FROM AGRICULTURE TO NUTRITION: PATHWAYS AND PRINCIPLES. Anna Herforth

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1 FROM AGRICULTURE TO NUTRITION: PATHWAYS AND PRINCIPLES Anna Herforth SCN Meeting of the Minds March 25, 2013

2 Great opportunities to improve through agriculture Agriculture is the main livelihood for the majority of ally vulnerable people 75% of the world s poor are rural most of the poor are farmers Produces food Agriculture affects the main underlying causes of mal

3 Nutrition security Healthy environments (free from contaminants and disease vectors) Women s decision-making power, income, time, and knowledge

4 Household assets and livelihoods Pathways from agriculture to National economic growth National prices Nutrition knowledge production Income (agricultural and non-agricultural) Female employment / resources Non-food consumption Health care Caring capacity & practices Nutrient intake Health status Female energy Child Mother s Adapted by J. Harris and A. Herforth from: Stuart Gillespie, Jody Harris, and Suneetha Kadiyala, 2012 The Agriculture-Nutrition Disconnect in India, What Do We Know? IFPRI Discussion Paper 01187

5 As GDP rises, profiles shift Source: WHO World Health Statistics 2006

6 Household assets and livelihoods National economic growth National prices Nutrition knowledge production Income (agricultural and non-agricultural) Female employment / resources Non-food consumption Health care Caring capacity & practices Nutrient intake Health status Female energy Child Mother s prices food purchase

7 Calorie production and under Positive relationship only at low levels of calories Also, high variance (not deterministic) MDG 1: Halve poverty and hunger by 2015 Hunger goal includes 2 indicators: % hungry % underweight Of the 21 countries that have already met the goal of halving the proportion of the population below the minimum level of dietary energy consumption, only six are on track to meet the underweight goal. Source: World Bank 2013

8 Calorie production focuses on starchy roots and cereals despite larger dietary gaps Source: Herforth 2010, based on FAO data

9 Share of Energy Source & Budget in Rural Bangladesh Non-Staple plants Fish and Meat Energy Source Budget Staple foods Slide Source: Howdy Bouis; FNB Mar 2011

10 Household assets and livelihoods National economic growth National prices Nutrition knowledge production Income (agricultural and non-agricultural) Female employment / resources Non-food consumption Health care Caring capacity & practices Nutrient intake Health status Female energy Child Mother s Income food purchase

11 Household assets and livelihoods National economic growth National prices Nutrition knowledge production Income (agricultural and non-agricultural) Female employment / resources Non-food consumption Health care Caring capacity & practices Nutrient intake Health status Female energy Child Mother s Income healthcare purchase

12 Household income and Prevalence of child stunting across wealth quintiles in Ethiopia Source: World Bank Nutrition Country Profiles, 2010

13 Evidence from previous agricultural efforts to increase income Overall, cash-cropping schemes [whether staple crops or other] did not have a significant impact negative or positive on child al status. Household incomes generally improved. Consumption effects depended on base household income, how much was controlled by women, and changes in relative prices. Source: World Bank, 2007

14 Household assets and livelihoods National economic growth National prices Nutrition knowledge production Income (agricultural and non-agricultural) Female employment / resources Non-food consumption Health care Caring capacity & practices Nutrient intake Health status Female energy Child Mother s Own production food consumption

15 production affects consumption With very few exceptions, home garden programs increased the consumption of fruit and vegetables; aquaculture and small fisheries interventions increased the consumption of fish; and dairy development projects increased the consumption of milk. Source: Masset et al, 2012 Available data from home gardens programs also show positive impact on vitamin A status.

16 Household assets and livelihoods National economic growth National prices Nutrition knowledge production Income (agricultural and non-agricultural) Female employment / resources Non-food consumption Health care Caring capacity & practices Nutrient intake Health status Female energy Child Mother s Women s income resource allocation

17 Women s empowerment Linked to over 50% of reductions in all child stunting from Shown in many studies, in many parts of the world: women s income has greater impact on child and food security than men s Need more case studies of where agriculture projects affect this; not frequently measured Women s empowerment in agriculture index: USAID/IFPRI/OPHI

18 Household assets and livelihoods National economic growth National prices Nutrition knowledge production Income (agricultural and non-agricultural) Female employment / resources Non-food consumption Health care Caring capacity & practices Nutrient intake Health status Female energy Child Mother s Women s time use care capacity

19 The zero-sum game agricultural production child care maternal health and care incomeearning activities McGuire and Popkin, & Nutr Bull, 1989

20 The zero-sum game agricultural production child care maternal health and care incomeearning activities McGuire and Popkin, & Nutr Bull, 1989

21 Household assets and livelihoods National economic growth National prices Nutrition knowledge production Income (agricultural and non-agricultural) Female employment / resources Non-food consumption Health care Caring capacity & practices Nutrient intake Health status Female energy Child Mother s Women s workload energy use

22 Women s agricultural labor Excessive physical activity increases risk of low birthweight and preterm deliveries Mean birthweight of infants significantly lower among mothers engaged in heavy agriculture work (Lima et al. 1999) Evidence that heavy labor reduces lactation Workload constraints reduce likelihood that children routinely access health and medical services Potential for exposure to vector-borne disease, hookworm, and agrochemicals

23 Photo: Manoff Group Photo: Anna Herforth Agriculture is essential to the first 1000 days

24 Household assets and livelihoods An 8 th pathway: Natural resource management prices Nutrition knowledge production Income (agricultural and non-agricultural) Female employment / resources Non-food consumption Health care Caring capacity & practices Nutrient intake Health status Female energy Child Mother s Natural resource management (water, soil) Adapted by A. Herforth from: Gillespie et al. 2012

25 Overall Messages: Pathways to Nutrition OLD: Assumptions about impact have been challenged Increasing production of calories Increasing overall household incomes as a singular priority Agriculture as an engine of overall economic growth; trickle-down effect on minimal NEW: These need more attention if we are going to reach Increasing production of diverse, nutrient dense foods Increasing women s incomes And avoiding harm due to additional time demands or energy of women Incorporating behavior change communication for enhanced impact from food production and income

26 Synthesis of Guidance on Agriculture Programming for Nutrition

27 Planning for 1. Incorporate explicit objectives in agricultural policy and program design. 2. Assess the context and causes of mal at the local level, to maximize effectiveness and reduce negative side effects. 3. Do no harm. Identify potential harms, develop a mitigation plan, and set in place a well-functioning monitoring system. 4. Measure al impact through program monitoring and evaluation. 5. Maximize opportunities through multisectoral coordination Target the vulnerable, increase equitable access to productive resources, and plan how to maximize impact from income

28 All approaches should: 9. Empower women Income access to extension services and information, land, other productive resources avoiding harm to their ability to care for children labor and time-saving technologies 10. Incorporate behavior change communication to improve consumption and effects of interventions. 11. Manage natural resources for improved productivity, resilience to shocks, adaptation to climate change, increased equitable access to resources through soil, water, and biodiversity conservation.

29 Increasing access to diverse, nutritious foods 12. Diversify production and livelihoods for improved food access and dietary diversification, natural resource management, risk reduction, and improved income. 13. Increase production of nutrient-dense foods, particularly locally-adapted varieties rich in micronutrients and protein, chosen based on local issues and available solutions. 14. Reduce post-harvest losses and improve processing. 15. Increase market access and opportunities, especially for nutritious foods that smallholders may have a comparative advantage in producing. 16. Reduce seasonality of food insecurity through diversification throughout the year, improved storage and preservation, and other approaches.

30 Supportive environment 17. Improve policy coherence supportive to, including food price policies, subsidies, trade policies, and pro-poor policies. 18. Improve good governance for, by drawing up a national strategy and action plan, allocating adequate budgetary resources, and implementing surveillance. 19. Build capacity in ministries at national, district, and local levels, and increase staff. 20. Communicate and continue to advocate for.

31 Opportunity for Consensus Statement Implicit consensus apparent Report and synthesis of current guidance elaborated through extensive consultation and peer review (2012) Ag2Nut AIARD FAO in-house 70+ individuals, 30+ organizations Use by USAID/SPRING, Govt. of Rwanda FSN Forum discussion (Nov. 2012) Came to a 1-page draft statement Reviewed last week in Ag2Nut CoP conference call

32 Nutrition-sensitive agriculture Is about increasing availability, affordability, and consumption of diverse, safe, nutritious foods and diets, in line with dietary recommendations and environmental sustainability, through increased production and improved transport, storage, processing, distribution, and consumer awareness.

33 Guiding Principles for Nutrition-Sensitive Agriculture (Draft) 1. Have a objective(s) and measure progress toward the objective(s) through M&E of relevant indicators, and track and mitigate potential harms. 2. Base goals and activities in the context and causes of mal at the local level. 3. Target the vulnerable and improve equity through participation, access to resources and decent employment. 4. Empower women. 5. Increase production and reduce post-harvest losses of nutrient-rich foods, and facilitate production diversification. 6. Incorporate promotion and education that builds on existing local knowledge, attitudes and practices. 7. Improve processing to retain al value, shelf-life, food safety, and to make healthy foods convenient to prepare. 8. Expand markets and market access for vulnerable groups particularly for nutrientrich foods. 9. Collaborate with other sectors (health, environment, social protection, labor, water and sanitation, education, energy) and programmes. 10.Maintain or improve the natural resource base (water, soil, air, climate, biodiversity).

34 Next steps Finalization Endorsement by individual organizations? At higher level (SCN, SUN, CFS, CAADP, ASEAN)? Used through the above networks and agriculture high-level networks? Can it serve both programs and policy?

35 Nutrition-sensitive agriculture: two levels Directly affecting farmer households Affecting the larger food system and all consumers prices Convenience (location, time)

36 Pathways and Principles in the evidence base So far, principles built on 3 E s: Experimental evidence, Experience, and Ethics Going forward: What is our expectation for the evidence base? More examples of successful programs Not just, but win-wins with other goals Need appropriately-designed studies Rigor requires attention to impact pathways, and effect modification due to context (program delivery, participation, intra-household behavior and external circumstances) Need to offer generalizable lessons learned

37 Ultimately, what is it that we want to scale up? Probably not individual programs Rather, principles that explain how individual programs have positive impact, and processes for successful implementation. Bigger opportunities: influencing large investments Biggest opportunities: agriculture and food policies that affect production, food environments and behavior Already have evidence that high-quality nutritious diets are not accessible to most; what policies make them accessible? Requires a different way of thinking about evidence

38 Summary Basic pathways from agriculture to Set of common principles Need to consider farmer households, and also strengthening the larger food system to support for all Going forward, clarify expectations for evidence, including from large-scale agriculture investments and policy

39 Discussion

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