There are numerous good arguments for why it should be effective to integrate nutrition into EAS including:
- Established infrastructure. In some countries, the EAS delivery system is already in place and it is just a of ‘topping-up’ their portfolio with simple nutrition activities and messages.
- Reach. Existing networks of extension agents already reach many people, and thus there is no need to tap into or seek new clientele. Extension agents have direct and sometimes extensive links to farming communities in rural and remote areas. These links are founded upon well-established structures and systems that cover most farming households.
- Community trust. Extension agents maintain regular contact and have established relationships with the people and the communities in which they work. It is much easier to introduce nutrition issues into communities with preexisting relationships built on trust.
- Cultural awareness. Extension agents are often aware of the local social norms, cultures, and belief systems that accompany and contextualise food. Agents frequently hail from the region where they work and therefore have intimate knowledge and understanding of the local context.
- Empathy and understanding. Because of their familiarity with the conditions and context under which the farmers work and associated limitations and opportunities, extension agents are more able to demonstrate empathy with the farmers. This is particularly true with regard to questions of food production and access. Equipped with knowledge of the local food production system, access to markets, and the nutrition status of households, extension agents have a clearer understanding of how to mitigate the constraints faced by farmers.
- More knowledge. We now know more on what to do and the eight principles for integrating nutrition into agriculture and rural development serve as a guide for ensuring EAS have a strong footing in the integration of nutrition into their own services. Beyond just producing or having access to nutritious foods, we also know there are three main pathways that potentially improve nutrition: agricultural production, agriculture-derived income, and women’s empowerment.
Food-based approaches would provide the best use of the skill sets of extension agents. These approaches can focus on:
- Nutrition-rich crops and their cultivation at the farm level.
- Linking farmers to markets and value chains to sell and buy nutritious foods at the farm gate level.
- Better use of foods grown and purchased at the household level through preservation, cooking, storing, and processing.
- Nutrition messaging and education geared towards behaviour change at the individual level. One source of this could be the essential nutrition actions, (2)which provide core messages that can be adapted.(2) While most nutrition interventions are delivered through the health sector, non-health interventions can also be critical. Actions should target the different causes to reach sustainable change, which requires a multi-sectorial approach. The essential nutrition actions (ENA) are a package of interventions that could reduce infant and child mortality, improve physical and mental growth and development, and improve productivity.
- Improving food safety at the farm gate level by reducing aflatoxin during post-harvest storage and minimising environmental enteropathy (3)by pairing work with other interventions such as Water, Sanitation, and Hygiene (WASH).(3) Environmental enteropathy, also known as tropical enteropathy, is a condition (subclinical disorder) believed to be due to frequent intestinal infections. There are often minimal acute symptoms. There may be chronic problems with absorbing nutrients, which may result in malnutrition and growth stunting in children.
Non-food based approaches can also impact nutrition. Approaches such as:
- Providing women with the tools and technology to improve their own livelihoods and reduce their work and time burden, thus addressing women’s empowerment.
- Generating income through raising livestock. Improved husbandry practices very likely will reduce incidence of environmental enteropathy.
- Adopting good agricultural practice (including safe use of chemicals) can have an impact on nutrition and health without even explicitly mentioning nutrition.
There are several delivery channels that EAS could use to deliver better nutrition. These include:
- On-farm demonstrations
- Farmer field schools and associations
- Public health and school platforms
- Water and sanitation programmes.
Adoption of more nutrition-sensitive agriculture takes more than just providing tools, technologies, and messages. If we want to see behaviour change, it is important for EAS to understand farmers’ decision-making processes and how these impact livelihoods, incomes, and nutrition outcomes. This would include increasing awareness and interest, decision and uptake, evaluation, adaptation, and finally, adoption.