COMMENT (NPW): In the full text the authors conclude: ‘The key gap is that some drivers and manifestations of nutrition have hardly been addressed (or not at all). Because of the desire to foster effective nutrition governance, holistic approaches including more systems-based framings are necessary to ensure that the progressive nutrition policy designs enable multisectoral action.’ The big unanswered question is: How to promote systems-based framing by policymakers? Not just for nutrition but for other complex global health challenges?
The quest for political commitment to reducing malnutrition in sub-Sahara Africa draws attention to the role of national parliamentarians. Whereas parliamentarians have the authority to ratify legislation, monitor policies and budgets and transform behaviour, to date little is known about how malnutrition is understood and debated in sub-Saharan African political arenas. This study addresses that gap by exploring how (mal)nutrition has been framed by parliamentarians in Uganda between 2001 and 2017. Applying framing theory we performed a qualitative content analysis of 131 Parliament Hansards transcripts to determine the different meanings of nutrition. Our analysis distinguishes seven co-occurring frames that entail different, sometimes competing, understandings of the drivers and possible solutions of malnutrition. The frames are: (i) the emergency nutrition frame, (ii) the chronic vulnerability frame, (iii) the school feeding frame, (iv) the disease-related frame, (v) the diversification frame, (vi) the overnutrition (among politicians) frame and (vii) the poverty and inequality frame. These frames are sponsored by different groups of parliamentarians, most notably politicians representing constituencies with high degrees of malnutrition, the president, some ministers and politicians in parliamentary forums concerned with children and women issues. Our analysis helps to understand why policy measures get prioritized or disregarded by policymakers. Overall, we show that frame sponsors prioritize short-term tangible solutions, such as food assistance and agricultural inputs, over longer term solutions. We suggest that a more comprehensive policy frame is prerequisite to developing a more effective governance approach to malnutrition in Uganda.