Interconnections between food production, nutrition and health in conditions of rural poverty

1. Interconnections between food production, nutrition and health in conditions of rural poverty Mike Joffe Imperial College London

2. household income nutritional and health status dietary intake

3. labour productivity household income nutritional and health status

4. labour productivity household income nutritional and health status dietary intake

5. land access soil fertility & climate non-agricultural livelihoods (jobs) agricultural livelihoods labour productivity household income food availability nutritional and health status dietary intake pathogens healthcare services clean water, sanitation, pesticides, etc women’s time, education, power

6. Poverty as a self-perpetuating cycle • the cycle is intended to correspond with households’ lived experience • different households will differ in its applicability and its content • the outcome “variable” is perpetuation of the cycle • the central concept is reserve capacity • when this reaches zero, cycle interruption occurs • food insecurity: variability in reserve capacity • the cycle’s causal processes occur over time • attention is needed to generalisability of: overall structure, component variables & links, parameter estimates – and, reasons for the latters’ variation • between households and between locations

7. irrigation improved crops agricultural tools chemical inputs landmine clearance micronutrient-dense crops education re consumption improved infant feeding labour productivity household income nutritional and health status dietary intake healthcare immunization maternity care TB treatment ART for HIV primary prevention impregnated bed nets protective measures against aflatoxins, chemicals, etc non-polluting fuels

9. Thank you!

10. Poverty as a self-perpetuating cycle • the cycle shows the main interrelations: BREADTH of poverty • outcome “variable” is perpetuation of the cycle • the central concept is reserve capacity, corresponding to SEVERITY/DEPTH of poverty • when this reaches zero, cycle interruption occurs • cf. food insecurity: variability in reserve capacity • the cycle’s causal processes occur over time • this has implications for DURATION of poverty • it requires longitudinal assessment • the cycle corresponds to households’ lived experience • attention is needed to generalisability of: overall structure, component variables & links, parameter estimates – and, reasons for the latters’ variation • “deterministic” links include: dietary intake & anthropometry; bed nets & malaria • probabilistic links include the risk of child & adult mortality • representative population; theoretical sampling

11. low functional health status low birth weight risk of infant/child death impaired neurodevelopment poor childhood growth low energy/strength risk of (adult) death impaired immune function poor health status diseases infections • TB • measles • malaria • HIV • pneumonia • diarrhea • etc etc anemia poordietary status macronutrient deficiency micronutrient deficiency low dietary intake

12. poor hygiene practices low level of education water sewage disposal low income healthcare availability housing quality low socio- economic position other amenities injury zoonoses e.g.bird ‘flu poor labor conditions pesticides fuel poverty indoor air pollution polluting fuels poor health status lack of wellbeing social hierarchy