Landscape Analysis of Nutrition-sensitive Agriculture Policy Development in Senegal.

BACKGROUND: Unlocking the agricultural potential of Africa offers a genuine opportunity to address malnutrition and drive development of the continent. OBJECTIVE: Using Senegal as a case study, to identify gaps and opportunities to strengthen agricultural policies with nutrition-sensitive approaches. METHODS: We carried out a systematic analysis of 13 policy documents that related to food production, agriculture, food security, or nutrition. Next, we collected data during a participatory analysis with 32 national stakeholders and in-depth interviews with 15 national experts of technical directorates of the different ministries that deal with agriculture and food production. RESULTS: The current agricultural context has various elements that are considered to enhance its nutrition sensitivity. On average, 8.3 of the 17 Food and Agriculture Organization guiding principles for agriculture programming for nutrition were included in the policies reviewed. Ensuring food security and increasing dietary diversity were considered to be the principal objectives of agricultural policies. Although there was considerable agreement that agriculture can contribute to nutrition, current agricultural programs generally do not target communities on the basis of their nutritional vulnerability. Agricultural programs were reported to have specific components to target female beneficiaries but were generally not used as delivery platforms for nutritional interventions. CONCLUSIONS: The findings of this study indicate the need for a coherent policy environment across the food system that aligns recommendations at the national level with local action on the ground. In addition, specific activities are needed to develop a shared understanding of nutrition and public health nutrition within the agricultural community in Senegal.

Effectiveness of a community-based intervention to improve nutrition in young children in Senegal: a difference in difference analysis.

There are few studies of community growth promotion as a means of addressing malnutrition that are based on longitudinal analysis of large-scale programmes with adequate controls to construct a counterfactual. The current study uses a difference in difference comparison of cohorts to assess the impact on the proportion of underweight children who lived in villages receiving services provided by the Senegal Nutrition Enhancement Project between 2004 and 2006. The project, designed to extend nutrition and growth promotion intervention into rural areas through non-governmental organisation service providers, significantly lowered the risk of a child having a weight more than 2 sd below international norms. The odds ratio of being underweight for children in programme villages after introduction of the intervention was 0.83 (95% CI 0.686, 1.000), after controlling for regional trends and village and household characteristics. Most measured aspects of health care and health seeking behaviour improved in the treatment relative to the control.

Determinants of malnutrition in Senegal: individual, household, community variables, and their interaction.

The relationship between poverty and nutrition is a two-sided one: on the one hand, economic growth (which is generally associated with an eradication of poverty) leads to reduced malnutrition. On the other hand, nutrition is one of the key ingredients for human capital formation, which in turn represents one of the fundamental factors of growth. There are numerous studies that show the correlates of malnutrition using both household- and community-level variables. However, few of these studies allow for the potential endogeneity of community infrastructure or indicate their interplay with characteristics of the mother. The current study considers the socio-economic determinants of child malnutrition and investigates how programs compensate for the increased risks facing young mothers and their children or substitute for a low social status of the mother in the household. The empirical results show that children of mothers giving birth at a young age are disadvantaged in terms of their anthropometric status. Interaction effects of the presence of a non-governmental organization (NGO) or a health post in the village with characteristics of the mother stress the important role played by these institutions in helping disadvantaged mothers overcome their difficulties. These findings have implications for efficient program design and represent a further step towards gaining an improved understanding of the complex determinants of child (mal)nutrition.