Interconnections between food production, nutrition and health

in conditions of rural poverty

Mike Joffe Imperial College London

dietary intake

nutritional and health status

household income

labour productivity

nutritional and health status

household income

labour productivity

dietary intake

nutritional and health status

household income

labour productivity

dietary intake

nutritional and health status

agricultural livelihoods

land access

healthcare services clean water, sanitation, pesticides, etc women’s time, education, power

food availability

soil fertility & climate

non-agricultural livelihoods (jobs)

household income

pathogens

Poverty as a self-perpetuating cycle • the cycle is intended to correspond with households’

lived experience • different households will differ in its applicability and its content

• the outcome “variable” is perpetuation of the cycle • the central concept is reserve capacity • when this reaches zero, cycle interruption occurs • food insecurity: variability in reserve capacity • the cycle’s causal processes occur over time • attention is needed to generalisability of: overall

structure, component variables & links, parameter estimates – and, reasons for the latters’ variation • between households and between locations

dietary intake

nutritional and health status

primary preventionimpregnated bed netsprotective measures against aflatoxins, chemicals, etcnon-polluting fuels

micronutrient-dense cropseducation re consumptionimproved infant feeding

irrigationimproved cropsagricultural toolschemical inputslandmine clearance

healthcareimmunizationmaternity careTB treatment ART for HIV

household income

labour productivity

low labourproductivity

poor childhood growth

diseases

risk of infant/child death

impaired neurodevel.

risk of (adult) death

low energy/strength

higher fertility

lower per-child“investment”

larger families

D less schooling

more childbearing& childrearing

risk of loss ofworker/parent

labour of caringfor the sick

healthcare costs

low level ofeducation

low labourintensity

less labourtime

expenditure,offsettingwhat is earned

determinants ofdeterminants oflabour productivity

determinants oflabour productivity

loss of farm-specific knowledge

Thank you!

Poverty as a self-perpetuating cycle • the cycle shows the main interrelations: BREADTH of poverty • outcome “variable” is perpetuation of the cycle • the central concept is reserve capacity, corresponding to

SEVERITY/DEPTH of poverty • when this reaches zero, cycle interruption occurs • cf. food insecurity: variability in reserve capacity • the cycle’s causal processes occur over time

– this has implications for DURATION of poverty – it requires longitudinal assessment

• the cycle corresponds to households’ lived experience • attention is needed to generalisability of: overall structure,

component variables & links, parameter estimates – and, reasons for the latters’ variation

• “deterministic” links include: dietary intake & anthropometry; bed nets & malaria

• probabilistic links include the risk of child & adult mortality • representative population; theoretical sampling

low dietary intake

poor healthstatus

poor dietary status macronutrient deficiencymicronutrient deficiency

low functional health status low birth weightrisk of infant/child deathimpaired neurodevelopmentpoor childhood growthlow energy/strengthrisk of (adult) deathimpaired immune function

diseasesinfections•TB•measles•malaria•HIV•pneumonia•diarrhea•etc etcanemia

low socio-economicposition

fuel poverty

indoor airpollution

housingquality

healthcareavailability

low level ofeducation

pollutingfuels

poor healthstatus

poor hygienepractices

low income

water

sewagedisposal

social hierarchylack ofwellbeing

other amenities

poor laborconditions

zoonosese.g. bird ‘flu

pesticides

injury