To identify lessons in the management, governance, and overall value of NFAs in order to provide guidance to food fortification programs. Background: The multi-sectoral nature of food fortification necessitates multi-stakeholder collaboration to define roles and responsibilities, coordinate efforts, and drive sector-wide decisions and actions. National Fortification Alliances (NFAs) have been established in many countries as a coordination body for the diverse stakeholders involved. To date, the added value of NFAs has not been adequately documented.
A framework to measure performance based on effectiveness, functionality and efficiency was developed. Structured questionnaires were sent to three stakeholders per country in Bangladesh, Cambodia, Mozambique, Nigeria, Senegal, Tanzania, and Uganda. Detailed interviews were conducted with 18 stakeholders in Kenya and Indonesia.
NFAs provided a valuable platform for coordination and oversight in establishing food fortification programs. They helped to forge relationships between business, government, and civil society to overcome system-wide hurdles. Challenges included special interests among sectors and competing efforts by individual parties to further their own agenda. Success factors included strong leadership by the chair; available budget to coordinate activities; formation of results-based short-term goals, and active sub-committees delivering onintended results.
In early stages of programs, NFAs are a useful mechanism to build trust and alignment between various sectors. For mature programs, NFAs continue to play a relevant coordination and management role. Countries may establish NFAs either as new entities or built on existing networks. Government and/or donor funding commitment for fortification is a key factor to activate and sustain NFAs.