11 December 2017. Brussels. DevCo Infopoint. Countries are seeking to improve nutrition through multiple sectors, including agriculture and food systems. This requires navigating dietary transitions, strengthening country ownership of programmes and investment decisions, working with public and private partners, and better understanding drivers that shape demand. These are key considerations for lesson learning moving forward. Introduction: Bernard Rey, Deputy Head of Unit, DEVCO C1- Rural Development, Food Security, Nutrition Panel discussion: John McDermott, Director, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH) Namukolo Covic, Senior Research Coordinator, IFPRI, Addis Ababa, Ethiopia Roseline Remans, Research Scientist, Bioversity International, Brussels Thom Achterbosch, Senior Researcher, Wageningen Economic Research, International Policy Please find also the link to the video of the conference: https://ec.europa.eu/europeaid/news-and-events/agriculture-nutrition-outcomes-countries_en

1. Helping countries improve nutrition
outcomes through agriculture and food -
what have we learned? what next?
John McDermott, Director
CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)

3. IMPROVED FOOD AND NUTRITION
SECURITY FOR HEALTH
IMPROVED NATURAL RESOURCE
SYSTEMS AND
ECOSYSTEM SERVICES
REDUCED POVERTY
EQUITY, CAPACITY AND
ENABLING ENVIRONMENT
A4NH PHASE II RESULTS FRAMEWORK:
IMPACT PATHWAYS AND KEY ACTORS
PROGRAM GOALS:
DEVELOPMENT PROGRAMS
PATHWAY
• Agriculture, nutrition, and
health program
implementers (NGOs and
governments)
AGRI-FOOD VALUE CHAINS
PATHWAY
• Producers
• Change agents
• Consumers
• Regulators

4. Agriculture-Nutrition Programs:
What Have We Learned?

5. Where We Started:
Key Findings from Ag-Nutrition Program Reviews 2001-2013
Evidence of impacts on nutrition is
inconclusive:
Livelihoods, income, food security
Diet quality, women’s empowerment
Ag-nutrition programs have impacts on
several underlying determinants of
nutrition:
Likely due to weaknesses in design,
targeting, implementation, evaluation
Except for vitamin A
Source: Ruel and Alderman, 2013

6. Project Portfolio (Selected Projects) Social protection Agriculture Health/WASH Gender Nutrition
Four countries w/WFP, (completed) X X X
Bangladesh w/WFP, (completed) X X X X
Burundi and Guatemala w/USAID (FANTA) X X ♀/kids X
Ethiopia w/Gov’t of Ethiopia (PSNP) X X x x x
Mali w/WFP and World Bank X X X X
Burkina Faso w/Helen Keller International (HKI),
(completed)
X X X X
Zambia w/Concern Worldwide X X X X
Burkina Faso and Tanzania w/HKI X X X X
Bangladesh w/Gov’t of Bangladesh X X X X
India w/PRADAN (Professional Assistance for
Development Action)
X X X X
Bangladesh, Ethiopia, and Vietnam w/FHI360
(Alive & Thrive)
X ♀/Kids X
Burkina Faso and Mali w/HKI X ♀/Kids X
GAAP I/II (multiple countries and partners) X ? X X

7. Nutrition-sensitive agricultural programs work !
Two recommendations:
1. Focus on improving access to and intake of high-quality diets for all household
members, rather than on reducing childhood stunting.
2. Carefully tailor programs to specific context, culture, economic and food environment
factors (especially markets, nutrient gaps, and gender roles)
Updated Review of Agriculture-Nutrition Programs 2014-2017
Source: Ruel, Quisumbing, and Balagamwala, 2017

8. Gender Strategies in
Agriculture-Nutrition Programs:
What Have We Learned?

9. Reach Benefit Empower
Objective
Include women in program activities
Objective
Increase women’s well-being (e.g. food
security, income, health)
Objective
Strengthen women’s ability to make and put
into action strategic life choices
Strategy
Invite women as participants;
reduce barriers; implement quota
system for training events
Strategy
Design project to consider gendered
needs, preferences, constraints to ensure
women benefit from activities
Strategy
Enhance women’s decision making power in
households and communities; address key
areas of disempowerment
Indicators
Number/proportion of women who
participate in a project activity:
attend training, join a group, receive
extension advice, etc.
Indicators
Sex-disaggregated data for positive and
negative outcome indicators such as
productivity, income, assets, nutrition,
time use, etc.
Indicators
Women’s decision making power over
agricultural production, income, household
food consumption; reduce
disempowerment outcomes: gender-based
violence, time burden, etc.
Source: Johnson et al., 2017

10. • Bangladesh had the lowest women’s empowerment scores out of 19 USAID
Feed the Future countries at baseline in 2012
• Ministry of Agriculture worked with IFPRI to design, implement, and
evaluate a pilot program to see what worked best:
• Reach  Agricultural extension directed to men and women farmers
• Benefit  Behavior change communication to improve nutrition
knowledge
• Empower  Gender sensitization of men and communities to support
women in their productive and reproductive roles
• The project is now being piloted; endline results will be available next year
and we will know which approach works best to improve food security.
Agriculture, Nutrition, and Gender Linkages (ANGeL)

11. Helping Countries Create Enabling
Environments for Nutrition:
What Have We Learned?

12. Evidence: Enabling Environment for Nutrition
Transform Nutrition: By pushing nutrition
higher up the political agenda – through
strengthening the evidence base and
engaging decisionmakers and program
implementers in dialogue - this research
consortium aims to stimulate more
effective action to improve nutrition.
The Lancet 2013: Two of the four
papers in this agenda-setting
maternal and child health series
led by A4NH researchers
Global Nutrition Report 2014-2017:
A4NH researchers have contributed
content and editorial guidance to
this comprehensive analysis of
undernutrition
POSHAN: By synthesizing, generating, and
mobilizing nutrition evidence, POSHAN
enables policymakers, program implementers,
researchers, and other stakeholders to access
the latest, best evidence to support effective
decisions to improve maternal and child
nutrition in India.

13. National Food Systems for Healthier
Diets: What’s Next?

14. Food Systems for Healthier Diets
Main objective: To understand how changes in food systems can
lead to healthier diets and to identify and test entry points for
interventions to make those changes
Diagnosis and
foresight
Food systems
innovations
Anchoring
and scaling up

15. National Food System Transformation
Issues
• Dietary Transition (balancing
healthy and unhealthy) difficult
• Collaboration:
– Public – Private
– Longer supply chains, multiple agents
• Appropriate Enabling / Anchoring
– Realistic in national / regional context
– Balanced / fewer distortions
– Evolving roles – public and private

16. Food consumption patterns drive health risk
Dariush Mozaffarian Circulation. 2016;133:187-225

17. Agri-Food System Transformation and the
Future of Agriculture: Ethiopia
• Food system and dietary indicators (AGP2, PSNP)
• Dietary gap and food system foresight analysis
• Food-based dietary guidelines
• Value chain innovations for nutrient-dense foods
• Enabling SMEs
• Food system capacity development for national
partners (policy, technical)

18. a4nh.cgiar.org
Photo: Photoshare/M. Hasan

19. References
Development Initiatives. 2017. Global Nutrition Report 2017: Nourishing the SDGs. Bristol, UK: Development Initiatives.
FAO. 2012. The State of Food Insecurity in the World. Rome: Food and Agriculture Organization of the United Nations (FAO).
Johnson, Nancy L., Mysbah Balagamwala, Crossley Pinkstaff, Sophie Theis, Ruth S. Meinzen-Dick, and Agnes R. Quisumbing. 2017. “How do agricultural
development projects aim to empower women?: Insights from an analysis of project strategies.” IFPRI Discussion Paper 1609. Washington, D.C.: International
Food Policy Research Institute (IFPRI).
Leroy, Jef L., Deanna K. Olney, and Marie T. Ruel. 2016. “Evaluating nutrition-sensitive programs: challenges, methods, and opportunities.” In Achieving a
nutrition revolution for Africa: The road to healthier diets and optimal nutrition. Covic, Namukolo and Hendriks, Sheryl L. (Eds.). Chapter 10. Pp. 130-146.
Washington, D.C.: International Food Policy Research Institute (IFPRI).
Ruel, Marie T., Agnes R. Quisumbing, and Mysbah Balagamwala. 2017. “Nutrition-sensitive agriculture: What have we learned and where do we go from here?”
IFPRI Discussion Paper 1681. Washington, D.C.: International Food Policy Research Institute (IFPRI).
Ruel, Marie T. and Harold Alderman. 2013. “Nutrition-Sensitive Interventions and Programmes: How Can They Help to Accelerate Progress in Improving Maternal
and Child Nutrition?” The Lancet 382 (9891): 536–51.
Webb, Patrick. 2013. “Impact pathways from agricultural research to improved nutrition and health: literature analysis and research priorities.” Rome: Food and
Agriculture Organization of the United Nations and Geneva: World Health Organization.