Undernutrition remains one of the world’s greatest human and economic development challenges. One in four children under 5 years of age suffers from stunting, or chronic undernutrition, which is caused by poor quality and quantity diets, inappropriate care and feeding practices in early life, and high rates of infectious disease. Poor nutrition can result in an inter-generational cycle of undernutrition, since undernourished women are more likely to give birth to children that begin life nutritionally disadvantaged and are more likely to be stunted by the age of five years and more likely to grow into short and disadvantaged adults. Improving nutrition requires a multisectoral approach that brings health, agriculture, education, water, sanitation and hygiene and social protection sectors and programs together.
There is currently a tremendous momentum at a global and country level to identify ways to ensure that agriculture is nutrition-sensitive i.e. that agricultural programs and policies are designed in such a way as to enable nutrition outcomes to be improved. However, many look at the experience of the Green Revolution in Asia, which dramatically increased agricultural productivity but did not result in equally impressive improvements in nutritional status, and ask: how can we achieve gains in agricultural productivity but do so in a way that directly improves nutritional status and health in vulnerable households, and contributes to a more nutritious food system?
The links between agriculture, nutrition and health are complex although there is a clear potential for the agriculture sector to play a critical role in enhancing health and specifically maternal and child nutrition and health outcomes. A well-developed agriculture sector can deliver increased and diversified farm outputs (crops, livestock, non-food products) and this may enhance food and nutrition security directly through increased access to and consumption of diverse foods, or indirectly through greater profits to farmers and national wealth. Indeed, agriculture is a significant source of livelihoods in many poor countries and, in these settings, is also a major employer of women. The links also work in reverse in that better nutrition and health of farmers and farming households increases their agricultural and economic productivity. However, agriculture carries risks to nutrition and health outcomes, for example, through zoonotic and other agriculture-related diseases, through impact of agriculture on women’s workload and time for child care and feeding, and through the impact of agriculture on major environmental determinants of health including water scarcity, climate change and biodiversity loss.
There is some evidence that certain agricultural interventions can enhance dietary intakes and improve nutrition and health outcomes (DFID Evidence Paper 2014; Ruel et al 2013). Currently however, the evidence base for the potential of agricultural strategies to improve the nutrition and health of women and young children is mixed, based on a relatively small number of heterogeneous studies, and generally constrained by methodological limitations (Masset et al 2012; Webb Girard et al 2012). There is a need for robust and large-scale evidence generation to guide global policy and advocacy efforts in nutrition-sensitive agriculture.
Key outstanding research questions identified by the global community include:
- How can agricultural interventions be designed to improve nutritional outcomes for individuals in farm families and communities as a whole?
- What are the best delivery mechanisms through which agriculture can affect nutrition?
- What agricultural interventions improve nutrition and health in the most cost-effective way?
This program complements support currently provided by DFID and the foundation to deliver high-quality evidence on the links between agriculture, nutrition and health to multiple initiatives including: the Leveraging Agriculture for Nutrition in South Asia (LANSA) research program consortium, Harvest Plus, Tackling the Agriculture and Nutrition Disconnect in India (TANDI 2), Sweet Potato Action for Security and Health in Africa (Mama SASHA), the Nutrition Embedding Evaluation Program (NEEP), Innovative Metrics and Methods in Agriculture for Nutrition Program (IMMANP), and Improving Nutrition Outcomes through Optimized Agricultural Interventions.
The program will be expected to contribute significantly to ongoing international efforts to increase the quality of evidence linking agriculture, nutrition and health, such as those underway under the CGIAR Agriculture for Nutrition and Health (A4NH), and the Strengthening Impact Assessment in the CGIAR (SIAC) project from the CGIAR Standing Panel on Impact Assessment (SPIA). This coordination will be used to minimize duplication of research activities and to ensure that newly commissioned research builds on the emerging evidence.