Simple solutions for complex problems? What is missing in agriculture for nutrition interventions

Abstract

Within the nutritionism paradigm, in this article we critically review the marketization and medicalization logics which aim to address the pressing issue of malnutrition in low- and middle-income countries. Drawing from political economy and food system transformation discourses, we are using the popular intervention types of nutrition-sensitive value chains (marketization logic) and biofortification exemplified through orange-fleshed sweet potato (medicalization logic) to assess their outcomes and underlying logics. We demonstrate that there is insufficient evidence of the positive impact of these interventions on nutritional outcomes, and that their underlying theories of change and impact logics do not deal with the inherent complexity of nutritional challenges. We show that nutrition-sensitive value chain approaches are unable to leverage or enhance the functioning of value chains to improve nutritional outcomes, especially in light of the disproportionate power of some food companies. We further demonstrate that orange-fleshed sweet potato interventions and biofortification more broadly adopt a narrow approach to malnutrition, disregarding the interactions between food components and broader value chain and food system dynamics. We argue that both intervention types focus solely on increasing the intake of specific nutrients without incorporating their embeddedness in the wider food systems and the relevant political-economic and social relations that influence the production and consumption of food. We conclude that the systemic nature of malnutrition requires to be understood and addressed as part of the food system transformation challenge in order to move towards solving it. To do so, new evaluation frameworks along with new approaches to solutions are necessary that support multiple and diverse development pathways, which are able to acknowledge the social, political-economic, and environmental factors and drivers of malnutrition and poverty.

Who is responsible for fixing the food system? A framing analysis of media reactions to the UK's National Food Strategy

“…This requires reframing "what we eat" from issue of consumer choice to a wider transformation of the broken food system. As such, the re-politicisation of nutrition and food security as a structural problem that contests the nature of what is produced and how it is distributed (Patel et al, 2015) is essential for policymakers to view the food system transformation as part of a wider social justice process (Hambloch et al, 2023).…”

Embracing uncertainty: foundations of a learning system for food systems transformation

“…Understanding food systems as complex systems requires an awareness that solving complex systems problems, such as food insecurity, cannot be achieved by simply analyzing the component parts of the system (Hambloch et al, 2023). Nonlinear cause-effects are inherent properties of the system itself (Conti et al, 2023;Hambloch et al, 2023). When attempting to improve food systems outcomes, the complexity and uncertainty of food systems can manifest in various and often contradictory ways.…”

“…This can lead to unintended consequences, such as perpetuating poverty and malnutrition, despite well-intentioned development efforts (Leach et al, 2020). For instance, efforts to enhance diets and address nutritional security may face obstacles due to the interests and incentives of influential actors in food value chains who are seeking new sources of revenue (Hambloch et al, 2023; for a case study, see Ansari et al, 2018). In addition, it is important to note that powerful actors and their interests can greatly influence the way problems and solutions are presented.…”

Impacts of population growth and economic development on food security in low-income and middle-income countries

“…According to the paradigm of political economy, food and nutrition are considered purely composed of nutrients, disregarding the political-economic and socio-cultural circumstances that determine the economic and cultural value of food production (Hambloch et al, 2022). Within the scope of this paradigm, the delivery of private sectors and the whole food and nutrition systems as well as increasing nutrient-consuming efforts was significantly supported by many people.…”

“…On a global level, the attention to addressing undernourishment in low-and middle-income countries (LMICs) expanded notably since the beginning of the 21 st century (Hambloch et al, 2022). The percentage of the population that is undernourished in low-income countries since 2014 constantly has grown, especially in Sub-Saharan Africa, where the prevalence of undernourishment raised from 18% in 2014 to 23.2% in 2021 (Hambloch et al, 2022), and the rise in Sub-Saharan Africa is to some extent driven by population growth. Improvement toward lessening undernourishment has been especially restrained in West Africa, particularly in Nigeria, which accounts for a significant portion of global malnutrition (Adeyemi et al, 2022).…”