Milk-and-Dairy-Products-in-Human-Nutrition-FAO

280
Milk and dairy products in human nutrition
between increasing agricultural productivity and nutrition outcomes through the
agriculture sector’s contribution to national income and macroeconomic growth.
The report finds that most information about agricultural programming pertains to
changes in food availability and access, and very little to direct nutrition outcomes.
It concludes that in order to successfully influence nutrition, agricultural programmes
should more broadly address women’s empowerment, behavioural change
and health, and incorporate specific, targeted nutrition and health interventions.
Berti, Krasevec and FitzGerald (2004) also found that interventions with explicit
nutrition objectives and those including investments in human capital inputs (nutrition
education and gender) were more likely to show positive nutrition outcomes.
Tangka, Jabbar and Shapiro (2000), Leroy and Frongillo (2007) and Randolph et
al. (2007) also found that livestock interventions improve production and income,
but such programmes often do not have evaluations capable of demonstrating
impact on dietary intakes or nutritional status. Positive impacts on “intermediate”
outcomes (production, income and dietary intake) do indicate the potential for
improving nutrition through increasing livestock production and highlight the need
for better-designed evaluations and cost-benefit analyses (Leroy and Frongillo,
2007). Tangka, Jabbar and Shapiro (2000) cite several observational studies that
link ownership of milk-producing livestock to improved child nutrition outcomes.
These reviews did not conduct meta-analyses of original study data, and did not
assign comparative quality ratings, as was done in the present review.
Eleven dairy production and agriculture programmes were included in this
review, seven from sub-Saharan Africa and four from Asia. Six of the programmes
were not included in the five previous reviews described above: Ayalew, Gebriel
and Kassa (1999), Ayele and Peacock (2003), Hop (2003), Cunningham (2009),
Iannotti, Cunningham and Ruel (2009) and Sadler and Catley (2009). The typical
programme model involved only production strategies such as improved animal
feeding (e.g. zero-grazing) or the introduction of cross-breeds. Some programmes
introduced a gender component either through targeting women for dairy production
inputs or use of female extension workers. Others incorporated more explicitly
nutrition-related strategies in the dairy production inputs, including behaviour
change communication, promotion of milk consumption and, in the case of
Viet Nam, policy-level links between agriculture and nutrition goals. Finally, some
programmes applied a more comprehensive, multidisciplinary approach combining
agriculture, health and nutrition interventions.
7.3.1 Africa
In the Kilifi District of Kenya, a national dairy development project (DDP) initiated
in 1980 and supported by the Netherlands Government aimed at improving dairy
management practices primarily through the introduction of “zero-grazing” or keeping
cattle permanently in stables (Hoorweg, Leegwater and Veerman, 2000). A study
was conducted to assess whether households participating in the DDP since before
1985 (group 1; n=30) or dairy customers of DDP farmers (group 2; n=24) showed
higher levels of milk consumption and improved anthropometry of young children
(6–59 mo) compared with a control group of rural households (group 3; n=90). Using
a 24-hour dietary intake recall, the study showed that milk consumption was higher
in DDP farmer and customer groups than in control households and that height-for-