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Re: Making agriculture work for nutrition: Prioritizing country-level action, research and support

Dr. Kathleen Kurz United States of America

A few lessons learned thus far in trying to improve nutrition through our agriculture and food security projects:
“Nutrition” has different meanings – being clear about them in each project or policy context is essential to good planning, goal setting and approach.
Nutritionists tend to seek to reduce the stunting and wasting rates (the poor nutritional status) among children under 2 years, and often also to reduce maternal and child anemia and vitamin A and iodine deficiencies. Agriculture and food security specialists tend to picture increasing the nutritional quality of diets in households, assuring adequate vitamin, mineral, protein and fat content. Having enough quantity of food so as to avoid hunger tends to be categorized more as household food security than household nutrition. The two are related, but not the same. Agriculture and food security projects are well-suited to improving the nutritional quality of diets. If a goal of a project or policy is to improve nutritional status (reduce stunting, wasting, anemia and vitamin and iodine deficiencies), however, two other types of interventions beyond diversifying diets are essential: improved care such as the behavior elements of child feeding practices and hygiene, and improved health such as preventing or quickly treating diarrhea, malaria and pneumonia. All three – diversified diet, care, and health -- are needed to improve a child’s nutritional status; if one is missing, it will become the limiting factor; and often all three limited where child stunting and anemia are prevalent. If a project seeks, for example, to improve maternal and child dietary diversity, then the outcomes against which it is evaluated should be maternal and child dietary diversity, but not child stunting.
Awareness in households and communities of the importance of dietary diversity and of good child growth is low, and the best communication channels for increasing awareness are not always clear.
The term “hidden hunger” was coined for micronutrient malnutrition, but actually applies to the vast majority of child stunting and wasting as well. Unless a child is severely malnourished, he tends to look small, and in many countries with stunting prevalence near 50%, small looks normal. Raising awareness about the problem whose impact looks normal is extremely challenging. This is particularly true amid myriad other development priorities whose impacts are visible. A robust country- or region- specific communication strategy is essential, including knowledge on how households and communities perceive nutrition, and what and who are the key influences on raising nutrition awareness.

Kathleen Kurz, PhD
Principal Development Specialist-Nutrition
DAI, 7600 Wisconsin Ave., Suite 200, Bethesda, MD 20814