1. Agricultural Pathways to Improved Nutrition Prabhu Pingali Professor of Applied Economics & Director, Tata-Cornell Initiative for Agriculture & Nutrition, Cornell University David Sahn International Professor of Economics in the Division of Nutritional Sciences & Department of Economics, Cornell University Katie Ricketts Research Associate, Tata- Cornell Initiative for Agriculture and Nutrition, Cornell University

2. Household food access (quality, quantity and diversity) Raising incomes Ensuring market availability of low-cost nutritious food Dietary diversity Meeting individual dietary needs and ensuring nutrient absorption/utilization Food choice and intra-household allocation Good health and prevent infection Also, look at reverse causality, between health and nutrition, and agricultural productivity. Nutrition-Agriculture Pathways

3. Focus on women and girls during childbearing years, and infants/young children: First 1,000 days from conception to 2 years old in utero: prenatal care; nutrient/prenatal supplements; ~ 6 months: promote exclusive breastfeeding 6 -12 months: weaning; public health measures – water and sanitation; primary health care to avoid infection-nutrition interaction (e.g., bed nets, immunization, ORT) – education, women’s empowerment, and basic nutrition messaging – safety nets and cash and conditional transfers?? low income elasticity of nutrition outcomes possibly greater effect with conditionality, e.g., health care Overall, limited direct role of food systems -- largely through increased wealth, incomes and education Malnutrition is multidimensional

4. …as well as other nutrition problems Micronutrient deficiency Nutrition and cognition Emerging epidemic of chronic disease

5. Food system classification Characteristics Subsistence systems Little to no Green Revolution gains Low per capita income Low agricultural productivity High malnutrition Intensive cereal crops systems Green Revolution gains Low-medium per capita income Moderate agricultural productivity Persistent malnutrition Often poor market linkages Commercial/export systems Medium-high per capita income Higher opportunity for agricultural productivity High levels of nutritional inequality and coexistance of undernutrition and overnutrition 5 A FRAMEWORK FOR CONSIDERING POLICIES THAT LINK FOOD SYSTEMS AND AGRICULTURE TO NUTRITION OUTCOMES

6. 6 SUBSISTENCE SYSTEMS Much of Africa and other regions that missed out on the productivity, income, and food supply growth of the Green Revolution. CharacteristicsProductivityFood value chains LITTLE TO NO GREEN REVOLUTION GAINS LOW PER CAPITA INCOME LOW AGRICULTURAL PRODUCTIVITY HIGH MALNUTRITION FOCUS ON NEGLECTED STAPLES AND TRADITIONAL CROPS: RESEARCH, EXTENSION AND INPUTS TRADITIONAL AND NON- TRADITIONAL CROPS CULTIVATED BY WOMEN PROMOTION OF KITCHEN GARDENS, BACKYARD LIVESTOCK ACCESS TO LAND AND PROPERTY RIGHTS BIOFORTIFICATION CONDITIONAL FOOD/CASH TRANSFER PROGRAMS UPGRADING TRADITIONAL MARKETS SMALL SCALE POST-HARVEST STORAGE AND PROCESSING IMPROVING FOOD SAFETY AND QUALITY

7. 7 Characteristics ProductivityFood value chains GREEN REVOLUTION GAINS LOW-MEDIUM PER CAPITA INCOME MODERATE AGRICULTURAL PRODUCTIVITY PERSISTENT MALNUTRITION LABOR SAVINGS TECHNOLOGIES FOR WOMEN FOCUS ON ACCESS TO INPUTS, INCLDING WATER AND FERTILIZER INFORMATION AND EXTENSION SYSTEMS.. FINANCIAL SERVICES SUSTAINED CROP PRODUCTIVITY GROWTH AND DIVERSIFICATION TOWARDS MICRONUTRIENT RICH FOODS. CONNECTING SMALLHOLDER FARMERS TO GLOBAL /DOMESTIC RETAIL CHAINS. EMPOWERMENT OF WOMEN IN CASH AND COMMERCIAL CROP SALES DEVELOPMENT OF COOPERATIVES EXPAND OPPORTUNITIES FOR FOOD PROCESSING AND FORWARD LINKAGES IN FOOD SYSTEM TO CREATE EMPLOYMENT OFF FARM INTENSIVE CEREAL CROP SYSTEMS Much of Asia and Latin America that experienced the productivity gains of the Green Revolution suffer from sustained poverty, malnutrition, poor market linkages, and lack of dietary and production diversity.

8. 8 COMMERCIAL/EXPORT-ORIENTED SYSTEMS CharacteristicsProductivityFood value chains MEDIUM-HIGH PER CAPITA INCOME STILL LARGE OPPORTUNITY FOR PRODUCTIVITY GAINS NUTRITION INEQUALITY (UNDER-NUTRITION AND EMERGING EPIDEMIC OF CHRONIC DISEASE) GREATER ATTENTION TO SUSTAINABILITY AND ENVIRONMENTAL PROTECTION FINANCIAL SERVICES INPUT MARKETS AND INFORMATION SYSTEMS DIVERSITY INTO HIGH VALUE ADDED CROPS AGRIBUSINESS DEVELOPMENT INFRASTRUCTURE INVESTMENTS AND REGULATORY SYSTEMS FOR SMALLHOLDER INTEGRATION INTO FOOD VALUE CHAINS. STRENGTHENING OF PUBLIC- PRIVATE PARTNERSHIPS TO ENCOURAGE GENERAL RURAL INVESTMENT, FORTIFIED FOOD PRODUCTS IMPROVED REGULATORY ENVIRONMENT FOR FOOD SAFETY FOCUS ON SECTOR BEING THE SOURCE OF FOOD AS A SOURCE OF MODERATELY PRICED WAGE GOODS FOR GROWING URBAN MANUFACTURING AND INDUSTRIAL DEVELOPMENT COMMERCIAL/EXPORT-ORIENTED SYSTEMS High-growth export-driven countries in Latin America and Asia that have specializing farmers still need support transitioning to agriculture as a global/domestic business.

9. For poorest populations in Africa and South Asia Health and well-being in rural areas lag far behind urban areas Productivity effects more serious where physical labor critical input Women are particularly vulnerable -Employment patterns: -women play a predominant role in the production of food crops ; especially in Africa. -Biological vulnerabilities: -women have special vulnerabilities related to reproductive health and they are adversely affected by health and nutrition risks. -Life responsibilities: - women have a set of unique responsibilities in the home, particularly in terms of the care of children. Role of Health and Nutrition in Agricultural Development