Are sub-Saharan African national food and agriculture policies nutrition-sensitive? A case study of Ethiopia, Ghana, Malawi, Nigeria, and South Africa

Abstract

Background In sub-Saharan Africa (SSA), malnutrition coupled with rising rates of undernutrition and the burden of overweight/obesity remains one of the most significant public health challenges facing the region. Nutrition-sensitive agriculture can play an important role in reducing malnutrition by addressing the underlying causes of nutrition outcomes. Therefore, we aim to assess the nutrition-sensitivity of food and agriculture policies in SSA and to provide recommendations for identified policy challenges in implementing nutrition-sensitive agriculture initiatives. Methods We assessed past and current national policies relevant to agriculture and nutrition from Ethiopia, Ghana, Malawi, Nigeria, and South Africa. Thirty policies and strategies were identified and reviewed after a literature scan that included journal articles, reports, and policy documents on food and agriculture. The policies and strategies were reviewed against FAO’s Key Recommendations for Improving Nutrition Through Agriculture and Food Systems guidelines. Results Through the review of 30 policy documents, we found that the link between agriculture and nutrition remains weak, particularly in agriculture policies. The review of the policies highlighted insufficient attention to nutrition and the production of micronutrient-rich foods, lack of strategies to increase farmer market access, and weak multi-sectoral collaboration and capacity building. Conclusion Nutrition-sensitive agriculture has received scant attention in previous agricultural and food policies in SSA that were riddled with implementation issues, lack of capacity, and ineffective methods for multi-sector collaboration. Recognition of these challenges are leading countries to revise and create new policies that prioritize nutrition-sensitive agriculture as a key driver in overcoming malnutrition.

Government Budget for Nutrition-Sensitive Agriculture in Nigeria Increased Following Development of Related Strategy

“…48 Still, the decrease in budgetary allocations to the Nutrition Division from 2018 to 2020 is of particular concern because it might be due to inadequate spending by the Nutrition Division in 2017. Several authors have highlighted that implementation of the AFSNS has been inadequate, [49][50][51] not just because of inadequate funding, but because of insufficient capacities to implement. 49 Nigeria used incremental budgeting in preparing budgets up until 2016.…”

Enhancing the health supply chain for non-communicable diseases management in Rwanda: A qualitative exploration of the perceptions from policy implementers.

“…This is in line with a recent study conducted in Rwanda on local manufacturing of generics products, which reported the limited manufacturing capacity as one of the challenges to the availability of health products (26). Different studies conducted in Sub-Saharan Africa reported limited local production capacity of nutrition products to cause long lead time of manufacturers and suppliers (22,(27)(28)(29).…”

Fostering an Enabling Environment for Nutrition-Sensitive Agriculture and Food Systems in Nigeria

“…While the AFSNS has been reported to be a comprehensive strategy, it has remained largely unimplemented 7 years after its ratification. 18 Ensuring that the available capacity can cope in the short term with the scope of NSA activities planned is important.…”

“…Agricultural policies prior to 2010 did not explicitly address nutrition and included limited considerations for food security. 18,20,21 Beginning from the National Agricultural Investment Plan (NAIP) 2011-2014 developed in 2010, influenced by the Comprehensive African Agriculture Development Programme (CAADP), 22 and drawing on experiences from a nutrition-sensitive National Programme on Food Security that commenced in 2008, agricultural policies and strategies in Nigeria began to include nutrition objectives, activities, and/ or indicators, 23 leading to intentional implementation of NSA.…”

“…17 For instance, stunting in children younger than 5 years of age reduced from 48% in 1990 to 37% in 2013 and then stagnated. 17,18 Anemia has little declined and was 62%, 55%, and 86% among children 6 to 59 months old, women 15 to 49 years old, and pregnant women, respectively, in 2021. 19 Although agriculture has been the mainstay of the Nigerian economy for decades, policy and programmatic responses to malnutrition were mostly channeled through the health sector.…”