AN ANALYSIS OF NUTRITIONIN SENEGAL

Three Views:

~larvin Miracle: Food Consumption and NutritionComponents of Development Effortsin Senegal, Sept. 1980

James Pines: A Nutrition Strategy for USArD/SenegalOctober, 1980

Linda Worthington: The Nutrition Factor in SenegalJune, 1980

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Narvin l"Ziracle

September, 1980

FOOD CONSill1PTION Ai'JD ~UTRITION COl-1PONENTS. OF ngVELOPl-'lENT EFFORTS

IN SENEGAL

Ny terms of reference liere as follows:

1. rro evaluate GOS goals/priorities in t.he nutrition/consumption areaa

2 0 To evaluate GOS/donors performanCE) rf;~lated to these or more

appropriate goalso

3. To assist the r..iission in developing a nutri.tional/conslunption

. strategy to be integrated into the overall joint planning effort ..

llo To assist the 1'1ission in determini.ng futu!'() areas of study needed

in the nutrition/consumption areno

GOA L S

Senegal's food consumption/nutrition goals for the 1977-1985period are principally contninnd in the Food Investment Strategy1977-1985, published by the ~1inistry of Hural Development and ',inter

Resources in February, 19770 The Ii'ooc] InvestmellL.3trategr considers

average food consumption levels to be near mi nimu.ns needed and suggests

that n.t the time it was publishod the prine; pal .food consumption/nutrition problems· to be addressed were tt seAsonal mnlnutri tiOll,tt

nnd "inadequate food intake amongst part of the vulnernblo groups",

defined as c~lildren and pregnnn~ or lactating womene The extent orseverity of either "seasonal malnutri.tior '; or inndequto food consl.unp­

ticn among vulnerable groups is never fnJ.ly considered: nnd, \ihile

some interventions are propose(~ \J:[hicb l:U'G relevant to thes\; probiems,

the main thrust of the Food Investment·strntegy is o.nticipntory,

addressing problems that its uuthcrs fear may arise in the futureoThe bulk of the document is focvsed on efforts to achieve import

substitution in foodstuffs, parttculnrly cerealso A critical readingsuggests there is far mor(~ conce:'n \~rith reducing the burden of foreign

exch::lnge earnings imposed by impurted cereals, especially rice,

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than on improving diets or preventing their deterioration over time.

One cannot demonstrnte that they nrc l1!rOng. There is as good a

case for their position as for the contrasting one, taken by the\1orld Bonk, that, on average, iocd ccnsrunptions is cor:""~:~ic'Jously b~low

minimum amounts needed throughcut the country, and particularly among

the 65 percent of the populati(q that is ruralo Both positions arebased on construction of a national food balance sheet, an approachwhich yields debntl:1ble results ;)ven ,",hen there i.s an ubunda.nce of

fairly reliable data" I~ is an~pproach lihich makes no sense appliedto Senegal, given' .. - present s ;age of developmento

To construct a food balance sheet one starts with estimates oftotal supplies available and ,yo~l(s backward to amounts available forconsumption at the table, then 'oDverts these to calories and nutrients;divides by the si~e of the popuiation; an~ finally compares the resul­ting estimate of cnlories avail( 1)lc per person per (1ny to amountsrecommended. If estimr.lted nmouni3 nV11ilable are less than amountsrecommended it is common prncti(~ to say the populaticn is, on average,hung:-y.

For such an exercise to be m0aningful one needs good data onproduction; exports, i~ports, Q~' ch~~5es 5~' stocks; Amount fed to

livestock; nmounts saved for see~; a~orrts diverted to" non-food indus­'trial' uses; amounts lost in storL~e; processing losses; and plntewaste (i. 0 0 , amonntp served consu J\~rs hut not enten); the appropriate

caloric and nutrien1. values fa:, en.ch item enter :!.ng the diet (vc'llues,that vary according to var'iety and ,.;hiell nutri tiona.l authority's tablesom chooses); and the total size of the populntil,n and its breakdown

by age, ,.;eie;ht, sex., nnd, if female, loJhether rrl~gnant or lactating.An occupational brtakdo"~ is also needeu sinc(~ some occupationsrequire. as much as twice the caloric intnke on others.

Cne only needs to consider 'an item or tWG on this list to seethat with such D~ appronch we don't really DIve any i(1ea whether inrural SenegC1l th l3 average consumer is above ,~')r below target consumlJtion

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Perh.'lps most fundnmental is the inadequacY.of production data. The

enormity of gaps in information of Rl1ricultural production, other than

for major c}"ops such os peanuts, rice, millet, sorghum, and cotton isreadily admit ted by knowledgc.lble obscr,·ers ~ and even for these crol:fi,

publi.shed estimates are highly suspect 0 Our d.iscussi0i1S in the Ninistryof Rural Development reveal that official statistics come from poorlytrained district agents. Moreo~er, in recent years only data on crops

covered by regional parastntal orcaniznti~ns are reported with any

regularityo Shortage of funds forced the Hinistry of Hural Developmentto take personnel responsible fer gathering statistics on other cropsout of the fieldo But there are more f\uH~amental problems than thoseassociated with the aCequncy of the staff and procedures for gathering

agriculturnl statistics. l~ven for ma..io1' crops mU~h of the productionis carried out under various systems of shifting cultivation whichmakes accurate estimatie:n of acrcnge impossible with present limita-'t ions cGIlcerninrs funds and personnel.. Harvest i.ng may be spread out over

a considerable period; storage Js mainly on farm in granaries thatvary grcntly ii1 size and shape; farmeJ"~ lceep almost no written records

and often hav...~ substantial incentive to distort inr"rHiut'i\)il th~1j" arerequested to suprly~

If there are numerous reasons thnt production esti.mates for majorcrops have extremely large mnrgins of error, there are no estimntes

at all--or admittedly very crude ones--for other elements'in the natio­nal food balance sheet o There is a complete lack r;f data on amounts

. stored at the villo5C level. storage losses .arc estimated by somestudies as low as 3 nnd by others as high as 20 percent~ There is noinformation on amo,unts' sold locally and across frontiers \iith neigh",,:,boring countries, although both are commonly thouu;ht to be sizeablein many areaso

Nor are the nutrient vnlues of local fooclstuffs adequately known.Accordine: to officials we contacted, regional and varietal variationsof even the major foodstuffs nre poorly established, and for the minorcrops arid wild foodstuffs collected the current state of knowledgeis even more defi.cient~

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An alternative to the food balnnc~ sheet approach is to conduct

a food consumption survey of Q s~lple of the population and then

project the results natic,n wide 0 Here thtrH tlre also many pr0hlomp,; and

consumption surveys in Senegal nppcnr to be thorOuf~hly flawedo ''Ieare told by officials in n position to J~now thot the most recent

consumption survey, commission .by GOS an(1 the \1orld Bank (supposed

to be available sometime in 1980), covered 2,000 individualso However,the survey team weighed foo<1 prepared fer consumption only for a. week

for each family in the sample, samplinG in one area then movine; to

another area. for a \o{cek, etco until 2,000 individuals hnd been surve­

yeGo Thus not only does this study have no reliable measure of

seasonal variations in diets, but the time frame is different for

eoch segment of the snmpleQ Even worse, n~cording to local observerswho are familiar with this exercise, the study ~'las so poorly dcne that

even the data that were obtained arc hi[:~hly snspect ..

The next most recent consumption survey--one of n sample offamilies in Dakar, Laugo, Lingu'ere and K~(1ougou carried Dut in 1977

ano 1978--found considerable variation in results by arena Dakar

consumers were esti.mateC! to he getting nr:prQx.11nt.:~i~oly 96 pl~rcent of....

calories needed; those of Louga and Linguere w{-~re estimated to be

at 95 percent of calori.es I)eeded; but K~'dougou consumers were estima­

ted to be getting only 78 percent of calories required (Chevassus­

Anges, et al., p.5). All areas in the study were above st0ndaros for

protein consumption but belo\l for calcium, vitamin A, ana vitamin B2 -

It is hard to know how much credence to give this studyo Thesurvey covered .1,031 perscns in Dakar, 1,382 in Louga-Lingu~re, nne666 in Kedougouo \1e are net' told how the samples were selected or

what measuring techniques were except that the motho(~ used was to

weigh food prepared for meals for five Gays for each f~mily in

Louga-Linguere and ICedcugou and only for three days in Dakarorfhe time periods covered arc !!lay to July, 1977 for Dakar; June andJuly, 1977 for Xe'dougou; and ~t~rch to May, 1978 in Louga-Linguere_

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If the data base doesn't allo\\" us to make L1 convincing caseon the adequacy of diets usin~ the sort of statistic~l measures~ommonly employed in relati.vely devoloped countries, what other

evidence is there? Probably the easiest and cheapest to obtain is

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the opinions of consumers themselves. If asked a leadinG question such

as "'.V-ould you lil{c to hQ're 1"10rc: food?", most would probably reply

in the.affirmative, th0 ~esponse one is likely to get to that question

in any O'uuntry, includint; the United Stfltes. But if, on the other hand,

one examines the concerns forthcoming when people are asker] to list

their prohlems--as in the beneficiary surveys of the r~3cently concluded

Joint A~sessment--wie0sprearlhunger does not seem to be sugBested.

No. doubt some segment~ ot the population are .concernec1 about food shor­

tages in some years, c:). g., ~:oars of drought, but hunger among some

parts of the population some years is quite a different problem,

calling for quite differont solutions, than chronic hunger throughout

the country all the time.

Seasonal Hunger .

. The only evidence the Food Investment StratefiY cites f~r the"seasonal malnutrition" it talks about is a 1966 study in Thies and

a 1968 study in Sine Seloum. It appears to project' from these t,,,o

areas nationwidco Nany local observers seem to be of the opi.nion that

althcugh we don't have reliable evidenc(~ to document it, pre-:harvest

hunger is, indeed, wicc.ly c:<periencedo However, one can also findthoughtful people, i.ncludine; some who have been involver~ in village­

level dietary surveys, who argue that Sener:al--.~s in many otherAfricon countries--pre-harvest dietary str<3ss 1s sometimes more psy­

chological than physical, with rural populstions substituting food­

stuffs low in their preference hierarchies for preferred foods but

suffering little, if at nIl, in terms of inB~equate levels of nutrientintake. In one of ()ur discussions on tht') ;;H~ttBr we were told of ins­tances in which Senegalese farMers r(~p:~lrt(;dly say they have no food­

stuff reserves when, if fact, they h~d only a six to nine monthreserve of millet rather than the two yaar reserve they normally

s1J1ved for. Simila.rly, \ve heard reports of farmers not countingunharvested stands of manioc--n common famine reservc-- because itwas not part of the reserves in their granariesD Also possiblyrelevant is the tendency of many Senegalese· to S9.y they havu''t "eaten"

no matter wh,1)t they have ingested unless they havf; consumed theirpreferred staple.

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The Food Investment Stratef\l has no el~lnents designed specificallyto reduce or eliminate preharvest hunger, which seems to sugGest that

GOS does not really consider sensonal hung~Jr a serious problem•

.Vulnerable Groups

The last food consumption/nutrition problem addressed by theFOOQ Investment Strategy'is underconsumption (shortage of calories)by chilc1ren under six and pregnant and lactating womenoRe.f.erring; to 1970 data, from a stUGY and for locations and timeperiods never identified,. the F00d Investment Strntegl suggests thntthese groups get only 70-88 percent of the calories neeuec even

though the rest of the social grc.ups to \vhich they belong get 99.percent or more of th~ calories needed. There is no discussion of

the cause of un(lerconsnmption amoni; these vulnerable see;ments of the

population but the r.r()~rmns pro:)oscd that are (~esigne(~ specifically'

to raise their foo(~ consur.lption ,:ll"e nu.trition ec1ucati0n programs,which impli\~s that the pr'oblcm is viewed as mere one of igllorance

than one of ina(;cquate supplies of food avai.lable Q

The Appropriateness of GOS GoalsGOS goals appear to be consistent with the. present state of

knowledge concerning the nature of consumption/nutrition problcmsftAs we have seen, one cannot at this juncture document nati.on""ide

either 'chronic undernutrition or malnutrit.ion .. Either' or both may

well be found i.n some areas anl'. ther~; shDulu be ccntinuation of

efforts to identify SllCh art~£lS or :"ef3;i(illS, the first step in improvingpresent fooe] ccnsui~~ption/nutrit,ic:n programs 0

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GOS DONORS t PERFO~/IANCE

Seasonal Hln~er

NeithE~ GOS ncr dono~ agencies have projects designef specifically

to alleviate sensonal hunger, perhaps because, as notec earlier, it

seems to be largely ignored in the food Investment Strntegyo

Linda 1{or'::ingt'Jn' s June, 1980 3urvey of programs in Senegal

rel~tec1 t"\ n"l+"i--l-';p!1 tr.rJ:.)r.f·Ju·r1.°t-ion "i'actpr lOU S~ne"'Dll) c:!11·-t'-"~'·sts t'le_ ~ \..,: ... ,.~ ~ '-'.4.. ,.1. \. L ",.'1,;; ... "':"-":,,' r c; J ,) _ ,... h~-:' .., .·.t;.~.\:· 1.

larges t Pr'C :~T'D'Ti i.s USiiI[~ I S -.- -L180 Title II pro[ram \'111 iC~~1 has been

operating throuGh Cathol~c ~cliGf Services for 19 years distributingsupple""'i\Ont ~l fno(l ·l·?"'r0t1"-,"" PD'Tr..~ (p'!l"oO'r~nl 'far J':'.:'<Ttr; '.' i.·.·.. nd Heal'th for.iI ... A ~ 1.:.1 ,-, .... t 1.", ...... '-"' -t.. .t ... C. tJ ,.. l L, l:".l. . • -' ..... \.. '. - . .. ......

\Yeanin:~ ~?r·n ..), to 2~7,;J,000 mothers and childr,~n bui; its ir pact is not

clear g ~·{or.1.c1 Banl{ studi(.;s in Diourhel f1n(~ Casal" ~nce reportedly show

no overall diffe.!'[Jncc i.n nutritiona'. s·~· "'+"';'3 b~JtltJeon families receivin(;

such supp13me11ta:L foo{l comp,~~:ce(1 ''Ii th those 'Hila ~~o not ('~lorthington,

pc 6) .. 3ette:{' ur,lc'erstonoinrj is needed c~~: how ~:·:;.ficient the diets c,f

such groups a:::-'o~ the extGnt to wh.ich t~.lGir nut,-,ition problems are

associated '-Ii 'C!l their diets rath.~:r than Hith ether factors, and the

extent t~ l~r'~.·;.cb tar ..Jet populations flctually '''surne foods earmarked

for the'.

US.. ··:=~ '·.ealth programs in Sine Gnloum an:; B... :':n! may also improve

the nutri·1 ion of chilCren inc:irectly by re(:~cj .~ parasitic infections

and c1i~>~r.",es which cause malabsorption of l1··'tj ··.ents available in thefoods '1.. '.(I-{ eat 0

Othe':' relevant donor activitics are UNI- ..'F' s fun(1ing of equipmentsne training in health and nutrition and i~ t pilot nutrition project

in the Sine Salou.m regiono Canada also ~.~;-: ·8m;·~·"f.1.: :,~ •..,,;, 1 ·:.. ·······'.~:h

program in Sine Saloumo'

Lit tIe can be deter···~inc:.1 at this jv···ctu ;~ concerni.ng the performance

of these donors o

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FURTiffiR DEVELOPING Tr~ MISSION'S FOOD CONSm~PTION/NUTRITICN STRATEGY

In order for the Mission to uevelop an effective food consumption/

nutrition strategy it is essential to have better information on where

diets are inadequate ana whyo

Unless one can get a better grasp of geographical variations inthe severity ana character of uietary inadequacy there is a risk ofproviaing more assistance than needed in some areas anc not enoughin others--and perhaps the \~ong kind of assistance in either caseDFor example, '''Jhere childrens r diets are inadequate because of igno­rance, educational proe;.rams arc more li!{cly to be successful thnnprograms designed to change the Pl"'oJuction or distribution of faDeL.

Where shortages and surpluses 0ccut simultaneously in differentcistricts of the same region, programs to improve transportation,market information systems, or storage may he more effective than

programs focused on iner-casinr; crop yields~

An effort that should pay high dividends would be to ask farmersin areas thouGlt to have inadequate <0iets to list the major problemsthey need help with. Such lists, coupled with the impressions ofl<nowledgcable local observers, such as project managers, Peace CorpsVolunteers, etc 0' not only \v-Quld help indentify· areas where food

consumption/nutrition problems arc important but liould also yieldinsights as to \-lhat the causes are, insights essential to desi.gningeffective solutionsoSuch an approach would help provide inform3tion on a variety of thinGsother than diets, information new cften obtained only after n projecthas run into troublC 1 nnd it would allow programs to be tailored tothe needs of each are~ or regiono (It seems likely that needs varyccnsidcrably from one nreEa to another tJecause of the country's diver­sity in resources, agricultural systems, un~ population pressure onland, and opportunitie1 for earning income outside of agriculture)~

An additional effort that would quickly provide some of theinformation needed would be collecticn of clinical evicence ( by

weighing or measuring indivi(~uals, takinG blood s~mples, etc 0) fromBEST AVAILABLE COpy

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a sample of villages scattered throUChout the country by a seniornutrition specialist~ It has been sUGgested that such an individual

could,in as little as two months, ~nQrmously increase our present

und.erstandin~ of where the more ser::i.<.lUS nutri.t ional problems f:1.!'c,especially among vulnerable groupso

This sort of effort and the info'rtnfltion obtained frem local obser­

vers such CoS Peace Corps ·Volunteers, ~l\)uld nicely complement each o~her,

the clinical dat~ s~rvinc to provid0 n check on the incidence andnature of (~i0tary rrohlems while th.€:. abscrvn"t i.ons of local observerscan be expected to provide insi5hts on why the patterns detected occur

and \~l~t sorts of i~terventions are likely to be effective.

Reachintr, Vulnerable Groups

There is general concensus among kno"ilcdGcnhle observers that

wherever childrens I diets nr\'~ inf1dcquate the C~\U8eS are complex and

likely to involve lac).: of aHarfJl:CSS by p:'1r0nts of ~,\That their offsprings t

nutritional needs are and the effect of dis~as0 and parasites on the

capacity of children to absorb nut.rientG, ita a.dditj.. or. to ~l;Cr.i .f.'nctoro :; as

food avnilability and frunily income. Thus it l,.,.oul(~ mnke s~nf:)e fnr t~.. ,,;Mission, as part of its nutrition strategy, to follow a mllitifacetedappro::lch to improving childrcns' nutrition, never Jt1.erely attempting

to increase f00rl availability wit~cut con~aniop efforts in education'

and health. Such an approach mig~t inv~)lve provi :Jin~" h:alth and educll­

tion programs in areas where nutr.'_ t j·:nal problems ur:1ong children have

been identified, anf including, as well, efforts to improve foodavailability in th0S0 areas where }H~[11th and education alone areinadequate and incrensing food supplies is also needed.

The situation is furttl(~r complicato" by the fact that there isa concensus of local o~~}inion that merely inc,'easing food availabilityat the household level often may fail to ch~n~e the food intake ofparts of the vulnerable groupo Here one nc:eds to be able to identify

areas where this comes about throuGh iejl\0ranCe i ..n contrast to thosewhere it stems from the low status of pert or all of the vulnerable

group. Education programs lUuy have littlQ, if any, impact in the

latter case.

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Dealing with FamineNatural disasters, particularly drought, leading to hunger can

hit some or all of Senegal's population at any timeo It is likelythat there will be hunger in some regions at least part of the yearwith some frequency, at least for the rest of this decade, even ifhunr:;c·r is n'~t wicespreac1 th.coughout the countryo ·TLe NiBsion m~y welJ.want to iilaintain a capability to pr,')vide relief to s~ch populations ..

..

It is probably desirable here to clearly <1i.stineuish welfare

efforts--e .. g., programs to help procur(: foo(~stuffs neeced for relief

efforts or programs to improve transport~')ti~~n, storege, or other

aspe~ts of a system for r:istributinG reliof' ">':", .. "!:;:t<:VOJ.'ir~·~ent efforts ,',­

ieeo, those which inCr(Hls\~ the capacity cf thE: tar~~et population tosurvive a natural c1is:lster without h(~viTig; to depenc on ol.ltside helpoExamples of the development component of a food consul!1pti.on/nutrition

strategy are the ~iissicn's ongoing programs to increase proGuction andimprove income ~istribution in the FIctive rcgion4

Dealinr;:J with Other Special Prohlem Areas

The Peanut Basin, rarticularly, but perha~s other areas as well,woul~ s~~m to deserve special attention because of the potential ofbecoming areas of chronic huncer if present rates of population grolnhcontinue wi.thout substantial improvement in :pro(~uctivi.tyQ 'rhus the

Mission's faDe strateGY for the Peanut Basin needs, first of all,to provide interventions which rrcmis(; n rate of increase in produc­tivity at least adequate to 6ff~ct expected population growth in the

next few y~nrs .. In addition, it shoulC include efforts of the sortsdiscussed \:';arlier to determine \'!:]·et!~cr there are unc1et0cted pocketsof hunger or malnutrition alre::v:y, and, if 80_, what their causes are,

an effort which should provide n firm basis for including a fullerfood co~sumption/nutriti6ndimension to the strateGY for this regionin the futureo One c3nnot at this juncture specify exactly what formsuch a strategy should tal:e (see Appendix) 0

Senegal and the World Food Counci~'s Food Sector Strategy Stu~ie8

According to Charles Fr(~nch'S l-'lay 19, 1980 memo, "Status Report

3aseo on Judgement of Charles Eo French of Countries Reported to

be Interested in Peed Sector Strategy Studies (FSSS) by llorld Food

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Council, May 16, 1980~' Senegal is n potential participant but no donorhas boen identified although Canada \v3s approached: "Cann('a approached

them rGOS 7 but til.ey saic1 they had a food strategy nnd would accept

$12,000 to publish it 0 rpresumahly the Food Investment Stratep:Y 7.Canada declined o France may be negotiating to work with them but theyare probably still openo"

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J:JJPE!·::.~IS: Reflexions on the "Foed Strategy" Comments in the

\lashillgton Heview of the ~FY 82 CDSS •.

The April 12, 1980 A.I~D. review of the CDSS for Senegal,

FY 82, contains the following con~.nent:

"The GOS and I"'lissions I plans to cope wi/th "dust bowl"

conditions in the Peanut Basin should be covered in

the next CDSS including the ;~ecessary structural

economic and instituti.onal cLanges for improvement

of the food ana income levelr; of the general populntiono"

There are at least t,vo key assumptions here that are questionable~

First, is the nssnm[Jtion thr·}t food consumption levels are belol" that

needeG by the general populationo Second, is the assumption thatraisinG food consumption levels can be ~,ccoJ11?lished only by "structural

and institutional changes"o

One cannot, at this juncture, make a convincing case for either

assumption. As \<Ie have seen, '\"'e cannot demonstrate that c1iets arc

generally inarlequate-~tha: ~mproving ciets shoulo have priority overeverything else., It may 'veIl he that other things--fl"'lr example,

improverl medic~l care, housing, or education--are more important

to the beneficiary pcpulationo 7he more general objective of increa­

sing income levels allcwB the target population to bett~r meetwhatever it finus its needs to be--and allows flexibility when needsnre not :.'~' ~·,~t ienl among all members, or \vhen the needs of any indi­

vidual or family 0f the target rrroup ch~nges over the life of the

assistance programo

Singling out a specific assumed need--eogo, a different level of

food consumption--is question~ble unless one assumes rural SenegRlesein the Peanut Basin don 1 t l{nO~1 their own needs, or that there are

segments of the population that cannot be reached adequately by

programs specifically designed to raise fooe conslooption levelsoNeither of the~:'3 propositions can be demonstrated convincinr;ly for

the Peanut Basin ~t the present time and, moreover, the data available

suggest both are unlikelyo BEST AVlHLABLE COpy•• 4'

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Suppose, for sake of argument, it were determined it was importantto raise levels offcod intake in tho regiono ·f·lhat basis do we have

for thinking that structural eC0Por.~ic an(~ insti tution:'.ll chanGes are

the vehicles required to accomplish this task? It'is well possible

that simply changing production or storAge methods is more effectivethan structural or instituticnal Ch1Ugi::S 0 jls good a case can be made

for the varic~us components of the p.;issicn 1 s onGoing program, e"go

dissemination of a superior agronomic ~acknge, expansion and trainingof extension staff, provision of wells for gardens anc sheep, and

assi.sting ''1omen with grain gl'inc::J.'1g mills 1 !1s for basic structural or

institutional chanGe 0

In sum, the I~;,ission has in the P\~anut Dusin a proGram which hasan obvious potential for raising incomes .. One could perhaps spell

out the obvious in the next CDS3 1 ~ut to mobilize Mission energies todevelop a. strategy for bringing about "necessary structural economic

and institutional" chan~~es wh~~n it hasn't been C::eP.1onstrated such aremore appropriate than the pr':~sent strato13Y mal~es no sense o If and when

the ~:ission hos evidence cf a food problem which cannot be effectivelyaQ(~ressed by programs to raise income levels :lnd imFrove income distri­bution then a sep3rate food strategy may be called for~

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of UoSo Assistance Proe;rnms in

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DOCU~~NTS CONSULTED

.1. USAID, Senegal: Country Development Strategy Stntement, FY B2

Washington, D~Ce, Jan~, 1980~

2 0 USAID nnd Ninistry of Plnnnin,~ and Cooperation, Senegal,' Joint

Assessment of U 0 S D Assis tance Pror;rams in Sener;al, Final Report,

Dakar, 1980"

3. , Joint Assessment

Senc~al, Annex, Dakar, 19800

4-. Sheldon Geller, "Analysis and Evaluation of Roles Playeo by

Promotion Huma.ine, Regional Development i~gencies, and Local

Institutions in Promoting Rural Development in Senegal and

Prospects for Future USAID Collaboration", Da!{ar, .Augo 11, 19800

5. Clark C. Ross, "A Village Level Study of Producer Grain

Transactions in Rural Senegal," Ann Arbor, r'~ichigan, June, 19790

______, "Grain Demand and Consumer Prefl~rences, Dakar,

Senegal, If Ann Arbor, !"iichigan, June, 19790

7 e Presirlential Commission on \-{orld Iiunger, "Preliminary Report of

the Presidential Commission on h'orld Huneor, H 'Vlashington, D.Co,

Dec., 1979 0

8 .. United Nations ~Jorld Food Council, "National Food Strategies,"

nop., nod~

90 Lucie Gallistel Colvin, "Private Initiatj.ves in the Senegalese

Economy: Potential Modes of AID Assist~nce,ft Dakar, 1980..

10t' ~linistry of Agriculture, Philippines, Itai~hlir:hts of the 1st

Philippine Food and Nutrition 'Plan," Nanila, .April, 1980.

,"First Philippines Food and Nutrition Plan,"--------~iianila, ~·~ay, 19800

12. Anon" "A strategy for IncorporatinG Nutrition into A~ricultural

Sector Studies," nttp~, n.d.

13. L. R. Venema, The Vlolof of Saloum, Wageningen, 1978 0

14. .Anon 0' "Procram Proposal, Sener.;al: Food for Dcvelopmel?t Program,

PL 480-Title III,,"nop • .; Feb •• 19800

- 15 -

15. A.non .. , "Ap:ency Operation strater.;y and Style in i1[:,:ricultural and

Rural Development," n ... pe, April 29, 1980 ...

16. USAID, "Senetjnl's Production Project II, 685-0235," tlashington, D.C."Dec .. 18, 1979 ..

17. Republic of Senegal, It~inistry of Rural Development pnd ;later

Resour':es, "Feod Investment Strc·ter;y, 1977-1985," Dr.kar, Feb 0' 1977 e

18. Anono, "Pr!~:!("l:~·'·::~.on Set·TED," Dak-ir, FebG 23, 19800

19 0 Charles :':alinoro "Analyse des D(,:~''''''.....: Sanitaires et Froposit ion eeIn "Composante-Sante" Susceptible d'ctre Intecree nu PrcjetIntef~re d' Alimentation et Nutrition au Senegal (PiiNS)," n.,pu ,nod.>

20. Gannett Flem-~.ng Corddry and Carpenter, Inc 0' ~p.::§ment of .

Enviropmentel Effects o~ ProEose.~~_})eY~!--0l?mc:_nts ~.7-( the .~ener;al

R~~~~.J3i'"~~!l, no po, n 0 ~ 0

21 ...

22.

______. , Ass~~nt of Environ~cntal Effects of Propose~

______, .6t~.~~2;.:::,:~·nt of Envil"'o~..,mental ~:~.rfects of Proposed

DevelcT]nlc:lts j:~..J:.tl:0... ~;~;'.~!£E-:a~ Ri·"r~.~' ~?1~i.n~~:;·tj:.al ~ep~rt for

!l.p .. , n .. d~, J /

23. Ecole Nt1tiCiKJule cl 'Ecc;~ t -:.e lippl:i.· ~,.r,-:'·~·luntion aupres des Bene-

ficiaire§. :'1u Fro1iet Pt·'t::·:i."ts Perim;:. tl"'0.8 1.~.~:cihu~s (Dcf~,~rt(~m~\lt: der\'.:\lre1 ...., .....'o:"1.l"~r '1','.",,"u'£:". ~l<~ ~~., l/..h.,\.U, , ,1' 1,1:\.,. ,-_.. ...

270

28.

________, EV[-il\1J~i:_~·_':,n aurl. - ~~,~)3 nel).~t;icia:i.res ~u Pro,jet

Elevar;0 !D~:partement d~: .i~alcel);. )akar, Nay, 1980 0

T:" 1 t ' \ =- .- / "f ° " 1 P '.L______-:-_, ~VA uq J~cn aur~E.?S Ges dcne 1Cl~1.rcs eu rOJ~ '"I

Elev8r:e (Departement (~.(~ Jakel): _~~omm.nire, D~'~kar, f"jay, 19800

/ 1'" ] t' \ 1 B//fo.,Met' ode de ':'VB.ua 10n aupres Les ·ene lC1G.lres--------, -- .._--_._----_ •

.' .du Projet ;' nnte de 3.?:. sc au S:t ne-Saloum, ! aJG::\l', June, 19800

\.E 1 to 1 ""' /r' , " P 't_________, _:~r.::.~ un lon aUl;?reS (~es oene_3.Cl.D1.reS au ·re.:.1£..:.

Sant6 de Base (DeJ?~t'tement de i~aolDck), La2car, Eay, 1980 ..

________, f~valuation Compare'c du Fr-ojet Sant~ de. Base,\ --, / / n • • • / .

nupres rle!L..~ nn,cLJ lCl.::l1reS des Dcpartcmenj.g _de Nioro ot I(nolac~'~,

Dakar II He·,·" 1.:'.it) 0

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2 t \ 1 / 'lot ,9. , Note de Syn hese sur ~ es Resu.i. "nts d-a 1 EvaluEl-

tion du Pro,jet Sante de Base dans Ie Departement d~ Nioro, Daka.r,Iviay , 1980 •

• I I

30. , Evaluation aupres des Beneficillir~s du Projet" /' 1 ~ /. ~ Th' \ dCerealier dans es i\e(r,10ns ce . i 1€S et Diourbel, Annexe,. Dakar, n. •

"!1 ...., 1 t . . 1 B / /f' . . 1'0 d P . t!J It , ~va un 10n aupres Les cne lC1a1re~ u rOJc

·Cereul.ier dans les Rep;i.ons de Thies et Diolirbt-:l, Note de Synth~se,

Dal{ar, Nay, 1980 &>

32. Nartin Je Forman, "..[L.I~r::o and the Huncer Issue, II nepo, n .. d.,

33. Linda l~lorthington, "The Nutrition Factor in Senegal, II Dal-<:ar, nltd.

34. Center for Disease Control, Do So Department cf liealth, Education

and 1iJelfare, Yrotein/EnerrJ;Y Un(~ernutrit ion Surv~ys in the Sahel,

1974 and 1975, Atlanta, Geor~i3, no~~

350 Frances BriGham Johnson, ftFcau for All," The ~Jay to Score for

ttl Human Riehts," n.p ... , Nov., 1978.,~~ 36. John L. Fischer, "The TU80n Hodel: Slunmary of an Illustrative

§ Developiug Country StrateGY f0r I~}.c()ting Basic Food/Nutrition needs, nr:?; nopa, n.o.l"

~ 37 0 n~publique du Senegc~l, 1\lin ~ du Plan et de la Cooperation,~ Cin9ui~me Plan lU'~ riennel de n.5veloppement economique ct social

(1er Juillet 1977-30 ,ruin 1981), Dakar-Abidjan, 1977.

38 0 The 'llorld BnnIt, Nu.trition Dd."l"(» ~ Agriculture nnd Rural Developr.lf-z·nt

Dept 0 t Identi.f:i.ce..tion Report, S~negal: Proposed Inter;ratcd Fooc1 anoNutritio!} Pro,1££!., 'llashington; r .. co, septa 20, 1.9780

30. Nalcom Ao Vers~l, ftA Perpsective on Farninr; ;?r3cticcs tn the

Saloum, n pa;~er prepared for th0 Uorks~~or on Sahelinn Agriculture,

Purdue Univorsity, Feb" 1 and 2, 1579.

40. Bozema Stomcl-~/ei~el, "Socioeconomic Study of 7arms in the Thies

anc1 Bambey rr·~fectures," popel' preparecl for the \'lorl{shop onSahelian A~;riculture, Puruue University, Feb o 1 and 2, 19790

41. CILSS, Club rlu Sahel, ivorkin3 Groups on 1trnr!(et ing, Price Policy

and storn[;c, rnrketinp; Price Policy 3nc1 Storaf~e of Food Grains

in the Sn~1el; A Survey, Volo 1, Anr~ J\rbor, l\'iichigan, AUBo, 19770

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42. Nichele Fielous, "Provisional Rerort: Socioeconomic Study in theDamage Region (Sencljal River), rr paper prepared for the ~"orl(shcp

on Sahelinn Agriculture, Purdue University, February 1 and 2, 1979 0

43. Arthur ~ZO Braunstein, "Offici~l Nee~ings in Senegal, December 17-31,1973, memo to files, Dakar, December 31., 1979.

44G P. Cantrelle Rnd H. Leridon, "Breast Feeding, Mortality in Child­hood nn{' Fertility i.n a Rural Zone of Senegal," Populatian Studies,

Yolo ~'\XV, no. 3, Hov., 1.9710

45. Catholic Relief Scrvic6s, Annual Public Summary of Activitie$,July 1, 1978-June 30, 1979, Dal{ar, no<1.

46ft S. Chevassus Anges, P. Canonne, Co,Scumat, J.Lo Dyck, and ~lo Ncli~ye,

Interpretation ce Trois Enquetes Alimentaires Faites ~u Senef~al:

Drotar, Lougn-Lin~uer~ et Kedougou Rural (1977 at 1979), Dakar, n.d.

470 Gordon Yaciak and Anne Dorothy Ynciuk, International Develo~ent

Researc~ Centre, Post-Harvest T8ch:-;'-',l:i~Y 1.n Scncr-;:;l: Current

Practices and Future Needs, IDnC-~iR13,(jttawa, 1 J'an~, 1980 0

48.48 ~:l ,I b 1 . ..:l roo I l I 11< - • f 7) 1 1 .,. d ,r t Ro hCpu . J.,:!ue \.lU uenega , l"~1n .. 0 hura neve opmen.; an ·:·~a er .I. esources,

Actions Planifiees de Production C6rf:[~1{ere (1977-"1985), Dakar,

Dec., 1:~79.

49. John Sundman, !lImpressions of Nianga, Senegal," paper preparedfor the Horkshcp on Sahelian ii~~riculture, Purdue University,'Feb. 1 Ii.:n~; ~, 1D79.

50. Douglas BOnnett, IISummary to the Thesis: 'Farmer's Goals andObjectives and the Effects of Goals on the Cultivation of Cropsin Sine Saloum, Senegal t" paper prepared for the t1orkshop on

Sahcliun Agricultur~, Purdue University, Febo 1 and 2, 1979.

510 Linda WorthirJGton and Natalie Johnson, "Senegal: Progress in

Developmento"'!tungor Notes, Vola 6, no. 1, June 1980 ..

54. Naomi Baumslag, Ed Sabin, and Chris Roesel, "Nutrition Problemsin Africa," nopo, noG e

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(This paper was prepared by a nutrition consultant asa comment on the Miracle paper)

By James No Pines,New Transcentury Foundation'

D:lAFT 10/80

A NUTRITION STRATEGY FOR USAID/SENEGAL

The USAID can, with gcoc reason, assume the existence of substantialmalnutrition in rural Senegalo ~lhile a recent consulting report(Miracle, September 1980) assesses correctly the paucity and limitedreliability of more direct nutrition status and family consumptiondata, disaggregated infant mortality and income figures, if anywherenear correct, provide incontrovertibleevicence of malnutritionproblemso At these high mortality and low income levels, seriousmalnutrition must be presentu The widely-referenced, though poorlyquantified,seasonal problems reinforce this conclusion.

The Mission's proper emphasis on agricultural production, and thelimited capacity of Sen0gal~se a0enci~s to ahscrb 3nd manage a ,necessarily complex nutrition project, SUggl~st that the USllIDnutrition strategy should be intGgr~teG with approaches to agricul­ture and rural f.;evelopment 0 This will c()ntribute to eventual develop­ment of nati(~nal nutritj.on planning and execution capability, asstaff acquiring skills ane! experience in decentralized programsmove to contral rolesg

The agriculture-based nutrition strategy begins with identificationof priority gec~raphical areas, in which malnutrition is suspectedond current or projected USAID-supported efforts are lilcely to increaseproduction nnd incornc o Tho strategy'saeks to assure th~t improvednutrition will flow from the positive economic effects e In the absanceof nutrition proGramming, t"hJre is 1it,tle likelihood that those hene­fitting will be from malnouriShec fomilies or, if malnourishedfamilies benefit in income, t~nt their nutrition will improve~

Nutritional consequences of agricult"ural projects easily becomenegative, for example, as a) families go to market for what they usedto produce, b) increased commercialization leads to excessive saleof food crops, anc c) economic improvement changes food hahitso

The f6regoing suggests an approach to integrating nutrition intoagricultural production and integrated rural development projects.The nutrition components must includ:·, for exampJ.;e, a simple systemfor establishing baseline nutrition status and monitoring it thereafteroThis permits orientation of production and other activities to groupshaving most serious malnutritiono ~Vhile it is desirable that the healthsystem monitor nutrition status routinely for all, the component needonly assure presence and operation of health services sufficient toprovic)e the small sample of dat~ required for adequate monitoring •

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Another step in the approach requires that proGuction plans be reviewedto explore a) likely impact on foou production, and b) inclusion ofmalnourisherlfarm families amone; participating producerso This leadseften to recognition that a project has neglected the need to assurethat producer families can ccntinue to feed themselves with little risk.It may also stimulate inclusion of poorer farmers among those served,or encourage development of a) extensicn services for food production,b) village and home gnr(~ens, and c) small livestock programs, tocomplement initial plans and reinforce attainment of nutrition goalso

Linking nutrition goals with producticn projects. requires increasedattention to disposition of production gains~ Plannors cannot assumegreater pr.oduction automatically improves nutrition .. Systematic addi­tion to, and replacement of, rlcnate~ food by local production, Infeeding pro(jrams, can be n useful step in providing nutritionallyfavorable markets for afidtional production. Home economics extensionto encourage nutriti0nnlly favorable consumer behavior may nlsobehelpful. storage and marketing interventions, geared expressly tonutritional neecs, can also form part of a nutrition component.Village level communi ty ~evelopment, in lvhich the commonly feltneed for improved health leads to nutrition-relnted communityactivities (e.g., day-care centers, feeoing programs using localfoo(1),mny also be ap~roprintco Development of community and family~espcnsibility for maintaining adequate nutrition of all, based onthe pr,oduction gains to be achieved throuGh other USli.ID-supportedactivities, is a feasible outcome for complementary nutriti'on workctWhere health services exist, or are pnrt of projected development,the nutrition component can incluce a tvide variety of nutrition­related henlth activttics (eGg., oral rehydration, targctted fee(1ing,

'de-worming, monitoring birth weights)e

These suggestions illustrate possible range nnd" content of a nutritioncomponent within an l')gricultural or rural development projecto Detailsof indivi{!ual elemonts, and the variety anti balance among them, willflow from exploration of specific project cGntexts, th.ough the basicquestions remain the sameo The Mission's expressed priorities behooveit to ask:

a) ilho nnd where are the malnourished familiBs in the target area?b) Can project-supported services include more of the malnourished

families?

6) ~hat is the likely disposition of any increased production inrelation to nutrition needs?

d) Can thecultivnti0n mix or disposition of ~roduction be modifiedin nutritionally fnvGrnble ways, ,·vi thout substantial reduction ofeconomic benefits?

e) (!hat other activities coulcl improve nutritional impnct of theproject?

These questions need to be adapted nnd raised for all projects, buttheir relevance to n~riculture and rural development is especially highoThere appears to be considerable interest \within the Nission inimproving the nutritional consequences of other projectsG The CentralNutrition Office (DSB/N) has a roster cf IQC contrnctors, who cnnhecalled on to provide project desi~n helpo ~o~

THE NUTRITION FACTOR IN SENEnAL

The evaluations for the joint assessment followed the log ,frames ofeach project. In only one of these, irrigated perimeters, were there anybasic nutrition questions asked. lTSAID/Sencgal in the 1982CDSS has statedthat "food/nutrition (has been chosen) ••• for special consideration" (p. 42).This. paper is an introduction of the wide spectrum of the nutritional factoras part of overall policy and strategy for USAID and the Government ·of Senegal.It presents a brief overview of the present situation, of the USAID, Govern­ment's 'and other donor's current approaches to nutrition issues, and somesuggestions for interventions.

Senegal's food and nutrition ,situation is both serious and deteriorating.Even in an average year, neither the quantitiy-nor the quality of availablefood supplies is adequate to meet the nutritional needs of the nation's5.5 million people.

There are three main inter-related nutritional problems: 1) Markedseasonal,undernutrition, occurring especially in rural areas and during the5-6 preharvest months (May-October); 2) Widespread·· protein-calorie malnutrition(peH), particularly among young children nod the" rural poor ,hut also amonglow-income groups in peri-urban areas and sm~ll towns. The source of caloriesand proteins in different regions of Senegal is seen in attached Ftgure 1.3.Various nutrient and vitamin deficiencies, most notably of iron, certain Bvitamins and iodine, mostly affecting the so called "vulnerable." ,groups "(infants, young children and mothers J and working males). There are consid­erable variations among ethnic .grou.ps and religions.

Overall caloric intake in the rural are~s is a little more than 2000calories per daYJ a deficit of 300-400 by internat:ional standards. Fourty­five per cent of Senegal's total pcpulation receives less than80Z of calorieneeds. As a whole the population does not seem to havp. a shortage of proteinfor the amount of caloric intake. These aggregate figures do not account foractual consumption levels over different seasons, especially of. the vulnerabiegroups. Adult \vomen on the average ne.:~rly meet the minimum daily requirement,but t\7hen pregnancy or lactation are factors they are 12-18% short of the goal.This, then, increases the possibilities of low birth wc:!ight, breastfeedinginadequacy and infant morbidity thus placing the young child at an earlyhealth risk.

Increasing evidence indicat~s that th~ pre-harvest seasonal shortage offood is the major nutritional problem. Though this is usually associat~dwith rural food shortages theurb~n poor are also greatly affected. Becauseof crowded living conditions, 10t07 incomes and high prices and urban populationnever quite gets enough of the available food supply. As is true world-wide,where families arc poor and under-e.ducated, malnutrition is greatest. Caloriedeficiencies~ especiallY9 are income related.

During this time, June through October (soudure), there is a sharp dropin food availability for all age groups. Aggregate caloric intake drops offby 10-15% even after a relatively good harvest year. Not only is less foodavailable but there is also a sharp rise in infection and disease during the

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rainy season, especially in the Cnsamance. World Bank studies during 1979-80confirm that there is a critical situation in the C~sarnance for caloriedeficits; the shortage is far more seVere there than in the niourbel tegionwhere comparable studies were done.

One reference shows that for these reasons infant mortality and morbiditygreatly increase during the soudure. Babies are born more often with lowbirth weights because the mothers are undernourished. Since less food isavailable there is underfeeding of the children, making them more vulnerableto infections and disenses. Child care is at a minimum because the arduouswork schedule during the millet and peanut planting and growing season requiresall family members to spend their limited energies and resources on the fields.

At least half of Senegal's 1,218,000 pre-school age children are belowrecommended growth standards, with 40-50% affected by 2nd and 3rd degreeprotein-calorie malnutrition.

Government of Senegal's Efforts:

Past efforts of the government to increase local food production and raisenutrition standards have met with relatively little success. No substantiveprograms to ma~e a per.manent impact on malnutrition among the most needypopulations have been successful.

Many crop development and diversification schemes were implemented withslight regard for their social or nutritional relevance. Attention tq nutri­tion has so far focused on research rather than investment. Pilot programs inapplied nutrition and on precessing local food mixtures for children have beentried. Relief of malnutrition is done through distribution of donated foodcommodities to the most vulcerable groups. Nutrition problems are studiedprimarilyns a public health issue with the health sector concentratingheavily on cur~ti~~~ rather than preventive care, on large urban hospitalsrather than rural community services, and on training physicians rather thanvillage health workers.

The Government's new approach, however, sig~als ~ commitment to begin tochange this situation. It began recognizi.ng the importance of nutrition asa basis for overall development plans in the mid-197Gs. The Fifth NationalPlan (1977-81) establishes a thorough foundation for a food and nutritionpolicy to undergird the National Planning in all sectors of the country. Inparticular it focuses on improvinp, the nutritional status of the vulnerablegroups. Some of the identified needs are to:

1) increase food supplies to compensate for seasonal, regional andsocio-economic deficiencies;

2) improve and extend nutritional education;3) develop and distribute a Senegalese weaning food;4) consider an iron fortification program (48% of the population is

anemic);5) do detailed food consumption surveys, particularly in areas of

widespread malnutrition.

1

o....r.-:~-

To implement the Fifth Plan a~ood Investment Strategy (1977-85) t>lasdesigned. This is a pioneering att·.mpt among Sahelian countries to addressthe complex food and nutrition issu(·~'1 in an integrated manner, and to adjustnational development policies to me~r nutrit'; 'inal requir·ements. It covers aperiod of time as the Sixth National Plan is being developed.

A constraint to implementing thip strategy is the lack of knOto1ledge inSenegal of how much is eaten by who'·',. Until this baseline information isavailable it is almost impossihle t) d~sign projects or policies to meet theactual food needs of the pe ' ..... e.

The COS agencies and organiz~ :io ~ which primarily are concerned withnutrition are as follows:

BANAS - Bureau of Food and Arlliei Nutrir:~~ - This organization under thedirectorship of Dr. Thian:lr 'r, vDo~ e is resi1;.'nsible for all nutrition issuesand services at the natiena". lev~\l. It operates under the Ministry of Health.It has responsibility fcc fulfilling the nntrition education component of thematernal and child heal U'.Jro.~rarn, but is :: n ·~ffectual because "to7e don't haveadequate resources. II TA',AS p,.1blishe~, tc.;.chi:i.cal materials on composition offoods in Senegal. They have done at least one report of food consumptionpatterns, but for the UJst p~rt have very Jittle information of this. Thoughthey are the parent body for sev~ral resea~:ch or service related projectsin Senegal (L''';:' example ~ the Catholic Reli :f Services (CRS) program in thehealth centerJ and ORA}~'s research) they eern to be poorly organized, under­staffed, and over exte~~ed.

ITA - Institute for Food Technology - Unc~r SERST, this government organization t

headed by l1adane Basse, is pr~·.marily a foci technology research center. It is .the organizati on which originr·.lly developr d the "pain-mi-ble" ~ the milletflour bread, ;~s a part of government poli~y to increase consumption of millet.Founded in 1-:'(!1, ITA is doing research in storage and preservation of anumber of sf.apl~ foods, development of so' plemental weaning foods, some workon soybeans F.:; :.1 possible cash crop in tb. Peanut Basin, or as a high-proteinsupplement in ~('Yeals, and assistanre to . .;velop new commercial products.They have cli:' tc,. t labs and do e~:ter~.8ive j nalyses of food components. ITAhas expressed tnt· rest in studying cuI tur;·l patterns of food consumption andvillage testiur 01 proposed new products. They have been primarily relatedto the conuuerc:... '.1 'ector.

CANAS - Comite d.'Arllyse NutritiC'nnellc et Alimentaire au Senegal - Underan. agreement on ... ul ') 1979" this coot"dina~~ive or;Clilization, under the Ministryof Plan, was offi.~:i.'lly established, thotl!:h it \·;a~ ori.ginally organized as anad. hoc agency in ~ ./6. The Commi.ttee is CCr.lpose..-! of:

The Minist r of Finance and Economic Affairs with the Director ofStatisti(..'.-nd Director of Foreign Tr'·~'~~.

The Hinistel of Plan and Cooperation w:·,.th the Director of 'Plan andthe Director of Finances and Plan.The Hinister"f Rural Development wit:t the Director General ofAgricultural!. t'oduction and Execut:!v~ Secretary of CER.

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The Minister of Public Health with the Director of BANAS, theDirector of ORANA and the Director of the Institute of SocialPediatrics. I

The Secretary of State for Promotion Humaine with the Director ofRural Training.The Secretary of State of Specialized Research and Technique (SERST), .with the Directors of ITA and ISRA.The Secretary of State of Woments Affairs with the Director of Program.

This high-powered group is supposed t~ act as a coordinative body withthe representative ministries to design, plan, establish the policies andprograms to solve the country's food problems.

ORANA - African Food and Nutrition Research Organization - This is a vlestAfrican regional research institution based in Dakar, under Director Dr. AmadouNakhtor Ndiaye. This organization has a. ~Tide capability in research of bothtechnical and social natures. Though som~ ~ork has been done in Senegal,particularly on anemia, much of the reserach is in other West African countries.The nutrition research work is largely done through ORSTON (see below).

ORANA research efforts encompasses: nutrition and infection, includingeffects of vitamin A on onchocerciasis; studies on the body's ability toabsorb nutrients when parasitic infections are prevalent; fetal nutritionalstatus; characteristics and prevalence of anemia and goiter. There researchindicates that third-degree malnutrition (kwashiorkor-marasmus) is moreprevalent in urban slums than in rural areas. They have done nutrition statussurveys for the design of the World Bank program. They are also doing qualitynutritive aspects of the millet bread ard are advocating food fortification tocounteract anemia. ORANA houses a library of the research materials whichthey have developed.

ORSTOM - Office de In Recherche Scientifique et Technique Outre-Mer - Thisprivate French research organization does basic research in many scientificfields, several of ~fhich are related to nutrition, such as population anddemography ~ heal th, soi Is and food. T1~e food and nutrition category is largelydone in the close cooperation with ORA~\iA. ORSTOM has extensive libraries oftheir reserach findings p some of which are ~tudies done over nearly twentyyears. They keep careful recor.ds, particularly in the demographic studies.

SONED - National Co;~.~.ny for Developrrant Studies - Though this is a privateconsul tine firm it ,;.8 government funcied to do specific design and planning offood related projcci:S. Specifically it is the major agency designing theWorld Bank :?ood and Nutri.tion Project.

IFAN - Institut Fondro'p.ntal d'AfriquE Noire - Based at the University of Dakarthis regional cent~r ~~ basically ~~.tural~ socio-anthropological studiescenter. One of the staff,Dra Solange Kamara, has done a major research onfood consillIl?tion puttn'ns in Dakar. Fer findings could have many implicationsfor future programI'lin.. ; of AID or ti e ':overnment of Senegal.

Specifically, sh~ points out the great difficulty entailed in convincingurban Senegalese that ":hey should 'st more mill~:: and less rice. Based on her

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studies, the evidence indicates that the rice-based diet may now be soentrenched in the urban dwellers' cultural patterns of eating that it cannotbe changed,-at ~east through any democratic or propa~anda efforts. She wascommissioned by President Senghor to do radio programs a few years ar,o forthis purpose, but found them largely ineffective. The question of economicincentives for purchasing rice substitutes was not sufficiently studied byher, and remains a needed field of research.

International Assistance

International assistance in the food and nutrition field has beenprovided at different times by U~ited Nations speci.alized agencies; multi­lateral and bilateral donors, and severAl non-governmental and private organi­zations. Following is a brief statement of these general programs.

UNDP has financed a number of projects in food crop and fishery develop­ment, and an eight year project to est~blish and develop ITA.

FAO has provided funds 9 equipment and training, in health and nutritioncenters-and health posts, rural m~ternities and village pharmacies, and fora pilot nutrition project in the Sine Saloum region.

WHO is assisting several small projects for development of health servicestraining of medical and para-medical personnel, combatting infectious .diseasesand improving environmental health.

UNICEF works prima.ri1y in rural· maternities and health posts:·WFP is currently operating six supplementary feeding projects in primary

and technical schoole and rural training centers, and food-for~work projectsin Sine Saloum and Eastern Senegal.

Though the programs of these agencies have a nutrition focus the scaleand character of the problems of undernutrition and caloric deficiency inSenegal are such that these efforts could provide only partial and temporaryimprovements in the situation.

Bilateral Agency Assistance is focused more specifically on projects inthe agriculture, health and education sectors. For example:

France is the primary donor to Senegal. Its aid programs are substantialin each sector; in health alone commitments amounted to g38,OOO,OOO in 1976.

Canada has surported the development of artisan fishing, research onmillet and ~o!6hum cultivation, storage and post-harvest technology, and ispioneering a small rural health pr~gram in the Sine Saloum.

Belgium is supporting the Institute of Pediatrics in Dakar.

West Germany, Great Britain, the Natherlands, and Norway are also pro­viding bilateral assistance. The European Economic Community through theFED gives considerable support to agricultural production.

There have been no measurements of: nutritional impact in these agricul­tural production projects. There is no d3surance that· resultant gains inincome and/or food output are raachin8 the most needy population groups.

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World Bank

The World Bank's recent lending for projects in rain-fed agriculture,irrigation, and agricultural credit has supported the Government's programto diversify and expand food production. They do not necessarily address

'nutritional impact issues.

To do that the World Bank is nearin0 completion of an extensive food andnutrition proposal for Senegal. This project area 1.s a new one for the Bankto support~ and it is new in Africa. The project design is being done bySONED, with the Ministry of Plan. The project is expectec to be finalizedin mid-1980.

There are two major aspects w~i~h the Bank Project will address accordingto their draft proposal of December 1979. One is in institution building,or more specifically up-grading. The three major government-offices whichhave responsibility for nutrition in Senegal will each be receiving fundingto increase their operationAl and management skills and capability. They areCANAS, BANAS, and ITA.

The other aspect of the proposal will be to establish programs in healthand nutrition in Diourbel and Casamance. Efforts are being msde to not over­lap r,lith USAID's Casamance project. l'Jhat the exact r.cope o·~ these pr('.jectswi.ll be, or the amount of funding, is still unclea.r since t:lle feasibilitystudies are not yet c(:'mpletc~ nor has the Bank established what nutritionalinterventions should be done.

USAID's Role

USAID presently finances proerams in agriclllture 3 grain storage and ruralhealth and assists in pilot-scale food productLon schemes for women's groupsand considerable supplementary food assistance. None of these have a statednutritional component though some may have ~ttritional impact on the bene­ficiaries.

The acknowledged ~ajor approach of USAID, to date, in terms of nutritionhas been the PL-480 Title II program. This project has been operatingthrough Catholic Relief Services (eRS) fOT the past 19 years, with a fooddistribution throup,h the PPNS 1 eenters. Totalling approximately ~6:,OOO,OOOa year. it supplements the food needs of 230,000 mothers and children withsorghum and weaning food. Little has been done to evaluate whether thisprogram actually increases the nutritional status of the r.ecipients. The'Wr-rld Bank, in its current studies of nutritional baseline data in Diourbeland Casamance, indicates that there is no overall nutritional differencebetween those families who receive this food and those who do not. 2

1~ J'PNS - Program for Nutrition a~d Health Protection of Vulnerable Groups.

2. Interview with IBRD representative May 20, 1980.

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In May, 1980 a PL 480 Title III program was signed with fhe governmentof Senegal. The $7,~OO,OOO per year "Ear three years engendered froin the saleof rice in the commercial markets is to be used for rural development projects.This project, though based on cereal, cannot be said to increase the nutri-

. tional status of the recipients since it will be primarily consumed by thosewho can. afford to buy the rice~ and are not part of the nutri.tionally atrisk groups. Hmvever, the recipients of the develolJment funds are allagencies whose objectives are to increase the productivity of the agriculturesector; as these agencies implement their programs some may incorporatenutritional programs.

In the tJSAID health hut program in sine Saloum and Bakel emphasis isplaced on general health conditions and only indirectly on nutrition. One ofthe causes of malnutrition in Senegal is malabsorption of nutrients available,often caused by parasitic infections and diseases. wnen these conditions arecured, persons, especially childrentare more able to absorb the nutrients theyreceive.

As USAID increases its programs and projects in irrigated agriculturespecial emphasis should be put on thehealth/nutrition situation. Horld­wide there is a growing body of knowledge which indi.cates an increase innegative health status in the irrigated areas, due largely to increase indiseages from water-borne vectors. Since AID's irrigated projects are in theareas of greatest poverty where food is least available, attention should begiven to the nutritional level of the beneficiaries in these areas.

Considerations for Future Action

Senegal's nutritional security is expected to decrease in the next twodecades. This follows the continued high population growth rate (Le Soleil,23 May 1980, indicates a population of 10,000,000 by the year 2000); thedeteriorating economy; erratic rainfall with concommitant drour,ht conditions~

the increasinR rate of unemployment. The many donors 11ave focused attentionon increasing quantity of food wi.th little effort to improve qu~lity orappropriateness l and limited efforts to reach the most needy (hungry) partsof the population, except througl~ relief p:t:ograms what at best are temporary ..Nutritional considerations are not major components of present USAID projects.Nevertheless it is important to ask of these projects, I1Does this (project)help alleviate malnutrition?" or stated differently, "Wil1 this help hungrypeople get fed?" {'lith these questions in r.lind the following considerationsB.re offered.

I) 7he GOS seems tc have the "political will", the commitment, to solveits problems of hunger and malnutrition, but it does not have the resourcesto do so. The U.S. Presidential Commission on World Hunger's preliminaryreport of December 1979 calls for the mobilization of political will bydevelopiag countries as the first ste? toward solving their hunger problems.Senegal's commitment to this and is clearly stated in both the Fifth NationalPlan and tile Food Investment Strategy. As USAID plans, and implements itsprojects, it should seek to support the GOS's policies and statements toincrease nutritional well-bei.ng. As stated earlier nutrition should benmajor consideration in project selection and desiRn.

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2) In each of USAIDts programs possible consideration should'be givento including a direct nutrition compo~~nt to the prbject, especially as re­design takes place. A specific illustration of this would be to design. aDddevelop a nutrition educa:ion program for the Sine Saloum Rural Health project.This is particularly appropriate because nutrition education is a form ofpreventive medicine, adding a dimension to the curative medicine route thatthe health huts now attempt to provide.

As the Casamance ProJect begins its design of a ',illage heal th pror,ramit could include from the start a nutrition education element. The WorldBank food and nutrition project is proposing such a program for its healthhuts in that area.

3) Evidence is mounting pointing toward the seasonal shortages of foodas the major cause of malnutrition in Senegal. But to date none of the donoragencies, nor the Government of Senegal have projects designed specificallyto alleviate this problem. Creative research should be conducted to determinethe best means of addressing this issue, then projects designed and fundedto do so." Since it is a chronic problem, as well as periodic, the usualincrease of food production, or food relief projects will not appreciablychange this condition. What is needed is a· means to stabilize the availabil­ity of food in an area over an entire year and make it accessible to thelocal population. Grain storage facilities and the development of a grainreserve which ~re being done for other purposes· do not necessarily addressthis problem.

4) Because one of the most difficult problems to deal with developingnutrition-related programs in Senegal is the lack of reliable baseline data,perhaps USAID could consider funding a basic project in data collection andresearch. There are several possible ways to do this: .

a) In each AID on-going pr~ject a data gathering component should beincluded. The question to answer is "lVho is eating how much, when and where?"When the answers are ascer.tained projects to solve the nutritional deficienciescan be designed.

b) The initiation of a specific project to get information on thisquestion should be done. It should be over a two year period, at least, inseveral geographic areas, and among a variety of ethnic groups. This shouldbe centered in tile rural areas, but include the urban and peri-urban as well.

c) There is increasing recognition of the inadequacy of baseline con­sumption data, in spite of a number of small studies being done in the past.It might be advisable for AID to work cooperatively with other donor agenciesto create a national study to get this information which could then becomethe definitive work for use by all agencies. This (QuId be done, withsufficient funding, through agencies such as OP~NA. The World Bank feasibilitystudies in Diourbel and Casamance have done some of this. As their Food andNutritiJn Project is developed and they support the up-grading of CANAS, itmight be possible for CANAS to undertake such a study.

d) Usins Pence Corps volunteers t or funding a PVO, to conduct a nationalconsumption survey. This could be done through an OPG.

5) USAID could seek a liaison role ,~ith the World Bank in order to keepinformed of the development of their Food and Nutrition Project, and find

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specific ways to cooperate. There is a small precedent for this in a USAIDinitiated 'donors' meeting regarding the Casamance health project. All con­cerned agencies, including the n.1nk~. seem anxious to avoid overlapping wi theach others projects.

6) Ways to increase consumable foods for rural populations should besought. There are some small projects underway, Inrgely by PVOs or PeaceCorps. Some po.sible ways t9 do this are:

a) Prom'otion of and technical training in vegetable growing in thepeanut-millet producing area, in the form of kitchen gardens;

b) Expanded marketing possibilities in the irrigated ?erimeters sothat vegetables grOt~ can be consumed locally, but with markets availabel forexcess; the Joint Assessment indicated that the small irrigated perimetersfarmers prefer to raise corn for consumption in the tlgreen" or "fresh" stage t

and that tomatoes sometimes spoil, on the vines before they can be eaten orsold.

c) Training of extension agents to teach ways to more efficiently uselocal products to increase nutritional status. An example would be increasingfamily consumption of the protein and calorie rich peanut~ before'it is soldas a cash crop.

d) In the livestock projects the beneficiary survey indicates thepeople would like to consume (as well as market) more of their product throughmaking cheese. Technical training in this method could be done throughextension agents. .

7) The mother is the key person in improvement of health and nutritionalstatus in the home. Inter'·;?ntions should concentrate on her. Improvednutrition during pregnancy is one of the most cost-effective measures ofreducing malnutrition. A baby born e..t or above normal weight begins lifewith much more chance of survival. lihen more infants survive the parents areless likely to produce more children~ T\~h~.. ch in turn makes more of the limitedfood supplies available for all~

8) Since the most vulnerable population, nutrition-wise, in Senegal isthe pre-school child, and the time of greatest nutritional deficiency isweaning, efforts to improve this situation should be undertaken. Nutritioneducation to the mothers, particularly of home p~eparation of appropriateweaning foods, should be initiated. Encouraging, training, enforcing thenutrition education component of the PFNS Title II food distribution couldbe a vehicle for this.

9) t~en people have adequate incomes to meet their basic needs they donot go hungry, nor are they as likely to be malnourished. (An exception isAmerican teen-agers whose "maIn-nourishment is based on poor nutrition;]lintake, not insufficient calories). One way to create incomes for ruralfaml1es is through small rural-based industries which employ local persons,especially in. the "off-season" of farming. Little has been done in Senegalto develop this decentralized approach to income generation. A serious studyof this potential, as well as initia.tion on a trial basis, of such industriescould begin the trend away from nutritional deficiency. Rural-based smallscale industries could further support the food self-sufficiency concept bydeveloping industries that directly support food production) i.e. fertilizerplants, canning ar.d preserving factories, parts for farm equipment factories,crafts industries using agricultural products such as basket weaving and cloth(cotton or wool) making.