Operationalizing Multisectoral Nutrition Governance: Examining Commitment, Capacity, and Mechanisms for Action in...

Effective Multisectoral Nutrition Governance (MNG) is critical for addressing the complex determinants of malnutrition. However, evidence on how key governance functions influence governance outcomes over time remains limited, particularly in low- and middle-income countries.

This study assessed the status, evolution, and drivers of MNG in Kenya from 2012 to 2023. It examined how commitment, capacity, and mechanisms for action explain current MNG status and perceived improvements over time.

A retrospective cross-sectional study was conducted using a validated MNG assessment tool. Respondents assessed current governance conditions in 2023 and retrospectively for 2012. Quantitative data were collected from 112 respondents across government and nongovernmental sectors. Descriptive statistics were used to assess governance trends. Wilcoxon Signed-Rank Tests and multiple linear regression were used to examine changes in MNG over time and identify factors associated with MNG outcomes. Relative importance analysis quantified the contribution of each governance theme.

A total of 96 out of 112 respondents completed the survey. MNG status improved significantly from 58.4% in 2012 to 71.1% in 2023 (P < 0.01). Significant improvements were also observed across MNG themes; commitment (r _b = 0.68), capacity (r _b = 0.61), and mechanisms for action (r _b = 0.67). Relative importance analysis indicated that capacity accounted for the largest share of explained variance (35.5%), followed by mechanisms for action (33.2%) and commitment (31.2%). However, the overlapping confidence intervals indicated that all 3 themes were comparably associated with variations in MNG status and improvement over time.

Kenya has made significant progress in strengthening MNG over the past decade. Although commitment and mechanisms for action remain essential, the capacity theme reflects the operational conditions through which governance improvements are implemented. Continued investments in institutional and operational capacity, including predictable and sustainable financing, are therefore important for sustaining and consolidating governance gains.