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

Autor: Heather Morgan, Jo Smith, Madhu Subedi, Sean Semple, Debbi Marais, Santosh Gaihre, Janet Kyle
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Psychological intervention
Food Supply
0302 clinical medicine
Promotion (rank)
030212 general & internal medicine
Qualitative Research
media_common
2. Zero hunger
Family Characteristics
Food security
Population Health
lcsh:Public aspects of medicine
1. No poverty
Stakeholder
Public relations
Middle Aged
Health
Evidence-Based Practice
Government
Income
Multisector
Female
Research Article
Adult
medicine.medical_specialty
media_common.quotation_subject
Nutritional Status
030209 endocrinology & metabolism
Intervention
Population health
03 medical and health sciences
Nepal
Stakeholder Participation
medicine
Humans
Healthcare Disparities
Nutrition
business.industry
Public health
Public Health
Environmental and Occupational Health
Administrative Personnel
lcsh:RA1-1270
Health Status Disparities
Intervention (law)
Low and middle-income countries
business
Transdisciplinary
Zdroj: BMC Public Health, Vol 19, Iss 1, Pp 1-14 (2019)
BMC Public Health
ISSN: 1471-2458
DOI: 10.1186/s12889-019-7204-4
Popis: Background Understanding stakeholders’ perceptions is crucial to the development and implementation of any intervention. However, a structured approach to eliciting stakeholder insights into complex, multisector issues of food security, household environment and health is lacking in many low and middle-income countries. This qualitative, workshop-based participatory study explores stakeholders’ experiences of developing and implementing multisector interventions to provide transdisciplinary lessons for future developments in low and middle-income countries. Methods Participants were purposely selected based on their involvement in, or exposure to, the multisector intervention. Participants with interests in agriculture, nutrition, household air-quality, drinking water-quality and health from academic institutes, government and developmental organisations were brought together at a one-day workshop to participate in a series of discussions on issues relating to food security, nutrition, household environment and health in Nepal. All group discussions were audio-recorded and transcribed, and a thematic qualitative analysis performed to identify relevant themes. Results The government’s ongoing Multisector Nutrition Plan, stakeholders’ willingness to work together, availability of local infrastructure for cross-institutional inputs and increasing global movement towards transdisciplinary approaches were identified by the 33 workshop participants, representing 23 organisations as key factors determining success of transdisciplinary work. Fragmentation, lack of research-based and practice-based evidence, limited transdisciplinary knowledge amongst sectoral stakeholders, short-term funding and lack of knowledge-sharing mechanisms were identified as barriers, often creating systematic problems for successful implementation. Stakeholders suggested methods to bring about success included: improved knowledge, both amongst policy-makers and implementers, of food security and its linkage with nutrition, household environments, health and hygiene; investment in collaborative practice-based research and evidence-based practice; and strengthened transdisciplinary collaboration between multi-stakeholders, such as researchers, implementers and beneficiaries, throughout the intervention development and implementation process. Conclusions This study suggests that multisector approach needs to adapt to take into account the experiences and views of the stakeholders concerned. The paper offers recommendations for successful development and implementation of future multisector interventions in Nepal that can be extrapolated to other low and middle-income countries, and lays foundations for future transdisciplinary working to support realisation of the recommendations. Electronic supplementary material The online version of this article (10.1186/s12889-019-7204-4) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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