Nutrition Sensitive Approaches to Combat Malnutrition
ICCO focuses on economic empowerment and food and nutrition security of smallholder farmers and their households. This relates to SDG 2: eliminating malnutrition, doubling the productivity and income of small-scale farmers and making food production systems more sustainable. Experience has shown that increased production of food not automatically leads to improved nutrition. In this article we look at additional steps needed to address malnutrition.
By Marijke de Graaf, Food and Nutrition Security Expert
What is malnutrition?
Malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients. The term malnutrition covers ‘undernutrition’ – which includes an overall lack of food, resulting in stunting (low height for age) and/or wasting (low weight for height), as well as a lack of diverse and nutritious food, resulting in micronutrient deficiencies (a lack of important vitamins and minerals). Malnutrition also includes overweight and obesity, resulting in diet-related noncommunicable diseases (such as heart disease, stroke and diabetes) (WHO).
Some key facts on malnutrition
- Today, 1 in 3 people worldwide are malnourished
- Two billion people lack key micronutrients, resulting in e.g. anemia and limited resistance to infections
- Two billion adults are overweight or obese
- 50 million children are wasted and 150 million children are stunted, which affects their physical as well as their intellectual development.
- 88% of countries face a serious burden of either two or three forms of malnutrition.
Malnutrition, in all its forms, is the leading cause of poor health globally. Unhealthy diets pose a greater risk to morbidity and mortality than does unsafe sex, and alcohol, drug and tobacco use combined. This all brings enormous economic and human capital costs.
Given these facts, improving nutrition is not only a matter of public health and human rights but it is also a precondition for sustainable development and poverty reduction. Kofi Annan said (2018):
“Nutrition is one of the best drivers of development: it sparks a virtuous cycle of socioeconomic improvements, such as increasing access to education and employment.”
How can we work on improving nutrition in development projects?
There are 3 important pathways to take into account:
- Food availability plus access: an important component is the availability of diverse and healthy food through local markets and/or homestead consumption. This goes hand-in-hand with the need for a proper income, because without this one cannot access food and or inputs for homestead food production. That’s why we support farmers to link to markets, so that they can also increase their income and contribute to the availability of diverse and nutritious food at local markets. For example in Mali, we promote the production and consumption of fish among smallholder farmers.
- Intra-household dynamics: Increased access to nutritious food at household level does not automatically lead to improved nutrition among all household members. Intra-household dynamics often impedes nutrition improvement. In many cases women do not have equal access to and control over household income. In our projects we therefore not only train women to strengthen their ability to generate income, but also to empower them to decide over the use of income. Of course with respect to the local culture and context. For example, in Senegal, we capacitate women so that they can better access finance for commercial onion production.
- Awareness and attitudes: in many cases we also see a lack of awareness of the importance of nutritious diets. People simply don’t know. Within farmer field schools and financial literacy courses, we therefore also include information on the importance of dietary diversity, good care and feeding practices. In addition we support nutrition behavioural change through nutrition agents, community food fairs and cooking demonstrations. In Bangladesh for example, we train Nutrition Sales Agents who inform women on the importance of nutrition and offer basic food and health products.
Each pathway has a unique role to play, but it’s about the combination of these three pathways together which can make a sustainable change.