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Burundi ECECHOMartin Karimi

There is a heightened awareness globally and within development institutions and governments of the need to better understand the links between agriculture and nutrition, and to decipher the ways in which the agriculture sector can contribute to improved nutrition. The ‘what’ and the ‘how’ of effectively delivering ‘nutritionsensitive agriculture’ (1)
(1) Nutrition-specific interventions address the immediate causes of undernutrition, like inadequate dietary intake and some of the underlying causes like feeding practices and access to food. Nutrition-sensitive interventions can address some of the underlying and basic causes of malnutrition by incorporating nutrition goals and actions from a wide range of sectors. They can also serve as delivery platforms for nutrition-specific interventions.
services to rural households remain even less understood.

Extension workers (through public, private, and nongovernment organisation (NGO) channels) are often thought of as a promising platform or vehicle for the delivery of nutrition knowledge and practices to improve the nutritional health of rural communities because they reach and interact closely with farmers in different settings. They act as significant service providers of crop, livestock, and forestry aspects of food security, consumption, and production.

Nutrition concepts were first introduced into the training of extension personnel for rural development projects in the 1960s. During those early stages, the general consensus was that to have an impact on nutrition, the agriculture sector would need to expand beyond its sole focus on food production, and incorporate food consumption as well. For this to succeed, a key step was to improve extension agents’ understanding of nutrition-related concepts, as the prevailing low levels of training did not equip them with the tools necessary to recognise the causes and consequences of malnutrition.

This new approach served as a global resource and was later adapted to the national contexts of numerous countries throughout Latin America and Africa. After the 1980s, globalisation altered agricultural policies significantly and resulted in market-oriented agricultural sectors that preferred food producers selling their output in the marketplace, thereby placing less emphasis on improving home consumption. Additionally, by the late 1990s, extension advisory services (EAS) across the developing world were deprived of funding as a result of changes in donor and lending policies, as well as due to the costs of the model. Both of these factors may have influenced the limited success of these early efforts to integrate nutrition and EAS.

Compiled by: Jessica Fanzo, July 2015


There are numerous good arguments for why it should be effective to integrate nutrition into EAS including:


Food-based approaches would provide the best use of the skill sets of extension agents. These approaches can focus on: 

Non-food based approaches can also impact nutrition. Approaches such as: 

There are several delivery channels that EAS could use to deliver better nutrition. These include:

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.

Capacities required

The types of service providers working in nutrition extend beyond traditional frontline agricultural extension agents. As EAS have become more pluralistic, the actors providing services have become more diversified. There is also a tension with other rural workers, such as community health workers. Often, nutrition is thought to rest in their responsibilities. However, often they too are over worked, undercompensated, and have many tasks in the primary health care package. The capacities that extension agents need to effectively integrate nutrition into EAS include: 

Training also encompasses support systems for extension agents including mentorship, feedback, and career advancement. If a country does not have a support system for EAS in place, the probability of younger generations entering the education system, or doing vocational training with a focus on EAS, remains low. Training should include pre-service and in-service training on nutrition sensitive agriculture and be on-going, reinforced, and mentored, in order for the addition of nutrition as a topic to be sustainable. This requires the public sector to take ownership and responsibility, and requires building the capacity of trainers and mentors in the field of nutrition. Training on nutrition-related agronomy can be done in the field by using field plots, greenhouses, and local biodiversity and ecosystems.


Determining the costs of integrating nutrition into EAS is hampered by a lack of conclusive information about the efficiency and cost-effectiveness of integrated agriculture–nutrition interventions. There is some variation in viewpoints regarding the bundle of additional resources required. There is general recognition that integrating nutrition into EAS would incur additional costs, and there is some convergence on what the main drivers of the cost increases would be. These include nutrition training for extension agents, additional skills training for extension agents, cost of demonstrations and logistics, and use of technology.

Interest in integrating nutrition into EAS stems, at least partially, from the perception that it could be an efficient, effective use of existing resources, as extension agents are already embedded within the communities. However, it is important to keep in mind that incorporating nutrition into EAS activities will require additional resources, and that these systems are generally under-funded.

Best-fit considerations 

Strengths and weaknesses


  • Many extension agents have substantial reach into the communities in which they operate, and trust and rapport with community members. Harnessing this social capital is considered to be effective in improving nutrition. 
  • Improving yield and incomes are major goals for farmers. Integrating communication about nutrition and dietary-related behaviour change into the portfolio of activities of extension agents may create the conditions for improved nutrition to be adopted and demanded within farmer families.
  • Extension agents focus on local food production systems. Through knowledge and adoption of new practices that integrate nutrition within local cropping, livestock, and food safety technologies and innovations, extension agents can better address the causal factors impacting the communities in which they work.
  • Use of other delivery platforms, such as WASH, could link agriculture with the health and water sectors in meaningful ways to impact nutrition.
  • Weaknesses

    Policy-making and enabling environment

    Securing and maintaining high-level political support for both nutrition and EAS is key to ensuring the inter-ministerial coordination and resource allocation necessary for EAS to play a meaningful role in contributing to nutritional outcomes.

    National multi-sectorial nutrition policies and strategies could provide a starting point for the integration of EAS delivery systems and nutrition activities. However, there needs to be an alignment with agricultural policies and priorities as well. Multi-sectorial coordination, particularly between the agriculture and health sectors, lies at the heart of integrating nutrition into EAS. While there are successful examples of coordination at the grassroots and district levels, stakeholders noted the need for higher-level support and engagement to replicate and scale successes.

    Evidence of impact and potential scalability

    With the increased attention on, and investment in, nutrition-sensitive agriculture, EAS should be considered as an important potential contributor to delivering effective nutrition to rural farming communities. EAS could be a promising vehicle for delivering nutrition interventions through agriculture. The extent to which it is effective to rely on EAS to deliver nutrition interventions is uncertain. Much more understanding is needed of what approaches have the most significant impact on nutrition outcomes. Without that understanding, and research to assess impact, it is difficult to understand the effectiveness of integration of nutrition into extension.

    Beyond gaining evidence of what approaches are most appropriate, there also needs to be significant investment and ramping up of EAS in general. If EAS are unable to provide the most basic agriculture services, it will be much more difficult to layer nutrition interventions, messages, and activities within their portfolio. EAS systems need support – financial, training, human resources, and infrastructure – to ensure that the services that are provided are robust.

    Training materials

    Aakesson, A., Pinga, V. and Titus, S. 2014. Using agriculture extension agents to promote nutrition: a process review of three Feed the Future activities in Ethiopia. Arlington, VA: USAID/ Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) Project.

    FAO. 2007. Nutrition education. In: Agriculture, food, and nutrition for Africa – a resource book for teachers of agriculture. Rome, Italy: FAO.

    Further reading

    Fanzo, J., Marshall, Q., Wong, J., Merchan, R.I., Jaber, M.I, Souza, A. and Verjee, N. 2013. The integration of nutrition into extension and advisory services: a synthesis of experiences, lessons, and recommendations. Lindau, Switzerland: Global Forum for Rural Advisory Services. 

    FAO. 2013. Synthesis of guiding principles on agriculture programming for nutrition. Rome Italy: Food and Agriculture Organization of the UN (FAO). 

    Herforth, A. and Harris, J. 2014. Understanding and applying primary pathways and principles. Brief No. 1. Improving Nutrition through Agriculture Technical Brief Series. Arlington, VA: USAID/SPRING Project.

    Hird-Younger, M. and Simpson, B. 2013. Women extension volunteers (Ghana): an extension approach for female farmers. MEAS Case Study No 2. Urbana, IL: MEAS.

    Sigman, V., Rhoe V., Peters, J., Banda, T. and Malindi, G. 2014. Assessment of agricultural extension, nutrition education and integrated agriculture–nutrition extension services in the Feed the Future focus districts in Malawi. USAID/Malawi and MEAS. 

    Simpson, B. 2015. Planning for scale: using what we know about human behavior in the diffusion of agriculture innovation and the role of agriculture extension. Urbana, IL: MEAS.


    This paper was produced by Jessica Fanzo with financial support from GIZ (Gesellschaft für Internationale Zusammenarbeit), and PIM (the CGIAR Research Programme on Policies, Institutions, and Markets).This work was undertaken as part of the CGIAR Research Program on Policies, Institutions, and Markets (PIM) led by the International Food Policy Research Institute (IFPRI). Funding support for this study was provided by the agencies with logos on the front page.

    This paper has not gone through IFPRI’s standard peer-review procedure. The opinions expressed here belong to the authors, and do not necessarily reflect those of PIM, IFPRI, or CGIAR.