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Linking Agriculture Health and Nutrition - Kabba

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IFPRI Policy Seminar 'Linking Agriculture, Health and Nutrition', dated 7th Dec, 2010, Washington D.C.

IFPRI Policy Seminar 'Linking Agriculture, Health and Nutrition', dated 7th Dec, 2010, Washington D.C.

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  • 1. LINKING AGRICULTURE, HEALTH AND NUTRITION:CHALLENGS AND POTENTIALS IFPRI POLICY SEMINAR Washington, DC 7 November, 2010 Kabba T Joiner
  • 2. PROBLEM STATEMENT
    • Agric - primary source of livelihood and nutrients for majority of world’s poor
    • Good health - an enabling condition for the development of human potential
    • Agric - driven by economic development rationale, whilst health sector aims to safeguard human development
    • These fundamental different societal functions and institutional organization keep the sectors apart
    • Health community too tribal – “failure to integrate our science, practice and advocacy hurts everyone, not least mothers and children” (Jeremy Shiffman)
  • 3. AGRIC LED GROWTH
    • Agric growth leads to higher rural income , particularly those with improved agric inputs
    • Infrastructure is positively related to better health and nutrition, as community infrastructure is financed by agric profits
    • Progress in health and nutrition achieved only if progress in agric development is sustained
  • 4. WHAT IS KNOWN
    • World’s rural poor rely on agric for their livelihood, income, food security, nutrition and health care
    • Women’s income contribute more to household security, child nutrition and health care than income controlled by men
    • Season income is generated and gender of the provider determine impact of household income on nutritional status and health care
    • Agric rich areas have a financial advantage - investments in community infrastructure, impact on improving health and nutrition status
    • High seasonal labour - negatively affects adult nutrition and child birth weight
    • Agric intensification - important role in emerging diseases
    • Supplementation and fortification - treating large numbers of people – short and medium term interventions for MND
  • 5. ON-GOING LINKAGES
    • West Africa :
    • NIP for water and sanitation – Senegal
    • Millennium Villages – Mali
    • Baby Friendly Community Initiative – Gambia
    • WAHO / BIOVERSITY / FAO / INFOODS / AFROFOODS collaboration – 7 West African Countries
    • WAHO/ HKI – Francophone West African States
    • WAHO / CILSS – Sahel states of West Africa
    • ROPPA / WAHO collaboration – West African States
    • Tulane University / WAHO / FDOA – child labour and health in cocoa plantations in Ghana, Cote d’Ivoire
    • Agric for Children’s Empowerment (ACE) – Liberia
    • ECOWAS Nutrition Forum – West African States
    • Others Regions
    • Gardens for Health – Kenya, Rwanda
    • Yellow Flesh Sweet Potato Trials - Uganda
    • International Federation of Plantation and Agric Workers – ILO / WHO
  • 6. Global Weak links among Agric and Health Organizations (Joachim von Braun, 2010)
    • FAO – info on food and agric and advice, some nutrition, some health
    • WFP – food assistance and some nutrition actions
    • IFAD – finances agric development projects
    • World Bank – poverty and agric, health and some nutrition
    • WTO – trade agreements and trade disputes
    • WHO – leadership in global health, including some nutrition
    • UNICEF – rights of children, including child nutrition and child health
    • CGIAR – reduce poverty and improve food security through research, some nutrition and health
  • 7. CRITICAL QUESTIONS TO BE ADDRESSED
    • Household decisions concerning labour allocation / child care
    • Level of maternal education
    • Changes in nutrient content of food through crop diversification / plant breeding
    • Economic, political, social and environmental matters intrinsically related to health
    • “ One World, One Health ”
    • Part played by agric intensification in emerging diseases
  • 8. NEGATIVE EFFECTS OF AGRIC ON HEALTH
    • Community exposed to diseases foreign to it
    • Increase spread of water and food-borne diseases – malaria, diarrhoea, zoonotic diseases, mycotoxins, hazardous pesticides, herbicides and fertilizers
    • Occupational hazards
    • Health impact of landscape destruction
    • Climate change
  • 9. HEALTH CONSEQUENCES OF UNBALANCED NUTRITION
    • (A) Calories / Proteins
    • PEM, Obesity
    • (B) Micronutrients - Trace elements (15) / Vitamins (12)
    • Impaired mental and physical disabilities
    • LBW infants with IQ 5 points lower than normal infants
    • Increase susceptibility to infections
    • Increase maternal mortality
    • High rates of neonatal deaths and still births
    • Poor attention span and decrease memory retention
    • Blindness
    • Deafness
    • Diarrhoea
    • Impaired reproductive performance
    • Delayed wound healing
    • Heart Disease
  • 10. AREAS OF CONCERN
    • Level of human and institutional capacity
    • Agric not considered as a primary weapon in eliminating MNM
    • Consumers understanding importance of divers and balance diet to their health, productivity and well being
    • Food systems developed with no attention to their ability to provide the nutrients to support good health and well being
    • Health and Livestock – significant health burden on the poor
  • 11. AREAS OF CONCERN (cont)
    • Limited human capacity and poor physical facilities cause new and emerging diseases undetected
    • Discrete, sectoral approach lead to – misdiagnosis, incomplete and ineffective control strategies, lack of effective communication
    • Vertical orientation by respective agencies – responsibilities divided according to bureaucratic mandate
    • Effects of increase female labour in agric and the increasing cash income in hands of men
    • Sustainable agric not including human health dimensions until recently
  • 12. CHALLENGES
    • Effects of increase female agric labour on child health and nutrition
    • High seasonal agric labour requirements affects women’s physical energy expenditure, nutritional status, child nutrition and birth weight, foetal development
    • Lack of data combining health and nutrition with agric productivity at the household level
    • Human and institutional capacity to address problems of linkages
    • “ Hidden Hunger” – changes in crop production system contributing to MNM
    • Government policies and subsidies promoting cash cropping and expansion of cereal crops without consideration of production of micronutrient dense crops
  • 13. CHALLENGES (cont)
    • Poverty and health related MDGs
    • Urbanization and Globalization
    • Undertaking cross-sectional action at community level
    • Health sector that would need to work with agric are underfunded, no formal arrangements for inter-sectoral roles and responsibilities, inadequate skills for inter-sectoral negotiation and decision making
    • Difficulties of establishing reliable communication between sectors
    • Building partnerships on mutual strengths to better link the sectors research, policy and practice
  • 14. POTENTIALS
    • Classical approach – What do I do? What am I responsible for? Is this my job?
    • Integrated approach – What needs to be done?
    • Proceeds from agric to develop health infrastructure and finance programmes
    • Direct - increase nutritious food consumed by household
    • Indirect - increase in income permitting households to purchase food and health services
    • Augmenting women’s income from agric activities increase demand for health care services
    • Improved coordination of data collection and dissemination
    • On the job training in nutrition education to health and agric personnel
  • 15. POTENTIALS (cont)
    • Improved linkages will rely on:
    • * Consultation in priority setting
    • * Joint preparedness planning
    • * Community consistent messages
    • * Exchanging select staff and sharing facilities
    • * Strengthening education – review curriculum
    • * Provide an appropriate institutional framework
    • * Encourage multi-stakeholder approach for improving public health
  • 16. BENEFITS FROM LINKAGES
    • Increase food security
    • Increase food safety
    • Reduce burden of disease
    • Reduce burden of chronic diseases
    • Improved occupational health
  • 17. POLICY IMPLICATIONS OF LINKAGES
    • Policies that help promote proper storage, transport, application and disposal of fertilizers, pesticides and herbicides
    • Increase household agric revenue to be used to finance greater access and improvements to health services (promotional activities)
    • Improved curriculum in health, nutrition and agric
  • 18. “ BUSINESS AS UNUSUAL”
    • Developing the entrepreneurial style / spirit
    • * Set Priorities
    • * Focus
    • * Measurement / Reporting – What gets measured, gets done
    • * Alignment
    • * Discipline – reduces need for much supervision
    • * Structure
    • * Communication - sent, received and understood
    • * Commitment
    • * Continuous Improvement
    • * Analysis – of opportunities
  • 19. FUTURE AREAS FOR RESEARCH
    • OBJECTIVE OF RESEARCH – Better understand effects of agric development on health and nutrition and determine mechanisms to improve their linkages.
    • Research for Impact
    • Coordinate ongoing and planned research
    • TOPICS FOR CONSIDERATION
    • Data on direct linkages between agro-forestry and health
    • Health impact assessment of urban sustainable agric
    • Chronic health problems that arise from unhealthy agric practices
    • Assess the potential environmental, health and social impact of any agric technology and the implementation of appropriate regulatory frameworks
    • What factors affect utilization of agric income and how the income is disposed of?
    • How will linkages work in refugee / IDP camps
  • 20. CONCLUSION
    • Need to incorporate youth in all sectoral planning
    • Work towards “VIRTOUS” as opposed to “VICIOUS” cycle
    • “ Not everything faced can be changed, but nothing can be changed until it is faced”
  • 21.
    • THANK YOU
    • FOR YOUR ATTENTION

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