Nutrition interventions can play a key role in combatting hidden hunger in developing countries. However, when malnutrition is affecting a large share of the population, such programs need to be implemented on a large scale, which involves major governance challenges, such as absenteeism of staff, elite capture, and leakage of funds or food. This paper discusses the underlying reasons of these governance challenges from a theoretical perspective and proposes a participatory research tool called "Process Net-Map" to analyze these challenges empirically. A case study of India's Integrated Child Development Services Scheme was conducted in Bihar to provide a proof-of-concept of Process Net-Map as a qualitative research tool that is suitable to identify governance challenges in the implementation of large-scale nutrition programs. Applying the Process Net-Map tool made it clear that the "devil is in the detail" when it comes to the implementation of large-scale nutrition interventions. The case study also shows that an understanding of the details of the implementation mechanisms of nutrition programs is essential for designing governance reform options that have good prospects to increase the effectiveness of large-scale nutrition programs in developing countries.
© 2018 S. Karger AG, Basel.