The Power of Nutrition and the World Bank
An unique partnership delivering more money for nutrition, and more nutrition for the money
The Power of Nutrition and the World Bank joined forces in 2015 to transform nutrition financing and deliver impact at scale. Since then, together we have delivered over USD $488m of programming in eight countries worldwide, delivering transformational impact for over 21 million women and 49 million children. The powerful partnership has successfully broken down silos in the sector, inspiring national and decentralised governments, civil society, academic and private sector actors and communities to work together to create long-lasting and systemic change.
49 mln
More than 49 million children have been supported with better nutrition.
21 mln
Over 21 million women have been reached with nutrition and health services.
71 mln
In total, more than 71 million women and children have been supported through the partnership.
Introduction
Over the past decade, The Power of Nutrition and the World Bank have forged a powerful alliance to address global malnutrition. Through our collaborative efforts, we've successfully mobilised significant investments and delivered impactful, cost-effective nutrition interventions at scale. This mutually beneficial partnership has demonstrated the transformative power of leveraging each other's strengths to drive progress towards global nutrition goals.
As we reflect on our journey, it's imperative to learn from our successes and challenges. This report offers invaluable insights into key lessons and recommendations for future collaborations, both within and beyond our partnership, to inspire even greater change for women, adolescents, and children worldwide.
The nutrition sector stands at a critical juncture. To achieve the Sustainable Development Goals by 2030, we must significantly increase investment in nutrition. The global community is united in calling upon multilateral development banks to play a pivotal role in driving this change.
Our partnership with the World Bank exemplifies the potential of innovative funding platforms and committed multilateral development banks to deliver transformative impact. By combining our expertise and resources, we've demonstrated the power of collaboration in addressing the complex challenges of malnutrition.
Meera Shekar Global Lead, Nutrition, World Bank"The need for The Power of Nutrition is even more acute than ever. The Power of Nutrition has significantly impacted the World Bank's engagement in nutrition."
Benefits of a joint approach
The innovative partnership has successfully leveraged the respective strengths of each organisation to achieve more together than each could achieve separately. Key benefits of the partnership, which could be scaled and replicated, include:
1. Scale and impact: The partnership positively impacted millions of women, adolescents and children. Individual programme evaluations and reports reveal a range of benefits, from increased access to key services, to improved knowledge, attitudes and practices, to policy change and systems strengthening and improved nutrition outcomes.
2. Technical rigor, robust monitoring, and value for money: Through combining the joint technical rigor and monitoring accountability of country governments, the World Bank, The Power of Nutrition and other academic, civil society and funding partners, the partnership strengthened national and decentralised monitoring and accountability systems to support evidence-based change. This includes investing in technical, monitoring and capacity support through both Recipient Executed Trust Fund (RETF) and Bank Executed Trust Fund (BETF) investments with the World Bank. Our joint interventions have also represented value for money, in terms of delivering on economy, efficiency, effectiveness and equity.
3. Addressing multisectoral drivers of malnutrition: Through investing in multisectoral approaches throughout the life course (from pre-conception to childhood, adolescence and adulthood), we have achieved an even broader and deeper impact. To address the multifaceted drivers of all forms of malnutrition, our partnership invested in creating impact through diverse sectors, including health, early childhood development, social protection, water, sanitation and hygiene, climate-sensitive food systems, and gender equity. As a result, the partnership not only empowered millions of women and children to fulfil their individual potential – it contributed to improving the human capital and economic prosperity of whole countries.
4. Pooling resources and leveraging greater financing for nutrition through an innovative match model: Through investing $114m, which was then matched by $374m of IDA funding, The Power of Nutrition offered country governments and investors the opportunity to maximise their investments in nutrition through an innovative match model, as well as pooling donor and government resources for greater cost-efficiency.
5. Influencing World Bank and national government prioritisation of, and investment in, nutrition: Through its targeted focus on nutrition and offering of grant funds alongside IDA loans, as well as targeted influencing and advocacy, The Power of Nutrition incentivised the World Bank and national governments to scale-up their investment in, and commitment to, nutrition. Through providing grant funding specifically for nutrition, The Power of Nutrition funds often led to greater targeting of resources to nutrition provision within national budgets, including mobilising domestic resource allocation for nutrition alongside IDA loans. By working in partnership with national and decentralised governments, The Power of Nutrition and the World Bank partnership supports national and local ownership, accountability and systems strengthening, ensuring development interventions deliver on national policies and plans.
Overview of programmes
Through a decade of partnership, The Power of Nutrition and the World Bank have implemented eight programmes across Africa that have supported over 71 million mothers and children.
The Power of Nutrition invested $15 million in Tanzania's $306 million Strengthening Primary Healthcare for Results Programme. Partnering with the World Bank and the Tanzanian government, our inaugural programme improved access to quality healthcare, focusing on reproductive, maternal, neonatal, and child health and nutrition. Our results-based approach, including innovative scorecards, incentivised the government to deliver evidence-based interventions, maximising impact for women and children while fostering sustainable government-owned change.
The Power of Nutrition invested $20 million into a $40 million Ethiopia programme in partnership with the World Bank and Government of Ethiopia. We focused on strengthening primary healthcare, improving nutrition services, and supporting adolescent girls, women and children under five from underserved communities. Our health systems strengthening approach focused on development of policies and guidelines, improving supply chains for health and nutrition commodities, and strengthening data systems to inform better evidence-based decision making.
In 2018, The Power of Nutrition partnered with the World Bank and Government of Madagascar to create the country's first multi-phased programme to reduce chronic malnutrition. We invested $10 million into the $90 million programme which helped integrate primary health and nutrition services, optimising efficiency and impact. Our investment convinced the Government to double its IDA allocation to nutrition, demonstrating that partnerships like these can incentivise greater investment, coordinate efforts, optimise aid delivery and ultimately accelerate impact.
The Power of Nutrition invested $10.4 million in a $60.4 million programme in Côte d'Ivoire to reduce malnutrition. Partnering with the World Bank and the Government of Côte d’Ivoire, we supported multisectoral interventions across 14 regions. Interventions were integrated through government services and delivered through empowered community-led groups. With a particular focus on health, nutrition, early childhood development, water, sanitation and hygiene and social protection, this locally owned and fully integrated approach shows how a holistic model is key to addressing the multifaceted drivers of malnutrition.
The Power of Nutrition invested $10 million in a $30 million Burkina Faso programme with the World Bank and Government of Burkina Faso. We focused on strengthening primary healthcare, improving nutrition services, and supporting high-risk populations, including pregnant women and young children. Our approach empowered communities and incentivised government action, demonstrating the power of collaboration in addressing malnutrition.
The Power of Nutrition invested $3.9 million into a Bank Executed Trust Fund to support research and technical assistance to the effective delivery of a $232 million health and nutrition programme scaling-up a package of nutrition interventions across 12 states in Nigeria. Support included: technical support to design a nutrition programme and assess pilots and innovations; technical support on knowledge management and learning; evaluation and improved data on nutrition programming; and research and data to inform nutrition governance, policy and financing.
The Power of Nutrition invested $35 million to leverage a $135 million programme (2018-2023) with the World Bank and Government of Rwanda to tackle malnutrition. We subsequently funded a further $5 million in the $79 million extension (2023-25). The partnership’s initial programme accelerated national progress using conditional cash transfers for pregnant women, supporting children in the first 1,000 days of life, early childhood development centres and expanding coverage of health and nutrition services. The extended programme builds and scales-up these successes: the government is now continuing the cash transfers so the partnership focuses on early childhood development and health and nutrition interventions.
The Power of Nutrition invested $4.4 million in a $26.4 million Lesotho programme to strengthen primary healthcare and improve nutrition outcomes. The programme helps build more resilient and sustainable health systems by supporting and strengthening community-based and local health and nutrition services, government stewardship and programme management, and programme monitoring and evaluation to ensure continual learning and improvements. It also supports breakthroughs in improving adolescent health through the delivery of peer-led adolescent sexual health education.
From Mathematica and Avenir Health, Evaluation of The Power of Nutrition Compendium, May 2023:
The Power of Nutrition has built a strong relationship and model for working with the World Bank and contributed to the increased prioritization of nutrition within the Bank…The Power of Nutrition’s partnership with the World Bank brought new money and visibility for nutrition at a time when there wasn’t enough attention to nutrition inside the Bank
From FCDO Project Completion Report 2023:
Eight of The Power of Nutrition’s 22 programmes are partnerships with the World Bank ($423m portfolio), channelling grant financing to large-scale international development assistance (IDA) nutrition programmes.
The programme in Côte d’Ivoire leverages rigorous World Bank procurement and recruitment processes and builds on local partnerships and expertise to ensure low-cost but high quality and high relevance actors are leading the interventions.
Monique, mother of three Bugasera, Rwanda"I came here today because my 2-year old used to be malnourished... they gave me foodstuffs...and taught me how to use them. I went home and followed the doctor's advice. When I compare when I first got here to today, my child is doing quite well."
From Mathematica and Avenir Health, Evaluation of The Power of Nutrition Compendium May 2023"By offering grant funding of $20m [in Ethiopia], the investment led to IDA loan allocations of $20m to nutrition. Further, by linking the disbursement of $35m of the $40m to meeting targets for nutrition outcomes, the investment led to greater prioritisation of nutrition by the Ministry of Health."
From Mathematica and Avenir Health, Evaluation of The Power of Nutrition Compendium, May 2023:
In some investment countries, The Power of Nutrition's investments have catalysed dialogue and commitment to nutrition… In Ethiopia, its investment brought nutrition into the discussions between the government and the World Bank during negotiations around a larger World Bank PforR program focused on strengthening health systems (which did not include payments linked to achieving nutrition outcomes).
From Mathematica midline (citation):
The World Bank and country stakeholders uniformly highlighted that in the absence of The Power of Nutrition’s funding, there would not have been a nutrition component in the program. Moreover, The Power of Nutrition’s funding (along with similar funding from GFF) contributed to increasing the overall envelope for the program and led to the allocation of additional IDA funds, which might have otherwise gone to infrastructure projects, towards a health and nutrition programme.
From FCDO Project Completion Report 2023:
The Government of Burkina Faso developed a $110m budget for improving health and nutrition, GFF and The Power of Nutrition raised $30m in grant funding that enabled to GoBF to take a lower IDA loan of $80m, complemented with $30m of grant funding. Whilst this made the IDA loan more favourable for the Government, the grant funding terms ensured that $30m was to be earmarked for nutrition.
In Rwanda The Power of Nutrition’s initial co-investment in social protection with The World Bank has resulted in extension of the social protection programme and significant allocation of domestic resources in social protection, with the Government of Rwanda showing strong ongoing commitment to addressing undernutrition through multisectoral programming. Building on its initial investment in Phase One (2018-2022) of the World Bank and The Power of Nutrition funded programme, the Government has followed on this investment with an additional $179million investment ($170m IDA ($100m for social protection), $5m The Power of Nutrition, $4m Early Learning Partnership Trust) in health and social protection for 2023-2025, including direct and indirect nutrition interventions. Importantly, with an expected funding requirement of $400million to support delivery of social protection services for the period until 2025, the Government plans to gradually increase the use of domestic resources by providing at least 60% of the funding required for social protection.
In Côte d’Ivoire, where there was already commitment from the government to invest in nutrition, additional funding from The Power of Nutrition allowed the government to increase the coverage of nutrition services to include additional regions. In Lesotho, $5m of grant financing from The Power of Nutrition incentivised the Government to maintain a $22m IDA allocation to nutrition, which may otherwise have been reallocated to COVID-19 response and resilience. In Burkina Faso $10million from The Power of Nutrition enabled an additional $20m of IDA to be earmarked specifically for nutrition from the overall $110m IDA loan.
Learning from an innovative partnership
The Power of Nutrition and the World Bank are both committed to evidence-based action, continual learning, course correction and adaptation to ensure the greatest efficiency, effectiveness, and impact. Through the course of our 10 years of partnership, many lessons have been learned, offering valuable insights for future partnership, both between our two institutions, and among others in the sector and beyond. Below, we have outlined key learnings.
1. Minimum investment required: The Power of Nutrition and World Bank joint investments represent a substantial opportunity for investors to partner with national governments to deliver proven impact at scale and leverage substantial funding multiples through IDA match. However, for many investors, particularly those new to nutrition, or with varying funding levels available, the scale of investment necessary to unlock these partnership benefits can present a challenge. This is particularly true of private sector investors, whom the nutrition sector, the World Bank and The Power of Nutrition are all particularly keen to mobilise to invest. Of the funding raised and disbursed to the World Bank to date, 27% has been generated from new investors to The Power of Nutrition, while 73% has come from The Power of Nutrition’s platform funding – from founding investors FCDO, CIFF and UBS Optimus Foundation. Therefore, to date, The Power of Nutrition and World Bank partnership model has been more appealing to more traditional investors seeking to mobilise large-scale, multi-million-dollar investments into substantial impact at scale, and has unfortunately been less accessible to newer or smaller investors. This is exacerbated by an increasingly challenging funding environment with perpetually shrinking funding envelopes, making securing the multi-million-dollar investments required for a World Bank co-investment more challenging.
While The Power of Nutrition has successfully curated a portfolio of eight programmes with the World Bank, representing total investments of $420m in nutrition, the pool of donors interested in or capable of partnering with the World Bank is limited. A minimum of $10m is typically required to partner with the World Bank, which is a very high barrier to entry for an individual donor. Pooling smaller contributions can also be unappealing as donors may feel their individual funds are a ‘drop in the ocean’ and therefore better allocated elsewhere.
The Power of Nutrition and the World Bank are adapting their investment levels to be more flexible and responsive to available funding opportunities. For example, our co-investments in Lesotho and Rwanda leveraged a smaller amount from The Power of Nutrition than the traditional $10m threshold. The Power of Nutrition is also keen to take this learning onboard in our partnership with other multilateral development banks and other key partners.
2. Level of detail in external financial reporting: The World Bank and The Power of Nutrition are both committed to rigorous financial management, accountability and audit processes for all co-investments. Total disbursement figures for all programmes are transparently published, and detailed financial reports shared internally between country governments and the World Bank. However, within the World Bank IDA loan structures, there are limitations to the level of detailed financial reporting that it is possible to disclose externally. As such, some prospective co-investors – including many in the private sector - find the lack of line-item financial reporting a challenge, as they require greater financial transparency. Pre-financing 100% of the investment also represents a challenge for many potential funders, who prefer a more phased disbursement, based upon delivery of contractual milestones.
The Power of Nutrition has learned valuable lessons in terms of matching the most appropriate investors with World Bank programmes – i.e. those who value the leverage, scale and government leadership afforded by World Bank programmes, and who have fewer requirements for line-item financial reporting. The Power of Nutrition is keen to take this learning forward in our partnership with other multilateral development banks and other key partners.
3. Institutional processes and timescale: The Power of Nutrition is committed to convening innovative partnerships to defragment an often fragmented nutrition sector, maximise efficiency (including cost-efficiency) and deliver greater impact together than we could do alone. Convening diverse partners, and working to deliver long-term, systemic change, can often result in complex negotiations which can take time to broker. As such, while the scale and leverage potential of such partnerships is unparalleled, the necessary time and process to steer such partnerships can be unattractive to some partners, who prefer more rapid or agile processes.
The Power of Nutrition and the World Bank continually reviews our partnership approach and ways of working to improve speed and efficiency of the partnership brokering process. This includes working to ensure a robust understanding of timelines and process from the offset, so expectations are better managed. The Power of Nutrition is also taking this learning onboard in our partnership with other multilateral development banks and other key partners.
The above lessons represent valuable learning for The Power of Nutrition and the World Bank as we move forward in our partnership, as well as offering The Power of Nutrition unique insight in leveraging relationships with similar partners, such as other multilateral development banks. We look forward to building on this learning for even greater impact.
From FCDO Project Completion Report 2023:
There are relative advantages and disadvantages to working with particular partners given their varying attributes and requirements. World Bank partnerships offer the greatest financial leverage but don’t lend themselves to regular detailed progress and financial reporting and require that all funds are paid before the programme can start.
Convening multiple donors and implementing partners in pooled funding arrangements brings benefits in terms of efficiency and effectiveness of programming, but can make the time from programme design to implementation lengthy.
The way forward for greater impact
The nutrition sector needs substantial increased investment if we are to achieve global goals for nutrition and beyond, including the Sustainable Development Goals by 2030. The global community is uniting in a collective call to action for Multilateral Development Banks to invest even more in nutrition and its positive impacts across multiple development areas.
The partnership between The Power of Nutrition and the World Bank has proven that an innovative funding platform such as The Power of Nutrition, and a leading multilateral development bank committed to nutrition investment and impact at scale such as the World Bank, can leverage each other’s respective strengths to deliver transformational change.
The Power of Nutrition is keen to expand this innovative partnership approach – with the World Bank and other Multilateral Development Banks – for even greater impact for nutrition, but we need even greater investment commitments at scale to deliver this. We welcome partnership discussions with potential investors and partners who share our vision for a world where every child has the right nutrition to thrive, and who is interested to be part of a transformational partnership to deliver a step-change in nutrition and have a catalytic impact on global development towards achievement of the SDGs.
Please reach out to info@powerofnutrition.org to learn more.
Read about what others had to say about our partnership
