Under-nutrition remains a serious problem for many countries: nearly 870 million people in the world suffer from chronic undernourishment 1. In 2011, there were 165 million children with stunted growth worldwide, restricting their development of cognitive and physical abilities and making yet another generation less productive than they could potentially beÂ 2.
Not only do high under-nutrition rates have serious consequences for peopleâ€™s health, but analysis also shows a huge impact on adult work output and future earnings and therefore on countriesâ€™ economic development. Under-nutrition in children negatively affects the health and education sectors and labour force productivity. Reducing under-nutrition prevalence by 50% worldwide by 2025 would result in potential economic benefits worth billions of dollars.
The 2013 Lancet series confirms that the causes of under-nutrition are complex and cannot be solved by one sector alone, or by only implementing nutrition-specific interventions. An increase in food production – the aim of many agricultural initiatives – has not generated the desired outcome to reduce under-nutrition rates throughout the world. Increased income has similarly not lead to an increase in consumption of nutritious foods. Classic health interventions around nutrition education have also not had the desired results in terms of higher intake of nutritious foods. Under-nutrition should therefore be addressed by multiple sectors that operate from different angles. In line with this statement, this toolkit aims to build bridges between agriculture, nutrition, gender, and WASH sectors to use lessons learned and good practices in each of these fields to reach effective community-driven interventions to address under-nutrition.
The toolkit is primarily intended for use by field staff engaged in designing, planning and implementing nutrition-sensitive agriculture programmes. Although the toolkit was developed in the context of SNVâ€™s Asia Nutrition Project, covering Cambodia, Indonesia, Laos and Nepal, it has also been field-tested in similar projects in Uganda and Zambia. It is primarily designed for practitioners working with communities to help them understand community perceptions about nutrition while, at the same time, enabling communities to gain insight into under-nutrition related issues, and consequently explore opportunities to address these issues.
The added value of this toolkit is twofold:
- It illustrates an integrated approach to understand under-nutrition by linking different sectors – namely agriculture, nutrition, WASH – and looks at this process through a gender lens, which ensures that issues related to empowerment are studied and addressed â€“ from intra-household relations to broader socio-economic institutions.
- Qualitative methods simultaneously allow for the development of a common approach, and provide insights for developing context-specific interventions. The added value of this approach, therefore, is that methods can be applied and adapted to any context, but may lead to tailor-made interventions. Furthermore, qualitative methods can be applied in a participatory manner, where community members become active participants rather than objects of study â€“ i.e. the data collection process is not extractive, and community members are also involved in processing and analysing the data. This creates opportunities to build awareness, articulate demands and make plans with due consideration to locally appropriate solutions.
It is assumed that field staff using the toolkit are experienced facilitators, who believe in and are committed to participatory and gender equitable development. Facilitators using this toolkit need to be:
- perceived as approachable, unbiased and open to multiple perspectives;
- adept at working with diverse interest groups and provide space for everyone to share their perspectives;
- able to create conditions that allow communities to safely question their assumptions and examine their positions.
Prior experience in using participatory appraisal techniques, along with a basic understanding of nutritional issues in the community, will certainly be an asset while using this toolkit.
For further information about the background of this tool, and the perspective we have taken to develop the tools in this toolkit, please download the background paper to this tool:
1Â FAO, The State of Food Insecurity in the World, 2012.
2 Robert E Black, Harold Alderman, Zulfiqar A Bhutta, Stuart Gillespie, Lawrence Haddad, Susan Horton, Anna Lartey, Venkatesh Mannar, Marie Ruel, Cesar G Victora,Susan P Walker and Patrick Webb. Maternal and child nutrition: building momentum for impact. The Lancet Vol 382, 3 August 2013.