A conceptual framework for understanding the impacts of agriculture and food system policies on nutrition and health

Navigating intersectoral collaboration in nutrition programming: implementors' perspectives from Assam, India

BACKGROUND

There is a growing interest in the use of intersectoral collaborative (ISC) approaches to address complex health-related issues. However, relatively little empirical research exists on the challenges of implementing, fostering and sustaining these approaches. Our study explores the perceptions and experiences of programme implementers regarding the implementation of an ISC approach, focusing on a case study of nutrition programming in Assam, India.

METHODS

We conducted qualitative semi-structured face-to-face in-depth interviews with eleven programme implementers from two selected districts of Assam, India. These participants were purposefully sampled to provide a comprehensive understanding of the experiences of implementing intersectoral collaboration. Following the interviews, an inductive thematic analysis was performed on the collected data.

RESULTS

The study identified three main themes: operationalisation of ISC in daily practice, facilitators of ISC, and barriers to effective ISC. These were further broken down into six subthemes: defined sectoral mandates, leadership dynamics, interpersonal relationships and engagement, collective vision and oversight, resource allocation, and power dynamics. These findings highlight the complexity of ISC, focusing on the important structural and relational aspects at the macro, meso, and micro levels. Interpersonal relationships and power dynamics among stakeholders substantially influenced ISC formation in both the districts.

CONCLUSION

Despite challenges, there is ongoing interest in establishing ISC in nutrition programming, supported by political development agendas. Success relies on clarifying sectoral roles, addressing power dynamics, and engaging stakeholders systematically. Actionable plans with measurable targets are crucial for promoting and sustaining ISC, ensuring positive programme outcomes. The insights from our study provide valuable guidance for global health practitioners and policymakers dealing with similar challenges, emphasising the urgent need for comprehensive research given the lack of universally recognised policies in the realm of ISC in global health practice.

Unlocking gender dynamics in food and nutrition security in Ghana: assessing dietary diversity, food security, and crop diversification among cocoa household heads in the Juaboso-Bia cocoa landscape

BACKGROUND

Malnutrition is a worldwide problem that impacts every country, affecting one in three individuals, including Ghana. According to estimates from the Food and Agriculture Organization (FAO), 690 million people were undernourished globally in 2019. Malnutrition is no exception in rural cocoa communities in Ghana. The expansion of cocoa is causing food insecurity and low dietary diversity in most cocoa-growing areas. There is little information on the food security status and dietary diversity among male-headed and female-headed cocoa households in the Juaboso-Bia cocoa landscape. Thus, this study sought to explore the dietary diversity distribution, food security status, sources of staple food, food unavailability periods, food production status, themes contributing to low dietary diversity and food insecurity, and perception of the impact of cocoa expansion on crop diversification among male-headed and female-headed cocoa households in the study area.

METHODS

Both quantitative and qualitative research methods were employed to address the research questions. The study collected 200 semi-structured questionnaire data and 14 in-depth interview data from cocoa household heads in the Juaboso-Bia landscape. The survey data was cleaned and analysis, such as household dietary diversity status, food security status, and binary logistic regression were performed in the Statistical Package for Social Scientists (SPSS). The in-depth interviews were analyzed using thematic analysis.

RESULTS

Through this study, it was revealed that 62.8% of the male-headed cocoa households had medium to high dietary diversity compared to their female counterparts 39.3%. About 47.9% of the male-headed households were food secure than the female-headed households (29.1%). Moreover, the months that both male and female-headed households recalled facing severe food unavailability were July and June. In addition, climate change/variability, unavailable lands, poverty, large household size, and gender stereotypes were themes promoting low dietary diversity and food insecurity among male and female-headed households. Furthermore, sex, total household income, and cropland conversion to cocoa were the variables influencing household heads' perception of the impact of cocoa expansion on crop diversification.

CONCLUSIONS

The study showed that the male-headed cocoa households had high dietary diversity and were food secure than the female-headed cocoa households, lending credence to the conceptual framework applied in this study. There is a significant relationship between household head gender and food security status. Therefore, this study recommends the following interventions to improve dietary diversity and food security among male and female-headed cocoa households: raise awareness about the need for diverse diets and provide practical information on how to incorporate a greater variety of food groups into their daily meals; and promote gender equity and inclusivity in food security interventions. Future research could investigate how gender mainstreaming policies in agriculture have helped empower and improve the food security of female-headed households in Ghana.

Health burden associated with tillage-related PM2.5 pollution in the United States, and mitigation strategies

Exposure to airborne particulate matter of diameter less than 2.5 μm (PM2.5) is associated with cardiovascular diseases (CVD) and chronic obstructive pulmonary disease (COPD). In agriculture, the practice of tilling generates PM2.5 emissions that can jeopardize human health. This paper estimates the annual deaths and disability-adjusted life years (DALYs) from CVD and COPD attributable to PM2.5 emissions from corn, soybean, cotton, and wheat tillage in the contiguous United States. Primary PM2.5 from crop-tillage combination was calculated using values obtained from the Environmental Protection Agency's National Emissions Inventory, 2017, while deaths and DALYs estimates were calculated using data from the Institute of Health Metrics and Evaluation's global burden of risk factors study, the US decennial census, and the US Centers for Disease Control. We also propose and implement a conceptual framework for identifying the optimal subsidy upon accounting for health benefits arising from reducing conventional tillage, and we discuss strategies to achieve conservation tillage. Annual PM2.5 emissions from crop tillage is about 0.25 million tons. We estimate that approximately 1000 annual deaths and 22,000 DALYs from CVD, as well as 300 annual deaths and 7400 DALYs from COPD, were attributable to tillage-related PM2.5 emissions. Tillage related primary PM2.5 emissions contribute about 0.002 % of total CVD and COPD deaths in the United States, and its related health economic value loss is about 12.9 billion USD annually. About 350 annual deaths may be averted upon a shift from conventional to conservation tillage. Conservation tillage is generally adopted when the pecuniary and soil health benefits exceed those from adopting intensive tillage. Agricultural policies and on-farm measures that may help reduce intensive tillage, and the related PM2.5 emissions, include subsidies for adopting conservation tillage and carbon capture credits, use of herbicides and herbicide-tolerant crops, protecting herbicide-tolerance traits, planting cover crops, and use of windbreaks.

Promoting insect farming and household consumption through agricultural training and nutrition education in Africa: A study protocol for a multisite cluster-randomized controlled trial

BACKGROUND

Edible insects are a sustainable source of high-quality animal protein. Insect farming is gaining interest globally, particularly in low-income countries, where it may provide substantial nutritional and economic benefits. To enhance insect farming practices in Africa, new farming systems are being developed. However, knowledge on how to best promote uptake of these systems is lacking. This study aims to fill this gap by investigating the effectiveness of educational interventions in promoting insect farming for household consumption in Africa.

METHOD

The study is designed as a multi-site randomized controlled trial to evaluate the impacts of agricultural training alone or in combination with nutrition education on the adoption of insect farming in Ghana, Kenya and Uganda. In each of the three countries, ninety-nine villages are randomly assigned to one of three arms: two intervention arms and a control arm with no interventions. Focusing on production (P), the first intervention arm covers agricultural training on insect farming combined with provision of insect production starter kits. Focusing on both production and consumption (PC), the second intervention arm involves the same intervention components as treatment P plus additional nutrition education. The impacts of the interventions are measured by comparing baseline and endline data collected one year apart. Primary outcomes are adoption of insect farming and consumption of the farmed insects.

DISCUSSION

Understanding the drivers and impacts of novel agricultural practices is crucial for transitioning to sustainable food systems. The current project is the first to investigate how educational interventions promote insect farming for household consumption in low-income countries. The results will contribute evidence-based knowledge to support sustainable development through insect farming in Africa.

TRIAL REGISTRATION

The protocol is registered in the American Economic Association registry for randomized control trials with registration number AEARCTR-0009996. Initial registration date: 02 September 2022, last updated 17 May 2023.

Evaluation of Antimicrobial Effect of Silver Nanoparticle Based Whey Emulsions and Edible Films for the Extension of Shelf Life of Fruits and Vegetables

The purpose of this study was to develop and assess the antimicrobial properties of silver nanoparticles (AgNPs)-based whey emulsions and edible films for extending the shelf life of fruits and vegetables. The AgNPs were synthesized using a biological method, and their morphological and topographical characteristics were evaluated using scanning electron microscopy (SEM). The AgNPs were incorporated into the emulsions and films to increase their antimicrobial efficacy. Bacterial and fungal strains were identified by DNA regions, including 16S and 18S rRNA, TEF-1α, and RPB2 to evaluate antimicrobial activity. AgNPs-based emulsions and films were used to extend the shelf life of fruits and vegetables for up to 15 days. The results showed that the use of AgNPs in the coated samples significantly increased their effectiveness against bacterial and fungal strains. SEM analysis revealed the presence of AgNPs of varying sizes, ranging from 21 to 62 nm. The zones of inhibition were measured against Staphylococcus aureus, Escherichia coli, Salmonella enterica, Aspergillus flavus, Aspergillus tamari, and Aspergillus niger. The total viable count (log cfu/ml) decreased from 6.423 in the control group to 3.301 in the treated samples. The antioxidant activity of the treated fruits and vegetables was also significantly improved, with values of 56.12, 23.36, 26.10, 7.6, 36.04, and 33.81% for strawberry, taro root, guava, peas, green chili, and carrot, respectively (p < 0.05). The AgNPs-based whey protein emulsions were found to exhibit the highest antimicrobial activity and are therefore a promising approach to extend the shelf life of fruits and vegetables.

Flood hazards vulnerability and risk of food security in Bait community flood-prone areas of Punjab Pakistan: In SDGs achievement threat

Climate change in the global perspective has increased the occurrence of natural disasters, which subsequently decreased agricultural production and intensified the issue of food security. Developing countries, such as Pakistan, are facing severe food security issues, where most of the population still experiences poverty and hunger in their daily lives. Flood disasters ruin valuable land, cause agricultural production losses, and interrupt livelihood routines as expected household livelihood becomes more vulnerable. This research work focused on investigating the flood hazards vulnerability and risk of food security in the Bait community flood-prone areas of Punjab, Pakistan, with a broader aspect in contrast to previous research work. A constructed food security index composed of several IPCC and FAO factors with correlated dimensions of food security was used for the empirical estimation in this study. A composite food security index was developed through polychoric principal component analysis. To estimate the influence on the overall food security condition in the study area, a food security index was regressed on various independent variables. Estimates of the study indicated that three-fourths of household respondents in the study area are confronted with the issue of food security with changeable scale. Financing schemes, physical assets, and family type illustrated the positive influence on respondents' food security level, whereas respondents suffering property losses owing to floods had a negative influence. The study findings suggested integrated strategies must be adopted to effectively deal with issues of food security in the scenario of increasing severity of flood disasters. Policymakers and disaster-concerned institutions need to develop disaster risk mitigation strategies by constructing new water reserves and clearing river encroachments to deal with flood disasters. Agricultural research and development authorities need to provide climate friendly seed varieties and promote particular food crops for flood prone areas to ensure food security and reduce livelihood vulnerability, specifically for the flood-prone communities.

The Indirect Impact of Smallholder Vegetable Production on Children's Nutrition Outcomes in Rural Vietnam

Childhood undernutrition, particularly stunting, wasting, and micronutrient deficiencies, remains a major health concern in rural Vietnam. While literature suggests leveraging agriculture to improve child nutrition via agricultural diversification, market engagement, and women's empowerment, very few studies have empirically explored how smallholder vegetable production can influence household nutrition. This paper examines the association of household-level vegetable diversity, market access, and market participation with nutrition outcome measures of children in smallholder households. We use a cross-sectional household dataset, collected in 2016 in northwest Vietnam, covering 234 children aged 6–60 months. We estimate and compare the results of regression models using three-stage least squares (3SLS), ordinary least squares (OLS), logistic regression, and seemingly unrelated regression (SUR), to explore variations in six nutrition outcome measures: height-for-age z-score (HAZ), weight-for-height z-score (WHZ), weight-for-age z-score (WAZ), stunting, wasting, and underweight. Our results suggest smallholder vegetable production has a significant indirect association with children's nutrition status via market participation. Market participation is an important factor in improving girls' HAZ and WHZ, and in reducing the probability of boys being stunted and underweight. The additional income from selling vegetables allows households to purchase nutritious food, which is likely to have a positive impact on children's nutrition outcomes.

Nutrition modeling tools: a qualitative study of influence on policy decision making and determining factors

Nutrition modeling tools (NMTs) generate evidence to inform policy and program decision making; however, the literature is generally limited to modeling methods and results, rather than use cases and their impacts. We aimed to document the policy influences of 12 NMTs and identify factors influencing them. We conducted semistructured interviews with 109 informants from 30 low‐ and middle‐income country case studies and used thematic analysis to understand the data. NMTs were mostly applied by international organizations to inform national government decision making. NMT applications contributed to enabling environments for nutrition and influenced program design and policy in most cases; however, this influence could be strengthened. Influence was shaped by processes for applying the NMTs; ownership of the analysis and data inputs, and capacity building in NMT methods, encouraged uptake. Targeting evidence generation at specific policy cycle stages promoted uptake; however, where advocacy capacity allowed, modeling was embedded ad hoc into emerging policy discussions and had broader influence. Meanwhile, external factors, such as political change and resource constraints of local partner organizations, challenged NMT implementation. Importantly, policy uptake was never the result of NMTs exclusively, indicating they should be nested persistently and strategically within the wider evidence and advocacy continuum, rather than being stand‐alone activities.

Organizational Food Environments: Advancing Their Conceptual Model

Understanding the complexity of the elements that constitute organizational food environments and their operating dynamics is essential to improving their healthiness. This study developed a conceptual model of organizational food environments. For this purpose, a comprehensive literature review was conducted, a first version of the conceptual model was prepared, a panel of experts was consulted, the model was improved, a second panel of experts was consulted, and the model was finalized. The model consists of four components (the institutional level, internal level of eating spaces, surroundings, and the decisional level) and 10 dimensions related to the institutional level and internal level of eating spaces (the availability, accessibility, affordability, quality, food and nutrition information, and promotion of foods, beverages, and culinary preparations and the availability, acceptability, convenience, ambience, and infrastructure of the eating space), as expressed in a graphical scheme. The conceptual model presented here offers innovative elements which contribute to understanding of the organizational food environment. It can guide the development of both assessment studies of food environments and interventions for their improvement.

Connecting the food and agriculture sector to nutrition interventions for improved health outcomes

To achieve the Sustainable Development Goal of zero hunger, multi-sectoral strategies to improve nutrition are necessary. Building towards this goal, the food and agriculture sector must be considered when designing nutritional interventions. Nevertheless, most frameworks designed to guide nutritional interventions do not adequately capture opportunities for integrating nutrition interventions within the food and agriculture sector. This paper aims to highlight how deeply connected the food and agriculture sector is to underlying causes of malnutrition and identify opportunities to better integrate the food and agriculture sector and nutrition in low and middle income countries. In particular, this paper: (1) expands on the UNICEF conceptual framework for undernutrition to integrate the food and agriculture sector and nutrition outcomes, (2) identifies how nutritional outcomes and agriculture are linked in six important ways by defining evidence-based food and agriculture system components within these pathways: as a source of food, as a source of income, through food prices, women's empowerment, women's utilization of time, and women's health and nutritional status, and (3) shows that the food and agriculture sector facilitates interventions through production, processing and consumption, as well as through farmer practices and behavior. Current frameworks used to guide nutrition interventions are designed from a health sector paradigm, leaving agricultural aspects not sufficiently leveraged. This paper concludes by proposing intervention opportunities to rectify the missed opportunities generated by this approach. Program design should consider the ways that the food and agriculture sector is linked to other critical sectors to comprehensively address malnutrition. This framework is designed to help the user to begin to identify intervention sites that may be considered when planning and implementing multi-sectoral nutrition programs.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12571-022-01262-3.

Multidimensional Food Security Nexus in Drylands under the Slow Onset Effects of Climate Change

Hyperarid, arid, semiarid, and dry subhumid areas cover approximately 41% of the global land area. The human population in drylands, currently estimated at 2.7 billion, faces limited access to sufficient, affordable, and nutritious food. We discuss the interlinkages among water security, environmental security, energy security, economic security, health security, and food security governance, and how they affect food security in drylands. Reliable and adequate water supply, and the prevention of water contamination, increase the potential for ample food, fodder, and fiber production. Protecting woodlands and rangelands increases food security by buffering the slow onset effects of climate change, including biodiversity loss, desertification, salinization, and land degradation. The protection of natural lands is expected to decrease environmental contamination, and simultaneously, reduce the transfer of diseases from wildlife to humans. Biofuel production and hydroelectric power plants increase energy security but generate land-use conflicts, deforestation, and ecosystem degradation. Economic security generally positively correlates with food security. However, economic growth often degrades the environment, changes tenure rights over natural resources, and stimulates migration to urban areas, resulting in lower food and health security. Moreover, civil unrest, political instability, and armed conflicts disrupt local economies in drylands. Maintaining food security is crucial for health security; conversely, malnourished populations and unresponsive health systems decrease economic security, and adversely affect environmental, energy, and food security. Climate change is expected to deteriorate health security by spreading vector-borne diseases. Effective governance and timely interventions can substantially shorten periods of food insecurity, lower their intensities, and accelerate recovery from inevitable crises, and are therefore crucial in preventing humanitarian crises. Since global drylands population will nearly double by 2050, and since drylands are among the most susceptible areas to climate change, integrated multi-hazard approaches to food security are needed.

How to design a complex behaviour change intervention: experiences from a nutrition-sensitive agriculture trial in rural India

Many public health interventions aim to promote healthful behaviours, with varying degrees of success. With a lack of existing empirical evidence on the optimal number or combination of behaviours to promote to achieve a given health outcome, a key challenge in intervention design lies in deciding what behaviours to prioritise, and how best to promote them. We describe how key behaviours were selected and promoted within a multisectoral nutrition-sensitive agriculture intervention that aimed to address maternal and child undernutrition in rural India. First, we formulated a Theory of Change, which outlined our hypothesised impact pathways. To do this, we used the following inputs: existing conceptual frameworks, published empirical evidence, a feasibility study, formative research and the intervention team’s local knowledge. Then, we selected specific behaviours to address within each impact pathway, based on our formative research, behaviour change models, local knowledge and community feedback. As the intervention progressed, we mapped each of the behaviours against our impact pathways and the transtheoretical model of behaviour change, to monitor the balance of behaviours across pathways and along stages of behaviour change. By collectively agreeing on definitions of complex concepts and hypothesised impact pathways, implementing partners were able to communicate clearly between each other and with intervention participants. Our intervention was iteratively informed by continuous review, by monitoring implementation against targets and by integrating community feedback. Impact and process evaluations will reveal whether these approaches are effective for improving maternal and child nutrition, and what the effects are on each hypothesised impact pathway.

How food systems change (or not): governance implications for system transformation processes

This paper argues that supporting food system transformation requires more than obtaining science-based understanding and analysis of how components in the system interact. We argue that changing the emergent properties of food systems (what we call food system synthesis) is a socio-political challenge that is affected by competing views regarding system boundaries and purposes, and limited possibilities for central steering and control. We point to different traditions of ‘systems thinking’ that each emphasize particular types of interventions for achieving system change, and argue that food systems are best looked at as complex multi-dimensional systems. This implies that we need to move beyond rational engineering approaches to system change, and look for approaches that anticipate and accommodate inherent social tensions and struggles in processes of changing food system dynamics and outcomes. Through a case study on the persistence of an undesired emergent property of food systems (i.e. poverty) we demonstrate that a multi-level perspective (MLP) on system transformation is useful in understanding both how food system transformation has happened in the past, and how desirable transformations is prevented from happening today. Based on such insights we point to key governance strategies and principles that may be used to influence food system transformation as a non-linear and long-term process of competition, negotiation and reconfiguration. Such strategies include the creation and nurturing of diversity in the system, as well as process interventions aimed at visioning, destabilization and formation of discourse coalitions. Such governance interventions imply a considerable re-orientation of investments in food system transformation as well as a rethinking of the role that policy-makers may play in either altering or reproducing undesirable system outcomes.

Identifying 'win-win-win' futures from inequitable value chain trade-offs: A system dynamics approach

CONTEXT

There is growing recognition that food systems must adapt to become more sustainable and equitable. Consequently, in developing country contexts, there is increasing momentum away from traditional producer-facing value chain upgrades towards efforts to increase both the availability and affordability of nutritious foods at the consumer level. However, such goals must navigate the inherent complexities of agricultural value chains, which involve multiple interactions, feedbacks and unintended consequences, including important but often surprising trade-offs between producers and consumers.

OBJECTIVE AND METHODS

Based around the 'Loop' horticultural aggregation scheme of Digital Green in Bihar, India, we develop a system dynamics modelling framework to survey the value chain trade-offs emerging from upgrades that aim to improve the availability of fruits and vegetables in small retail-oriented markets. We model the processes of horticultural production, aggregation, marketing, and retailing - searching for futures that are 'win-win-win' for: (i) the availability of fruits and vegetables in small retail markets, (ii) the profits of farmers participating in aggregation, and (iii) the sustainability of the initial scheme for Digital Green as an organisation. We simulate two internal upgrades to aggregation and two upgrades to the wider enabling environment through a series of 5000 Monte Carlo trajectories - designed to explore the plausible future dynamics of the three outcome dimensions relative to the baseline.

RESULTS

We find that 'win-win-win' futures cannot be achieved by internal changes to the aggregation scheme alone, emerging under a narrow range of scenarios that boost supplies to the small retail market whilst simultaneously supporting the financial takeaways of farmers. In contrast, undesirable producer versus consumer trade-offs emerge as unintended consequences of scaling-up aggregation and the introduction of market-based cold storage.

SIGNIFICANCE

This approach furthers ongoing efforts to capture complex value chain processes, outcomes and upgrades within system dynamics modelling frameworks, before scanning the horizon of plausible external scenarios, internal dynamics and unintended trade-offs to identify 'win-win-win' futures for all.

Consumer Food Environment Healthiness Score: Development, Validation, and Testing between Different Types of Food Retailers

The aim of this study was to develop and validate a scoring system, based on AUDITNOVA, to assess the healthiness of the consumer food environment, considering food availability, price, advertising, and placement strategies. Audited data of 650 food retailers were used to develop, validate, and test the consumer food environment healthiness score. To compose the score, the reference was the Dietary Guidelines for the Brazilian Population. The total and subscores were standardized for a scale from 0 to 100. Construct validity was assessed using the Kruskal–Wallis Dunn tests. Cronbach’s alpha coefficients were calculated to determine the consistency of the scores. The median score was 33.7 (p25 = 26.9; p75 = 42.1). The public and private specialized indoor fresh food markets showed the highest medians; otherwise, bakeries and food retailers with the predominant sale of ultra-processed foods showed the lowest. The score was able to satisfactorily classify the extreme food retailer groups by the predominant sale of fresh or minimally processed foods and the predominant sale of ultra-processed foods. The results of Cronbach’s alpha showed excellent internal consistency (α = 0.91). The score helped to provide an overall assessment of consumer food environment healthiness and was able to classify food retailer groups as healthy and unhealthy according to the degree of processing of the available foods.

Conceptual frameworks linking agriculture and food security

Many conceptual frameworks have been developed to facilitate understanding and analysis of the linkages between agriculture and food security. Despite having usefully guided analysis and investment, these frameworks exhibit wide diversity in perspectives, assumptions and application. This Review Article examines this diversity, providing an approach to assess frameworks and suggesting improvements in the way they are specified and applied. Using criteria-based systems modelling conventions, we evaluate 36 frameworks. We find that many frameworks are developed for the purpose of illustration rather than analysis and do not clearly indicate causal relationships, tending to ignore the dynamic (stability) dimensions of agriculture and food security and lacking clear intervention points for improving food security through agriculture. By applying system modelling conventions to a widely used framework, we illustrate how such conventions can enhance the usefulness of a framework for overall illustration purposes, delineate hypotheses on agriculture-food security links and examine potential impacts of interventions.

Supporting food systems transformation: The what, why, who, where and how of mission-oriented agricultural innovation systems

Agricultural innovation systems has become a popular approach to understand and facilitate agricultural innovation. However, there is often no explicit reflection on the role of agricultural innovation systems in food systems transformation and how they relate to transformative concepts and visions (e.g. agroecology, digital agriculture, Agriculture 4.0, AgTech and FoodTech, vertical agriculture, protein transitions). To support such reflection we elaborate on the importance of a mission-oriented perspective on agricultural innovation systems. We review pertinent literature from innovation, transition and policy sciences, and argue that a mission-oriented agricultural innovation systems (MAIS) approach can help understand how agricultural innovation systems at different geographical scales develop to enable food systems transformation, in terms of forces, catalysts, and barriers in transformative food systems change. Focus points can be in the mapping of missions and sub-missions of MAIS within and across countries, or understanding the drivers, networks, governance, theories of change, evolution and impacts of MAIS. Future work is needed on further conceptual and empirical development of MAIS and its connections with existing food systems transformation frameworks. Also, we argue that agricultural systems scholars and practitioners need to reflect on how the technologies and concepts they work on relate to MAIS, how these represent a particular directionality in innovation, and whether these also may support exnovation.

Nutrition and food security impacts of quality seeds of biofortified orange-fleshed sweetpotato: Quasi-experimental evidence from Tanzania

This study examined the nutrition and food security impacts of a project that was designed to improve availability of disease-free planting materials of biofortified orange-fleshed sweetpotato (OFSP) in rural Tanzania. Difference-in-difference and matching techniques were employed to estimate causal effects using panel data. Participation in the project increased agronomic and nutritional knowledge of households, raised uptake rate for OFSP varieties, and improved food security status. Effects on nutrition are, however, weak. These results suggest that timely access to quality seeds accompanied by a transfer of skills is important to reduce barriers to adoption of biofortified crops with resulting positive effects on the welfare of rural households. Adequate promotion of both agronomic and nutrition aspects of the technologies may enhance nutrition effects.

European Rural Development Policy Approaching Health Issues: An Exploration of Programming Schemes

Malnutrition, obesity, type 2 diabetes, micronutrient deficiencies, and the increase in non-communicable diseases are among the future European key challenges in health and welfare. Agriculture and rural development policies can positively contribute to a healthier and nutritious supply of food. The objective of the research is to analyze to what extent European 2007-2013 and 2014-2020 rural development programmes address the nexus between agriculture, food, health, and nutrition to respond to the evolving dietary needs. The research carries out a quali-quantitative content analysis on all 210 European rural development programmes. Results show that the interconnection between agriculture, food, health, and nutrition is present, with differences in the European agricultural and rural policy programming periods. The main interlinking issues of the nexus are food safety, food quality, diseases, nutritional aspect, animal health and welfare, plant health, and environmental health. Healthier and nutritious food-related issues are emerging, addressing dietary needs, and sustaining consumer food trends. Healthy and nutritious food is pursued by combating foodborne communicable diseases and non-communicable diseases. The future Common Agricultural Policy, including its rural dimensions, should support the consumption of healthy foods produced in ways that are environmentally and economically sustainable.

Integrating Agriculture and Health Research for Development: LCIRAH as an Interdisciplinary Programme to Address a Global Challenge

The multiple burdens of persistent undernutrition and micronutrient deficiencies, along with the rapidly growing rates of overweight, obesity, and associated chronic diseases, are major challenges globally. The role of agriculture and the food system in meeting these challenges is very poorly understood. Achieving food security and addressing malnutrition in all its forms, a Sustainable Development Goal, requires an understanding of how changing food systems affect health outcomes and the development of new tools to design and evaluate interventions. An interinstitutional programme to address this interdisciplinary research challenge is described. Over the past seven years, the Leverhulme Centre for Integrative Research on Agriculture and Health has built a portfolio of successful and innovative research, trained a new cadre of interdisciplinary researchers in "Agri-Health," and built an international research community with a particular focus on strengthening research capacity in low- and middle-income countries. The evolution of this programme is described, and key factors contributing to its success are discussed that may be of general value in designing interdisciplinary research programmes directed at supporting global development goals.

Does Agricultural Commercialization Affect Food Security: The Case of Crop-Producing Households in the Regions of Post-Reform Vietnam?

Agricultural commercialization remains a widely pursued approach in development projects to improve food security in low-income countries, although there is no clear scientific evidence for it. This study examines the impact of agricultural commercialization on the food security status of crop-producing households in the regions of Vietnam in the 1990s. We used the food system framework including output and input markets. We explore three indicators of commercialization: Cash crop production share (CCPS), crop output market participation share (COMPS), and crop input market participation share (CIMPS) based on fertilizer use. For food security, we looked at caloric intake and dietary diversity (Food Variety Score). We use a balanced panel data sample from the Vietnam Living Standards Survey (VLSS) of 1992/93 and 1997/98. We apply four specifications for all combinations of commercialization indicators and food security indicators for seven regions: OLS 1992/93, OLS 1997/98, pooled sample, and difference estimator. The results show that the effect of commercialization on food security is widely heterogeneous. It depends upon the commercialization indicator and the region in Vietnam. In general, there is no clear evidence for the direction of commercialization on either caloric intake or dietary diversity; however, it is clear that the impacts are generally more positive for southern regions than for northern regions of Vietnam.