Research Gaps in Food and Nutrition Security Across Africa Richmond Aryeetey University of Ghana School of Public Health

Key challenges of Food & Nutrition Security Poor Quality Diets 3 Billion Undernutrition: Africa & Asia 3-16% GDP loss Nigeria (2011-2030) 3 – 6 million cases Manage and Use existing evidence Generate new evidence (IFPRI, 2016; Global Panel, 2016)

Assumptions about research Evidence Better decisions

Broader evidence landscape Case studies in Ghanaian context

Evidence landscape New Research (applied) generate manage translate use Existing research Data & findings New Research (applied) Evidence Synthesis Utilization for Decision making New research (basic) Strengthen quality Formalize evidence use Share evidence Demand Promote use of evidence

“Level of evidence” pyramid GOLDEN STANDARD For example P: I:e.g. drug or a therapy, a screening questionnaire or a health improvement program, or an exposure. C: O: For example, you may be interested in knowing whether an intervention has a health benefit or a service quality improvement, or whether an exposure results in mortality.

GAPS in EVIDENCE Landscape Substantial duplication of research effort Research not adequately linked with local priorities Research was driven by external parties Research and policy community not linked Sustainable Nutrition Research for Africa in the Years to come (SUNRAY) Lachat et al 2014, Holdsworth et al, 2014)

The Roles of Implementation Knowledge and Capacities (in the Implementation Spectrum) Identifying nutrition problems, agenda-setting, commitment-building, and priority-setting at all levels Coordination, alignment and collaboration in assessments, analytics, planning, implementation and evaluation Monitoring, evaluating, learning, adapting, sustaining and/or terminating Implementation Capacities Procedures, Practices, Policies Accessing information on potential nutrition-specific interventions, nutrition sensitive actions, programs, policies, and implementation innovations Initiating, managing and expanding implementation Implementation Knowledge Portfolio Evidence, Information, Guidelines, Experience Mobilizing human, financial and organizational resources Adopting, adapting and designing actions and innovations Detailed implementation planning, guidelines, commodities, training manuals, job aids.. Credit: David Pelletier

Food and Nutrition Research landscape in Ghana Focus on undernutrition Micronutrient deficiencies Epidemiology of undernutrition focused on children Limited attention to nutrition of women and adolescents Emerging attention on over-nutrition Focused on epidemiology of overweight/obesity Limited evidence on diets, food environment & behaviors Experiments testing interventions are rare Emerging attention to nutrition sensitive research Focused on social safety nets and nutrition-sensitive food security Limited evidence on harnessing poverty alleviation programs to address nutrition

1. Gaps identified in Nutrition Links Project How can effective strategies in nutrition sensitive agriculture work in one setting but not in another? Replicating success What strategies are needed to promote inter-institutional planning and programming between health and agriculture? Delivery mechanisms Integration of data systems across Agriculture, health, nutrition, livelihoods? Quality of routine data Strenthening use District Data systems

2. Priority research gaps in Nutrition in Ghana Behavioural issues Understanding traditional diets Socio-cultural influences on diet and nutrition Social and behaviour change Dynamics of complementary feeding Implementation issues Local context evidence for recommended actions Implementation gaps How social norms influence intervention uptake Anemia (women and children), Stunting, iodine deficiency disorders, zinc deficiency and diarria

3. Research Gaps relating to healthy diets in Ghana Weak contextual evidence for developing food-based dietary guidelines Food consumption behaviour Portion sizes Eating habits Understanding of the food environment Food access Food composition Drivers of food choice

4. SUN Movement Nutrition Research Gaps Nutrition capacity Mapping capacity in nutrition Building nutrition capacity in non-health sectors Deploying nutrition training through community institutions eg banks Nutrition sensitive interventions How to make social protection programs work for nutrition Promoting uptake and scale up of nutrition-sensitive solutions eg OFSP, ODF Working together Understanding best mechanisms for working together across sectors How to build and sustain transformational leadership in multi-sectoral teams Food and nutrition data systems to monitor progress

Conclusions There is need for attention to broader evidence pipeline Leadership is needed at country level to manage food and nutrition security research across sectors Need to recognize the contextual differences within countries and to focus attention on understanding subnational gaps in evidence