The United Nations estimates that more than one billion people suffered from hunger in 2009. Worldwide, nearly 250 million children under age five are underweight or malnourished. For children of this age, malnutrition contributes to more than one-third of deaths, about 3.5 million annually. But, despite the best efforts of development and humanitarian organizations, the fight against hunger has been stalled for the past decade. The United Nations Millennium Development Goal of halving the number of underweight children by 2015 is unlikely to be met.
Why is this issue so hard to solve? Let’s examine the heart of the problem: the undernourished child. He or she likely suffers from insufficient food intake, poor hygiene and health, improper dietary practices, or any of several other causes. All these conditions need to be addressed simultaneously in order to achieve success. In practice, however, each tends to be addressed in isolation.
The good news is that proven and cost-effective interventions exist to address these causes. The promotion of exclusive breastfeeding, the treatment of household water, the provision of nutritional supplements, and food fortification, for example, all contribute to the prevention of hunger and malnutrition. Yet most children in need never benefit from these relatively inexpensive, well-studied solutions.
Why? Lack of funding is one problem. The largest challenge, however, is the fragmented landscape of wellmeaning organizations, each pursuing its own agenda. In a country such as Bangladesh, for example, hundreds of organizations are trying to address child malnutrition. Most, however, focus only on particular interventions and operate at a small scale in specific regions. This collection of separate activities provides spotty coverage (See Exhibit 1). By contrast, a comprehensive solution can ensure that several interventions reach each child.
Clear organizational responsibility and accountability are also missing. Within most governments, the responsibility for eradicating hunger and malnutrition is distributed across many agencies, such as agriculture, health, and—depending on the country—social affairs, women’s affairs, disaster management, and fishery. This fragmentation is mirrored in the community of development and humanitarian organizations.
Within the United Nations, for example, at least four key agencies are fighting against hunger as part of their mission: the United Nation Children’s Fund (UNICEF), the World Food Programme (WFP), the Food and Agriculture Organization (FAO), and the World Health Organization (WHO). The problem of malnutrition often falls through the cracks of responsibility.
One potential solution would be to reorganize and rationalize responsibilities among all these parties. But this is unrealistic, given the political realities and the complex landscape of the organizations involved.
The best practical alternative, therefore, is to ensure that all stakeholders collaborate effectively with one another in joint efforts that have the overall well-being of children as their primary objective. But collaboration does not just happen. It is an undertaking that requires resources, analysis, planning, monitoring, stakeholder management, patience, and persistence.
Drawing on its experience in the private sector, BCG has helped create a process for encouraging greater collaboration and partnership among public and development organizations.
The approach was developed in partnership with the REACH initiative, which was convened by WFP, UNICEF, FAO, WHO, governments, NGOs, and the private sector. It has been tested and implemented in pilot programs in Mauritania and Laos and is currently being rolled out in Bangladesh, Sierra Leone, and other countries.
Drawing on our experience in development work in many fields and with public- and private-sector clients, we have identified seven key success factors for largescale collaborative processes.
1.A convincing vision of the solution that is ambitious and aspirational—and a clear view of the approach for achieving it. In the field of hunger, there is no need to focus this vision on new science. Interventions exist that are proven, field-tested, and often cost-effective. The vision, ambition, and aspiration can center on coordinating these interventions on a large scale in order to maximize reach and effectiveness.
2.A clearly defined process that is fact driven and action oriented. Effective collaboration among many parties requires clarity about the process and the timeline. Leaders must develop a common fact base so that all parties have a similar understanding of the challenges. Decisions can then be based on logic and analysis rather than hunches and biases. And identifying “quick wins” helps encourage forward momentum and keep engagement levels high. In Mauritania, creating this common fact base helped expose a potentially harmful double dosing of Vitamin A by two agencies unaware of each other’s efforts.
3.An effective governance and working structure that involves all levels. By their very nature, social problems are difficult to solve and require leadership at three levels—overall political leadership, a technical decision-making and coordination body, and a working group on the ground responsible for day-to-day implementation. Key stakeholders need to be involved at all three levels in order to promote collaboration. The challenge is to create this involvement without stifling progress and creating bureaucracy. A relentless focus on the welfare of the beneficiary works wonders in this regard.
4.Dedicated process managers who drive and coordinate collaboration. Most of the relevant organizations are stretched thin in the developing world. Yet collaboration among these organizations will not succeed unless there are people whose only responsibility is to prepare and coordinate activities, meetings, and tasks. Without these so-called process managers, the best-laid plans will grind to a crawl. Frustration will rise. Motivation will decline. Ideally, process managers should not be affiliated with any of the key parties. They do not need to be experts on the content and should not be responsible for developing solutions. They should, however, be strong general managers who can structure, monitor, and drive the required work activities.
5.Accountability through assigning clear responsibilities and monitoring progress. Collaboration does not mean that all activities are done jointly. Individual parties remain responsible for delivering on specific, agreed-upon goals and actions. But their progress is carefully monitored and made transparent to all partners, so that obstacles can be identified and overcome quickly. In order for this type of collaboration to work, processes are needed for collectively evaluating facts, agreeing on actions, identifying areas of cooperation and synergies, and assigning clear responsibilities (See Exhibit 2). The process managers should have the objectivity required to help facilitate these discussions.
6.The capture and dissemination of relevant experience and lessons learned. Most organizations involved in social impact endeavors have valuable experience and knowledge to contribute. It is critical to leverage this expertise in order to achieve the best possible results quickly. The REACH partnership has created a small team that manages and coordinates the practical experiences and lessons learned in order to share best practices across country borders.
7.Engagement of hearts and minds through leadership and consistent communication. Collaboration requires extra effort from everyone involved. This extra effort can generate greater benefit to those in need than can the independent efforts of the relevant organizations. There will, however, likely be a lag between the expenditure of this effort and the achievement of visible results. To keep processes moving forward during those times, active and visionary leadership is essential. Consistent and frequent communication among all parties is also required.
Although these success factors might appear straightforward, putting them into practice can be challenging, especially in developing countries.
The REACH pilots have already achieved significant results. In Laos, for example, REACH’s action plan has been adopted as a priority in the nation’s new nutrition policy. In Mauritania, a new law gives the prime minister’s office the authority to coordinate the fight against hunger.
In addition, various quick wins have been implemented along the way, such as the creation of a new referral system to coordinate the therapeutic and supplementary feeding of children.
A tremendous amount of work remains to be done to significantly reduce the number of the world’s underweight and malnourished children. But we believe that this challenge—and indeed many others in the development sector—can best be solved through carefully managed collaboration.
This article was contributed by Ulrich Villis, Jan Willem Maas, and Thomas Lewis. Ulrich Villis is a principal in the Munich office and global coleader of the Social Impact practice of The Boston Consulting Group, Jan Willem Maas is a senior partner and managing director in BCG’s Amsterdam office, and Thomas Lewis is a senior advisor in the firm’s Rome office and global coleader of the Social Impact practice.