

0=Dissatisfied 1=Neither satisfied nor dissatisfied 2=Satisfied 3=Highly satisfied 1st R: I cannot say I am satisfied because there are no specific activities on the ground for sustainability. (Lack of sustainable plan) 2nd R: Yes the way forward is to encourage people through the council, we will definitely see change. c) Why? – Discussed above

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d) Did communities regard nutrition as one of the important household need?

1st R: Yes they consider nutrition very important only that they lucky materials because most of them they are poor. But they are aware and they understand. 2nd R: Most of them do not prioritize nutrition need in their homes although they may know that it is important e) Why?

Due to poverty, there are immediate needs such as general food and clothes f) What is your view regarding commitment and programming content of key players such as NGOs in

nutrition security projects including the central government?

They do not make consultations with important stakeholders before implementation. They want to do what they

want and not responding on what is coming from the ground

g) What could you change at planning level and in the community to achieve higher rate of awareness

and participation in implementation of nutrition security projects?

1st R: The other problem which has made this difficult is that the NGOs brought their own structure which they are using leaving out the existing structure which are on the ground. When their phase ends it means a new thing has been taught in the community. I would have loved these NGOs when they come to be using the existing structure not to formulate their own. The problem of formulating their own when the project ends these structures stops working, yet if they had used the already existing like CBO, youth groups things would have been different. So they should empower these CBOs and youth groups. NGOs should adopt using existing structures in the communities. They should avoid creating their own structures because when they leave, it is difficult to sustain their interventions. There are groups such as CBOs and youth groups which they must use. (creating new structures which may not help to sustain interventions) 2nd R: I would have loved these NGOs when they come in the areas to come to us so that we can help in advising because we know the area and we have experiences of what happens. Like the organisation that give peanut I would have loved they give the people peanut for one year and they give them seed to grow groundnuts so that they are taught how to make peanut. So that even if they go they would have empowered the people. NGOs should implement their projects with sustainability plan. For example if they distribute peanut, they should empower communities to produce groundnuts and taught how to make peanuts. 3rd R: In most projects they are lucking ownership because most of them they want the people to follow them so that they convince their donors, yet the people at the village what they are looking for its just the benefit that are coming with the project. If these NGOs were coming and encouraging people about ownership. It could have worked well. This is the reason that most of the project of NGOs when they phase out you would find, there is nothing on the ground that the NGOs did and is still practised down a year. Most NGOs implement these projects to convince their donors for more funding. As a result they have criteria of implementation that do not conform to what is required in a given environment. As a result, people in villages drift along what they bring simply to benefit for that particular period. In a way, NGOs are encouraging the culture of hand outs in communities Objective 4: To establish gaps in decentralization program affecting sustainable nutrition security

a) What is your perception towards decentralization program in promoting nutrition security in communities

under the council?

1st R: Things are not working because they are just teaching and the one that are coming to work on the ground are NGOs with their money not the Council. The work that the NGOs are doing was supposed to be done by the council and its money. The council has left nutrition intervention to the NGO community. What the NGOs are doing should have been championed by the council and the NGOs would simply add up. (Contradicting govt spelt out commitment through policy documents?) I: so the percentages you have discussed above (Objective 3a), they are for the NGOs not the council?

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1st R: Yes it is for NGOs, they are the ones raising nutrition awareness in hospitals and distribute food items. So the Organisations are doing something on nutrition unlike government. 2nd R: There is a need to establish a lasting solution, like in the past we used to have Community Development Assistance they were going for training in Thyolo and they were settling in the villages. They were teaching women how to cook with things that are found in the village like Sweet potato, beans, and groundnuts. And they be feeding the children. So the district council was supposed to employee such people so that they work hand in hand with the hospitals. There is urgent need to streamline nutrition education, this can be a lasting solution

b) What training did you receive or attend on management and implementation of these projects?

1st R: no we have never had any training 2nd R; No we have never had.

c) What sort of support does the council require to advance implementation of nutrition security projects?

One R: Trainings and the will to act on nutrition challenges

d) How would you like to be supported as one of the key officers under the council to contribute better

towards implementation of projects?

N/A e) How can the council achieve nutrition security and sustain it?

1st R: The council should put aside funding for Nutrition and see how they can encourage people at TA level or Group Village Head Level. Say every Monday women in the villages should be going to school and learn about nutrition. In so doing people will be desiring to prepare their families the food they have been taught. And with this idea people will want to have a variety of food. Need for nutrition education 2nd R: I agree with him there should be people specifically employed by the council they way they do with market fee collectors, they should do the same only these will be in the villages to monitor the nutrition side. They should be send to training and they work together with hospital. So when LDF has come they should be a component that will empower those people to grow groundnuts, bananas, orange and avocado pair. Community based nutrition officers should be introduced to emphasize on the need for nutrition awareness I: You said LDF and CDF the nutrition components are not there? 2nd R: yes they are not there. What happens is that when LDF is coming there are different components including administration. And on CDF the council can lobby from MPs for funding on the nutrition project that each contribute say 10%. So it’s possible the DC can do that. The council can allocate a percentage of LDF and lobby MPs to allocate funding on nutrition projects through CDF 3rd R: The funding of projects they should have removed the conditions attached to them and this will enable the Nutrition component to have funding. Central government should fund and leave the councils and the people to decide 4th R: I think as a council of Zomba they should priorities the nutrition aspect because it is very important. It is only a health citizen that will be able to contribute effectively for the development of the nation. So the people if they are to work and develop Zomba they have to be health otherwise it will be a challenge. The central government if they have decentralised their power they should let go not holding on to it so that people are able to benefit well. Even here at the council there others who are failing to adopt the new system because they have been in the old system for a long time and they are finding this a challenge they should know that things are changing. It is very important for central government to realize that nutrition is important for a healthy nation. People will contribute to development when they are health. So government should devolve powers on nutrition, and in the councils those in decision making positions should also let go the old way doing things being holding on to decision making without involving the grassroots. They should know that things are changing now.

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Consent form

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Research Ethics Checklist

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A photo during one of the FGD sessions