Fighting malnutrition requires a holistic and multidisciplinary approach as expressed in a previous blog post. 2 general comments below.
Targeting where impact could be greatest: Malnutrition is higher in rural areas, especially in the drylands where poverty and climate vulnerability is high; women, young children and elderly are particularly vulnerable; pregnant women and breastfeeding mothers are priority targets [1,000 days opportunity window];
A group that is rarely reached out in agriculture programmes: rural workers and subsistence farmers. Which public institutions are in charge to tackle poverty and malnutrition issues? Agriculture or Social Protection? One innovation that could improve diet diversity for these vulnerable groups and should be further studied/impact assessed: Nutri-Kitchen gardening kits [for instance promoted through ICRISAT watershed programme] including for instance vegetable seeds, low cost drip system, support for small chicken husbandry, etc. There is a field of research to design the kit and the type of intervention [public support or social business model] as well as impact assessment.
Such vulnerable groups are not homogeneous so social longitudinal studies to understand trends and drivers of change for better nutrition in the targeted malnourished population are important. See for instance Minimum nutrition dataset for agriculture (Tata Cornell Initiative) under the Village Dynamics Studies research programme. To understand the change of dietary patterns through the years (from 1970s), across gender and age, and identify statistically potential drivers (policies, introduction of technology, household economics, …). Read latest insights of this study [April 2015]
Responsibility of food industry – marketing of nutritious foods:
In agrifood policies, often value chain approach prevails to conceptualize how market forces can work so that poorest can have access to more nutritious foods. The reality is that junk foods tend to be much cheaper than healthier diets [ODI, 2015 rising cost of healthy diet report]. Urbanization and marketing of urban lifestyle in rural areas mean an increasing homogeneity towards energy-dense easy-to-eat foods and decrease of more nutritious “indigenous crops” like millets. It has health consequences, with rise of diabetes and other food related ailments [Khoury, 2014]
From the point of view of the poor, the choice to eat nutritious food is not only economic, social norms play a strong role. Drivers of purchase act include: Hedonism (appeal of sugar and oil) and convenience food [eg rice easier/quicker to cook compared to coarse cereals]. There is a responsibility of the food industry, and governments could act through tax for instance. It is important to review and assess the impact of tax on junk food like the tax on sugary drinks in Mexico in 2014.
Funds should be allocated funds to promote nutritious and climate resilient crops like millets, sorghum and grain legumes that are key for dryland farmers. A more diversified farming system (rotation) and growing more water-efficient crops will also improve water and soil resources [See for instance ICRISAT’s smart foods campaign and also in Andhra Pradesh India, the Millet Network of India’s efforts to promote iron-rich millet].
I would also point out the recent study proving that iron-rich biofortified pearl millet can reverse iron deficiency in school aged Indian children in 6 months. It highlights the potential of biofortification, and looked also at the important aspect of bioavailability.
Innovation in Africa that could be transferred in South Asia: The concept of Field nutrition schools, a participatory and practical nutrition programme [scheme of nutrition training of trainers chosen among the targeted rural population] has improved nutrition situation in rural South Mali. [article on Guardian professional network Rebranding bran: teaching nutrient-rich cooking in Mali]. The theory of change: Better nutrition education of young mothers/pregnant women and men [with adoption of good practices too, eg breastfeeding, pregnancy health follow-up, hygiene] and adoption of more nutritious recipes using local products [dryland cereals + legumes + fruits/vegetables/tree products rich in vitamins and essential minerals] and better food preparation [eg looking at whole grain sorghum, impact of grain decortication, fermentation or malting on iron/zinc bioavailability]. More details : An Be Jigi project ; also look at INSTAPA research project.
How this concept of field nutrition school could be adapted in South Asia? [Dr Swaminathan has called for “community hunger fighters”]
Involving women in practical cookery sessions is powerful, well adapted for illiterate target population. Could be linked to other government initiatives like the promotion of clean stoves in South Asia.
Jerome Bossuet