Cross-posted from the FSP India website written by Bas Paris
A paper in Food Policy provides a review of various studies on the impacts of agricultural interventions on the nutritional status in South Asia. Past review exercises and studies have analysed the available evidences to understand the ways in which agriculture can be leveraged to enhance nutritional status, however, very few of them have employed a systematic approach encompassing a significant number of studies. This paper aims to fill this gap through conducting a systematic review assessing the existing evidence in 25 studies for combating food insecurity and malnutrition through agricultural interventions.
The paper analysed studies on the impact of interventions in agriculture and allied sectors (horticulture, livestock, fisheries and forestry) in South Asia (and India) on the nutritional outcomes for adults and children, published since the year 2000. The nutritional outcomes were captured through intermediate outcome indicators such as dietary diversity, calorie intake and nutrient intake, and outcome indicators such as anthropometric factors and DALYs (Disability Adjusted Life Years). The studies selected were not homogenous in terms of a common outcome indicator and the studies used different metrics for examining the linkage. Some studies analysed nutritional outcomes by examining the stunting and wasting of children and adolescents, whereas others analysed the Body Mass Index for determining adult malnutrition or levels of micronutrients such as vitamin A and haemoglobin. Some studies used intermediate outcome indicators, such as changes in consumption patterns, dietary diversity, and intakes of certain foods. Most of the included empirical studies analysed data from secondary datasets and had large sample sizes. Others were primary baseline surveys, with smaller sample sizes.
The paper categorizes the findings of the studies according to six pathways developed by UNICEF, and slightly modified by the paper, through which agriculture can influence nutritional outcomes. These six pathways are: sources of food, source of income of households involved in agriculture, agricultural policy and prices, women in agriculture and their socio-economic status, maternal employment in agriculture, and maternal nutrition and health status.
Regarding the sources of food the study highlights that 22 of the 25 reviewed studies examined the contribution of agriculture as a source of food for nutrition. The studies indicate strong evidence that the dietary intake of agricultural households largely depends on food supplies from their own farm, this is because subsistence farming is common across South Asia. The evidence, however, is not conclusive for the impact of supply of livestock on food consumption. A negative and significant association was also reported in three studies between improvements in agricultural productivity and under-nutrition. Particularly, the interventions for increasing the productivity and production of specific nutritious food crops such as vegetables and pulses, widely grown and consumed in India, showed positive implications for increased intake and child nutrition. However, a number of studies, two of which focused on India, estimated a weak relationship between calorie consumption and nutritional outcomes.
8 out of 25 studies investigated the impact of agricultural incomes on nutrition. In this regard the paper highlights that it is unclear whether agricultural growth leads to improvements in nutrition. Specifically, Heady illustrates that high agricultural growth rates in some states of India, such as Gujarat, Rajasthan and Bihar, were not accompanied by a decrease in under-nutrition. However, a number of studies find that nutritional security was reported to be significantly influenced by per capita agricultural income, one study also reported that increased household wealth also significantly positively affected the diet diversity of children in India.
Only 5 studies analysed the role of agricultural policies aimed at reducing relative prices or increasing the affordability of food on nutritional status. Based on the representative sample for India, it was demonstrated that policy interventions for affecting food prices played an important role in diet diversification and nutritional outcomes. The policy of improving the affordability of staples by the public distribution system provided food and nutritional security. However, the relative price of staples has a strong and significant association with diet diversity, but not with calorie availability.
8 studies covered the importance of women empowerment in agriculture and its contribution to household food and nutritional security. The nutritional status of the mothers, measured using the BMI, had statistically significant positive effects on height and weight for age scores of their children aged less than three years. Women empowerment influenced the quality of feeding practices for infants and young children, but was weakly associated with child nutrition status.
In conclusion the paper highlights that agricultural interventions (pathways 1-3) have the potential to influence nutritional outcomes in India and South Asia. However, the available evidence linking the agricultural interventions and their impact on the nutritional status of women and children is small (pathways 4-6). Overall, the paper stresses that these findings show that linkages between agriculture and nutrition are complex and require multi-sectoral and multi-dimensional approaches to tackle malnutrition problems. The findings clearly indicate the importance of the home production of nutrient-rich food crops for improving the nutritional outcomes. This suggests that bio-fortification of staples and homestead gardens can influence the intake of a micronutrient-rich diet and consequently nutritional outcomes. This also suggests that the diversification of agriculture towards fruits and vegetables can potentially promote dietary diversity and improve nutritional outcomes.
The full paper can be accessed here