Enhancing the Nutrition Sensitivity of Agriculture and Food Systems: What Has Been Done, and What Needs to be Done? Stuart Gillespie, Senior Research Fellow, PHND, IFPRI, United Kingdom

1. Making African Agriculture and Food
Systems Work for Nutrition:
What Has Been Done, What Needs To Be
Done?
Stuart Gillespie (International Food Policy Research Institute) and
Charlotte Dufour (UN Food and Agriculture Organization)

2. The challenge
• In Africa south of the Sahara, progress in reducing
undernutrition has been lagging behind other regions.
• Majority of the nutritionally vulnerable population is
dependent upon agriculture as a primary source of
livelihood—for food, for employment and income.
• Agriculture has close links to both the direct causes of
undernutrition (diets, feeding practices, and health) and
the underlying factors (such as income; food security;
education; access to water, sanitation, and hygiene;
access to health services; and gender equity).

3. • Ag sector has huge potential to drive down rates of
malnutrition, yet this potential is not being realized.
• Agricultural growth may generate more gains for
nutrition than gross domestic product (GDP) growth per
se, but…..
• ….nutrition has historically not been a primary concern
for agricultural policy makers—for whom aggregate
staple crop production is the primary target.

4. Evidence gaps
• Lack of evidence that agricultural interventions are
benefiting nutrition.
• Why?
• Poor design and implementation of interventions, which are
not as nutrition-enhancing as they could be
• Limitations in terms of targeting (few interventions are
targeted to the 1,000-day window within the human life cycle)
• Poor design of evaluations, which are seldom rigorous enough
(in terms of sample size, valid comparison groups, and so on)
to demonstrate impact

5. The opportunity
• The African Union Maputo Declaration on Agriculture
and Food Security places strong emphasis on ensuring
food and nutrition security. Three recent Malabo
Declarations related to nutrition reinforce this
commitment.
• Nutrition indicators incorporated in the CAADP Results
Framework, and in partnership with IFPRI under
ReSAKKS, countries supported to report their progress
on nutrition commitments biennially.
• Many SUN Movement member countries active.

6. Conceptualizing links

7. Adapted from Gillespie et al. 2012 and Headey et al 2012
Food
prices
Food
consumption
Food
expenditure
Non-food
expenditure
Nutrient intake Child
nutrition
outcomes
Householdassetsandlivelihoods
Health status
Mother’s
nutrition
outcomes
Health care
expenditure
Female
employment /
resources
National
nutrition
outcomes
Income
(agricultural and
non-agricultural)
Caring capacity
& practices
Female energy
expenditure
Food
production
Nutrition
knowledge
National
economic
growth
Pathways from agriculture to nutrition

8. Conceptualizing the pathways between
agriculture and nutrition
Agriculture is a
key driver of
poverty
reduction
but...
Pathways to
nutrition are
diverse and
interconnected
1. Agriculture as a source of food
2. Agriculture as a source of income:
– how income from agriculture/non agriculture is
spent on food and non food (other basic needs)
3. Agricultural policy and food prices
Gender dimensions
4. Women’s employment, time and ability to
manage young child care
5. Women’s status, decision making power
and control over resource allocation
6. Women’s own health and nutritional status
Source: Gillespie et al., TANDI project

9. What is LANEA?
Leveraging Agriculture for Nutrition in East Africa (LANEA)
IFPRI/FAO initiative in Ethiopia, Kenya and Uganda
To investigate the enabling environment in these countries and
the opportunities and challenges related to enhancing the
nutrition-sensitivity of agriculture.
Enabling environment: “the wider political and policy processes
which build and sustain momentum for the effective
implementation of actions that reduce undernutrition”
(Gillespie, Haddad, Menon, Nisbett, Mannar 2013)

10. What does an enabling environment look like?
Three vital factors for creating momentum and converting it to impact:
Framing,
knowledge
and
evidence
Politics and
governance
Capacity
and
financial
resources
Impact
10

11. Methods
LANEA country studies took place in 2014
1. Structured review of evidence relating to agriculture-
nutrition pathways for each country
2. Key informant interviews with individuals working on
nutrition and agriculture.
3. Stakeholder workshops in each country to
disseminate the findings and gain further
perspectives and input on agriculture and nutrition
linkages
4. Country reports and policy briefs

12. Number of studies
in evidence reviews by pathways
Pathway
Number of studies
Ethiopia Kenya Uganda
1: Agriculture as a source of food 12 8 6
2: Agriculture as a source of income for food and
non-food expenditure
3 3 2
3: Agriculture policy and food prices affecting
food consumption
2 1 0
4: Women in agriculture and intra-household
decision-making and resource allocation
3 4 2
5: Female employment in agriculture and child
care and feeding
1 1 1
6: Women in agriculture and women’s nutritional
and health status
2 0 0

13. Randomized controlled trials 0 0 2
Quasi-experimental studies 4 1 0
Observational studies using analytical
methods such as multivariate regressions
and econometric modelling
7 13 3
Observational descriptive studies 2 2 0
Mixed method studies (involving
quantitative & qualitative studies)
0 0 2
Studies that do not clearly identify a design 1 0 0
Number of studies in
evidence reviews by design

14. Key challenges
Emerging from the interviews and stakeholder
consultations

15. How do agricultural
policymakers and other
stakeholders perceive the issue of
undernutrition, and its relationship to agri-food
systems?
• Programmes and research need to be practical and well-
adapted to the context.
• Ongoing engagement and interaction with the
government is needed, so that communication is not just
one-way, post-research outreach.
• Data availability is a major challenge. Pervasive data
disconnect -- surveys rarely include both nutrition/health
and food security/agricultural indicators, rendering it
difficult to establish relationships.
• Improved data streams to link these types of indicators in
national data collection, as well as quality and timeliness
of data, could better inform understanding about
agriculture-nutrition linkages, and also allow
accountability.

16. What incentives and disincentives
exist for decisions and actions to
become more pro-nutrition?
• Focus within the agriculture sector has historically been on
increasing production and productivity of cash crops as an engine
of economic growth.
• Without clear and transparent systems of accountability for
action, progress on nutrition will not happen. Accountability
requires timely and appropriate information on how agriculture is
affecting nutrition outcomes.
• Multisectoral and “invisible” nature of malnutrition represent
challenges for holding policymakers and programme managers to
account.
• Agriculture stakeholders cannot be held accountable for stunting,
but diet diversity is a more useful indicator.
• Unless nutrition advocates understand the mindsets, motivations
and the “language” of the sector, change will be elusive.
• Along with incentives to act, there is a need – through policy
process/political economy-related research -- to identify the trade-
offs and potential synergies of any change.

17. What type of capacity and financing
is required to maximize the nutrition
sensitivity of the agri-food system?
• Training and education needs to be strengthened with regard to
agriculture’s linkages to nutrition.
• Leadership is a pivotal form of individual capacity, and is
potentially transformational.
• Nutrition champions, policy entrepreneurs, and civil society
activists at all levels need to be supported and encouraged.

18. In conclusion…..
Leveraging agriculture for nutrition implies:
• creating and strengthening institutional and policy
environments that enable agriculture to support
nutrition and health goals
• making agricultural policy and practice more
nutrition sensitive and therefore more effective in
improving nutrition and health, and
• developing capacity and leadership to use evidence-
informed decision making to enhance the impact of
agriculture on nutrition and health.