"Reducing malnutrition levels calls for concerted efforts"
Rural 21: Ms Wanjiru, in Kenya, the Ministry of Health and the Ministry of Agriculture have been cooperating closely since 2017. Why?
Jane Wanjiru Wambugu: In Kenya, the level of malnutrition is high, both in terms of stunting and wasting, and in terms of overweight and obesity. The Ministry of Health, which has the mandate for nutrition policy, and the Ministry of Agriculture, which is responsible for food policies, saw the need for concerted efforts to tackle this problem.
How did you develop this cooperation?
In 2017, the food and nutrition security policy implementation framework was developed, co-ordinatinng policies at both National and county government level. For the devolution of agricultural extension, to mention an example, is the mandate of the county government. The same applies to health extension.
At the national policy level, we have the Kenya National Nutrition Action Plan (KNAP) 2018–2022. In the context of this action plan, we created a food and nutrition linkages technical working group that plans for nutrition-related interventions which are based in agriculture. In accordance with KNAP, key department areas were identified at each ministry which compile the respective documents, for example the Agri-Nutrition Strategy 2020-2025. The aim is to further link the policies in food to the policies in nutrition and health, thus delivering on the mandate to reduce malnutrition levels in Kenya.
Has this already resulted in concrete initiatives?
In 2017, we ran the first National Agri-Nutrition Conference. Both the counties and national governments were involved. Since then, we have held such a conference each year. It is a forum in which we bring together all the stakeholders who are doing nutrition work in agriculture.
Responding to COVID-19, the national government has installed the One Million Kitchen Gardens campaign. The aim is to mainstream nutrition in the agriculture value chain. With this we are supporting households – especially the vulnerable households – with a variety of seedlings to plant fruits and vegetables. Moreover, all the programmes in agriculture have a nutrition component. Every proposal made that is related to agriculture and has a nutrition goal is provided with support via a grant.
Furthermore, there is the School Meals Strategy 2017–2022. Here, the role of agriculture is to stimulate home-grown school meals. The school committees are strengthened through the capacity to procure safe nutritious foods within the local communities, stimulating production and consumption of diverse food at school level.
Do you especially address women in your programmes?
Yes, because women empowerment is very critical for nutrition improvement, and this applies to many areas. Let’s take agricultural production. When women farmers produce more, they can consume more. And if they don’t produce for dietary diversity, they can sell what they have so that they can buy more nutritious food. Women who are more empowered are able to understand what is good to prepare for their family. At the end of all our activities is the fact that it is women who decide what will be cooked. And if they are empowered in terms of either producing or even buying in terms of the money at their disposal, they have access and control. That’s why we are emphasising that the women should also be trained on what to produce, how to produce and how to prepare, giving them control of what gets onto the kitchen fire. Actually, this is a major item in our Agri-Nutrition Strategy.
What are the biggest obstacles on the way to better nutrition?
Maize flour is a staple food in Kenya. Normally, it is over-processed. But because it is easy to cook and is also easily available, almost 90 per cent of households in Kenya consume maize meal. Here, the Ministry of Health has launched an initiative to fortify the maize flour in order to make it more nutritious. But this is not enough. A study done in 2015 shows that the consumption of fruit and vegetables is very low in Kenya. Changing this so that the households consume at least five servings of fruit and vegetables a day, as recommended by the World Health Organization, calls for behaviour change and campaigns addressing the issue.
Is there a difference between dietary patterns in rural and urban areas?
The same study – the STEPwise survey for non-communicable diseases risk factors – has shown that there is not so much of a variance in terms of rural and urban. Sometimes, the urban population even consumes better than the rural households, the reason being that different types of food are available. What prevents them from being consumed more is their cost, their affordability. In the rural settings, in some regions, people consume more beef than any other food because that is what happens to be available and what they themselves produce. But when people produce for the market, for example French beans or cauliflowers, these products often do not end up in the rural households because they are not affordable in the rural settings. However, production for income doesn’t translate into better nutrition, because the income gained through crop sales doesn’t translate into buying nutritious foods. This has been noted in cash crop sectors like coffee and tea, where we still find high levels of malnutrition at household level.
Do you interact with civil society partners in your nutrition programmes?
We are part of the Scaling up Nutrition (SUN) Movement, where we have different organisations playing their part. Actually, under the One Million Kitchen Garden Campaign, we involve civil society in terms of advocating for production and sales of nutritious food. It is one thing to produce food, but the other thing is whether that food will be safe. So we are bringing civil society on board in order to show people the importance of producing more affordable and safe, nutritious food, especially fruit and vegetables.
What about the private sector? With its advertising campaigns, for example, it exerts considerable influence on food choices …
In the SUN Movement, we also have the private sector network. This month, we are going to launch a strategy on the private sector’s role in improving nutrition. The private sector can play a role in many areas, particularly in agriculture, for example in coffee growing or tea growing. We are talking to sector representatives about how they can improve nutrition in sectors they are buying certain kinds of commodities from.
How is the Agri-Nutrition Strategy developing?
In implementing our Agri-Nutrition Strategy, we want to achieve more engagement and cooperation between the national and the county governments, between the private sector and civil society, and between all stakeholders. One example here is the flour-blending initiative for household food and nutrition security, income and employment creation. With this initiative, we are trying to improve the nutrition content of our maize meal by blending maize with more nutritious flours like millet and sorghum. Here, the role of the private sector is critical because it is the millers who process the blended flours. At the same time, the farmers need to produce the blending crops which currently are under-produced due to climatic conditions. So there is a need for more engagement between the national and county governments as well as with the private sector to produce and process blended flours.
Any programme designed, whether in crops, livestock, or fisheries, is now required to have a nutrition objective to attract any funding. The need to understand nutrition indicators in agriculture is a capacity-building agenda both for national and county government, because, for a long time in Kenya, nutrition was seen as a health issue. Retraining the extension workers on nutrition matters in agriculture value chains is our next initiative.