Nutrition Sensitive Agriculture

A growing number of governments, donor agencies, and development organizations are committed to supporting nutrition-sensitive agriculture (NSA) to achieve their development goals. Although consensus exists on pathways through which agriculture may influence nutrition-related outcomes, empirical evidence on agriculture’s contribution to nutrition and how it can be enhanced is still weak. This paper reviews recent empirical evidence (since 2014), including findings from impact evaluations of a variety of NSA programs using experimental designs as well as observational studies that document linkages between agriculture, women’s empowerment, and nutrition. It summarizes existing knowledge regarding not only impacts but also pathways, mechanisms, and contextual factors that affect where and how agriculture may improve nutrition outcomes. The paper concludes with reflections on implications for agricultural programs, policies, and investments, and highlights future research priorities.

This publication provides a list of food system-based intervention options to improve nutrition and a set concrete entry points for maximizing the impact of each intervention. Developed through leveraging different expertise in FAO, it is a key resource to assist professionals involved in different areas - from breeding to production; from food transformation and packaging to transportation and trade; from marketing and value chain to food safety; from food labelling to consumer education - to u nderstand the linkages with nutrition, and to increase their contribution for a world free from malnutrition in all its forms.

This book highlights the important links between agriculture and nutrition, both direct and indirect, both theoretical and practical. It explores these relationships through various frameworks, such as value chains, programmes and policies, as well as through diverse perspectives, such as gender. It assesses the impacts of various agricultural interventions and policies on nutrition and profiles the up-and-down journeys of countries such as Bangladesh, China, Ethiopia, India, and Malawi in integrating nutrition into agricultural policies and programmes. It highlights successes such as biofortification, the integration of behaviour change communication and gender equality into existing agricultural interventions, and agriculture's role in improving household access to nutritious foods and diet diversity. It analyses challenges such as climate and environmental change, undernutrition, and obesity. And it ponders big questions, such as how to build capacity, engage with the private sector, participate in the big data revolution, and foster strong governance and leadership throughout agriculture and nutrition. The book has 20 chapters and a subject index.

We use a randomized controlled trial in rural Bangladesh to compare two models of delivering nutrition content jointly to husbands and wives: deploying female nutrition workers versus mostly male agriculture extension workers. Both approaches increased nutrition knowledge of men and women, household and individual diet quality, and women’s empowerment. Intervention effects on agriculture and nutrition knowledge, agricultural production diversity, dietary diversity, women’s empowerment, and gender parity do not significantly differ between models where nutrition workers versus agriculture extension workers provide the training. The exception is in an attitudes score, where results indicate same-sex agents may affect scores differently than opposite-sex agents. Our results suggest opposite-sex agents may not necessarily be less effective in providing training. In South Asia, where agricultural extension systems and the pipeline to those systems are male-dominated, training men to deliver nutrition messages may offer a temporary solution to the shortage of female extension workers and offer opportunities to scale promote nutrition-sensitive agriculture.

Nutrition-sensitive agricultural diversification continues to receive interest among developing country stakeholders as a viable option for achieving dual goals of poverty reduction and food/nutrition security improvements. Assessing the effectiveness of this strategy is also essential in countries like Tajikistan. We attempt to enrich the evidence base in this regard. We assess the linkages between household-level agricultural diversification and dietary diversity (both household- and individual-levels) using unique panel samples of households and individual women of reproductive ages in the Khatlon province. Using difference-in-difference propensity-score methods and panel fixed-effects instrumental variable regressions, we show that higher agricultural diversification together with greater overall production per worker and land at the household level leads to higher dietary diversity, particularly in areas with poor food market access. Typology analyses and crop-specific analyses suggest that vegetables, fruits, legumes/nuts/seeds, dairy products and eggs are particularly important commodities for which a farmer’s own production contributes to dietary diversity improvement. Furthermore, decomposition exercises within the subsistence farming framework suggest that nutritional returns and costs of agricultural diversification vary across households, and expected nutritional returns may be partly driving the adoption of agricultural diversification. In other words, households’ decisions to diversify agriculture may be partly driven by potential nutritional benefits associated with enhanced direct on-farm access to diverse food items rather than farm income growth alone. Our findings underscore the importance of supporting household farm diversification in Tajikistan to support improved nutrition intake, especially among those living in remote areas. In a low-income setting with limited local employment opportunities that is vulnerable to a wide range of external shocks, this will likely continue to be one of the most straightforward and realistic paths to improving household’s nutrition resilience.

Over the past decade, interest in gender equality and women’s empowerment has grown rapidly, creating a unique opportunity to institutionalize gender research within agricultural research for development. This book, edited by researchers from the CGIAR Gender Platform, reviews and reflects on the growing body of evidence from gender research. It marks a shift a way from a traditional focus on how gender analysis can contribute to improved productivity, flipping the question to ask, How does agricultural and environmental research and development contribute to gender equality and women’s empowerment? Chapters synthesize the wide range of CGIAR and other research in this area, covering breeding research and seed systems, value chain participation, nutrition-sensitive agriculture, natural resources, climate adaptation and mitigation, the “feminization” of agriculture, women’s role in agricultural research, and emerging gender transformative approaches.

Investments in social assistance programs (SAPs) in low- and middle-income countries (LMICs) are increasing. As investments increase, the objectives of these programs are expanding from focusing on reducing poverty to addressing other social issues such as improving diets and nutrition. At the same time, there is increasing interest in addressing all forms of malnutrition within the framework of food systems. Given the intersections between SAPs and food systems, we reviewed the effectiveness of SAPs (agriculture asset transfers, cash transfers, in-kind transfers, vouchers, public works and school meals programs) for reducing all forms of malnutrition across the lifecycle within a food systems framework. As several programs included multiple treatment arms, each representing a unique program design, we used study arm as the unit of analysis and assessed the proportion of study arms with positive or negative program impacts on diet and nutrition outcomes among men, women and children. The majority of the studies included in this review were from evaluations of agriculture asset, cash and in-kind transfer programs. There was clear evidence of positive impacts on women’s and children’s diet-related outcomes. Very few studies assessed program impact on women’s nutritional status outcomes. However, there was some evidence of impacts on increasing body mass index and hemoglobin concentration (Hb) with in-kind transfer programs. Among children, several study arms across the agriculture asset, cash and in-kind transfer programs found positive impacts on increasing height-for-age Z-score (33%-45% of study arms) and weight-for-height Z-score (33%-50% of study arms) and decreasing the prevalence of wasting (43%-60% of study arms). Cash and in-kind transfer programs also found positive effects on reducing stunting prevalence in 33% and 45% of study arms, respectively. Lastly, a few study arms assessed program impact on increasing Hb with some evidence of positive impacts in in-kind and school feeding programs. There was a paucity of relevant evidence of the effectiveness of voucher and public works programs on diet and nutrition outcomes, for men’s outcomes and on micronutrient status. Several challenges remain in understanding the potential for SAPs to improve diet and nutrition outcomes within food systems including the heterogeneity of program and evaluation designs, populations targeted by the programs and included in evaluations and indicators used to assess impact. Addressing these challenges in future evaluations is important for informing program and policy actions to improve the effectiveness of SAPs within food systems for improving diet and nutrition outcomes across the lifecycle.