Investigating market-based opportunities for the provision of nutritious and safe diets to prevent childhood stunting: a UKRI-GCRF action against stunting hub protocol paper.

BACKGROUND: Inadequate access to affordable, safe, desirable and convenient nutrient-dense food is one of the underlying causes of child stunting. While targeted nutrition-sensitive interventions (eg, backyard 'nutri-gardens') may increase dietary diversity within farming households, such interventions have limited scalability across the wider food system where markets remain underdeveloped. This research aims to develop and assess market-based interventions for key nutrient-dense foods to help improve the diets of women and children in the first 1000 days of life. METHODS: Data collection uses four parallel approaches in each of the three study countries (India, Indonesia and Senegal). (1) A novel food environment tool will be developed to characterise the accessibility and affordability of nutrient-dense foods in the study countries. The tool will be validated through pretesting using cognitive interviewing and piloting in purposively sampled households, 10 (cognitive interviewing) and 30 (piloting) households in each country; (2) stakeholder interviews (eg, with producers, intermediaries and retailers) will be conducted to map out nutrition-sensitive entry points of key value chains (eg, animal-sourced foods), before hotspots of potential food safety hazards will be identified from food samples collected along the chains; (3) the Optifood and Agrifood tools will be used to identify foods that can address food system nutrient gaps and engage key stakeholders to prioritise market interventions to improve nutrition outcomes. Optifood and Agrifood parameters will be informed by publicly available data, plus interviews and focus groups with value chain stakeholders; (4) informed by the previous three approaches and a campaign of participatory 'group model building', a novel system dynamics model will evaluate the impact of alternative market-based solutions on the availability and affordability of nutrient-dense foods over time. ETHICS AND DISSEMINATION: The study has received ethical approval in the United Kingdom, Senegal, Indonesia and India. Dissemination comprises peer-reviewed journals, international disciplinary conferences and multistakeholder dissemination workshops.

Transforming food systems with trees and forests.

The global food system is failing to deliver sufficient and nutritious food to all, while damaging the earth and unsustainably drawing down its resources. We argue that trees and forests are essential to solving these challenges. We outline the current contributions of trees and forests to the global food system and present recommendations to leverage these contributions as part of the efforts to reshape food systems to better support healthy diets and environmental sustainability. Trees and forests provide nutrient-rich foods, incomes for food security, ecosystem services for food production, and add resilience to food systems. At the same time, trees and forests protect biodiversity and mitigate climate change through carbon sequestration. We recommend four approaches to realise the full potential of trees and forests to contribute to healthy and sustainable food systems: scaling up current tree-based food production, reorientating some agricultural investments towards nutrient-dense food production, repurposing production incentives from support of calorie-rich but nutrient-poor foods to support nutrient-dense foods, and integrate nutrition objectives into forest conservation and restoration programmes. Trees and forests have important roles to play in the transformation of our food systems, but more needs to be done to ensure that these roles are realised.

Oil palm and gendered time use: A mixed-methods case study from West Kalimantan, Indonesia.

Measuring the social impact of oil palm requires the use of multiple metrics which capture different dimensions of well-being. To date, most studies have examined welfare outcomes at the household level, relying on a relatively narrow range of indicators. There is a need for a more diverse range of metrics to measure the social impacts of oil palm as well as more explicit accounting for study context and gendered effects. Here we demonstrate the utility of specialised time use methods used in combination with qualitative research to understand intra-household labour dynamics associated with oil palm adoption. We use a mixed-methods approach to investigate the role of smallholder oil palm plasma schemes on men and women's time use in Kapuas Hulu District, West Kalimantan. Time allocation is an important determinant of well-being as well as maternal and child nutrition and an indicator of women's empowerment and gender equality. We integrate the results from a fractional multinomial logistic regression of data from 603 individuals with qualitative findings on the subjective experience of time allocation, as well as, the causes, consequences and coping strategies to manage trade-offs in time allocation. We find that relative to non-oil-palm adopting swidden farmers, participation in oil palm plasma schemes is associated with more time spent in productive labour for both men and women, driven by off-farm labour on oil palm plantations. For women, increased time comes at the cost of reduced time spent in rest, leisure and sleep. Increased time spent in off-farm labour drives households to adapt agricultural production methods, changing cash crop production as well as accelerating swidden transitions. These changes alter gender dynamics and responsibilities within the household. Our results suggest that changes in time allocation may have significant consequences for women's well-being and gender equity. Women in the oil palm site experienced greater stress over time scarcity and employed coping strategies more frequently. Our findings indicate that time allocation could be used as an indicator of the effects of oil palm expansion and adoption on well-being and that potential effects of time scarcity on well-being, gender equity, and maternal and child nutrition should be considered by policy makers when making land use decisions.

Perspective: Food Environment Research Priorities for Africa-Lessons from the Africa Food Environment Research Network.

Over the last 2 decades, many African countries have undergone dietary and nutrition transitions fueled by globalization, rapid urbanization, and development. These changes have altered African food environments and, subsequently, dietary behaviors, including food acquisition and consumption. Dietary patterns associated with the nutrition transition have contributed to Africa's complex burden of malnutrition-obesity and other diet-related noncommunicable diseases (DR-NCDs)-along with persistent food insecurity and undernutrition. Available evidence links unhealthy or obesogenic food environments (including those that market and offer energy-dense, nutrient-poor foods and beverages) with suboptimal diets and associated adverse health outcomes. Elsewhere, governments have responded with policies to improve food environments. However, in Africa, the necessary research and policy action have received insufficient attention. Contextual evidence to motivate, enable, and create supportive food environments in Africa for better population health is urgently needed. In November 2020, the Measurement, Evaluation, Accountability, and Leadership Support for Noncommunicable Diseases Prevention Project (MEALS4NCDs) convened the first Africa Food Environment Research Network Meeting (FERN2020). This 3-d virtual meeting brought researchers from around the world to deliberate on future directions and research priorities related to improving food environments and nutrition across the African continent. The stakeholders shared experiences, best practices, challenges, and opportunities for improving the healthfulness of food environments and related policies in low- and middle-income countries. In this article, we summarize the proceedings and research priorities identified in the meeting to advance the food environment research agenda in Africa, and thus contribute to the promotion of healthier food environments to prevent DR-NCDs, and other forms of malnutrition.

Forests, Trees, and Micronutrient-Rich Food Consumption in Indonesia.

Micronutrient deficiency remains a serious problem in Indonesia with approximately 100 million people, or 40% of the population, suffering from one or more micronutrient deficiencies. In rural areas with poor market access, forests and trees may provide an essential source of nutritious food. This is especially important to understand at a time when forests and other tree-based systems in Indonesia are being lost at unprecedented rates. We use food consumption data from the 2003 Indonesia Demographic Health Survey for children between the ages of one and five years and data on vegetation cover from the Indonesian Ministry of Forestry to examine whether there is a relationship between different tree-dominated land classes and consumption of micronutrient-rich foods across the archipelago. We run our models on the aggregate sample which includes over 3000 observations from 25 provinces across Indonesia as well as on sub-samples from different provinces chosen to represent the different land classes. The results show that different tree-dominated land classes were associated with the dietary quality of people living within them in the provinces where they were dominant. Areas of swidden/agroforestry, natural forest, timber and agricultural tree crop plantations were all associated with more frequent consumption of food groups rich in micronutrients in the areas where these were important land classes. The swidden/agroforestry land class was the landscape associated with more frequent consumption of the largest number of micronutrient rich food groups. Further research needs to be done to establish what the mechanisms are that underlie these associations. Swidden cultivation in is often viewed as a backward practice that is an impediment to food security in Indonesia and destructive of the environment. If further research corroborates that swidden farming actually results in better nutrition than the practices that replace it, Indonesian policy makers may need to reconsider their views on this land use.

La Bolsa Escuela en Brasil: Lecciones Para el Programa de Transferencia de Dinero Condicionado Alrededor del Mundo / The Brazilian Bolsa Escola: lessons for conditional cash transfer schemes around the world (june 2008)

The Bolsa Escola (‘school stipend’) and its successor the Bolsa Familia (‘family stipend’) schemes have formed a crucial and successful part of Brazil’s welfare program. Bolsa Escola provided aid to Brazil’s poorest families on the condition that their children attended school, and Bolsa Familia has extended this idea, giving aid on the condition that children both attend school and receive vaccinations. Bolsa Familia is currently the largest Conditional Cash Transfer Program (CCTP) in the world, costing roughly 0.5 of Brazilian GDP and helping around 11.2 million families (around 44 million Brazilians, constituting roughly one fifth of the population). Multilateral institutions have praised the schemes, and they are setting a leading example to other developing nations. In 2005, Paul Wolfowitz (former president of the World Bank) said, ‘Bolsa Familia has already become a highly praised model of effective social policy. Countries around the world are drawing lessons from Brazil’s experience and are trying to produce the same results for their own people’.This paper will ask whether such attempts to implement schemes like Bolsa Escola in other countries are likely to have sustainable success. In order to answer this question, we the authors will take broadly two approaches:Firstly, we will focus specifically on Bolsa Escola in Brazil. We will ask which have been the most successful, and which have been the most problematic, parts of Bolsa Escola (and Bolsa Familia; although emphasis will be placed upon Bolsa Escola, since we will predominantly focus upon the role of CCTPs in the educational sector). In light of this analysis, we shall consider whether a Bolsa Escola-style scheme could feasibly be implemented in other countries; and if so, which particular aspects of the Bolsa Escola scheme should be emulated and which should be adapted or avoided.Secondly, we shall examine how other countries’ actual attempts to implement a Bolsa Escola-type scheme have fared…