Food production and consumption in Bamyan Province, Afghanistan: the challenges of sustainability and seasonality for dietary diversity

In Asia, high levels of malnutrition threaten the health and livelihoods of millions of households. This paper concentrates on linkages between agriculture and nutrition in Afghanistan where food and nutrition insecurity are increasing and agricultural sustainability is increasingly compromised by climate change. We explore seasonal patterns of food production and consumption in the remote and robust ecological environment of Shah Foladi, Bamyan Province. Analysis of qualitative data from household interviews in eight villages has provided a wealth of insights into the seasonality of diets. Even within a broadly homogeneous environment, households were found to be markedly heterogeneous in respect of their assets, production, market, finance and employment strategies. The so-called ‘lean season’ was found to vary accordingly. Nevertheless, a general lack of dietary diversity during much of the year is likely to cause micronutrient malnutrition, especially for the vulnerable groups of children, adolescent girls and women. Potential interventions are proposed which need to account for the local context in order to overcome the natural and political constraints. These strategies include agricultural innovation and multi-sectoral policy approaches. In the end, reducing national insecurity is a pre-requisite for sustainable improvement in nutrition-sensitive agricultural development

Efficiency, food security and differentiation in small-scale irrigation agriculture: Evidence from North West Nigeria

Ambiguity over the effectiveness of agricultural intervention is more pronounced in rural areas where the majority of North West Nigeria’s poor population, and those involved in agriculture, reside. Further characterising these areas is the paucity of research on the issue of differentiation within the smallholder community. Specifically, definite classification of households based on efficiency, food security and income status remains inadequate. The study explores smallholder households’ differentials on the basis of these three phenomena, and other factors that affect smallholder typologies. Data was collected from 306 randomly selected smallholders involved in the Middle Rima Valley Irrigation Project, Sokoto State, Nigeria. Smallholders’ technical efficiency and households’ Food Consumption Score (FCS) were assessed. Also, Pearson correlation analysis, a segmentation approach using cluster analysis and multinomial regression model were used for the study. The study showed that the mean efficiency level of smallholder farms was 85.9% and that the majority of the households were food insecure

The Double Burden of Malnutrition: A Systematic Review of Operational Definitions

Background Despite increasing research on the double burden of malnutrition (DBM; i.e., coexisting over- and undernutrition), there is no global consensus on DBM definitions. Objectives To identify published operational DBM definitions, measure their frequency of use, and discuss implications for future assessment. Methods Following a structured search of peer-reviewed articles with terms describing “overnutrition” [e.g., overweight/obesity (OW/OB)] and “undernutrition” (e.g., stunting, micronutrient deficiency), we screened 1920 abstracts, reviewed 500 full texts, and extracted 623 operational definitions from 239 eligible articles. Results We organized three identified DBM dimensions (level of assessment, target population, and forms of malnutrition) into a framework for building operational DBM definitions. Frequently occurring definitions included coexisting: 1) OW/OB and thinness, wasting, or underweight (n = 289 occurrences); 2) OW/OB and stunting (n = 161); 3) OW/OB and anemia (n = 74); and 4) OW/OB and micronutrient deficiency (n = 73). Conclusions Existing DBM definitions vary widely. Putting structure to possible definitions may facilitate selection of fit-for-purpose indicators to meet public health priorities

A qualitative investigation of lived experiences of long-term health condition management with people who are food insecure.

Background: As more people are living with one or more chronic health conditions, supporting patients to become activated, self-managers of their conditions has become a key health policy focus both in the UK and internationally. There is also growing evidence in the UK that those with long term health conditions have an increased risk of being food insecure. While international evidence indicates that food insecurity adversely affects individual's health condition management capability, little is known about how those so affected manage their condition(s) in this context. An investigation of lived experience of health condition management was undertaken with food insecure people living in north east Scotland. The study aimed to explore the challenges facing food insecure people in terms of, i. their self-care condition management practices, and ii. disclosing and discussing the experience of managing their condition with a health care professional, and iii. Notions of the support they might wish to receive from them. Methods: Twenty in-depth interviews were conducted with individuals attending a food bank and food pantry in north east Scotland. Interview audio recordings were fully transcribed and thematically analysed. Results: Individuals reporting multiple physical and mental health conditions, took part in the study. Four main themes were identified i.e.: 1. food practices, trade-offs and compromises, that relate to economic constraints and lack of choice; 2. illness experiences and food as they relate to physical and mental ill-health; 3. (in) visibility of participants' economic vulnerability within health care consultations; and 4. perceptions and expectations of the health care system. Conclusions: This study, the first of its kind in the UK, indicated that participants' health condition management aspirations were undermined by the experience of food insecurity, and that their health care consultations in were, on the whole, devoid of discussions of those challenges. As such, the study indicated practical and ethical implications for health care policy, practice and research associated with the risk of intervention-generated health inequalities that were suggested by this study. Better understanding is needed about the impact of household food insecurity on existing ill health, wellbeing and health care use across the UK