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Impacts of Agriculture on Nutrition: Nature of the Evidence and ...

Impacts of Agriculture on Nutrition: Nature of the Evidence and ...

a range

a range ong>ofong> nutritional outcomes, but this allowed for consideration ong>ofong> irrigation and cash croppingschemes, large ruminant husbandry, and mixed garden-small ruminant interventions. They appliedformal search protocols and conducted quality (validity) control based on used ong>ofong> counterfactuals,sample sizes appropriate to measuring intended differences in outcomes, and appropriate choice ong>ofong>outcome variables. They found “mixed results in terms ong>ofong> improving nutritional status in participatinghouseholds.”(Berti et al. 2004) That is, some interventions reported significant improvements, whileothers found no impact or even negative impacts. A lack ong>ofong> disaggregation ong>ofong> data, lack ong>ofong> statisticalpower (small sample sizes), and lack ong>ofong> a clear understanding ong>ofong> confounders prevented any overallconclusion to be reported.LeRoy and Frongillo (2007) took a different direction, choosing to narrow down the focus to the role ong>ofong>animal sourced protein in improving nutrition as generated by interventions promoting animalproduction. This systematic review generated 14 studies across a range ong>ofong> husbandry, small ruminant,aquaculture and/or BCC activities. Most ong>ofong> the studies reported positive impacts on productionassociated with an intervention, but only 4 evaluated nutrition outcomes directly. Those 4 reportedimprovements in various nutritional parameters (night blindness, serum retinol and ferritin levels,hemoglobin levels, and linear growth), but did not document statistical significance attributable to theintervention or in relation to counterfactuals. The authors concluded, as had Ruel (2001) and Berti etal. (2004), that studies available for review “suffered from important limitations in their design,evaluation and analysis.” This meant that while there were indications that increased production andconsumption ong>ofong> animal protein could be promoted through the kinds ong>ofong> interventions considered,conclusive evidence remained elusive.The World Bank (2007) compilation ong>ofong> lessons learned was not systematized (search methods andresults were no specified and conclusions drew heavily from the earlier reviews outlined above), but itincluded assessment ong>ofong> 52 studies that considered agricultural impacts on food expenditure, caloricintake and anthropometry. The over-riding conclusion was that interventions aimed at increasingproduction and productivity ong>ofong> staple foods showed impacts on child nutritional status that were“limited and mixed‟. Similarly, programmes focused on promoting animal source foods (many ong>ofong> whichhad been reviewed by LeRoy and Frongillo (2007) “showed mixed results‟, while home gardenactivities “failed to achieve significant impacts on nutritional outcomes‟.The Lancet series on maternal and child nutrition ong>ofong> 2008 (Bhutta et al. 2008), also included a review ong>ofong>interventions designed to improve nutrition under the rubric ong>ofong> dietary diversification strategies.Although most ong>ofong> the 29 studies considered demonstrated various benefits to producer households interms ong>ofong> increased food production and consumption, especially when combined with a nutritioneducation component, significant impacts on nutrition were weak (Haider and Bhutta 2008). As aresult, the Lancet review concluded that “although some promising multidisciplinary nutritioninterventions have been implemented, dietary diversification strategies have not been proven to affectnutritional status or micronutrient indicators on a large scale.” (Bhutta et al. 2008) As a result, dietdiversification strategies ong>ofong> the kinds considered were classified as an ‘optional’ intervention to beused in appropriate settings (when trying to improve nutrition), but without modeling the potentialeffects to be gained or specifying what settings are more ‘appropriate’ than others.

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