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Sergio Valiente, Sonia Olivares, Teresa Boj, Margarita Andrade, and Juliana Kain
Hunger and undernutrition are mainly caused by economic and social deficiencies. Their solution is very complex and requires a multifaceted programme . A significant number of Latin American countries have agriculture-based economies; however, this has not meant a high standard of living for the rural population. The Economic Commission for Latin America estimates that in 1982 between 130 and 147 million Latin Americans were living in poverty; of these, 71 million lived in rural areas . In addition, the development of agricultural markets has caused farmers to replace subsistence food crops with a single commercial crop. Thus, although, in general' food production in these countries has increased, undernutrition has also increased, especially among vulnerable groups such as landless rural farmers.
Since 1960 the Food and Agriculture Organization of the United Nations (FAO) has introduced nutrition components into its rural development projects and into the training of personnel in this area [5, 6]. In the 1970s the United States Agency for International Development (USAID) also began to support activities in this field, in collaboration with FAO and other institutions, with the goal of improving the quality of life of the rural population . According to Forman, however, "Everybody talks about hunger and malnutrition, but the response to this problem is not confronted accordingly. This is due to the complexity and multicausality of the nutrition problem, creating difficulties as to who should decide what to do in solving them" .
The agricultural sector would have a larger impact on nutrition if one of its objectives were to increase food consumption as well as production. Changing these objectives requires a different policy approach for the agricultural sector and full comprehension of the nutrition problem. A first step in this direction would be to introduce courses on nutrition in the education of agriculture students at different levels. Without this knowledge and comprehension, there is little hope for positive change [8, 9].
The general objective of such training is to foster understanding of the causes, consequences, and possible solutions of the nutrition problems faced by the rural sector. The most important of these are insufficient food availability and a lack of essential nutrients in the diet, probably caused by low income as well as poor housing conditions, low levels of education, poor access to health care, and unhealthy food habits.
Agricultural extensionists and agronomists are the only professional groups in direct contact with the farm population in some countries. Therefore these professionals should also be trained to transfer their knowledge of nutrition to farmers, thus closing the gap between food availability and consumption. To facilitate their work as educators, modern teaching techniques such as case studies, demonstration, field work, and, in general, the use of "learning by doing" should prove more effective than the traditional theoretical approach .
In Chile, under the sponsorship of FAO and USAID, the Food and Nutrition Policies and Programmes Division of the Institute of Nutrition and Food Technology (INTA) of the University of Chile, has created a working group to adapt and test teaching materials and to train Latin American agricultural professionals. This paper describes INTA's activities in this field.
INTA's contribution, 1980-1986
Since 1980, a programme of nutritional training in agriculture has been in operation at INTA. Its main activities include preparing teaching materials for agricultural field workers, agricultural schools, and agronomists; training professionals in the agriculture, health, and educational sectors; participating in seminars and workshops related to nutrition and agriculture; and presenting programme activities in national and international congresses and publications [ 1113].
Between 1980 and 1986 INTA adapted and tested three sets of teaching materials. A brief summary of these materials and activities related to them is presented above.
TABLE 1. Teaching materials and professional training in nutrition and agriculture, 1980-1987
|Materials||Main groups covered||No.||Countries involved|
Food and Nutrition (1984),
graduate students (INTA)
Brazil, Cuba Chile,
Ecuador, Peru, Dominican
Republic, Paraguay, Mexico
Teaching Food, Nutrition and
Agriculture, 1st ed. (1982),1,800
copies; 2nd ed. (in press, 1987)
(also used in schools of
social sciences, education, and
Ecuador, Paraguay, Peru,
Uruguay, Colombia, Brazil,
Republic, Costa Rica,
Nutrition and Agriculture:
A Multidisciplinary Approach for
Latin America (1986), 2,000 sets
(also used in schools of nutrition
and veterinary medicine)
distribution in Chile,
Ecuador, Peru, Argentina,
Uruguay, Mexico, Venezuela,
Paraguay, Brazil, Guatemala
a. Participants in courses conducted by INTA. We do not have data on participants in courses conducted by FAO in other countries.
Field programme management
The teaching set "Field Programme Management: Food and Nutrition" , which was developed for agriculture field workers, consists of a textbook, a teacher's manual, and a student's workbook. The most interesting materials include games, role-playing, case studies, and problem-solving items. It was adapted to the Latin American agricultural and nutritional situation and tested with INTA students in 1980 (FAO/INTA joint project). It is a valuable and practical tool for teaching how to plan food and nutrition programmes in the community.
In 1981 it was tested in Chile with seven groups of 107 professionals, including agricultural extensionists, nutritionists, social workers, and health workers .
Five years later, 50% of these professionals were interviewed to check whether they were still using this teaching resource. The results showed they used it extensively, proving it to be most effective in demonstrating how to evaluate the food and nutrition conditions of a community in order to focus on the solution of the problems from a multisectoral viewpoint.
The FAO printed the Spanish version in 1984 and has encouraged its use throughout Latin America. Ecuador, Brazil, Cuba, Bolivia, Peru, Chile, and the Dominican Republic have already applied it, demonstrating its effectiveness in agriculture as well as in other fields.
FAO has also developed guildelines for teaching nutrition in agriculture schools, especially those that train extensionists. The first version was tested in South-east Asia with satisfactory results. INTA prepared a Spanish version to be used in Latin America in collaboration with FAO . It is a substantial modification of the original in that it stresses the use of a multisectoral approach to nutrition problems. This approach (see FIG. 1. The food and nutrition system approach (Source: S. Valiente, INTA, 1981)) considers nutrition not only as a health problem but also as related to other disciplines, of which agriculture is one of the most important .
In January 1982 an international workshop was held in Santiago, Chile, where this version was analysed and enriched. Among the specific recommendations for implementation were collaboration by FAO as well as other international agencies, and designing similar teaching materials for agronomists in which the interaction of professional and technical personnel would be strengthened.
Thus far, 1,800 copies of this text have been printed and distributed throughout Latin American schools of agriculture with the financial support of FAO. A second edition, benefiting from five years of field experience, is in press.
A multidisciplinary approach for Latin America
With the technical collaboration of Laura Harper and her group at Virginia Polytechnical Institute, USAID and FAO developed a course on the multidisciplinary approach to nutrition, "Food, Nutrition and Agriculture" [l5], adapted for use in South-east Asia, based on previous materials published by FAO. The main objectives of the programme are to ensure that future agronomists (1) understand the relationships between agriculture, food, nutrition, and quality of life and (2) identify their role and responsibility in improving the food and nutrition conditions of the community. The course includes a general textbook and two manuals, one for the teacher and the other for the student. It was tested successfully in Indonesia (1982) and later edited in English (1984) to be used in English-speaking countries.
In 1983 a joint project of USAID/INTA and the Catholic University of Chile adapted this set of teaching aids for use in instructing Latin American agronomists. The adaptation followed the "food and nutrition system" approach, already tested by INTA [16, 17]. The objectives of the course, the comprehensive approach, the preparation of the three texts, and the emphasis on student participation all remained unchanged. In the Latin American version, however, the core centred on the teacher's manual, with the other two texts serving as necessary complements.
The texts were tested with 22 students of the Catholic University of Chile. Tests to evaluate the students' knowledge were given at the beginning and the end of the one-semester course (54 hours). Of the students taking the final examination, 83% achieved more than 75 % correct answers. The difference between the initial and final performances was highly significant (p<.001). Figure 2 (see FIG. 2. The nutrition knowledge of agronomy students as measured by tests at the beginning and end of a multidisciplinary course, by subject areas. Area 1, food, nutrition, and agriculture; II, nutritional recommendations; III, food and nutrition systems; IV, food and nutrition planning; V, nutrition education in agriculture. (t = 18.373; p<.001)) summarizes these results in terms of the areas of knowledge taught during the course, showing the difference between the two examinations in each area .
After this testing, 2,000 sets of books were published in 1986 by INTA, with the financial support of USAID. The texts will be sent to all the Latin American faculties of agriculture over the next two years. More information about these materials can be obtained directly from INTA.
The programme of nutrition training in agriculture developed by INTA since 1980 has been extended to other Latin American countries in association with FAO, USAID, and other agencies. Implementing a programme of this type, with an international perspective and a multidisciplinary approach and involving several institutions, is not easy and can be done only with a co-operative effort. It can, however, make important contributions to improving the nutritional status and the quality of life of Latin America's rural population.
Bendley F. Melville
Malnutrition is a widespread public health problem in developing countries. It is estimated that it affects approximately half of the children under the age of five years to some degree . Nutritionists have become increasingly aware that the condition is multifaceted and is not just a problem of food shortage. In fact, social and economic variables are the most significant predictors of nutritional status [2-4]. The consensus, therefore, is that malnutrition is a poverty problem and that any long-lasting solutions will have to include changes in the social and economic structure of developing countries. In other words, nutrition interventions should be aimed at improving the standard of living of households at risk of malnutrition.
Land ownership is linked with wealth. Since the most widespread cause of rural poverty appears to be the unequal distribution of land, there is a general tendency for nutrition planners to recommend redistribution of land (land reform) as a means of alleviating malnutrition. In light of this emphasis on land reform, it is critical to determine whether sufficient evidence exists to justify such a strategy. That is, are land ownership and amount of land critical determinants of nutritional status in developing countries, and, if so, do the types of crops cultivated influence malnutrition?
Land-related variables and nutritional status
In a study of child malnutrition and land ownership in southern Brazil, Victora et al.  found that the prevalence of stunting and underweight was higher among children of landless families than children of landed families. In examining socio-economic factors associated with undernourished children in El Salvador, others found no difference in the prevalence of low weight for age between children of rural landless (15%) and landed households (15%) . The prevalence of wasting was highest among landless households however. Similar studies carried out in Sri Lanka  and rural Kenya  showed that stunting was more prevalent among children in landless than landed households. In Bangladesh the children of landless households had the highest prevalences of underweight and wasting .
In a study of food consumption in rural Jamaica, more dietary inadequacy (below 80% of the recommended dietary allowance) was noted among landless than landed households . A recent study of determinants of child nutritional status in Nepal  showed a positive correlation between land ownership and nutritional status. A study conducted in Maharashtra, India , showed that dietary inadequacy was highest among landless households; similar patterns were observed in rural Bangladesh [13, 14]. Low weight for age was more prevalent among the children of landless labourers than those of landowners in Punjab, India, and Papua New Guinea [15, 16], with a similar relationship reported in the Philippines  and in Brazil . In addition, a positive association was demonstrated between land ownership and nutritional status in India [19, 20]. Thus, a review of the literature points to a relationship between owning land and nutritional status. Land-reform policies targeted to the landless are therefore likely to improve nutrition.
Amount of land owned
The relationship between the amount of land owned and nutritional status has been studied more frequently than that between the fact of land ownership and nutritional status. Apparently, this is because most nutrition planners have made the assumption, without adequate scientific evidence, that households that own land are less likely to become malnourished than those that do not.
TABLE 1. Studies on the association between the amount of land owned and nutritional status in developing countries
|Costa Rica||1976||30||W/A, S|
|Costa Rica||1981||31||2,613||W/A, NS|
|El Salvador||1978||6||1,109||W/A, NS|
W/H = weight for height
H A = height for age
s = significant
DA = dietary adequacy
W/A = weight for age
NS = not significant
NA = not available
Table 1 shows that the relationship between the amount of land owned and nutritional status is not consistent, and differences exist both within and across countries. In addition, although one would expect less stunting among children of households with large land ownership, this was not substantiated by the review. On the other hand, it appeared that these children tended to have higher energy and protein intake than those of households owning small amounts of land. This was not always true for weight and height, however. It is therefore likely that, although children whose families have large land holdings may consume more energy and protein than those in families with little land, this may not be reflected in their growth. Perhaps energy expenditure is higher among the former than the latter . A relationship between land size and nutritional status was observed more often in Africa and Asia than in Latin America, probably due to more unfavourable land-tenure arrangements and higher levels of malnutrition in these countries.
By and large, evidence is not sufficient to show a clear-cut relationship between amount of land owned and nutritional status. It is likely that this may be due to failure by most researchers to control for possible confounding factors, such as quality of the soil, occupational multiplicity , and percentage of income spent on food, that could have biased the results. For example, in northern Haiti, when distance to a road was considered together with land size, the smaller landowners at greater distance were worse off nutritionally than those at shorter distance . Thus there is an urgent need for more significant research on the relationship between farm size and nutritional status. Nevertheless, it should be noted that, in the meantime, redistribution of land to small landowners should be considered in terms of improving the nutritional status of these persons.
Information on the impact of the cropping pattern on nutritional status is conflicting. Some nutritionists have suggested that raising cash crops can lead to deterioration in nutritional status and have strongly advised against farmers shifting to these from subsistence crops [41-43]. Others, however, have said that cropping pattern was not related to nutritional status .
After an extensive review of the literature on this association, Fillmore and Hussain  noted, "In many cases nutritional evaluation of agricultural development projects was an after-thought. Impact evaluation was undertaken after the projects were well underway. . . sometimes on the basis of a single survey." According to these authors, the main limitations of the studies reviewed were lack of baseline data on nutritional anthropometry and inadequate or non-existent control groups. They concluded, "The question of whether agricultural development has a positive effect on nutrition remains unanswered." A review of the literature on the impact of expanded production of cash crops on nutritional status in Africa also concluded that little evidence exists to support the hypothesis that the one is inversely related to the other.
It is quite clear that here too there is a need for more properly designed studies. Nutrition planners should therefore be cautious in making recommendations with respect to the types of crops that farmers should cultivate. Nevertheless, consideration should be given to the recommendation that "it is probably better for farming families to have a mix between cash and cereal crops than a cash crop alone" .
Nutritional status appears to be related to ownership of land but not to the amount of land owned or cropping patterns. It is quite obvious that more valid research is required in this area. The selection of adequate control groups and the timely collection of baseline data are extremely important. Nevertheless, land reform should not be excluded as a means of improving the nutritional status of the needy. Developing countries should therefore make a positive effort to achieve a more equitable distribution of land and improve land-tenure arrangements. Land redistribution should be targeted to families with small land holdings or no access to land. It is noteworthy, however, that during the past twenty years land-reform policies have not been very successful in most developing countries, especially Latin America and to a lesser extent Africa.
In a land-reform programme in Jamaica in the 1970s, only a very small percentage of the small landholders benefited . Similarly, attempts at land reform in Kenya and Tanzania met with disaster . Thus radical land-reform measures appear to be necessary to make sure that groups at risk benefit. In fact, this was done in two countries in the 1970s.
After the revolution in Ethiopia in 1974, the new government implemented radical agrarian-reform measures to promote more economic equality in the country. A review of the progress of these reform measures concluded, "Despite all the revolutionary reforms and the rhetoric which has accompanied them, Ethiopia remains potentially one of the richest but actually one of the poorest agrarian nations in Africa" .
A similar attempt to introduce radical agrarian reform in Nicaragua in 1979 met with more success . By the end of 1980, corn and bean production had increased by 7% in response to the increased acreage (43%) planted by small producers. This was mainly because of the highly structured and organized manner in which the government went about the reform. Credit and technical assistance were made available to small producers. Co-operatives were organized to deal with the increase in demand for credit, and unions were formed to represent the interests of the small producers. In addition, a national literacy campaign targeted to the rural poor was initiated. Finally, the government strengthened the administrative structure and placed emphasis on social services.
It seems that agrarian reform is a significant social change that must be accompanied by well-structured and organized programmes, such as suitable roads, credit, marketing facilities, proper irrigation, and technical information on proper agriculture production. The agriculture extension services should be strengthened to facilitate small farmers. Improvements in literacy among the rural poor will make it easier for them to accept these changes. Assessing agrarian reform and nutrition in Vicos, Peru, Neff  concluded, "Time and continual commitment is required for acceptance of and adaptation to a new agrarian organization."
In addition, farmers should become more flexible with respect to cropping pattern. Most small farmers in the Caribbean are not totally involved in subsistence production; instead, "Crops are usually grown for sale at one time or another" . Therefore, efforts should be directed toward mixed farming - mixed cropping and small livestock - and toward obtaining off-farm employment in order to maximize a combination of limited resources and thus meet monetary needs. Furthermore, in a study of six different occupations in Sri Lanka, the most favourable one in terms of income, per capita food expenditure, and nutrition was mixed farming (earning both off-and on-farm income) . Improvements in all of the three sources of income - subsistence food production, off-farm employment, and farm sales - by increasing production and providing job opportunities are likely to increase the household income and, consequently, the per capita calorie intake of the near landless and small-farm households.
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