Deliberate nutrition design
While nutrition’s critical role in health and livelihood outcomes has been documented for decades, the Malawi most hungry nation article—and the March Afrobarometer report it discusses—fail to mention nutrition’s critical importance to both Malawi’s battle against hunger and efforts to increase the country’s agricultural production. These pieces also downplay the importance of diversifying agricultural production in combatting poor nutrition.
Recent data from Malawi Government and donor interventions reveal agricultural growth, most particularly in maize production. But this growth has not translated into improved nutritional outcomes. There is a need for deeper systemic analyses that look beyond total calories produced and consumed, to the specific types of foods available, the nutritional quality of individual diets, and the level of food insecurity and malnutrition that individuals and communities face. As the government evaluates its current and future priorities, nutritional measures and outcomes should be front and centre.
A growing community of multisectoral actors, from civil-society organisations to academic institutions, have recognised the need to connect agricultural interventions with nutritional outcomes. Instead of approaches that solely emphasise the production of staple crops, strategies that encourage diversified production can impact the variety of foods available across seasons while highlighting nutrient-dense and indigenous value chains.
Another important consideration is that of household dynamics. Beyond examination of the availability of nutritious foods is an understanding that food allocation in many households gives preference to men, boys and elders. Women and girls may not see equal benefits from diversified agricultural production; it is important to establish interventions that are carefully designed.
To achieve this, a systems approach to understanding local contexts and potential points of intervention is needed. This article proposes three ways to better design interventions to create a cycle of increased productivity that leads to better nutrition: incorporate local communities into all discussions, include explicit extension goals, and ensure multisectoral responses and coordination.
Limited understanding of Malawian community preferences, patterns, and decision-making habits makes it difficult to assess how specific crops will ultimately overcome the many nutrient shortfalls. This is especially true for women, who comprise an untapped, yet critical, resource for understanding how to improve household and child nutrition. As primary caregivers, women face more significant economic and decision-making barriers and, therefore, additional challenges in helping decrease food insecurity while improving the nutritional quality of household diets.
The proposed systems approach should include a variety of multisectoral stakeholders in early conversations, and should take place in familiar local settings, and in Chichewa and other local languages whenever possible.
When it comes to the specific type of intervention, previous research indicates that significant changes in nutritional outcomes and diet are more consistently observed when education, counselling, capital investments, and gender considerations are explicitly included.
Productivity interventions that lack explicit extension and women’s empowerment cannot reach their full potential as communities aren’t versed in how they should best utilise them or ensure their sustainability.
There are dozens of important questions to ask the communities in greatest need, including those that are food insecure and malnourished. Coupling this approach with business counselling, lessons on the importance of women’s leadership and equality, and appropriate capital investments, communities will be empowered to increase production and use any additional income to improve their consumption patterns.
Nutrition must be considered important to the design of both agricultural production and dietary interventions. Often, it’s perceived as important for one or the other; however, this narrow lens has proved short-sighted. Both governments and donors need more coordinated, multisectoral approaches that discard this false dichotomy. As the new Malawian government reprioritises and designs future plans, we encourage a diversity of ministries and others to come to the same table with the goal of integrating nutrition into their key priorities.
Addressing the complexities of malnutrition and food insecurity will require sustained effort across multiple sectors for years to come. We hope to contribute to these conversations, decisions, and ultimately to improve health across the country.
