Reflections on 30 years of nutrition-sensitive agriculture

By Heather Danton   

Heather Danton is the food security and nutrition director with JSI Research and Training Institute Inc. for USAID’s global nutrition project, SPRING. She has a Masters of Science degree in Agriculture from Cornell University and three decades of experience working in livelihoods and food security programming for international non-governmental organisations (NGOs). 

At the age of 20, I found my passion - and it was not what I expected it to be. I was an undergraduate pre-med student at Stanford thinking that I would specialise in neurology or pathology, as my sister did a few years later. But my best friend convinced me to take time off before my senior year to teach English in Indonesia. I returned home to Palo Alto 10 months later with a changed world view and a mission: I wanted to figure out how to link what people were growing in the developing world to better health and nutrition for families there. I had decided to save lives in a different way—by becoming an agriculturalist.

At the time, I would not have thought to ask about chronic malnutrition or to wonder whether there were more cost-effective planting techniques for the acres and acres of rice I saw. And value chains? The term was not even used by agricultural economists at the time. What I did know was that at 5 feet 8 inches, I was always the tallest person in the village. I saw that although Indonesia had the climate to support the growth of the most amazing array of fruits and vegetables I had ever seen, and the food was some of the most exquisite and diverse I had ever experienced, rural families ate mostly rice; they were simply not consuming the diversity of foods that I found in most rural markets. Women were too busy taking care of their homes, their families and their farms to worry about the nutritional value of the food they prepared.

It took time to adjust to the lack of sanitation, too. In fact, sanitation systems in Surubaya, the city where I was living and teaching, seemed worse than in the villages. People used the open sewers for just about everything that required water: defecation, washing clothes, washing bodies, washing bicycles, “becaks” (bicycle rickshaws), and cars, and -yes -even drinking. Water, sanitation, and hygiene were challenging in rural areas as well. Only the wealthiest had toilets, and few families had latrines. Defecation into streams and rice paddies was standard practice.

Development agencies and donors were focused on their own sectors: the Food and Agriculture Organisation (FAO) meant agriculture; the World Health Organisation (WHO) did health. That laser focus powered the Green Revolution and the development of food fortification to increase availability of the range of micronutrients needed for good health. At the same time, among NGOs that sought to improve well-being, concepts of sectoral integration were common, in recognition that families do not function in sectoral silos. The era of farming systems research was in; the concept of food systems had not yet been devised.

With The Lancet’s 2013 call for agriculture and other sectors to do more for nutrition, nutritionists have been working hard to educate agriculturists in nutrition basics and to figure out how to better integrate key approaches, targets and resources across and between sectors. This work has yielded a range of terms that many have sought to define, share and build consensus and evidence around. Over the past two years, workshops, trainings and conferences have focused on sharing these terms and ideas, and it has been heartening to view the effort dedicated to research designed to build evidence around what agriculture can do to better support nutrition -- and how best to do it. The term “nutrition-sensitive agriculture” and the concept behind it is now part of national food and nutrition policies and donor strategies; the concept has become the basis for a range of departments, bureaus and staff positions within the very organisations that worked in sectoral silos 30 years ago. 

Today, I lead a team of agriculture and nutrition experts working together to better understand and document how agriculture can better contribute to improving nutritional outcomes, especially in countries with the highest burdens of malnutrition.  Some days, as I struggle with colleagues to reach agreement about a term or the interpretation of a conceptual framework for multisectoral project design, I remind myself of what it was that coloured my world as a 20-year-old in Indonesia. I did not need terms to make the links. Conceptual frameworks would have taken my attention away from what I observed in the places I lived and travelled and from what I learned from the people I met. Sometimes, I wonder whether our information- and terminology-driven age distracts us from seeing, hearing and experiencing the world in a way that would better answer the challenge of working together.

Does nutrition-sensitive agriculture address the underlying contributors to malnutrition in Indonesia today? The situation there continues to be challenging. Significant reductions in poverty, increased levels of education, greater accessibility of health services, and improvements in transportation, market, and food production systems have shifted the way we need to think about agriculture’s contribution to nutrition in Indonesia. Rice is still a key part of the diet. But so are packaged, processed and affordable fast foods. The double burden of malnutrition—where overweight and obesity exist side by side with under-nutrition—is a menacing reality, even in the most remote communities. Women’s time is still oversubscribed, and diets are still not ideal.

What can agriculture do? Should agriculture extension agents deliver messages on dietary diversity? Do seed purveyors need to promote plant varieties that are more nutrient-rich or biofortified? Can labour-saving technologies be more widely promoted? The answer may be yes to all those questions. But worrying less about whether an approach is “nutrition-sensitive” and working harder to look through the eyes of families who struggle every single day with the complex choices associated with food, health, and care might be a good place to start.

Agriculture can do more to improve the quality, safety, availability, and accessibility of more-nutritious foods. And it can do more to promote better health—or, at least, to “do no harm” in the production, storage, processing and marketing practices being promoted. Providing healthier foods in a way that does not expand the demands on women’s time and labour should also be possible. With these changes in how we think about solving the complex problems that smallholder farm families face, I firmly believe it IS possible, as an agriculturalist, to save lives in a different way.