4.3.5. Overview of Food Utilization and the Value Chain Approach

Introduction

Food utilization is defined by USAID as: “[f]ood is properly used; proper food processing and storage techniques are employed; adequate knowledge of nutrition and child care techniques exists and is applied; and adequate health and sanitation services exist.”^[1] Utilization is often used interchangeably with nutrition, yet while utilization focuses on nutrition; it also includes also food storage, processing, health and sanitation as they relate to nutrition.

Malnutrition is a serious global challenge: almost a third of children in the developing world are underweight or stunted and poor nutrition is responsible for nearly 60% of child deaths worldwide.^[2] The overall economic costs of undernutrition are estimated at $20-30 billion per year^[3], caused primarily by lowered productivity and cognitive capacity and increased health care costs. There is ample evidence that although economic and agricultural growth are necessary to achieve sustained reductions in malnutrition, they do not fully address malnutrition.^[4] There is more evidence that they can generate improvements in caloric intake than dietary diversity.^[5]

Some value chain programs have attempted to improve food utilization and achieve nutritional gains, mostly by targeting agriculture value chains. However, results have been mixed, and it is generally considered that much more could be accomplished.^[6] Based on an evaluation of Food for Peace Multi-Year Assistance Programs, Feed the Future, the U.S. government's global hunger and food security initiative, estimates that integrating a package of nutrition interventions into projects that are targeting agricultural value chains can reduce chronic undernutrition by up to 57%.^[7] A recent review of experiences in applying the value chain approach to addressing nutrition identified a serious lack of documented experience and case studies.^[8] A lot still remains to be learned. Understanding the causes of malnutrition is an important starting point that will allow practitioners to identify the most appropriate intervention strategies. 

Critical Issues to Consider in Addressing Food Utilization with a Value Chain Approach

The issues of income-nutrition linkages, value chain selection, food safety, gender and household nutrition practices, post-harvest handling, complementary interventions and nutritionally sensitive groups are important to consider when working to improve utilization: 

• Income-nutrition linkages: Research indicates that while increased household income does tend to improve caloric intake, it does not necessarily improve nutrition.^[9] Households will not always spend additional earnings on food, particularly if it is earned erratically or infrequently. Value chain initiatives should seriously question whether increasing income will be sufficient to address food security challenges, or whether other interventions will also be required. 
• Value chain selection: Agricultural growth will not have a positive impact on utilization if it does not benefit the nutritionally insecure. In Tanzania, for instance, recent agricultural growth did not lead to nutritional improvements because the growth was in large-scale farming in a few parts of the country, and in a few crops.^[10] Research suggests that value chains with the following characteristics may have greater potential to improve nutrition:  

1. Directly benefit the food insecure either as consumers or producers
2. Offer opportunities for local processing, thereby creating savings in food costs and time while offering people greater control over their diets and better nutritional value. 
3. Increase availability of varieties with greater nutritional value than those in widespread use. 

• Food safety: As demand for perishable food rises with growing incomes, and urbanization increases the distances between producers and consumers, there is greater potential for food contamination. Food safety plays a major role in effective food utilization, as the consumption of unsafe food and water can significantly exacerbate malnutrition.^[11] Producing 'safe food' that meets emerging standards offers new market opportunities for producers. However, there are often conflicts between the interests of consumers (who will benefit from regulation that improves food safety) and smallholder farmers (who are often unable to meet more stringent standards and risk being cut out of markets). The costs of compliance are often prohibitive for small-scale producers, and safe food that is monitored inevitably costs more, making it less accessible to poorer consumers.^[12]
• Gender and household nutrition practices: Research has shown that there is often significant variation in caloric intake among household members; individuals may be malnourished even in households with high overall food consumption.^[13] Household food selection, preparation and allocation practices as well as child care practices have an enormous impact on food utilization. Improving these practices through behavior change requires that messages reach the household members that are responsible for these tasks. While women play a major role in food selection, purchase and preparation in many cultures, it is increasingly recognized that projects need to target both women and men with utilization messaging given the role that men often play in influencing their decision-making. Additional information is available on the role of gender as a cross-cutting issue in food security.
• Post-harvest handling: The nutritional value of food may vary significantly from the point of harvest to when it is consumed. With urbanization and rising incomes, individuals are eating greater quantities of processed foods and increasingly relying on others to mill their cereal crops. This trend creates increasing scope to fortify foods with needed nutrients and vitamins, but also risks reducing food quality through long-term or poor quality storage and certain types of processing.^[14] For example, stored milled maize is more susceptible to infestation from weavils so must be stored properly to avoid this pest and maintain the nutritional value of the product.
• Complementary interventions: Effective sanitation, water and health services reduce the likelihood of illness and ensure that individuals are able to absorb the nutrients in the food they eat. Food-borne and water-borne illnesses, such as parasitic and other infections, increase the amount of calories and nutrients necessary for an individual to maintain a healthy body weight.^[15] Understanding where the absence of sanitation, water and health services causes negative food security impacts is important for determining whether these represent critical barriers to improving food security. While beyond the scope of most value chain initiatives to address directly, projects can establish linkages with complementary initiatives. 
• Nutritionally sensitive groups: While improving the nutrition of all malnourished individuals is important, the return on investment is considered to be greatest in improving the nutrition of pregnant mothers and children under two years old. Malnutrition during this "golden interval" is recognized to cause significant and permanent damage to future development.^[16] Value chain initiatives should consider how their efforts can support better nutrition during this critical stage. In many instances, pregnant women are already engaged in value chain initiatives. Tailoring programming to remove barriers to participation is a clear opportunity, as is targeting fortified food initiatives towards these groups.

Applying the Value Chain Approach to Food Utilization

There are a number of strategies for applying the value chain approach to improve food utilization.

Footnotes

1. ↑USAID Policy Determination:  Definition of Food Security, 1992, 4. 
2. ↑World Bank, Repositioning Nutrition as Central to Development, 5-22.  
3. ↑UNICEF, Progress for Children:  A Report Card on Nutrition, 2006.
4. ↑The World Bank, Repositioning Nutrition as Central to Development:  A Strategy for Large-Scale Action, 2006, 27. 
5. ↑Shenggen Fan and Joanna Brzeska, The Nexus between Agriculture and Nutrition: Do Growth Patterns and Conditional Factors Matter?, 2. 
6. ↑Academy for Educational Development, Deepening the Dialogue, 2010. 
7. ↑Lawrence Rubey, Feed The Future Strategy Planning and Development Presentation. December 2, 2010.
8. ↑Corinna Hawkes and Marie T. Ruel, Value Chains for Nutrition, 17. 
9. ↑Fan and Brzeska, The Nexus between Agriculture and Nutrition: Do Growth Patterns and Conditional Factors Matter?, 2. 
10. ↑Pauw and Thurlow, The Role of Agricultural Growth in Reducing Poverty and Hunger: The Case of Tanzania, 3-4. 
11. ↑Trench et al, Responding to Health Risks along the Value Chain, 1. 
12. ↑Trench et al, Responding to Health Risks along the Value Chain, 4. 
13. ↑Patrick Disken, Understanding Linkages among Food Availability, Access, Consumption, and Nutrition in Africa: Empirical Findings and Issues from the Literature, 16. 
14. ↑Joachim von Braun, The Way Forward on Food and Nutrition Security, 2009.   
15. ↑Nesheim, Human Nutrition and Parasitic Infection, 1993, S7. 
16. ↑The Lancet, Maternal and Child Undernutrition: An Urgent Opportunity, 1.