6 TH African Conference of Agricultural Economists 2019, Abuja: 25 September 2019 - PowerPoint Presentation

6TH African Conference of Agricultural Economists 2019, Abuja: 25 September 2019 Access to nutritious diets as a policy indicator for Africa’s agricultural transformation and healthy food systems Daniel Bruce SARPONGUniversity of Ghana Derek HeadeyIFPRI, USA William A. MastersProfessor, Tufts University (PI) Fulgence MishiliSenior Lecturer, Sokoine University, Tanzania Anna HerforthNutritionist, Tufts University Fantu BacheweIFPRI-Ethiopia Kalyani RaghunathanIPPRI-India Stevier KaiyatsaGovt. of Malawi Yan BaiDoctoral Student, Tufts University Kate Schneider Doctoral Student, Tufts University CANDASA TEAM

IANDA (2015-2017) CANDASA (2018-2020)Indicators of Affordability of Nutritious Diets in Africa developed several new metrics (CoRD/CoNA)IANDA conducted a landscape analyses of food price data collection at national and global level to understand collection, dissemination and its use in decision makingEngaged with stakeholders in Ghana/Tanzania, building the metrics using Ghana/Tanzania existing data and exploring integration into food price monitoring system   Access to nutritious diets as a policy indicator in AfricaBackground introduction | methods & data | results

IANDA (2015-2017) CANDASA (2018-2020)Changing Access to Nutritious Diets in Africa and S outh Asia builds directly on IANDA and ARENA at IFPRIRefining and publishing CoNA/CoRD methodologiesResearching the CoNA/CoRD in India, Malawi, Ethiopia, Tanzania, Ghana, Myanmar (exploring Nigeria, Nepal)Researching how access to nutritious diets changes based on shifts over time and space in food prices, wages and upstream determinants such as infrastructure and GDP How food prices are associated with diet and nutritional status, where data are available Continued contact with Ghana government stakeholders on integrating the new metrics into her food price monitoring Access to nutritious diets as a policy indicator in AfricaBackground introduction | methods & data | results

Structure of presentationWith that background, I briefly give the motivation for the IANDA/CANDASA projectdescribe some of the methods developed and some general results, and end bytalking about the policy dialogue process, where CANDASA is trying to integrate the new metrics into Ghana food price monitoring (as this demonstrates utility and use of the new metrics)  Access to nutritious diets as a policy indicator in Africaintroduction | methods & data | results

In the key area of agriculture-nutrition linkages, metrics are inadequate*Nutritious food to meet dietary needsAccess to nutritious diets as a policy indicator in Africa motivation | methods & data | resultsNot just staple prices or income; not just staple food availability but access to nutritious diets. We don’t track diet quality well enough. We also don’t track food access well enough.

Agriculture, Food Systems and Nutrition Agriculture and food systems can make nutritious diets more available and affordable. But, governments and projects typically don’t have an information system that tracks prices of nutritious diets.Countries can use existing food price monitoring systems better to understand availability and prices of nutritious foods.International agencies could monitor these across countries.Access to nutritious diets as a policy indicator in Africamotivation | methods & data | results

Rural and urban food markets are changing rapidlyfrom own-production to use of marketsfrom generic commodities to branded, packaged foodslower cost of starchy staples relative to milk, eggs, meat, fruit & veghigher earnings, allowing more choice among affordable foodsTo monitor change, we need new kinds of price indexesexisting indexes focus on trade, producer prices, or the cost of livingwe add nutritional data, to measure the cost of a healthy dietcomparison to earnings reveals affordability at each time and placeMeasuring access to nutritious diets can guide interventionwhere do diet costs exceed earnings, so transfers are needed? which foods & nutrients drive costs up, so access can be improved? are some foods already accessible at low cost, but under-consumed?Mal-nutrition challenges in Africa prevalent hence the need to have mechanisms to track progress from diverse disciplinesPhoto by Anna Herforthat Nsawam market, Ghana Why measure the cost of nutritious diets? Access to nutritious diets as a policy indicator in Africamotivation | methods & data | results

For foods actually consumed, a very long historyFleetwood (1707) food price index = 5 ‘quarters’ of wheat, 4 ‘hogsheads’ of beerLowe (1823) different baskets for different socioeconomic groupsJevons (1865), Laspeyres (1871) and many others lead to modern CPIFor affordability of dietary energy, a long history and wide usePlayfair (1821) chart of wheat prices and wages from 1565 to 1821Sukhatme (1961) and FAO’s Prevalence of Undernourishment in caloriesDrewnowski (2004) measure of energy cost ($/kcal) and density (kcal/kg)For nutrient adequacy, more recent history and many specific usesStigler (1945) linear programming to compute least-cost diets USDA Thrifty Food Plan for US nutrition assistance (1975, 1983, 1999, 2006)SCUK Cost of Diet tool (2009) and FANTA et al. Optifood (2012) for aid programsNow, diet diversity in terms of functional food groupsObtaining at least one food from each of at least 5 different groups …or nutritional scoring in terms of many attributesWeighting foods by a healthy-eating score, e.g. 1 to 100 …or recommended diets for specific food basketsIncluding specific quantities of particular food categories, e.g. dietary guidelinesHow might we measure the cost and affordability of a nutritious diet? Access to nutritious diets as a policy indicator in Africamotivation | methods & data | results

All essential nutrients required for long-term healthCost of nutrients = min. { C = Σipi × qi } least-cost combination of foodsWith: Σiaie × qi  = E daily energy balance Σia ij × qi ≥ EARj   estimated average requirements Updated to address dietary transition: Σiaij × qi ≤ ULj upper limits for toxicity Σiaij × qi ≤ AMDRj,u×E/ej Σiaij × qi ≥ AMDRj,l ×E/ej Parameter values are Dietary Reference Intake (DRI) requirements for the US and Canada, last revised by the Institute of Medicine in 2011 Use a total of 20 nutrients and 35 constraints, omitting DRIs for Vitamin D & cholesterol due to synthesis in the body, and iodine & molybdenum due to lack of nutrient composition dataBaseline is woman 19-30, can adjust for age, sex, pregnancy & lactationBaseline is ~2000 kcal/day, can adjust for physical activity level within acceptable macronutrient distribution ranges We construct food price indexes representing least-cost diets for nutrient adequacy and daily subsistence at each place and time Access to nutritious diets as a policy indicator in Africamotivation | methods & data | results Comparison is just subsistence energyfrom starchy staples

Our measures differ from traditional indexes which are a weighted sum of many pricesAccess to nutritious diets as a policy indicator in Africamotivation | methods & data | resultsFood CPI: fCPI = ∑ipiqi , where pi and qi are prices and quantities consumed  weights each price by quantities actually chosen

Cost of Calories (CoCa):CoCa = Mini{piqi} where aie q i = E, aie is energy content of foods, and E is energy requirement of people  the one least-cost energy sourceCost of Diet Diversity (CoDD): CoDD = Min5{min{pi1}, min{p i2}, …, min{pim }}  the least-cost way to include at least one food from at least 5 food groupsNutritious-food CPI (NPI):NPI = ∑ip ini , where n i is a food’s health score, eg NuVaL from 1 (worst) to 100 (best)  weighting each price by its nutritional value To measure affordability, we include only the least-cost foods Access to nutritious diets as a policy indicator in Africamotivation | methods & data | results

Cost of Nutrient Adequacy (CoNA):CoNA = MiniΣipiqi, where aij q i > EARj and aie q i = E a ij is nutrient content of foods, EARj is nutrient requirement of people  the least-cost combination of m foods to meet n nutrient needs(Uses data on (a) the price of each locally available food, (b) its nutrient composition, and (c) nutrient requirements in terms of both lower and upper limits)Cost of Nutrient Adequacy (CoNA ):CoNA measures the minimum cost of using locally-available foods to obtain enough of all essential nutrients needed for an active and healthy life CoNA shows the minimum cost of achieving minimum nutrient adequacy for a target population To measure affordability, we FOCUS on two least-cost food indicators (1) Access to nutritious diets as a policy indicator in Africa motivation | methods & data | results

Cost of a Recommended Diet (CoRD):CoRD = ∑jpijqj , where pij = min{pij} and qj = requirement for j={1,…, m} categories  weights each price by quantities in the recommended diet, without substitutionsCalculated by selecting the lowest-cost foods within each group, in sufficient quantities to meet each recommendation. Use data on (a) the price of each locally-available food (b) its edible portion and water content, and (c) the target quantity needed to meet recommendations Cost of a Recommended Diet (CoRD):CoRD measures the minimum cost of using locally-available foods to meet dietary recommendations (based on National food-based dietary guidelines which specify the quantity of each food group needed for both nutrient adequacy and prevention of diet related non-communicable disease within culturally acceptable diet To measure affordability, we FOCUS on two least-cost food indicators (2) Access to nutritious diets as a policy indicator in Africamotivation | methods & data | results

Our base case is an adult womanWe use average requirements, to meet needs of a median healthy person -- We also compare to recommended daily allowances (RDAs), to meet needs of almost all people (97.5%)-- We also compare across individuals, to meet needs of whole householdsAccess to nutritious diets as a policy indicator in Africamotivation | methods & data | results Nutrient needs vary over the life course and across people Source: Calculated from Institute of Medicine (2011), Dietary Reference Intakes. https://www.ncbi.nlm.nih.gov/books/NBK56068.

Nutrient adequacy costs over half of the international $1.90 poverty line and is twice as expensive as daily energy$1.90/day 50% ($0.85/day) Darker: Cost of nutrient adequacyLighter: Cost of caloric adequacy US$/day at 2011 PPP food prices Source: Alemu et al. (2019), Cost and affordability of nutritious diets at retail prices: Evidence from 744 foods in 159 countries calculated from World Bank ICP data. Results shown are daily cost of adequate nutrients (in black) and subsistence calories from starchy staples (in gray), using locally-available foods at retail prices reported to the ICP, converted from local currency units at each country’s average price level for all food. Nutritional adequacy is computed based on U.S. and Canada Dietary Reference Intake (DRI) estimated average requirements for calories and 17 essential nutrients to sustain a healthy adult woman, as well as upper limits for toxicity and acceptable macronutrient distribution ranges. Least-cost diets measure the cost of nutrients and calories relative to a country’s overall price level Access to nutritious diets as a policy indicator in Africamotivation | methods & data | results

Nutrient adequacy costs over 3x the cost of subsistence in many low-income countries (and in many high-income countries too)Source: Alemu et al. (2019), calculated from World Bank ICP data on food prices and DRI data on nutrient requirements. Least-cost diets identify hotspots, with high cost of nutrients relative to the cost of daily calories from starchy staples Cost of nutrients/ cost of calories Access to nutritious diets as a policy indicator in Africa motivation | methods & data | results

In poorer countries all food prices are relatively high, compared to earnings and non-food prices Price levels relative to all household expenditure Source: Alemu et al. (2019), calculated from World Bank International Comparison Project (ICP) data. Access to nutritious diets as a policy indicator in Africamotivation | methods & data | results

In the poorest countries, nutritious diets would cost a large fraction of all household expenditure Cost of nutrient adequacy relative to all household expenditure Source: Alemu et al. (2019), calculated from World Bank International Comparison Project (ICP) data. Cost of nutrients/ all expenditureAccess to nutritious diets as a policy indicator in Africa motivation | methods & data | results

The cost of a recommended diet (CoRD) depends on price and quantity per day Cost per dayFor Ghana, with the average of all items in each food group (except dairy), total cost would be US$0.75/day The required portions from each food group cost between $0.15 and $0.25 per day (Ghana 2015) Ghana prices not available for dairy Access to nutritious diets as a policy indicator in Africamotivation | methods & data | results

In Ghana, Cost per serving (nominal USD, Ghana 2015)Access to nutritious diets as a policy indicator in Africamotivation | methods & data | results

Ghana MoFA has updated its national food price monitoring system to allow calculation of new metrics In 2016, MoFA collaborated with IANDA to review their food price monitoring list. The list lacked sufficient diversity of nutrient-rich foods to calculate nutritious food price indexes.22 foods added in all; Such as: several dark green leafy vegetables; some fruits; two additional beans/seeds; meat and fish in the form typically bought by consumersMoFA-SRID piloted the expanded list and made the decision to institutionalize it.Expanded Food list Questionnaire sent to all 10 regional offices and 20 major selected markets have started using itWeekly Market Price Reports are now generated for the expanded food list since July 2017 MoFA can use these indicators for decision-making toward a more nutritious food systemCould see where, and when, nutritious diets are too expensiveMoFA-SRID is continuing to roll out the expanded food list nationwide Ghana Statistical Service is exploring reporting the new indicators as national statistics Access to nutritious diets as a policy indicator in Africamotivation | methods & data | results

The project has helped Ghana MoFA expand price data collection to include more diverse foodsCerealsWhite Roots and Tubers PlantainPulses Nuts and SeedsDark Green Leafy VegetablesSeed OilMaize YamPlantain Cowpea (white)Groundnut (unsh) NkontommireCoconut oilMillet Cocoyam Soya bean Groundnut (red)Jute mallowPalm oilSorghum Cassava  Bambara BeanMelon SeedsAlefu (Amaranthus)Groundnut oil RiceGari   Sweet potato    Cassava dough    Dried cassava   Meat, Poultry and Fish Vegetables Fruits Egg Dairy Beef Tomato Mango Egg Fresh Cow Milk Pork Garden Egg Pineapple Salted dried fish Okro Palm fruit Live chicken bird Onion Watermelon Smoked herring Ginger Orange Anchovy Pepper Banana Fresh fish Cabbage Coconut Chicken meat Lettuce Avocado Snail Carrot Pawpaw Goat meat Mutton Ghana’s Weekly Market Price Reports now include the additional foods marked in red, for all major markets Access to nutritious diets as a policy indicator in Africa motivation | methods & data | results

There is government interest, but support is needed Policy dialogue for use of new price indexes in GhanaTo help introduce new metrics, an informal “ Nutritious Food Prices Analysis Support Group” to be hosted at the University of Ghana’s Institute for Statistical, Social & Economic Research (ISSER) This is to allow government statistical officers to meet regularly with local economists and other stakeholders, before and after release of new data, to discuss the significance and interpretation of each indicator Meetings will begin later this yearPOLICY OBJECTIVE? Measuring access to nutritious diets to guide intervention Since 2016 IANDA/CANDASA has worked with Ghanaian authorities (GSS, MoFA) to help officials use the new price indexes within their routine food price monitoring

Thank you!Details here: https://sites.tufts.edu/willmastersCo-authors: Robel Alemu, Yan Bai & Kate Schneider, PhD students, and Steven Block (Tufts University); Anna Herforth (Consultant);Daniel Sarpong (University of Ghana); Fulgence Mishili (Sokoine University, Tanzania); Stevier Kaiyatsa (Government of Malawi); Derek Headey, Fantu Bachewe & Kalyani Raguthanan (IFPRI)This research is supported by USAID through the Rutgers University Feed the Future Policy Consortium (USDA award # TA-CA_15_008), and by UKAid with the Bill & Melinda Gates Foundation through the CANDASA project (OPP1182628) Photo: Anna Herforth, 2017 Food price measurement is not easy

The CANDASA Research Team