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AGRICULTURE, HEALTH, AND NUTRITION 19 Third, are the inputs into health and nutrition complements or substitutes? If a cer-


tain level of nutritional status can be maintained by reducing time spent preparing meals and purchasing prepared foods, then these purchased foods are a substitute for time spent cooking. But not all inputs are substitutable. If a child is suffering from diarrhea, trying to increase her food consumption without treating the illness will not improve nutritional status. Finally, how are these changes—their benefits and costs—distributed within the


household and across households? Are the people who benefit from these changes the same people who incur costs?


Implications for Policy These myriad links—both beneficial and adverse—among agriculture, health, and nutrition pose challenges for policymakers. In an area of ongoing research such as nutrition, the key policy lever for poor countries—where a large proportion of the population relies on agriculture for their livelihoods—will be the changes in crops, farm practices, and markets. Technological improvements and value-chain enhancements, if distributed effectively, can affect the supply of healthy and nutri- tious foods while simultaneously boosting incomes. It is this potential that makes agricultural innovation a leverage point for policy and programmatic interventions.


Concluding Remarks The links among agriculture, health, and nutrition are most complex when we con- sider smallholder households. However, the framework is equally applicable to other household types. For example, landless rural households and urban households are typically net food consumers, and so changes in agriculture affect health and nutri- tion largely through changes in the quality, variety, and prices of foods available to them. The framework can also be readily adapted to national or global levels. Anything that affects agriculture has the potential to affect health and nutrition,


and anything that affects health and nutrition has the potential to affect agriculture. While some of these pathways imply that changes in agriculture will have positive impacts on human health, this is not true of all pathways. Policymakers in all sec- tors need to be cognizant of these multiple pathways and their bidirectional effects. The importance of different links will often be context-specific and determined by characteristics of the population being considered. The policy challenge is to ensure that changes occurring in agriculture come about in a way that maximizes benefits to human health and nutrition while minimizing the risks. Many of the chapters in this book describe particular contexts and circumstances where this has been


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