Contributions to Understanding Nutrition Policy

Many policies influence people’s food security and nutrition, including a wide range of agriculture, food safety, health, infrastructure and income/taxation policies, among others. Under Feed the Future, nutrition has been addressed through several dedicated activities such as Feed the Future Innovation Lab for Nutrition and SPRING with some attention on policy. This brief discusses the contributions by the Feed the Future Policy Team to improve the understanding of nutrition policy.

1. Agricultural transformation in countries and its relationship to food security have been intensely studied over the past decades. There is a concomitant nutrition transformation which has been less frequently examined. Prof. Will Masters, along with other researchers from the Feed the Future Food Policy Research Consortium through Rutgers University, has examined this transformation. Prof. Masters’ presentation describes significant global shifts, including:

• decreases in national stunting and underweight rates over time for countries in all income categories;

• a negative relationship between national income and stunting and underweight across countries; 

• for the poorest, much less stunting, wasting and diarrheal disease; 

• at middle-income levels, more diabetes and other diet-related disease; and

• in the richest countries, more obesity but also more healthy food intake.

The most surprising shifts may be in policy choices: First, that there is no longer a need to push food prices down in poor countries/up in rich countries, and second, there is no longer a need to keep starchy staples cheaper than fruits and vegetables. A policy concern for nutritional intake of young children is that nutrition content and labeling laws are not being enforced: Weaning foods may not meet the protein, vitamin or other nutritional content as labeled on the container, or may even contain anti-nutrients.

2. Food fortification has the potential to improve micronutrient intake for many people who need supplementary nutrients to their standard diet. In the U.S., for example, milk has long been fortified with Vitamin D. For fortification to be effective and reach the right people, government and the private sector need to work together. The processes behind fortification policies in three countries — Zambia, Malawi and South Africa — were analyzed by researchers from the Feed the Future Innovation Lab for Food Security Policy applying the kaleidoscope model of policy development and implementation (or see our recent post). The results demonstrated that the role of national leadership was one common driver in evolving policy responses, while the level of stakeholder engagement varied significantly across the case studies. The case studies demonstrate the importance of different levers for policy change across contexts.

3. One of the most successful system changes toward improved agricultural productivity and income growth has been the African Union’s Comprehensive African Agricultural Development Programme (CAADP), a pan-African framework providing a set of principles and strategies to help countries review their situations and identify investment opportunities. In the Maputo Declaration, CAADP set broad targets for six percent annual growth in agricultural GDP and an allocation of at least 10 percent of public expenditures to the agricultural sector. The CAADP agenda has raised awareness that the lack of agricultural growth has been a significant constraint to food security in sub-Saharan Africa. However, according to Sheryl Hendriks and Namukolo Covic, in Achieving a nutrition revolution for Africa: The road to healthier diets and optimal nutrition, the first generation of agricultural investment plans under CAADP lacked a comprehensive approach to tackle hunger and malnutrition. This report by Hendriks and Covic was commissioned by the Regional Strategic Analysis and Knowledge Support System (ReSAKSS) (a Feed the Future-funded activity) to identify “opportunities for making Africa’s food system deliver healthier and more nutritious foods, making these foods more available and affordable to all people and promoting better food consumption patterns as African economies develop.” According to Hendriks and Covic, second generation plans are improving, and nutrition indicators have now been incorporated in the CAADP Results Framework and can be monitored as part of the implementation process.

4. The Feed the Future Innovation Lab for Food Security Policy Research has supported the CAADP process through reviewing data availability for countries to use in setting targets and investments toward the Malabo objectives. A recent publication by Hendriks et. al. offers summaries of the currently available indicators and data on food security in 20 priority countries. These data can assist countries in identifying indicators for use in monitoring and evaluation systems for the NAFSIPs toward food security and nutrition outcomes.

5. As an example of how to improve the quality and accountability of national policies and investment plans, staff from the University of Pretoria, a partner of the Feed the Future Innovation Lab for Food Security Policy, developed and tested an integrated framework for gender analysis of nutrition policy in Malawi to support the development of their nutrition policy which contributes to the Malabo commitments. Applying this framework in Malawi included supporting a nationwide policy dialogue on the National Multisectoral Nutrition Policy with two recommendations from the policy dialogue incorporated in the final document. Inclusive policy dialogue can be time consuming, but the quality of the policy improves and local ownership increases.

6. Feed the Future worked with focus countries in 2013 to jointly identify priority policies to further the initiative’s objectives. Nutrition policy was one of these priority areas. Feed the Future support toward improved nutrition policy is illustrated by the following examples: Mozambique prioritized the alignment of the CAADP and Multisectoral Action Plan for the Reduction of Chronic Undernutrition (PAMRDC). Both Ethiopia and Rwanda are on track to create coordination units across food security and nutrition sectors. In 2016, progress was accelerated in Malawi on coordination mechanisms to better integrate health, nutrition and agriculture programs as part of the Scaling Up Nutrition (SUN) initiative. Uganda enacted a national advocacy and communication nutrition strategy which provides a tool to strategize and operationalize platforms for nutrition advocacy and communication, while streamlining implementation of activities, e.g. social and behavioral change communication, for nutrition at the community level. And in the West Africa region, Feed the Future has facilitated progress on mandatory legislation on food fortification in ECOWAS.