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Day 1 Session 3 Harris and Kennedy_ Ag nutrition pathways
1. FROM AGRICULTURE TO NUTRITION
(VIA GENDER!)
A4NH Gender-Nutrition Methods Workshop
Nairobi, December 2013
Jody Harris (IFPRI)
Gina Kennedy (Bioversity)
2. 2
Overview
• Why nutrition?
• Why women and children?
• Why agriculture?
• What are the links between agriculture and nutrition?
• Why gender?
• What to measure?
3. 3
Malnutrition
Food security:
consistent access to
diverse, nutritious
diets
(Quantity and quality)
Underlying
causes
Women’s
empowerment:
decision-making
power, income, time
use, and knowledge
Nutrient
intake
Food
security
and
quality
Immediate
causes
Health
status
Care
resources
and
practices
Health
services
and
WASH
Healthy
environments: free
from contaminants
and disease vectors
Institutions
Political and ideological framework
Basic
causes
Economic structure
Resources
Environment, technology, people
Source: Adapted from
UNICEF 1990
5. 5
What is stunting?
• Low height-for-age
index
• Globally 34% children
<5y are stunted (195
million)
Two girls, both 12 years old, stand
in front of a wall with a black tape
line indicating the normal height
for a 12-year-old girl
(Source: Badham & Sweet,
Sight & Life Magazine, issue 3/2010)
6. PREVENT – Focus on 1st 1000 Days
-9 to 24 months
Europe &
Central Asia
LAC
North Africa
Near East
SS Africa
South Asia
8. 8
As GDP rises, nutrition profiles shift
Source: WHO “World Health Statistics 2006”
9. National
economic
growth
National
nutrition
profile
Enabling
environment
Food market environment
Health
environment
Agricultural Production
Household assets and livelihoods
Natural resources
Food
production &
gathering
Processing
& storage
Food
expenditure
Food access
Diet
Health care
Health status
Agricultural
income
Non-food
expenditure
Women’s
empowerment
Household
Child
nutrition
outcomes
Mother’s
nutrition
outcomes
Caring capacity
& practices
Female energy
expenditure
Nutrition and health knowledge
Individual
Source: Herforth and Harris 2013
10. National
economic
growth
National
nutrition
profile
Enabling
environment
Food market environment
Health
environment
Agricultural Production
Household assets and livelihoods
Natural resources
Food
production &
gathering
Processing
& storage
Food
expenditure
Food access
Diet
Health care
Health status
Agricultural
income
Non-food
expenditure
Women’s
empowerment
Household
Child
nutrition
outcomes
Mother’s
nutrition
outcomes
Caring capacity
& practices
Female energy
expenditure
Nutrition and health knowledge
Individual
Source: Herforth and Harris 2013
11. 11
Share of Energy Source & Food Budget in
Rural Bangladesh
Staple foods
Fish and
Meat
Non-Staple
plants
Energy Source
Food Budget
Slide Source: Howdy Bouis; FNB Mar 2011
12. Agricultural Production
Household assets and livelihoods
“Potential negative impacts can occur if (1) projects increase
National
National
economic
nutrition
standing water where growth
parasitic disease-carrying vectors can
profile
breed, without also increasing access to health services and
Enabling
education for prevention;marketprojects increase use of a toxic
(2) environment
environment
Food
water source… (3) projects to increase irrigation in the short
Health
environment
term result in longer-term water shortages” Herforth et al 2012
Natural resources
Food
production &
gathering
Processing
& storage
Food
expenditure
Food access
Diet
Health care
Health status
Agricultural
income
Non-food
expenditure
Women’s
empowerment
Household
Child
nutrition
outcomes
Mother’s
nutrition
outcomes
Caring capacity
& practices
Female energy
expenditure
Nutrition and health knowledge
Individual
Source: Herforth and Harris 2013
13. National
National
“Stunting occurs in setting of ubiquitous Environmental
economic
nutrition
growth
profile
Enteropathy; gut microbiomes of malnourished children are
abnormal, and promote weight loss and malnutrition… Farm
Enabling
environment
Food market environment
practices to control spread of disease are well known – Keeping
animals out of human water supplies” Ghosh etenvironment
al Health
2013
Agricultural Production
Household assets and livelihoods
Natural resources
Food
production &
gathering
Processing
& storage
Food
expenditure
Food access
Diet
Health care
Health status
Agricultural
income
Non-food
expenditure
Women’s
empowerment
Household
Child
nutrition
outcomes
Mother’s
nutrition
outcomes
Caring capacity
& practices
Female energy
expenditure
Nutrition and health knowledge
Individual
Source: Herforth and Harris 2013
14. National
economic
growth
National
nutrition
profile
Enabling
environment
Food market environment
Health
environment
Agricultural Production
Household assets and livelihoods
Natural resources
Food
production &
gathering
Processing
& storage
Food
expenditure
Food access
Diet
Health care
Health status
Agricultural
income
Non-food
expenditure
Women’s
empowerment
Household
Child
nutrition
outcomes
Mother’s
nutrition
outcomes
Caring capacity
& practices
Female energy
expenditure
Nutrition and health knowledge
Individual
Source: Herforth and Harris 2013
15. National
economic
growth
National
nutrition
profile
Agricultural Production
Household assets and livelihoods
“With very few exceptions, home garden programs
increased the consumption of fruit and vegetables;
Enabling
aquaculture and small fisheries interventions increased
environment
Food market environment
the consumption of fish; and dairy development projects
Health
increased the consumption of milk.” Masset et al, 2012
environment
Natural resources
Food
production &
gathering
Processing
& storage
Food
expenditure
Food access
Diet
Health care
Health status
Agricultural
income
Non-food
expenditure
Women’s
empowerment
Household
Child
nutrition
outcomes
Mother’s
nutrition
outcomes
Caring capacity
& practices
Female energy
expenditure
Nutrition and health knowledge
Individual
Source: Herforth and Harris 2013
16. National
economic
growth
National
nutrition
profile
Agricultural Production
Household assets and livelihoods
Enabling
“Overall, cash-cropping schemes [whether staple crops
environment
Food market environment
or other] did not have a significant impact – negative or
Health
positive resources
– on child nutritional status.” World bank, 2007
environment
Natural
Food
production &
gathering
Processing
& storage
Food
expenditure
Food access
Diet
Health care
Health status
Agricultural
income
Non-food
expenditure
Women’s
empowerment
Household
Child
nutrition
outcomes
Mother’s
nutrition
outcomes
Caring capacity
& practices
Female energy
expenditure
Nutrition and health knowledge
Individual
Source: Herforth and Harris 2013
17. National
economic
growth
National
nutrition
profile
“Women’s empowerment is linked to over 50% of
reductions in all child stunting from 1970-1995”
Smith and Haddad 2000
Enabling
environment
Food market environment
Agricultural Production
Household assets and livelihoods
Shown in many studies, in many parts of the world:
Health
environment
women’s income has greater impact on child nutrition
Natural resources
and food security than men’s UNICEF 2011; Smith et al 2003
Food
production &
gathering
Processing
& storage
Food
expenditure
Food access
Diet
Health care
Health status
Agricultural
income
Non-food
expenditure
Women’s
empowerment
Household
Child
nutrition
outcomes
Mother’s
nutrition
outcomes
Caring capacity
& practices
Female energy
expenditure
Nutrition and health knowledge
Individual
Source: Herforth and Harris 2013
18. National
economic
growth
National
nutrition
profile
Enabling
environment
Food market environment
Health
environment
Agricultural Production
Household assets and livelihoods
Natural resources
Food
production &
gathering
Processing
& storage
Food
expenditure
Food access
Diet
Health care
Health status
Agricultural
income
Non-food
expenditure
Women’s
empowerment
Household
Child
nutrition
outcomes
Mother’s
nutrition
outcomes
Caring capacity
& practices
Female energy
expenditure
Nutrition and health knowledge
Individual
Source: Herforth and Harris 2013
21. Agricultural activities tend to make up a major share of rural
National
National
economic
nutrition
women’s energy expenditure, often at high levels of effort and in
growth
profile
addition to normal domestic duties.
Enabling
environment
Food market environment
Women are more likely than men to suffer from seasonal energy
Health
deficiency and seasonal weight loss.
environment
Natural resources
Agricultural Production
Household assets and livelihoods
Negative impacts on children of pregnancy during hunger season
Food
Processing
production &
& storage
(or famine).
gathering
Food
Occupational health hazards in agriculture can have an impact on
Diet
Food access
Child
expenditure
nutrition
women, and on their children in-utero.
Agricultural
outcomes
income
Harris, forthcoming
Women’s
empowerment
Household
Non-food
expenditure
Health care
Health status
Mother’s
nutrition
outcomes
Caring capacity
& practices
Female energy
expenditure
Nutrition and health knowledge
Individual
Source: Herforth and Harris 2013
22. 22
Overall Messages: Pathways to Nutrition
OLD: Assumptions about
nutrition 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 nutrition
minimal
NEW: These need more
attention if we are going to reach
nutrition
• Increasing production of - and
access to - diverse, nutrientdense foods
• Increasing women’s control of
income…
• …and avoiding harm due to
additional time demands or
energy expenditure of women
• Incorporating nutrition
education for enhanced
nutrition impact from food
production and income
23. National
economic
growth
National
nutrition
profile
Environmental
contaminants
or vectors
Food market environment
Agricultural Production
Household assets and livelihoods
Food
production &
gathering
Health
environment
Individual diet
Food prices
and
availability
Natural resources
Production
diversity
diversity
Target nutrient
consumption
Processing
& storage
Target food
consumption
Food Household
Food access
expenditure security
food
Agricultural Consumption
income / Expenditure
Health care
Non-food
expenditure
Women’s
Women’s Empowerment
empowerment in Ag Index
Household
Enabling
environment
Caring capacity
& practices
Diet
Health status
Infant and
young child
feeding
Time use
Female energy
expenditure
Nutrition and health knowledge
Child
nutrition
outcomes
Anthropometry /
biomarkers
Mother’s
nutrition
outcomes
Energy
expenditure
Individual
Knowledge /
attitudes
26. 26
How to choose indicators…?
• Which pathway(s) is your program trying to address?
• Which of the boxes along that pathway (or any
intermediate steps not adequately captured there) can
you feasibly measure?(As many as possible!)
• What (preferably validated) tools and metrics exist to
measure each of these?
• In what way will each of these need to be adapted to your
particular context (without losing the validity of the tool)?
• How does the totality of your indicators build a picture of
how your agriculture program is affecting nutrition?