The Egg Hub Model: A Sustainable and Replicable Approach to Address Food Security and Improve Livelihoods.

Background: Despite progress in improving living standards and reduced poverty, food insecurity and malnutrition remain a significant issue worldwide. Childhood is a critical time for the intake of protein to support physical and cognitive growth, including animal-source foods like eggs which can effectively mitigate stunting in low- and middle-income countries. In Malawi, high malnutrition rates among women and children represent a significant public health challenge, but high-quality sources such as eggs remain costly, scarce, and rarely consumed by children in Malawi. The Egg Hub model, identified and piloted by local agri-food entrepreneurs and the Sight and Life Foundation in Malawi, tackles the obstacles faced by smallholder farmers, working to increase egg production, enhance availability, and improve consumption within rural communities by supporting small-scale farmers transition from unsustainable and unproductive backyard rearing to small-scale farm through access to high-quality inputs, training, loans, and a guaranteed market for their eggs. Objectives: This paper provides a detailed account of the implementation of the pilot of the Egg Hub Model in Malawi including the demand creation process, the impact of the model on producers, consumers, and operators, and the social, economic, and environmental sustainability aspects of the model. Methods: Qualitative and quantitative surveys (n = 217 consumers) were used for demand creation and qualitative surveys were used with 15 retailers to determine egg sales. With 16 farmers and the egg hub operator, business metrics, including profits and loss records, were analyzed. Results: The pilot of the Egg Hub model in Malawi supported 85 farmers to triple their egg production, allowing their communities to purchase eggs at prices reduced by 40%, benefiting an estimated number of 180,000 rural poor. Egg consumption among the target population increased from an average of 2 to 9 eggs/month and led to reduced egg wastage and better biosecurity, reducing the risk of children's exposure to chicken feces and infections. The achievements of this Egg Hub in Malawi allowed the model to be replicated in Ethiopia, Peru, and Brazil, producing 40 million eggs annually and benefiting more than half a million consumers. Conclusion: The Egg Hub model is a comprehensive and scalable solution to increase egg supply, address malnutrition and food insecurity, and improve livelihoods. The advantages include centralizing key activities through a community-centered approach, empowering female farmers, increasing access to a highly nutritious food, and economic benefits for farmers and their communities.

Knowledge, Attitudes and Practices of Pregnant Women and Healthcare Providers in Bangladesh regarding Multivitamin Supplements during Pregnancy.

Micronutrient deficiencies are widespread among pregnant women in low- and middle-income countries (LMIC) and lead to potentially adverse effects for mother and baby. In Bangladesh, maternal malnutrition remains a severe problem, with high rates of anemia (49.6% of pregnant women and 47.8% of lactating women are anemic) and other nutritional deficiencies. A Knowledge, Attitudes, and Practices (KAP) study was conducted to assess Bangladeshi pregnant women's perceptions and related behaviors, as well as awareness and knowledge among pharmacists and healthcare professionals concerning prenatal multivitamin supplements. This was done in both rural and urban areas across Bangladesh. A total of 732 quantitative interviews were conducted (330 with providers and 402 with pregnant women, with an equal split between urban and rural areas for both sets of audiences; 200 women were users of prenatal multivitamin supplements, while 202 women were aware non-users). The study identified a few findings that can guide further research or market-based interventions to reduce micronutrient deficiencies. These include most pregnant women not knowing the right time to start multivitamin supplements (56.0%, [n = 225], stating that a woman should start taking supplements 'after the first trimester'), not knowing their benefits, and how they help both the mother and baby-only 29.5% [n = 59] stated that they believed the supplements helped their baby to grow well). Further, barriers to taking the supplements include women believing a nutritious diet is a substitute (88.7% [n = 293]), and a perceived lack of support from other family members (21.8%, [n = 72]). This suggests that there is a need for further awareness-raising among all pregnant women, their family members, and providers.

Nutrition in City Ecosystems (NICE): Protocol of a multi-sectoral development project to improve food and nutrition security of secondary city populations in Bangladesh, Kenya and Rwanda.

Background: Secondary cities tend to be better linked with local food systems than primate cities, acting as important platforms to trade agricultural produce with rural surrounding. COVID-19, conflicts and climate change continue to expose inefficiencies in food systems and have further exacerbated malnutrition, calling for substantial food systems transformations. However, tackling current food systems' challenges requires new approaches to ensure food and nutrition security. Nutritious and agroecologically produced food offer the potential to transform food systems by improving diets and alleviating pressure on the environment, as well as by creating jobs and reducing poverty. This paper describes the design of a project by a Swiss public-private consortium to improve food and nutrition security and to reduce poverty in city ecosystems in six secondary cities in Bangladesh, Kenya and Rwanda through governance/policy and supply and demand side interventions. Methods: The Nutrition in City Ecosystems (NICE) project promotes well-balanced nutrition for city populations through interdisciplinary agricultural, food, and health sector collaborations along city-specific value chains. Adopting a transdiciplinary systems approach, the main interventions of NICE are (i) advocacy and policy dialogue, (ii) building of decentralized institutional capacity in multi-sectoral collaborations, (iii) support of data-driven planning, coordination and resource mobilization, (iv) anchoring of innovations and new approaches in city-level partnerships, (v) capacity building in the agricultural, retail, health and education sectors, as well as (vi) evidence generation from putting policies into practice at the local level. NICE is coordinated by in-country partners and local offices of the Swiss public-private consortium partners. Discussion: The NICE project seeks to contribute to urban food system resilience and enhanced sustainable nutrition for city populations by (A) strengthening urban governance structures involving key stakeholders including women and youth, (B) generating income for producers along the supply chain, (C) triggering change in producers' and consumers' behavior such that nutritious and agroecologically produced foods are both in demand as well as available and affordable in urban markets, and (D) allowing a scale up of successful approaches to other national and international cities and city networks.

Principles for Evidence-Based and Sustainable Food System Innovations for Healthier Diets.

Climate change, rapid urbanization, war, and economic recession are key drivers of the current food systems' disruption, which has been exacerbated by the COVID pandemic. Local, regional, and global food systems are unable to provide consumers with nutritious and affordable diets. Suboptimal diets exacerbate the triple burden of malnutrition, with micronutrient deficiencies affecting more than two billion people, two billion people suffering from overweight, and more than 140 million children who are stunted. The unaffordability of nutritious diets represents an obstacle for many, especially in low- and middle-income countries where healthy diets are five times more expensive than starchy staple diets. Food system transformations are urgently required to provide consumers with more affordable and nutritious diets that are capable of meeting social and environmental challenges. In this review, we underline the critical role of innovation within the food system transformation discourse. We aim to define principles for implementing evidence-based and long-term food system innovations that are economically, socially, and environmentally sustainable and, above all, aimed at improving diets and public health. We begin by defining and describing the role of innovation in the transformation of food systems and uncover the major barriers to implementing these innovations. Lastly, we explore case studies that demonstrate successful innovations for healthier diets.