Undergoing the FSS Prioritization Process may also:
- Raise the profile of a community’s food and nutrition challenges and needs.
- Provide stakeholders with a sense of ownership over programmatic decisions.
- Promote a more coordinated approach to addressing food security in a community.
Here are some example situations where a prioritization process can help.
- A general sense that more can be done with the resources available. If overlapping services are identified, or there is a feeling that the food security situation is just not improving despite ongoing efforts, the prioritization process can lead to a more coordinated and potentially effective approach to addressing food security.
- A change in available resources or knowledge. Budget cuts, an influx of funding from a new grant or donor, new community assessment data or new knowledge about how well an ongoing program works can all prompt re-examination and reallocation of how resources are being used guided by the prioritization process.
- A shift occurs within the community. A change in government officials or local leadership, regulations, policies or priorities can shift a community’s focus and is often reflected in the programs being delivered. Prioritization is an effective way to translate a strategic plan or strategic priorities into an operational plan.
The FSS Prioritization Process was field-tested in several communities, each with unique needs, resources and stakeholders. They all were able to identify solutions that best met their needs with the resources they had available. Along the way, they were able to raise awareness about food insecurity, build relationships and partnerships and develop a long-term commitment to support this work. Examples of the positive feedback received:
- “I’ve been in this community for a very long time and this is the first time I’ve ever seen the community come together like this, aside from a natural disaster. Even those who were standing back, waiting, now want to engage because they see good things coming.”
- “We felt it was time to try something different that would heighten our focus on certain areas. It’s easy to spin your wheels and have a hard time in deciding what comes first. This process helped us prioritize what to do first.”
- “The outcome of the data was powerful. It provided us with facts, not assumptions, that hunger is truly present in an affluent community like ours.”
- “There is a lot of overlap in services. That discovery was probably the best thing that came out of this process.”
- “We thought certain interventions would work, but when we started putting in scores, we realized what was and wasn’t practical.”
- “I liked the uncertainty scoring. Often, people talk about budget and ideas but not about risk of a program not working.”
- “In this work, some people talk about money, numbers and impact while others want to change the world and you never see eye-to-eye. Bringing everyone together for this systematic process worked to bridge the gap.”
- “There was discussion about using the process for non-food issues and other prioritizations. I think it can be used in any industry.”
The FSS Prioritization Process is based on key concepts from the fields of ethics and economics related to the allocation of scare resources. From the field of ethics, we know that in order for people to accept outcomes as reasonable, they must find the process leading to these outcomes to be fair. Fair processes are generally objective, transparent and systematic. From the field of economics, we know that resource allocation should be based on a marginal analysis and account for opportunity costs.
Program Budgeting and Marginal Analysis (PBMA), an economic approach to prioritizing resources, embodies these important characteristics. With this approach, each suggested solution is rated against a defined set of pre-weighted criteria, allowing for objective comparisons. This process is a stark contrast to more traditional and common decision-making processes, which are typically influenced by historical patterns or conflicts of interest and often result in a suboptimal use of resources. PBMA has been successfully used throughout the world for nearly four decades in many sectors, including health care and public health, and provides the framework for the FSS Prioritization Process.
When allocating resources, PBMA considers marginal analysis and opportunity costs. Marginal analysis is about how changes, for example the expansion of a program or the creation of a new program, impact total benefit. In line with this principle, PBMA starts with understanding the community as it is now (the current needs and services in the community – step 1 of the process) and attempts to estimate how much benefit any change to the current situation would produce (steps 3 and 4 of the process).
Considering opportunity cost means that a decision to invest in any given possible change cannot be made in a vacuum, based only on the expected costs and benefits of that change. This is because by choosing one action, you will not be able to allocate those resources to other actions – i.e., you lose the opportunity to create benefits from the alternate options. Therefore, to make the right decisions about how to allocate resources, the value of each change under consideration must be estimated in a systematic way (step 3 of the process) that allows a fair comparison across all the possible changes (step 4 of the process) in any given setting.
Source: Mitton C, Donaldson C. Health care priority setting: principles, practices and challenges. Cost Eff Resour Alloc. 2004;2(1):3.
Yes. The FSS Prioritization Process is designed to be applied within the United States and globally. While the overall FSS Prioritization Process and specific steps will be similar, some of the worksheets — such as the community assessment, program inventory, and financial and impact estimates — and some of the food security indicators, program categories, impact criteria and the weights of those criteria will need to be adjusted.
Global versions of the Community Assessment Worksheet, Program Inventory Assessment (both used in step 1) and Impact Score Worksheet (used in step 3) are available for adaptation and take into considerations concerns of low and middle income countries (e.g., micronutrient deficiencies).
The prioritization process is managed by an advisory panel, organized around the shared goal of identifying food security solutions. The prioritization process is a participatory process; broad engagement is key. Including diverse stakeholders on the panel empowers the community and generates a long-term commitment to success. There is no better resource for the prioritization process than the collective knowledge and experience of this panel.
This panel should include individuals, organizations or specific groups with an understanding of the local socioeconomic, health, cultural and political context. The recommended number of people on the advisory panel is 5 to 15. If more are needed, create a smaller working group to report to the advisory panel. Consider including recipients of the community’s food security services, as their lived experiences can be invaluable. Organizations that directly provide food security services may be able to recommend individuals that would be interested in participating.
Note that if the prioritization process is applied within one organization, most or all advisory panel members will be internal. In this circumstance, the advisory panel is supporting that organization in identifying its priorities. If the process is applied at the community level, then multiple entities should have the opportunity to be represented. In this circumstance, the advisory panel is identifying priorities that will apply to the community or to a coalition of organizations.
The Academy of Nutrition and Dietetics has a suite of tools for public health and community registered dietitian nutritionists (RDNs) and their partners. These include the web-based Academy of Nutrition and Dietetics Health Informatics Infrastructure (ANDHII) platform and the ANDHII Surveys mobile app.
The ANDHII Surveys app helps RDNs and their partner organizations to collect community assessment and program monitoring and evaluation data and syncs data collected on mobile devices with the ANDHII web application. A data file may be exported for analysis and reporting purposes. For more information, write to ANDHII@eatright.org or visit www.ANDHII.org.
The FSS Prioritization Process offers a fresh, novel approach prioritizing food security solutions. These are some of its unique features:
- There is no one “right way” to use the prioritization process; it is adaptable, dynamic and can be customized to fit the unique context of any setting.
- It is evidence-based and driven by the best information readily available.
- It considers indicators and weighted criteria identified by subject matter experts that reflect public health priorities.
- By using a defined set of pre-weighted criteria that allows for objective comparisons, it is systematic and transparent.
- It can be utilized by a coalition of organizations or a single entity and by volunteers or paid staff.
- It is a participatory process with broad engagement; it actively seeks diverse perspectives; it builds consensus.
- It empowers the community and generates a long-term commitment to success.
- It positions the community for action to execute the solutions and improve food security.