Simba Sibanda ssibanda@fanrpan.org - PowerPoint Presentation

1. Simba Sibandassibanda@fanrpan.orgHow to Make Agriculture Nutrition-Sensitive

2. Nutrition and Food Security: What is it all about?

3. Source: CFS 2012.Exists when:all people at all times have physical, social and economic access to food, which is safe and consumed in sufficient quantity and quality to meet their dietary needs and food preferences, and is supported by an environment of adequate sanitation, health services and care, allowing for a healthy and active life.From this definition, we see the four pillars of food security as:AvailabilityAccessibilityUtilization andStabilitySource: CFS 2012 Food and Nutrition Security (FNS)

4. A state of inadequate nutrition, “an abnormal physiological condition caused by deficiencies, excesses or imbalances in energy and other nutrients necessary for an active, healthy life” Malnutrition manifestation: Undernutrition - result of insufficient intake of nutritional energy and/or nutrients; also caused by inadequate health and hygienic conditionsMicronutrient deficiencies, hidden hunger - result of an inadequate supply of vitamins and/or minerals. Sometimes called hidden hunger.Overweight & obesity - result of an excess intake of nutritional energy over a longer period of time. When all three conditions are found together, this is referred to as the triple burden of malnutrition Malnutrition

5. All three problems occur, in some instances, in the same countries, societies and familiesIndividuals may suffer from underweight or overweight and micronutrient deficiencies at the same time Undernutrition and micronutrient deficiencies still major challenges worldwideOverweight and obesity are increasing rapidly, causing nutrition-related chronic diseases (non-communicable diseases)NCDs responsible for over 75% of deaths globallySource: gizTriple Burden of Malnutrition

6. Vicious cycle of malnutritionCommon phenomenon in communities experiencing malnutritionIt starts off with a stunted girl child, resulting in a stunted adolescent Stunted adolescent develops into a malnourished womanMalnourished women then gives birth to a low weight (less than 2.5 kg) babyLow eight baby develops into a stunted baby

7. Africa is ranked as having amongst the highest rates in the world and SSA carries a high burden of under-nutrition with 33% of childhood deaths linked to under-nutrition. In 2019, 40% of stunted and 25% of wasted and obese children came from AfricaAfrica is only region where number of stunted children has increased between 2000 and 2019 from 49.7 mil to 57.5 milMalnutrition in AfricaPercentage of stunted children under 5, by United Nations sub-region, 2019 Source: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition. 

8. ConditionMalawi %Zambia %Wasting (Children 0-59 months) 0.66.2Overweight (Children 6-59 months) 4.75.7Stunting (Children 6-59 months) 37.032.3Underweight (Children 6-59 months) 9.011.8Vitamin A deficiency (Children 6-59 months)54Anaemia among women31.431.5Anaemia in children (6-59 months)55.155.1Malnutrition in Malawi, Mozambique, ZambiaSource: UNICEF, WB and WHO 2020: Global Observatory Indicator Views

9. Malnutrition and diet are the biggest risk factors for the global burden of disease, responsible for over 70% of mortalitiesLosses of 11 percent of gross domestic product (GDP) every year in Africa and AsiaPreventing malnutrition delivers $16 in returns on investment for every $1 spent. Countries have agreed on targets for nutrition, but still a long way in reaching the targetsWhile policies may be in place, countries do not always know how to design and implement effective interventionsGlobal Nutrition Report 2017The Economic Cost of Malnutrition

10. Nutrition is central to achievement of SDGsAt least 12 of the 17 SDGs contain indicators that are highly relevant for nutritionImproved nutrition has a positive impact on health, education, employment, female empowerment, and poverty and reduction of inequality Conversely, poverty and inequality, water, sanitation and hygiene, education, food systems, climate change, social protection, and agriculture affect nutrition outcomesImportant to incorporate nutrition targets into development and social sectors, where many governments spend more than 30 percent of their budgetsDelivering nutrition requires a multi-sectoral approachGlobal Nutrition Report 2016Nutrition and SDGs

11. SDG 2: End hunger Achieve food security and improved nutrition Promote sustainable agricultureAfrican Union Vision 2063:Healthy and well-nourished citizensMalabo Declaration 2025 targets:End hunger by 2025Reduce stunting to 10%Underweight reduced to 5%Global and Regional Nutrition Goals

12. General Causes of MalnutritionUNICEF 1990

13. How to Address Malnutrition

14. How to Address Malnutrition

15. Addressing Malnutrition Requires a Multi-sectoral Approach

16. Food system: all processes and infrastructure involved in feeding a population by growing, harvesting, processing, packaging, transporting, marketing, consumption, and disposal of food and food-related items. Many sub-systems: farming system, waste management system, input supply system, etc.) and interacts with other key systems (e.g. energy system, trade system, health system, etc.)A food system approach better in dealing with complex issues such as nutrition which need a multi-sectoral approach to resolve themFood systems need to be nutrition-sensitive to address the underlying causes of malnutritionAgriculture is but one component of the food system which should help to deliver healthy dietsFood Systems Approach to Nutrition

17. The Link Between Agriculture and Nutrition

18. Agriculture is fundamental to food productionLink to nutrition through food use via food availability and access is apparent …… but availability and access do not always lead to good nutritionAgriculture also has impacts on health-related outcomes.Source: gizHow is Agriculture Linked to Food and Nutrition Security?

19. There is a disconnect between agriculture and nutritionWhat can agriculture projects do to deliver positive nutrition outcomes?Traditionally, agricultural development tended to focus on productivity, production and incomes rather than nutritionNutrition was considered intuitiveAgriculture must transform to become nutrition-sensitive in order to deliver on healthy diets and SDGsAgriculture and Nutrition Disconnect

20. … an approach that addresses potential disconnect between agriculture and nutritionseeks to ensure the production (and purchase) of a variety of affordable, nutritious, culturally appropriate and safe foods in adequate quantity and quality to meet the dietary requirements of populations in a sustainable manner.Nutrition-Sensitive Agriculture

21. Role of Agriculture in Delivering NutritionAgriculture has a big role to play in delivering nutritious and safe food for positive nutrition outcomes through the following possible pathways:Food production for household consumption;Income-oriented production for food, health and other non-food items;Empowerment of women as agents;Reduction in real food prices associated with increased agricultural production; andNutrition-sensitive agricultural growth.

22. Agriculture-Nutrition Pathways

23. Adapted from Gillespie et al. 2012 and Headey et al 2012Food pricesFood consumptionFood expenditureNon-food expenditureNutrient intakeChild nutrition outcomesHousehold assets and livelihoodsHealth statusMother’s nutrition outcomesHealth care expenditure Women empowermentNational nutrition outcomesIncome (agricultural and non-agricultural)Caring capacity & practices Female energy expenditureFood productionNutrition knowledgeNational economic growthPathways from Agriculture to Nutrition

24. source: FAO (2016) adapted from Herforth and Ballard (2016)Source: gizPathways from Agriculture to Nutrition

25. Entry Points for Nutrition-Sensitive Interventions (NSIs)

26. Can be anywhere along the agricultural value chain, depending on the design and objectives of project Opportunities for Nutrition-Sensitive Interventions

27. Crop / animal husbandryAflatoxin controlStorage and handlingFood processingNutrition knowledgeFortificationBiofortificationWomen EmpowermentSoil fertility Market EnhancementPolicy environmentFood utilisation/CookingLabor saving technologiesGender EnvironmentGermplasmWhere are Opportunities for Nutrition-Sensitive Interventions (NSIs)?

28. Policy environment entry pointsPolicy interventions should be targeted at creating nutrition-sensitive agriculture and food value chains by creating an enabling environment for:Improved supply of nutritious food; Added nutritional value to foods; andIncreased demand for nutritious food.These strategies operate at different points along the value chain

29. Policy environment entry pointsImproved supply of nutritious food:Facilitate access to agricultural inputs to improve productivityPromote post-harvest storage and processing, especially at local level, infrastructureEnsure efficient distribution and transport, including cold chainFacilitate trade in food commodities and access to local food marketsImproved nutritional value and quality of foods:Improve nutritional value of primary products, e.g. fertilizer regime, biofortification, diverse production, including local crop varietiesImprove quality of foods during processing, e.g. fortification, avoid over processingImprove food safety, e.g. reduce aflatoxin contamination of foodPromote management practices to reduce food waste and loss

30. Policy environment entry pointsIncreased demand for nutritious food:Consider how affordability, availability and acceptability affect consumption and, consequently, demandPromote demand for nutritious food (e.g. create awareness through social marketing, nutrition knowledge and behaviour change communication campaigns)Promote small packaging targeted at the poorPromote food labelling practices – nutrition informationProvide knowledge on preparation and consumption (e.g. cooking classes, recipes). Promote alternative markets, e.g. institutional markets (e.g. public purchasing programmes, school feeding programmes). 

31. Specific Examples of Policy Interventions to Support Supply and Demand for Nutritious FoodIncrease incentives (and decrease disincentives) for availability, access and consumption of diverse, nutritious and safe foods through environmentally sustainable production, trade and distribution policies.Monitor the performance of policies on dietary consumption and access to safe, diverse and nutritious foods, e.g. food price data, consumption data and build capacity of relevant agencies to conduct impact assessments.Promote measures to protect and empower women and the poor through social safety nets, land reform and access to land by women and vulnerable groups and access to local procurement schemes for produce from smallholder farmers.

32. Develop human resources capacity among relevant institutions to support NSA interventions, e.g. recruiting nutritionists in ministries, include nutrition curricula in training institutions, provide basic training on nutrition and NSA to extension service staff and others responsible for implementing frontline programmes.Support multi-sectoral coordination strategies to improve nutrition within local, regional and national government structures, e.g. agriculture, health, social services, rural development, education etc.Implement tariff regimes that encourage import/export of nutritious foods (Trade for nutrition).Promote private sector to engage in nutritious value chain development by creative use of the fiscal incentives.Specific Examples of Policy Interventions to Support Supply and Demand for Nutritious Food

33. “Do no harm” - avoid possible negative impacts of policy interventionExamples:New crops with high labour requirements, especially for women;Subsidies of specific crops which can result in reduced crop diversity and monocultures, e.g. maize subsidies;Promotion of cash crops and other commodities, for example through contract farming, resulting in farmers selling all their produce and leaving nothing for home consumption;Promotion of “male” crops, resulting in marginalisation of women; Free distribution of chemical inputs resulting in soil contamination and risk of poisoning people;Irrigation projects not accompanied by malaria control can result in health problems; andTrade policies favouring import of highly processed food which is not good nutritionally.

34. The most basic requirement for nutrition-sensitive programming is to avoid possible negative impacts on nutrition.intended pathwayunintended pathwaySource: gizExample of “Do no harm” Principle

35. What Will Success Look Like?

36. References and further readingsBMZ (2013): Promoting sustainable agricultureGIZ (2016): Sample results models and indicators for rural development and agriculture projects WorldBank (2013): Improving nutrition through multi-sectoral approachesFAO (2017): Nutrition-sensitive agriculture and food systems in practice IFPRI (2017): Discussion Paper: Nutrition-Sensitive Agriculture – What Have We Learned and Where Do We Go from Here? Herforth and Harris (2014): Understanding and Applying Primary Pathways and Principles.FAO e-learning course Improving Nutrition through Agriculture and Food SystemsGloPan (2016): Food systems and diets: Facing the challenges of the 21st centuryHLPE (2017): Nutrition and food systemsFAO (2016): Compendium of indicators for nutrition-sensitive agriculturehttps://www.fanrpan.org/projects/atonu/about?block=prj-homeGlobal Nutrition Reports – 2015, 2016, 2017, 2018, 2019, 2020

37. Thank you