What about nutrition security?

Food Security09 Jan 2014Klaas de Vries

In regions that produce cash crops like tea, cocoa and coffee, nutrition security is rarely on the agenda of decisionmakers. However, nutrition is key to triggering a positive effect on the health of farmers and plantation workers, and on economic development and productivity.

Nutrition security is different from food security as it is about a community’s access to essential nutrients, not just calories. Zinc, selenium, iron and all kind of vitamins should be present in human diets. A growing export market for cash crops is increasingly threatening such variety in diets for local farmers and plantation workers in developing countries. Undernutrition in regions that primarily produce cash crops is among the worst in most developing countries, resulting in poor productivity levels, low school performance of children and a poor health situation for farming families. (Read box 1.)

Problems of undernutrition are intergenerational; when undernutrition is not adequately addressed, children will grow into undernourished adults and their children will experience the same problems. This affects not only families, but also local economic development. The World Bank estimates that undernutrition causes losses in GDP of 2 to 3%.

Promoting nutrition security offers several opportunities to stimulate economic and pro-poor development in cost-efficient ways. This potential of nutrition security is stressed by the World Bank, the United Nations, the African Union, the World Economic Forum and in the Copenhagen Consensus, a reoccurring meeting of some of the world’s most prominent economists. This recognition has attracted the attention of policymakers in governments all over the world and dramatically increased funding for programmes that focus on nutrition security.

Undernutrition in major coffee production areas

How much are the regions where cocoa, tea and coffee are sourced suffering from poor nutrition standards? Two important nutrition indicators are stunting and child mortality. Stunting is the most frequently used indicator for monitoring undernutrition by measuring children under five years old and is a visible sign of chronic malnutrition.* When children are stunted, it means they are too short for their age as a result of a poor diet and poor health circumstances.

Stunting levels of 25% or higher are alarming and were encountered in 18 out of 21 coffee producing regions analyzed in India, Vietnam, Indonesia, Kenya and Ethiopia. Stunting levels of that magnitude can only be addressed through interventions that are specifically aimed at reducing undernutrition. In all countries but Vietnam, there are coffee-producing regions in which stunting levels top 40%.

Undernutrition also affects the immune system and decreases the defence of the human body to infectious diseases, making it an underlying cause of terminal infectious diseases. As many as 53% of children’s deaths can be attributed to being underweight, making child mortality an important indicator in measuring undernutrition.** Child mortality refers to death of infants and children under the age of five. These rates are particularly high in Africa. In cocoa-producing regions in Ivory Coast, for example, 11% to 17% of children do not live to reach the age of five.

Issues like stunting and child mortality can only be addressed during the first 1,000 days of pregnancy and in the first two years after birth. Furthermore, like physical consequences, if undernutrition is not addressed within the first two years after birth, it leads to approximately 15% less cognitive capacity.*** After two years, the damage done can no longer be ‘repaired’. This is why interventions to stimulate nutrition intake always need to take into account young children and especially pregnant women.

Sources: * WHO reference median: Percentage of children stunted is the percentage of children under five years who have a height-for-age below minus two standard deviations of the National Center for Health Statistics; ** Black, R.E., Morris, S.S. and Bryce, J. (2003) Where and why are 10 million children dying every year?; *** Grantham-McGregor, Fernald, and Sethurahman (1999).

Better for health and productivity

How can nutrition security be stimulated in practice? There are many opportunities: supporting fruit and vegetable value chains; fortifying oil with micronutrients; creating awareness on the importance of eating healthy among consumers, etc. There is, however, another option: making cash crops nutrition-sensitive.

Cash crops, like tea, coffee and cocoa, are sourced from developing countries and emerging economies and exported for consumption in high-income countries. By themselves, these cash crops and the related value chains have no direct effect on food or nutrition security, they only create an income that is very low for most of the farmers and plantation workers. An effect on food and nutrition security can however be created by diversifying the crops that farmers and plantation workers grow. Diversification means engaging in the cultivation of fruits and vegetables, but introducing chickens, ducks or fish can also make a difference. This can be done on and around land where the cash crops are grown, as well as in home gardens. By introducing nutritious cash crops, they become so-called ‘nutrition-sensitive cash crops’.

One of the main reasons that nutrition-sensitive value chains are a remarkable window of opportunity relative to other interventions in food and nutrition security is that there are resources available within cash crop value chains through the involvement of large multinational companies. When these resources are partly invested in stimulating the nutrition security of farmers and plantation workers, the interests of different stakeholders in the chain can be served.

Research shows that a 1% increase in a person’s height leads to 1.4% increase in that person’s productivity, whereas a 1% reduction in iron status (anaemia) leads to 1% reduction in productivity.1 In other words, there is a case to be made that investing in the nutrition status of the people who are at the beginning of the cash crop value chains will contribute to the increase of labour productivity and thus benefit the multinational companies that profit from the growing worldwide demand for cocoa, tea and coffee.2 And, more importantly, it benefits the farmers and their families who are the main beneficiaries. They can achieve a healthier diet that, among other things, increases their incomes and reduces the prevalence of anaemia.

A recent study in Nairobi showed that knowledge of the importance of eating healthy is increasingly present.3 However, purchasing other goods (e.g. staple crops like maize, wheat and rice) takes priority over consuming fruits and vegetables.4 This is because putting any kind of food on the table regularly is the first priority for low-income households and consuming staple crops has been a long-time habit.5 Eating staple crops is embedded in many cultures, as is growing them. Yet farmers often grow staple crops without recognizing that markets for these commodities are regularly flooded, as the majority of farmers grow the same crops out of habit.6 This has a negative effect on farmer income, but also limits the availability, for example, of fruits and vegetables. Limited availability and perishability of fruits and vegetables also negatively affects the accessibility of these commodities due to, for instance, the resulting relatively high prices. By stimulating access to and increasing availability of micronutrient rich foods through diversification of value chains,’ the choice to eat healthier is promoted and also contributes to increased household income. Although this will not solve all the problems and constraints that farmers and their households face, the anticipated results would mean a major step forward in improving health and income.

When more varied cultivation of vegetables and fruits is promoted along with nutritious food consumption, the empowerment of women and nutrition education, the health and income of farmers and plantation workers and their families will improve, as will productivity. Results from programmes engaging in these activities are promising, as three recently published concept briefs by the Wageningen UR Centre for Development Innovation (CDI) and the Global Alliance for Improved Nutrition (GAIN) show.

Intervening in food systems

The first intervention concerns the implementation of value chain diversification for local products. This can be achieved by first increasing local production and preserving and marketing of affordable nutrient dense foods (vegetables, fruits, animal-based food products) that are to be sold in local markets. The second intervention is increased nutritious food consumption through food diversification. This is done by promoting household food production that includes a diversified basket of nutrient rich crops including fruits and vegetables, and animal-sourced foods such as eggs, chicken, fish and dairy products. The third intervention is strengthening the role of women. Ensuring women are empowered to make household decisions is key to stimulating the spending of resources on improving nutrition for all family members at all stages of the lifecycle. Finally, the fourth intervention focuses on nutrition education and raising awareness about good nutrition, health and sanitation practices through education programmes. Together, these four interventions constitute a combination that benefits both good agricultural practices and good nutritional practices.7

As plantations supply a significant amount of coffee and tea in the world, two additional interventions that particularly target plantation workers are proposed. Addressing nutrition problems while simultaneously increasing plantation workers’ productivity will have a significant impact on raising worldwide production to meet growing demand.8 The first intervention particularly aimed at plantations is encouraging ‘backyard farming’. Plantation workers may not have as much land of their own as smallholder farmers, but they do have small plots surrounding their own houses. Encouraging plantation workers to produce vegetables and raise chickens in their backyard for their own consumption can make a difference in improving the household diet. The second intervention is strengthening the link with public health services for access to micronutrient supplementation. Promoting programmes in which plantation workers are provided with micronutrient supplements (vitamin A, iron, zinc and iodine) have already sparked positive results at plantation level for workers’ health and productivity in countries like India.9 Plantation owners/management can cooperate with public health institutions.10

These interventions can be integrated in cash crop certification training programmes. Organized farmer groups are the entry point for promoting household production of nutrient-rich crops and developing viable local value chains for animal-sourced food products. Farmer groups can also play a role in empowering women to make nutritious choices that benefit their families. In addition, farmer groups provide a platform for linking nutrition education to agricultural production.11

Lessons learned

The benefits of diversification of farm produce are well known in the agricultural context in developing countries. It, for example, serves as a safety net as farmers depend less on income from one single commodity. A recent study in Malawi shows that both the ecosystem and farmers’ incomes benefit from crop diversification.12

The proposition to make cash crops nutrition-sensitive through diversification is, however, still relatively new. Not much evidence is yet available of successful implementation. However, first indications are that the approach can indeed work out positively. It builds on the benefits of crop diversification in general with the extra benefit of having a positive effect on the availability and access to nutritious commodities for farmer households and their surrounding communities.

In addition, the approach builds on earlier work of the promotion of backyard farming by Helen Keller International, including small livestock, which has proven successful in diversifying the dietary intake of household members in rural Bangladesh. In this project, results for women empowerment were particularly remarkable. Other positive results were increased incomes, an increase of vitamin A rich food sources and an improved food security situation for millions of people.13

Recent farm visits showed that diversification can be achieved with a minimal burden for the farmer. Trees to provide shade for cocoa trees can also produce fruits such as bananas and vegetables and can grow along fences or in otherwise unused corners of the farm. Moreover, chickens and ducks fertilize the farms and catch mosquitoes and insects that could potentially harm crops. This provides farmers with sources of micronutrients, extra income in the low season for cash crops and a safety net in case of bad harvests. Increased labour productivity on plantations due to micronutrient supplementation has already been mentioned. The key to success is making farmers and plantation workers aware of the benefits in combination with a low burden to implement changes.

Of course, farmers and plantation workers cannot implement the described solutions on their own. A variety of challenges that frustrate access to healthy commodities as well as agriculture in general need to be addressed. They include limited access to quality seeds for vegetables, poor technology, high post-harvest losses and weak market linkages. Governments, both local and national, are key to creating an environment in which these issues can be addressed and for maintaining a positive attitude towards, in this case, making the link between value chains and nutrition. For this reason, it is positive that governments in developing countries and emerging economies are increasingly acknowledging the importance of nutrition for the general development of their respective countries and regions. In the past few years, governments of countries like Ethiopia, Indonesia and Rwanda have committed to improving the nutrition status of their populations.

A call to action

On top of the above mentioned interventions, investments to produce better nutrition and achieve significant results in improved health and increased income are relatively low. This benevolent cost benefit ratio, in combination with an increase in productivity, makes it attractive for companies to get involved. The results of the analysis could encourage the cocoa, tea and coffee industries to invest in nutrition-sensitive cash crop chains in areas experiencing high rates of undernutrition to prevent future generations of undernourished cash crop producers and plantation workers with decreased productivity.


  1. Behrman and Rozenzweig (2001) / Hunt (2005).
  2. See Tropical Commodity Coalition’s Barometers for cocoa (2010), tea (2010) and coffee (2012).
  3. Van der Lans, C. et al (2012), Vegetable chains in Kenya; Production and consumption of vegetables in the Nairobi metropolis.
  4. Ofwana, A.C. (2013), An Analysis of the Patterns of Food Consumption among Households in Kenya, Journal of Emerging Trends in Economics and Management Sciences 4(1): 111-113.
  5. Kamau, M., et al. (2010). Consumption and Expenditures on Key Food Commodities and its Implications on Households’ Food Security: the case of Nairobi. Expanding Kenya’s Agricultural Competitiveness Market Access and Food Security: Research Findings and Policy Options. Nairobi, Kenya.
  6. Meridian Institute (2012), Science and innovation for African agriculture value chains: Maize value chain overview.
  7. Wiegers, E., Van Dorp, M., Torgerson, S. (2011), Improving nutrition through Agriculture.
  8. Panhuysen, S., Van Reenen, M. (2012) Coffee Barometer 2012, Tropical Commodity Coalition.
  9. Scholz B.D. et al., Anaemia is associated with reduced productivity of women workers even in less-physically-strenuous tasks, The British journal of nutrition 1997;77:47-57.
  10. Biswas, S. et al. (2005), Nutritional Survey of Tea Workers on Closed, Re-Opened, and Open Tea Plantations of the Dooars Region, West Bengal, India, p. 11.
  11. Van Dorp, M., Oenema, S., Verdonk, I. (2011), Agriculture – Nutrition Linkages.
  12. Snapp, S.S., et al. (2010), Biodiversity can support a greener revolution in Africa.
  13. Iannotti, L., Cunningham, K. and Ruel, M. (2009), Diversifying into healthy diets: Homestead food production in Bangladesh.