From persistent undernutrition to the rising numbers of children and adults who are overweight or obese, Mexico faces complex nutrition problems. Effective governance mechanisms are crucial for the country to address nutrition issues from a system-wide perspective, writes Paola Abril Campos Rivera.

The triple burden of malnutrition – undernutrition, micronutrient deficiencies and overnutrition – is a pressing public health concern with far-reaching implications in Mexico. Rates of diet-related diseases like diabetes and hypertension are high, causing suffering and straining the country’s healthcare system. Compounding this challenge is the prevalence of food and water insecurity – over 60% of households in the country experience food insecurity, and 16% experience water insecurity.

To accelerate progress in improving nutrition, federal and state governments in Mexico need to design and implement multi-sectoral nutrition strategies that address this triple burden in a systemic manner.

Governance mechanisms are an essential part of a holistic nutrition strategy. Formal and informal governance mechanisms can improve cross-sector coordination, accountability and transparency. They are necessary to set priorities and to design, implement and evaluate policies that address malnutrition at multiple levels – individual, household, community, and policy.

To understand what works in implementing effective nutrition governance, our research team designed a study to assess two nutrition governance mechanisms in Mexico: the State Council on Nutrition and Chronic Diseases, a formal body established in the Mexican state of Yucatán in 2012, and the Intersectoral Group on Health, Food, Environment and Competitiveness, an informal ministerial group created by the federal government in 2019.

Existing nutrition governance mechanisms in Mexico

The aim of our study was to analyse the implementation of the two governance mechanisms, examining their design features and how they operated in practice. The strengths and weaknesses of these mechanisms should inform the future of nutrition governance in the country.

Our research team used a mixed-methods approach. First, we analysed data from the national survey on nutrition and health and other publicly available databases to understand the level of performance of key nutrition indicators; second, we reviewed governance frameworks related to nutrition and food systems transformation to identify key governance dimensions; third, we conducted 23 interviews with stakeholders to identify barriers and facilitators in implementing these governance mechanisms and to analyse which governance dimensions were present in the mechanisms.

The study identified clear differences between the characteristics of the two mechanisms, which are outlined in the table below.

Results

The preliminary results of our study reveal common facilitators and barriers in the design and implementation of these governance mechanisms.

Design

Common facilitators

Participation of multiple ministries: engaging diverse government sectors (health, agriculture, environment, and economy) was a positive step toward integration.

Civil society involvement: despite limitations, including civil society organizations provided an avenue for stakeholder participation.

Common barriers

Lack of allocated budget: both the Intersectoral Group and the Yucatán State Council faced limitations due to inadequate funding. This constraint hindered their ability to translate well-intentioned policies into concrete actions.

Limited community participation: despite engaging various sectors and civil society groups, the mechanisms struggled to meaningfully involve the communities most affected by malnutrition.

Weak transparency and accountability: the lack of transparency in priority setting, progress monitoring, and decision-making undermined the mechanisms’ responsiveness and accountability. Clear processes are essential for effective governance.

Difficulty in achieving multisectoral collaboration: while recognizing the need for a systemic approach, the mechanisms encountered challenges in coordinating efforts across different government sectors. Multisectoral collaboration remains a critical goal.

Implementation

Common facilitators

Collaborative technical work: technical experts and stakeholders from health, agriculture, environment and other key sectors managed to collaborate effectively.

Stakeholder engagement: active engagement with various stakeholders was identified as a common facilitator in both mechanisms.

Common barriers

Voluntary participation: the governance mechanism relied on the goodwill of members who participated without formal incentives. This approach has limitations, as commitment may wane without tangible rewards or recognition.

Lack of systematic data collection: there was no systematic collection of information about the priorities, preferences and needs of people. This hindered the mechanism’s ability to be responsive and tailor its actions to the actual demands of the population.

Absence of incremental implementation: there was no clear strategy for implementing changes in small, manageable steps—a practice that can facilitate learning, adaptation, and progress.

Limited engagement of political leaders: despite initial support from political leaders, their interest dwindled over time. The lack of sustained support prevented the formalization and strengthening of the governance mechanism at the federal level.

Strengthening nutrition governance in Mexico

Governance mechanisms are crucial for Mexico to move beyond a fragmented approach to nutrition. Formal mechanisms need to be established to bring together decision-makers from the different systems that can contribute to improving nutrition and health. These mechanisms need to ensure the participation of diverse actors such as civil society and academia. Potential conflicts of interest need to be managed and avoided to ensure that the actions derived from the mechanisms are in the interest of population health and well-being. These mechanisms also need to include the communities they serve, which has been challenging to achieve. Finally, these mechanisms need to be transparent and accountable to the communities they serve. They need to ensure access to information about priorities, decision-making and progress in implementing action.

This blog is adapted from a lecture given by Dr Paola Abril Campos Rivera at LSE on 12 June 2024, hosted by the LSE Global Health Initiative. In an accompanying blog, Andrea Jimenez Ortiz, an MSc student in Health and International Development at LSE who attended the talk, shares the key takeaways from the lecture. The full lecture is available to watch on the LSE Global Health Initiative’s YouTube channel.