Integrating Agriculture and Nutrition Actions to Improve Maternal and Child Nutrition: Research on Program Impact Pathways

From a LCIRAH Workshop, June 21-22, 2012, London.

There is a need to establish solid, empirical knowledge of the effects of integrated programs targeting agriculture, health and nutrition, which are often complex, multi-sector interventions. In particular, there is a need to develop metrics and measures that will allow researchers within the realm of agriculture-to-health to understand the barriers, facilitators and drivers of nutrition impact- and to be able to rigorously say why and how a program succeeded or failed, as well as draw more generalizable lessons about the combination of inputs and services across multiple sectors that together achieve value-added gains for nutrition. In other words, innovative evaluation designs and metrics are needed to consider not only the overall impact of integrated programs, but also to assess theorized programme impact pathways, and the parameters of effective implementation (process research or, as some call it, delivery science).

The meeting built on a May 2011 Leverhulme Centre for Integrative Research on Agriculture and Health (LCIRAH) workshop, and the International Food Policy Research Institute (IFPRI)'s 2020 Vision Initiative, on multi-sectoral metrics. This workshop, co-facilitated by LCIRAH and USAID's Nutrition Collaborative Research Support Programme (N-CRSP) led by Tufts University's Friedman School of Nutrition, focused on the development of metrics, using a selected set of projects as material for a structured, case-study exercise.

Generation of Key Questions

The workshop generated several key questions for researchers assessing complex interventions in field settings. Participants debated what constitutes 'nutrition-sensitive' development, and whether there is a common understanding of the elements of agriculture, health and nutrition which make up many of these programs. Other key questions included:

- What are the actual linkages between agriculture and nutrition? What are the assumptions we are making about impact pathways? Can we quantify the conversion factors linking each step in the impact pathways?

- What goals are we trying to achieve with the interventions: Local improvements; progress to catch-up to a national mean; or the reaching of international standards/targets for outcomes and processes?

- What evidence do we need, at what level, rigor, and scale, to recognize causal or highly plausible effects of complex interventions? What are the key metrics, and what essential data are needed by the different research communities to measure them? What should be measured in field studies, to what sensitivity?

- What is a minimum package for agri-health for nutrition, and what are its elements? How locally contextual are such packages? Where is integration essential, for optimizing different outcomes?

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