At the end of this blog posting I have pasted an email that was distributed by 3IE. The email summarizes a recent review by Edoardo Masset and others entitled “A systematic review of agricultural interventions that aim to improve nutritional status of children”. The review itself was excellent, but the summary of the review was seriously flawed. I wrote Masset who agreed with my assessment and planned to contact 3IE about it. However, I have since heard the errors propagated in the summary referred to in a talk at IDRC and referred to in other websites. It seems the summary has been widely read, but the review itself has not been. So, I am writing here a summary of the problems with the review, hoping to stop some of these errors from being propagated further.

Again, the report itself is excellent, and I congratulate the authors on a job well done. But the four statement summary by 3IE has three major errors.

• “Nutrition-focused agricultural interventions are short term and cannot address the root causes of malnutrition like chronic poverty and maternal health.”

There is a small body of literature that shows the impact of agriculture-nutrition interventions does not usually last long beyond the formal intervention period. But this is hardly something peculiar about agriculture-nutrition interventions! At least agriculture-nutrition interventions often have a short/medium term nutrition impact, which is better than most agriculture interventions alone. The report makes the following valid point, which is an entirely different matter than what is written in the 3IE summary: “The studies reviewed found a greater impact of the intervention on the prevalence of short term indicators of hunger (wasting and underweight) versus long-term indicators (stunting). However, this result could be a consequence of the short time frame adopted by the evaluations, which is not well suited to detect long term effects.”

• “Agricultural interventions to tackle malnutrition are not reaching the poorest and most at risk to chronic hunger such as orphans and other vulnerable children.”

I am not sure of the particular evidence for this, although I believe it is true. But again, this is hardly something specific to agriculture-nutrition interventions. Inequity of reach is always a problem. More importantly, I did not find this point being made in the review.

• “Many development agencies believe that fortifying foods with vitamins and minerals is a cost- and time-effective way to tackle malnutrition, but more studies showing positive impact are needed for justifying further investment in such programmes.”

The report deals specifically with biofortification (selecting and growing crops with higher micronutrient content), which is relatively new, and totally different than conventional food fortification (industrial process of adding micronutrients to processed foods, such as adding iodine to salt, or vitamin A to vegetable oil). The review is correct in stating that biofortification needs more study. There has been success with biofortified orange flesh sweet potatoes in southern Africa, but no other biofortified crops have yet been successful. The review does not deal with conventional food fortification for which there is overwhelming evidence of its effectiveness and enough evidence of its cost-effectiveness. It would be a shame if observers of global nutrition efforts now have the impression that food fortification does not work.

There is a longer summary on the 3IE website and it gets biofortification more or less right. One unsubstatiated statement is made: “Bio-fortified seeds ...do better in poor soils and can be more resistant to disease than ordinary seeds.” It sounds like they have conflated some GMO claims with biofortification. Boy, if a seed could produce a plant that was more disease resistant, grew well in poor soils and was more nutritious, then all our problems would be solved!

************Email from 3IE*********************

Dear colleagues,

Many solutions to malnutrition are nutrition-focused agricultural interventions like bio-fortification, homegardens and livestock development. The first issue of Evidence Matters -- a new brief from 3ie and the Institute of Development Studies (IDS) -- draws from a recent systematic review of agricultural interventions which have aimed to improve the nutritional status of children. It addresses the fundamental question of whether there is sufficient evidence to show that increased household income and a better diet can improve children’s nutritional status.

There is evidence to show that:

• Nutrition-focused agricultural interventions are short term and cannot address the root causes of malnutrition like chronic poverty and maternal health.
• While such interventions may increase income from one source, they may result in reduced income from other sources which may mean no change in overall buying power.
• Agricultural interventions to tackle malnutrition are not reaching the poorest and most at risk to chronic hunger such as orphans and other vulnerable children.
• Many development agencies believe that fortifying foods with vitamins and minerals is a cost- and time-effective way to tackle malnutrition, but more studies showing positive impact are needed for justifying further investment in such programmes.

Read the first issue of the 3ie-IDS brief Evidence Matters Zero child hunger: breaking the cycle of malnutrition