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Plateforme pedagogique sur l'investissement (ILP)

Nutrition-sensitive investment activities

What is nutrition-sensitive investment?

Malnutrition across the world remains an under-recognized threat to development, affecting 1 in 3 people (for most updated information on key nutrition-related facts refer to FAO-nutrition); there is no country in the world that is not affected by this challenge. The risk that poor diets pose to mortality and morbidity is now greater than the combined risks of unsafe sex, alcohol, drug and tobacco use.  The long-term effects of early malnutrition are largely irreversible, impairing both cognitive and physical development. Good nutrition is imperative for livelihood development (labor, health etc.) as are robust livelihoods for good nutrition. Malnutrition costs governments trillions of dollars in health care costs and loss of economic productivity each year, however, these prolonged malnutrition rates are simply ethically unacceptable.

Economically-disadvantaged households relying on markets to access their food basket are particularly affected, compromising their intake of nutrient-dense and diverse foods such as vegetables, fruits and animal-based products. A food systems approach, considering the interface of individual behaviors with his/her food environment is required to tackle all forms of malnutrition, looking at the quality of inputs, production, post-harvest handling, processing, retailing and consumption habits, preferences, and knowledge. 

In November 2014, at the Second International Conference on Nutrition, FAO and WHO member States adopted the Rome Declaration on Nutrition and its Framework for Action, which invites governments to mainstream nutrition in food and agricultural investments and policies, complementing health-based nutrition approaches (termed nutrition-‘specific’) that focus on improving access to nutritional supplements, maternal health, and disease prevention. FAO defines nutrition-sensitive agriculture as ‘a food-based approach to agriculture development that puts nutrient-rich foods, dietary diversity, and food fortification at the heart of overcoming malnutrition and micronutrient deficiencies. The overall objective of nutrition-sensitive agriculture is to make the global food system better equipped to produce good nutritional outcomes’. The expected results should contribute to the achievement of the Sustainable Development Goal 2 "End hunger, achieve food security and improved nutrition and promote sustainable agriculture" endorsed in September 2015 by UN member countries.

Momentum to “invest in nutrition” has increased globally over the past few years, particularly through initiatives such as the Scaling Up Nutrition (SUN) movement. At country level, an increasing number of countries have placed nutrition at the helm of their development agendas by developing nutrition plans that allow them to increase and improve the effectiveness of resource allocation and strengthening capacities to integrate nutrition considerations in a range of sector policies and programmes. Some of these countries’ major financing partners have also shown clear commitment to support them in these efforts, both multilaterally (e.g. IFAD, WB) and bilaterally (e.g. the EU, USAID). International Financing Institutions, including the World Bank and IFAD, are increasingly making “nutrition-sensitive agriculture” a priority of their investments. This demands a different approach to designing and implementing livelihood and agriculture programmes.

Why do you need to know about this?

At its core, agriculture development is concerned with producing enough good food to provide for people’s nutrition. Both supply and demand for food is driven by a range of factors from production, processing, marketing, infrastructure, social norms and values, other livelihood opportunities etc. (see Social Analysis). Any investment in agriculture, rural development and livelihoods can impact the nutrition situation of an individual, household, community and nation, positively and/or negatively. Therefore, it is important to understand through which pathways or means, investments can better contribute to an improvement in nutrition and minimize harmful effects.  

Nutrition sensitive programming is not just a fleeting development agenda but rather a renewed call to address the crux of people’s food and livelihood needs by placing individuals at the center of the food system.  Large-scale agriculture and livelihood investments often aim to improve yields and improve market linkages to ultimately increase incomes. However, even with incremental improvements in household income, diets can quickly change to include both more micronutrient-rich foods and at the same time also more high calorie unhealthy foods. While, the agriculture sector at large currently produces enough food to meet the world population’s energy (calorie) requirements, there is still untapped potential to build a nutrition-sensitive food system that promotes socio-economic development, improved market-based systems, and strengthened livelihoods, meeting the right of every individual to a healthy and active life.

How does this differ from business-as-usual?

To render a project, programme or investment plan truly nutrition-sensitive, special considerations need to be made in all phases of the project cycle, starting with the situation analysis, project scoping (see project identification) and design, implementation support, and ex-post assessment. This requires a different approach from business-as-usual.

Firstly, nutrition-sensitive programming places consumers’ nutritional and health needs at the center of agricultural and rural development planning. This means that during the design of an investment, questions cannot only concern what can be produced and better sold, but also, what are people eating, where they are located, who is most at risk of malnutrition and why? What should we eat more (or less) of? How do people access food and how can we make diverse, healthy foods more accessible, affordable, and attractive? Nutrition-sensitive programming looks at the underlying causes of malnutrition. It also requires looking at how agricultural activities affect individual people’s health, such as through food safety, access to safe water, and reducing the work load and drudgery associated with agricultural work.

Secondly, nutrition-sensitive programming requires a participatory, multi-sectoral and integrated approach, ensuring that both food supply and demand-side interventions support healthy diets as well as a robust and sustainable agriculture sector. For the above process to be effective in shaping the program, these stakeholders should be at the center of the design process.

FAO has developed a set of 10 Key Recommendations together with a checklist and guidance material for Improving Nutrition through investment in Agriculture and Food Systems, to help guide this process.

These recommendations can help shape the operational structure of an investment program. From experience, once the target groups and areas have been identified, activities can be designed with the aim to improve  on-farm availability/diversity and safety of food, market access, income, women’s empowerment (see Gender Analysis), nutrition knowledge and norms, and natural resource management with the ultimate aim to have an impact on food access, care practices and health and sanitation environments. These can in turn improve diet and health of individual producers and consumers.

Nutrition-sensitive Investment plans

Investment plans (see Investment Plans) are tools to review existing and past investments and plan future investments that contribute to a particular purpose (e.g. nutrition), prioritize activities that best contribute to a commonly agreed set of results, strengthen and fill gaps in existing sector plans- considering their complementarity with other sector plans, and finally to mobilize additional resources and coordinate interventions. Countries are increasingly requesting support to develop investment plans that cover more than agriculture, as enhanced nutrition often becomes a key objective. This is in particular the case with the National Agriculture Investment Plans (NAIPs) that are largely developed in the context of the Comprehensive Africa Agriculture Development Programme (CAADP). With the support of the New Partnership for Africa’s Development (NEPAD) and with the assistance from FAO and other partners, three one-week regional workshops  for multidisciplinary teams from all 50 African countries were organized to “mainstream nutrition” into their CAADP investment plans. In 2016 and 2017, a second generation of NAIPs are developed that increasingly incorporate nutrition considerations from the start. The Bangladesh Country Investment Plan for agriculture, food security and nutrition is another example of multi-sector investment plan that primarily aim to reduce food insecurity and malnutrition. A first one was developed in 2011 and its successor is being developed in 2017.

Win-wins

Investing in agriculture and food systems can produce multiplier effects for complementary sectors, such as service or manufacturing industries, thus further contributing to food security and nutrition and overall economic development. Without accompanying investment in public goods and services, such as infrastructure or a reinforced capacity for local government to deliver public services, many investments in agriculture and food systems would not be possible. However, the viability of investments in agriculture and food systems is also dependent on well-functioning ecosystems and sustainable use of natural resources. At the same time, the value of safety and health in generating productive agriculture and food systems is important and investing successfully means taking a holistic approach in terms of human, animal, environmental and overall public health. Responsible investment entails respect for gender equality, age, and non-discrimination and requires reliable, coherent and transparent law and regulations.

As nutrition is inherently linked with other cross cutting themes, investing in nutrition has the potential to positively impact other investment objectives such as to stimulate economic growth, improve human wellbeing, equity, or health, support environmental sustainability and enhance resilience. In other words, nutrition sensitive investment can both be introduced into and contribute to outcomes of investment operations related to:

  • Safety nets. Cash transfers, complemented by behavior change communication or nutrition education, can stimulate economic growth and simultaneously promote healthy consumer choices, preparation practices, and eating habits.
  • Value chain development. Encouraging value chain development can strengthen the local economy and facilitate people’s access to diverse, nutrient-rich foods (through supply and demand-side approaches and considerations). Choice of commodity based on dietary gaps and activities catered particularly to at-risk/vulnerable people can contribute to both improved nutrition and livelihoods.
  • Market development. Incentives/taxes can stimulate markets to improve the supply of nutrient-rich and diverse foods and education/social marketing can encourage demand for nutritious foods. This can help spur innovation, generate livelihood opportunities, and increase access to a healthy diet.
  • Environmental sustainability. Strategically chosen crops can support ecologically sustainable and healthy diets. For example, diversification (e.g. planting fruit trees, setting up hygienic poultry housing and laying facilities), intercropping, combined livestock rearing with agriculture, extended growing seasons through use of greenhouses and promotion of agroforestry can simultaneously improve people’s access to diverse and nutrient-dense foods throughout the year and help to maintain soil fertility and improve water retention capacity.
  • Climate Change. The 2016 World Food Day reminds us that “with climate change, food and agriculture change too”. Climate change can negatively impact food security and nutrition (seasonal changes, irregularity of rainfall, pests etc) while the agriculture sector contributes to an important share of Greenhouse gas emission. As such, investment programs should prioritize interventions that produce co-benefits or positive synergies between climate change (e.g. climate smart agriculture, ) and enhance nutrition (nutrition sensitive interventions) (see Climate Change);
  • Gender equality. Investments should be informed by a thorough gender-disaggregated analysis of the distribution of labor in rural households, decision-making, control and use of income, time use, access to services, knowledge and information, networks, social taboos and norms. This is crucial to effectively design culturally-appropriate and sustainable interventions that ensure equity and reduce work burden and drudgery as women often assume multiple roles including economic, social, care and domestic activities (see Gender Analysis).

Key Resources

Scaling up nutrition: what will it cost? (Word Bank, 2009)

The report analyses the costs of undernutrition worldwide and offers suggestions to raise resources to invest in child nutrition and human capital in the most vulnerable developing countries.

CAADP Pillar III - Framework for African Food Security (NEPAD, 2009)

Provides a comprehensive description of the CAADP Pillar 3 framework, identifies challenges and explores options for increasing food supply, reducing hunger and malnutrition and improving risk management.

Enhancing the Nutritional Impact of Agriculture Investment Programmes. Checklist and guidance for programme formulation (FAO, 2015)

Assists practitioners in reviewing e.g. National Agriculture and Food Security Investment Plans with a “nutrition lens”, identifying challenges and proposing recommendations for better integrating nutrition in and enhancing the nutritional impact of those plans.

Combating Micronutrient Deficiencies: Food-based Approaches (FAO, 2011)

Provides professionals with the information needed to better understand, promote, support and implement food-based strategies to combat micronutrient deficiencies in their respective countries.

Guidelines for measuring household and individual dietary diversity (FAO, 2012)

Provides a standardized questionnaire of universal applicability from which various dietary diversity scores can be calculated. The dietary diversity questionnaire represents a rapid, user-friendly and easily administered low-cost assessment tool.

Agreeing on causes of malnutrition for joint action: Joint planning guidelines for nutrition (FAO)

Assists professionals who seek to promote integrated planning for sustainable improvements in nutrition. Provides simple guidance for common planning and thus supporting joint implementation, monitoring and evaluation.

Nutrition agenda setting, policy formulation and implementation: Lessons from the Mainstreaming Nutrition initiative ((Health Policy and Planning, 2011)

Since implementing interventions that target undernutrition at a national scale has proven difficult, this paper reports on findings from five country studies, which sought to identify the challenges in the policy process and ways to overcome them.

A systematic review of agricultural interventions that aim to improve nutritional status of children (Masset E, Haddad L, Cornelius A and Isaza-Castro J, 2011)

This report is a systematic review of the impact of potential „win-win‟ agricultural interventions that aims to improve children’s nutritional status by improving the incomes and the diet of the rural poor.

E-learning course on “Agreeing on causes of malnutrition for joint action” (FAO, 2015)

Shows how to use a methodology based on malnutrition problem-and-solution trees to support joint planning for combating food insecurity and malnutrition. 

E-learning course on “Nutrition, Food Security and Livelihoods: Basic concepts” (FAO, 2015)

Addresses basic terms and concepts relating to food and nutrition, malnutrition, food security and livelihoods. Important to assess the nutrition situation, to design, and to evaluate the nutritional outcomes of programmes, investments and policies.

Key Recommendations for improving nutrition through agriculture (FAO, 2015)

Provides guidance how to apply principles of increasing availability, affordability, and consumption of diverse, safe, nutritious foods and diets to strengthen resilience and contribute to sustainable development.

Designing nutrition-sensitive agriculture investments. Checklist and guidance for programme formulation (FAO, 2015)

Assists practitioners in reviewing e.g. National Agriculture and Food Security Investment Plans with a “nutrition lens”, identifying challenges and proposing recommendations for better integrating nutrition in and enhancing the nutritional impact of those plans.

Compendium of Indicators for Nutrition-Sensitive Agriculture (FAO, 2016)

Helps selecting indicators to monitor if nutrition-sensitive investments have an impact on nutrition (positive or negative) and if so, through which pathways. Lists indicators that can be relevant as part of a nutrition-sensitive approach.

The Cost of Malnutrition: Why Policy Action is Urgent (Global Panel on Agriculture and Food Systems for Nutrition, 2016)

Provides evidence on the economic value of urgent efforts to accelerate and sustain reductions in malnutrition globally.

Committee on World Food Security Principles for Responsible Investment in Agriculture and Food Systems(RAI) (2014)

Outlines the RAI Principles that apply to all types and sizes of agricultural investment and can be used by both public and private stakeholders to think through the key issues for food security and nutrition that need to be considered. 

Voluntary Guidelines to support the progressive realization of the right to adequate food in the context of national food security (FAO, 2004)

Provides practical guidance to States in their implementation of the progressive realization of the right to adequate food.