Table 3.

Enabling conditions for progress in each country

Country	Enabling Conditions
Burkina Faso	High levels of malnutrition (C) Commitment and leadership from the MOH (Director of Nutrition, SUN focal point, Director General, General Secretary, Minister, and a regional director) (Int) Prior experience with the sectoral consultation platform (Int) Some favorable relationships among local actors (Int) Critical deadlines for policy revision (Int) A large, experienced NGO (SEMUS) (Int) Favorable staff turnover in key positions (C) Financial incentives (real or perceived) for sectors, NGOs, and individuals (Int/Ext) Country commitment to global initiatives, ie, SUN movement (Int/Ext) REACH arrival in the country (Ext) Strong support from donors and the partner and technical platform (Ext)
Mali	High level of malnutrition and the “Sikasso paradox” (C) Favorable momentum and progress with the policy, action plan, and coordination structures (Int) Decree establishing MSN structures (Int) Flexibility and openness of members of the coordinating structure to explore all opportunities to learn and advance the agenda (Int) Commitment and leadership of central and local authorities (Int) Strong presence of some credible partners in the district (UNICEF and the ASDAP NGO) (Int/Ext) Strong support from donors and partners and technical forum (Ext) REACH presence in the country (Ext) Country commitment to global initiatives, ie, SUN movement (Int/Ext) Government commitment to ending malnutrition (Int)
Uganda	High levels of and long‐standing malnutrition (C) Government acceptance of country‐owned, country‐led approach (Int) High‐level political commitment and support from the President and Prime Minister (OPM), holding others accountable (Int) Country experiences with earlier attempts at MSN (Int) Availability of reference materials (policy/program documents) (Int) Action plan as a reference document for MSN implementation (Int) Earlier decision to have OPM as anchorage (Int) Well‐established government structures: OPM, sectors, districts, and below (Int) Directive from OPM to orient all districts by a deadline (Int) Earlier experiences with multisectoral coordination from HIV/AIDS (Int) Ability to build on some ongoing activities in 5 districts (Int/Ext) Country commitment to global initiatives, ie, SUN (Int/Ext) Strong support from some donors and development partners (Ext)
Ethiopia	High rates of malnutrition (C) Momentum for transitioning from emergency response to development approach to nutrition (Int) Endorsement of NNP by State Ministers and pressure to launch and cascade to regions, reinforced by their request for progress markers to monitor and create accountability (Int) Political expectation to reach NNP goals and align them with high‐level government goals and strategies (Int) Existence of positive examples of MSN working at the woreda level for use as an inspiration and examples in regional workshops (Int) Existence of regional universities as potential partners on regional learning platforms and for operations research; regional buy‐in for university involvement because of past research on nutrition (Int) Existence of strong partners at the regional level to advocate for and support cascading (Int/Ext) Strong support from some donors and development partners (Ext) Global dialogue and evidence on MSN helped get high‐level buy‐in (Ext)

Abbreviations: C, conditions; Ext, external; Int, internal; MOH, Ministry of Health; MSN, multisectoral nutrition; NGO, nongovernment organization; NNP, National Nutrition Program; OPM, Office of the Prime Minister; REACH, Renewed Efforts Against Child Hunger and Undernutrition; SUN, Scaling Up Nutrition; UNICEF, United Nations Children's Fund. Adapted from Moseley and Charnley.52