vitamin A deficiency—decreased. In addition to increased
dietary diversity, women earned on average $4 more per
month from the sale of fruits and vegetables. This additional
income was used to further improve diets and household living conditions.44
Celia Escudero Espadas
McGovern-Dole School Feeding Program). Of this amount,
approximately 66 percent was sold on markets to generate
cash for development activities.34 Little information is
available about how much of the non-emergency food aid
was used for nutrition programs.
The President’s Emergency Program for AIDS Relief
(PEPFAR) also addresses nutrition concerns to improve
the effectiveness of anti-retroviral medications among some
program participants. Nutrition counseling and food by
prescription are provided to malnourished people living with
HIV. Additionally, PEPFAR provides nutritional support
(assessment, counseling, and food when needed) as part of
the continuum of care for orphans and vulnerable children.35
Of PEPFAR’s large annual budget (approximately $5 billion
in 2008) about 10 percent is directed toward care for orphans
and vulnerable children, and only a portion of this budget is
used to address malnutrition.36
If spending within maternal and child health programs
(which includes funding for IYCN) is any indication,
total commitments for nutrition are small. In 2008, $447
million was directed at achieving maternal and child
health objectives, of which reducing malnutrition is just
one component.37 Clearly, this is a modest investment,
particularly considering that U.S. poverty-focused
development assistance amounted to $15.4 billion in 2008.38
Linking Agriculture, Food Security,
and Nutrition
In 2008, food riots focused media attention on increased
hunger among urban populations. Still, the vast majority of
people suffering from hunger and malnutrition live in rural
areas and earn a living through farming. Improvements in
agriculture can help enhance food security and nutrition.
For example, higher yields and better storage capacity
can increase the amount of food available to households,
ending cycles of seasonal hunger where food shortages lead
to malnutrition. Planting crops high in micronutrients can
lead to diversified diets, ensuring that children get essential
micronutrients. Increasing the capacity to process foods
locally and to fortify commonly consumed foods (salt, soy
sauce, wheat, corn) can ensure that basic foods contain the
vitamins and minerals young children need to grow up
healthy and strong.
In Bangladesh, a USAID-supported program encouraged
women to grow small home gardens in order to increase family fruit and vegetable production and consumption. Along
with seeds and other inputs, the program provided practical
information about farming and nutrition education. Household consumption of foods rich in vitamin A increased, and
in turn, the incidence of night blindness—an indicator of
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As the Bangladesh example demonstrates, strengthening
the linkages among agriculture, food security, and nutrition
will not come without specifically focusing attention on the
roles of women as caregivers and as farmers. Agriculture
programs designed to raise incomes, for example, must
also address barriers to women’s control over financial and
productive resources. Projects to expand the kinds of crops
being grown must also provide mothers with information
about how to feed children a diversified diet and why it is
important. Recent pledges to increase international funding
for agriculture after years of neglect present an opportunity
to further explore the link between agriculture and nutrition
and to try new approaches.
It is also critical to ensure that new efforts to promote
agriculture do no harm. Efforts to increase income by
promoting the cultivation of cash crops such as coffee
or cotton may actually lead to a worsening of household
nutrition, especially if it leads to a greater demand for
female labor without returning income women can use to
buy food or other important household items. Incorporating
nutrition analysis into agriculture programs can help to
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