Linking Agriculture Health and Nutrition - Kabba

LINKING AGRICULTURE, HEALTH AND NUTRITION:CHALLENGS AND POTENTIALS IFPRI POLICY SEMINAR Washington, DC 7 November, 2010 Kabba T Joiner

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)

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

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

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

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

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

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

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

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

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

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

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

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

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

BENEFITS FROM LINKAGES
Increase food security
Increase food safety
Reduce burden of disease
Reduce burden of chronic diseases
Improved occupational health

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

“ 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

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

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”

THANK YOU
FOR YOUR ATTENTION

Linking Agriculture Health and Nutrition - Kabba

by International Food Policy Research Institute (IFPRI)

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