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Food and Nutrition Bulletin
Journal Prestige (SJR): 0.768
Citation Impact (citeScore): 2
Number of Followers: 6  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0379-5721 - ISSN (Online) 1564-8265
Published by Sage Publications Homepage  [1176 journals]
  • Trends and Determinants of Children’s Wasting and Women’s
           Thinness in Chad, 2015 to 2021

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      Authors: Sarah Adler, Eleonor Zavala, Edgar Wabyona, Martin Ahimbisibwe, Fanga Haisset, Shannon Doocy
      Pages: 172 - 182
      Abstract: Food and Nutrition Bulletin, Volume 44, Issue 3, Page 172-182, September 2023.
      Background:Cross-sectional surveys using the Standardized Monitoring and Assessment of Relief and Transitions methodology have been conducted annually in Chad since 2015 to evaluate population-level nutritional status.Objective:This analysis characterizes national and subnational trends in child wasting and women’s thinness from 2015 to 2021 in Chad and identifies risk factors during the COVID-19 pandemic.Methods:Annual survey data with 12,000 to 15,000 households were included. Wasting was estimated for children 6 to 59 months using the WHO child growth standards, and among women 15 to 49 years, thinness was defined as mid-upper arm circumference
      Citation: Food and Nutrition Bulletin
      PubDate: 2023-09-20T10:28:00Z
      DOI: 10.1177/03795721231190203
      Issue No: Vol. 44, No. 3 (2023)
       
  • Effect of an Integrated School Garden and Home Garden Intervention on
           Anemia Among School-Aged Children in Nepal: Evidence From a Cluster
           Randomised Controlled Trial

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      Authors: Ghassan Baliki, Dorothee Weiffen, Pepijn Schreinemachers, Akina Shrestha, Rachana Manandhar Shrestha, Monika Schreiner, Tilman Brück
      Pages: 195 - 206
      Abstract: Food and Nutrition Bulletin, Volume 44, Issue 3, Page 195-206, September 2023.
      Background:Integrated school and home garden interventions can improve health outcomes in low-income countries, but rigorous evidence remains scarce, particularly for school-aged children and to reduce anemia.Objective:We test if an integrated school and home garden intervention, implemented at pilot stage, improves hemoglobin levels among school children (aged 9-13 years) in a rural district in the mid-hills of Nepal.Methods:We use a cluster randomized controlled trial with 15 schools each in the control and treatment groups (n = 680 school children). To test if nutritional improvements translate into a reduction of anemia prevalence, hemoglobin data were collected 6 months after intervention support had ended. Using structural equation modeling, we estimate the direct and indirect effects of the treatment through several pathways, including nutritional knowledge, good food and hygiene practices, and dietary diversity.Results:The integrated school and home garden intervention did not lead to a direct significant reduction in anemia. Causal positive changes of the treatment on nutritional outcomes, although significant, are not strong enough to impact hemoglobin levels. The program improved hemoglobin levels indirectly for children below 12 by increasing the use of good food and hygiene practices at home. These practices are associated with higher hemoglobin levels, particularly for girls, young children, and in households where caregivers are literate.Conclusions:Even integrated school and home garden interventions are not sufficient to reduce anemia among school children. Incorporating behavioral change components around food and hygiene practices into integrated garden interventions is important to unlocking their health impacts.Plain language titleEffect of a Joint School and Home Garden Programme on Child Health Among School-Aged Children in NepalPlain language summaryThe effects of agricultural and nutritional support programs on health are not fully understood. This article looks at school and home gardens, which are gaining attention in the research and development community, but evidence for their effects is limited, particularly for lower-income countries. We examine whether a joint school and home garden program improves blood iron levels among school children (aged 9-13 years) in rural Nepal. Low levels are an indicator for anemia—a common nutritional disorder in South Asia. Our data come from an experiment involving 30 schools and 680 children and was measured via a finger prick method 6 months after program support ended. We also evaluate if the program influenced blood iron levels through the nutritional knowledge of children and their caregivers; through the use of good food and hygiene practices at home and the children’s dietary diversity. Our results indicate that the program did not lead to a direct reduction in anemia. However, for children under the age of 12, the program indirectly improved blood iron levels through behavioral changes in the use of good food and hygiene practices (e.g., washing hands before eating). We therefore argue that including education on nutrition and good food and hygiene practices as part of integrated garden support programs is key to improving children’s health.
      Citation: Food and Nutrition Bulletin
      PubDate: 2023-09-20T10:27:58Z
      DOI: 10.1177/03795721231194124
      Issue No: Vol. 44, No. 3 (2023)
       
  • Assessing the Progress of the Philippine Plan of Action for Nutrition From
           1974 to 2022: A Narrative Review

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      Authors: Cristela Mae C. Candelario
      Pages: 207 - 220
      Abstract: Food and Nutrition Bulletin, Volume 44, Issue 3, Page 207-220, September 2023.
      Background:Malnutrition remains a public health burden in the Philippines, with the country struggling to meet global nutrition targets.Objective:This study aims to review the Philippine Plan of Action for Nutrition (PPAN) and its progress in addressing malnutrition in the Philippines.Methods:A narrative literature review of the PPAN and its implementation from 1974 to 2022 was conducted, including an analysis of relevant data on the nutrition status and programs for Filipinos.Results:The study found that the PPAN has been largely supportive in addressing malnutrition in the Philippines over the years. However, obstacles hindering the achievement of its nutrition-related goals have been identified. Challenges include inadequate coordination of programs at the local level, concerns regarding data quality, and insufficient training of personnel involved in implementing the PPAN. The results also indicate that the country has made limited progress toward achieving the global nutrition targets set by the Sustainable Development Goals 2030.Conclusion:This study highlights the need to revisit and refine the PPAN to respond to the changing nature of malnutrition in the country. Recommendations to address the remaining gaps in the planning, implementing, and monitoring of the PPAN are discussed. Finally, the paper offers some valuable insights from the experiences of the PPAN that can be applied to other countries facing comparable nutrition contexts.Plain language titleUnderstanding the Evolution of the Philippine Plan of Action for NutritionPlain language summaryThis study is a review of the Philippine Plan of Action for Nutrition (PPAN), which is a comprehensive plan initiated in 1974 to address nutritional issues in the Philippines. The study looks at how the PPAN has been implemented over the years and its effectiveness in addressing malnutrition. It also discusses challenges and issues with the PPAN, such as compliance problems at the village level, and the need for stronger political will and context-specific approaches. Additionally, the study provides recommendations for the next iterations of the PPAN in order to achieve sustainable nutrition outcomes, as well as lessons learned for other countries facing similar nutrition problems. Overall, this study highlights the need to reexamine and adapt the PPAN in order to effectively address the changing nature of malnutrition in the Philippines.
      Citation: Food and Nutrition Bulletin
      PubDate: 2023-09-20T10:27:59Z
      DOI: 10.1177/03795721231192742
      Issue No: Vol. 44, No. 3 (2023)
       
  • Food Insecurity and Perceived Effects of COVID-19 on Livelihoods in Rural
           Sri Lanka

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      Authors: Nishmeet Singh, Samuel Scott, Neha Kumar, Gayathri Ramani, Quinn Marshall, Kate Sinclair, Saman Kalupahana, Malika Fernando, Renuka Silva, Amila Perera, Renuka Jayatissa, Deanna Olney
      Abstract: Food and Nutrition Bulletin, Ahead of Print.
      Background:Little is known about how the COVID-19 pandemic has affected food security and livelihoods in Sri Lanka.Objective:This article aims to assess food insecurity, perceived effects of COVID-19, and coping mechanisms among agriculture-based households in rural Sri Lanka.Methods:We used 2 rounds of panel data from phone surveys (n = 1057 households) conducted in 5 districts. Food insecurity (30-day recall), perceived impacts of COVID-19 (6-month recall), and coping mechanisms (6-month recall) were assessed using a household questionnaire. To assess food insecurity, we used the 8-item Food Insecurity Experience Scale. We tested for differences between T1 (baseline: December 2020-February 2021) and T2 (follow-up: July 2021-September 2021) and explored the association between food insecurity and the perceived effect of COVID-19 on income using a logistic regression model.Results:Food insecurity was highly prevalent (T1: 75%, T2: 80%) but varied across districts. Most respondents were affected by COVID-19 and/or COVID-19-associated mitigation measures (T1: 84%, T2: 89%). Among affected households, commonly reported impacts included those on income (T1: 77%, T2: 76%), food costs (T1: 84%, T2: 83%), and travel (∼90% in both rounds). Agricultural activities were also adversely affected (T1: 64%, T2: 69%). About half of COVID-19-affected households reported selling livestock or assets to meet basic needs. Households whose income was impacted by COVID-19 were more likely to be food insecure (adjusted odds ratio: 2.56, P < .001).Conclusions:Households in rural Sri Lanka experienced food insecurity and livelihood disturbances during the COVID-19 pandemic. Additional surveys are needed to assess recovery post-COVID-19 and to understand if programs that support livelihoods have been protective.Plain language titleFood Insecurity and Perceived Effects of COVID-19 on Livelihoods in Rural Sri LankaPlain language summaryBackground: Sustained levels of high food insecurity are associated with a range of negative health, nutrition, and well-being effects.The COVID-19 pandemic is expected to aggravate food insecurity and worsen the livelihood situation.Little is known about how the COVID-19 pandemic affected food security and livelihoods of agriculture-based households in rural Sri Lanka. Method: This original article used household level survey data from 2 rounds of phone surveys conducted in 5 districts of Sri Lanka.Using a household-level questionnaire, we recorded experience of food insecurity in the last 30 days, perceived impact of COVID-19, and adopted coping mechanism in the 6 months prior to the survey.We reported statistical means and tested for differences between 2 survey rounds.We also explored association between food insecurity and the perceived effect of COVID-19 on income. Results: Household-level food insecurity was highly prevalent during the pandemic.Households perceived a negative effect of the pandemic on their income and employment sources.Households whose income was impacted by the pandemic were more likely to be food insecure. Conclusion: Agriculture-based households in rural Sri Lanka experienced food insecurity and livelihood disturbances during the COVID-19 pandemic.Additional research is needed to assess recovery post COVID-19 and to understand whether livelihood support programs have been protective.
      Citation: Food and Nutrition Bulletin
      PubDate: 2023-09-13T07:27:11Z
      DOI: 10.1177/03795721231197249
       
  • Biofortification in Ethiopia: Opportunities and Challenges

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      Authors: Fantu Bachewe, Tirsit Genye, Meron Girma, Aregash Samuel, James Warner, Cornelia van Zyl
      Abstract: Food and Nutrition Bulletin, Ahead of Print.
      Background:Children younger than 5 years and women of reproductive age often suffer from micronutrient deficiencies. Biofortification, which involves enriching staple crops with micronutrients, is a nutritional intervention focused on addressing micronutrient deficiencies. It is equitable, sustainable, and costs less than other nutritional interventions.Objective:This study investigates biofortification in Ethiopia; considering 6 globally biofortified crops, 5 of which are currently being biofortified in Ethiopia. However, only 2 of these crops are important in the consumption baskets of most Ethiopians. Therefore, efforts to mainstream biofortification should begin with studies to identify crops that have larger impacts in reducing local micronutrient deficiencies and their cost-effectiveness.Methods:Literature was searched between July and December 2021 using Google Scholar to provide insights into the state of biofortification in Ethiopia. Key-informant interviews were conducted to gain insights into the state of biofortification in Ethiopia and to identify bottlenecks for scaling up the production and consumption of biofortified foods. Furthermore, Annual Agriculture Sample Survey and 2015/16 Ethiopian Household Consumption and Expenditure Survey data were used to describe the area under production of biofortifiable crops and their importance in total consumption, respectively.Results:Mainstreaming biofortification in Ethiopia faces several challenges. Policy documents appear to be inconsistent, regressive, and vague regarding biofortification. Critically, there is no specific institution to oversee and/or coordinate biofortification-related activities.Conclusion:Overall, the success of biofortification depends upon a strong coordination body with clear mandates from detailed policies; adequate funding for research and development; and robust monitoring and evaluation of the identified production, adoption, and consumption issues.
      Citation: Food and Nutrition Bulletin
      PubDate: 2023-07-27T05:34:58Z
      DOI: 10.1177/03795721231188913
       
  • Advancing a Multisectoral Platform for Nutrition-Sensitive Agriculture in
           Nigeria: Reflections on Effectiveness and Lessons Learnt

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      Authors: Oluchi Ezekannagha, Olutayo Adeyemi, Victor Ajieroh, Adeyinka Onabolu
      Abstract: Food and Nutrition Bulletin, Ahead of Print.
      Background:Inadequate coordination mechanisms and capacity to coordinate are limiting factors for maximizing the ability of agriculture to improve nutrition in Sub-Saharan Africa. Effective coordination requires the availability of a platform for stakeholder convening, planning, operationalization of ideas, communication, and accountability. Nigeria’s Federal Ministry of Agriculture and Rural Development established one such platform to support the institutionalization of nutrition-sensitive agriculture. Platform members include several departments within the Ministry, other ministries, and development partners. While the platform achieved key milestones and fostered collaboration, some gaps remained.Objective:This study reports an assessment to understand the perspectives of members of the coordination platform and identify ways of increasing effectiveness.Methods:Desk reviews of relevant documents and 18 key informant interviews were conducted. Documents and interview notes were coded and analysed to identify recurring themes. Themes were appraised using a nutrition coordination framework.Results:Sufficiently understanding the nutrition role of representatives’ own organization/department and the purpose of the coordination platform and its activities was important for success. The profile and seniority of representing officers also mattered. While the leadership of the Ministry was committed to advancing nutrition through agriculture, the coordination platform could improve its functionality through consistent leadership, increased seniority of member representatives, and appropriate communication.Conclusions:Multisectoral coordination platforms are necessary but do not alone achieve nutrition coordination. Effective leadership and investments in time, strategic orientation, and training are critical to achieving a shared purpose, individual sector fulfilment of nutrition roles, and additional coordination success factors.Plain language titleNeeded Factors for Facilitating Collaboration to Ensure Integration of Nutrition Into Agricultural InterventionsPlain language summaryImproving nutrition through the agriculture sector requires collaboration among various departments and stakeholders within the sector and with other sectors that provide complementary services, such as the water and health sectors. Effective collaboration requires a platform through which involved stakeholders can discuss and reach agreements on actions that need to be taken. The Federal Ministry of Agriculture and Rural Development in Nigeria established such a platform as part of efforts to address malnutrition. However, the platform did not seem to be adequately effective because the departments and stakeholders involved were not meeting frequently to discuss and limited collaboration was happening. This research interviewed stakeholders that attended meetings of the platform to identify suggestions for improving the use of the platform. The research found that there was strong interest to participate among all stakeholders, and the platform was useful for the Ministry to increase awareness and support for nutrition-sensitive agriculture. Still, the common vision around the platform’s objectives, among the stakeholders involved was insufficiently articulated and communicated. Actions meeting attendees were required to take often differed from their departmental/organizational mandate and/or were not in their technical area of competence. Participating in activities related to the platform, therefore, increased the workload of its attendees. Furthermore, communication about the roles and expectations of the stakeholders involved in the platform was inadequate. The stakeholders additionally had inadequate clarity about the leadership of the platform. Guidance from a framework for nutrition coordination developed by other authors suggests that improving leadership; creating a shared understanding of the objectives of the platform among all stakeholders; increasing nutrition capacity among all organizations involved; and ensuring that involved organizations find the collaboration to be beneficial for their own mandate; will be important next steps for achieving the purpose of collaboration.
      Citation: Food and Nutrition Bulletin
      PubDate: 2023-06-15T06:33:32Z
      DOI: 10.1177/03795721231179786
       
  • Government Budget for Nutrition-Sensitive Agriculture in Nigeria Increased
           Following Development of Related Strategy

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      Authors: Olutayo Adeyemi, Yeside Adesiyun, Samuel Omenka, Oluchi Ezekannagha, Adekunle Adanlawo, Rasaq Oyeleke, Larry Umunna, Francis Aminu, Adeyinka Onabolu, Victor Ajieroh
      Abstract: Food and Nutrition Bulletin, Ahead of Print.
      Background:Financial resources that are commensurate with the magnitude of malnutrition problem are requisite for effective interventions to reduce malnutrition. Understanding the amount and nature of sectoral investments in nutrition is important for advocating and mobilizing increased government budgetary allocations and release.Objective:This study assessed trends in Nigeria’s agriculture sector nutrition allocations and whether launch of nutrition-sensitive agriculture strategy and/or the COVID-19 pandemic may have affected these nutrition allocations.Methods:Agricultural budgets from 2009 to 2022 of Nigeria’s federal government were analyzed. Nutrition-related budget lines were identified using a keyword search and were then classified as nutrition-specific, nutrition-sensitive, or potentially nutrition-sensitive, based on defined criteria. Potentially nutrition-sensitive items were further screened. Budget lines finally included as nutrition allocations directly targeted improvements in nutrition or intermediate outcomes in pathways between agriculture and nutrition. Budget lines were summed, and these nominal values were adjusted for inflation (using the consumer price index for each year) to obtain real values.Results:Nutrition allocations in the agriculture budget increased considerably even after adjusting for inflation and went from 0.13% of agriculture capital budget in 2009 to 2.97% in 2022; while the real value of total government agricultural budget declined. Large budgetary increases coincided with the development/launch of costed strategies with nutrition-sensitive agriculture components. Still, there were some missed opportunities to increase nutrition allocations.Conclusions:Existence of nutrition-sensitive agriculture strategies has facilitated increased nutrition funding and improved the enabling environment. There is need to optimize existing nutrition allocations while advocating for additional funds.Plain language titleChanges in Federal Government Allocation for Nutrition in the Nigerian Agriculture Sector Budgets From 2009 to 2022Plain language summaryAdequate nutrition requires widespread access to sufficient amounts of safe and nutritious foods, empowerment of women, and prevention of illnesses. The agriculture sector is responsible for primary food production and, therefore, has important roles to play in improving nutrition. The agriculture sector also has roles in reducing poverty, empowering women and preventing diseases from contaminated food, water, and environment. Achieving these roles requires deliberate actions that must be funded. This research looked at federal government budgets for the agriculture sector in Nigeria from 2009 to 2022 to see if actions needed to improve nutrition were being funded and how much was being allocated to these actions. Specifically, the research tried to see whether more money was being allocated to nutrition actions after the launch of documents that described actions needed to improve nutrition and the cost of those actions. The research found that some of the actions needed to improve nutrition were being funded, and the money being allocated to these actions increased over time. The years immediately following the launch of the key documents had more money allocated for nutrition in the budgets. More money could, however, have been allocated to nutrition if more agricultural activities in the budget included considerations for improving nutrition among vulnerable people. The conclusions from the research are that documentation of actions needed to improve nutrition, and how much these actions cost, helps in mobilizing nutrition resources. Properly distributing nutrition allocations across relevant actions can ensure that money already allocated is able to address priority actions. Nutrition allocations can be further increased by making sure that agricultural activities included in budgets directly consider how to increase access to safe and nutritious foods, empower women, and/or prevent food, water, and environmental contamination.
      Citation: Food and Nutrition Bulletin
      PubDate: 2023-06-15T06:32:13Z
      DOI: 10.1177/03795721231179783
       
  • Comprehensive Approach for Improving Adherence to Prenatal Iron and Folic
           Acid Supplements Based on Intervention Studies in Bangladesh, Burkina
           Faso, Ethiopia, and India

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      Authors: Tina G. Sanghvi, Phuong Hong Nguyen, Thomas Forissier, Sebanti Ghosh, Maurice Zafimanjaka, Tamirat Walissa, Zeba Mahmud, Sunny Kim
      Abstract: Food and Nutrition Bulletin, Ahead of Print.
      Background:The World Health Organization recommends daily iron and folic acid (IFA) supplementation during pregnancy, but consumption remains low, and high prevalence of anemia among pregnant women (PW) persists.Objectives:This study aims to (1) examine factors at the health system, community, and individual levels, which influence adherence to IFA supplements; and (2) describe a comprehensive approach for designing interventions to improve adherence based on lessons learned from 4 country experiences.Methods:We conducted literature search, formative research, and baseline surveys in Bangladesh, Burkina Faso, Ethiopia, and India and applied health systems strengthening and social and behavior change principles to design interventions. The interventions addressed underlying barriers at the individual, community, and health system levels. Interventions were further adapted for integration into existing large-scale antenatal care programs through continuous monitoring.Results:Key factors related to low adherence were lack of operational protocols to implement policies, supply chain bottlenecks, low capacity to counsel women, negative social norms, and individual cognitive barriers. We reinforced antenatal care services and linked them with community workers and families to address knowledge, beliefs, self-efficacy, and perceived social norms. Evaluations showed that adherence improved in all countries. Based on implementation lessons, we developed a program pathway and details of interventions for mobilizing health systems and community platforms for improving adherence.Conclusion:A proven process for designing interventions to address IFA supplement adherence will contribute to achieving global nutrition targets for anemia reduction in PW. This evidence-based comprehensive approach may be applied in other countries with high anemia prevalence and low IFA adherence.Plain language titleDesigning Comprehensive Interventions to Improve the Consumption of Prenatal Iron and Folic Acid Supplements in Low- and Middle-Income CountriesPlain language summaryAnemia among women of reproductive age, particularly during pregnancy, is widespread, but there are remedies such as iron and folic acid (IFA) supplements that can increase iron intake. This study documents the barriers faced by pregnant women (PW) in adhering to daily IFA supplementation as recommended by the World Health Organization. We designed interventions for large-scale antenatal care programs to improve adherence in Bangladesh, Burkina Faso, Ethiopia, and India. The barriers included poor supplies, lack of counseling during antenatal visits, and insufficient community and family support for PW. We strengthened service delivery protocols and the capacity of community workers to engage families. We trained health workers, improved supervision and counseling quality, strengthened supply systems for IFA tablets, and facilitated family support for PW. We improved women’s knowledge, beliefs, self-efficacy, and perception of social norms through interventions tailored for each country setting. Considering the high burden of anemia in low- and middle-income countries among women especially during pregnancy and health consequences for mothers and newborns of low iron intake, decision makers and implementers need to pay greater attention to understanding local barriers to adherence and designing interventions that can improve adherence. Social and behavioral science theories and health systems strengthening frameworks provide a strong technical basis for designing effective interventions to improve IFA adherence.
      Citation: Food and Nutrition Bulletin
      PubDate: 2023-06-13T05:14:37Z
      DOI: 10.1177/03795721231179570
       
  • Effect of School Feeding Program on School Absenteeism of Primary School
           Adolescents in Addis Ababa, Ethiopia: A Prospective Cohort Study

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      Authors: Bekri Mohammed, Tefera Belachew, Shemsu Kedir, Kalkidan Hassen Abate
      Abstract: Food and Nutrition Bulletin, Ahead of Print.
      School feeding program (SFP) in low-income countries is designed to provide food to vulnerable school children to create optimal educational and health conditions for learners. Ethiopia scaled up the implementation of SFP in Addis Ababa. Yet, the utility of this program in terms of school absenteeism has not been monitored thus far. Hence, we aimed at evaluating the effect of the SFP on school performance of primary school adolescents in Addis Ababa, Central Ethiopia. A prospective cohort study was carried out from 2020 to 2021 on SFP-beneficiary (n = 322) and non-SFP beneficiary (n = 322). Logistic regression models were done using SPSS version 24. In logistic regression, unadjusted model (model 1), the school absenteeism of non-school-fed adolescents was higher by 1.84 (adjusted odds ratio [aOR] 0.36, 95% confidence interval [CI] 1.28-2.64) as compared to school-fed adolescents. The odds ratio remained positive after adjusting for age and sex (model 2: aOR 1.84, 95% CI 1.27-2.65), and sociodemographic (model 3: aOR 1.84, 95% CI 1.27-2.67). In the final model, adjusted model 4, health and lifestyle, there was a significant increase in absenteeism of non-school-fed adolescents (model 4: aOR 2.37, 95% CI 1.54-3.64). The likelihood of absenteeism in female increase by 2.03 (aOR 2.03, 95% CI 1.35-3.05), whereas being in a low tertile wealth index family decreases absenteeism by (aOR 0.51, 95% CI 0.32-0.82). School feeding was negatively associated with school absenteeism. The findings imply the need for strengthening school feeding programs.Plain language titleSchool Feeding and AbsenteeismPlain language summaryTo ensure optimal educational and health conditions for students, the school feeding program (SFP) provides food to needy children in low-income countries. Ethiopia has expanded the implementation of the SFP in Addis Ababa. However, the benefits of this program in terms of school absenteeism have not been studied. Therefore, we sought to examine the impact of the SFP on the school performance of primary school students in Addis Ababa, central Ethiopia. A prospective cohort study of SFP beneficiaries and non-SFP beneficiaries was conducted. This study found a significant increase in absenteeism among youth who did not receive school meals compared with their school-supplied peers. The results indicate that school meal programs need to be strengthened. Therefore, it is imperative that the Ethiopian government allocate significant resources to the program for it to be successful and scaled up to other regions of Ethiopia. Programs should include cross-sectoral participation, strong institutional resource management, capacity building, and linkages with fundraising nongovernmental organizations.
      Citation: Food and Nutrition Bulletin
      PubDate: 2023-06-13T05:12:49Z
      DOI: 10.1177/03795721231179264
       
  • Fostering an Enabling Environment for Nutrition-Sensitive Agriculture and
           Food Systems in Nigeria

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      Authors: Victor Ajieroh, Adeyinka Onabolu, Oluchi Ezekannagha, Olutayo Adeyemi
      Abstract: Food and Nutrition Bulletin, Ahead of Print.
      Background:Although recommendations exist for making agriculture and food systems nutrition sensitive, guidance about how to successfully operationalize these recommendations within national institutions is limited. Over the 13 years from 2010 to 2023, there were several undertakings to strengthen the enabling environment for sustainable nutrition-sensitive agriculture (NSA) and food systems in Nigeria. Some studies were also conducted over the period to foster better understanding of the national enabling environment and facilitate effective actions.Objective:This article documents successes and failures from Nigeria’s experiences by reflecting on critical developments, events, policies, and programmes on Nigeria’s journey toward advancing nutrition through agriculture and food systems; as well as findings from conducted studies.Discussion:Successes include the existence of a Nutrition and Food Safety Division in the Ministry of Agriculture and an approval for a Nutrition Department, existence of an agriculture sector nutrition strategy, increased private sector engagement and commitment to nutrition-sensitive food systems, and increased funding for nutrition in the agriculture sector. Challenges especially remain for scaling up strategic, operational, and delivery capacity of both organizations and individuals involved in advancing NSA and food systems. Lessons learned include—institutionalizing NSA and food systems takes time; knowledge brokering is indispensable and requires several collaborating entities and stakeholders; and approaches used should be suited to available government capacity.Conclusion:More than a decade of efforts targeting different enabling environment factors has resulted in greater political commitment for nutrition within the agriculture sector and an improved enabling environment for NSA and food systems.Plain language titleThe Ability of Nigeria’s Agriculture Sector and Food Systems to Improve Nutrition Has Increased Following Policy, Advocacy, and Capacity InterventionsPlain language summaryGlobally, countries are being asked to ensure that their agricultural and food systems promote adequate nutrition and health. There are published recommendations about what countries need to do to ensure such agricultural and food systems, but very little operational guidance about how to implement these recommendations within the context of established, often inert institutions. In the 13 years from 2010 to 2023, Nigeria worked to make recommendations for agricultural and food systems that improve nutrition become the normal practice among relevant institutions and stakeholders. Efforts included policy, advocacy, and capacity-building activities as well as the conduct of research to direct necessary actions. Several successes and failures were encountered in the process. This article documents the successes and failures and summarizes research findings. The goal of the article is to provide lessons to other low- and middle-income countries that would like to develop agricultural and food systems that improve nutrition so that these countries are able to avoid or manage predictable risks. Successes include the establishment of an Office in the Ministry of Agriculture that oversees the incorporation of nutrition considerations into agricultural activities, the development of a strategy to help agricultural stakeholders know what to do to improve nutrition, and increased financing of activities related to the target recommendations. Challenges include difficulties in increasing the knowledge, skills, and motivation of relevant organizations and stakeholders to add new ways of action to their normal routine. There is a need to keep on doing the things that facilitated success and avoid the causes of the challenges. The commitment of the government to implementing the recommendations for agricultural and food systems that improve nutrition remains strong and the government will continue to try different methods to increase required knowledge, skills, and motivation.
      Citation: Food and Nutrition Bulletin
      PubDate: 2023-06-07T10:13:00Z
      DOI: 10.1177/03795721231173852
       
  • Data on Humanitarian Crises: Who and What Are We Missing'

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      Authors: Anastasia Marshak, Helen Young, Elena N. Naumova
      Abstract: Food and Nutrition Bulletin, Ahead of Print.

      Citation: Food and Nutrition Bulletin
      PubDate: 2023-04-06T06:53:46Z
      DOI: 10.1177/03795721231162429
       
  • Nutrition Capacity Assessment of Agriculture Extension Services in Nigeria

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      Authors: Olutayo Adeyemi, Victor Adejoh, Olufolakemi Anjorin, Oluwaseun Ariyo, Babatunde Makanjuola, Mawuli Sablah, Adeyinka Onabolu
      Abstract: Food and Nutrition Bulletin, Ahead of Print.
      Background:Achieving meaningful malnutrition reductions in Nigeria and other high-burden countries requires sustained improvements in diets, mediated through nutrition-sensitive agriculture and food systems. Yet, the capacity to design, plan, implement, and monitor such nutrition-sensitive systems is very limited, including within agricultural extension services delivery. Understanding existing capacity of actors required to implement nutrition change is crucial for effective capacity development.Objective:This study assessed the nutrition capacity of agriculture extension agents (AEAs) in Nigeria and the capacity of their organizations and the institutions within which they operate.Methods:The study assessed 31 extension training materials for inclusion of recommendations for nutrition-sensitive agriculture. Structured interviews and focus group discussions were conducted with 23 extension agents and were coded and analyzed for major themes.Results:Training materials hardly included nutrition objectives and or nutrition-related services to be delivered. Some nutrition-related services were being delivered, including promotion of biofortified crops and nutrient-dense crops and animals, home gardening, food safety, and dietary diversification. However, these services were limited, and service delivery was unstructured, nonuniform, and inconsistent. Numbers of AEAs are quite inadequate while available AEAs had high workloads, are poorly motivated, and had limited funding, supervision, and logistics capacity to perform roles. Physical security was also a challenge for service delivery. Further, complementary activities in other sectors that were necessary for adequate delivery of nutrition-sensitive agriculture did not always exist.Conclusion:Extensive development of nutrition capacities of extension agents appears unlikely to achieve nutrition-related changes if limiting institutional and organizational capacity deficits are not addressed.Plain Language Title:Capacity of Agriculture Extension Agents in Nigeria to Deliver Nutrition Services.Plain Language Summary:Reducing the significant burden of malnutrition in Nigeria requires increased availability and consumption of foods that are nutritious and free from harmful substances. To produce such foods, farmers need adequate nutrition and food safety knowledge and skills. The production of such food will also need to support nutrition in other ways, including increased women’s empowerment. Extension agents traditionally support farmers to adopt new methods of food production and/or processing that support increased food yields. These agents can also be used to deliver services that will address nutrition if they have the necessary knowledge and skills. This study assessed the capacity of agriculture extension agents in Nigeria to deliver nutrition services, in order to determine how to increase their capacity to deliver these services. The results from the study are that the extension agents do not have sufficient knowledge and skills to deliver nutrition services, and that their organizations and the wider context in which they work do not have the capacity to enable them to deliver nutrition services effectively. For instance, the organizations do not have sufficient numbers of staff and do not provide current staff with adequate means of transportation to visit farmers. Insecurity is high and so extension agents are unable to visit farmers frequently because of the potential threats to their lives. The study concludes that effectively using extension agents to deliver nutrition services will require not just training of the extension agents but also improvements in organizational capacity and contextual factors.
      Citation: Food and Nutrition Bulletin
      PubDate: 2023-03-22T10:20:08Z
      DOI: 10.1177/03795721231158417
       
  • Evidence-Based Design Process for Nutrition-Sensitive Agriculture
           Interventions: A Case Study of the Advancing Local Dairy Development
           Programme in Nigeria

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      Authors: Ayodeji Ojo, Olutayo Adeyemi, Fisayomi Kayode, Olumide Oyebamiji, Adeyinka Onabolu, Audu Grema, Kristen MacNaughtan, Victor Ajierou
      Abstract: Food and Nutrition Bulletin, Ahead of Print.
      Background:Nigeria is a significant contributor to the global burden of chronic undernutrition in children under 5 years of age. The undernutrition challenge constrains the productivity of rural households. This study was carried out among beneficiaries of the productivity-enhancing Nigerian Dairy Development Programme (NDDP) to guide incorporation of nutrition into the successor program—Advancing Local Dairy Development in Nigeria (ALDDN). Therefore, this study contributes to the literature about operationalizing nutrition-sensitive agricultural frameworks.Objective:The study sought to determine potential entry points for improving the nutrition of smallholder dairy farmers (≤=5 milk cows) with a focus on food system entry points.Methods:Primary data were collected from 514 smallholder dairy households in Oyo and Kano states of Nigeria. Both quantitative and qualitative data were collected. Quantitative data collected included minimum dietary diversity for women, nutrition status, and socioeconomic characteristics of households. Qualitative data included information about sources of food, markets, and other food system characteristics. Quantitative data were analysed using descriptive statistical tools and correlation analysis, while common themes were identified from qualitative data.Conclusions:The study showcased men’s important role in food purchase and consumption, particularly in Kano. Increasing opportunities and the ability of women to use nutrition education appeared necessary for translating knowledge into improved practices. The own consumption (i.e., the portion of the milk kept for households’ consumption as well as diversification of foods produced for consumption); income; women’s empowerment; and environmental sanitation pathways seemed to be the most feasible pathways for improving nutrition within the context of the study population.
      Citation: Food and Nutrition Bulletin
      PubDate: 2022-12-06T08:45:33Z
      DOI: 10.1177/03795721221138396
       
  • Industry Self-Regulation of Food Fortification Compliance: Piloting the
           Micronutrient Fortification Index in Nigeria

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      Authors: Tobi Durotoye, Ike Ilegbune, Dominic Schofield, Victor Ajieroh, Oluchi Ezekannagha
      Abstract: Food and Nutrition Bulletin, Ahead of Print.
      Background:Sustaining large-scale and good-quality food fortification requires strategies that incentivize food processors to invest in and consistently meet national food fortification standards where they exist. A standardized Micronutrient Fortification Index (MFI) piloted in Nigeria has provided a ranking of fortified branded products for each participating company based on a score aggregating the effectiveness and efficiency of the company’s systems and levels of product fortification. The MFI has demonstrated the significance of brands as a focal point for investment and industry accountability in food fortification and the power of harnessing the competitive nature of businesses to drive their food fortification performance.Results:The initiative started with a pilot consisting of well-known brands of 4 companies and has since expanded participation to 15 companies, representing 31 brands, having completed the first entire ranking cycle. The publicly listed brands on the Index now cover approximately 80% of the flour milling market, 40% of the edible oils market, and 88% of the sugar market in Nigeria, reaching over an estimated 134 million people in the country in 2022 (Based on analysis by TechnoServe Supporting African Processors of Fortified Foods [SAPFF] program in Nigeria. Underlying information as supplied by industry participants.). The data inputs are made through company-owned digital portals, and the results are published on a secure, web-based public portal which also serves as a gateway for stakeholders to access related information on micronutrient fortification and food quality (https://technoserve-mfi.web.app/). The ultimate aim of the MFI is to serve as a leverage for private sector efforts to both digitalize quality assurance and business processes linked to industrial automation and to harness their competitiveness through voluntary participation in the Index to drive improved food fortification performance based on industry best practices and quality benchmarks.
      Citation: Food and Nutrition Bulletin
      PubDate: 2022-11-09T11:30:56Z
      DOI: 10.1177/03795721221132610
       
  • Building the Commitment of the Private Sector and Leveraging Effective
           Partnerships to Sustain Food Fortification

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      Authors: Tobi Durotoye, Rizwan Yusufali, Victor Ajieroh, Oluchi Ezekannagha
      Abstract: Food and Nutrition Bulletin, Ahead of Print.
      The private sector is a critical partner in achieving the universally adopted Sustainable Development Goals (SDGs)—UNDP 2022. As part of a national strategy to address malnutrition (SDG2), Large-Scale Food Fortification of commonly consumed staple foods and condiments with vitamins and minerals is a proven intervention that requires the concerted engagement of multiple actors in a country’s agri-food and public health ecosystems. Lessons from TechnoServe’s Strengthening African Processors of Fortified Foods (SAPFF) Program, implemented from 2016 to 2022 in Kenya, Nigeria, and Tanzania with support from the Bill and Melinda Gates Foundation, provide essential learnings about how to effectively engage, motivate, and improve the food fortification performance of the industry in compliance with national standards, through capacity building, responsive technical assistance, and multistakeholder engagement that builds trust and accountability of industry in the fight against malnutrition.
      Citation: Food and Nutrition Bulletin
      PubDate: 2022-10-12T05:09:12Z
      DOI: 10.1177/03795721221123699
       
  • Training to Build Nutrition Capacity in the Nigerian Agricultural Sector:
           Initial Assessment and Future Directions

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      Authors: Olutayo Adeyemi, Olapeju Phorbee, Folake Samuel, Rasaki Sanusi, Wasiu Afolabi, Namukolo Covic, Adeyinka Onabolu, Victor Ajieroh
      Abstract: Food and Nutrition Bulletin, Ahead of Print.
      Background:In response to calls to increase nutrition-sensitive agriculture (NSA), the Federal Ministry of Agriculture and Rural Development developed the Nigeria Agricultural Sector Food Security and Nutrition Strategy 2016-2025 (AFSNS). Capacity development activities to facilitate the AFSNS implementation subsequently commenced.Objective:This study analyzed the processes and outputs of initial capacity development efforts, examined findings from the analysis using existing literature, and identified critical next steps for nutrition capacity development in the Nigerian agriculture sector.Methods:The study reviewed documents including a proposal for nutrition training of agriculture sector actors, reports of meetings held among 6 resource persons who designed and/or delivered training, training reports, participants’ pre- and posttraining assessments, and participants’ training evaluation. Interviews were conducted with 2 resource persons involved in training design and delivery. Documents and interviews were coded and analyzed to identify emergent themes. Participants’ pre- and posttests results were compared using paired t test in Stata 12.0.Results:Knowledge and practice gaps were more extensive than had been anticipated. Training had some but limited effects on knowledge scores at the federal level. Modules addressing implementation practices had to be scaled down for participants to keep up with the learning pace. Existing literature indicates that such training would have been better planned as part of a broader sectoral nutrition workforce strategy, to facilitate greater tailoring of training to participants’ job roles.Conclusion:Effective AFSNS implementation requires developing and operationalizing a comprehensive short-, medium- and long-term Agriculture Sector Nutrition Capacity Development Strategy for Nigeria.
      Citation: Food and Nutrition Bulletin
      PubDate: 2022-09-21T04:48:56Z
      DOI: 10.1177/03795721221123870
       
  • Stakeholders, Relationships, and Coordination: 2015 Baseline Study of
           Needed Enablers for Bridging Agriculture-Nutrition Gaps in Nigeria

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      Authors: Olutayo Adeyemi, Victor Ajieroh, Larry Umunna, Francis Aminu, Adeyinka Onabolu
      Abstract: Food and Nutrition Bulletin, Ahead of Print.
      Background:Renewed efforts by the Nigerian government to address malnutrition have led to nutrition actions by several sectors, including the agriculture sector. However, the success of these actions depends on the characteristics of the stakeholders involved, including their relationships and coordination.Objective:This article reports a 2015 study of nutrition-sensitive agricultural stakeholders in Nigeria that assessed what the stakeholders do, where they work and how they are organized to improve nutrition. The study provides a baseline for assessing progress and measuring stakeholder and coordination changes in the Nigerian nutrition-sensitive agriculture landscape.Methods:Semi-structured interviews (n = 17) and focus group discussions (n = 2) were held with federal, state, and local government level stakeholders; reviews of stakeholder program documents were also conducted.Results:The study identified 7 groups of nutrition-sensitive agriculture stakeholders and several coordination challenges. Political leadership, advocacy and provision of material and human resource support by nongovernmental organizations, and donor interest and funding have been vital for mobilizing nutrition-sensitive agriculture. Still, although stakeholders frequently highlighted that nutrition was an important consideration in their interventions, nutrition goals and activities and/or indicators to measure outcomes were not regularly communicated. Also, while coordination mechanisms existed, there appeared to be minimal actual cross-sectoral partnerships because of inadequate trust, competition, and conflicts over institutional turf and mandates.Conclusions:Needed enablers for improving nutrition-sensitive agriculture in Nigeria included improved stakeholder nutrition literacy, as well as enhanced stakeholder engagement facilitated by role definition, clarification, and consensus. Exploring different approaches to coordination may also be necessary.
      Citation: Food and Nutrition Bulletin
      PubDate: 2022-09-01T07:00:45Z
      DOI: 10.1177/03795721221119249
       
  • Transforming Nigerian Food Systems Through Their Backbones: Lessons From a
           Decade of Staple Crop Biofortification Programing

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      Authors: Ekin Birol, Jennifer Foley, Caitlin Herrington, Rewa Misra, Bho Mudyahoto, Wolfgang Pfeiffer, Michael Tedla Diressie, Paul Ilona
      Abstract: Food and Nutrition Bulletin, Ahead of Print.
      This article presents the evolution of the biofortification program in Nigeria over the last decade and the role of interdisciplinary research in informing cost-effective, efficient, and inclusive development; implementation; and scaling of this program. Launched in 2011 to improve Nigeria’s food systems to deliver accessible and affordable nutrients through commonly consumed staples, the Nigeria biofortification program was implemented through an effective partnership between the CGIAR and public, private, and civil society sectors at federal, state, and local levels. By the end of 2021, several biofortified varieties of Nigeria’s 2 main staples, namely cassava and maize, were officially released for production by smallholders, with several biofortified varieties of other key staples (including pearl millet, rice, and sorghum) either under testing or in the release pipeline. In 2021, the program was estimated to benefit 13 million Nigerians consuming biofortified cassava and maize varieties. The evidence on the nutritional impact, consumer and farmer acceptance, and cost-effective scalability of biofortified crops documented by the program resulted in the integration of biofortified crops in several key national public policies and social protection programs; private seed and food company products/investments, as well as in humanitarian aid.
      Citation: Food and Nutrition Bulletin
      PubDate: 2022-08-26T05:20:26Z
      DOI: 10.1177/03795721221117361
       
 
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