The Latin American and Caribbean region (LAC) has been actively participating in the international development Agenda 2030, focused on food and nutritional security. In addition, the region has established its own more demanding objectives through several regional initiatives. Although food availability in the LAC region is sufficient to meet the energy needs of its population, undernourishment still affects 5.5% of the regional population. Stunting and overweight affects 11.3 % and 7.2 % of children under five in the region respectively (FAO, 2017). Adult overweight and obesity maintain an upward worrying trend in the region, with overweight affecting 58% of the population and obesity 23% (ibid.).
Besides this, wide gamma of nutrition-related and nutrition-sensitive public programmes, the paper considers that in the region less emphasis is placed on holistic programmes and interventions which can empower vulnerable communities and make them active participants in their development and in the achievement of food and nutritional security. Departing from the position that self-resilient and healthy rural communities can provide food not only for themselves but also for urban communities, this article identifies an integral model to reduce hidden hunger in rural areas amongst small-scale family farmers.
A community-based nutrition-sensitive model for rural development is presented in Figure 1. The four main strategies of the model place education as a core and underlying strategy (see below).
The Community-based Nutrition Strategy Model
Figure 1: Community-based nutrition strategy model (Own elaboration)
A baseline assessment of the target community/communities is required before the four main strategies are implemented. This includes an assessment of the malnutrition indicators of the target population in order to understand the underlying causes; an agro-ecological assessment (soil, water, climate, rainfall etc.); an assessment of basic socio-economic indicators such as assets and sources of basic income; previous observations in order to understand the family decision-making and gendered division of labour within the family; an assessment of hygiene and sanitation conditions; as well as an assessment of the organisational capacity (social capital) within the community.
1. Diversification of agricultural production
This strategy is directly related to the garden food production at the small-scale family level, such as vegetables, herbs, fruits, some pulses etc. This represents the basic form of interventions, in that it takes into account nutrition and sanitation education for the beneficiaries by local trainers. This may include workshops on possible types of vegetables or spices that can successfully be grown in the region, accompanied by training on its preparation by using traditional cooking techniques, training in construction of energy-saving cooking stoves, pit latrines etc. The expected direct outcomes are diversified food production for self-consumption and dietary diversity.
2. Sustainable farm management
This strategy is related to the garden and field food production at the small-scale family level. The beneficiaries are accompanied by local facilitators trained in agro-ecological farming techniques based on improved local and indigenous farming techniques. In addition, there is training for the construction of eco-technologies with local materials and adapted to local conditions, such as rainwater harvest cisterns, biogas plants, suitable poultry houses, or even water storage infrastructure at the community level. The direct outcome would be appropriation of sustainable farming practices. This strategy may contemplate finance education (savings and microcredit) since small production surpluses are contemplated in the longer-term.
3. Identify and support local producers’ organisations
This strategy includes beneficiaries which already produce surplus for market sale. The model contemplates support for the establishment of local committees of surplus producers for different types of products which can grow into farm cooperatives in the long-term. The assessment of the level of social capital in the target community/communities is crucial for this strategy since it implies collaboration and a certain level of trust among committee members/cooperatives. If the latter is absent, the intervention should not be proposed for the time being. The model contemplates the creation of platforms where committees and cooperatives can come to an agreement and collectively buy cheaper inputs for their production; connect to governmental agencies, local schools and hospitals for public acquisition of their products; furthermore, it takes into account building the organisational and financial capacity of the committees and cooperatives, such as group lending or saving.
4. Support the establishment of agro-industry
The final strategy is long-term and goes beyond functional farm cooperatives. It considers a joint venture between several farm cooperatives which represent a chain/s of production of one or several products. The model contemplates the adoption of certification schemes so that the products can reach national and international markets, and with that, the creation of employment for locals and an additional source of income for the community/communities.
Finally, the most important phase of every intervention, in addition to the baseline assessment, is continuous monitoring and evaluation. The model predicts short-term, mid-term and long-term evaluations of its outcomes. Short-term (6-monthly and yearly) evaluations should be regularly implemented on health and nutritional outcomes, as well as on increases of agricultural production for certain food products. Mid-term (2-3 yearly) evaluations should be implemented around the creation of additional income for the beneficiaries, soil improvement, increase in agricultural production, etc. Long-term (5-10 yearly) evaluations should be implemented on the general economic development of the targeted community/communities considering improvements in human, physical, social and natural capital.
5. Nutrition education
The common source of hidden hunger has been considered a poor diet. Many diets based mostly on staple crops (maize, wheat, rice, and cassava), provide a large share of energy but relatively low amounts of essential vitamins and minerals, which frequently results in hidden hunger (Kennedy et al. 2002). People suffering from hidden hunger may not know the importance of a balanced, nutritious diet. Nutrition education can empower people and create an enabling environment for making informed choices about food products (Contento 2016). Some good nutritional education practices are:
- Women’s community groups learning about the vicious cycle of malnutrition where malnourished mothers give birth to underweight children who are likely to have stunted growth rates and face a greater risk of delivering low birth-weight babies themselves.
- Behavior-change communication which aims to improve women’s, infants’, and young children’s utilization of health services, clean water, good sanitation, and hygiene to protect themselves from diseases which interfere with nutrient absorption;
- Promotion of the benefits of exclusive breastfeeding up to 6 months followed by breastfeeding up to 24 months with adequate and sufficient complementary food as an economic and sustainable way to prevent hidden hunger in children (Scherbaum 2016).
Primary results of larger studies have shown that if nutrition education is properly linked to nutrition-sensitive agricultural interventions, behavior change is possible and may consequently improve nutritional status (Olney et al. 2015; Kuchenbecker et al. 2017; Reinbott et al. 2016; Chiutsi-Phiri et al. 2017; Girard et al. 2017).
Strengthening food and nutrition security in rural areas in LAC require sustainable development policies and interventions that: empower local communities, build on the capacities, needs, and potential of the local people, support integrated, cross-sectoral development policies and actions including nutrition education. The proposed Community-based Nutrition-strategy model is an attempt to combine such interventions at the community level. It has the primary objective of reaching dietary diversity for all households and goes beyond this by considering income-generating activities as well. The model implies that nutrition strategies should be part of integrated rural development strategies in order to achieve resilient and healthy communities.
Note: This work is co-authored and a shortened version of a scientific article in the process of being published.
Acción Social (2010) PROGRAMA FAMILIAS EN ACCIÓN ASPECTOS GENERALES [PowerPoint slides] Agencia Presidencial para la Acción Social y Cooperación Internacional. Accessed from: https://www.mineducacion.gov.co/1759/articles-217596_archivo_pdf_familiasenaccion.pdf [29.07.2017]
FAO (2017) 2016 Panorama de la seguridad alimentaria y nutricional Sistemas alimentarios sostenibles para poner fin al hambre y la malnutrición. La Organización de las Naciones Unidas para la Alimentación y la Agricultura y la Organización Panamericana de la Salud. Santiago, 2017.
Gob.mx (n.d.) Programa de Inclusión Social PROSPERA ¿Qué hacemos? [WWW] Accessed from: https://www.gob.mx/prospera/que-hacemos [29.07.2017]
Chiutsi-Phiri G, Heil E, Kalimbira AA, et al. (2017) Reduced Morbidity Motivated Adoption of Infant and Young Child Feeding Practices after Nutrition Education Intervention in Rural Malawi. Ecology of Food and Nutrition, 0(0), pp.1–20.
Contento IR (2016) Nutrition education: linking research, theory, and practice, Third edition. Burlington, Massachusetts: Jones & Bartlett Learning.
Girard AW, Grant F, Watkinson M, et al. (2017) Promotion of Orange-Fleshed Sweet Potato Increased Vitamin A Intakes and Reduced the Odds of Low Retinol-Binding Protein among Postpartum Kenyan Women. The Journal of Nutrition, 147(5), pp.955–963.
Kennedy G, Nantal G & Shetty P (2002) The scourge of “hidden hunger”: global dimensions of micronutrient deficiencies. Food, nutrition and agriculture, 32, pp.8–16.
Kuchenbecker J, Reinbott A, Mtimuni B, et al. (2017) Nutrition education improves dietary diversity of children 6-23 months at community-level: Results from a cluster randomized controlled trial in Malawi. PloS One, 12(4), p.e0175216.
Monteiro C (2010) The big issue is ultra-processing. World Nutrition, (November 1,6), pp.237–259.
Olney DK, Pedehombga A, Ruel MT, et al. (2015) A 2-Year Integrated Agriculture and Nutrition and Health Behavior Change Communication Program Targeted to Women in Burkina Faso Reduces Anemia, Wasting, and Diarrhea in Children 3-12.9 Months of Age at Baseline: A Cluster-Randomized Controlled Trial. Journal of Nutrition, 145(6), pp.1317–1324.
Reinbott A, Schelling A, Kuchenbecker J, et al. (2016) Nutrition education linked to agricultural interventions improved child dietary diversity in rural Cambodia. The British Journal of Nutrition, pp.1–12.
Scherbaum V & Srour ML (2016) The Role of Breastfeeding in the Prevention of Childhood Malnutrition. World Review of Nutrition and Dietetics, 115, pp.82–97.