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.

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Linking Agriculture Health and Nutrition - Kabba

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