Sharing experience of scoping Cocoa Nutrition Initative

Smallholder Performance Measurement Practitioner's Workshop BREAK OUT SESSION Action agenda on nutrition security Nienke Keen- IDH Christina Nyhus Dhillon- GAIN Bärbel Weiligmann- GAIN

Today:

•  Intention – process

PART 1. Cocoa Nutrition Initiative

•  How – learnings

PART 2. Pre-assessment tool

•  Findings – Conclusion – Next steps – Discussion

PART 3. Collaborative scoping, and next steps

Cocoa Nutrition Initiative

Part 1

About the Cocoa Nutrition Initiative

Our starting point §  Malnutrition is a serious issue of cocoa communities in West Africa §  Improving income ≠ improved nutrition §  Commercial value of reducing malnutrition;

-  Productivity (labour/absenteeism/loyalty) -  Future generation of farmers -  Brand value

Objective: Develop and validate models how cocoa industry can improve nutrition of cocoa producers through addressing underlying causes of malnutrition in their standard business practice Region: 4 prototypes in Ghana and Cote d’Ivoire Period: 3 years (excluding scoping) Budget: IDH € 1 million;

GAIN in-kind contribution of technical assistance; against a 1:1 co-funding of industry

Participatory scoping

  Better understanding of the issue of malnutrition in cocoa communities

  Support industry in understanding the issue

  Explore to what extend companies can be part of the solution

  Secure ownership with industry, ensure relevance through expert partner GAIN, facilitate pre-competitive collaboration through convening by IDH

Pre-assessment tool

Part 2

Nutrition pre-assessment tool for agricultural supply chains

  Origin: Initial Nutrition Screening Manual and Tool Developed for the Seeds of Prosperity Program (Tea India with Unilever & GAIN)

  Purpose: To assess whether there is a problem around dietary diversity in the population of interest and if so, to provide a clear overview of the nutrition situation among farmers in the supply chain as well as insights and opportunities for designing an intervention.

  Who does the assessment? The nutrition screening tool is designed to enable and guide in-country agriculture experts and non-technical staff to perform basic nutrition screening with the support from a local person to assist with logistics and translations.

Pre-assessment process

Description Initial nutrition situation appraisal based on desk research

Initial appraisal of the nutrient adequacy of the diet of farmers and their household using the MDD-W as indicator

Qualitative nutrition assessment into underlying causes of malnutrition (such as food access, availability and use)

Sample n/a Short nutrition interviews 8-12 farmer’s wives per community, one market visit

2-3 key informants, one market visits, 1 group discussion, 8-12 long nutritional surveys

Time 1 day (2 countries)

2 days 2 days

Result •  Document providing information on the nutrition situation in this area.

•  Assessment of local nutrient adequacy of the diet of farmers and their household.

•  Assessment of availability and accessibility

•  Insight in the need and relevance of further nutrition assessments.

•  Overview of key determinants and barriers of nutrition related behaviours.

•  Assist in the design of appropriate nutrition interventions

Main indicators used for screening Minimum Dietary Diversity- Women §  Percent of women who consume a minimum of 5 food groups (out

of ten food groups) in the previous day. §  Interpretation: Women consuming at least 5/10 food groups are

more likely to consume adequate micronutrients. Cannot be used to assess an individual diet, but rather the sub-population of women.

§  Based on the FAO/USAID/FANTA III validated MDD-W indicator guidance, with a global cut-off of 5 food groups and an indicator for the SDG Goal 2.

Home production §  Observation of home garden

Market Observation §  Availability and prices

Learnings around the tool Our starting point §  Tool is very useful for agricultural experts to

become aware of the issue of monotonous food patterns and stimulates them to think about possible supply chains solutions

§  User friendly except around correct classification of food groups

§  Requires training of enumerators to correctly probe on foods consumed

§  Requires nutritionists to analyze and interpret data

Limitations §  Cannot estimate the prevalence of any

outcomes (MDD-W or other): sufficient to get a feel for the problem, not sufficient for baseline

§  Focused around assessing dietary diversity in women and the factors affecting it (not other aspects of dietary quality, or nutrition including illness which contribute to malnutrition, etc.; not children)

§  Does not have criteria for go/no-go with an intervention

Learnings around the tool (2)

Next step with the tool §  Improved the user friendliness of the data entry

and analysis

§  Better estimate minimum sample size and sampling frame

§  Capture more localized health statistics during the co-development phase

§  Expand to a have a wider focus

Collaborative scoping, and next steps

Part 3

Application of the tool for the Cocoa Nutrition Initiative

For Ghana and Côte d’Ivoire in a participatory scoping process;

GAIN, report shared with industry

All

Data collection by 5 cocoa companies supported by GAIN + Data analysis by GAIN

GAIN & IDH, with 2 cocoa companies

All

Cocoa companies

Stunting severe in Côte d’Ivoire 34% and medium in Ghana 22% Severe anemia levels among women and children in both countries (exceeding 40%) Diarrhea prevalence higher in Côte d’Ivoire 18% than Ghana 12% Exclusive breast feeding (0-6 months) is very low 12% in Côte d’Ivoire, low 52% in Ghana Water, hygiene and sanitation can be improved in both countries, but is worse in Côte d’Ivoire

Findings Desk Study Step 1

Dietary diversity: Average 2 and 3 (minimum is 5/10): Food groups mostly consumed §  Staple (cassava, plantain, yam, maize) §  Other vegetables (tomato, union, eggplant) Sometimes §  Dark green leafy vegetables (Kontomire/ Taro) §  Nuts and seeds Occasionally §  Fruits §  Meats and fish

Home production = frequent many farmers grow: §  Vegetables and fruits §  Poultry, goats and sheep Availability of water and land main constrain to home production

Lean months due to no cocoa income & little availability of fresh foods (Ghana = June-July, CDI = February - May)

Field Survey Findings Step 2

Inadequate nutrition is a serious problem for cocoa communities There are many opportunities for the industry to promote improved nutrition in the supply chains And the industry has a genuine interest in exploring these

Conclusion after Field Visit

Step 3

Identified focus areas

Dietary diversity

Water and hygiene

Food access (during lean

season)

Early childhood nutrition

Next steps for Cocoa Nutrition Initiative

Develop nutrition prototype interventions that are designed for scaling in already ongoing programs of the industry.

Robust prototype design: §  Evidence based §  Designed for scale §  Double-loop learning §  Evaluation against a control group §  Proof: nutritional relevant, impact and cost-efficiencY

Large scale baseline study by KIT (n=3000)

Better nourished cocoa communities are

healthier, more productive and

provide a more attractive prospect

for the next generation cocoa producers

Discussion