In the face of mounting challenges attributed to anthropogenic climate change, many in the international development community are grappling with its effect as a risk multiplier for those who suffer most from preexisting inequities. Recent research has found that since 1960, climate change has worsened economic inequality worldwide by stifling economic prosperity and GDP growth in the world’s poorest and often formerly-colonized countries, many in Sub-Saharan Africa – and it will continue to do so. [i]

Sub-Saharan Africa is a region undergoing significant change. The region has seen generally positive economic growth in the past decade, which are expected to continue after a year of significant contraction due to COVID-19.[ii] At the same time, health and development were significantly improved in pursuit of the Millennium Development Goals (MDGs) and now Sustainable Development Goals (SDGs).[iii] Amidst these changes, malnutrition remains a stubborn challenge for the region among low-income populations – between 2010 and 2016, Sub-Saharan Africa saw its number of undernourished people rise amidst economic growth, and 59 million children under the age of 5 were developmentally stunted in 2017.[iv]

Malnutrition is a symptom of many underlying challenges, but primarily indicative of a food system that cannot provide a nutritionally adequate diet at a price the population can afford. Urbanization, a growing population expected to double by 2050[v], and economic inequality have strained an already fragile food system, hamstrung the supply chain, and elevated the risk of food insecurity. Climate change is decreasing the availability, access, and utilization of nutritious food through decreased crop productivity, strained infrastructure and food storage, and increased disease. The outcome is a more expensive diet, progressively composed of a less diverse range of food sources of increasingly lower nutritional value and absorption capacity.

In a region already forced to contend with some of the most acute changes in its weather patterns and environment, climate change poses an existential threat to food security and malnutrition.Crop and livestock failure, reductions in biodiversity and food nutrient content, disruption to supply chains and labor, and increased disease and food safety challenges have already materialized and are anticipated to get much worse. Subsistence farming remains a primary element of the food system, and it is estimated at about ~80% of the African continent’s population remains dependent on low-yielding, rain-fed agriculture.[vi] These less climate-resilient farming practices will be hard-hit by shifting weather patterns and other changes, and yields are forecasted to drop by ~15% for sorghum and 10% for millet by 2050, both of which are key food staples. Additionally, some important cash crops, such as coffee and cocoa, will no longer flourish in parts of their present growing areas.[vii] Heat stress will cripple productivity and livelihoods, with estimates of excessive heat leading to a loss of 5% of working hours in 2030, equal to ~9 million full-time jobs. Of these hours, 60% are accounted for by heat stress-related losses in the agricultural sector.[viii]

Through their damaging effects on the food system, these impacts would have a significant destabilizing effect on societies and populations. The end line impact on nutrition of all of these climate and food system-related challenges is sobering: in Mali, climate change is expected to increase the percentage of the population at risk of hunger from 34% to between 64-72% by 2050,[ix] and a study cited in a 2018 IPCC report found that the relative percent of children in Sub-Saharan Africa with severe stunting would see an increase of 31-55% due to the impact of climate change.[x] Worryingly, food insecurity has been found to increase strife and migration, disrupt global markets and supply chains, exacerbate inequities and governance limitations, and increase strain on women and caretakers – a tragic cascade of effects that are difficult to reverse once they have begun.

To meet this challenge, we believe that there is a need for multi-level collaboration amongst governments, NGOs, and other stakeholders to help reinvent the food system in Sub-Saharan Africa to be resilient, adaptable, and equitable. We see the need for action existing at 3 levels:

1. Elevate the discussion. To date, acute needs around other areas of health and human development have created an environment wherein the connections between climate change and nutrition have been under-recognized and under-resourced. At the international and regional level, there is a need for coalition building and investment to build awareness and understanding among key international development players.

2. Create an enabling policy environment. Policies and government structures must acknowledge food system vulnerabilities. At the national and sub-national levels, more robust food systems will require policy change as well as larger scale access to innovations which support resilience in food production and security.

3. Empower communities. Solutions are needed which are built by and for unique communities within the Sub-Saharan African context, allowing growth to leapfrog less efficient stages of food systems development. Community and individual-level interventions will be key to changing practices and improving the resilience and adaptability of households and farmers, while also sparking innovation in infrastructure and the supply chain.

The food system is just one of many foundational systems which are already being fundamentally changed and challenged by climate change; however, it is decidedly unique in its dual role of both nourishing populations and serving as an economic engine which offers employment and supports livelihoods. Enhancing these essential functions of the food system will be a cornerstone of the region’s continued rise to prosperity, and that calls for concerted action at all levels to acknowledge, explore and overcome this critical climate challenge.

Global warming has increased global economic inequality. Noah S. Diffenbaugh, Marshall Burke. Proceedings of the National Academy of Sciences May 2019, 116 (20) 9808-9813; DOI: 10.1073/pnas.1816020116

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by Joanne Lee, Zack Henderson, and Bethanie Thomas  

Collaborative working sessions. Open debate. Face-to-face sharing of expertise, experiences, and opinions. Hard-won alignment on a path forward.  

With COVID-19 disrupting workplaces around the globe, many impact-oriented organizations which rely on stakeholder input, consensus-building, and partnerships have found their decision-making processes paralyzed, hamstrung by distance and the complexity posed by teleworking.  

The pandemic has forced us to identify new ways to align stakeholders and build coalitions that don’t rely on the time-honored practice of bringing stakeholders together in the same room. In this environment, we have found the Delphi approach to be an especially powerful tool for consensus-building.  

The Delphi approach uses multiple rounds of anonymized feedback and reflection to bring panels of stakeholders to consensus on complex issues in a remote working environment. In fact, its very nature as a remote consensus-building tool brings added benefits in terms of improved participation by dispersed stakeholders, reduced influences of biases, and increased efficiency over in-person convenings.      

The Delphi approach has been used on a range of topics, from aligning experts around needs for global health technology development to creating shared public health roadmaps. At Camber Collective, we have used a modified Delphi approach to successfully facilitate groups toward consensus on topics ranging from scientific parameters for new health interventions to strategy development for emergent coalitions. 

How it works

Usually requiring three stages of participant engagement, the Delphi approach uses a transparent, iterative process of feedback and response:  

By making anonymized comments visible to all parties and focusing the group on points of misalignment, participants naturally gravitate towards agreement while ensuring all voices are heard. 

Benefits  

In implementing this approach, Camber Collective has found several critical benefits that may make this approach appealing not just in the near-term of the COVID outbreak response, but in the longer-term as a decision-making asset for remote teams: 

1. Remote consensus-building on complex issues 

The Delphi process provides a systematic methodology for iterative input provided anonymously by remote, expert participants.  The model ensures that even the most complex or technical topics are reviewed comprehensively and that a wide range of voices and areas of expertise inform a collaborative final product by:  

• Establishing clear and transparent decision-making threshold criteria at the outset 

• Providing an online platform for structured content review in multiple rounds 
• Sharing back anonymized comment integration in each round for participant consideration. 

The iterative, multi-round review structure of the Delphi also provides advantages over in-person discussion, particularly in early development stages of a new concept: 

• Process is scalable to larger group of stakeholders where many points of view can be collected and documented. Very early stage, rough draft prototypes can be reviewed without a high number of unknowns distracting or limiting conversation. 
• Collected feedback can be systematically evaluated to highlight where agreement exists – driving the process forward – and naturally focuses participants’ reviews on areas of misalignment. 

Successfully achieving these benefits during an in-person meeting challenges even the most skilled facilitator. In contrast, Camber Collective has successfully carried out a Delphi process including +20 expert participants across global geographies to publish a new global standard best practice for technical health assessment. 

2. Improved equity in decision-making 

The Delphi process allows distributed groups of stakeholders to build toward consensus despite geographic boundaries – in fact, it often outperforms virtual meetings or even in-person meetings in this regard. From our experience in the global health context, this means that it is possible to effectively engage international stakeholders or voices on-the-ground. It can also accommodate different engagement styles, mitigating any outsized influence that might otherwise be given to the loudest voices in the room. 

This method is uniquely equitable as well, capitalizing on the benefits of being a partially blinded process – by offering anonymity in responses as well as equal opportunities for response, it creates a democratized process that can elevate diverse or underrepresented voices. Properly deployed, the process ensures equity by removing biases such as race, accent, gender, or even seniority. 

In Camber’s experiences both before and after the COVID-19 outbreak, the Delphi approach has yielded large enough sample sizes to be considered representative. Global health and development organizations in particular have seen the benefit of gathering in-depth feedback from stakeholders located in key geographies in the global south who might otherwise have connectivity, travel, or time zone challenges for joining even a virtual meeting. 

3. Light-lift, high-reward 

For an organization supported by an experienced Delphi facilitator, the investment in resources and time is low in comparison with in-person working groups or convenings. The Delphi’s replicable, adaptable, and scalable model for gathering input means that an experienced facilitator can easily and effectively apply this methodology towards a wide range of content and stakeholder groups.  

Remote input from participants vastly reduces time, financial, and operational cost of implementation compared to in-person working group convenings. With an experienced facilitator, a 2-3 round Delphi process can typically be carried out over 2-3 months – an impressively rapid development process to go from early ideation stages to broad-based consensus on anything from detailed guidelines to a high-level theory of change.  

Beyond facilitator time to establish the methodology, engage stakeholders, and carry out analysis, the Delphi process itself has few incremental costs. Aside from the small cost of a subscription to a simple survey platform, we often recommended conducting a final virtual convening to offer closure to the process and provide an opportunity for dynamic, live conversation to close out any final points of complex disagreement.  

Despite the challenge of the current moment, our team believes that novel approaches like the Delphi process pose an opportunity to solve complex problems with greater efficiency – not just now, but also as organizations continue to find effective working models in the “New Normal”.  Let us know if you have found other innovative solutions to stakeholder engagement, or if you would like to discuss how a Delphi process could help drive consensus for your organization. 

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