Contributions

This article makes three contributions. First, I conceptualize a new class of policies—benevolent policies—which the comparative welfare state scholarship has overlooked and undertheorized. While the empirical focus of this article is nutrition policies, the concept travels to any social welfare and public goods policy that serves a group with low power on an issue with low visibility. Examples include policies that serve migrants, refugees, low-income and racialized groups, or policies that address non-communicable diseases, sanitation, long-haul COVID, or water fluoridation, as I will discuss. This article opens up analytical space for studying evidence-based policies that dramatically improve welfare but provide governments with limited short-term political gains.

Second, I draw attention to technocrats as an important catalyst of change. For challenging issues like malnutrition, we tend to think of powerful social movements or vote-seeking politicians as the drivers of change. But technocrats, I argue, and their strategic deployment of international pressure within the bureaucracy, can also act as a source of policy change. While the comparative politics scholarship has “tended to ignore the bureaucracy itself” (Pepinsky, Pierskalla, and Sacks Reference Pepinsky, Pierskalla and Sacks2017, 250), recent research is advancing knowledge on bureaucratic politics (Bersch Reference Bersch2019; Bozcaga Reference Bozcaga2020; Centeno, Kohli, and Yashar Reference Centeno, Kohli and Yashar2017; Ding Reference Ding2020; Kim Reference Kim2020; Toral Reference Toral2021; Utama Reference Utama2014). I join this work by drawing on studies which bring the oft-divorced comparative politics and international relations literatures into conversation (Dion Reference Dion2008; Keck and Sikkink Reference Keck and Sikkink1998; Martínez Franzoni and Sánchez-Ancochea Reference Martínez Franzoni and Sánchez-Ancochea2014; Orenstein Reference Orenstein2013; White Reference White2011), continuing efforts to dissolve boundaries that have traditionally separated subfields.

Third, this work intervenes in a long-standing debate on democracy and welfare. Influential studies have produced contradictory results. Some find that democracy reduces infant mortality (McGuire Reference McGuire2010), whereas others do not (Ross Reference Ross2006). The concept of benevolent policies helps explain this disagreement. I show that democracy’s effects on social policies are not uniform. Although electoral competition contributes to the expansion of policies addressing issues with high visibility, it sidelines issues with low visibility. Studies have primarily documented democracy’s effect on policies for high-visibility issues like cash transfers or health insurance. But the sidelining of low-visibility issues such as micronutrient malnutrition, which contributes to 45% of global child deaths, can explain why democracy produces mixed results.

This article begins by discussing the concept of benevolent policies. These policies improve social welfare but produce minimal political gains for governments enacting them. While governments do not have strong incentives to expand these policies, some have done so. In 2012, the Indonesian government suddenly prioritized nutrition, marshaling resources toward the formulation and introduction of new nutrition policies. This was a break from past behavior. For decades, malnutrition rates remained “stubbornly high” (Rokx, Subandoro, and Gallagher Reference Rokx, Subandoro and Gallagher2018, 19). Despite the availability of simple, low-cost policy solutions, the government did not appear to pay serious attention—until 2012 when it unexpectedly introduced a raft of new policies.

To explain policy expansion, I develop an analytical framework that shines a bright light on the inner workings of the government bureaucracy. After describing my methods, rationale for case selection, and the data collected, I illustrate the analytical framework using the Indonesia case. I conclude by explaining the relevance of the benevolent policies concept for other social policies, then discuss the theoretical contributions of this article and an agenda for future research.

Good Policies, Bad Politics

Benevolent policies have two core characteristics: they serve groups with limited power and address issues with low visibility. These policies improve welfare and well-being. But in comparison with policies that serve groups with high power or address issues with high visibility, benevolent policies produce limited short-term political gains for the government. These policies cannot easily be used to win votes, reward supporters, anchor coalitions, enhance government legitimacy, or ease popular discontent. The gains accrue to beneficiaries, a group with limited power, not the government enacting them. Moreover, welfare improvements take years to become apparent, limiting the government’s ability to claim credit for positive outcomes. These are good policies—but bad politics.

As there are an infinite number of groups to serve and issues to address but a finite amount of resources, governments must prioritize. Given their desire to continue governing, governments have strong incentives to serve groups with high power and address issues with high visibility, as I will explain.

The Group: Political Power and Policy Expansion

The “group” refers to two or more individuals who share a common characteristic. The group’s political power is shaped by its access to resources. These resources, whether they be funds, capital assets, or political connections, provide the group with greater influence over the government’s political survival.

Governments have strong incentives to respond to groups with significant resources (Ramesh Reference Ramesh2000), often governing on behalf of the powerful rather than the people. In the United States, the government has accommodated the demands of the upper class, resulting in a welfare state that “showers its benefits far more generously on the haves than on the have-nots” (Mettler Reference Mettler2011, 25). Similarly, in Uganda, the government has channeled favors to groups whose support they wish to secure (Mwenda and Tangri Reference Mwenda and Tangri2005).

A group’s political power can be augmented through collective action and social mobilization (Díez Reference Díez2013). When “marginalized groups are incorporated into the political arena and possess mobilizing power, there is greater pressure on the state to respond to their needs and expand social protection policy” (Pribble Reference Pribble2011, 194). In Sweden, the government responded to blue-collar workers who, organizing through labor unions, used strikes and protests to exert their political power (Korpi Reference Korpi1978). In Argentina, the government expanded social policies for unemployed and informal workers when they organized roadblocks and demonstrations (Garay Reference Garay2007). The government is more likely to attend to groups that have mobilized and can threaten its survival.

The most “pressing problems” are those that are “forced on the policymakers through pressure from injured or interested outside parties” (Hirschman Reference Hirschman1981, 146). These outside parties, however, vary in power, and social policies reflect the relative strength of different interest groups (Mesa-Lago Reference Mesa-Lago1978). It is domestic societal pressures emanating from groups with high power—that is, groups with access to substantial resources or the ability to coordinate large-scale collective action—that demand government attention and policy action. When a group has high political power, there is a need to appease it or, at the very least, avoid provoking its ire. For this reason, governments have strong incentives to prioritize groups with power.

The Issue: Visibility and Policy Expansion

The “issue” is the social problem that exists in society. The issue’s visibility is reflected by the public’s awareness of the issue or the public’s awareness of the government response.Footnote ⁴ The more immediate the consequences of the issue or the government response, the higher the public’s level of awareness. For example, crises such as earthquakes and nuclear power plant accidents, which have immediate consequences, often precipitate policy action (Birkland Reference Birkland1998). The public is very aware of the issue and the government’s role in remedying it.

Governments have strong incentives to address issues with high visibility. For social policies, an example is economic poverty. People know when they lack access to money and that the consequences can quickly result in deprivations such as hunger or homelessness. When governments expand social policies, such as conditional cash transfers (CCTs), the public sees the benefits of government action right away. For this reason, CCTs “with clear attribution of responsibility have provided electoral advantages to incumbent presidents” in Latin America (Niedzwiecki Reference Niedzwiecki2018, 12). Indeed, “the immediate electoral rewards to incumbents who implement and expand programs can entice rulers around the world to adopt CCTs” (Zucco Reference Zucco2013, 811).

In addition to cash transfers, governments have used other social policies to garner political support (Diaz-Cayeros, Estevez, and Magaloni Reference Diaz-Cayeros, Estevez and Magaloni2016). Following democratization, governments in Korea and Taiwan had strong incentives to extend health insurance to the broader citizenry, as everyday citizens had gained the ability to vote (Wong Reference Wong2006). Similarly, in Malawi, the government garnered political support by addressing food insecurity and expanding agricultural subsidies (Dionne and Horowitz Reference Dionne and Horowitz2016). In Tanzania, the government improved political approval because of its efforts to address malaria through bed net distribution (Croke Reference Croke2021).

Governments have also used social policies strategically, introducing reforms to preempt popular discontent. For instance, “social insurance in the early Latin American adopters” was “initiated by political elites who pre-empted the pressures for reform with policies aimed at diverting labor from radical demands” (Malloy Reference Malloy1989, 319).

Of its arsenal of social policies, governments have incentives to prioritize those that address high, rather than low, visibility issues. Like clientelistic exchanges, where politicians rely on the distribution of particularistic benefits rather than public goods to win office (Mares and Young Reference Mares and Young2018), social policies are politically useful when the recipient is aware of the issue addressed, or the government response. Therefore, governments are better positioned to garner political support or preempt discontent when they expand policies addressing high-visibility issues.

The Puzzle of Nutrition Policies

Unlike policies studied in the welfare state canon—which serve groups with high political power or address issues with high visibility—benevolent policies are a separate class of social policies. They serve groups with limited power on issues with low visibility. To be sure, a group’s level of power and an issue’s visibility are not set in stone. A group can augment its power if it gains access additional resources or effectively mobilizes. Similarly, an issue’s visibility can change. Advocates can launch information campaigns to increase awareness of an issue. An incumbent government can draw attention to its role in introducing policies the public may not previously have been aware of.

However, benevolent policies serve groups and address issues before political action is taken—when the group has low power and the issue has low visibility. Nutrition policiesFootnote ⁵ are a classic example. Chronic malnutrition affects 149.2 million children worldwide (UNICEF/WHO/World Bank 2021). To address the issue, nutrition expertsFootnote ⁶ have drawn upon scientific evidence and recommended that governments introduce nutrition policies which serve low-income women and children (a group with low political power) and address micronutrient malnutrition (an issue with low visibility.

For the poor, the hardship of economic adversity, including the sheer mental and physical exhaustion accompanying life at the margins, constrains their ability to demand government action (Thawnghmung Reference Thawnghmung2019). Concerned with daily survival, they rely on piecemeal responses rather than on organized approaches. Indeed, a history of inadequate access to social services can give way to “diminished expectations” reducing the likelihood that the poor organize (Holland Reference Holland2018).

At the same time, many low-income women and children work in the informal sector in Asia, Africa, Latin America, and the Middle East, taking jobs as domestic helpers or street vendors, for example. Informal workers are occupationally diverse and geographically dispersed, reducing their opportunities to organize and gain political power.

While there have been instances of women and informal workers mobilizing (Garay Reference Garay2007), this has occurred around visible issues. By contrast, low-visibility issues, such as micronutrient malnutrition, do not serve as effective rallying points. Micronutrients are essential vitamins and minerals such as iodine, Vitamin A, iron, and folate. Micronutrient malnutrition—the inadequate intake of essential vitamins and minerals—is commonly called “hidden hunger” or an “invisible” issue (Haddad Reference Haddad2013; Semba Reference Semba2012).

Often people do not know their diet is insufficient. They might eat starchy staples, such as rice or potatoes, which provide the calories to stave off hunger but not the essential vitamins and minerals they need. As micronutrient malnutrition only becomes apparent when the problem is severe, accumulating over long periods, deficiencies can cause impairments but remain undetected. As a result, low-income women and children are unlikely to mobilize and demand improved nutrition policies.

Nutrition experts have developed effective interventions (Zlotkin et al. Reference Zlotkin2005) and identified optimal delivery methods (Baxter et al. Reference Baxter, Roth, Mahmud, Ahmed, Islam and Zlotkin2014). However, governments will not necessarily adopt evidence-based recommendations. This is, in part, because the public is not typically aware of the government’s role in improving micronutrient intake. For example, governments can introduce an iodized salt policy, adding iodine to pregnant women’s diets, thus preventing irreversible physical and cognitive impairments in their children. However, the public does not often link government policies like salt iodization to their well-being. As it can take years to reap the benefits of nutrition interventions, governments are less able to claim credit for improving outcomes. In effect, the “costs of reforms are prompt and clear” but the “political rewards are delayed and uncertain” (Nelson Reference Nelson, Kaufman and Nelson2004, 31).

Benevolent policies, such as nutrition policies, might be categorized as “easy” redistribution because they are fiscally cheap and politically uncontested (Holland and Schneider Reference Holland and Schneider2017). But expanding these policies is, in practice, hard as governments lack strong incentives to pursue reform. The public does not mobilize to demand expanded policies, and governments cannot use these policies to garner short-term political gains. If public policy is “whatever governments choose to do or not do” (Dye Reference Dye1972, 18) then benevolent policies shed light on government inaction—the less studied aspect of public policy.

Yet certain governments have expanded benevolent policies, despite the absence of powerful groups agitating for reform or strong political incentives to pursue change. What explains this?

Looking Outside the State: International Organizations

Constructivist research shows how IOs use social processes to shape domestic policies (Avant, Finnemore, and Sell Reference Avant, Finnemore and Sell2010; Dobbin, Simmons, and Garrett Reference Dobbin, Simmons and Garrett2007; Risse, Ropp, and Sikkink Reference Risse, Ropp and Sikkink1999). For instance, IOs organize international meetings such as conferences, workshops, and forums. At these meetings, IOs put forward a core set of ideas that emphasize the need for governments to prioritize specific issues and policy solutions (Dion Reference Dion2008; Weyland Reference Weyland2004). IOs assess governments on their fidelity to the recommended policies. Governments that adopt the policies receive praise, while those that do not are shamed, stoking reputational concerns (Kelley and Simmons Reference Kelley and Simmons2015).

These processes of socialization can lead to policy change. For example, the United Nations Educational, Scientific, and Cultural Organization’s efforts led to a wave of governments adopting new science policies, despite the absence of domestic demand for reform. The IO “took up science policy as a cause and… ‘taught’ states the value and utility of science policy organizations” (Finnemore Reference Finnemore1993, 566). Similarly, I draw attention to the role of socialization.

However, I am not making the case for IOs as teachers of norms. Rather, I argue that IOs, through their efforts at socialization, serve as “coalition magnets” (Béland and Cox Reference Béland and Cox2016) when there is “congruence” between IOs’ efforts and technocrats’ agendas (Acharya Reference Acharya2004).

The term, “coalition,” typically refers to coordination between different groups to achieve a common goal (Kwon Reference Kwon2007; Nam Reference Nam2015). For example, transnational advocacy networks have built new links between actors in civil society and IOs (Keck and Sikkink Reference Keck and Sikkink1998). Similarly, human rights norms have facilitated the mobilization of both domestic and international groups (Black Reference Black, Thomas, Ropp and Sikkink1999). However, I modify the definition of coalition to refer to coordination between individuals of the same group. The coalition I describe in this article is primarily composed of actors within the government bureaucracy.

IOs draw attention to a range of policies. Their efforts are especially important for benevolent policies, where domestic pressures for policy expansion are weak. But IOs do not drive the domestic agenda. Instead, IOs’ efforts at socialization serve as the focal point around which technocrats coalesce and mobilize like-minded individuals within the government bureaucracy. These individuals believe that policy expansion is needed, but their experiences have taught them that technical knowledge alone cannot facilitate reform.Footnote ⁸ They view international pressure as an opportunity to advance their agenda and use it to integrate knowledge-based experts from their formal and informal networks into their efforts.

Meanwhile, IOs are inviting high-ranking government officials to international meetings, with the purpose of socializing these individuals. Technocrats follow up with government officials and bring them into their network. I call this group “the coalition.”

Looking Inside the Bureaucracy: The Coalition

In this scenario, technocrats are no longer acting alone. IOs have articulated similar ideas, granting legitimacy to their calls for policy expansion. Technocrats strategically deploy international pressure to facilitate the construction of a coalition, broadening the network of actors within the government bureaucracy involved in their cause. I emphasize the centrality of these networks, which encompass both formal and informal linkages, to explain policy expansion (Lee and Goodman Reference Lee, Goodman, Lee, Buse and Fustukian2001). These include vertical networks, which connect technocrats to executive decision makers, and horizontal networks, which cut across ministries.

The coalition leverages international pressure, in conjunction with its expanded networks, to gain the support of executive decision makers. Studies have documented the use of this strategy by activists outside the government. For example, the Council of Europe (CoE) sought to push governments to change their views of citizenship and minority rights. German activists, who shared the CoE’s ambitions, used CoE efforts as a “tool for generating pressure on political elites in Bonn” (Checkel Reference Checkel1999, 105).

Similarly, the coalition uses IO efforts to place pressure on executive decision makers within their own government. As social policy issues “in health and education can rarely capitalize on a sense of urgency” (Kaufman and Nelson Reference Kaufman and Nelson2004, 13), international pressure becomes a tool for insisting on immediate action. The coalition draws upon its political connections to set up meetings with executive decision makers. Citing international scrutiny and reputational concerns, the goal is to get the head of state’s support in policy expansion.

Executive support signals that policy expansion is a priority (Grindle Reference Grindle2004). The coalition then uses executive decision makers’ commitment to policy expansion, in conjunction with international pressure, to create a sense of urgency for reform and demand interministerial cooperation.

This is a dynamic process, shaped by interactions over time. IOs play a role in structuring the international environment, but their efforts alone do not decisively create new domestic policies. Their attempts at socialization may draw attention to the importance of certain policies, but the extent to which this leads to policy change is constrained by the domestic context. It is technocrats, who work inside the bureaucracy and understand the complexities of the policy-making process, who play a crucial role in facilitating coordination within the bureaucracy (Figure 1).

Figure 1. Analytical Framework

Here, I lay out the scope conditions for the analytical framework, specifying the conditions under which it has more, or less, explanatory power. For benevolent policies, policy expansion is likely to have its origins in the bureaucracy, given that domestic societal pressures are weak. Technocrats who believe there is a need for reform play a critical role. They are better positioned to facilitate policy expansion when they have access to executive decision makers. In the absence of direct access to leadership, technocrats can devise alternative methods for obtaining leadership support, such as constructing a coalition with politically connected members. This is true for all welfare states, truncated or not.

However, technocrats are more likely to emerge and wield influence in certain contexts. When a bureaucracy is staffed by highly trained technocrats with long-term careers, they are more likely to emerge to champion reform. Their higher level of training provides them with the skills needed to identify and address societal problems while also socializing them into a certain way of thinking. There is an increased chance that they belong to the same knowledge-based communities as their IO counterparts. This overlap increases the likelihood that technocrats share similar ideologies and view IO efforts as “congruent” with their own agendas. With extended time horizons, these technocrats see the value of benevolent policies, which pay off in the long run. These technocrats are better able to use IO pressure to garner executive attention if governments are, or recently have been, foreign aid recipients. Governments that have accepted aid are enmeshed in complex relationships with IOs and thus more susceptible to external influence.

Policy Expansion in the 1970s

The expansion of nutrition policies in the 1970s illustrates how Nitisastro, who supported nutrition policies and had access to the president, shaped policy reform. While Nitisastro was a market-oriented economist, he nevertheless advocated for government intervention to achieve development goals (Chalmers Reference Chalmers, Vedi and Chalmers1997). In his keynote speech at the National Institute of Sciences in 1970, he declared “we must not operate under the illusion that economic development will in itself cause development in other sectors” and indicated there was a need for the government to expand social policies (Soekirman Reference Arsjad Anwar, Ananta and Kuncoro2008).

At Nitisastro’s instruction, nutrition was included in national development planning in 1978 (Soekirman Reference Arsjad Anwar, Ananta and Kuncoro2008). In 1979, the government expanded its nutrition policies, introducing the Family Nutrition Improvement Program (Usaha Perbaikan Gizi Keluarga or UPGK). Many of the program’s interventions, such as vitamin A supplementation, iron-folate tablets, and nutrition education and counseling, produced limited short-term political gains.

Policy expansion, then, can be traced to the executive support.Footnote ¹² Technocrats in Bappenas advocated for the introduction of nutrition programs (Heaver Reference Heaver2005). And these technocrats, especially “top decision makers from Bappenas,” were crucial for establishing “an interministerial national program in nutrition” (Rohde and Hendrata Reference Rohde, Hendrata, Scrimshaw and Wallerstein1982, 227). Reflecting on this, a technocrat working in the bureaucracy in the 1970s noted the importance of Nitisastro’s connections to the president for elevating nutrition on the government agenda (Table 1).Footnote ¹³ The Family Nutrition Improvement Program continued until the 1990s.

Table 1. Periods of Nutrition Policy Expansion and Retrenchment in Indonesia

Policy Retrenchment in the 1990s and 2000s

In 1993, Suharto announced the sixth development cabinet. The leadership of BappenasFootnote ¹⁴ as well as several ministerial posts, previously held by Nitisastro’s protégés, were taken over by individuals who sympathized with Bacharuddin Jusuf Habibie’s ideas on development. Habibie had held a number of key bureaucratic positions in the Indonesian government and had a close personal relationship with the president (Amir Reference Amir2008).

In contrast to Nitisastro, Habibie was an aeronautic engineer by training and placed industrial sectors at the core of development. But “concentrating on high-technology development inevitably entails marginalizing the development of other sectors more beneficial for the populace as a whole” and this “failed to address social issues such as poverty and unemployment” (Amir Reference Amir2008, 320).

In 1997, Indonesia was hit by a massive currency depreciation. As the economy plummeted, the government had no choice but to accept IO loans and the accompanying policies, including social safety nets. The government introduced the JPS program (Jaring Pengaman Sosial), a social safety net program, with the World Bank, Asian Development Bank, and bilateral donors providing budget and program support (Sumarto, Suryahadi, and Widyanti Reference Sumarto, Suryahadi and Widyanti2002). The JPS program was intended to mitigate the adverse effects of the crisis including poverty, unemployment, and malnutrition. However, nutrition efforts largely ignored micronutrient intake. Indeed, the “inclusion of too many other health issues may have diluted the nutrition interventions” (WHO 2012).

Amidst mass protests, Suharto resigned as Indonesia’s president in 1998, handing over office to Habibie. This marked the country’s transition to a democratic system of governance. By this time, the executive decision makers who had supported nutrition policies had been replaced or were losing power. Nitisastro’s last formal position with the government’s Economics Assistance Team ended in 2001 (Table 1).

At the same time, democracy, long hailed for its potential to facilitate the expansion of the welfare state, was not pushing nutrition policies to the forefront of Indonesia’s policy agenda but was instead sidelining it. While the extension of the voting franchise increased the power of low-income groups, it sidelined low-visibility issues. Politicians had a better chance at securing office if they addressed high-visibility issues, and they relied on policies like JPS and cash transfers. JPS was “a key plank” in Habibie’s attempt “to survive politically … at a time when the first post-Suharto elections were looming” (Aspinall Reference Aspinall2014, 812). The following two administrationsFootnote ¹⁵ continued to reach out to poor voters in the same way, as low-income groups favored parties that demonstrated concern for social welfare (Mujani and Liddle Reference Mujani and Liddle2010).

In the 2009 elections, Susilo Bambang Yudhoyono, the then president, campaigned for reelection on a pro-poor platform. It was “the introduction of massive cash programs for the poor that triggered Yudhoyono’s meteoric rise from electoral underdog to almost unassailable frontrunner” in 2009 (Mietzner Reference Mietzner2009, 4). Even as the economy rebounded and began to skyrocket, social policies focused on high-visibility issues.

The Indonesian economy rumbled along on high for years. Yet amidst significant economic growth and poverty reduction, malnutrition persisted. According to the World Bank (2021), 42.4% of children in the newly democratized country were affected by chronic malnutrition in 2000, as measured by rates of stunting (low height-for-age; Figure 2). A decade later, the numbers had hardly improved and 39.2% of children were malnourished in 2010.

Figure 2. Prevalence of Stunting among Children under the Age of Five in Indonesia

Note: Source: World Bank 2021.Footnote ¹⁷

As nutrition policies had not reemerged as a political priority, observers remained concerned. “Progress on reducing stunting rates has not been as good as on other social development indicators in Indonesia,” they lamented (Rokx, Subandoro, and Gallagher Reference Rokx, Subandoro and Gallagher2018, 19). In the scramble to introduce policies that would secure political office, nutrition policies had been left behind.

The UNICEF office in Indonesia observed that malnutrition remained a stubborn issue, in part because “stunting and maternal nutrition are not easily visible. People are generally not aware that malnutrition is a problem” (UNICEF Indonesia 2012, 2). This made it difficult to get the issue onto the national agenda. In interviews conducted in 2015, interviewees agreed, attributing the difficulty of getting nutrition policies prioritized to low visibility. As a technocrat explained,

As emphasis shifted to visible health policies, nutrition policies fell to the wayside. This, I contend, contributed to the dismantling of Indonesia’s Family Nutrition Improvement Program. The program was provided by the posyandu (Pos Pelayanan Terpadu), the Integrated Health Service Post in Indonesia. The posyandu provides services for basic maternal and child health, including nutrition services. While the number of health posts grew by 15% in the years following democratization, between 2000 and 2006 (Chaparro, Oot, and Sethuraman Reference Chaparro, Oot and Sethuraman2014), Indonesia’s Family Nutrition Improvement Plan was gradually removed (WHO 2012). As another technocrat explained,

Nutrition programming, with its low visibility, was slowly dismantled and replaced by more visible health services. And because technocrats advocating for nutrition no longer had the ear of the president, malnutrition continued to persist on a large scale. Government attention never reached the same levels as in the 1970s. Commenting on this, an employee of a bilateral donor in Indonesia observed that since democratization, “everything has stalled.”Footnote ¹⁹

Policy Expansion in 2012

Against this backdrop, technocrats trained in nutrition continued to advocate for policy expansion.Footnote ²⁰ But nutrition did not become a priority on the government agenda, even as the Indonesian economy recovered from the economic crisis and began to grow rapidly. It was not until IOs began concerted efforts to draw attention to malnutrition that the Indonesian government again expanded its nutrition policies.

In 2010, the World Bank introduced the Scaling Up Nutrition Framework for Action at its spring meetings in Washington, DC. This laid the foundation for the “Scaling Up Nutrition” movement (SUN). IOs, including the World Bank, UNICEF, WHO, and Food and Agriculture Organization (FAO), renewed their efforts to pressure governments to expand nutrition policies.

Operating under the auspices of the UN, SUN began recruiting governments to join the movement and commit to “developing or revising national policies, strategies and plans to scale up nutrition” (SUN 2018, para. 3). Indonesian technocrats saw this as an opportunity to advance their agenda. They had been pushing for the prioritization of nutrition for years, yet it continued to be sidelined.

SUN does not have legal status, nor does it provide financial resources to governments that commit to policy reform. Instead, SUN places pressure on governments by drawing attention to the need for expanded policies that serve poor women and children and address micronutrient malnutrition. In 2011, SUN organized a meeting at the United Nations General Assembly in the United States, emphasizing the prevalence of malnutrition and the need for government action (SUN 2011). Over the next few years, their efforts would build to a crescendo.

Indonesian technocrats coalesced around SUN and began reaching out to individuals sympathetic to their cause within the bureaucracy. They formed a coalition, calling themselves “the Sunners.”Footnote ²¹ Over time, the coalition began to gain attention. Within the bureaucracy, Indonesian technocrats working on social policies, but not specifically on nutrition, acknowledged the emergence of the coalition.Footnote ²² Outside the bureaucracy, representatives working for an IO in Thailand,Footnote ²³ in addition to nutrition consultants based in the US, observed how the coalition had formed in response to SUN.Footnote ²⁴ A Sunner, whose early calls for nutrition reform had gone unheeded said, “nutrition in a country is influenced by the world and its perceptions of the issue,” and “now, we have started moving, because of the international.”Footnote ²⁵

Central to the Sunners’ plan for policy reform was convincing the president to join SUN. However, the Sunners did not have direct access to him. To reach the president, a Sunner drew on her connection to the Minister of Health, Endang Rahayu Sedyaningsih, who had attended the 2011 SUN meeting. As the Sunner explained,

The Sunner kept pressing the Minister of Health. Eventually, the Minister of Health agreed and obtained approval from the President, who sent “the letter to Sec-Gen Ban Ki Moon, saying that Indonesia was willing to be part of the movement.”Footnote ²⁷ After the letter was sent to the Secretary-General, a Sunner said, “I initiated a meeting of the senior nutritionists in Indonesia and I said to them we need to establish a policy framework. We cannot only involve in the movement without having a policy framework in place.” She used Indonesia’s commitment to SUN to divert resources to the formulation of new nutrition policies. As the Sunners gained momentum, the coalition grew to include Indonesians based at universities and nongovernmental organizations.

The Sunners were keen to demonstrate progress to IOs. This was especially true for policy reform, as SUN evaluates governments on their national policies and then compares them with other governments. Government officials attended meetings every six weeks by telephone to report progress updates. A Sunner said, “We were monitored by the [SUN] Secretariat through the teleconference, and the teleconference was done every six weeks. So it was very intensive.”Footnote ²⁸ As such, they diverted resources to formulating policies.

The Sunners used this pressure to keep policy efforts on track. This facilitated the rapid drafting and introduction of nutrition policies. In 2012, new policies were launched under the name the First Thousand Days of Life Movement (1000 Hari Pertama Kehidupan). Notably, SUN’s emphasis on the first thousand days of life meant that policies would be directed toward women and children. Ministers from the Coordinating Ministry for People’s Welfare, Bappenas, the Ministry of Health, and the Ministry of Women’s Empowerment and Child Protection carried out the launch (Kementerian PPN/Bappenas 2012).

The first document was a policy framework called the National Movement on Accelerating Nutrition Improvement within the Framework of the First Thousand Days of Life (Kerangka Kebijakan Gerakan Nasional Percepatan Perbaikan Gizi Dalam Rangka Seribu Hari Pertama Kehidupan). The policy framework articulated the role of key ministries and stakeholders in supporting nationwide efforts to address malnutrition, including micronutrient malnutrition. This was accompanied by a second document called the Guidelines for Program Planning: National Movement on Accelerating Nutrition Improvement within the Framework of the First Thousand Days of Life (Pedoman Perencanaan Program Gerakan Sadar Gizi Dalam Rangka Seribu Hari Pertama Kehidupan). This provided guidance on implementing the policy framework.

By this point, the Sunners had generated momentum by obtaining commitment from the president and developed policies that adapted international recommendations to the Indonesian context. While these policies created basic guidelines, the Sunners needed buy-in from different ministries to set up policy implementation (Sardjunani and Achadi Reference Sardjunani and Achadi2016). Describing past attempts to introduce policy change, an Indonesian national working for an IO in Jakarta said, “there is a Coordinating Minister but anything that needed coordination in the past did not work.”Footnote ²⁹ The Sunners knew this. But this time, they could use the international pressures to insist on the necessary coordination. Because the president had committed to SUN and international attention remained focused on nutrition policies, they could push recalcitrant ministries to cooperate. At the same time, they were drawing on their informal networks and reaching out to government officials with whom they had existing relationships.

The Sunners invoked the Indonesian government’s commitment to SUN to convene high-level meetings and presented internationally recommended policies as “best practices” to avoid internal conflict.Footnote ³⁰ They brought drafts of the newly formulated policies to show that the core work had been completed, and they emphasized the need to introduce new policy, given the external attention on Indonesia’s high levels of malnutrition.

In 2013, the president launched Presidential Decree 42, the National Movement to Accelerate Improvements in Nutrition (Peraturan Presiden Republik Indonesia Nomor 42 Tahun 2013 Tentang Gerakan Nasional Percepatan Perbaikan Gizi). The presidential decree created a taskforce within the government spanning several ministries, which would coordinate efforts to improve nutrition. The interministerial taskforce, while slow to get started, reported to the president and convened 13 government ministries and UN agencies on malnutrition.

Later, Indonesia’s 2015–19 National Medium-Term Development Plan (Rencana Pembangunan Jangka Menengah Nasional or RPJMN) recognized nutrition as requiring the cooperation of different ministries and incorporated the nutrition policy framework. New indicators, introduced through these policy changes, were harmonized with the 2011–15 National Food and Nutrition Action Plan (2011–15 Rencana Aksi Nasional Pangan Dan Gizi or RAN-PG).

The expansion of nutrition policies demonstrates how technocrats used IO pressure to augment their political power within the bureaucracy then obtained executive support and mobilized relevant government officials for policy expansion (Table 1). By 2015, there was a buzz of excitement—that this might be the beginning of improved nutrition in Indonesia.Footnote ³¹