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Policy Guidelines: Enhancing markets for nutrient-dense foods in Ghana

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This report analyses policy options for promoting nutrient-dense foods to reduce undernutrition in Ghana. Markets have great potential for providing nutrient-dense foods, but they are commonly inhibited by a number of market failures. Imperfect
  IDS EVIDENCE REPORT  No  28 Reducing Hunger and Undernutrition Policy Guidelines: Enhancing Markets for  Nutrient-Dense Foods in Ghana Henry Anim-Somuah, Spencer Henson, John Humphrey and Ewan RobinsonSeptember 2013  POLICY GUIDELINES: ENHANCING MARKETS FOR NUTRIENT-DENSE FOODS IN GHANA Henry Anim-Somuah, Spencer Henson, John Humphrey and Ewan Robinson September 2013 This is an Open Access publication distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the srcinal author and source are clearly credited.First published by the Institute of Development Studies in September 2013© Institute of Development Studies 2013IDS is a charitable company limited by guarantee and registered in England (No. 877338). The IDS programme on Strengthening Evidence-based Policy works across seven key themes. Each theme works with partner institutions to co-construct policy-relevant knowledge and engage in policy-inuencing processes. This material has been developed under the Reducing Hunger and Undernutrition theme. The authors gratefully acknowledge input from the Global Alliance for Improved Nutrition during research.The development of this material has been led by IDS who holds the copyright. The material has been funded by UK aid from the UK Government, however the views expressed do not necessarily reect the UK Government’s ofcial policies. AG Level 2 Output ID: 517    Contents List of Abbreviations 3 Executive Summary 4 1   Introduction and overview 7  1.1 Project goal and context 7 1.2 Outline of the report 9 2   Linking agriculture, food and nutrition 10  2.1 Market-based approaches to food and nutrition 10 2.2 The value chain approach 11 2.2.1 Strengths of using a value chain approach to policy development 12 2.2.2 Evidence on the effectiveness of value chains for nutrition 13 2.3 Market failures and underinvestment 14 2.4 Using value chains to reduce undernutrition 16 2.4.1 Availability 16 2.4.2 Acceptability 17 2.4.3 Affordability 17 2.4.4 Nutritional quality 18 3   The role and challenges for nutrient-dense foods in Ghana 21  3.1 State of undernutrition in Ghana 21 3.1.1 Iron deficiencies 21 3.1.2 Vitamin A deficiencies 22 3.1.3 Determinants of undernutrition in Ghana 22 3.2 Constraints for nutrient-dense foods 23 3.2.1 Food safety problems in important commodities 23 3.2.2 Low consumer awareness of food safety and nutrition 24 3.2.3 Absence of mechanisms to signal nutritional quality 25 3.2.4 Low affordability and availability 26 3.3 Challenges to providing products for the poor 27 4   Policy context for nutrient-dense foods in Ghana 28  4.1 Agricultural policies and programmes 28 4.2 Nutrition policies 32 4.3 Food product policies 34 4.4 Policy on aflatoxin contamination 35 4.5 Coordination among policy actors 35 5   Policy guidelines for promoting nutrient-dense foods 36  5.1 Overarching policy principles 36 5.2 Supply-side policies 38 5.2.1 Incentivise aflatoxin control by linking value chain actors 38 5.2.2 Promote the production of commodities that are inputs to nutrient-dense foods 41 5.3 Demand-side policies 42 5.3.1 Generate consumer demand 42 5.3.2 Promote nutrition awareness 43 5.3.3 Use public  – private partnerships to increase demand and consumer awareness 44 5.3.4 Create mechanisms to signal nutritional quality 45  2 5.4 Integrating supply- and demand-side approaches 50 6   Conclusions 53 Annex 1 Strategic priorities for the proposed National Nutrition Policy 57   Annex 2 National Board for Small Scale Industries 61   Annex 3 Remit of the Food and Drugs Authority 62 References 63   Boxes Box 1 Value chains and value chain analysis 12 Box 2 Necessary conditions for addressing Undernutrition through agri-food value chains 16 Box 3 Comparison of studies modelling drivers of undernutrition 22 Box 4 What are aflatoxins? 24 Box 5 Gaps in the market for complementary food products 26 Box 6 Requirements for complementary foods for the poor 27 Box 7 Government of Ghana commitment to private sector investment in agriculture under the New Alliance for Food Security and Nutrition 30 Box 8 Promoting complementary foods and feeding practices 33 Box 9 ‘Good Food for Good Life’ Nutrition Education Campaign  33 Box 10 Enforcing standards for fortified staple foods 33 Box 11 Technical options for controlling aflatoxin contamination 38 Box 12 Creativing incentives to control aflatoxins in smallholder value chains In Malawi 40 Box 13 Efforts to promote on-farm production and consumption of nutrient- dense commodities in Ghana 42 Box 14 Proposal for third-party certification of complementary food production in Ghana 48 Box 15 Credence health goods 48 Box 16 Summary of policy options 54 Figures Figure 2.1 Stylised value chain 13 Figure 2.2 Channels from production to consumption 17 Tables Table 2.1 Market failures and policy interventions to address them in value chains 15 Table 4.1 Recent agricultural policies and programmes relevant to nutrient-dense foods in Ghana 31 Table 5.1 Implications of value chain and product approaches for design and outcomes of policy interventions 51 Table 5.2 Examples of interventions categorised by whether they target particular products or the market environment 52 Table 6.1 Policy recommendations for Ghana, grouped according to where they intervene in value chains and whether they target specific products 56  3 List of Abbreviations  ADVANCE Agricultural Development Value Chain Enhancement BAC Business Advisory Centre CAADP Comprehensive Africa Agriculture Development Programme CMAM Community Management of Acute Malnutrition CRSP Collaborative Research Support Program CSO civil society organisation DFID UK Department for International Development ENA Essential Nutrition Action FASDEP II Food and Agriculture Sector Development Policy FDA Food and Drugs Authority (of Ghana) FDB Food and Drugs Board GAIN Global Alliance for Improved Nutrition GCAP Ghana Commercial Agriculture Project GHS Ghana Health Service GIZ Deutsche Gesellschaft für Internationale Zusammenarbeit GSA Ghana Standards Authority IDS Institute of Development Studies IFAD International Fund for Agricultural Development (UN) IMNCI Integrated Management of Newborns and Childhood Illness IYCN Infant and Young Child Nutrition Project (USAID, Ghana) JICA Japan International Cooperation Agency M4P Making Markets Work for the Poor METASIP Medium Term Agriculture Sector Investment Plan (Ghana) MLGRD Ministry of Local Government and Rural Development MOAP Market Oriented Agriculture Programme (GIZ, for Ghana) MOFA Ministry of Food and Agriculture MOH Ministry of Health MOTI Ministry of Trade and Industry NAFSN New Alliance for Food Security and Nutrition NBSSI National Board for Small Scale Industries NCD non-communicable disease NGOs non-governmental organisation NHIS National Health Insurance Services NNP National Nutrition Policy OFSP Orange-fleshed sweet potato PCRSP Peanut Collaborative Research and Support Programme RING Resiliency in Northern Ghana RUF Ready-to-use foods RUTFs Ready-to-use therapeutic foods SBCC Social Behaviour Change Communication SME Small and medium-sized enterprise SUN Scaling Up Nutrition USAID United States Agency for International Development WIAD Women in Agricultural Development Directorate
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