Tackling Agriculture-Nutrition Linkages in India: Emerging Findings from the TANDI Initiative

1. Agriculture-Nutrition Linkages In India:  Emerging findings from the Tackling Agriculture Nutrition Disconnect in India (TANDI) initiative Suneetha Kadiyala, Research Fellow Poverty Health and Nutrition Division, International Food Policy Research Institute, IFPRI LCIRAH Lunch Seminar, 20th July 2011

2. Acknowledgements • IFPRI: D. Headey, A. Chiu, P. Menon, J. Harris, S. Gillespie & others • TANDI Core Group: • Mahendra Dev, Indira Gandhi Institute of Development Research (IGIDR) • Harshi Sachdev,Sitaram Bhartia Institute of Science and Research • Sukhadeo Thorat, Indian Institute of Dalit Studies • Rajani Ved,National Health Systems Resource Center • S. Parasuraman, Tata Institute of Social Sciences (TISS) • Consultants: Priya Bhagowalia • Funding: BMGF

3. Outline • Some key trends in development indicators in India • Trends in undernutrition: Some global and regional comparisons • Conceptual frameworks and pathways • Determinants of child nutrition • Agriculture -nutrition pathways • 6 sets of emerging findings • Lingering questions and some points for discussion

4. Trends in Indian development 5 facts

5. Trends in Indian development: 5 facts • Sustained & rapid economic growth trajectory • Steady declines in poverty rates, but 42% < $1.25.day • Agriculture sector performance is below the target growth rates of 4% • Discouraging progress in human development • HDI (134/182); GGI (114/134) • Glacial progress in nutrition % growth Source: Gulati &Shreedhar Considerable variations in progress by state & social groups

6. Undernutrition in India Some global and regional comparisons

7. 2009 Global Hunger Index

8. 2008 India State Hunger Index • India State Hunger Index scores • Serious in 4 states • Alarming in 12 states • Extremely alarming in 1 State India State Hunger Index 2008

9. Indian states rank poorly even globally India Gujarat Madhya Pradesh Punjab Global Hunger Index and India State Hunger Index 2008

10. Child Nutrition among under-5s in South Asia (2005 – 2007) Source: UNICEF http://www.childinfo.org/undernutrition_nutritional_status.php National Family Health Survey, India, 2005-06 Bangladesh Demographic Health Survey, 2007 Nepal Demographic Health Survey, 2006 Sri Lanka Demographic Health Survey, 2006-07 Pakistan National Nutrition Survey 2001-02, Re-analyzed by WHO Nov 2007 Source: Menon, Bamezai et al

11. Maternal BMI (weighted) in select South Asian countries Source: Menon, Bamezai et al

12. Tackling Undernutrition in India The causes and consequences of undernutrition cut across sectors and so do the solutions

13. Long term consequences Adult size, intellectual ability, economic productivity, reproductive performance, metabolic and cardiovascular diseases Short term consequences Morbidity, disability , mortality Direct interventions Infant feeding Vitamin A, Zinc Hygiene Biofortification Maternal and child undernutrition Immediate causes Inadequate dietary intake Diseases maternal & child care Household food security Hygiene; Access to health services Indirect Interventions Agriculture (pattern, pace) Social protection Education Health Systems Women’s empowerment Underlying causes Income poverty: employment , dwelling, assets, remittances, transfers Lack of capital: Financial, human physical , social and natural Economic growth; poverty reduction; environment ; institutions and governance Basic causes Social , economic and political context Adapted from Black et al, 2008; Ruel 2008

14. Status of 12 essential direct interventions in India

15. Interventions to reduce undernutrition • Effective health and nutrition interventions are essential, but not enough: • Direct interventions, if scaled up and implemented effectively, will address only 1/3rd of the burden • Indirect interventions essential to address 2/3rds of the undernutrition burden • There is not enough understanding of how to make indirect interventions “pro-nutrition”

16. Tackling the Agriculture-Nutrition Disconnect in India (TANDI) Some emerging findings

17. TANDI’s Approach • Facilitate transdisciplinary dialogue and research on key knowledge gaps on linkages between agriculture and nutrition in India • What are the pathways between agriculture and nutrition? • Is the potential being realized? • What can be done to increase the realization of the potential? • Progress to date: • Consensus reached on pathways and analytical frameworks • Systematic literature review • Data set audit undertaken • Empirical analyses underway

18. Conceptualizing the pathways between agriculture and nutrition Agriculture is a key driver of poverty reduction But Pathways to nutrition are diverse and interconnected • Agriculture as a source of food • Agriculture as a source of income (employs 2/3rd of rural and half of India’s labor force) • Agricultural policy and food prices • Expenditure patterns: how income derived from agriculture is actually spent Gender dimensions (83% of female rural labor force is in agriculture) • Women’s status and intrahousehold decisions and resource allocation • Women’s ability to manage young child care • Women’s own nutritional status

19. Important household level "leakages” along the agriculture-child nutrition pathways • In B’desh, a 1% increase in income improved the height-for-age scores by just 0.03%. Source: Ahmed 1993

20. Emerging findings 1 Cross-country evidence

21. Is the agriculture-nutrition potential being realized? Cross-Country evidence (Headey 2011) • Does agriculture growth (vs. non-ag growth) influence nutrition? • A GDP per cap growth of 5% reduces stunting prevalence around 0.9 percentage points • Ag growth has a significant and negative effect on stunting • Effects much stronger when Indian states are excluded from the sample – i.e. disconnect between agriculture & nutrition in India?

22. Agricultural growth is certainly a huge driver of changes in energy supply It is hard to disentangle channels – is it poverty reduction, increased energy availability, or increased dietary diversity? Source: Headey 2011

23. The impacts of 10% increase in income on stunting Source : Headey 2011

24. Emerging findings 2 The data disconnect

25. India specific studies are sparse • Systematic search of 15 databases • Only 71 articles of varying scale, scope, methodology and rigor attempted to address the issue of ag-nutrition • None measured nutrition status • The main reason for this paucity pertains to data • Early on in TANDI we saw some value added in exploring the different datasets in the Indian context, seeing where the gaps were and whether there might be “quick wins” from merging data • Starting point was to think of the characteristics of an ideal dataset linking agriculture and nutrition

26. Type 1 datasets: “Nutrition/health” datasets with little economic information

27. Type 2 datasets: Agricultural/economic datasets with little nutrition or health information

28. Type 3 datasets: “Hopeful” (e.g. IHDS, ICRSAT VDS, Young Lives Panel)

29. Emerging findings 3 Trends in agriculture performance and nutrition outcomes

30. Trends in prevalence of underweight children, per capita food production and expenditures (1970-2008) • 22% point decline in underweight when food production increased • As food production per capita slowed from the mid 1990s, so too did nutritional improvements • At the national level, there does not appear to be a disconnect, but large interstate variations

31. Agriculture performance and anthropometric outcomes Weak association between ag. growth and stunting Strong association between grain production and stunting Source: Headey, Chiu and Kadiyala, 2011

32. Weak relationship between agriculture performance and nutrition status outcomes (income linkage) Estimated elasticities between malnutrition and welfare indicators *significant differences from zero at the 10% level, # indicates marginal insignificance at the 10% level Source: Headey, Chiu and Kadiyala 2011

33. Emerging findings 4 Trends in dietary patterns

34. Trends in average household calorie availability and non-cereal calorie shares Source: Headey, Chiu and Kadiyala 2011

35. Dietary Diversity : Sources of Calorie Intake in the Rural Areas (Food Consumption linkage) Source: Dubey and Thorat 2011

36. Changes in prices (1983-2000) explain changes in consumption (food price linkage ) Lowest Income group Highest Income group • But what explains changes in prices? • Source: Calculation from NSSO

37. Rising pulse prices linked to long term neglect of pulse sector by government policies Rising coarse grain prices linked dietary diversification >> rising use of coarse grains in meat and diary production Source: Calculations from USDA 2011 data

38. Emerging findings 5 Implications of income growth for child nutrition

39. Does income influence child’s dietary diversity?

40. Does child’ dietary diversity affect nutrition status outcomes? P<0.001 for HAZ & WAZ; p=0.10 for WHZ Source: Aguayo et al, 2011

41. Emerging findings 6 Maternal employment and time use effects

42. Maternal employment in agriculture and child care • Some evidence of mother’s employment status on child survival (Kishor and Sulabha 1998) • Long hours and physical work of agriculture may lead to neglect of children • Also provides possibility for other adults or older children to take care of infants

43. Impact of employment in agriculture on maternal and child nutrition

44. Who takes care of the children?

45. Impact of care giving status on stunting

46. Discussion points

47. Some discussion points • Weak agricultural growth, but there is indeed an agriculture-nutrition disconnect at state level • Diets have diversified, but not for the poor • Through improved food production and prices, agriculture influences diet quality • At the household, it is unclear if engagement in agriculture influences consumption patterns and nutrition status in India • Agriculture may adversely affects mother’s BMI, and childcare, but observable effects are quite small • Is this an agricultural problem or a rural problem? • Strong wealth effects on dietary diversity of children>>child anthropometry

48. Knowledge gaps—some discussion points • Several!!!! • Why are some states doing better than others (positive outliers)? • Who is being left out of the growth process? Why? • What are the gender implications of the current agriculture interventions/policies? How do they mediate nutrition outcomes? • Implications of child labor • Convergence of various services • Political economy to strengthen rural economy (farm and non-farm)

49. Comments suggestions appreciated!!!