India has the largest number of undernourished people globally including a 40 percent stunting rate in many states. Efforts addressing undernutrition in developing countries have predominantly focused on boosting production and consumption of nutritious foods by farm households. However, it is increasingly recognised that a majority of the poor derive some or all of their food through markets. This requires that attention is given to the functioning of the agri-food value chains through which food is produced, processed, stored and distributed, and how this can be improved.
A review conducted by the Leveraging Agriculture for Nutrition in South Asia (LANSA) research programme investigates the interventions along agri-food value chains aimed at enhancing the availability, affordability, acceptability and consumption of nutritious foods by the poor in India. The aim is to identify the most effective strategies for ensuring that nutritious foods are available for and consumed by poor households.
The study provides a review of 40 existing value chain-based interventions in India. These studies were selected using three criteria (that the intervention increases the consumption of nutrient-dense food, that the intervention uses value chains involving the private, public and not-for-profit sectors to reach the target population and that the intervention is beyond the experimental phase). The review classifies interventions into three broad categories: interventions focused on foods that are naturally nutrient-dense (vegetables, pulses, animal and dairy products); interventions that focused on enhancing nutritional intake by improving access to fortified foods, and food distribution programmes that incorporate foods in either of the preceding categories.
The review found that a large number of interventions (20 out of 40) concentrated in the naturally nutrient-dense category in comparison to the other two categories (foods of increased nutritional value (11 out of 40) and food distribution (9 out of 40)). Regarding the nutrient dense category, most of the interventions were found to be limited to the farm gate. Examples include a number of dairy interventions primarily focused on the sustainable livelihood of smallholder farmers. Other interventions focused on addressing the losses farmers experience due to lack of adequate storage and processing facilities. For instance, an intervention led by Adani Fresh in Himachal Pradesh focused on improving the storage quality of apples which significantly reduced the post-harvest losses of farmers. Third, there are numerous interventions (led by NGOs and research organizations) that focus on increasing the consumption of millets. Overall, the study highlights that these interventions that are focused on improving the production of nutrient-dense foods are important for addressing undernutrition but the review argues that innovations and policy measures are needed in the value chain to ensure that these products are available beyond the farm gate.
Regarding foods of added nutritional value, the study highlights that the value chain interventions can be split into two broad categories: the bio-fortification of crop varieties at the breeding stage (such as iron-fortified pearl millet and zinc-fortified rice), or post-farm gate by adding micronutrients and minerals to foods (such as iron-fortified flour). The review highlights that most of the bio-fortification interventions are government or international donor initiatives (such as HarvestPlus). Trials of bio-fortification have shown positive impacts on nutrition but implementation of these varieties (notably rice, wheat and millets) are still at an early phase and are yet to be introduced at scale. As such, most interventions focus on food fortification and are mainly led by the private and international sectors. Interventions in this category have generally found improvement in nutritional outcomes. For instance, a study in Madhya Pradesh found a 4 percent decrease in anaemia among the population due to the fortification of flour. The review further discusses that regulatory measures can go a long way in ensuring compliance with fortification, calling for further government action in promoting fortified foods.
Regarding food distribution interventions, the review highlights that there are both state and central government schemes. The three major food distribution interventions covered are the Mid-Day Meal Scheme, Supplementary Nutrition Programme under ICDS and the PDS which are operational across all states of India. The studies reviewed indicate that these programs have significant beneficial nutritional outcomes. For instance, a study, which focused on the dietary impact of the Mid-day Meal Scheme, found that during the course of one year, for a cost of $0.03 per day per child spent on school meals, protein deficiency was completely eliminated, calorie deficiency reduced by 30 percent, and iron deficiency by 10 percent in children that were covered by the scheme as compared to children who were not covered by the scheme. The study used a randomized control trial which compared children that were covered by the Mid-day Meal Scheme and those that were not. It was conducted in January and February 2004, over a year after implementation of the scheme, and covered children from 615 households in 74 primary schools in Madhya Pradesh. However, the review notes that India’s continuing high rates of undernutrition illustrate leakages in the various food distributions systems and issues regarding dietary diversity.
The main reflection out of the review is that relatively few interventions are focused directly on improving post-farm gate consumption for poor groups and that as malnutrition is a multi-sectorial problem it is likely to be improved by increased interventions that focus on nutrition post-farm gate.
By: Bas Paris