Nutrition Sensitive Agriculture

A Complementary Manual for Agriculture Students

Center for Food Science and Nutrition, College of Natural Science, Addis Ababa University

By: Tadesse Fikre Teferra

School of Nutrition, Food Science and Technology, College of Agriculture, Hawassa University

February, 2015

Increased Production

Product Diversification

Home utilization

ii

TABLE OF CONTENT

LIST OF FIGURES ........................................................................................................................................... iii

LIST OF TABLES ............................................................................................................................................. iv

LIST OF ABBREVIATIONS ............................................................................................................................... v

1. BACKGROUND ....................................................................................................................................... 1

2. TRAINING OBJECTIVES .......................................................................................................................... 3

3. WHAT IS MALNUTRITION? .................................................................................................................... 4

3.1. Types of malnutrition .................................................................................................................... 4

3.2. Malnutrition in Ethiopia ................................................................................................................ 5

4. MACRO AND MICRONUTRIENTS IN FOODS .......................................................................................... 7

4.1. Macro Nutrients and their functions ............................................................................................ 7

4.2. Micro Nutrients and their functions ........................................................................................... 11

4.3. Balanced Diet and Food Pyramid ................................................................................................ 15

5. ROLE OF AGRICULTURE IN REDUCING MALNUTRITION ..................................................................... 19

5.1. Increased Productivity ................................................................................................................ 19

5.2. Diet Diversification ...................................................................................................................... 19

5.2.1. Production of Legumes, Fruits and Vegetables .................................................................. 19

5.2.2. Rearing of Small Ruminant Animals and poultries .............................................................. 20

5.3. Promoting High Quality Nutritional Foods .................................................................................. 20

5.4. Nutrition Education ..................................................................................................................... 20

5.4.1. Complementary feeding ..................................................................................................... 20

5.4.2. Food Quality and safety ...................................................................................................... 21

5.4.3. Hygiene and sanitation ....................................................................................................... 21

SOURCES ..................................................................................................................................................... 22

iii

LIST OF FIGURES

Figure 3-1 Components of food and nutrition security ................................................................................. 4

Figure 3-2 Stunting prevalence of the different regional states, Ethiopia .................................................... 5

Figure 3-3 Food balance sheet for Ethiopia, FAO, 2014 ................................................................................ 6

Figure 4-1 Recommended energy shares of the different macronutrients for a healthy life......................... 8

Figure 4-2 Sources of carbohydrates............................................................................................................ 9

Figure 4-3 sources of proteins .................................................................................................................... 10

Figure 4-4 sources of dietary fats ............................................................................................................... 11

Figure 4-5 Foods considered to be rich sources of micronutrients ............................................................ 12

Figure 4-6 Sources of micronutrients (vitamins and minerals) .................................................................. 13

Figure 4-7: Ethiopian traditional: a plate with the different food groups.................................................. 16

Figure 4-7: Food pyramid showing the types and amount of food groups in a healthy diet. ..................... 17

Figure 4-8: Food plate showing the types and amount of food groups for a healthy diet. ......................... 18

iv

LIST OF TABLES

Table 4-1: Summary of the functions of carbohydrates in humans body .................................................... 8

Table 4-2: Summary of the functions and dietary sources of some vitamins .............................................. 14

Table 4-3: Summary of the functions and dietary sources of important minerals ...................................... 14

Table 4-4: Summary of types and functions nutrients ................................................................................. 15

v

LIST OF ABBREVIATIONS

COHA Cost of Hunger in Africa

DDS Dietary diversity score

EDHS Ethiopian demographic and health survey

FAO Food and Agricultural Organization [of the United Nations]

FTC Farmers training center

GDP Gross domestic Products

IDA Iron deficiency anemia

IDD Iodine deficiency disorder

IFPRI International Food Policy Research Institute

MAD Minimum acceptable diet

MDD Minimum dietary diversity

NNP National Nutrition Program [Ethiopia]

OFSP Orange-fleshed sweet potato

PEM Protein-energy malnutrition

SAM Severe Acute Malnutrition

VAD vitamin A deficiency

1. BACKGROUND

Malnutrition continues to affect the lives of millions of children and women worldwide. Every

country is affected by some form of nutrition problem1. Malnutrition can be over nutrition

(usually in the developed world) and under nutrition (in developing countries). Under-nutrition

mostly affects hundreds of millions of pregnant women and young children in developing

countries. It is manifested in both macro- (protein-energy) and micro-nutrient (iron, zinc, iodine

and vitamin A) deficiencies in these countries. Chronic under-nutrition is indicated in children by

high prevalence of stunting (too short for their age). Acute forms of malnutrition are indicated by

the prevalence of wasting (too low weight for height). Globally, 19 million new cases of severe

acute malnutrition (SAM) are documented each year, which is responsible for over one million

under-five mortality.

The Global Nutrition Report of 2014 indicated that the burden of under-nutrition is affecting the

economies of the countries in the Easter African, the Caribbean and South -Eastern Asian

regions. The report also indicated that very limited progress in nutrition interventions were made

in these regions. The cost of hunger in Africa (COHA) study, also reported that malnutrition

costs Ethiopia about 55.5 billion birr per year, which is 16% of the total gross domestic product

(GDP) of the country.

The Ethiopian demographic and health survey (EDHS) of 20112, indicated that the prevalence of

stunting, underweight and wasting are 44%, 29% and 10%, respectively. Under-five mortality

was also reported to be about 88 deaths per 1000 live birth, of which over 51% is attributable to

malnutrition. Micronutrient deficiencies are also of public health significance in Ethiopia. The

prevalence of iron deficiency anemia (IDA), iodine deficiency disorder (IDD), vitamin A

deficiency (VAD) and zinc deficiency is very high and is identified as nutritional problem of

public health significance.

1 International Food Policy Research Institute (IFPRI) (2014), Global Nutrition Report, the words of HE, Dr. Kesetebirhan

Adamsu Birhane, Minister, Federal Ministry of Health, Ethiopia. 2 Central statistical Authority, EDHS, 2011 (CSA), (2012]

2

Ending malnutrition throughout the world requires action on many fronts which the health sector

cannot do alone3. The Ethiopian government launched a 5 years national nutrition program in

2008. The program was revised and re-launched in June 2013. The revision emphasized on a

multi-sectorial implementation approach and 9 line ministries have shown their commitments to

take their part and play a role. Much is expected from the Ministry of Agriculture (MA) in

effective implementation and sustainable improvement of the nutritional status of women in the

reproductive age groups and young children. Other ministries are also expected to play their

roles to realize the long term plans of the Ethiopian government of making the country among

the middle income ones in the near future.

3 International Food Policy Research Institute (IFPRI) (2014), Global Nutrition Report, the words of Margaret Chan, Director

General, World Health Organizations.

3

2. TRAINING OBJECTIVES

This training manual is designed for training professionals and students in the fields of

agriculture to:

aware students in the agriculture fields about the impact of under-nutrition on the

wellbeing and economic development of the community

make the agriculture students understand the importance of proper nutrition and its

association with the socio-economic development of the community and the nation

enable students in the agricultural fields to understand the different categories of nutrients

and their roles in the normal functioning of human bodies.

elaborate the concept of balanced and healthy diet for humans depending on different

preconditions and health situations of individuals.

capacitate the agriculture students and professionals to contribute to effective

implementation of nutrition programs at all levels .

sensitize the agriculture professionals on how to make their activities agriculture sensitive

and contribute to accelerated and effective implementation of the National Nutrition

Program (NNP) of the Ethiopian Government.

orient the agriculture sector actors of tomorrow on their roles in the multi-sectorial

implementation approach of the national program.

enable the agriculture sector students and professionals to focus on not only the yield but

also the quality and diversity of crops.

integrate home utilization of nutritious crops and products into the agricultural extension

systems, rather than market oriented production.

promote rearing of small ruminant animals for home consumption, particularly for young

children and pregnant/lactating women.

promote hygiene and sanitation practices in the preparation of foods and feeding children.

4

3. WHAT IS MALNUTRITION?

Malnutrition is the lack of adequate amounts and types of nutrients that result in ill health. It can

also be due to a situation where our body is unable to absorb or utilize the nutrients from the

food we eat. Malnutrition particularly under-nutrition therefore occurs when sustainable

availability, accessibility and utilization of adequate and quality foods is compromised.

Malnutrition is the opposite of Food and nutrition security.

Figure 3-1 Components of food and nutrition security

3.1. Types of malnutrition

Malnutrition can be over-nutrition which is manifested in terms of obesity and/or overweight or

under-nutrition which is stunting and micronutrient deficiencies. Over-nutrition is usually

associated with chronic disease like hypertension, diabetes mellitus and different forms of

cancer. Under-nutrition is associated with limited mental, physical and immunity developments

and frequent illnesses and low performance at school and lower productivity.

Food & Nutrition Security

Availability accessibility Utilization

Sustainability over time

5

3.2. Malnutrition in Ethiopia

Both protein energy malnutrition (PEM) and micronutrient deficiencies are highly prevalent in

Ethiopia. The average energy intake of the population is about 1980 kilocalorie per person per

day and this is about 10% less than the recommendation (2250 kilocalories per person per day).

Stunting prevalence as an indicator of the PEM among the different regional states in Ethiopia is

summarized in Figure 3-2 below.

Figure 3-2 Stunting prevalence of the different regional states, Ethiopia

As it can be clearly seen in the map (Figure 3-2), the prevalence of stunting is the highest in the

Amhara region, regardless of the high production practices and potentials of cereal staples.

Stunting prevalence of Amhara, Tigray, Affar and Ben-Shangul Gumuz regional states is much

higher than the national average (44%). Figure 3-3 below shows the composition of Ethiopian

diet (kcal proportion), food balance sheet based on the 2011 EDHS.

6

Figure 3-3 Food balance sheet for Ethiopia, FAO, 2014

The latest FAO food balance sheet (Figure 3-3) for Ethiopia shows that the majority of energy

(>70%) comes from cereal and starchy roots. Other non-staple foods of importance [milk,

vegetable oils and sugar (sugar and honey)] are contributing very little to the diet. Food

diversification is one of the cost effective mechanisms of addressing micronutrient needs. That is

why micronutrient deficiencies like IDA, IDD, VAD and zinc deficiencies will continue to be

highly prevalent in the country, if the current 15% contribution (which is far below the

recommendation of 40 -45%4), of the non-staple crops continues. The Government is trying to

address the situation in a multi-sectorial approach and much is expected from the agriculture and

health sectors.

4 SUN movement compendium 2014

Cereals

Starcy Roots

Pulses

Vegetable oils

Sugar

Milk

Vegetables

Oil crops

Animal fat

Meat

Fruit

Spices

Alcohol beverages

7

4. MACRO AND MICRONUTRIENTS IN FOODS

Nutrients are substances in foods that are necessary for humans body for energy, repairing and

immunity development. The main categories of nutrients include carbohydrates (sugars and

starches), proteins, fats, vitamins and minerals. There is no single food that provides all the

categories of nutrients in adequate level. The various nutrients are found in various food groups

and one has to eat foods composed from various groups to ensure balanced nutrition. Based on

the amount our body requires, nutrients are classified into two groups: macro- and micro-

nutrients. Details of these categories will be discussed in sub-sections to follow.

4.1. Macro Nutrients and their functions

Macro nutrients, which are required in larger quantities, include carbohydrates, fats and proteins.

They are used as a source of energy and for growth and cell repair. It is recommended that the

carbohydrates and proteins contribute larger proportion of the caloric requirements and are

usually obtained from staples. The level of sugars (sweets) and fats in the diets need to be limited

(Figures 4-1 and 4-2) to maintain a healthy life. The energy share of carbohydrates, fats and

proteins is recommended to be 55%, 30% and 15%, respectively for a healthy life (Figure 4-1).

A) Carbohydrates

Carbohydrates are the single most abundant & economic sources of food energy in the human

diet, constituting 4080% of total energy intake in different populations. The food sources of

carbohydrates include: cereals, starchy roots, sugar, honey, sweet fruits and processed foods like

pasta and macaroni. Intakes of optimum amounts of different types of carbohydrates are

associated with good health through effects on energy balance, digestive functions, blood

glucose control, and other risk factors for several chronic diseases. Detail in the functions of

carbohydrates is summarized in Table 4-1.

8

Table 4-1: Summary of the functions of carbohydrates in humans body Function Reason

To keep alive Our bodies are turned on and use energy from the moment of conception until we die. For example, energy

To keep warm Our bodies are warm, even if we are asleep. Keeping warm uses energy

To build tissues The body uses nutrients such as starch to provide the energy for building

To secrete fluids The body uses energy to secrete fluids such as saliva and breast milk

To repair tissues After injury or illness, the body uses energy to repair damaged tissues

To move and work We need energy to move muscles, to move our bodies, to walk, to talk, to

play, to run and to work.

Figure 4-1 Recommended energy shares of the different macronutrients for a healthy life

0% 20% 40% 60% 80% 100%

Energy share (%)

Mac

ron

utr

ien

ts

Carbohydrates Fats Proteins

9

Figure 4-2 Sources of carbohydrates

B) Proteins

Protein is the most abundant nitrogen-containing compound in the diet and the body. The

simplest units of proteins are amino-acids. Essential amino acids cannot be synthesized by

humans from materials ordinarily available to cells and they have to be obtained from diets. For

infants, children, and pregnant as well as lactating women, requirements would include protein

deposited and secretion of milk proteins. The food sources of proteins include: legume crops

(common beans, faba beans, peas, lentils, chickpeas, soybeans) and animal sources like milk and

milk products, eggs, lean meat, fish and chicken. All animal foods contain better quality proteins

than plants and are therefore usually better sources of body building foods. The better quality of

animal source foods can be explained in terms of their essential amino acid content and

bioavailability for utilization by our body.

Proteins have the following functions in the body:

For growth and development of the body

For body maintenance and the repair as well as replacement of worn out or damaged

tissues

To produce metabolic and digestive enzymes

As an essential constituent of certain hormones, (e.g. thyroxine and insulin).

10

Figure 4-3 sources of proteins

C) Fats

Fat is an essential nutrient for life. Our bodies require small amounts of several fatty acids from

foods (the so-called essential fatty acids). Dietary fats are obtained both from plants (vegetable

and seed oils) and animals (lard, butter, and eggs). Fats play the following vital functions in the

body:

to build cell membranes and to make several essential hormones.

Dietary fat is the most concentrated source of energy.

Fats impart palatability to foods as many of the substances responsible for the flavour

and aroma of food are fat-soluble and are associated with fat in the diet.

Dietary fats also permit one group of vitamins, the fat-soluble vitamins (A, D, E & K) to

be absorbed from foods during the process of digestion and also help these vitamins to be

transported by the blood to their destinations.

The essential fatty acids are required for:

o growth,

o reproduction,

11

o skin integrity,

o utilization of body fat and

o maintenance of cell membranes.

Figure 4-4 sources of dietary fats

4.2. Micro Nutrients and their functions

Micronutrients are those required for our body in tiny amounts, yet failing to get even those

small quantities virtually results in illnesses. Micronutrients include the different vitamins and

minerals. The dietary sources of vitamins and minerals are fruits, vegetables, animal source

foods, grains, seeds, nuts and so on. Benefits of micronutrients include:

Strong bones: combination of calcium, vitamin D, vitamin K, magnesium, and

phosphorus protects bones against fractures

Prevents birth defects: taking folic acid supplements early in pregnancy helps prevent

brain and spinal birth defects in offspring.

Healthy teeth: the mineral fluoride not only helps bone formation but also keeps dental

cavities from starting or worsening.

12

Figure 4-5 Foods considered to be rich sources of micronutrients

A) Vitamins

Vitamins are organic compounds that are required by humans body in limited amounts.

Vitamins are compounds which cannot be synthesized in the body but obtained from diets.

Vitamins are classified according to their solubility in water and fat soluble groups:

a. The fat soluble vitamins (vitamin A , vitamin D, vitamin E and vitamin K)

Here are some examples of the essential roles these vitamins play:

Build bones: Bone formation would be impossible without vitamins A, D, and K.

Protect vision: Vitamin A also helps keep cells healthy and protects our vision.

Interact favourably: Without vitamin E, humans body would have difficulty absorbing

and storing vitamin A.

Protect the body Vitamin E also acts as an antioxidant (a compound that helps protect

the body against damage from unstable molecules).

b. The water soluble vitamins [vitamin B1 (thiamin), vitamin B2 (riboflavin),

vitamin B3 (niacin), biotin, vitamin B6 (pyridoxine), pantothenic acid, folate,

vitamin B12 (cobalamin) and vitamin C (ascorbic acid)].

Some examples of how different water soluble vitamins help us maintain health:

Release energy Several B vitamins are key components of certain coenzymes (molecules

that aid enzymes) that help release energy from food.

Produce energy. Thiamin, riboflavin, niacin, pantothenic acid, and biotin engage in

energy production.

13

Build proteins and cells. Vitamins B6, B12, and folic acid metabolize amino acids (the

building blocks of proteins) and help cells multiply.

Figure 4-6 Sources of micronutrients (vitamins and minerals)

14

Table 4-2: Summary of the functions and dietary sources of some vitamins

Vitamins Functions Food Sources

Vitamin A

Night vision, healing epithelial

cells, normal development of

teeth & bones

Breast milk, Tomatoes, Cabbage, lettuce,

Pumpkins, mangoes, papaya, Carrots,

liver, kidney, egg yolk, milk, butter,

cheese, cream

Vitamin B

complexes

Metabolism of carbohydrates,

proteins and fats

Milk, egg yolk, liver, kidney and heart,

whole grain cereals, meat, whole bread,

fish, banana

Vitamin C

Prevention of scurvy, aiding

wound healing, assisting

absorption of iron

Fresh fruits (orange, banana, mango,

grapefruits, lemons, potatoes) and

vegetables (cabbage, carrots, pepper,

tomatoes), breast milk

Vitamin D

Needed for absorption of

calcium from small intestine

calsification of the skeleton

Ultra violet light from the sun, egg,

butter, fish, fortified oils, fats

Vitamin K For blood clotting Green leafy vegetables, Fruits, Cereals,

meat, dairy products

A) Minerals

Minerals have numerous functions in humans body. Sodium, potassium and chlorine are present as salts in body fluids, where they have a physiological role in maintaining osmotic pressure.

Minerals form part of many tissues. For instance calcium and phosphorus in bones combine to

give rigidity to the whole body. They are also essential constituents of certain hormones. Iodine

for example is important part of the thyroxine produced by the thyroid gland. The principal

minerals in the human body are calcium, phosphorus, potassium, sodium, chlorine, sulphur,

copper, magnesium, manganese, iron, iodine, fluorine, zinc, cobalt and selenium. Minerals that

are of most importance in human nutrition are calcium, iron, iodine, fluorine and zinc.

Table 4-3: Summary of the functions and dietary sources of important minerals

Minerals Functions Food Sources

Calcium Gives bones and teeth rigidity &

Strength

Milk, cheese and dairy products, Foods fortified

with calcium, e.g. flour, cereals, eggs, fish,

cabbage

Iron Formation of haemoglobin Meat and meat products, eggs bread, leafy

vegetables, pulses, fruits

Iodine Normal metabolism of cells

Iodized salt, sea vegetables, yoghurt, cows milk, egg, cheese, fish, plants grown in Iodine

rich soil

Zinc For children to grow & develop

normally, for wound healing Maize, fish, breast milk, meat, beans

Fluorine Helps to keep teeth strong Water

15

Table 4-4: Summary of types and functions nutrients

Nutrients Their uses for the body

Carbohydrates (starches and

Sugars) Energy supply

Fiber Keeps the gut healthy & helps digestion

Fats For energy, builds cells and stored to be used as

energy when needed

Proteins Building cells, making fluids, for chemical

process, for energy, protection against infection

Minerals Building cells, making fluids & for chemical

processes

Vitamins For chemical processes, building cells,

protection against infections

Water for chemical processes,

Building cells & making fluids

4.3. Balanced Diet and Food Pyramid

Eating a balanced diet means choosing a wide variety of foods and drinks from all the food

groups (cereals and starchy roots; legumes and nuts; vegetables; fruits; milk and other dairy

products; meat, poultry, eggs and fish products; fats, oils and sweets). Balanced diet also means

having larger proportion of grains, roots and legume products; fair amounts of fruits, non-starchy

vegetables, meats and poultry products as well as milk products and small portion of fats, oils

and sweets in our daily meals. The levels of the different food groups in our daily meals are

usually demonstrated in a food guide pyramid (Figure 4-8) or in a food plate (Figure 4-9). The

Ethiopian Food culture is more related to the food guide plate and as injera or other flat breads

are prepared in round (circular) shapes and are accompanied by different stews (sauces) prepared

from different food groups (Figure 4-7).

16

Figure 4-7: Ethiopian traditional: a plate with the different food groups.

Including the recommended levels of the different food groups in our daily meals guarantee the

intake of all the macro- and micro-nutrients required by our body for the normal growth and

proper functioning of the various systems. Eating balanced diet and doing physical exercises on a

regular basis will help us have a healthy and productive life.

Individuals or groups eating meals prepared from less than 4 of the various food groups are said

to have poor dietary diversity score (DDS) and are at risk of both macro- and micro-nutrient

deficiencies. A global report on nutrition (IFPRI, 2014) indicated that a small proportion of

young children have been reported to have the minimum acceptable diets (MAD) 15% and

minimum dietary diversity score (MDD)-27%. This is situation is worse in developing countries

like Ethiopia. Food availability, affordability and awareness of the community can be mentioned

as the factors behind lower dietary diversity scores.

17

Figure 4-8: Food pyramid showing the types and amount of food groups in a healthy diet.

18

Figure 4-9: Food plate showing the types and amount of food groups for a healthy diet.

19

5. ROLE OF AGRICULTURE IN REDUCING MALNUTRITION

5.1. Increased Productivity

The agriculture sector needs to make effort to increase the production and productivity of the

food crops to ensure the sustainable availability and affordability of staple and nutritious crops.

Food crops with high nutritional importance need to be selected and made to give high yields

with reasonable resistant to adverse environmental conditions. The agriculture sector needs to

play a role of improving the production and productivity and also work on the awareness of the

community on the importance on new crops for nutrition and health.

5.2. Diet Diversification

Besides increasing the production and productivity of crops, increasing the diversity of food

crops is crucial to improving nutrition. High quality nutritious crops like fruits and vegetables,

legumes and nuts as well as rearing of small ruminant animals and poultries is very important for

food and nutrition security of the farming community. Production of diversity of foods alone

does not guarantee improved nutrition of the community. The agriculture professionals need to

also educate the farmers on hygienic preparation of the crops and encourage the home

consumption of the nutritious crops, and to take only the surplus to the market. Teaching the

mothers to include these nutritious crops in complementary foods for children under 2 years of

age is also very important.

5.2.1. Production of Legumes, Fruits and Vegetables

Legumes (cheap protein sources poor mans meat) need to be grown and used for consumption

at household level. The production (back yard gardens, irrigation) and consumption of fruits and

vegetables, (rich sources of many micronutrients vitamins and minerals), are also required to

be promoted to the farming communities. Orienting the farmers to feed adequate amounts of

fruits and vegetables to their children and women of reproductive ages is expected from the

agriculture sector professionals.

20

5.2.2. Rearing of Small Ruminant Animals and poultries

Rearing of small ruminant animals (goats, sheep) and poultries (chicken) are among the low cost

agricultural activities. The small animals can be consumed at home or can be used as a source of

income to buy more nutritious foods for the families. Eggs for instance can be fed to children and

lactating or pregnant women to improve their protein requirements. Milk and milk products can

also be used to improve the nutritional status of the families.

Education and demonstration on better management practices for the small animals and poultries

as well as importance of home consumption of animal source foods need to be delivered to the

farming communities by the agricultural professionals and development agents.

5.3. Promoting High Quality Nutritional Foods

High quality nutritious crops like the deep colored fruits and leafy vegetables as well as orange

fleshed sweet potato (OFSP) can be promoted to new areas to improve the vitamin A deficiency

problems in young children. Depending on the availability and quality of water, small scale

fishery farms can also be established at farmers training centers (FTC) and demonstrated to the

community. The utilization of fortified foods and their preparations can also be demonstrated to

the community on special events or regular basis. For instance the importance of iodized salt and

its management during storage and cooking can be demonstrated to women groups by the

agriculture professionals and extension workers.

5.4. Nutrition Education

5.4.1. Complementary feeding

The Agriculture sector should be the major player in promoting complementary feeding of young

children between 6 and 23 months of age for accelerated stunting reduction in Ethiopia. The

agriculture sector needs to promote the production of crops that are important for the formulation

of high quality complementary foods. The agriculture sector should also take the responsibility

of formulating cereal-based local complementary foods with the inclusion of 20-30% legumes

and nuts. The Agricultural extension and development agents need to own the complementary

feeding component of the national nutrition program.

21

The Agricultural extensionists and development agents need to be trained on the consistency

(appropriate thickness) and feeding frequency and amount of the complementary food. They are

also required to get training on the enrichment of complementary foods (adding meet powder,

using milk instead of water, use of oils and fats, use of sugar and iodized salt).

5.4.2. Food Quality and safety

The foods that are consumed by humans are also needed by other organisms like bacterial, molds

and yeasts. They are also important for rodents and other pests. The micro and macro organism

that feed on human foods will reduce its nutritional and functional qualities and compromise its

safety for humans. The agriculture sector needs to make sure that the farming families are aware

of all the food hazards from production through storage and preparation to consumption.

Postharvest management practices and transforming perishable foods to amore storable ones by

using simple and affordable food processing technologies like drying, cooking, packaging,

preserving and so on need to be promoted by the agriculture sector.

5.4.3. Hygiene and sanitation

Hygienic practices in food storage, preparation and consumption is a crucial issue in maintaining

human health. The sources of water and its quality, the cleanliness of the food handlers and the

sanitation of utensils used for food handling are all important issued. Spoilage of foods by

microbes and other natural processes will drive the nutrients to be unavailable for our body to

readily absorb them. Therefore the hygiene and sanitation issues in food preparation and

consumption are very important. The agriculture sectors need to work in collaboration with the

health sector to ensure proper management of wastes and safety and hygiene of water for

domestic and agricultural consumptions.

22

SOURCES

1. International Food Policy Research Institute (IFPRI), 2014. Global Nutrition Report: Actions and Accountabilities to Accelerate the Worlds Progress on Nutrition, A peer reviewed publication

2. Central Statistical Agency [Ethiopia] and ORC Macro, 2012. Ethiopia Demographic and Health Survey 2011. Addis Ababa, Ethiopia and Calverton, Maryland, USA:

Central Statistical Agency and ORC Macro.

3. SUN Compendium Ethiopia, Scaling-up Nutrition, 26 October 2014.

4. Federal Ministry of Health (FMOH) Ethiopia, 2012. The Cost of Hunger in Ethiopia:

Implications for the Growth and Transformation of Ethiopia Social and Economic

Impacts of Child Under-nutrition in Ethiopia. Addis Ababa Ethiopia.

5. UNICEF, 2014. Integrating Agriculture and Community-based Nutrition (CBN) to

Improve Nutrition: A training manual (Draft) for Agriculture Development Agents and Health Extension Workers, Addis Ababa.

6. School of Nutrition, Food Science, Hawassa University and Center for Development

Innivations, Wageningen University, 2015. Agriculture development agents training

manual linking agriculture and nutrition for healthy and strong Ethiopian families,

Hawassa, Ethiopia.

LIST OF FIGURESLIST OF TABLESLIST OF ABBREVIATIONS1. BACKGROUND2. TRAINING OBJECTIVES3. WHAT IS MALNUTRITION?3.1. Types of malnutrition3.2. Malnutrition in Ethiopia

4. MACRO AND MICRONUTRIENTS IN FOODS4.1. Macro Nutrients and their functions4.2. Micro Nutrients and their functions4.3. Balanced Diet and Food Pyramid

5. ROLE OF AGRICULTURE IN REDUCING MALNUTRITION5.1. Increased Productivity5.2. Diet Diversification5.2.1. Production of Legumes, Fruits and Vegetables5.2.2. Rearing of Small Ruminant Animals and poultries

5.3. Promoting High Quality Nutritional Foods5.4. Nutrition Education5.4.1. Complementary feeding5.4.2. Food Quality and safety5.4.3. Hygiene and sanitation

SOURCES