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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.

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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.