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Transitioning Toward Nutrition-Sensitive Food Systems

Food systems are typically defined as comprising all activities that are part of the production, distribution, and consumption of food. This includes (but is not restricted to) processes such as cultivation, harvesting, maintaining livestock, postproduction processing, packaging, storing, transport, selling, and consumption. In TCI’s conceptual framework, we extend this definition of a food system to also include factors that impact the distribution of food within a household and that affect individual-level absorption and intake of micronutrients. It is necessary that a food system be oriented toward addressing nutritional issues.

A nutrition-sensitive approach  not only takes into account policies related to the macro level access and availability of nutrient-dense food, but also focuses on more micro level determinants (e.g., household- and individual-level) of improved nutrition. We explain in depth what it means to have a nutrition-sensitive food system in our review article, “Transitioning Toward Nutrition-Sensitive Food Systems in Developing Countries,” published in the Annual Review of Resource Economics (Vol. 9, 2017, pp. 439–59). 

By emphasizing nutrition outcomes, this approach critically differs from previous others, which primarily focused on health outcomes. Our approach also goes beyond the “farm-to-table” pathway and weighs individual-level factors that affect the access, consumption, absorption, and inequity in food among members within a household. The primary goal is to enhance the diversity, quality, and safety of the entire food system while making it more accessible and inclusive to all people at all times. This necessitates special policy attention toward vulnerable groups. Therefore, our approach aims to address these nutritional concerns throughout the food system, using a holistic policy framework.


Conceptual framework: Multisectoral pathways toward improved individual nutrition. Adapted with permission from Pingali & Rickets (2014)

A major component of this holistic approach to food systems is the promotion of dietary diversity. Diverse diets play an important role in addressing micronutrient deficiencies and improving anthropometric outcomes for all age groups, while also having a positive impact on cognitive outcomes. In lower-productive, subsistence agricultural systems, diversity of small farm production is integral in determining household dietary diversity. However, this interdependence is weaker in areas where market development and modernization of agricultural systems have taken place. While concentrating on staple grains could be appropriate in the early stages of development, with economic growth and urbanization, there may be an accompanying rise in the demand for nutrient-rich non-staples (such as fruits, vegetables, pulses, dairy, etc.), which then requires a different suite of policies to foster and cater to this new demand. The nature of policies suitable for a particular country (or state) critically hinge on the stage of development being experienced by the country (state).

Household-level factors also have a significant impact on individuals’ nutritional outcomes. We explain how three main mechanisms—income, access to food diversity, and the role of safety net programs—affect households. First, as economies undergo structural transformation, markets develop, incomes grow, and consumer demand evolves. Supply-side policies and demand-side incentives can be used to leverage this income growth to deliver better health and nutrition outcomes for households.

Within the issue of access to food diversity, it is crucial to understand the role that access to markets play. Whether people grow all the food that they consume or they primarily buy it from the market, especially in regions that are particularly resource scarce, infrastructural investment, smallholder linkages to markets, and the use of biofortified crops play a huge role in a household’s ability to access a micronutrient-rich, diverse diet.

Additionally, safety net programs ensure intertemporal stability in consumption, which is especially useful in the wake of rising climatic shocks and food price volatility. Cash transfers have taken a prominent role in related policy discussions, and we recommend their inclusion in an integrated food systems approach. 

In addition to these factors, we must also highlight the individual-level characteristics that play a role in determining nutrition outcomes. The most essential among these are the inequity of food access within the household. Traditionally, it has been the case that the distribution of food within the home has been lopsided in favor of men and older boys. This implies that, even if the household as a unit is food secure, there could be individuals (mostly women and girls) who are food insecure. In addition, this food insecurity might be especially acute in more nutrient-dense foods (for instance, men and boys receiving larger or more choice portions of meat, and women and girls being left with only broth or gravies to consume). Therefore, enhancing the status of women within the household by raising their decision-making and bargaining power is of paramount importance. The current literature explains how women’s empowerment has been shown to improve not only nutritional outcomes of individual women, but also has positive effects on the nutritional outcomes of their children. 

Finally, among environmental factors, water, sanitation, and hygiene (WASH) policies have a vital role in shaping the physical and cognitive development of children. Across a variety of contexts, sanitation conditions have been shown to have a significant impact on disease incidence and health status of children. Other empirical evidence shows the impact of access to clean water on a variety of health outcomes, including child morbidity and mortality. Added to this is the potential of contaminants entering the food system at different stages of the “farm-to-table” process. To counter these effects, there is a need for significant public and private investment in these spheres to ensure food safety across the supply chain. 

In conclusion, the Tata-Cornell Institute has provided a description of a holistic food system policy framework that accounts not only for the macroeconomic challenges facing the system, but also for the factors at household and individual levels. We discuss some of these factors and current policy solutions that could be used to tackle these issues in different contexts. In describing their pros and cons, we provide a framework to think about these solutions, their complementarities with other policy options, and how to potentially choose between different options.

By Naveen Sunder

Naveen Sunder is a Tata-Cornell Scholar and fifth year Ph.D. candidate in the Economics Department at Cornell University. His primary research interests are in the field of development economics, health economics and applied econometrics.