SCALING UP IN AGRICULTURE, RURAL DEVELOPMENT, AND NUTRITION


Delivering Nutrients Widely through Biofortification: Building on Orange Sweet Potato | HOWDY BOUIS AND YASSIR ISLAM


Focus 19 • brIeF 11 • June 2012 T


he biofortification strategy aims to reduce the prevalence of vitamin and mineral nutritional deficiencies that are


widespread in low-income populations by developing nutrient-rich varieties of staple food crops that the poor consume habitually. Biofortification is potentially a cost-effective and sustainable means of delivering more micronutrients to the poor. Since biofortification aims to increase the daily micronutrient intakes from improved staple foods, two factors—scaling up (to reach larger populations) and sustainability (to ensure long-term public health benefits)—are integral to its success.


Scaling up an innovation: Orange sweet potato


Orange sweet potato (OSP), rich in vitamin A, is the first biofortified crop to be released. OSP varieties that are suited to African tastes and environments have been developed and distributed in parts of Africa where prevalence of vitamin A deficiency is high and where white or yellow varieties—which provide little or no vitamin A—are traditionally consumed. Lessons learned from OSP delivery can be applied to the scaling up of other biofortified crops to ensure that target groups (primarily women and children) are consuming adequate amounts of biofortified crop foods to improve their nutritional status. From 2007 to 2009, HarvestPlus and its partners distributed


OSP to more than 24,000 households in Uganda and Mozambique as it scaled up pilot projects. In Mozambique its precursor was a program called Towards Sustainable Nutrition Improvement (TSNI). TSNI had 1,094 direct beneficiaries who received OSP, but the total cost per beneficiary was considered too high for the program to be sustainable. Lessons from TSNI were applied to a bridging project called Eat Orange that attempted to reduce costs per beneficiary while maintaining impact: adoption and consumption of OSP by farming communities. In Mozambique, HarvestPlus built on Eat Orange by horizontally scaling up its project to two more districts and increasing the number of beneficiaries to 10,800. An operations research component was tasked with monitoring


implementation activities, in part to draw lessons that could be applied to scaling up. A parallel impact evaluation team worked with the implementation team to carry out a prospective randomized control study—perhaps the first time this has been conducted on such a large scale with an agriculture-nutrition intervention. Despite differences between Uganda and Mozambique, in both countries the project led to increases in OSP adoption by farmers and consumption of OSP by households. As a result, vitamin A intake as much as doubled for both children and women.


Lessons from the OSP experience


For biofortification to be a viable strategy, the cost of delivering nutrients through food crops must be lower than the cost of interventions, such as supplementation and fortification. Factors that could have reduced delivery costs without affecting impact were identified. For example, the educational component


of the project could have focused on key messages directly related to OSP and eliminated modules on complementary nutrition or agronomic practices. Diffusion was identified as a viable mechanism for spreading the innovation and reducing costs. Once a critical core mass of OSP adopters and producers has been established in a region (at a relatively high cost per household), complementary activities encouraged diffusion of OSP at lower cost to neighboring villages, thus creating a group of secondary beneficiaries. Adoption was highest among households that previously had regularly consumed high amounts of white sweet potato. In Mozambique, the lowest marginal and average costs per


target beneficiary (children 6–59 months and mothers) were US$17 and $52, whereas in Uganda they were as low as US$10 and $26, respectively. Costs were lowest in Ugandan villages where the diffusion rate of OSP vines to nonproject households was highest: 1.4 households received vines through diffusion per project target household. Disability-adjusted life years (DALYs) are a commonly used


metric for measuring the cost-effectiveness of health interventions. In Uganda, preliminary calculations (after taking cost reduction factors into account) suggest that the intervention cost US$15 to $20 per DALY saved, which by World Bank standards is considered highly cost-effective. No evidence has yet emerged that small-scale farmers chose to


grow OSP due to the project’s marketing efforts. A lack of evidence is not surprising, given the short two-year project duration, as developing markets and products usually takes longer. Since markets may be critical for sustainability, costs could be kept low during the initial phase of an OSP project by focusing on seed systems and demand creation, with marketing and product development introduced at a later stage. Gender roles as they relate to household production,


consumption, and marketing of biofortified foods must be understood and carefully leveraged. A key factor in the success of OSP was the critical role played by women, both as caregivers of young children and as producers and retailers of OSP. It is thus important to reach women with messages on better agricultural production techniques as well as nutrition education. At the same time, men control family resources in the project areas and are the key decisionmakers regarding allocation of land and crops, so their role must be also considered. The issue of gender also extends to other actors. For example, in Mozambique female nutrition extension workers were significantly more successful than their male counterparts in conveying messages to the nutrition volunteers in target communities. Successful branding of biofortified crops and determining


whether visible traits (such as color) impede or facilitate acceptance and diffusion is an area for further research. Contrary to a priori assumptions, building an “orange brand” around OSP (traditional sweet potato varieties are yellow or white) was effective in both countries. Other similar research has shown that Zambian


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47