Learning Routes Peru - Towards effective scaling up of nutrition efforts through cross-country learn

I had been excited about the opportunity to take part in the second pilot Learning Routes of the SUN movement. For me as the SUN CSN coordinator this not only presented an opportunity to discover the methodology used by PROCASUR but also to deepen my knowledge and understanding of the Peruvian case, seeing first hand multi-stakeholder exchange of experiences based on a series of presentations and field visits as well as spaces for cross-learning between countries, meet with various stakeholders of the countries that took part in this route (Laos PDR, Guatemala, Peru, Senegal, El Salvador, Tanzania, Sri Lanka, Madagascar) and to develop/strengthen relationships with country actors.

The journey – a start to beautiful, unique and unexpected relationships and alliances between 7 countries across 3 regions of the world

The route started by a couple of days intense and filled with presentation of key initiatives that have made the Peru example such an interesting one like the political will and commitment at highest level reflected all the way down to regional and local levels characterised by ownership and engagement by all actors from families to regional policy and decision makers and underpinned by a strong political and legal framework. We then went on to fly to Ayacucho a region where reduction of chronic malnutrition has been extremely successful. At 2700m altitude Ayacucho is a typical mountainous city clearly showcasing what was brought through colonisation with over 20 odd churches. Beautiful yet a witness to the impact colonisation has had on the Peruvian context. During our time in Ayacucho we were able to visit a regional hospital facility and experience RENIEC’s citizen registration system first hand, visiting Huamanguilla and its annex community of Chullkupampa.

Quechua and Spanish are the spoken languages in the region. The landscape is an arid one in a mountainous region and remote villages and communities. On the road you can see most houses are either made of brick or adobe, farmers often have motorised tractors (a very different landscape to the one I recently experienced in Madagascar with cattle and manual instruments defining this small holder driven country). The region mostly produces dairy products, quinoa, root vegetables like potatoes, corn some of which contributes to trade and some of which helps nourish the local population. A middle income country stricken by the realities of hard to reach areas due to the landscape of the country and developed urban areas.

This was definitely a humbling yet inspiring experience. The level of engagement and ownership by the local population with all community actors clearly engaged, convinced and driving their own empowerment towards improving their living conditions and own social development towards sustainable communities. This is clearly a major asset in Peru but would not be possible without the support across all levels of government from national to regional, municipal and district level and key initiatives like JUNTOS and CUNA Mas, social protection programmes that also contribute to household safety by providing small yet important incentives to household and communities. Enough to ensure community driven solutions to addressing chronic malnutrition and aneamia from definition of the problem, development of locally adapted and SIMPLE solutions, implementation of efforts and monitoring and evaluation of these, owned lived and breathed by the community every day of their Lives. Simple lives yet so inspiring, enriching and that could teach us a lot in other countries.

The political commitment was also witnessed by the visit of the first lady of Peru, Nadine Heredia, to this remote community and her clear engagement and inspiration for the cause in Peru.

Three days later we flew back to Lima to complete the experience with visiting countries developing concrete realistic action plan to take back to their countries. These plans were inspired by the experiences shared throughout the journey both experienced first hand through the visits and meetings but also shared by other countries.

It was clear that this sort of learning change is extremely valuable and certainly the participants demonstrated a thirst for more of these with more time for learning from each other and sharing experiences from different countries.

All participants returned home inspired and thrilled to have connections to follow the learning exchange beyond the route but also to have made the most unexpected of acquaintances and friendships, a true representation of the diversity and wealth the SUN movement has been able to bring to the world of international development.

The Peruvian context

The Peruvian context is interesting as the current situation is the result of a democratisation process asked by both populations and politicians at a time where democracy was not the preferred model in country. Through this process, nutrition became a priority in the country with a focus on chronic malnutrition and anaemia and was institutionalised through political and legal frameworks which were then rolled out and owned across different levels of government. Peru was then realising that though investment was made and interventions implemented and rolled out, poor results were seen. This is when the country adopted a Budget for results approach. Combined with effective disbursement and use of funds across all levels of government; a focused approach targeting children under 3 years of age; and locally owned and implemented efforts underpinned by strong social protection programmes like JUNTOS and SUNA MAS have led to drastic reduction in rates of chronic malnutrition in children under 5. However, challenges remain like the high levels of anaemia in the country.

What really stroke me and many participants throughout our learning journey was the self-empowerment and ownership of issues, solutions and sustainable engagement by all actors at all levels. It was fascinating to see the engagement of the community actors, from an engaged mother dedicating her time to Cuna Mas, a social protection programme to stimulate child development, to the Rodriguez family and other families with a vision, annual plan and monitoring of progress for the family.

Some key messages from the Peruvian experience

• Strong political will and commitment across all levels of government translated into concrete actions and underpinned by strong legal, political and financial framework based on scientific evidence.

• Impressive engagement and empowered actors from government officials to civil society to families.

• Ownership and empowerment to change own conditions in suitable and adapted manners across all levels from national to regional, municipalities, districts, communities and families.

• An effective decentralisation model that is rooted in adapted simple solutions.

• Results-oriented management driving the implementation of concrete actions, involving multiple governmental and non-governmental stakeholders (international development organizations, United Nations agencies, civil society, private sector and academia) in promoting and financing joint work to address child chronic malnutrition.

• Reduction of rates of chronic malnutrition from 37.35 to 17.5% between 1991 and 2013.

Some key messages from the Learning Route

• An intense and enriching experience made possible by open-minded multi-stakeholder national delegations from 7 very diverse countries

• A clear thirst for more exchange of this sort between countries with increased spaces for discussions and experience sharing around the 4 SUN processes and within and across stakeholder groups

• A continuously improving model to be adapted for and by countries of the SUN movement to best suit needs for strengthening capacity to deliver and scale up nutrition in countries.

I was privileged to yet again meet such amazing people who are able to put aside differences and come together to address a common cause. A fresh paradigm for international development the SUN experiment is embracing. Thank you to all the participants, and friends, the organisers and the SUN movement for such exhilarating human experiences.

Senegalese and Madagascar Delegations visit Healthy Family Model in Chullkupampa (Huamanguilla municipality, Ayacucho Region, Peru)

Dr Claire Blanchard, SUN Civil Society Network Coordinator