Africa Talk

Making Agriculture Development Programmes Deliver Better on Nutrition Outcomes

The majority of development interventions that have been implemented in Africa have been focused on improving farming practices for increased agricultural production by rural smallholder farmers. The implementation of the Green Revolution between 1950 and the late 1960s resulted in increased agricultural production, especially in the developing world. This increase was a result of the adoption of new technologies that included high-yielding varieties (HYVs) of cereals, the use of chemical fertilizers and agro-chemicals, adoption of improved farming practices, and mechanisation. From a rural household to a national perspective, emphasis was on food security, with the picture of success in all cases being cereal adequacy. In most countries in sub-Saharan Africa, thriving households derived comfort form the number of bags of grain in safe storage, whilst the national equivalent was the status of the aptly named ‘Strategic Grain Reserves’, being national stockpiles of grain for the purpose of meeting future needs, either domestic or international. That focus on cereal adequacy, and mainly maize for most of Africa, became synonymous with ‘food security’. That narrow focus which relegated the importance of ensuring the availability of other nutrient dense foods became  the foundation for one of the continent’s entrenched challenges – undernourishment and its attendant problems.

At a time when agricultural investments and productivity of food staples are finally increasing in Africa, sub-Saharan Africa has the highest prevalence of undernourishment. According to the 2019 State of Food Security and Nutrition in the World (SOFI), the region has over 22% of the world’s undernourished, equivalent to 239 million people. Sub-Saharan Africa is home to 27 of the world’s 41 countries with high rates of the three forms of malnutrition – stunting, micronutrient deficiency and overweight – the triple burden of malnutrition. Researchers have established that malnutrition undermines the health and limits the opportunities of almost a quarter of the people in Africa. Apart from health-related impacts, it is estimated that high rates of malnutrition can reduce a country’s gross domestic product (GDP) by as much as 12 percent. 

How can Africa turn the tide against the challenge of undernourishment? 

The situation is so dire to warrant a continental policy pronouncement. Through the Malabo Declaration of 2014, African Union Member States committed to eliminate child under-nutrition by reducing stunting and underweight to 10% and 5%, respectively, by 2025. Whilst the search is on for innovative approaches and strategies to deliver these goals, it is apparent that impacting the agricultural production process will be the quickest approach. 

Agricultural development initiatives have the potential to improve the nutrition of those most vulnerable to malnutrition, particularly women of child bearing age and young children below five years of age. For this to happen, agricultural programmes need to balance their focus between increasing productivity of staple foods and value chain development with guaranteeing nutritional security. If agricultural development programmes are to fulfil their potential for reducing poverty and hunger, they must incorporate nutrition-sensitive interventions, and ensure consumption of diverse diets with essential proteins, minerals and vitamins and sufficient caloric intake. While the prescribed solution sounds easy to implement, the required transition is a difficult one for most development practitioners. Traditionally used to designing and implementing interventions with a single focus – improving productivity- delivering nutritional outcomes can be challenging. However, technical assistance is available.

Through its Nutrition-Sensitive Agriculture (NSA) Programme, the Food, Agriculture and Natural Resources Policy Analysis Network (FANRPAN) has developed tools and approaches to ensure that agriculture delivers positive nutrition outcomes to smallholder farm families. The approach involves the integration of robust, tailor-made nutrition-sensitive interventions (NSIs) into agricultural development projects, through a stepped process as illustrated in Figure 1 below. 

1.Select and assess suitability of an agricultural project/ programme for feasibility of integration of nutrition
2.Identify, screen and design nutrition-sensitive interventions:
(i) Conduct situation analysis through a desk study/literature review to assess the food and nutrition security policy and institutional environment, opportunities for and barriers to possible interventions
(ii) Assess nutrition status of communities served by project and their contextual circumstances
(iii) Convene stakeholder workshop to identify and select nutrition-sensitive interventions, results framework, impact evaluation and process indicators, and M&E and implementation plans
4.Design and elaborate selected NSIs
5.Identify and train country implementation partners to implement nutrition-sensitive interventions
6.Conduct baseline study
7.Implement NSIs
8.Conduct process and impact evaluation studies
9.Document and communicate results
Processes for selecting and implementing nutrition-sensitive interventions

Apart from providing capacity building to help institutionalize the integration of nutrition to agriculture, FANRPAN is available to provide technical assistance to integrate tailored NSIs into existing or new agriculture development programmes and projects. 

How applicable is the FANRPAN approach?

An example of successful application of the FANRPAN approach is the overlaying of the network’s ‘Agriculture to Nutrition’ (ATONU) project onto an existing project in Ethiopia and Tanzania. The objective of the existing agriculture project was to improve the production and productivity of chickens kept by smallholder households by introducing improved and tropically adapted genotypes in four rural regions of Ethiopia and three zones of Tanzania. To enhance the chicken project’s ability to deliver positive nutrition outcomes, the ATONU Project integrated selected NSIs and assessed their impact on nutrition outcomes among smallholder farming households. To complement the chicken initiative, the ATONU project introduced and tested a package of NSIs aimed at delivering improved nutrition to smallholder farming households. 

The FANRPAN NSI package delivered to participating households consisted of three main components, namely (i) the promotion of increased production and consumption of chicken meat, eggs and vegetables, especially by women and children, and delivery of education on nutrition and hygiene; (ii) implementing social behaviour change communication (SBCC) to promote increased expenditure of income from sale of eggs, chicken and vegetables on complementary nutritious food; and (iii) SBCC to promote the empowerment of women with a view to influencing their use of time and their role in decision making within the household. This also involved the engagement of both men and women to establish the impact of workload on women’s time and energy, and how that affected the productivity and nutritional status of family members. This component also promoted joint budgeting and planning by husbands and wives.

These interventions had a positive impact on the level of nutrition knowledge among participating households. Some of the observations include the growth in knowledge and use of safe drinking water; improvement in sanitation and hygiene practices such as handwashing with soap after using the toilet, before preparing food, and feeding children. The participating households registered an increase in the production and consumption of eggs, especially for feeding children; and increased production and consumption of vegetables. A series of ‘stories of change’ from a sample of households from both Ethiopia and Tanzania were compiled to demonstrate the effectiveness of the FANRPAN intervention through the ATONU Project.

Mrs Teresia Francis from Konga village, Tanzania, appreciates ATONU knowledge on child feeding

“I did not know that I could feed vegetables, eggs or chicken meat to my 7-month-old baby. I just did not know how to prepare these foods for a baby, until I learnt from the ATONU cookery sessions. When ATONU was introduced, I was heavily pregnant with my son Erick. My first two children did not benefit as much from the new knowledge I gained from ATONU as Erick has. Firstly, I breastfed Erick exclusively for 6 months and only started him on solids when he was six months old. Initially, baby food was difficult to make, but I am grateful for the ATONU cookery sessions where we were taught how to make baby porridge. I learnt how to include chicken, eggs and vegetables in the baby’s food.  Now I know that apart from porridge made from plain rice (uji) or maize, there are several other ingredients I can add to my baby’s porridge” 

Yezbua Mengie and her family in Tsion Teguaj kebele, Ethiopia

We used to eat chicken meat and eggs only on holidays and special occasions, but the ATONU project taught us the importance of consuming a diverse diet, including chicken meat and eggs. Now we do not sell all our chicken and eggs but save the cockerels for eating. When our chickens are laying eggs we now consume the eggs weekly instead of sending all of them to the market. Mommina (ATONU field assistant for Tsion Teguaj) taught us that there are six food groups and that we should eat at least 4 of the six food groups in a day. Before ATONU I would prepare 2 different kinds of Shiro (lentil dish) for the same meal thinking that they were different foods, but I have since learnt that this is one food group, all made from pulses. Now that I know about the different food groups I include vegetables, meat and milk, then for carbohydrates I include injera or bread. We do this because it is better to have a good diet and be healthy than to sell everything and then spend money on medicine. Our health is the biggest motivation for me to act on this new knowledge”. 

Yayaw Tarekegun (far right) an ATONU champion from Tsion Teguaj kebele in Ethiopia, with his wife Mulu Muche (middle) an ATONU beneficiary 

As a family, we all wanted to be healthy. When I heard that ATONU would be teaching us about how to eat for better health, I decided to attend to hear for myself. When Mommina (ATONU field assistant for Tsion Teguaj) taught us about budgeting, I knew I would not miss a session. The best thing that I learnt from ATONU is that I, as a man, can do everything that my wife can do, except giving birth. For a very long time, our culture as the rural community has been that even when a wife is pregnant she should fetch water for the household, carry the water pot on her head while carrying a baby on her back and then when she gets to the homestead, she would still need to take some of the water and kneel on the floor to wash my feet. Since ATONU, I have learnt a lot about helping our women with work. Now I do not let my wife go to fetch water. I fetch water myself and carry it back on a donkey’s back. I can no longer allow my wife to wash my feet or do heavy work while pregnant”

Jumane Athman Kipembe (left) and ATONU champion from Lipangalala village in Tanzania with his wife, Fatuma Omari, an ATONU beneficiary

Jumane Athman Kipembe is a farmer in Lipangalala and his wife Fatuma Omari was the beneficiary of the research project. However, Jumane was the one who attended the SBCC sessions and then shared the information with his wife. After attending cooking demonstrations, Jumane went home to teach his wife the new recipes. “I taught my wife about the food groups and the importance of a diverse diet. Now I help my wife to ensure that every meal is well balanced.”

The importance of having a backyard garden is that it is easily accessible even on days when you cannot go to the farm. Before ATONU we only grew vegetables at the farm which is far from our home. But having a backyard garden makes us access vegetables more easily and eat them more frequently.”

Emmanuel Muidete an ATONU champion and husband to an ATONU beneficiary from Uhambule village in Tanzania 

ATONU has taught us that a diverse diet can be achieved by eating small portions of different food groups in a meal and not eating just one food group per meal. Before ATONU we would just eat injera and shiro (bean/lentil dish) but now we do our best to include other foods such as animal source foods and different kinds of vegetables. As a farmer, before ATONU I was producing potatoes, cabbage and peppers, but thanks to ATONU now I have introduced new varieties such as carrot, beetroot and kale which we now also include in our diet.”

ATONU beneficiary from SNNPR Ethiopia holding up vegetables from his garden
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