Harmonizing agriculture and health sector actions to improve household nutrition: policy experiences from Afghanistan (2002-2007)

Coordination across sectors to address undernutrition with its varied underlying causes remains a challenge in developing countries. In Afghanistan, harmonization of health and agriculture policies and actions to reduce endemic undernutrition occurred during 2002-2007. This qualitative case study explores the forms of harmonization, enabling features and constraints in the policy process. We interviewed 57 stakeholders (39 central level, 18 provincial) involved in public nutrition or food security issues. Forms of harmonization included written policies, reseach, training and advocacy. Important features of the policy process included: policy entrepreneurs with operational and strategic capacity, consensus-building using a shared causal framework, working groups and strategic alliances. This case presents an interesting alternative to a national nutrition coordinating body, an approach that has met with mixed results, often due to the lack of authority, budget, and operational capacity of such a body to oversee ministries and enforce national nutrition objectives. Mid-level professionals mobilized into task forces achieved much with the support of national and international partners. This study highlights the importance of building capacity for sustaining change through local institutions.