pathways and principles for improving nutrition through ......production pathway agriculture as own...

This presentation was made possible by the American people through the U.S. Agency for

International Development (USAID) under Cooperative Agreement No. AID-OAA-A-11-00031, the

Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) project.

Pathways and Principles for

Improving Nutrition through

Agriculture

Sarah Titus and Jessica Tilahun

Global Health Mini-University

March 2, 2015

Cost of Malnutrition

Morbidity and Mortality

45% of under-five mortality attributable to

undernutrition

Underweight is #1 contributor to burden of disease

in SSA

Economic

Lower IQ and school performance

Asia and Africa lose 11% of GNP every year b/c of

poor nutrition

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Black et al. Lancet. 2013

Lim et al. 2012

Horton and Steckel 2013

Global Nutrition Report, IFPRI

Countries with Multiple Burdens

in Children under 5 years

Global Nutrition Report,

2014

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We Have Made Significant Progress

Ethiopia stunting rate dropped from 57% to 44% in

one decade

Between 2006 and 2012 stunting went from 29%

to 22% in Haiti

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Peru doubled their EBF

rates, with greatest

improvements among the

poorest children

In DRC, coverage of treatment for SAM went from less

than 46k in 2007 to greater than 157K in 2011

What Works to Reduce Undernutrition?

Nutrition-specific interventions address

the immediate causes of undernutrition

Health Status

Nutrient Intake

Examples

IYCF and ENA

Micronutrient Fortification &

Supplementation: Iron, Zinc, Vit. A

Integrated Management of Child Illness

Community Management of Acute Malnutrition

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Is This Enough?

Findings from Lancet series 2013

If 90% of the population is reached with 10 key

nutrition-specific interventions

an estimated 900,000 lives could be saved in 34 high

nutrition-burden countries;

prevalence of stunting could be reduced by 20%;

number of children with stunted growth and development

would be reduced by 33 million;

estimated cost of $9.6 billion.

“We need to find solutions beyond targeted nutrition-

specific interventions and beyond the health sector.”Marie Ruel, 2013

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Nutrition-sensitive vs. Nutrition-specific

Nutrition-sensitive interventions strive to

address the underlying causes of

undernutrition

Food security and quality: Consistent access to

diverse nutritious food

Child and family care resources and practices:

Supported through women’s empowerment

Health services and Water, Sanitation and

Hygiene (WASH): Focus on healthy environments

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How Does Agriculture Affect Nutrition?

Food ConsumedCaloriesProtein

Micronutrients

Income Invested inDiverse diet, nutrient-rich foods

Health care

Sustainable livelihood for year-round food and health care access

Gender roles within the Food SystemMaximizing women’s control of income

Managing time and energy demands

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Primary Pathways

Linking Agriculture and Nutrition

Key Principles for Linking

Ag/Nut

Production Pathway

Agriculture as own source of food is most

direct pathway

Production decisions influenced by market

prices, relative costs & risks, productive

assets, preferences and cultural norms

Processing and storage impact food access

and nutrient content

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Production of goat milk

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Production Pathway

Agricultural Income Pathway

Improved year-round income and cash flows

to meet household needs, including diverse

foods

Assumes nutritious foods are available in

markets – reflects the importance of

generating demand and need for nutrition

education

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Agricultural Income Pathway

Netsanet lives in SNNPR, Ethiopia

Coffee Value Chain Project

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Income Pathway

Women’s Empowerment

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Women’s Empowerment

In summary: for agriculture to

help move the needle on nutrition

Ag/VC activities should be designed

to include nutrition-sensitive ag

activities, outcomes, and indicators

Ag/VC activities should link with

nutrition-specific activities in co-

located areas

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Frameworks, principles, and pathways should be

referenced to help check assumptions and plan

If we want to reach the SDG and WHA goals—nutrition-

sensitive agriculture will need to be the norm

Thank You

Sarah Titus MALD, Food Security and

Nutrition Manager— stitus@jsi.com

Jessica Tilahun MS RD, Food Security and

Nutrition Advisor– jtilahun@jsi.com

www. SPRING-nutrition.org

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