Why is this important for MSPs?
Power is a pervasive phenomenon and affects all aspects of MSP governance, from designing and planning to implementation and long term sustainability of the MSP. In the MSP process, power can be seen in different ways. It could mean the power of holding resources or funding; power to decide who is involved in the MSP and what it aims to do; or authority vested in certain stakeholders within the MSP.
Power can work both as a facilitator and barrier to change within an MSP. Since the MSP brings together different actors who have different degrees and types of power, who may have a conflict of interest or different ideas about what should be done and how, mechanisms need to be put in place to identify power and its outcomes, and address them. When used in a positive way, power can help in directing change, broadening participation, facilitating decentralisation, and making the MSP framework more inclusive. Power can also limit change and risk delays due to overt centralisation and top-down management. These expressions of power function in three broad ways:
The visible power which comes through written constitutions or policy orders for the MSP;
The hidden power of influence by setting the agenda of the MSP, designing rules for consultation and participatory processes;
The invisible power of norms and culture that subconsciously guides the functioning of an organisation such as an MSP.
During design and setup or renovation of an MSP, power analysis can be undertaken to understand the relationships between different actors. This is an extension of mapping the relevant stakeholders for the MSP (see Stakeholder mapping), which adds different ways of expressing the different types of power of those stakeholders. Making the different forms of power working in the MSP explicit helps with the transparency of the MSP for all involved. Power analysis can also help in leveraging different kinds of power to bring about change, or to understand the structural and personal barriers to change.
How does this work in practice?
Mobilising power for change: Getting actors to work together is a serious challenge for the sustenance of the MSP. In various countries, nodal agencies within the government perform the convening role for the MSP platform. At the outset, it can make certain processes insular and non-transparent, but convening power can also help in the smooth functioning of the MSP. In Sri Lanka, the MSP platform is based within the Presidential Secretariat and is chaired by the President. This has provided strong convening power to the MSP and has helped with the implementation of programmes at the local level.
Addressing conflict of interest: Indonesia has a very active business community, and there have been tensions between the private sector, civil society and health professionals over issues such as violations of the International Code of Marketing of Breast-Milk Substitutes (ICMBMS) and the contribution of ultra-processed foods to overweight/obesity. The SUN Secretariat, supported by UNICEF, is working on developing a conflict of interest resolution process in the country which will be available to other countries as a model.
Power of funding: In Mozambique, within the national nutrition coordination system, sectoral coordinators in the MSP have little influence over their respective sector budgets. There is greater coordination success among actor groups with the power to influence spending. Thus, power becomes the causal mechanism which links coordination to spending outcome.