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Country Policy Analysis

Nutrition Impact of Agriculture and Food Systems

Nepal November 2013

UN System Standing Committee on Nutrition country study for the

second International Conference on Nutrition

ACKNOWLEDGEMENTS

The country assessment for nutrition sensitive agriculture in Nepal was led by Jessica Fanzo

(Columbia University), Mr. Raj Kumar Pokharel (Child Health Division Nepal), and Danielle

Andrews (UCLA School of Public Health) and supported by Dr. Senendra Upreti (Child Health

Division, Nepal). The team received technical assistance and advisement from Mr. Ashok

Butyral and Mr. Ramesh Bastola (WHO, Nepal). Lina Mahy and Marzella Wüstefeld (UNSCN,

Switzerland) ensured overall coordination of the country case study.

This report was possible thanks to the sponsorship by the German Government.

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TABLE OF CONTENTS Acknowledgements............................................................................................................................2

Abbreviations ....................................................................................................................................5

I. Executive Summary .........................................................................................................................6

II. Purpose of Study and Research ..................................................................................................... 13

III. Introduction ................................................................................................................................ 14

3.1 Background: Nutrition sensitive agriculture and food systems ................................................................. 14 3.2 Situation analysis ........................................................................................................................................................... 16

3.2.1 Nutrition situation ........................................................................................................................................................ 17 3.2.2 Dietary transition .......................................................................................................................................................... 21 3.2.3 Agriculture and food security situation ............................................................................................................. 23

3.3 National nutrition priorities ...................................................................................................................................... 32 IV. Methods ..................................................................................................................................... 33

4.1 Data collection and sources of information ........................................................................................................ 33 4.2 Data analysis .................................................................................................................................................................... 35 V. Findings ....................................................................................................................................... 36

5.1 Description of the relevant food and agriculture policies and plans ........................................................ 36 5.1.1 Description of the major food and agriculture Policies ............................................................................. 36 5.1.2 Secondary policies ........................................................................................................................................................ 48

5.2 Analysis of the nutrition-sensitivity of the policies and frameworks ...................................................... 52 5.2.1 Analysis of the major food and agriculture policies and plans .............................................................. 52 5.2.2 Analysis of secondary policies ................................................................................................................................ 61

5.3 Unintended consequences on nutrition outcomes ........................................................................................... 63 5.4 A Funding of and implementation of nutrition-sensitive agriculture and food plans ....................... 67

5.4.1 Funding ............................................................................................................................................................................... 67 5.4.2 Implementation and capacity.................................................................................................................................. 69

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5.5 Policy processes and alignments ............................................................................................................................. 75 5.5.1 Cross sectoral coordination ..................................................................................................................................... 75 5.5.2 Sustainability ................................................................................................................................................................... 77 5.5.3 Use of terminology ........................................................................................................................................................ 77

5.6 Analysis of monitoring and evaluation approach in the policies ............................................................... 78 VI. Conclusions ................................................................................................................................. 81

6.1 Nutrition-sensitive analysis of nepal’s food and agriculture policies ...................................................... 81 6.2 Recommendations and knowledge gaps .............................................................................................................. 83 VIII. References ................................................................................................................................ 87

IX. Annexes ...................................................................................................................................... 91

Annex 1: Persons Interviewed and Focus Groups .................................................................................................. 91 Annex 2: Interview Guide ................................................................................................................................................... 93 Annex 3: Guiding Principles of Nutrition Sensitive Agriculture......................................................................... 96 Annex 4: On-going Programmes in Nepal ................................................................................................................... 98 Annex 5: Terms of Reference for Nepal case study ............................................................................................. 101

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ABBREVIATIONS

ADS Agriculture Development Strategy, Nepal

CBS Central Bureau of Statistics, Nepal

CMR Child Mortality Rate (under 5 years of age)

DDC District Development Committee DHO District Health Offices DLS Department of Livestock Services DoA Department of Agriculture DoHS Department of Health Services

FAO Food and Agriculture Organization of the United Nations

FNSP Food and Nutrition Security Plan of Action, Nepal

GoN Government of Nepal

IFPRI International Food Policy Research Institute

IIDS Institute for Integrated Development Studies

IMR Infant Mortality Rate

MoAD Ministry of Agriculture and Development, Nepal

MoE Ministry of Education, Nepal

MoFALD Ministry of Federal Affairs and Local Development MoF Ministry of Finance, Nepal

MoHP Ministry of Health and Population, Nepal

MoUD Ministry of Urban Development

MSNP Multi-Sectoral Nutrition Plan, Nepal

NAGA Nutrition Assessment and Gap Analysis, Nepal

NARC Nepal Agriculture Research Council

NDHS Nepal Demographic Health Survey

NLSS Nepal Living Standards Survey

NFSCC Nutrition and Food Security Coordination Committee

MSNP Nepal Multi-Sectoral Nutrition Plan

NPC National Planning Commission, Nepal

UN United Nations

UNICEF United Nations International Children’s Emergency Fund

UNSCN United Nations Standing Committee on Nutrition

USAID United States Agency for International Development

WB World Bank

WFP World Food Programme

WHO World Health Organization

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I. EXECUTIVE SUMMARY

Nepal is on track to achieve its Millennium Development Goal (MDG) to reduce the prevalence

of underweight children ages 6-59 months to 29% by 2015 (National Planning Commission,

2010a). Furthermore, Nepal has shown significant improvement in both its Infant Mortality Rate

(IMR) and Under 5 Child Mortality Rate (CMR), which serve as indicators of the country’s overall

health status. Additionally, the prevalence of childhood stunting decreased by 14% from the

period 2001 to 2006 and further declined by 16% between the years of 2006 and 2011 (NDHS).

Also, the percentage of underweight children declined by 9% between 2001 and 2006 and 26%

between 2006 and 2011; however, despite significant improvement in recent years, Nepal’s

rates of chronic undernutrition remain high in comparison to similar low-income developing

nations. Currently, about 41% of children under five are stunted, and although the prevalence of

child acute undernutrition or wasting decreased by 15% in the period 2006 to 2011, this

measurement is still high by global standards and remains at a critical level of 13% (NDHS,

2011).

For these reasons, Nepal is committed to improving nutrition and has recently demonstrated this

commitment with the drafting of a Multi-Sectoral Nutrition Plan (MSNP) and an Agriculture

Development Strategy (ADS) with a Food and Nutrition Security Plan of Action (FNSP)

embedded within its core cross-cutting mandate. Nepal has also demonstrated its commitment

to improve nutrition in the country by joining the Scaling Up Nutrition (SUN) movement. The

Nepalese economy is fundamentally agrarian and profit generated through its agriculture

contributes to approximately one third of Gross Domestic Product (GDP) and is the largest

source of informal employment to the Nepalese people. Without inclusive development of the

agriculture sector in an agrarian-dominated economy such as Nepal’s, it is unlikely the country

can achieve its goals of poverty reduction, improved food and nutrition security and sustainable

development (Bajagai, 2013).

The timing is right for an in-depth review of specific ways in which Nepal’s food and agricultural

policies have or are intended to have an impact on nutrition in the country. This study provides a

descriptive review of food and agricultural policies in Nepal and is aimed at answering the

following: how the range of Nepal’s policies and subsequent actions improve nutrition through

food and agriculture innovations and what populations are most impacted and through which

institutions? Also, this study highlights successes as well as key knowledge gaps in the

relationship between food and agricultural systems and nutrition outcomes and improvements in

Nepal. Additionally, this report provides recommendations for improvement to ensure policies

are nutrition sensitive.

An extensive literature review, a country visit and stakeholder and focus group interviews were

completed as part of the policy analysis. The primary strategies and plans analyzed for this

report were the Nepal Multi-Sectoral Nutrition Plan (MSNP) 2013-2017, the Agriculture

Development Strategy Final Draft Final (ADS) 2013 and the Food and Nutrition Security Plan of

Action (FNSP) 2013.Support reports for these three plans/strategies included: the MSNP

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Implementation Guide 2012, the Nepal Nutrition Assessment and Gap Analysis 2011 (NAGA),

the ADS Assessment Report 2012, and the ADS Vision Report 2012. Some secondary policies

and legislation were also analyzed including: the Nepal Interim Constitution 2007, NARC’s

Strategic Vision for Agriculture Research 2011, the Nepal Biodiversity Strategy 2002, the Nepal

Environment Management Framework 2012, the National School Health and Nutrition Strategy

2006 and the Nutrition-relevant legislation on mandatory flour fortification 2011.

Analysis of the Nutrition Sensitivity of the Food and Agriculture Policies

Overall, the most recently drafted [Agriculture Development Strategy (Long Term 20 Years)]

nutrition, food, and agriculture policies and plans for the country of Nepal are nutrition sensitive

and multi-sectoral. There has been great advocacy for improving food and nutrition security in

the country, illustrating commitment at the national and community level and among Nepal’s

donors and development partners. The plans over the next ten years are ambitious for Nepal

with complex interventions and frameworks. In providing lessons of what is an on-going

process, it helps to re-examine the principles of nutrition-sensitive agriculture.

Overall, all three plans have:

• Explicit nutrition objectives in their design.

• Elements of doing no harm, particularly to women.

• Nutritional impact measurements in their M & E systems.

• Opportunities to maximize through multi-sectoral coordination.

• Targeted the most vulnerable (particularly the FNSP).

All the plans include activities, and in some way, shape, or form activities and interventions that:

• Diversify production and livelihoods for improved food access and dietary diversification,

natural resource management, risk reduction and improved income.

• Increase production of nutritious foods, particularly locally adapted varieties rich in

micronutrients and protein, chosen based on local nutrition issues and available

solutions.

• Reduce post-harvest losses and improve processing.

• Increase market access and opportunities, especially for smallholders.

• Reduce seasonality of food insecurity through improved storage and preservation and

other approaches.

• Target household income to improve nutrition, mainly by increasing women’s income.

The three main plans as well as the secondary plans could be strengthened in the following

three areas:

• Empowering women, the primary caretakers in households, through: increasing income;

access to extension services and information; avoiding harm to their ability to care for

children; improving labor and time-saving technologies; and supporting their rights to

land, education and employment. This is particularly true for the issues of land rights and

employment.

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• Incorporating nutrition education to improve consumption and nutrition effects of

interventions; in addition to employing agricultural extension agents to communicate on

nutrition. The MoE (Ministry of Education) must be more engaged in all nutrition plans.

• Managing natural resources for improved productivity, resilience to shocks, and

adaptation to climate change. There must also be more equitable access to resources

through soil, water and biodiversity conservation. These areas are largely neglected in

these plans with the exception of the biodiversity strategy, which doesn’t provide direct

links to nutrition.

The plans are weak in:

• Assessing the context and causes of malnutrition at the local level, to maximize

effectiveness and reduce negative side effects. For this reason, there must be improved

local surveillance and understanding of situational and causal analysis at the VDC and

district level.

• Increasing equitable access to productive resources. Although the FNSP tries to target

the bottom of the pyramid, the equity issues around food distribution and access remain

vague in all the plans.

• Identifying research need to understand intra-household dynamics of food consumption

and distribution along with most adequate nutrition sensitive agriculture interventions

and way of knowing this.

Concerns remain on the lack of adequate supportive environment across all three plans.

These areas include:

• Policy coherence across all policies and plans to support nutrition, including food price

policies, subsidies, trade policies and pro-poor policies. The ADS is of particular concern

with its focus on commercialization.

• Sufficient governance for nutrition, by drawing up a national nutrition strategy and action

plans, allocating adequate budgetary resources and implementing nutrition surveillance.

• Although plans are currently in place, they are left primarily to the NPC to coordinate. It

remains to be seen if this governance can be effective in the long-term.

• Resource (in terms of finance, human, infrastructure) gap analysis and resource

mobilization plan for agro-based interventions impacting on nutritional improvement.

• Capacity in ministries at national, district and local levels. Capacity at all levels for these

ambitious plans remains the lynch pin for their ultimate effectiveness, sustainability and

impact.

Impact on Nutrition Outcomes

It is too early to assess the impact of these policies and plans on nutrition outcomes for Nepal. It

can be assumed that in the past, Nepal’s nutrition plans failed in many aspects. Overall, it is

safe to say that agriculture has been underfunded and not engaged in nutrition activities;

however, with new plans in place this could change. Even still, there are drivers that are beyond

the plans and policies that Nepal will inevitably face, inhibiting better nutrition (or perhaps

improving it in some cases) as Nepal continues to develop. These drivers include: remittances

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and outmigration and their impacts on the feminization of agriculture, the impact of rice

consumption, commercialization of agriculture, equitable distribution of food and access to hard

to reach populations, land grabbing and the role of the private sector in the nutrition transition

and dietary shifts.

Some lessons that are revealed through this analysis that should be noted and enhanced in all

three plans in order to successfully assess nutrition impacts include:

• Know your local epidemiology: Planning must involve a better understanding of the

causal and situational analysis of nutrition in local districts. This requires developing new

capacities of district level staff. By knowing your local epidemiology, program design,

planning and budgeting will be more focused and impactful.

• Focus: All of the plans are ambitious with many outcome measures and target groups.

To make substantive improvements, Nepal must focus on several key populations –

children under two, pregnant and lactating women and the landless. If nutrition actions

focus on these three populations within Nepal, coordination and impact of the plans will

be optimized. • Incorporate Education and BCC: With nutrition sensitive approaches involving food-

based actions, education and behavioral-change communication interventions are key to

making substantive improvements. Without this piece, interventions have been shown to

be ineffective. This means engaging the MoE in a more thoughtful and substantive way

is crucial to the success of these plans. • Go beyond gardens: Most of the food–based interventions proposed involve home

gardens. Although important, we need to go beyond gardens and begin thinking about

nutrition sensitive value chains and consumer demand driven interventions. Most of the

plans have very little on value chains.

• Know the Nepalese diet: All the plans aim to improve dietary diversity; however,

without data on consumption patterns and nutrient composition in Nepal, programmers

and planners are working in a black box. Consumption data should be collected,

analyzed and shared as part of baseline data collection and larger scaled national

surveys, Furthermore, the data should also reflect districts and communities in addition

to regions.

Funding

From these short summaries of financial mechanisms, it is clear that there are three separate

pots of money that are allocated for nutrition purposes in Nepal. It remains a concern how the

districts will handle these separate pots: the DDF, the ATF and the PAF. Also, it will be difficult

to understand how funds are spent across the agriculture sector and on what activities since

different funding pots are allocated for specific activities. Furthermore, this may cause confusion

among donors that want to contribute to the MSNP mission but whom only want to focus on the

BPL populations. There must be a co-funding mechanism for food and agriculture investors that

want to fund MSNP-specific activities that the MSNP can work through, but have the ability to

focus on the ultra poor populations that FSNP targets. As they stand, separate funding pots are

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confusing and difficult to manage at the country level and donors may worry about absorptive

capacity. Perhaps, one unified framework and source of funding for nutrition-related work should

be instituted to remedy this issue. Lastly, the budget for the Agriculture Sector has been too low

for too long. The GoN has increased its allocation but it is still not enough to match the role of

agriculture's contribution to the country’s overall GDP. To improve food and nutrition security in

the country, funding must be substantially increased.

Implementation

International and local NGOs are essential partners in the design, planning and implementation

of Nepal’s various nutrition-sensitive plans. The NPC and other government structures must

oversee and manage the coordination of multiple layers of organizations working in nutrition

sensitive agriculture and food-based approaches. With the many activities proposed, progress

tracking platforms and accountability mechanisms must be instilled to ensure smooth

implementation. In addition, the three strategies and plans have distinct implementation

mechanisms that must be coordinated by the NPC, making it unclear if this coordination will

streamline activities or simply create additional complications.

Capacity

For implementation to be effective there is a need for increased capacity from the bottom to the

top. The lack of nutrition-related human resources remains an obstacle for implementing

nutrition sensitive interventions. This involves the sheer number of staff available to carry out

functions but also, the knowledge and skill sets needed to design, implement and monitor more

complex multi-sectoral nutrition plans. It is clear that the GoN understands the dearth of

capacity in the country and many within the donor community and amongst NGOs are working

to help build the necessary capacity by the scaling up of nutrition activities. The MSNP and ADS

have included comprehensive capacity objectives and activities into their overall plans. Various

levels are analyzed from the central, district and community levels, as well as academic

institution involvement for longer-term capacity development.

Coordination

There is much that can be learned from past efforts to improve food and nutrition security. In

Nepal, there are multiple sectors that need to be more engaged in the plans to improve nutrition

sensitive agriculture. For example, many stakeholders perceive the MSNP to be strictly led by

the MoHP. To many, this leadership is considered a disadvantage for achieving true

coordination responses. At the moment, ministries, such as Education, Urban Development and

Women, Children and Social Welfare, and Local Development are seen as secondary.

Furthermore, many are unaware of their role in the MSNP and ADS plans. For instance, in the

FNSP, the MoE unfortunately does not play a role. For a multi-sectoral response to nutrition to

be feasible, these sectors must become primary, engaged entities. This will involve providing

incentives and accountability structures for these plans. Furthermore, these individual sectors

need to understand the advantages to their involvement in nutrition sensitive plans.

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With the NPC leading the coordination of the three main plans–- the MNSP, the ADS and the

FNSP—mechanisms that will vertically coordinate central, regional, district and VDC must be

vitalized to ensure ownership by all sectors. At the central level, the NPC should frequently

assess and refocus their efforts by overseeing the allocation of funding, monitoring progress on

outcomes, and integrating ministries. For this analysis to be successful, the NPC needs high-

level political support and appropriate funding. The national and local governments should

create legal frameworks, technical capacities and incentives to transfer resources, share

information and remain accountable to one another.

Monitoring and Evaluation

Having reliable nutrition data and performance indicators can lead to better delivery. Often, this

means that local ownership of outcome data on nutrition programmes are important and should

be encouraged. However, this ownership requires data collection at regular intervals. Increased

frequency of data observations required to monitor progress and ensure accurate and timely

data can improve response times to re-evaluating programmes.

The ADS and MSNP five-year targets for nutrition are aligned, which is a great step forward.

However, how can the frameworks across the plans be better synergized? With regard to

nutrition-related aspects, perhaps one unified framework should be established with a set of

core indicators to track. Additionally, the FNSP and MSNP food and agriculture related

indicators, sampling, and methodologies should be consistent. More specifically, their indicators

should be limited to 5 to 10 core measures that reflect the broader aspects of what is to be

achieved. Currently, there are too many indicators included in the design of these plans.

Also, many stakeholders argued that more focus and planning needs to take place beyond data

collection. Those working on these plans need to ensure analysis, sharing and transfer of data

knowledge occur beyond data collection. Data analysis and sharing within communities can be

achieved by encouraging local and district level ownership and accountability.

Sustainability

High-level government officials play a decisive role in these plans. They must coordinate all

actions across ministries and government offices, channeling donor and civil society efforts, and

developing compelling narratives around nutrition as a poverty reduction priority. However,

issues that repeatedly emerge include transient government and mandates which prove

challenging for Nepal. Without a constitution (with a right to food mandate) and a stable

government and long-term positions in ministries, priorities shift. Governments such as Brazil

sustained their commitments to ending hunger by their demonstrative successes, even after

President Lula left office. If Nepal can make a measurable impact in a short time with these new

plans, it is in the best interest for Presidents to continue the work. It is also important for food

and nutrition security to be embraced as a major objective of long-term national development

strategies.

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Finally, long lasting change takes time. Nepal’s current food and agriculture plans are ambitious,

and commendable. At the same time, Nepal is a young country, and faces a long path towards

development and economic security. Undernutrition reductions take time. With that said,

nutrition goals and targets should be aggressive, but also realistic and achievable in the

appropriate time scales.

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II. PURPOSE OF STUDY AND RESEARCH Many countries have started to link their national agriculture and/or food and nutrition security policies to nutrition-related outcomes and the multiple burdens of malnutrition. These countries refer to the multiple underlying causes of malnutrition in broad areas such as agriculture, food security, food supply and various stages along their food value chains. Nepal was selected for an in-depth review to analyze specific ways in which its food and agricultural policies have or are intended to have an effect on nutrition in the country (Annex 5 for Term of Reference). This study provides a descriptive review of food and agricultural policies in Nepal and is aimed at answering the following: how the range of Nepal’s policies and subsequent actions improve nutrition through food and agriculture innovations and what populations are most impacted and through which institutions? Also, this study highlights successes as well as key knowledge gaps in the relationship between food and agricultural systems and nutrition outcomes and improvements in Nepal. Additionally, this report provides recommendations for improvement to ensure policies are nutrition sensitive. The specific objectives for the Nepal case study are:

a) To perform a nutrition sensitive analysis of the 2012 Nepal Nutrition Multi-sectoral Plan including its operation among Nepal’s agricultural and other sectors.

b) To review how the agricultural, climate change and biodiversity and right to food policies and mandates impact nutrition in Nepal by performing a food and nutrition situation analysis and a review of current large-scale agriculture and food policies and frameworks.

c) To advance the discussion on nutrition-sensitive agriculture through the description of policy processes and alignments, and analyzing the nutrition sensitivity of the multi-sectoral nutrition plan—as well as specific agricultural and food policies that currently exist.

In order to achieve the above objectives, the report focuses on the following research areas:

1) A review of the current nutritional, agricultural, and environmental situation in Nepal including nutrition status, food supply, consumption and dietary patterns, access and affordability, and current influences and determinants. A right to food analysis is performed as outlined in the Nepalese constitution.

2) An analysis of the “nutrition sensitivity” of Nepal’s main food, agriculture, environment and nutrition national policy frameworks and their relevant implications on programs and implementation strategies.

3) A “nutrition sensitive” analysis of the current multi-sectoral nutrition plan for Nepal and an assessment of the interventions, targets and cost of the proposed nutrition sensitive actions.

4) A description of the current political economy and environment supporting nutrition sensitive strategies in Nepal, with emphasis on the process required to develop the multi-sectoral nutrition policy.

5) A district-level case study that is scaling the multi-sectoral nutrition plan.

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III. INTRODUCTION 3.1 BACKGROUND: NUTRITION SENSITIVE AGRICULTURE AND FOOD SYSTEMS

In view of the global food system challenges and threats, “protection of nutrition, let alone

acceleration of progress, will entail more than bringing nutrition-specific interventions to scale. It

will require a new and more aggressive focus on coupling effective nutrition specific

interventions (i.e., those that address the immediate determinants of nutrition) with nutrition-

sensitive programmes that address the underlying causes of under nutrition” (Ruel et al, 2013,

need pg. 1).

Nutrition-sensitive approaches are those that draw upon relevant sectors such as agriculture,

health, social protection, early child development, education, water and sanitation, and women’s

affairs to affect the underlying determinants of malnutrition and child development including

poverty, food insecurity, lack of access to adequate care resources, and health and water and

sanitation services. These approaches should be designed to address critical underlying

determinants of nutrition, be able to be implemented at large scale and be effective at reaching

the poor who suffer from malnutrition. They must also be focused on prevention, be

complementary to curative approaches needed to address malnutrition and be able to be

leveraged to serve as delivery platforms for nutrition-specific interventions (Ruel et al, 2013).

Although it is well understood that involving these sectors is critical to addressing the underlying

determinants of malnutrition, more evidence and understanding of how to carry out these

sensitive approaches is needed.

Agriculture is the major source of food, employment and income upon which the majority of

humanity relies for their livelihood. Given the high level of dependency of many of the world’s

poor and nutritionally vulnerable, the primary importance of the food and agriculture sector is to

improve household food security and alleviate and prevent malnutrition (Herforth et al 2012;

World Bank 2013). Thus, the agriculture and food systems are best placed to influence food

production and the consumption patterns of nutritious foods that are necessary for healthy and

productive life. Extensive research and experience concerning global development trends demonstrate that

growth in the agricultural sector is at least two to three times more effective in reducing poverty

than the same degree of growth in the non-agricultural sector. Therefore, in low-income

developing countries like Nepal where the agricultural sector generates over a third of the

national GDP and employs over three quarters of the its workforce; improvement and growth in

agriculture is imperative to combating poverty, hunger and undernutrition (USAID/ IIDS/ IFPRI,

2010).

The modern agricultural and food systems have evolved to be more complex and global—

creating longer supply chains from farm to fork. Nutrition-sensitive agriculture involves the

design and implementation of nutrition-based approaches to sustainable farming and cropping

systems. Ultimately, nutrition-sensitive agriculture is aimed at improving the nutritional outcome

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of a population by maximizing the impact of food and agricultural systems while minimizing the

potential for negative externalities concerning sector’s economic and production-driven goals.

Essentially, it is agriculture with a nutrition lens, and should not detract from the sector or

consumer goals.

Also, nutrition sensitive agriculture should focus on the entire lifecycle approach in which the

nutrients and determinants that are important for development, growth and maintenance of

health at different stages of life are considered. Furthermore, interventions should be food-

based. Food that is nutrient-rich and dense should be the primary tool for overcoming and

preventing malnutrition and nutritional deficiencies while also improving overall diet quality.

Lastly, the approach should encompass the entire food system – a complete array of activities

ranging from input distribution, on-farm production, marketing and processing involved in

producing and distributing healthy, nutritious, safe, sustainable and equitable food to both rural

and urban populations.

Nepal is committed to improving nutrition and has recently demonstrated this commitment by

drafting the Multi-Sectoral Nutrition Plan and an Agriculture Development Strategy with a Food

and Nutrition Security Plan of Action embedded within its core crosscutting mandate. Also, this

commitment is illustrated by Nepal joining the Scaling Up Nutrition movement.

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3.2 SITUATION ANALYSIS

Nepal is a small South Asian country, with a total land area of 147,181 square kilometers and a

population of approximately 27 million people. It boasts rich cultural heritage, highly varied

topography, and an abundance of biodiversity (CBS, 2011a, DHS, 2011). The country is land-

locked and bordered by China on the north and India on the south, east and west. Nepal has

three distinct topographic regions mainly running east to west: fertile plains bordering India

(Terai), Hills in the middle, and Mountains in the north. Eight out of ten of the world’s highest

mountain peaks are found in Nepal’s Mountain region, and range in altitude from 4,877 meters

to 8,848 meters (Mount Everest) (DHS, 2011) (Figure 1).

Figure 1: Nepal’s Ecological Zones and Physiographic Regions (ADS 2013)

The Mountain ecological region accounts for approximately 35% of Nepal’s total land area

(51,817 square kilometers), however, due to harsh climate and terrain, transportation and

communication infrastructure in these areas are limited. For these reasons, only 7% of Nepal’s

population inhabits this region.

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The Hills account for 42% (61,345 square kilometers) of Nepal’s total land area and is densely

populated holding 43% of the country’s total population. The population distribution varies

significantly by altitude in this region, which ranges from 610 meters to 4,876 meters above sea

level. With higher population numbers in the valleys, population numbers decrease above 2,000

meters and become sparse above 2,500 meters where there is occasional snowfall. Nepal’s

most fertile and urbanized area, the Kathmandu Valley lies in the Hills. Although rugged in

terrain, the Kathmandu Valley is significantly more developed than the Mountain region due to

milder climate, higher concentrations of people, and improved transportation and

communication services.

The subtropical to tropical climate of the Terai is “an extension of the relatively flat Gangetic

plains of alluvial soil” constitutes only 23% (34,019 square kilometers) of the total land area in

Nepal but holds 50% of its total population. This region’s dense population is mainly due to its

mild terrain, climate and fertile land (DHS, 2011, pg. 2). The Terai region with its broad low

valleys and expansive plains is a diverse combination of dense forests, national parks, wildlife

reserves and conservation areas. Its altitude ranges in height from 700 to 1,000 meters above

sea level (DHS, 2011).

Additionally, Nepal has five administrative development regions: Eastern, Central, Western, Mid

Western, and Far Western withal total of 14 zones and 75 districts (DHS, 2011). These various

regions, zones and districts are characterized by diverse geography, ecology, ethnicity and

culture. Although Nepal is blessed with a wealth of ecological resources, it is a food-deficit

country with a longstanding history of poverty, food insecurity, and malnutrition.

3.2.1 NUTRITION SITUATION

In Nepal, the prevalence of undernutrition is highest among pregnant women, lactating mothers,

infants and children under 5 years old. According to the International Food Policy Research

Institute (IFPRI) 2012 Global Hunger Index that combines three indicators of hunger

(undernourishment, child underweight and child mortality) into a single index, Nepal’s score of

20.3 falls within the designated alarming range.

Unfortunately, high rates of chronic undernutrition in women and children cause long-term

consequences for national development by perpetuating the cycle of intergenerational poverty

and hunger (NMNP). Poor nutrition from the prenatal period through pregnancy and the first 2

years of life, can lead to lifetime health barriers to economic success these children that include:

compromised immunity, increased susceptibility to disease, impaired physical and mental

development, and reduced overall productivity (GoN/NPC/CBS, 2013). Children that face

chronic undernutrition in the first two years of life are most likely to suffer linear growth

retardation throughout their childhood resulting in permanent short stature in adulthood. Overall,

Nepal’s six major nutritional issues include: high prevalence of low birth weight, childhood

undernutrition, chronic energy deficiency in mothers and various disorders associated with

vitamin A, iodine and iron deficiencies (FAO, 2010).

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Through careful analysis of statistical trends associated with anthropometric indicators, it is

apparent that social, cultural, geographic and political forces play a critical role in the nutritional

status of vulnerable groups outside of just food availability in Nepal. These forces influence

access and utilization of food by specific groups, ultimately shaping their nutrition outcomes. A

discussion of the nutrition situation of Nepal’s marginalized groups can be found in the “Food

Security Situation” section of this report.

Nutritional status of children

The nutritional status of women and children are indicative of the overall nutrition situation in a

country. According to the 2011 NDHS, 29% of children (under 5 years old) were underweight, 41% were stunted, and 13% were wasted (NDHS, 2011) (Figure 2). With an estimated 1.6 of

3.5 million children under the age of 5 suffering from chronic undernutrition, Nepal is among the

world’s top 10 countries with the highest prevalence of stunting in children under age 5

(UNICEF 2013). Nepal falls behind all other South Asian countries in this measure (NMNP). In

2010/11, 42% of children in Nepal were stunted and 15% were severely stunted (NLSS,

2010/2011).

Figure 2: Undernutrition prevalence in children under 5 in Nepal from 2001 to 2011(NDHS

2011)

Although the prevalence of stunting in children less than five years of age has declined by

approximately 7% since 2006, aggregate improvements masks significant disparities amongst

Nepal’s diverse population. Variations in prevalence of stunting is seen by gender, age, religion,

culture, region and socio-economic strata. For instance, stunting is higher in females than

males. From a geographic perspective, rural areas (44%) experience significantly higher rates

of stunting and than urban areas (28%) with the rural Hill and Mountain districts having highest

prevalence of childhood stunting along with the highest rates of food insecurity (Nutrition

CSRP). Overall, severe stunting is highest in rural areas (17%) versus urban areas (6%)

(NDHS, 2011). More specifically, Nepal’s Mountain ecological region has the highest rate of

severe childhood stunting (20%) and stunting (56%) as compared to the Hills and Terai regions

(NLSS, 2010/11). Nepal’s Mid-Western region has the highest rate of child stunting (50%) than

19

all other development regions (NDHS, 2011). Consequently, about three-fifths (60%) of children

in the Western Mountain sub-region are stunted whereas one-third of children in the Central Hill,

Eastern Terai and Far-Western Terai sub-regions are stunted (NHDS, 2011).

In 2010/11, 14% of children in Nepal were wasted and 3% were severely wasted (NLSS).

Similar to child stunting trends in Nepal, females have slightly higher rates of wasting than

males. Although stunting tends to be the most pervasive in the Mountain region, wasting is more

prevalent in the Terai than in the Hills or Mountains. The rural Central Terai has the highest rate

of child wasting whereas the urban Hills have the lowest rate. In 2010/11, 20% of Terai children

were wasted and 5% were severely wasted. The urban and rural areas of the Terai have similar

high rates of child wasting (NLSS, 2010/2011).

Additionally, 31% and 8% of children less than 5 years of age were underweight and severely

underweight in 2010/11, respectively. The trends in underweight children mimic those of

childhood wasting in Nepal as females suffer higher rates than males with the highest rates in

the Terai region. Similar to wasting, the rural Central Terai has the highest prevalence of

underweight children. The urban areas of the Kathmandu Valley have the lowest prevalence of

underweight children. In general, rural areas have twice as many underweight children than

urban areas but have similar rates of severely underweight children.

The prevalence of childhood stunting, wasting and underweight varies with age in Nepal. For

example, only 13% of children less than one year are stunted as compared to 42% of children

12-23 months and 50% of children 3 years and older. In Nepal, the proportion of underweight

children follows a similar age pattern. In 2010/11, 17% of children less than 12 months were

underweight with increased to 32% for children age 24-35 months and to 38% for children age

48-59 months. On the other hand, the prevalence of wasting tends to decrease with increasing

age groups.

On average, children from the richest quintiles are least likely to be undernourished and suffer

from stunting, wasting or underweight (NLSS, 2010/11). Among all three nutrition indicators,

children from the poorest wealth quintiles had the highest burden of undernutrition. Although

acute and chronic undernutrition is most common in poor households, children belonging to

households in the top consumption quintile still experienced undernutrition. For children under

the age of 5 in the top richest quintile, about22% are stunted, 5% are severely stunted, 15% are

underweight, 3% are severely underweight, 9% are wasted and 2% are severely wasted (NLSS,

2010/11). These statistics suggests that intra-household food distribution and food utilization

practices influenced by culture and religion play a role in nutrition outcomes.

Nutritional status of women

Healthy nutritional status in women, especially women of reproductive age, is not only crucial for

decreasing her susceptibility for illness and reproductive complications but it is imperative for

the health of her children and her country. For instance, “a woman with poor nutritional status,

as indicated by a low body mass index (BMI), short stature, anemia, or other micronutrient

deficiencies, has a greater risk of obstructed labor, of having a baby with a low birth weight, of

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producing low-quality breastmilk, of death from postpartum hemorrhage, and of morbidity for

both herself and her baby” (DHS, 2011, pg. 163). Overall, 18% of Nepalese women are

underweight (below BMI of 18.5) whereas 14% of women in Nepal are overweight or obese

(above BMI of 25) (DHS, 2011).

Micronutrient deficiencies

In the past two decades, Nepal has made significant strides towards reducing micronutrient

deficiency using a variety of widespread interventions and supplementation programs mainly

targeting children under five, as well as pregnant and lactating mothers.

Micronutrient deficiency, or “hidden hunger”, is most commonly caused by poor diet diversity

and is a pervasive problem in Nepal and other low-income developing countries. Poor diet

diversity is usually due to high and very high staple diets, in which 60-75% and 75%+ of total

caloric energy is derived from staple foods, respectively. Staples tend to be calorically dense but

low in bio-available protein and micronutrients; therefore, high and very high staple diets lead to

deficiencies in essential nutrients such as vitamin A, iron, protein and iodine. Micronutrient

deficiency causes diet-related non-communicable diseases and increases susceptibility to

illness and infection.

On average, starchy staples such as rice, wheat and maize make up 72% of the Nepalese diet,

however, urban populations seem to have better diet diversity than rural populations.

Approximately 87% of rural households have high staples diets and 52% have very high staple

diets, whereas 70% of urban households have high staple diets and only 24% have very high

staple diets (NLSS, 2010/11). Additionally, some regions are particularly prone to poor diet

diversity in Nepal including the Mountain areas and certain development regions in the Hills and

Terai (GoN/NPC/CBS, 2013).

Anemia is a major health issue in Nepal, especially among infants, children and pregnant

women. The disease is characterized by low hemoglobin in the blood usually due to insufficient

dietary of essential nutrients required to synthesize hemoglobin such as iron, folic acid and

vitamin B-12.Other causes of anemia may be sickle-cell disease, malaria or parasitic infections.

Anemia is a major contributor to maternal mortality, spontaneous abortions, premature births

and low birth weight (NDHS, 2011). In the last decade, the micronutrient status of pregnant

women has improved with the prevalence of maternal anemia reduced by 50% (NDHS, 2011).

Currently, 23% of all Nepalese women (age 15-49) suffer from some degree of anemia.

Approximately 29% are mildly anemic, 6% are moderately anemic and less than 1% are

severely anemic (NDHS, 2011). This improvement in maternal micronutrient deficiency is

attributable to increased coverage of iron folic acid supplements and de-worming pills during

pregnancy (NDHS, 2011).

Furthermore, about 46% of Nepali children under age 5 are anemic with 27% mildly anemic,

18% moderately anemic and less than 1% severely—the prevalence of the disease has only

decreased 2% in the past 5 years (NDHS, 2011). Even more concerning is that 69% of

Nepalese children age 6-23 months suffer from anemia.

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3.2.2 DIETARY TRANSITION

Nepal consumption and income levels have increased remarkably since 1995/96, with the

average household income increasing more than 363% and average consumption increasing

about 415% (NLSS, 2010/11). Also, Nepal’s poverty headcount ratio (PHCR) declined

dramatically in recent years, from 41.8% in 1995/6 to 25% in 2010/11; however, the country

remains in a low stage of development and dietary transition compared to other developing

countries (GoN/NPC/CBS, 2013). Even with its high rate of poverty reduction, particularly in the

period from 1995 to 2003, Nepal still has the highest level of poverty among South Asian

countries with more than half of its population living below the revised World Bank (WB)

standard of US$1.25 per day (although only 25% by national definition) (USAID/IIDS/IFPRI,

2010).

According to the UNDP’s 2012 Human Development Index (HDI), which provides an overall

score based on health, education and income indicators; Nepal is considered one of the least

developed countries in the world and is ranked 157of 187 countries based on this index. Nepal’s

rate of poverty reduction and gross national product from agriculture (GDPA) growth rate were

among the highest rates for all other South Asian countries (MoF, GoP, 2010); although,

Nepal’s annual growth rate for GDP and per-capita income remains the lowest among these

same countries (USAID/IIDS/IFPRI, 2010). Socioeconomic changes continuously alter Nepal’s

nutritional landscape and level of national food security.

In 2010/11, Nepal’s population was 26.4 million with an annual growth rate of 1.35% (NLSS).

Nepal’s has the highest population growth rate of all other South Asian countries, which results

in food shortages and price hikes due to increased demand for food at a time when national

population growth outpaces agricultural growth. Although Nepal has the highest annual

agricultural growth rate in its region, the growth is relatively stagnant as compared to its rapidly

burgeoning population. For this reason, Nepal is an overall food-deficit country that is

dependent on imports to meet its increasing food demand. About 42 out of 75 districts in Nepal

suffer food deficits each year, and per-capita food availability continues to erode (WFP 2006).

Nepal still suffers with high levels of malnutrition, food insecurity and poverty on the global

scale, but urbanization and increased remittance income from out-migrant significantly reduced

poverty levels—altering food consumption patterns and improving overall nutrition. The impact

of remittances on nutrition is further discussed in the findings of this report.

The evolution of food consumption patterns in low-income countries are commonly caused by

increased per capita income levels that occur as a product of national development and social

transition. In Nepal, the population is consuming more calories per-capita per day and has a

more diverse diet in both rural and urban areas than in the past (WFP, 2006) (NLSS). Across all

income quintiles, food consumption patterns have shifted towards high-value food items such as

refined rice, fruits and vegetables, livestock and fishery products which has improved diet

diversity and nutritional outcomes (USAID/IIDS/IFPRI, 2010). The diet diversity score slightly

improved with the percentage of the population consuming less than four food groups per day

22

decreasing from 10% in 2003/04 to 9% in 2010/11 (NLSS). Overall, Nepalese households are

consuming greater quantities of protein and micronutrient rich foods as compared to ten years

ago (Nepal Thematic). Rice consumption has increased drastically in the Hill and Mountain

regions due to imports and transportation of the grain to remote areas by the GoN. Also, Nepali

households consumed three times the amount of vegetables in 2010/11 as compared to

2003/04 (from 470g/ month to 1,309g/month) and twice the amount of meat and fish (from

402g/month to 847g/month) (NLSS). The share of staples in the average Nepalese diet

decreased from 83% in 1995/96 to 81% in 2003/04 to 72% in 2010/11 (NLSS, 2010/11;

GoN/NPC/CBS, 2013). The prevalence of Very High Staple Diets decreased from 83% of the

population in 1995/96 and 74% of the population in 2003/04 to 46% of the population in 2010/11

(NLSS, 2010/11; GoN/NPC/CBS, 2013).

Compared to previous years, Nepal’s population is consuming about 12% more calories than in

2003/04 and about 21% more calories than in 1995/96 (NLSS, 2010/11). At a national level, the

proportion of the population that consumes less than the minimum caloric requirement is

decreasing. According to the GoN threshold, 38% of the population was food energy deficient in

2010/11 as compared to a staggering 60% in 1995/96 (NLSS, 2010/11). During this time period,

improvement in prevalence of food energy deficiency was slightly higher in rural than urban

areas (GoN/NPC/CBS, 2013).

Although rapidly changing consumption patterns have improved nutritional outcomes in Nepal,

there has also been a simultaneous shift to potentially unhealthy dietary patterns. On average,

Nepalese households are consuming 84% more sugar than recorded in the 2003/04 NLSS and

are consuming ten times the amount of sweets (16g/month to 137g) (GoN/NPC/CBS, 2013). In

addition, oil/ghee also increased by 50% in the past 10 years.

Due the fact that Nepal’s population continues to suffer from high rates of undernutrition, the

prevalence of disorders associated with micronutrient deficiency are high; however, by a global

standard, the prevalence of chronic diseases such as obesity and type II diabetes, related to

more affluent dietary patterns remain low. Still, a relatively small issue, the problem of excess

intake is beginning to surface in Nepal with changing dietary patterns. Since 2006, the

prevalence of overweight and obesity in women increased over 5 percentage points. In 2011,

11% of women were overweight (BMI 25-29 kg/m2) and 2% of women were obese (BMI 30

kg/m2 and over) (NDHS, 2011). Overall, mortality rates of both women and children are

declining due to improved nutrition, albeit fewer infections and illnesses.

Although at the national level, nominal per-capita consumption increased by more than five

times in the past 15 years, the gap in consumption shares between the bottom 20% and the top

20% of the population has become exceedingly polarized—leading to worse nutritional and

health outcomes among people in the poorest wealth quintiles (NLSS, 2010/11). As 25% of

Nepal’s population still falls below the national poverty line, this poses substantial obstacles to

improving the overall nutritional status and food security of the Nepalese people.

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3.2.3 AGRICULTURE AND FOOD SECURITY SITUATION

Food and agriculture situation

The agricultural sector is a crucial part of Nepal’s economy. In 2008/9, agriculture accounted for

34% of the country’s GDP and employed approximately 70% of its workforce (MoF, 2009).

Nepal’s gross domestic product from agriculture (GDPA) was the highest among all South Asian

countries in the period 2000-07 with a growth of 3.3% per annum; where as its overall gross

domestic product (GDP) was the lowest among these same countries with a growth of only

3.4% per annum (USAID/ IFPRI, 2010). The close movement between Nepal’s annual growth

rate in GDPA and GDP highlights its dependency on the agriculture, therefore, improvements in

this sector aid in overall economic growth, poverty reduction and improved nutrition (NASDP).

The GoN is beginning to recognize this trend and is working towards accelerating the process of

broad-based economic growth with social inclusion and poverty reduction by investing in

research, marketing, food technologies development, extension services, quality control and

rural infrastructure development (GoN/NPC, 2008).

In the past 15 years, Nepal’s agricultural sector has experienced changes that significantly alter

the country’s overall food security situation. Since 1995/96, the percentage of agricultural

households with land decreased by approximately 10% largely due to development transition

factors such as urbanization and out-migration. Currently about 74% of Nepal’s total households

are agricultural households with land, and 2% are agricultural households without land (NLSS).

Agricultural households with land are mainly concentrated in Nepal’s Central Hills and Terai with

over 91% of land holdings in rural areas (NLSS, 2010/11). Of the total households operating

agricultural land, 58% are in the Hills, 43% are in the Terai and 9% are in the Mountains (NLSS,

2010/11).

Nepal’s average size of agricultural land holdings is also diminishing over time. The national

average per-capita holding size of agricultural land decreased from 1.1 hectares in 1995/96 to

0.7 hectares in 2010/11, which generally produces less than 6 months of food for a household in

the low production environment (NASDP). Not surprisingly, the average size of land holdings in

rural areas is larger than in urban areas (0.7 ha as compared to 0.5 ha, respectively). Among all

farmers, the proportion of “small” farmers (operating less than 0.5 ha of land) increased from

41% in 1995/96 to 52.7% in 2010/11, whereas the proportion of “large” farmers (operating 2 ha

of land or more) decreased (NLSS, 2010/11). In 2010/11, small farmers accounted for 53% of

all agricultural households and operated 18% of the total cultivated land whereas large farmers

accounted for only 4% but operated 22% of the total cultivated land (NLSS, 2010/11). Also, on

average, landowners in the richest consumption quintile operate about 0.3 more hectares of

land than landowners in the poorest consumption quintile (NLSS, 2010/11). Additionally, the

total area of holdings shows significant disparities among its three ecological regions with49% of

the total area in the Terai region. Also, inequitable distribution of Nepal’s total cultivated land

area is apparent among its various development regions, which range from 31% of the area in

the eastern region to only 9% of the area in the far-west region (NLSS, 2010/11). These

disparities highlight the significant problem of uneven distribution of land in Nepal.

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The major crops grown in Nepal are paddy, wheat, maize, millet, barley and legumes (NLSS,

2010/11). Cereal crops such as paddy, wheat, maize, millet and barley dominate the cropping

pattern in Nepal and occupy 75% of its total cultivated land (USAID, 2010). Of all agricultural

households in Nepal: 72% cultivate main paddy, 57% cultivate wheat, 64% cultivate summer

maize, 38% cultivate millet, 27% cultivate soybean, 31% cultivate lentil, 53% cultivate winter

potato, 39% cultivate mustard, 36% cultivate onion, 41% cultivate garlic, 72% cultivate winter

vegetables, and cultivate 69% summer vegetables (NLSS, 2010/11).

Among all cereals in Nepal, paddy is the most important in terms of area and production,

although it’s shown a small decrease in its percentage of holdings that operate the crop in

recent years. As the country’s most common crop, paddy accounted for 35% of total cultivated

area and 46% of all cereal area in 2008/09 (MoAC, 2009). In 2008/09, another key staple,

maize, showed the fastest growth rate of all cereals and occupied 26% of the total area share.

Due to the use of hybrid maize seed from India, it’s the only cereal whose production growth

rate exceeds Nepal’s population growth rate as a result of yield enhancement rather than

increase in area. Other staples and their proportion of the total area share include: wheat (26%),

millets (8%) and barley (less than 1%) (USAID//IIDS/IFPRI, 2010).

There is clear regional variability in Nepal’s dominant crop patterns due to its diverse climate

and terrain. The Terai and Hill Valleys, the irrigated plains and terraced fields, predominately

grow main paddy and wheat. In these regions, the area share is 70% main paddy and 57%

wheat with similar production shares of 72% and 63% respectively (USAID/IIDS/IFPRI, 2010).

The rural western Terai has the highest proportion of households that cultivate main paddy but

lentil is also popular in these areas. In addition, the Terai grows the highest proportion of onion

in the country along with cash crops such as sugarcane, oilseeds, potatoes and pulses (NLSS,

2010/11) (USAID, 2010). Nepal’s Hills, or dry lands, are mostly occupied by maize, wheat and

millet and are the most areas for winter and summer vegetables. The percentage of households

that cultivate wheat and summer maize are highest in the Rural Mid and Far Western Hills,

respectively (NLSS). Finally, in the high Mountain region, potatoes, millet and barley dominate

the cultivated land. This region is also most popular for growing garlic (NLSS, 2010/11).

In recent years, Nepal’s agricultural sector suggests diversification towards high value crops

and products such as fruits and vegetables, spices and condiments, and livestock (USAID,

\IIDS/IFPRI, 2010). Despite the trend in crop diversification, cereal occupies the most

agricultural land in Nepal; however, its share in terms of total value decreased from 41% to 37%

between 1981-2005 while high-value crops’ share rose from 54% to 59% during this same

period (USAID/IIDS/IFPRI, 2010). The increase in high-value crop share is largely due to growth

of the fruit and vegetable sector. From 1995/96 to 2010/11, the percentage of holdings

cultivating summer vegetables increased from 35.6% to 68% respectively (NLSS, 2010/11).

Currently, fruits and vegetables occupy about 6.5% of the total cultivated land in Nepal but

contribute to a much larger share of the total value of agricultural output than cereals

(USAID//IIDS/ IFPRI, 2010). This trend in diversification of agricultural product is beneficial to

Nepal’s population in that it augments farmers’ incomes and improves the nutrition content of

domestically produced foods; however, these benefits are limited due to the small share of land

25

that is used for cultivating high-value crops. The Terai region tends to be the most favorable

ecological zone for cultivation of cash crops in Nepal, along with the Western development

region, which produces most of the high-value crops such as winter potato, garlic, mustard and

vegetables (NLSS 2011/11).

Livestock and poultry are considered an integral part of Nepal’s food system and are kept by the

majority of its agricultural households. The proportion of households that keep animals

increased in the past two decades, also contributing to improved nutritional outcomes of

agricultural households. As a percentage of all agricultural households, about 50% keep cattle,

52% goats or sheep, 38% buffalo, 44% poultry and 10% swine (NLSS 2010/11). In 2010/11, the

national average of the number of cattle, buffalo, goat, sheep and poultry per household were

1.4, 0.7, 2.2, 2.4 and 3.4, respectively (NLSS, 2010/11). Similar to the increased popularity of

some crops in certain development and ecological regions, there are also clear variations in the

popularity and quantity of certain kinds of livestock and poultry by region. Households in the

Mountains most commonly keep cattle, goat, and sheep and have the highest average number

of head of these animals per holding than the Hills or Terai. Buffalo, goat, sheep and poultry

birds are more popular in Hills (NLSS, 2010/11). The Hills have households with the highest

number of poultry birds per holding, but also the highest concentration of pigs, buffalo, goat and

sheep than Nepal’s other ecological regions. The Eastern development region is characterized

by the highest concentration of cattle, pigs and poultry. More specifically, piggeries are most

common in the rural eastern hills. Generally, the vast majority of households own less than 6

livestock head in all regions of the country.

Agricultural land productivity in Nepal is constrained by low agricultural inputs necessary for

growth. Because small rural households operate the majority of land in Nepal and generally

have poor agricultural inputs, the county’s agricultural outputs and investments remain fairly

stagnant. Smallholder farmers tend to have lower yields and higher production per unit of output

than in other neighboring South Asian countries due to lack of supply of improved seed,

fertilizers and other modern technologies such as irrigation and farming equipment.

With an annual mean rainfall of about 1500 millimeters, Nepal has a natural advantage in terms

of both surface and ground water resources (CBS, 2006a, DHS, 2011)(USAID, IFPRI, 19). This

is still a fairly untapped resource since much of Nepal’s cultivated land is without modern

irrigation technology. Improving irrigation in the country will unlock enormous potential for the

stability and growth of certain crops in Nepal.

Although Nepal increased its area of irrigated agricultural land from 39.6% in 1995/96 to 54% in

2010/11, this improvement is unevenly distributed throughout the country’s wealth quintiles and

geographical regions (NLSS, 2010/11). Urban areas account for 69% of all irrigated agricultural

land and the Terai has the highest percent of irrigated land out of all ecological regions.

Additionally, the proportion irrigated agricultural land area increases with increasing household

consumption quintiles (NLSS, 2010/11). Sixty percent of the land area operated by the richest

consumption quintile is irrigated as opposed to 46.7% of the land operated by the poorest

consumption quintile (NLSS, 2010/11).

26

Also, the use of improved seeds, or “high-yielding varieties” has increased over the past

decade, however, utilization is still considered quite low as compared to other South Asian

countries. Only a small percentage of farmers use improved seed for their cereal crops. Just like

the distribution of irrigation, use of improved seed varies drastically by regions in Nepal. The

Central development region has the highest proportion of farmers that use improved seed for

main paddy, wheat, summer maize and onion, whereas the Western development region has

the highest proportion of farmers using improved seed for winter potato and vegetables (NLSS,

2010/11). The following select crops are listed with their corresponding average national

proportion of households that cultivate them with improved seed: winter potato (33%), onion

(29%), summer vegetables (26%), winter vegetables (16%), main paddy (15%), wheat (13%)

and summer maize (9%)(NLSS, 2010/11).

The use of chemical fertilizers, or fertilizers industrially produced with inorganic materials, has

also increased in recent years and is more common than the use of improved seed. Main paddy

has the highest percentage of growers using chemical fertilizers (71%), followed by wheat

(53%), summer maize (38%), and winter potato (32%)(NLSS, 2010/11). Similar to other

agricultural inputs, the prevalence in use of chemical fertilizers also varies by region with the

Central development region having the highest rate of use. On average, 88% of main paddy

growers in the Central region use chemical fertilizers followed by 70% of both wheat and maize

growers (NLSS, 2010/11).

Most Nepali farmers continue to use locally made agricultural equipment and tools that are not

modern or mechanically advanced. According to the 2010/11 NLSS, approximately 52% of

farmers own the most basic agricultural equipment (i.e. plough or improved type of plough

called a bikase halo). Currently, only a third of farmers use bins and containers for storing grain

and only 7% of farmers own a pumping set. Still, even more rare are modern tractors, power

tillers and threshers with only 1% of farmers owning these technologies.

Food security situation

Food and nutritional security are critical problems in Nepal. The FAO defines food security as “a

situation that exists when all people, at all times, have physical, social and economic access to

sufficient safe and nutritious food that meets their dietary needs and food preferences for an

active and healthy life.” In general, food insecurity is rooted in poverty, but it is further

exacerbated by other internal and external shocks. External shocks may include: low food and

livestock production, economic recession, price hiking, unemployment, decreased remittance

and income, national conflict, low development indicators, recurring natural and man-made

disasters, and unstable political landscape (FAO, 2010). Furthermore, internal shocks that

increase food insecurity may include loss of income, illness and chronic seasonal agricultural

lean periods.

Generally, the level of food security, albeit the consumption (income)-level a household, reflects

the nutritional status of its constituents. For example, children in Nepalese households that are

food secure and mildly food insecure are least likely to be stunted (33% and 41% respectively),

27

whereas children in households with moderate and severe food insecurity are most likely to be

stunted (46% and 49% respectively) (NHDS, 2011). Additionally, children in households from

the poorest wealth quintiles are more than twice as likely to be stunted than those from the

richest wealth quintile (56% versus 26% respectively) (NHDS, 2011). Therefore, it can be

assumed that levels of food security, wealth and nutrition are closely intertwined. It is not

surprising that the factors that cause food insecurity (such as poverty) tend to disproportionately

affect people of specific minority groups, castes and geographic locales. In turn, these groups

commonly experience poorer nutrition outcomes.

Nepal’s overall improvements in poverty and nutrition mask serious disparities amongst different

socio-economic, ethnic/ caste, gender, and region strata; and, vulnerability to food insecurity for

certain groups is actually increasing (NDHS, 2011). Nepalese in the poorest wealth quintiles are

facing worse health and nutritional outcomes than in the past as food prices rise and the

distribution of wealth becomes increasingly polarized.

Food availability

Until the 1980’s, Nepal was a food sufficient country and even a net food exporter; however, the

rapidly expanding population’s demand outpaces Nepal’s domestic food production. Nepal is

the only South Asian country whose population growth rate exceeds the cereal production

growth rate (USAID/IIDS/IFPRI, 2010). Currently, Nepal is a net cereal importer and relies

heavily on formal and informal trade across India’s open boarders to meet its domestic deficit

(USAID/IIDS/IFPRI, 2010).

Largely due to liberal trade policies, Nepal fares well among all South Asian countries in terms

of its per-capita cereal supply and net availability of high-value foods such as fruits and

vegetables, meat products and dairy (USAID/IIDS/IFPRI, 2010). In fact, Nepal ranked highest

among these countries for it availability of fruits and vegetables with a supply of 114

kg/capita/year (FAO, 2010). Additionally, production is stagnant due to Nepal’s insufficient

control over post-handling losses (NASDP). Limited food supply along with the growth of

Nepal’s population and migration to urban centers has eroded per-capita food availability and

security.

Per-capita land availability has decreased due to population growth leaving many households

with an insufficient amount of land to meet their nutritional requirements. The average per-capita

land availability in Nepal is less than 0.18 ha, which only produces about 6 months of food for

families living in low production areas (CBS, 2006 and NASDP). Only 16% of the total

geographical area of Nepal is under agricultural production of which 50% is in the Terai and

37% is in the Hills (USAID/IIDS/IFPRI, 2010). In the Mountain region, only about 3.9% of the

total land area is arable as compared to 38% of the total land area in the Terai (CBS, 2006).

Due to sparse population, per-capita land availability is the highest in the Mountains even

though it has the lowest share of arable land (0.31 ha). In contrast, the Terai and Hills have the

highest shares of arable land but the lowest per-capita availability of land at 0.17 ha and 0.16

ha, respectively. With current rates of population growth and land shortage, the Hills and Terai

risk inadequate food production. Poor landowning families face extreme challenges protecting

28

themselves against food insecurity caused by occasional shocks such as drought, flood and

illness. This obvious lack of land resources in specific locales leads to regional and seasonable

variability in access and availability of food. In 2008, 47% of landowning households owned only

15% of the land with an average plot size of less than 0.5 ha (FAO, 2010). According to the

WFP, the minimum amount of land for a household to be self-sufficient is 0.54 ha. The top 5%

of landowning households owned 37% of the land.

Another major issue to food availability is Nepal’s lack of control over food protein losses

caused by poor animal health and disease (NASDP). Insufficient agricultural and livestock

supply compounded with increased demand inevitably leads to food shortages and price spikes

(FAO, 2010).

Food access

In Nepal, many households and marginalized groups lack access to sufficient amounts and

varieties of foods due to physical and/or financial barriers. There is an obvious socioeconomic

component to food insecurity in Nepal. Food insecurity is rooted in poverty because “wealth

determines people’s ability to access food beyond their own self production” (GoN/NPC/CBS,

2013, pg. 28). The fact that the poorest households are generally the most likely to face food

insecurity is highlighted by a study conducted by the WFP in 2008 that found that approximately

75% of poor households and 95% of very poor households in Nepal had insufficient access to

food. Additionally, 35% of households in the poorest wealth quintile report inadequate diet

versus only 5% in the wealthiest quintile (GoN/NPC/CBS, 2013).

Agricultural daily wage laborers relying on their own crop production for their primary income

and food sources tend to be the most poor and the most food insecure. In rural areas, the

landholding size had a strong positive association with overall food consumption score.

Approximately 24% of Nepalese are landless and therefore depend on purchasing their food.

The proportion of Nepal’s population that is landless continues to rise with increased

urbanization and the shift away from self-production. The poorest households in Nepal are most

likely to be landless and therefore spend the majority of their income on food.

Although insufficient access to food is mainly caused by financial hardship, physical barriers to

access such as poor rural infrastructure and trade access routes or high transportation costs

also play a role in food security. For these reasons, Nepalese in rural locations tend to have less

access to food than their urban counterparts. More specifically, physical barriers to access are a

major problem for people in the Mountain regions along with inhabitants of the West and Far

West development regions, and therefore, people in these regions face the highest rates of food

insecurity in the country.

In rural areas, the consumption of food is a combination of home production, purchases, and in-

kind contributions. The amount of consumption of home produced foods, purchased foods and

in-kind foods vary by region. For example, in 2010/11 the average household in the Mountain

ecological zone consumed 53% of food from their own production, 40% from purchases and 7%

from in-kind whereas households in the rural Hills consumed 40%, 57% and 2%, respectively.

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The average household in the rural Terai consumed 43% of food from their own production,

54% of food from purchases and 3% from in kind (GoN/NPC/CBS, 2013).

Intra-household food distribution creates variability of nutrition within households (USAID, 2010).

Often times there is a hierarchy of food distribution within houses by gender and age, which

tend to discriminate against women and children. For this reason, women and children are

considered marginalized and vulnerable groups in Nepal, because they have poorer nutritional

outcomes.

Food utilization

Understanding food absorption factors, or food utilization, is “crucial for translating food

availability and access to better health and nutritional outcomes” (USAID//IDS/IFPRI 2010).

Absorption and utilization factors can include access to quality healthcare, hygiene practices/

conditions, educational attainment, water quality and supply, and food safety laws and

practices.

In Nepal, breastfeeding and complementary feeding practices, food diversity, quantity and

frequency play heavily into the nutritional and health outcomes of infants and children (NMNP).

Poor feeding practices can have detrimental effects on the physical and mental development of

a child. Although breastfeeding is nearly a universal practice in Nepal with about 50% of

children breastfed for 34 months or longer, only 70% of children less than 6 months are

exclusively breastfed with the median duration of exclusive breastfeeding of only 4.2 months

and predominant breastfeeding of 5.4 months (NDHS, 2011). On average, predominant

breastfeeding is lower (4 months) among children with mothers with no education than children

with mothers that are more educated (7 months). Similar differences are seen among children

from the wealthiest quintiles (3.4 months) as compared to the poorest quintiles (5.3 months)

(NDHS).

Additionally, only about 25% of children age 6-23 months are appropriately fed based on the

recommended infant and young child feeding practices prescribed by Infant and Young Child

Feeding (IYCF). This includes introducing complementary foods started at age 6 months to

maintain the child’s recommended daily caloric requirements. Ninety-two percent of breastfed

children are fed solid or semi-solid complementary foods by 6-23 months with include fortified

baby foods (8%), food made from grains (88%), vitamin A rich produce (35%), food made from

roots and tubers (65%) and other fruits and vegetables (21%). High protein complementary

foods include: legumes and nuts (49%), meat, fish and poultry (17%), eggs (9%) and dairy

products (i.e. cheese, milk, yogurt etc.) (9%). In Nepal, the diet transition that takes place at 6-

23 months is characterized by sharp increases in malnutrition and infections due to poor feeding

practices or infections (NDHS, 2011). The most common liquid other than breast milk given to

children age 6-23 months is animal milk (43%). Only 2% of children in Nepal are given infant

formula (NDHS, 2011). In addition, 28% of children age 6-23 months were fed foods from 4 or

more food groups.

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Diets and consumption patterns

Nepal’s national average dietary energy (Kcal) intake is 2,536 Kcal per capita per day, which

according to guidelines set by the GoN, exceeds the minimum average dietary energy intake of

2,220 Kcal (GoN/NPC/CBS, 2013; NLSS, 2010/11). In Nepal, average dietary energy intake is

similar in rural and urban areas at 2,539 and 2,525 Kcal per capita per day, respectively. In

2010/11, 43% of the urban population compared to 37% of the rural population consumed less

than the national minimum energy intake level; however, the proportion of the population in rural

areas that are food energy deficient is most likely significantly underestimated since the GoN

calculates minimum caloric thresholds based on “light” physical activity. Typically, rural people

expend more energy throughout the day than their urban counterparts due to increased physical

activity.

Although average food energy intake does not differ significantly in rural versus urban areas,

households in rural areas are more likely to consume high staple diets (60% or more of calories

from staples) than households in urban areas (87% versus 69% respectively). Differences in

energy intake seem to vary most substantially amongst Nepal’s ecological and development

regions. For example, the greatest per capita per day caloric intake is in the Rural Central Terai

(2,762 Kcal) whereas the lowest per capita per day intake is in the Rural Mid and Far Western

Hills (2,331 Kcal) (NLSS, 2010/11). In general, areas with higher average caloric consumption

also have lower proportions of its population that are food energy deficient (GoN/NPC/CBS,

2013).

The major staple foods in Nepal vary mostly by ecological region. In the Terai, the most

commonly consumed staples are rice and wheat whereas maize and millets are most commonly

consumed in the Hills. Millets, maize and barley constitute the primary staples consumed in the

Mountains. In recent years, the consumption of rice has increased in the Hill and Mountain

districts due to increased imports and government transportation of the staple to remote

locations. On average, 72% of energy intake by Nepalese people is from staple foods that are

rich in carbohydrates and calories but low in micronutrients (GoN/NPC/CBS, 2013).

Nepal has diverse consumption patterns that vary by region, caste, ethnicity, gender and

religion—all of which play a role in the access, availability and utilization of food (Pokharel,

GoN). Food consumption has a definite geographic component. In Nepal, rural households

have worse food consumption than urban areas and tend to rely more heavily on staples. In

Nepal’s urban areas, inadequate food intake does not have to do with the level of food

availability. For instance, the highest rates of inadequate energy intake are found in urban

Kathmandu even though there is greater food availability than in many rural areas (USAID,

2010). Culture plays a role in whether or not a group will consume a certain type of food

irrespective of if it is available or not (USAID, 2010). In the urban case, culture, ethnicity, religion

and caste determine consumption patters more so than access or availability of food.

Food stability

The relatively stagnant performance of Nepal’s agricultural sector is largely due to poor crop

yields and post-harvest losses caused by the country’s susceptibility to man-made and natural

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disasters, severe climate changes, limited land/production resources, and low agricultural input

usage. In addition, population growth has directly influenced agricultural outputs by altering

biodiversity and health conditions within the country.

Man-made and natural disasters that limit agricultural output in Nepal include monsoons, flash

floods, erosion and drought. Changing intensity, onset and retreat of monsoons often causes

severe flash floods in low-lying areas and periods of drought in regions lacking irrigation

(despite Nepal’s abundant water supply). Furthermore, erosion causes loss of land and

increased fragmentation of agricultural plots that ultimately limits production due to a lack of

land resources.

Additionally, there is a clear seasonal component to food insecurity in Nepal. Seasonal

vulnerability is due to agricultural lean periods that cause cycles of chronic food insecurity in the

majority of Nepal’s regions. Nepal has two distinct agricultural lean periods: the summer lean

period (July-August) and the winter lean period (February-April) (GoN/NPC/CBS, 2013).

Throughout the year, many households slip in and out of hunger due to the fluctuation of their

own crop production cycles and/or lack of access to purchased foods.

International/domestic economic recession and price-hikes contribute further to Nepal’s food

insecurity situation. The annual food price inflation rate is up to 15-18% whereas the annual

agricultural growth rate is only 2.5-3.5% (Feed the Future 2011). Poor households are the most

vulnerable to price hikes as those in the poorest consumption quintile spend up to 60% of

household income on food as compared to only 30% by those in the richest quintile (USAID/

IIDS/IFPRI, 2010). On average, the typical Nepalese households spend approximately 39% of

their overall expenditure on food items (USAID//IIDS/IFPRI 2010). The close relationship

between food price and level of food insecurity was especially apparent with the world food

crisis in 2007/08 and continues to push households closer to the poverty and food insecurity.

Food prices increased substantially in recent years despite government efforts to improve rural

road infrastructure and decrease transportation costs. At a time when households are less

dependent on self-production and more dependent on purchased foods, either due to poverty

and/or urbanization, increased national and international food prices increase susceptibility to

food insecurity for the population, especially among the already vulnerable groups in the lowest

wealth quintiles. Also, high food prices tend to disproportionally affect specific regions in Nepal.

The Mountain region and Western development region have the highest food prices, which is

exacerbated by the fact that the majority of the country’s poor reside in these areas.

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3.3 NATIONAL NUTRITION PRIORITIES The Government of Nepal expresses its national nutrition priorities in its Multi-sectoral Nutrition

Plan (NMSNP) (2013-17) (2023). With a staggering 42% of Nepalese children under the age of

5 facing irreversible and life-long consequences of chronic undernutrition, the GoN recognizes

chronic malnutrition and stunting in children as a fundamental problem impeding its overall

growth and development as a nation. As stated by the Prime Minister of Nepal, Dr. Baburam

Bhattarai: “addressing chronic malnutrition among children is the basic foundation for all social

and economic development and for the accelerated achievement of all Millennium Development

Goals (MDGs)” (NMSNP, pg. 1). Child undernutrition accounts for over a third of child

mortalities in Nepal and for surviving children causes “increased risk of morbidity and decreased

cognitive functions, which result in low academic performance, low economic productivity and

increased risk of degenerative diseases later in life” (NMSNP pg. 1). Due to the fact that child

stunting originates in maternal malnutrition before and during pregnancy and continues to affect

the child through the first two years of life, the GoN hopes to concentrate its efforts to reduce

chronic undernutrition for the following key target groups: adolescent girls, pregnant and nursing

mothers and all children under the age of 24 months. In addition, the government is gearing its

efforts towards impoverished and minority groups.

Central to its development plans, nutrition indicators and objectives are explicitly outlined in the

country’s Development Plan of 2010-2013, as a separate chapter with grouped with health.

Nutrition is also emphasized under agriculture, labor, water and sanitation, forest and women

and social services. In 2004, a National Nutrition Policy and Strategy was approved and further

updated in 2008. Nutrition was also emphasized in the 2006 School Health and Nutrition

Strategy. In attempt to further improve the nutrition situation in the country, a Nutrition

Assessment and Gap Analysis (NAGA) was completed in 2009, which emphasized a multi-

sectoral approach to addressing nutrition.

At that time, the National Planning Commission (NPC) revitalized the National Nutrition Steering

Committee (NNSC) of the country and set up a series of consultative seminars and workshops

with technical working groups to begin crafting a multi-sectoral national nutrition plan. By 2011,

the scope of the NNSC was expanded to the High Level Nutrition and Food Security Steering

Committee (HLNFSSC), resulting in the creation of the NMSNP of 2013 to 2017. This plan’s

long-term vision over the next ten years is to “lead the country toward significantly reducing

chronic malnutrition so that it no longer becomes an impediment to improving human capital and

for overall socio-economic development.” The goal is “to improve maternal and child nutrition,

which will result in the reduction of Maternal Infant and Young Child (MIYC) under-nutrition, in

terms of maternal BMI and child stunting, by one third.” The main purpose is to strengthen

capacity of the NPC and the key ministries to promote and steer the multi-sector nutrition

programme for improved maternal and child nutrition at all levels of society (NMSNP pg. 7).

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IV. METHODS

4.1 DATA COLLECTION AND SOURCES OF INFORMATION Literature review

The following literature databases were searched in order to complete the situation analysis:

PubMed, ISI Web of Science, Agris, Google Scholar, and FAOStat using the following key

words: Nepal and nutrition, agriculture, food security, diet, consumption and farming. Grey and

unpublished literature was also searched for reports, strategies, policies, and plans specific to

Nepal. Government of Nepal websites were also searched. Review of the literature was

restricted to English written reports and publications due to resource constraints. A snowball

process— whereby the reference list of all the included studies were scanned to discover

potentially relevant studies, policies and plans—was used to identify additional information. No

differentiation was made between published documents obtained through the initial search and

those identified through snowballing. The snowball process was also used to identify grey

literature not published in peer-reviewed journals.

Identification of strategies, policies and plans

For the purposes of this report, some terms are defined as follows: • A policy is a written statement of commitment (generally in broad terms) by a nation

state. A strategy is often similar to a policy.

• An action plan (e.g. a national plan of action on nutrition) arises from policy; it contains

detailed operational plans, including budgets, and goals and targets that are specific,

measurable, attainable, relevant and time-bound.

• A programme provides details for implementation of the action plan; specific projects are

defined within a programme.

The primary strategies and plans analyzed for this report:

1. Nepal Multi-Sectoral Nutrition Plan (MSNP) 2013-2017

2. Agriculture Development Strategy Final Draft Final (ADS) 2013

3. Food and Nutrition Security Plan of Action (FNSP) 2013

Supporting reports for these three plans/strategies included the MSNP Implementation Guide

2012, the Nepal Nutrition Assessment and Gap Analysis 2011 (NAGA), the ADS Assessment

Report 2012, and the ADS Vision Report 2012.

Secondary policies/legislations analyzed for this report:

1. Nepal Interim Constitution 2007 (issues related to food sovereignty)

2. National Planning Commission Three Year Plan Approach Paper 2013

3. NARC’s Strategic Vision for Agriculture Research 2011

4. Nepal Biodiversity Strategy 2002

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5. Nepal Environment Management Framework 2012

6. National School Health and Nutrition Strategy 2006

7. Nutrition-relevant legislation on mandatory flour fortification 2011

8. National Nutrition Policy and Strategy 2004

Identification of stakeholders for interviews and joint meetings

Specific contacts already known to the research team, in addition to information provided by the

Child Health Department of Nepal were utilized. No inclusion criterion for the relevant

stakeholders was developed to ensure sufficient capture of a range and variety of participants.

For interviews and joint meetings with relevant stakeholders, a brief consultation was done with

the Child Health Department of Nepal to generate a list of relevant stakeholders that would be

able to discuss the state of food and nutrition security in the country, the policies and plans in

place, and the political processes of nutrition sensitive agriculture. The consultant conducted

semi-structured interviews in person with key informants as well as joint focus groups with

relevant organizations. Planning for such interviews included compiling a set of questions, covering a specific pool of themes (see the interview guide and questions in Annex 2). The

participants interviewed were those who are involved in food and nutrition security and have

played a part in the design, synthesis and application of the policies and plans laid out above.

Snowball sampling was also employed to reach additional actors—the consultant first identified

individuals that fit the inclusion criteria, who in turn recommended others that met the same

criteria. All interviews were conducted in English.

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4.2 DATA ANALYSIS

Literature review

The literature review provided a basis for the report and background of the food and nutrition

situation in the country. The situation analysis section of this report relied heavily on the

literature and other observations were included in the findings section of the report.

Interviews and joint meetings

During the interviews and joint meetings, questions were asked from the interview guide, but in

varying order, depending on the flow of the interview or joint meetings, and the level of expertise

of the interviewee and participants on the different covered themes. The consultant audio-

recorded the interviews and wrote notes. A Daily Interpretive Analysis was performed to

assemble and interpret the information that was collected, to review the notes and the tapes,

and to write a log that synthesizes the bulk of interview information. Qualitative data analysis

consisted of identifying, coding and categorizing major themes for the policy analysis and

political process centered on nutrition. Interview responses were reviewed and analyzed to

identify trends. Interviews were conducted with experts from governmental agencies, the UN,

international and multilateral organizations, research and academic institutions, and NGOs at

the national level. In addition, interviews were conducted at the district level in Kapilvastu, where

the MSNP was launched and interventions are currently being scaled. In addition, three joint

meetings with various stakeholders from government, UN, NGOs, and academia were conducted. Annex 1 lists the individuals interviewed as well as who was in attendance at the

joint meetings.

Policy analysis

A qualitative assessment was done on the policies and plans including a scoring system using

the FAO Guiding Principles for improving nutrition through agriculture (FAO). The scoring

system looks at each guideline and answers “Yes”, “No” or “Partially” for each policy or plan

identified. The Guiding Principles below are applied with the idea that food systems provide for

all people’s nutritional needs, while simultaneously contributing to economic growth. The food

and agriculture sector has the primary role in feeding people by increasing availability,

affordability, and consumption of diverse, safe, nutritious foods and diets, aligned with dietary

recommendations and environmental sustainability. Applying these principles helps strengthen resilience and contributes to sustainable development. The guidelines are listed in Annex 3.

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V. FINDINGS 5.1 DESCRIPTION OF THE RELEVANT FOOD AND AGRICULTURE POLICIES AND PLANS

Nepal has made great strides in improving food and nutrition security in the country. Overall,

nutrition has modestly improved in the last five years. Food security has remained largely the

same in regard to production, however an increasing number of Nepalese households are able

to afford a minimum acceptable diet. Some of this improvement can be attributed to government

commitment towards the MDGs, a food-focused constitution and a multi-sectoral focus of the

GoN’s National Planning Commission towards food and nutrition security.

5.1.1 DESCRIPTION OF THE MAJOR FOOD AND AGRICULTURE POLICIES

I. Multi-Sectoral Nutrition Plan for Nepal (2013 - 2017)

Responsible Bodies: National Planning Commission, Ministry Health and Population, Ministry

of Agriculture and Development, Ministry of Education, Ministry of Urban Development, Ministry

of Federal Affairs and Local Development, Ministry of Children and Women’s Affairs and

Ministry of Finance

Objectives: To lead the country toward significantly reducing chronic malnutrition so that it no

longer becomes an impediment to improving human capital and for overall socio-economic

development. The goal is to improve maternal and child nutrition, which will result in the

reduction of Maternal Infant and Young Child (MIYC) under-nutrition, in terms of maternal BMI

and child stunting, by one third. Specifically, the plan hopes to achieve the following: Percent

prevalence of stunting among children under 5 years of age reduced below 29%; Percent

prevalence of underweight among children under 5 years of age reduced below 20%; Percent

prevalence of wasting among children under 5 years of age reduced below 5%; and Reduce

under-nutrition among women 15-49 years of age (BMI<18.5kg/m2) by 15%.

History: The Nutrition Assessment and Gap Analysis (NAGA) was undertaken ‘to provide the

synthesis of information necessary to develop a detailed multi-sector Nutrition Action Plan for

the next five years’. The NAGA report noted that while Nepal has performed ‘extremely well in

scaling up and to date sustaining micronutrient interventions’, it has lagged behind with respect

to ‘multi-sectoral interventions addressing food availability and household economics’. The

report further notes that the multi-sector interventions ‘have not yet been effectively focused on

reducing undernutrition’, and that ‘the current capacity to deliver health-related nutrition

programs at national, district, and community levels was inadequate’. The NAGA report

provided a detailed roadmap of possible interventions including corresponding implementation

mechanisms and systems for monitoring and evaluating the interventions (USAID/IFPRI 2010).

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The Plan: The multi-sectoral nutrition plan (MSNP) is a forward thinking plan that has ambitious

goals to scale up nutrition efforts in all 17 districts of Nepal and make significant reductions in

undernutrition within four years. The agriculture sector plays an important role in this plan with

food as a central component to reducing micronutrient deficiencies and improving nutrition

outcomes.

The plan focuses on the first 1,000 days of life, with an urgent set of essential interventions. It

complements other relevant sector policies and strategies, such as the health sector’s National

Nutrition Policy and Strategy (2004/8) and the agriculture sector’s upcoming Food and Nutrition

Security Plan (FNSP) as part of the Agriculture Development Strategy (ADS) (Reviewed in this

report), and delineates responsibilities of various ministries. There are three major outcomes to

the plan:

• Outcome 1: Policies, plans and multi-sector coordination improved at national and local

levels.

• Outcome 2: Practices that promote optimal use of nutrition ‘specific’ and nutrition

‘sensitive’ services improved, ultimately leading to an enhanced maternal and child

nutritional status.

• Outcome 3: Strengthened capacity of central and local governments on nutrition to

provide basic services in an inclusive and equitable manner.

The MSNP identifies eight outputs with a set of indicative activities that contribute to the three

outcomes.

• Output 1: Policies and plans updated/reviewed, and the incorporation of a core set of

nutrition specific and sensitive indicators at national and sub-national levels. NPC and

sector ministries (local development, health, education, agriculture, physical planning

and works) will be responsible for achieving this result.

• Output 2: Multi-sector coordination mechanisms functional at national and sub-national

levels. NPC and local bodies will be responsible for achieving this result.

• Output3: Maternal and child nutritional care service utilization improved, especially

among the unreached and poor segments of society. The health sector will be

responsible for achieving this result.

• Output 4: Adolescent girls’ parental education, life-skills and nutrition status enhanced.

The education sector will be responsible for achieving this result.

• Output 5: Diarrheal diseases and ARI episodes reduced among young mothers,

adolescent girls, and infants and young children. The physical planning and works sector

will be responsible for achieving this result.

• Output 6: Availability and consumption of appropriate foods (in terms of quality, quantity,

frequency and safety) enhanced and women’s workload reduced. The agriculture,

environment and local development sectors will be responsible for achieving this result.

• Output 7: Capacity of national and sub-national levels enhanced to provide appropriate

support to improve maternal and child nutrition. NPC, health, education, physical

planning and works, agriculture and local development sectors will be responsible for

38

achieving this result.

• Output 8: Multi-sector nutrition information updated and linked both at national and sub-

national levels. NPC, health, education, physical planning and works, agriculture and

local development sectors will be responsible for achieving this result.

The Ministry of Agriculture and Development results include: increasing availability of animal

foods at the household level, increasing income amongst young mothers and adolescent girls

from the lowest wealth quintile, increasing consumption of animal foods by adolescent girls,

young mothers and young children, reducing the workload of women and better home and work

environments.

But agricultural growth, although critically important, may not be a sufficient condition to improve

child nutrition. Ensuring adequate quantities of food alone does not address the multifaceted

problem of undernutrition in Nepal. Investments are required to improve the poor’s access to

healthy, nutritious food beyond just rice. At the same time, efforts have to be made to improve

food absorption and utilization. For that, the MSNP will invest in other sectors including female

education, general sanitation, basic health care, and some select direct nutrition interventions.

Due to Nepal’s is heterogeneous nature; the MSNP cannot be used as a “cookie cutter”

approach in which the same interventions and delivery systems are the same across the

country—particularly with agriculture and food security interventions addressing nutrition. The

MSNP has to be fine-tuned for each district with active participation and leadership of local

governments.

Coordination: Written implementation of the MSNP will be guided by the High Level Nutrition

and Food Security Steering Committee (HLNFSSC), which is chaired by the Vice Chairperson

of the National Planning Commission (NPC). The HLFNSSC will be responsible for policy direction, guidance and oversight functions (Figure 3).

Figure 3: The Multi-Sectoral Nutrition Plan Governing Structure (MSNP 2013)

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A technical multi-sector nutrition committee will be formed at the national level to provide

technical guidance for the MSNP. Also, the NPC will undertake the key role in improving

policies, plans and multi-sector coordination and in strengthening the capacity of the central and

local governments on nutrition—all in close collaboration with the five Ministries involved in the

MSNP. At the sub-national level, nutrition will be incorporated into their periodic and annual

plans and monitoring frameworks by adopting the multi-sector principles and approaches into

the district context. Steering Committees will also be formed at three levels: district, municipality

and village levels with specified Terms of References focusing on coordination, guidance and

oversight functions. The initial plan was to scale up in six model districts with eventual scale up

to all 17 districts by 2017.

II. Agriculture Development Strategy (2013 - 2033)

Responsible Bodies: The National Planning Commission (NPC) provides overall policy

coordination, the Ministry of Agricultural Development (MOAD) provides leadership in

implementing agricultural programs, and related agencies support the implementation for the

ADS. The Department of Irrigation (DOI) is responsible for irrigation development, the

Department of Local Infrastructure Development and Agricultural Roads (DOLIDAR) is

responsible for the development of agricultural roads, the Department of Forestry (DOF) and the

Department of Soil Conservation and Watershed Management (DSCWM) are responsible for

the protection and conservation of forestland, the Department of Agriculture (DOA) and the

Department of Livestock Services (DLS) are responsible for agricultural and livestock extension

and the Nepal Agricultural Research Council (NARC) is responsible for agricultural research.

Objectives: To accelerate agricultural sector growth through four strategic components

including governance, productivity, profitable commercialization, and competitiveness while

promoting inclusiveness (both social and geographic), sustainability (both natural resources and

economic), development of private sector and cooperative sector, and connectivity to market

infrastructure (e.g. agricultural roads, collection centers, packing houses, market centers),

information infrastructure and ICT, and power infrastructure (e.g. rural electrification, renewable

and alternative energy sources). The acceleration of inclusive, sustainable, multi-sector, and

connectivity-based growth is expected to result in increased food and nutrition security, poverty

reduction, agricultural trade surplus, higher and more equitable income of rural households, and

strengthened rights of farmers. Nepal’s agricultural growth rate is targeted to increase to 5%

annually, and its share of agricultural production from commercialization is targeted to increase

to 80% of its total annual production.

History: Since 1995, the long-term, twenty-year strategy for the agricultural sector was the

Agriculture Perspective Plan (APP)—a strategic document that was formulated with the support

of Government of Nepal and development partners. In the past, the GoN developed various

policies, including the APP, to achieve food security. These policies include:

• Implementation of APP Support Programme (2003-2008)

• National Agriculture Policy (2004)

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• National Water Plan (2005)

• Forestry Master Plan

• National Transport Master Plan

• Agribusiness Promotion Policy (2006)

• Milk Development Policy (2007)

• Agriculture Biodiversity Policy (2007)

Some in-country perceptions recommended APP revisions that should include:

1. A new national and international context;

2. A general perception that the APP was not successful in achieving its main targets; and

3. The practical matter of the period of validity of the APP (1995-2014) approaching its end

and the need of a new long-term strategy.

However, at this time, new dimensions must be considered as part of the national context of

Nepal. This includes improved connectivity, not only with roads, but Internet and mobile phone

connectivity as well. Out-migration and remittance income continue to increase, which create

both positive and negative effects on the social dynamics, livelihoods and food and nutrition

security for Nepalese households. Also, the plan places more emphasis on decentralization of

development to districts in addition to increased community participation. Lastly, rapid

development and peace are high on the national agenda due to the country’s change in political

landscape (ADS Assessment report).

Nepal does not sit in isolation, and its immediate neighbors and the global context play

important roles in the country’s development. As international food prices continue to rise and

remain unstable, Nepal is greatly impacted as a net food importer, particularly impacting the

poorest households. Also, climate change, variation and unpredictability cannot be underscored

as challenges to development. There is no longer a “normal” climate pattern. Global food

productivity shifts and geopolitics are increasingly under pressure. Lastly, regional markets,

especially of China and India, Nepal’s neighbors, are rapidly growing and this will have both

positive and negative consequences on Nepal (ADS Assessment report).

The Strategy: The GoN has developed a long-term, twenty-year Agriculture Development

Strategy (ADS) for the agricultural sector. Preparation of the strategy began in 2011 with the

technical assistance of development partners, including: ADB, IFAD, World Bank, USAID,

DANIDA, DfID, EU, FAO, SDC, JICA, and WFP. The Steering Committee is co-chaired by the

Secretaries of Ministry of Finance (MOF) and Ministry of Agricultural Development (MOAD), and

twelve thematic groups were organized around the key policy issues affecting the sector. These

themes are:

1. Social and regional development

2. Land use and infrastructure

3. Water resource and Irrigation

4. Field crops

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5. Horticulture and high-value crops

6. Livestock and fisheries

7. Agriculture research and technology development

8. Food and nutrition security

9. Agribusiness and commercialization

10. Trade and competitiveness

11. Forest, climate change and sustainable agriculture

12. Rural finance, insurance and credit for agriculture

The thematic groups were composed of one chairperson and representatives from the private

sector, farming sector, government sector, agronomic experts and the Ministry of Agriculture

and Development.

The formulation of the ADS is based on in-depth assessment of the current situation, the

participatory formulation of a long-term vision for the agriculture sector, the identification and the

analysis of alternative policy and investment options to achieve the vision, and the preparation

of implementable plans. During the process of preparation of the ADS, the technical assistance

team (TA), guided by the Steering Committee and co-chaired by the Secretary of Ministry of

Finance and Secretary of Ministry of Agricultural Development, convened through consultative

meetings with numerous stakeholders at central, regional and local levels. The TA was

implemented over 4 phases:

1. Phase 1: Assessment addresses the key question: Where are we currently (the

agricultural sector in Nepal) and why? This involves a review and assessment of the

agricultural sector by its trends, key constraints, and policy, institutional issues and gaps.

2. Phase 2: Vision addresses the key question: Where do we want to be over the next 20

years? This phase must articulate a long-term vision for the agricultural sector in Nepal.

3. Phase 3: Policy Options will address the key question: How do we go from where we are

(the current situation of agricultural sector in 2011) to where we want to be (the vision for

2030)? The effort needs to explore different policy and investment options.

4. Phase 4: Road Map and Action Plan addresses the key question: what road map should

we choose and what are measurable milestones that suggesting progress? The idea is to

select the strategy and formulate action plans that guide the implementation of the

strategy.

Phase 1 resulted in the Assessment Report, aimed at understanding the current situation of the

agricultural sector and to explaining the sector trends and constraints since the founding of the

APP. The understanding of the current situation is the basis for undertaking subsequent phases

of the ADS preparation; namely its vision, policy options, action plans and road map. The

assessment is the result of a number of consultations at the central and local level, review of the

literature, and data analysis conducted by the TA Team over the period April to September

2011. Consultations included: 2 Steering Committee meetings, 5 Regional Workshops, a policy

roundtable, a strategy retreat meeting, 2 National Workshops, 9 Thematic Group meetings, 4

field-level thematic consultations concerning irrigation issues, 3 focus groups discussions with

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marginalized groups, and hundreds of key informant interviews with government agencies,

NGOs, private sector, farmers, researchers, development partners, project staff, trade

associations, financial institutions, scientists, educators, and communities.

Phase 2 gave way to a Vision Statement and Report. Additionally, numerous consultations at

the local and central-level identified a vision for agriculture in Nepal summarized as: A competitive, sustainable and inclusive agricultural sector that

contributes to economic growth, improved livelihoods, and food and

nutrition security.

The Vision Report for the TA presents the vision for the agricultural sector that was used in the

formulation of the ADS. The vision presented in the report is based on a number of

consultations at the regional and national-level and summarizes the collective opinion of various

stakeholders. The formulation of the vision takes into account four lessons created through the

review of agricultural transformation processes in other countries:

1. Total Factor Productivity (TFP) growth is the main source of future agricultural growth.

2. At an early stage of development, agricultural growth is the main driver of poverty

reduction. Minimizing inequality enhances the impact of agricultural growth on poverty

reduction.

3. Integration of smallholder farmers in modern value chains is a feasible solution to the

urbanization challenge.

4. As the economy moves closer to middle income status, the development of the rural non-

farm sector becomes increasingly important in closing the gap between rural and urban

areas.

Implications for the formulation of the ADS are:

1. Acceleration of investment in Science and Technology. Investment in the Knowledge

Triangle – research, education, and extension.

2. Security of broad-based and inclusive agricultural growth. Investment in programs to

moderate social and geographic inequalities.

3. Integration of smallholder farmers with competitive value chains.

4. Promotion of rural infrastructure and rural agro-enterprises.

The vision also takes into account the following trends:

• Declining Agricultural Labor Force

• Increasing Urbanization

• Changing Diet

• Globalization and Trade

• Outmigration

• Green Technology and Low Carbon Emissions

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• Diversification

• Modernization of Distribution Systems

• Increasing Importance of Quality and Safety Standards

• Rising Cost of Energy

• Impact of Climate Change

• Degradation of Natural Resources

• Pressure for Fiscal Discipline

The overall impacts of the ADS consist of five dimensions: increased food and nutrition security,

poverty reduction, agricultural trade surplus, higher and more equitable income of rural

households, and strengthened farmers’ rights. Furthermore, the ADS has four main outcomes:

• Outcome 1: Improved governance

• Outcome 2: Higher productivity

• Outcome 3: Profitable commercialization

• Outcome 4: Increased competitiveness

The ADS will accelerate agricultural sector growth through four strategic components related to

governance, productivity, profitable commercialization, and competitiveness while promoting

inclusiveness (both social and geographic), sustainability (both natural resources and

economic), development of private sector and cooperative sector, and connectivity to market

infrastructure (e.g. agricultural roads, collection centers, packing houses, market centers),

information infrastructure and ICT, and power infrastructure (e.g. rural electrification, renewable

and alternative energy sources). The acceleration of inclusive, sustainable, multi-sector, and

connectivity-based growth is expected to increase or improve the following: food and nutrition

security, poverty reduction, agricultural trade surplus, higher and more equitable income of rural

households, and farmers’ rights.

Coordination: The ADS proposes new mechanisms to improve its implementation and its

proposed mechanisms aim to support, complement, strengthen and build on existing

mechanisms. In addition to the NPC, MOAD and other related agencies, the ADS

implementation relies on the combination of four new institutions, prioritized national programs,

and key stakeholders. Linkages among the existing and new mechanisms are illustrated in Figure 5. The four new institutions include: the National ADS Coordination Committee

(NADSCC), the National ADS Implementation Committee (NADSIC), the ADS Implementation

Support Unit (ADSISU), and the ADS Implementation Support Trust Fund (ATF). The National

ADS Coordination Committee (NADSCC) is the national coordination committee of line

agencies under the chairmanship of Vice Chairman (VC) of the NPC. NADSCC will be

strengthened through secretariat service provided by the ADS Implementation Support Unit

(ADSISU) and will be enhanced with the establishment of the following NADSCC sub-committees charged with improving the coordination of ADS relevant issues (Figure 4).

44

Figure 4:The ADS Implementation and Coordination Mechanisms (ADS 2013)

III. Food and Nutrition Security Plan of Action (2013)

Responsible Body: The implementation of the Food and Nutrition Plan of Action (FNSP) will be

the responsibility of devolved local government and will require coordination by different line

Ministries and Departments/ Corporations. The National Nutrition and Food Security Steering

Committee (NNFSSC) under the lead of National Planning Commission (NPC) is responsible for

coordinating all food security and nutrition issues at national-level with participation from all

relevant line ministries. The Ministry of Agricultural Development (MoAD) is responsible for the

delivery of agricultural production technology, food technology, and SPS issues. The Ministry of

Supplies and Nepal Food Corporation (NFC) are responsible for delivery of food grains with

transport subsidy to remote areas. The Ministry of Health and Populations is responsible for

nutritional support programmes. Lastly, the Ministry of Local Development is responsible for

Food for Work.

Objectives: To reduce hunger and poverty by improving sustainable agricultural-based

livelihoods. The plan establishes the poverty reduction target at 7% (from current 15%). Also, it

targets Nepal’s 958,000 poorest households for the purpose of enhancing the assets and

productivity associated with agricultural livelihoods among this marginalized population.

History: Prior to this FNSP, there was a national FNS programme included in the NPC’s three-

year plan (2010/11 to 2012/13). In order to ensure that nutrition and food security was a part of

the ADS, the GoN in coordinated with the FAO in the preparation of a 10-year Food and

Nutrition Security Action Plan (FNSP). The team responsible for the preparation of the FNSAP

also coordinated with the team preparing the ADS. The GoN and FAO agreed that the FNSAP

45

Team would submit their reports to the ADS TA Team Leader to ensure consistency between

the two efforts. Ultimately, the FNSAP will become an entity of the ADS.

The Plan: The GoN, with technical support from FAO, formulated the FNSP, serving as a

chapter in the ADS for the decade of 2013-23. Also, the FNSP complements the MSNP and

complies with the National Planning Commission’s (NPC) Three Year Interim Plan (2007-/10),

its Three Year Plan (2010-13), the Ministry of Health and Population’s National Nutrition Policy

and Strategy (2004), and the Health Sector Strategy. The FNSP is intended to serve as the

Governments’ standard document for food security interventions during 2013-22 and is

specifically geared towards the country’s vulnerable populations. There are 9 components to the

FSNP plan:

• Component 1: Agriculture Crops - The main objective of this component is to improve

production and productivity of the main food crops per unit of land, which is the main

constraint in elevating levels of household food security. More specifically the

component intends to: (1) Increase food grain crop yields mainly through double

cropping and improved seeds and other inputs; (2) deliver improved extension and

research services through public-private partnerships; (3) focus on producer groups at

the VDC level; (4) Improve and expand small-scale irrigation.

• Component 2: Fisheries - The main objective of the fisheries component is to improve

both the income and nutrition status of extremely poor households by improving the

production, productivity and post harvest management of aquaculture. More specifically,

the component intends to: (1) introduce improved aquaculture technologies adapted to

different regions and socio-economic groups; (2) increase choice of fish species; (3)

improve carp genetics; (4) improve access to quality fish seed; (5) improve feeding

management for carp and trout; (6) reduce cost of trout feed; (7) improve fish disease

control; (8) improve quality and reach of fishery extension services supported by better

fishery research and district level participation, respectively.

• Component 3: Food Quality and Safety- The main objective of the component is to

ensure food safety in production and consumption in Nepal. More specifically, the

component intends to (1) protect consumers against various kinds of hazards present in

foods, require new laboratories, equip a regulatory agency, and require a diet survey

and database; (2) ensure a preventive or pro-active food quality and safety management

system throughout the entire food chain—requiring a GAP scheme for producers, codes

of practice (GMP, GHP, HACCP) for processors and traders, development of an

inspectorate, and a database; (3) promote agro-food trade by establishing an efficient

and effective food control system, requiring a strengthened inspectorate, a new

laboratory system and updated legislation/regulations.

• Component 4: Forestry- The main objective of the forestry component is to develop

alternative livelihoods for some of the poorest and food insecure households living near

forested areas. More specifically, the component intends to: (1) facilitate the cultivation

and processing of high-value medicinal plants and wild food crops in forest areas, (e.g.

pineapple, ginger, lapsi, chiuri, jackfruit, and fodder crops for livestock); (2) introduce

sustainable agricultural practices such as conservation agriculture, water harvesting for

46

vegetable production, wetland management for aquatic products, and agro-forestry; and

(3) introduce sustainable development practices in the forest buffer zones, where 30%-

50% of revenue from protected areas must, by law, be used for development.

• Component 5: Gender Equity and Social Inclusion- The main objective of the

component is to ensure that the FNSP and other similar programmes predominantly

benefit marginalized groups, including women, elderly, ethnic minorities and other

groups in target areas.

• Component 6. Horticulture- The main objectives of this component are to increase the

availability of diverse and nutritious food at the household level, in addition to domestic

consumption and marketing. The component is expected to improve household nutrition

and income through the year-round production of fruits and vegetables.

• Component 7: Human Nutrition- The main objectives of this component is to: (1)

Increase knowledge and practices regarding the nutritional value and use of locally

available food groups at the household-level; (2) Increase consumption of the locally

available diversified food commodities; and (3) Improve food consumption behavior in

line with FBDGs and develop social and media marketing focusing on locally available

foods at the household-level.

• Component 8: Legislation- The main objectives of the component are to ensure that

right-to-food approaches are mainstreamed and gender, age, caste and other forms of

discrimination are minimized. To achieve this, the following elements need to be

addressed: (1) comprehensive policy and legislation on right-to-food; (2) the human-

rights perspective in existing policies and legislation; (3) strong application of existing

laws including those that make discrimination in society illegal; (4) strengthened

institutional framework; (5) legal preparedness to cope with the liberalization of the

agriculture sector; (6) legal and regulatory terms for the vulnerability of marginal groups

to food and nutrition security, including an emergency coping mechanism; and (7)

ineffective food safety regulations.

• Component 9: Animal Health and Production - The main objectives of this component is

to increase the availability and consumption and income from animal production,

productivity and reduce mortality by providing capacity building and inputs in animal

husbandry, developing value chain, from grass to dairy, and health coverage through

village level private para-veterinarians in selected districts.

Coordination: At national-level, the National Food and Nutrition Security Steering Committee

(FNSSP) will coordinate the FNSP under the auspices of the National Planning Commission

(NPC). In the past, the FNSP formulation process made strong arguments to combine food

security and nutrition under one steering committee at the national-level. The Ministry of

Agriculture and Cooperatives (MOAD) will implement the FNSP through its central and

decentralized offices in target districts with the help and corroboration of other sectors such as

the Ministries of Forestry, Fishery, Livestock and Local Development. Currently, no additional

and/or parallel organizations are envisaged for the FNSP implementation and coordination.

Finally, existing government institutions shall be strengthened, where necessary, to implement

the FNSP.

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Furthermore, the FNSP proposes that the GoN modify the organizational structures in some of

its Ministries, Departments and Corporations, and assign additional mandates to perform the following functions of FNSP (Figure 6):

1. MoAD’s food security information cell will be upgraded into the “Food and Nutrition

Security Division”;

2. Department of Food Technology and Quality Control will be upgraded as the “Department

of Foods”, and its National Nutrition Programme will be upgraded, among others to the

“Nutrition Division” and the “Food Safety Division”;

3. Nepal Food Corporation will be transformed into the “Nepal Food Agency” and instilled

with new mandates to cater to the Right-to-Food;

4. Department of Health Services will have a ‘Medical Research Directorate’ on activities

relating to the Recommended Dietary Allowance and Nutritional Epidemiology, FBDGs,

and so on;

5. MLD/ MDG Section will include a “People’s Right-to-Food Cell”;

6. Local governments will make a community-level “Food and Nutrition Security Steering

Committee” that are comprised of the following: (i) Government: VDC Chair: President, (ii)

Line agency: Agriculture, Livestock, Health, Rangers/ Foresters, VDC: Secretary, and (iii)

Community Organisations.

Figure 6: Recommended New Structure for Implementation of FNSP (FNSP 2013)

Department of Foods

Food Safety Division Nutrition Division National Food

LaboratoryTechnology and Training Division

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5.1.2 SECONDARY POLICIES

I. Nepal Interim Constitution 2007

The term “Food Sovereignty” was included in the Nepal Interim Constitution in three different

sections of the document, under different rights and responsibilities:

• Article 18 (3): Right regarding Employment and Social Security

Every citizen shall have the right to food sovereignty as provided for in the law.

• Article 33: Responsibilities of the State:

(h) To pursue a policy of establishing the rights of all citizens to education, health,

housing, employment and food sovereignty.

• Article 35: State Policies:

(10) The State shall pursue a policy which will help to promote the interest of the

marginalized communities and the peasants and laborers living below poverty line,

including economically and socially backward indigenous tribes, Madhesis, Dalits, by

making reservation for a certain period of time with regard to education, health, housing,

food sovereignty and employment.

II. National Planning Commission Three-Year Plan 2013

The NPC drafted their 2013 three-year plan that will guide Nepal’s development into the post

2015 era. The consultant was not able to secure a copy of the plan for the purposes of this

report, however, in-country stakeholders shared that the report will have food and nutrition

security as a major objective. The plan also outlines that its larger focus is on economic growth:

a reduction in the population who are poor from 23.8% to 18% by 2016 with an average annual

growth rate of 6%.

III. NARC’s Strategic Vision for Agriculture Research 2011

The Nepal Agricultural Research Council (NARC) was created in 1991 as an autonomous

research body that informs policymaking, and coordinates and implements agriculture research

in the country. The NARC currently implements more than 400 projects annually (Sivley et al).

The NARC’s strategic vision paper includes “nutrition” as part of food security in its title alone:

Meeting Nepal's Food and Nutrition Security Goals through Agricultural Science & Technology.

The vision of the NARC is to tap institutional, human, and financial resources from the

government and a wider spectrum of stakeholders—civil society, research centers, donors, and

ultimately the private sector—to move the system from agricultural research and development to

agricultural research for development.

NARC recognizes the importance of maintaining proper conservation and management of

natural resources in conjunction with sustainable agricultural production, equitable distribution,

increased employment opportunities, increased quality of food products, and reduced

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vulnerability of disadvantaged population (children, old, occupational caste, women,

marginalized tribes, and people living in inaccessible areas). Within NARC’s researcher

portfolio, the focus is on livestock and fishery nutrition, not human nutrition, however, by

improving fisheries and livestock health, nutrition outcomes can also be gained for humans,

although indirectly. The research work on horticulture, natural resource management and

climate change also have downstream impacts on nutritional status of vulnerable populations.

IV. Nepal Biodiversity Strategy 2002

The Nepal Biodiversity Strategy (NBS) focuses on the protection, equitable sharing and

responsible use of Nepal’s biologically diverse resources, and ecological processes and

systems on a sustainable basis. This strategy is aimed at benefiting all Nepalese people and

honoring obligations under the Convention on Biological Diversity. Nepal is often considered a

hub of biodiversity. In turn, this diversity is linked to the livelihoods and economic development

of the country and its population, in addition to the agricultural productivity and sustainability,

human health and nutrition, indigenous knowledge, gender equality, building materials, water

resources, and the aesthetic and cultural well being of its society (NBS 2002).

Nepal has a wealth of non-timber forest products (NTFPs) due to its diverse ecosystem. NTFPs

are harvested not only from forests, but also pasturelands, grasslands, and fallow ground. For

marginalized farmers, the diversity of the non-farm environment has utility not only in timber for

building, bedding, and fodder for livestock, but also valuable nutritional, medicinal, economic,

religious and cultural purposes (NBS 2002). Therefore, the exploitation of wild plants is common

in economically poor areas because they are used to buffer periods of food scarcity. The main

components of NTFP programmes include: (a) immediate measures to solve problems

regarding collection, marketing, and related concerns, (b) cultivation of medicinal and aromatic

plants and other selected NTFPs, and (c) development of industries based on medicinal and

aromatic plants and other NTFPs (NBS 2002). The strategy components are directly relevant to

the nutrition and health of Nepalese communities that are dependent on these products.

V. Nepal Environment Management Framework 2012

The Environmental Management Framework (EMF) was created for the Nepal Agriculture and

Food Security Project (NAFSP), a project funded by the World Bank and other non-bank

sources. The EMF consists of environmental screening guidelines, environmental assessment

guidelines, a sample sub-project level Environmental Management Programme, institutional

arrangements for the implementation of the EMF, a project-level environmental monitoring

framework, a capacity strengthening plan, a consultation framework, and an environmental code

of practices.

The NAFSP aims to improve the current food security situation of poor and marginalized groups

in Nepal by increasing agricultural production, livelihood options, household income and

improving the utilization of food. The project has four main components: 1) technology

development and adaptation; 2) technology dissemination and adoption; 3) food security and

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livelihood enhancement; and 4) nutritional status enhancement.

The purpose of the nutritional status enhancement component is to improve nutritional status of

targeted beneficiaries through provision of dietary support, increased supply of nutritious foods,

and the promotion of appropriate nutrition, health, and hygiene practices. The target group is

comprised of pregnant and breast-feeding women, children under two years and adolescent

girls. The activities include: food quality regulation and a pilot on social transfers for pregnant

women in food insecure areas; community based education programme for improving nutrition,

health, and hygiene; increasing production diversification (e.g. kitchen gardens and small

livestock rearing); improving home preparation and preservation of food; improving feeding and

caring practices for pregnant/nursing women and 0-24 months old children; improving

micronutrient intakes during Critical Life-Stages; and promoting “Women-friendly” Household

Investments and Practices such as treadle pumps, improved cooking stoves, and bioga plants

(EMF 2012).

VI. National School Health and Nutrition Strategy 2006

The goal of the School Health and Nutrition Programme (SHNP) is to develop physical, mental,

emotional and educational skills of school children. There are four strategic objectives to the

strategy. They are to:

• Improve use of school health nutrition (SHN) services by school children;

• Improve health in the school environment;

• Improve health and nutrition behaviors and habits; and

• Improve and strengthen community support system and policy environment

Of the nutrition and food-based activities, the SNHP proposes micronutrient supplementation

(e.g. iron and vitamin A) and incorporation of a midday meal as part of the school meal

approach. The World Food Programme (WFP) is the largest supporter of the school-feeding

programme. The skill-based health education specifically teaches nutrition education with

lessons on a dietary guidelines based on the local context. Lastly, kitchen gardens are

encouraged and promoted to enhance nutrition knowledge and skills.

VII. Nutrition-relevant legislation on flour fortification 2011

The GoN has adopted two-pronged strategies with respect to flour fortification: fortification at

large-scale roller mills and fortification at smaller mills. As of 2011, the GoN made flour

fortification mandatory in the country. All flour processed at large-scale roller mills must contain

iron, folic acid and vitamin A. The Micronutrient Initiative was assisting the GoN and roller mills

in implementing voluntary fortification measures for several years. As the large mills

satisfactorily carried out voluntary fortification, the government decided to extend the project to

enforce fortification of flour from small roller mills. It is assumed that mandatory legislation will

increase the sustainability of the fortification program and ensure a level playing field for all

roller mills in the country (MI 2013). To ensure the effective implementation of flour fortification,

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monitoring and supervision is carried out at the mills, in addition to occasional random testing of flour. Other major ongoing programmes linking nutrition and agriculture are listed in Annex 4.

VIII. National Nutrition Policy and Strategy 2004

Prior to the Multi-Sectoral Nutrition Plan, Nepal had the National Nutrition Policy and Strategy

from 2004. This strategy focused on the government actions that were predominantly led by the

MoHP to address the overall malnutrition situation for Nepal. The strategy consisted of 13

strategic nutrition approaches, some that were already implemented by the nutrition sector and

others not yet implemented. The program consisted of both short and long-term objectives. The

short-term objectives were to focus on Protein-energy Malnutrition, Iron Deficiency Anemia,

Iodine Deficiency Disorder, Vitamin A Deficiency, Intestinal Worm infestation, Low Birth Weight,

Infectious Diseases and Nutrition in Exceptionally Difficult Circumstances. Those that were

considered long-term objectives were those focusing on Household Food Security, Dietary

Habit, Life-style Related Diseases and School Health and Nutrition. These longer-term

objectives required that other sectors, such as Agriculture and Education come to the table to

deliver. The 2009 Nutrition Assessment Gap Analysis (NAGA) reviewed the strategy and its

impact on nutrition outcomes. One suggestion from the NAGA was to reinvigorate nutrition

throughout the country and ensure that a more multi-sectoral approach was taken for the next

strategy. The NAGA outlined the key recommendations to step up progress on nutrition within

the country, with a call to establish the national nutrition architecture and to mobilise all the key

sectors to tackle the high prevailing rates of malnutrition in a sustained manner through a multi-

sector approach.

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5.2 ANALYSIS OF THE NUTRITION-SENSITIVITY OF THE POLICIES AND FRAMEWORKS

5.2.1 ANALYSIS OF THE MAJOR FOOD AND AGRICULTURE POLICIES AND PLANS

Based on the guiding principles for nutrition sensitive agriculture programmes and policies, a

qualitative assessment was done on Nepal’s three major food and nutrition security policies and plans. As shown in Table 1, the three policies were assessed to determine if the agriculture

investments positively impact nutrition. As shown in Table 2, the three policies were assessed

based on whether or not they support food security and nutrition.

Table 1: Nutrition Sensitive Guiding Principles on Investments

GUIDING PRINCIPLES POLICY

Agricultural programmes and investments can strengthen impact on nutrition if they:

MSNP ADS FNSP 1. Incorporate explicit nutrition objectives and indicators into their design, and track and mitigate potential harms, while seeking synergies with economic, social and environmental objectives. PARTIALLY YES PARTIALLY

2. Assess the context at the local level, to design appropriate activities to address the types and causes of malnutrition. PARTIALLY PARTIALLY NO

3. Target the vulnerable and improve equity through participation, access to resources, and decent employment. YES YES YES

4. Collaborate and coordinate with other sectors (health, environment, social protection, labor, water and sanitation, education, energy) and programmes, through joint strategies with common goals, to address concurrently the multiple underlying causes of malnutrition. YES YES YES

5. Maintain or improve the natural resource base (water, soil, air, climate, biodiversity), critical to the livelihoods and resilience of vulnerable farmers and to sustainable food and nutrition security for all. NO YES YES

6. Empower women by ensuring access to productive resources, income opportunities, extension services and information, credit, labor and timesaving technologies (including energy and water services), and supporting their voice in household and farming decisions. YES YES YES

7. Facilitate production diversification, and increase production of nutrient-dense crops and small-scale livestock YES YES YES

8. Improve processing, storage and preservation to retain nutritional value, shelf life, and food safety, to reduce seasonality of food insecurity and post-harvest losses, and to make healthy foods convenient to prepare. NO YES PARTIALLY

9. Expand markets and market access for vulnerable groups, particularly for marketing nutritious foods or products vulnerable groups have a comparative advantage in producing. NO PARTIALLY PARTIALLY

10. Incorporate nutrition promotion and education around food and sustainable food systems that builds on existing local knowledge, attitudes and practices. YES YES YES

Table 2: Nutrition Sensitive Guiding Principles of Policies

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GUIDING PRINCIPLES POLICY

Food and Agriculture Policies can support food security and nutrition if they:

MSNP ADS FNSP

1. Increase incentives (and decrease disincentives) for availability, access, and consumption of diverse, nutritious and safe foods through environmentally sustainable production, trade, and distribution. NO PARTIALLY PARTIALLY

2. Monitor dietary consumption and access to safe, diverse, and nutritious foods. YES NO NO

3. Include measures that protect and empower the poor and women. YES YES YES

4. Build capacity in human resources and institutions to improve nutrition through the food and agriculture sector, supported with adequate financing. YES YES YES

The GoN’s commitment to improving food and nutrition security is very strong. Although there

are current and future challenges for Nepal as it develops, its progress, strategies, government

structures, and overall strong multi-sectoral commitments towards improving nutrition cannot be

understated. Harmonization of these plans will be the next phase as Nepal scales food and

nutrition security efforts to ensure that what is on paper can meet the expectations of practical

implementation.

During interviews with stakeholders, the NPC outlined four major challenges in harmonizing

these plans:

1. Coordination of ministries;

2. Allocation and managing of resources;

3. Enhancing capacity; and

4. Sustainability issues once overseas development assistance ends.

I. Multi-sectoral Nutrition Plan (MSNP)

The MSNP is a strong plan that involves many sectors working together to positively affect the

main drivers that shape the country’s nutrition landscape. At the national level, many

stakeholders expressed the importance of this MSNP and commitment to ensuring its success.

From Table 1 and 2, it is clear that the MSNP lacks some of the important nutrition and

agriculture principles to be considered a true nutrition sensitive agricultural plan. Of all three

primary plans, the MSNP may have the weakest linkages with agriculture.

The Planned Results

The agriculture sector is responsible for Result 6 in the MSNP and must improve the availability

and consumption of appropriate foods (in terms of quality, quantity, frequency and safety), and

reduce women’s workloads.

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This output intends to increase consumption of diversified foods, especially animal

source foods, particularly among pregnant women, adolescent girls, and young children.

This will be achieved by increasing production of micronutrient (MN) rich foods, including

strengthening of the food supply and a distribution system to ensure food security

particularly among poor smallholder farm families in the food deficit areas. It also aims to

initiate infant breastfeeding within the first hour, exclusive breastfeeding for six months,

timely introduction of appropriate complementary foods at six months, and the

recommended minimum acceptable diet from six to 23 months of age. Changes in the

percentage of children receiving immunization and micronutrient supplements as per the

nationally recommended schedules are intended. Agriculture and development,

environment, federal affairs and local development sectors will be responsible for

achieving this result and implementing activities (MSNP 2012).

The activities within Result 6 remain questionable in their ability to improve nutrition status. They

are to:

6.1.Provide targeted support to make MN rich foods available, including animal source

foods, at households and community levels.

6.2 Recipe development and promotion of MN rich minor/indigenous crops.

6.3 Link-up programmes to increase income and consumption of MN rich foods among

adolescent girls, pregnant and lactating mothers and children less than 2 years of age

from the lowest consumption quintile.

6.4 Provide support for clean and cheap energy to reduce the workload of women.

6.5 Revise existing child cash grants mechanism (from pregnancy to children under two

years old) based on review of the existing evidence to reduce maternal malnutrition

and child stunting.

Activity 6.2, developing and promoting recipes, is an activity that remains inconclusive on

whether it can improve dietary diversity and nutritional outcomes. One question that remains is

whether recipe development is an effective Behavior Change communication tool to alter dietary

behavior, and can it be effective in improving the micronutrient status and nutrition outcomes in

children? Activity 6.3 targets adolescent girls. This is an underserved and key population to

target in effort to break the cycle of malnutrition, however, it is unknown how to most effectively

reach this group. Lastly, activity 6.5 is a review of evidence. For a plan of this scale, evidence-

based activities should be proposed as opposed to unproven ideas that require more research

to evaluate their efficacy.

Stakeholders expressed concern that the MSNP is still very health-driven and there is not

enough “food based approaches” included in the plan. The FSNP can potentially fill this gap.

Overlapping Objectives and Multi-Sectoralism

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The MSNP’s agriculture and environment activities are redundant to those in the FNSP. Will

efforts be done in duplication for both plans? Collaboration among the originators of both plans

is lacking, potentially causing confusion with funding lines on the district level. Less redundancy

between the two the plans and better coordination would optimize the use of funds and make

overall programming more efficient.

Some of the results and objectives proposed in the MSNP are delegated to a single sector but it

may be beneficial to engage multiple ministries to share in the responsibility for executing the

activities. For example, infant and young child feeding is relegated to the Ministry of Health and

Population, but the food elements of IYCF fall squarely on the Ministry of Agriculture. Food

fortification further illustrates this concept in that the MoHP is solely responsible for fortification

however; the food safety and quality elements of the objective should also be coordinated with

the Food Technology division in the MoAD. The MSNP is “thinking multi-sectorally, acting

sectorally” (World Bank 2013) however, objectives and activities of the plan may be more

effective if done in partnership among multiple sectors. Some stakeholders argued that the plan

does not provide enough detail and suggested that each sector provide their own sectoral plan

that they will implement for the MSNP.

Furthermore, some of the objectives will be relevant for specific regions and agro-ecosystems of

the country and others will not. There is substantive regional heterogeneity in Nepal, and a one-

size-fits-all approach is not appropriate for all regions and income groups. “Any strategy has to

be fine tuned to the local conditions, and in this local governments have to play a more active

role in promoting local economic development for which efforts must be made to ensure

effective participation of the local governments”(IFPRI/IIDS/USAID, 2010pg 92). Although

district planning will take place, it remains unclear how pliable these objectives are in their

localization.

Monitoring and Evaluation Framework and Data Management

When examining the monitoring and evaluation framework, some indicators, particularly

involving food, are vague and unable to be measured. In Results 6, the following indicators are

proposed:

1. Increased consumption of diversified food, especially animal products among pregnant

women and adolescent girls through increased production of these foods;

2. Food supply and distribution system strengthened – food security ensured particularly in

food deficit areas;

3. Percent of infants initiated with breastfeeding within the first hour and exclusively

breastfed for six months;

4. Percent of children receiving immunization and micronutrient supplements as per the

recommended schedule; and

5. Reduction in consumption of “junk food” by pregnant mothers, children and adolescent

girls.

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Indicator 1: It is unclear how consumption will be measured. If using the dietary diversity score,

it is important for Nepal to set targets and understand the baseline score for dietary diversity in

the country. Stakeholders indicated that there is a dearth of available consumption data in the

country, thus, it is important for Nepal to quickly determine the required data in order to capture

the level of diet diversity. Indicator 2: Measuring the “strength” of the food supply and

distribution system. Indicator 3 and 4: It is unclear why these indicators included in this section.

Indicator 5: Reducing “junk food” is an interesting indicator to include, as there is growing

concern of the role of industry and the nutrition transition in Nepal. However, it is unclear how

this result can be measured and from what data source it may be obtained. The MSNP indicates that baseline data will be collected in all 75 districts. However, obtaining

this data will consume substantive time as part of a 5-year plan. Some stakeholders indicated

that NGOs working in districts and larger scale programmes (such as those listed in Annex 6)

would serve as key contributors to this baseline data collection. If this is the case, it is

imperative that the GoN to coordinates what type of data is being collected and how it is

collected in order to avoid redundancy and scattered data collection systems and measures.

This would of course move away from a unified framework for the MSNP. This also brings into

question the brevity of the plan. The plan is to scale up to all of Nepal’s 75 districts in a phased

response. To ensure baseline data collection, district planning and sustainable capacity

development, the plan’s five-year time frame may be too short.

It may be useful to have the MSNP has a “living” or rolling document, as the ADS is. As plans

change and M&E frameworks are better tailored and honed, there is room to make adjustments.

Budget and Investments

The programmatic budget earmarked for delivering interventions is distinct for the MoHP and

the MoAD. For nutrition specific activities, the budget is NR 4,643,786 over the five years

whereas for the agriculture-related nutrition sensitive activities, the budget is NR 672,500 over

five years (USD 1 = NRs. 73.00). Both are quite low in budgetary terms, however, the

investments to MoAD are low and perhaps unrealistic to deliver the activities proposed under

Result 6. Also, the budget reflects some stakeholders’ concerns in that the MoHP will dominate

the activities in the MSNP. The relative weight not only in budgetary terms but also in work is a

sound indicator of collaborative multi-sectoralism.

Agriculture’s Role

It is clear that in the MSNP, agriculture is under utilized and many stakeholders felt that

agriculture has a bigger role to play. Some expressed that the there were no real new activities

proposed by the MoAD then what was already being done in the country. There was less

emphasis on consumption and utilization activities of food security, very little on indigenous

food’s role in improving nutrition, and no integration of the role of food technology in improving

infant and young child feeding practices through nutrient-dense complementary foods. Lastly,

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more work can be done to ensure that Nepal has new food-based dietary guidelines and the

introduction of a food labeling system. The MSNP has a role to play in these types of activities.

II. Agriculture Development Strategy (ADS)

The ADS is a strong 20-year strategy with a complementary 10-year action plan and roadmap. It

is expected that agricultural growth will double from 3 to 6%, and there is hope that the ADS will

make significant contributions to food and nutrition security through improved governance,

increased productivity and competitiveness and profitability through commercialization. With the

FNSP as a complement, the proposal provides a robust, nutrition sensitive approach to

development over the next 20 years.

Commercialization

Commercialization of agricultural production is one of the major elements of the ADS with a

project growth from 50%currently to 80% of total production. It is unclear what this will mean for

subsistence farmers, geographically remote farmers and the landless—as they will not reap any

direct benefits from this component of the ADS. The landless and subsistence farmers, often

women, are often the most vulnerable to food and nutrition insecurity. It is hoped that these

groups will benefit through other channels such as the Markets for the Poor and the Community

Agriculture Extension Service Centers; however, it is unclear how these programs will ultimately

improve nutrition outcomes. Many stakeholders in the country were concerned that the focus on

commercialization in the ADS will create more of a disparity gap for subsistence farmers. The

FNSP will help reach vulnerable populations, however the sustainability of this approach is

unknown. Some stakeholders expressed concern about how extension and social protection

services will function and coordinate their activities with the ADS.

Value Chains

Rice is the dominant and preferred staple in Nepal, but when the ADS ranked the top value

chain items, rice only sits at #6. Surprisingly, other nutrient-rich crops and foods rank higher

than rice. Maize ranks #1 followed by dairy, vegetables (unclear what type), tea, lentils, rice,

goat, poultry, potato, wheat, spices, coffee, and finally oilseeds. Hopefully, minor crops such as

millets and nutrient-rich vegetables are promoted to address economic gains as well as nutrition

benefits.

Impact

Stunting is considered one of the major impact indicators in the ADS and its long-term targets

are aligned with the MSNP. This is alignment is promising, however, it remains debatable

whether or not stunting is considered an appropriate impact target for agriculture interventions.

Perhaps, more focus on dietary and consumption indicators are more feasible and appropriate

for food-based interventions.

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Know your local agro-ecosystem

The ADS and the FNSP would benefit from more rigorous mapping of niche agro-ecosystem

analysis of the country. This mapping would help inform what types of nutritious crops can be

grown where and what type of local biodiversity is available that can be utilized in a sustainable

way. By understanding these ecological niches, better decision-making can be done on cost-

benefit, and risk assessments.

Budget and investments

It is highly commendable that Nepal drafted such a forward thinking agriculture strategy, but it

may be too ambitious for a country very small investments/ inputs in agriculture. It is assumed

that the majority of the budget will come from government and donors. However, the size of the

investment needed to carry out the strategy is unclear. Currently, Nepal’s agriculture sector is at

a low stage of development with slow growth and poor investments. Furthermore, the recently

published national budget for 2014 shows increases to the agriculture budget but still falls short

of other ministry budgets such as health and education. Thus, although the budget has

improved, it is inconclusive how investments can be sustained over the strategy’s 20 years

considering it has a less than optimal performance record.

Self Sufficiency versus Food and Nutrition Security

ADS Assessment Report (2012) indicated that there are at least two aspects related to food and

nutrition security (FNS) that need to be highlighted in the context of the ADS.

First, although FNS is a different concept from Food Self Sufficiency, there is a large part

of stakeholders in Nepal who interpret the objective of FNS as increasing food grains

production to achieve self-sufficiency. From this point of view, whether self-sufficiency in

food grains is economically desirable and efficient is not a major consideration; food

security is narrowly interpreted as food availability and food availability is interpreted as

food grain production at a higher level than population requirements. The additional

question of whether food self sufficiency ensures nutritional security or not is often

neglected, in spite of evidence in Nepal and other countries that food self-sufficiency and

even food surpluses can occur even in the midst of persistent food poverty, malnutrition,

and food vulnerability.

Second, food security is often identified with calorie intake rather than a balanced diet of

nutritious food. From a long-term perspective (20 years) the diet in Nepal is expected to

change, certainly among the upper quintiles of the population, towards a lower

consumption of staples and more diversified consumption of fruit and vegetables, meat

and fish products, and dairy products. The strategic implications of this for ADS are

crucial, and highlight the issue of the extent to which research and extension work and

overall agricultural investment should primarily be directed to food grains as in the past,

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or to other commodities.

This issue remains critical for Nepal. It will be important for the work stemming from the ADS to

expand its commodity focus in order to train extension agents on dietary and nutrition messages

and skills to better access and utilize nutritious foods— beyond just ensuring the cultivation and

availability of nutrient-rich crops.

III. Food and Nutrition Security Plan of Action (FNSP)

The FNSP fills in the gaps left by the ADS. The 5-year plan focuses much more on the

vulnerable, resource-poor households in Nepal. The 9 components are focused mainly on food

availability including agriculture crops, fisheries, forestry, horticulture, and livestock.

Nutrition as its Own Component

Nutrition objectives are to improve knowledge, increase consumption of nutritious foods and

promote behavior change. It is unclear why this is a separate component. Alternatively, it should

be weaved into the plans other eight components as a central pillar to the commodities, social

inclusion and right-to-food mandate. Placing nutrition as a standalone component as opposed to

mainstreaming and ensuring nutrition objectives are integrated into all components defeats the

purpose of the FNSP.

Coordination with MSNP

It remains unclear how the FNSP’s activities will align with the MSNP. Throughout the ADS, it is

suggested that the plan will coordinate with the MSNP. Although the objectives of the MoAD in

the MSNP overlap significantly with the objectives and activities of the FNSP, the plan does not

suggest any type of coordination with the MSNP. Will these objectives be rolled-out and scaled

separately or in collaboration with the MSNP? Will there be redundancies? Additionally, the

targets and M&E frameworks should also be aligned, which cannot be determined because the

FNSP does not include a framework.

Engaging Education

Throughout the FNSP there are education and behavior change activities that are proposed, but

there is little mention of the Ministry of Education’s involvement in the plan. This is a lost

opportunity. Without engaging the education sector, it is unrealistic to rely exclusively on

extension services to provide and transfer knowledge. The FNSP clearly states that it will

depend on the extension, particularly for the nutrition component 7. In fact, the FNSP works

solely through the ADS and states: “no additional and parallel organizations have been

envisaged for the FSNP implementation and coordination.”

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Markets and Value Chains

Of the components focusing on specific crops and foods, there are few activities emphasizing

value chains and market access. Since the FNSP only focuses on improving production, it is

unclear if the ADS will emphasize value chains, however, without the full food systems

approach from farm-to-fork and the focus on consumer demand, nutrition gains may be

inhibited. Activities within the FSNP can more explicit to ensure that technologies introduced

should be women-friendly

Fisheries

Interestingly, of the plan’s 9 components, the largest budget is granted to fisheries. Fish

consumption can have significant benefits on nutrition and health status of populations when

consumed in moderation. However, some stakeholders expressed concern that this investment

is too high considering, traditionally, Nepalese do not consume large quantities of fish. Although

this may be a new investment and promotion area for Nepal, it is also important to take into

account what will likely be consumed and what is locally appropriate for Nepal’s various regions.

Evidence-Based Indicators and an M&E Framework

The FNSP has no M&E framework, which becomes important as the plan is further developed.

M&E framework allows the opportunity to include dietary and consumption indicators as well as

evidence-based interventions and activities based on literature describing successful tools and

delivery mechanisms.

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5.2.2 ANALYSIS OF SECONDARY POLICIES

I. Food Sovereignty in the Nepal Constitution

It seems the term “Food Sovereignty” holds a rather different meaning in Nepali law than other

countries. “Food Sovereignty” is mentioned three times in the Nepali Interim Constitution (IC).

The term “Food Sovereignty” was included in the IC upon insistence from various farmer groups

and NGOs and was supported by some of Nepal’s political parties (elements in the CPN-UML

and the Maoists). The term is not defined in the IC, nor is its meaning easily deduced. The term

“Food Sovereignty” has a different generic meaning than what the strict language of the IC

would suggest. It appears that the IC refers to Food Sovereignty more as a right to food

sufficiency. To avoid including a controversial term in the IC vision statement, one could either

substitute the term “Food Sovereignty” for “Food Sufficiency”, or “Food Security” or alternatively,

attach an interpretative note to the vision statement describing the exact meaning of the term.

Since (controversial) interpretive notes are inherently disconnected from the statement itself, the

first proposal is recommended.

Some stakeholders expressed that there is no working modality on how to work on food

sovereignty issues, and that some felt this work should be led by the Social Sector, not the

MoAD.

Unfortunately the Constituent Assembly was not able to reach a consensus before the end of its

mandated time, and new elections are not expected until later this year. Therefore the issues of

right-to-food and food sovereignty as a central mandate in the Constitution will have to wait until

a formal Constitution is implemented.

II. Biodiversity and Environment Strategies

Biodiversity, indigenous foods and local food systems remain central to many organizations in

Nepal. The Biodiversity Strategy focuses on non-timber forest products and their importance in

food and nutrition security. The FNSP dedicates a component to forestry; however, it would be

more unique and beneficial to place greater emphasis on local food systems and their role in

nutrition for the three strategies. Also, ecosystem services, natural resource management and

resilience to climate risk lacked emphasis in all three proposals, particularly the MSNP. These

three elements are of critical importance to future food and nutrition security for Nepal. Perhaps,

a separate plan can be compiled analyzing how Nepal’s biodiversity, ecosystem and

environment strategies align with national food and nutrition security objectives.

III. School Health and Nutrition Strategy and Programme (SHNP)

The SHNP contains nutrition sensitive agriculture by its proposed extension of the school-

feeding programme. It also encourages kitchen gardens in schools, and improves school

policies on healthy food and nutrition behaviors. The main indicators in the SHNP appropriately

focus on the education sector, but anthropometry indicators are not tracked. The success and

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impact of this strategy, along with its subsequent programme on education objectives remain

unclear; however in theory, targeting this age group can also have influential and long-lasting

impacts on behavior and knowledge of nutrition and healthy diets.

IV. Flour Fortification Legislation

The mandatory national fortification program focuses on large-scale mills. In practice, the mills

fortify wheat flour and this is enforced by random inspections. The inspections involve on the

spot qualitative assessments and collection of samples to test for required micronutrient

content. The government is stringent on fortification indicating that if mills do not comply, they

are committing abuse of authority. However, one stakeholder involved in the fortification

programme notes that working with the private sector is challenging and more quality controls

need to be implemented. The next phase will be to work with smaller scale mills to determine

how best to fortify staple grains.

V. National Nutrition Policy and Strategy 2004

The 2009 Nutrition Assessment Gap Analysis (NAGA) reviewed the strategy and its impact on

nutrition outcomes. One suggestion from the NAGA was to reinvigorate nutrition throughout the

country and ensure that a more multi-sectoral approach was taken for the next strategy. The

NAGA outlined the key recommendations to step up progress on nutrition within the country,

with a call to establish the national nutrition architecture and to mobilise all the key sectors to

tackle the high prevailing rates of malnutrition in a sustained manner through a multi-sector

approach.

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5.3 UNINTENDED CONSEQUENCES ON NUTRITION OUTCOMES It is too early to assess the impact of these policies and plans on nutrition outcomes for Nepal. It

can be assumed that in the past, Nepal’s nutrition plans failed in many aspects. Overall, it is

safe to say that agriculture has been underfunded and not engaged in nutrition activities;

however, with new plans in place this could change. Even still, there are drivers that are beyond

the plans and policies that Nepal will inevitably face, inhibiting better nutrition (or perhaps

improving it in some cases) as Nepal continues to develop.

Remittances and Outmigration

Household income varies considerably in Nepal, with the majority of income generation coming

from agriculture. However, 2009 “official remittance” totaled US$2.7 billion, or 22% of the GDP,

excluding India remittance (GoN/NPC/CBS, 2013). The share of income from remittances

among urban households increased by 160% and by over 80% among the rural households

during the period 1995/96 to 2003/04 (IFPRI/USAID 2011). Also, up to 20% of poverty

reductions can be attributed to remittance in-flow (Loshkin et al 2007). In terms of country

distribution, remittances from within Nepal account for nearly 17%, from India 11%, from

Malaysia almost 16%, from Qatar 18% and from other countries 24%. Although India ranks

lower, it has the highest proportion of migratory workers with 26% but average remittance value

is lower (USAID/IIRI/IFPRI 2011).

Although remittances provide income, there is an increased burden on women and the

feminization of agriculture, due to out-migration of the working-age male population. However,

data shows that food security is often worse for female-headed households who do not receive

remittances, as compared to those that do. There is also an increased likelihood that she will

have undernourished children (GoN/NPC/CBS, 2013). Female-headed households that receive

some remittances have better nutritional statuses than male-headed households. The opposite

is true for households that are male-headed with a female migrant, as these households are

more likely to have undernourished children.

The wealth creation generated from remittances has a positive impact on food security. As

households escape from poverty, they also tend to escape from food insecurity (GoN/NPC/CBS,

2013). Poor households with a migrating household member are less likely to be energy

deficient and more likely to eat an adequately diverse diet (GoN/NPC/CBS, 2013; NLSS

2010/11). Almost 70% of households used remittances to cover day-to-day food consumption

costs (NLSS 2010/2011). While remittances have led to better overall Nepalese diets, the

improved food security achieved in recent years seems to be highly dependent on the

continuation of household remittance income.

Feminization of Agriculture

Nepal has experienced feminization of its agriculture sector attributable to the outmigration of

rural male laborers—a result of the country’s increasing levels of globalization and urbanization.

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Although the shift toward women as household decision-makers has some positive effects on

the health and nutrition of women and their children, the positive effects seem to be limited to

households that are also supported by remittance income. Many women from farming

households must take on the task of managing their land in addition to their already extensive

obligations at home without the support of outside income. Essentially, women that are left to

manage their farms in the absence of the family’s male(s) tend to be overburdened, leading to

poverty and poorer nutritional outcomes for both the women and their children. Not only does

the feminization of agriculture directly affect the nutritional status of rural households, it also

hampers the county’s overall agricultural potential. Therefore, policies aimed at improving

nutrition must address the lack of support for female-headed households that are not receiving

remittance income.

Rice-nation and Food Prices

The increasing popularity of rice in Nepal and other developing nations, known as “rice-nation”,

may stunt the effectiveness of nutrition-sensitive agricultural policy and strategy. The GoN has

distributed rice to its remote mountain regions since the establishment of the Nepal Food

Corporation (NFC) in 1974, which has increased the popularity and consumption of rice in these

areas (USAID, 2010). Currently, rice is considered a “wealthy” food staple in Nepal and many

Nepalese are abandoning their less expensive, more nutritionally dense traditional food items

for rice. Nepalese end up purchasing their rice because they cannot compete with the highly

subsidized improved seed from India and other foreign countries. In effect, since Nepal does not

have the comparative advantage in rice cultivation, its population pays higher prices for a food

item that has little nutritional value as compared to other locally grown staples.

Even so, the demand for rice in Nepal has dramatically increased, so the ADS aims to

commercialize the growth of rice crop. This will most likely have negative implications on

nutrition outcomes. Commercialization of rice by the ADS contradicts the FNSP objective to

diversify Nepalese diets and essentially promotes high-staple diets: a major cause of nutritional

deficiencies and diet-related illness in Nepal. In order for policy aimed at improving the food

security and nutrition situation in Nepal to be effective, the widespread preference and

consumption of rice over more diverse, locally-sourced food must be dissuaded.

In addition, high food prices and food price volatility will continue to shape Nepal’s nutritional

landscape. This formidable issue cannot necessarily be solved through domestic nutrition and

food policy. Nepalese households spend an average of 67% of their income of food and

therefore, price spikes inevitably cause poverty, food insecurity and poor nutritional outcomes.

For instance, in the food price crisis in 2008, 12% of households in Nepal reported skipping food

for a day. When food prices soar, the most common coping strategies for Nepalese include:

consuming less preferred foods (67%), consuming smaller portions (29%), spending less on

non-food items (26%), and spending less on food and borrowing money for food (14%) (ADS

2013). Since poverty, food insecurity and nutrition are so closely intertwined; high food prices

that push households below the poverty line will cause poor nutrition outcomes despite the

implementation of nutrition-sensitive policies and/or plans.

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Processed Foods and the Nutrition Transition

As income levels in Nepal rise, dietary preferences shift towards high-value items such as meat,

fruits, vegetables and processed foods. Although processed foods are considered a luxury in

developing countries facing the early stages of nutrition transition, these foods are often high in

sodium, fat and calories and low in micronutrients and protein. As the popularity of processed

foods increases in Nepal due to their convenience and novelty, it is likely that we will see a

gradual shift toward chronic and degenerative diseases associated with dietary excess, in

addition to already pervasive diseases associated with dietary deficiency (hidden hunger).

Furthermore, processed foods tend to cost less which means that Nepalese will spend their

income on these nutritionally “empty” foods instead of more natural nutrient-dense foods. Along

with this nutrition transition, there is an increased loss of biodiversity as urbanization spreads,

and there is less desire to consume “local” or indigenous foods.

Roads and Equitable Distribution of Food

There are populations in Nepal that are very hard to reach, particularly in the mountain and rural

hill regions. Due to the lack of roads and affordable transportation in these remote areas, they

are often reliant on food aid and assistance from the government to help meet their dietary

requirements. Without rural road development to improve market linkages and overall access to

food, remote areas will suffer poor nutrition outcomes irrespective of national food availability.

Not only does equitable distribution of food depend on rural roads and infrastructure, there is a

cultural aspect to food distribution within individual households. Commonly, women and children

have poorer nutritional outcomes in Nepal due to cultural practices/ beliefs that discriminate

against these groups. Women and children tend to receive smaller quantities and less nutritious

foods than their adult male counterparts causing disproportionate rates of malnutrition among

these groups.

Land Holdings and Grabbing

Who owns and holds their land is a contentious issue globally and Nepal is not immune. Land

grabbing, a term commonly used to describe large-scale land acquisitions by domestic or

international companies, has become increasingly popular in developing countries like Nepal—

particularly since the world food price crisis in 2007/08 and 2011. Corporations take advantage

of cheap land/water resources in developing countries for the purpose of generating profits from

food and bio-fuel production. Although land grabbing in developing countries was originally

thought to promote the growth of agricultural sectors and generate profit, it is now clear that the

acquisition of these lands curtails national food security endeavors by diverting precious land

resources and food production away from local populations. Furthermore, since the land is often

sold to private and/or foreign entities, utilization of the land does not guarantee increased

employment opportunities or profit for the local people and economy and production is

commonly exported abroad.

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As one of the main objectives of the ADS to improve productivity and commercialization of the

agricultural sector in Nepal, the country hopes to increase national food security; however,

these objectives are only effective if production and profit are kept in Nepal. If large portions of

Nepal’s fertile lands are grabbed, than the developing policies will lack the resources required to

carry out strategy aimed at commercializing agriculture. Therefore, land grabbing may directly

conflict with the government’s objectives and actually make the nutrition situation worse in the

long-term.

Lessons to take forward

Some lessons that are revealed through this analysis that should be noted and enhanced in all

three plans in order to successfully assess nutrition impacts include:

• Know your local epidemiology: Planning must involve a better understanding of the

causal and situational analysis of nutrition in local districts. This requires developing new

capacities of district level staff. By knowing your local epidemiology, program design,

planning and budgeting will be more focused and impactful. • Focus: All of the plans are ambitious with many outcome measures and target groups.

To make substantive improvements, Nepal must focus on several key populations –

children under two, pregnant and lactating women and the landless. If nutrition actions

focus on these three populations within Nepal, coordination and impact of the plans will

be optimized. • Incorporate Education and BCC: With nutrition sensitive approaches involving food-

based actions, education and behavioral-change communication interventions are key to

making substantive improvements. Without this piece, interventions have been shown to

be ineffective. This means engaging the MoE in a more thoughtful and substantive way

is crucial to the success of these plans. • Go beyond gardens: Most of the food–based interventions proposed involve home

gardens. Although important, we need to go beyond gardens and begin thinking about

nutrition sensitive value chains and consumer demand driven interventions. Most of the

plans have very little on value chains. • Know the Nepalese diet: All the plans aim to improve dietary diversity; however,

without data on consumption patterns and nutrient composition in Nepal, programmers

and planners are working in a black box. Consumption data should be collected,

analyzed and shared as part of baseline data collection and larger scaled national

surveys, Furthermore, the data should also reflect districts and communities in addition

to regions.

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5.4 A FUNDING OF AND IMPLEMENTATION OF NUTRITION-SENSITIVE AGRICULTURE AND

FOOD PLANS

5.4.1 FUNDING

All three strategies and plans have set budgets over the next five years. The budgets are:

Plan or Strategy Total Cost Time Period

MSNP $127,326,000 5 years

ADS $3,607,000,000 10 years

FNSP $89,036,000 5 years

For the MSNP, a Basket Fund will be established at the Office of the Financial Comptroller

General Office (FCGO). The GoN and development partners will make their committed

contributions into the basket fund. The development partners will make their commitments

normally for a minimum period of three years. Any

development partner(s) willing to support MSNP

may join this arrangement at any point in time under

the established arrangements. This basket fund will

be controlled by the NPC. Currently, the government

will commit some funds, but according to

government officials, it is unclear how the MSNP will

be funded and which donor agencies will contribute.

Funds from the basket fund at the central level will

contribute to a District Development Fund (DDF)

account and these funds will be solely dedicated to MSNP work.

For the ADS, some high cost activities include the irrigation plans and agricultural roads.

Financing modalities will remain the same with the addition of a multi-donor ADS Trust Fund

(ATF) that will be established and initially held with a development partner. This fund may later

be transferred to GoN. Resources may be used for (a) any TA which supports the ADS (b) non-

government and government entities for implementation of the ADS, (c) milestone performance

payments to parties (individuals and teams) responsible for implementing the ADS in line with

approved performance management plans, and (d) payment of the periodic ADS

implementation and strategic direction review. A Board will manage this ATF and will be chaired

by Vice Chairperson of NPC. Members will include the Sec Finance, Sec MoAD, Sec Irrigation,

Sec MFALD, DPs, and President FNCCI and CNI, DPs and independent experts. The ADS

(2013) proposed that the “ATF could follow the Nepal Peace Trust Fund model, with two tracks,

having a separate track for Government agencies, which could also allow for requiring matching

funds from GoN.”

Agriculture is an economic activity, and three of the four ADS outcomes involve private sector

financial contributions. ‘Private sector’ includes the stakeholders that get private benefit from an

economic activity, therefore this includes any kind of private enterprise, company, cooperative,

MoHP has implemented a number of nutrition interventions over several years. Most of the nutrition specific interventions are already established within the MoHP and it would have a destabilizing effect to bring them under a multi-sector structure. Therefore, it is proposed that these nutrition specific programmes continue to be funded according to the current arrangements” (MSNP 2012).

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individual farmer, peasant, trader or laborer. This makes up about 17% of the budget with the

other 83% coming from government and donors. According to the ADS, financing arrangements

for many of the ADS activities that generate economic activity include cost sharing or public-

private partnerships. Regardless, for this level of investment, the GoN will have to factor in

absorptive capacity to handle and manage this large of a budget.

Because there was much support in developing the ADS by the development agency groups,

some stakeholders thought that they might be considered the main funders into the ATF. These

supporters of the ADS development included Asian Development Bank (ADB), International

Fund for Agricultural Development (IFAD), European Union (EU), Food and Agriculture

Organization (FAO), Swiss Agency for Development and Cooperation (SDC), Japan

International Cooperation Agency (JICA), Denmark Agency for International Development

(DANIDA), World Food Program (WFP), United States Agency for International Development

(USAID), Department for International Development (DfID), the World Bank, the Australia

Agency for International Development (AusAID), and the United Nations Entity for Gender

Equality and the Empowerment of Women (UN Women).

For the FNSP, GoN has made a policy decision to use the Poverty Alleviation Fund (PAF) for

distribution of Below Poverty Line (BPL) certificates to households in over 40 districts. The

current PAF mechanism will be used to manage the flow of FNSP funds. The PAF has a good

track record of delivering capital grants and other services, as part of the social security

initiatives, directly to hard-core poor, medium poor, and poor households and the related

community services. Currently the PAF delivers the programmes by hiring partner organizations

(POs) from among the DDC and NGOs, and uses the service agencies for advisory services.

The FNSP suggests that technical issues should be designed and supervised by the relevant

line ministries. The FNSP will use PAF methodology to rapidly deliver inputs for livelihoods

development, and will coordinate with the line ministries of agriculture, forestry, irrigation, health,

etc., at village and community levels. It is unclear who will fund the FNSP and if the funds are

folded into the ADS, with original funding going through the ATF and then allocated to the PAF.

From these short summaries of financial mechanisms, it is clear that there are three separate

pots of money that will be used for nutrition. It remains a concern how the districts will handle

these separate pots: the DDF, the ATF and the PAF. It will also be difficult to understand how

funds are spent across the agriculture sector and on what activities with different funding pots

allocated for specific activities. This may also cause some confusion for donors who may want

to contribute to the MSNP work, but may want to focus on the BPL populations. Is there a co-

funding mechanism for food and agriculture investments that want to fund MSNP-specific

activities that the MSNP works through but focuses on the ultra poor populations that FSNP

targets? Separate funding pots will become confusing and difficult to manage at the country

level. Donors will worry about absorptive capacity. Perhaps one unified framework, and source

of funding for nutrition-related work should be instituted.

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5.4.2 IMPLEMENTATION AND CAPACITY Implementation

With these new strategies and plans, Nepal cannot approach food and nutrition security in the

“business as usual” way. There are many activities in these three plans to implement and Nepal

will have to be cognizant of overburdening the system and the human resources available.

There will also need to be a rethinking of how institutions are arranged and how they function

within and with each other.

The MSNP will engage the Ministry of Federal Affairs and Local Development, Ministry of Urban

Development, Ministry of Health and Population, Ministry of Agriculture and Development and

Ministry of Education as the main partners in delivering nutrition interventions. The NPC will

facilitate inter-sector coordination. These ministries will work together in co-designing and co-

implementation the action plan and are considered responsible for the NAGA multi-sector

Nutrition Results Framework (i.e. food availability, food affordability, food quality, feeding

behaviors, and physiological utilization). They are also the principal ministries that have been

involved in developing the MSNP.

The ADS implementation requires coordination of many agencies and stakeholders due to the

nature of the agriculture sector. The implementation will require a significant effort from various

institutions of the state, civil society, and development partners. The NPC, as with the MSNP,

will provide overall policy and planning coordination and MoAD will lead implementation.

Several related agencies will implement the core programs of the ADS, the four flagship national

programs (on food and nutrition security; value chain development; decentralized science,

technology, and education; and innovation and agro entrepreneurship), and other programs.

The ADS proposes new mechanisms that build upon the existing mechanisms as well as an

inclusion of new organizations and new national programs. The ADS will be implemented

through three different types of programs: the Core Programs, the Flagship Programs, and

Other Programs. The Core Programs are implemented mostly through existing agencies already

in place at the ministry levels or department levels of agencies. The Flagship Programs require

different management structure in view of the innovative and multi-sector nature of their

activities. Other Programs are those that are currently implemented but are not part of the

existing Flagship or Core Programs.

The FNSP envisages no new and/or parallel institutions to coordinate and implement its

activities. Its coordination and implementation heavily relies on existing institutions at all levels,

including central, district and cluster levels. This is aimed at strengthening existing institutions

and avoiding the creation of parallel institutions with a view to ensure sustainability and long-

term development of appropriate institutions. However, extensive suggestions were given in the

plan to revise current structures.

The role of international and local NGOs are essential partners in the design, planning and

implementation of these different plans, however, the NPC and the government structures will

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need to oversee and manage coordination of the multiple layers working in nutrition sensitive

agriculture and food-based approaches. With the various proposed activities, progress tracking

platforms and accountability mechanisms will have to be put in place to ensure implementation

goes smoothly. In addition, the three strategies and plans have distinct implementation

mechanisms that must all be coordinated by the NPC. It is unclear if this will facilitate

streamlining of activities or just create complications.

Capacity

For implementation to work effectively, there is a need for increased capacity from the bottom to

the top. "From the information presented, it is clear that there is very limited element of the work

force in Nepal – from the village to the level of line Ministry in Kathmandu, including academia

and technical training institutes – that has a thorough knowledge and capacity in public nutrition”

(NPC 2013). The lack of nutrition-related human resources is an obstacle for implementing

nutrition sensitive interventions. This involves the sheer number of staff available to carry out

functions but also, the knowledge and skillsets needed to design, implement and monitor more

complex multi-sectoral nutrition plans (MSNP 2012). It is clear that the GoN understands the

dearth of capacity in the country and many within the donor community and amongst NGOs are

working to help build capacity that is necessary with the scale up of nutrition activities. The

MSNP and ADS have built in comprehensive capacity objectives and activities into their overall

plans. Some stakeholders felt that the capacity exists in the country, but there is a need to

strengthen the systems.

The MSNP clearly stresses the urgency of capacity in nutrition for the country and emphasizes

that those working in nutrition need a multi-disciplinary focus, particularly when it comes time to

link nutrition and agriculture. The Nepal Nutrition Assessment and Gap Analysis (NAGA) found

that the current capacity to deliver health-related nutrition programs at national, district, and

community levels was inadequate (NAGA 2011). There are

plans in 2013 to “train trainers” for the MSNP rollout in the

districts. This training should ensure that nutrition sensitive

decision-making is included. It would also be valuable for Nepal

to share their capacity development training plans with other

neighbor SUN countries that are trying to get a handle on how

to do nutrition sensitive agriculture training of managers and

programmers.

The USAID sponsored Innovation Labs project published two

assessments examining the capacity needs from both the

agriculture sector as well as the nutrition sector. The authors

emphasized the need to build capacity of agriculture

professionals who can understand nutrition beyond their set

field of expertise (Global Nutrition CRSP 2012b). The same goes for nutrition staff working on

the ground. “Needs at the district level are acute, given the decentralized responsibility for

“While there is already a shortage of technically�adept professionals in agriculture and nutrition, especially at the lower administrative levels, professionals with an understanding of agriculture�health�nutrition linkages, and expertise in linked outcomes, are in even shorter supply” (Global Nutrition CRSP 2012b).

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implementing national programs like the MNSP. In this case, field�level, skills�based training

involving multiple (local) sectors is likely to be needed” (Global Nutrition CRSP 2012a).

Central and Regional Levels

Training individuals on the management, design and implementation of “nutrition sensitive”

approaches for development is not an easy task. Finding trainers with that specific skillset are

few and far between. It remains a question to how the senior level officials will receive training

on the planning and prioritization of nutrition sensitive work in the various sectors. In the MoHS,

the nutrition unit is located in the Child Health Division of the MoHP. There are only two

permanent staff working on nutrition, thus “the current capacity of the Nutrition Section is greatly

taxed” (NPC 2013). There are no regional level experts who focus on nutrition either. In the

MoAD, there is on-going work in food safety, quality, processing, and nutrition education, often

lead by the Department of Food Technology and Quality Control, that needs to be included and

integrated in the MSNP as well as the ADS. In the MoE, there is no staff with nutrition

specialization. In the NPC (2013) report, recommendations are made to: hire at least 2 people

to focus on public health nutrition for the MSNP at the MoHP and hire one public nutrition staff

member in agriculture, education, and water and sanitation to mainstream nutrition concerns

(NPC 2013).

District Level

The MSNP states: “The NAGA report recommended the creation of a District Nutrition Officer”

(MSNP 2012). These district officers should also have the capacity and knowledge to carry out

food-based approaches and interventions. They must also have facilitation, planning and

communication skills. Currently, there is a focal point person working at the district level on

nutrition who must plan, implement and monitor nutrition activities in their district, however, they

are also responsible for other health sector issues such as Family Health. "There is a need for a

dedicated public nutritionist who can act as a focal point in the DCC to oversee all technical

aspects of what is ongoing in the district. This focal point person would also provide

backstopping to the district nutrition and food security committee. In addition, there may be a

need to establish an additional non-technical position at the district level to help manage the

inter-sectoral work that will be involved stemming from the MSNP, the ADS and the FNSP.

Community Level

What kind of community workers can deliver nutrition? Extension is overextended and Female

Community Health Volunteers (FCHVs) lack a strict mandate to focus on nutrition. This is

particularly true for the more nutrition sensitive approaches that fall outside nutrition direct

interventions (e.g. supplementation). (FCHVs) are facility- rather than community-based and

report to health posts. Also, their activities in nutrition are limited. For agriculture, there are no

such community-type volunteers.

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The FNSP indicates that there will be heavy reliance on the extension system, however, a

recent study indicated that the public extension system is hindered by a lack of resources;

especially trained human capacity. With the ADS however, there is a significant effort to

revitalize the extension advisory system. The focus for extension on crops and livestock is done

in the district offices of the 75 districts. Each district works through the 4 or 5 service centers,

which cover up to 4 VDCs. With Nepal’s geographic difficulties, and limited resources provided

to extension historically, it is difficult for them to take on additional duties (USAID/ IIDS/ IFPRI

2010).“Local level organizations such as VDCs, farmers, cooperatives and private sector need

to play key roles in planning, implementing, monitoring and evaluating extension programmes

and services. At the present, the agriculture extension system doesn’t cover food and nutrition

education and this shortage needs to be addressed” (NPC 2013). It is hoped that the ADS and

the FNSP has provided for adequate support to lift Extension Advisory Services in Nepal to

ensure they have the support and structures to not only execute core work but additional

nutrition activities prescribed by these three plans and policies.

NGOs Roles

The on-going large-scale projects listed in Annex 4, such as Suaaharaand the Nepal

Agriculture and Food Security Project (NAFSP) are currently and will continue to be important

contributors to the capacity in the country. Because these projects are multi-sectoral in nature,

they provide a unique opportunity in training providers, practitioners and community workers

with new skills that integrate nutrition, health and agriculture. The Suaahara project, for

example, is training health care providers, female community health volunteers, social

mobilizers, agriculture extension workers, pharmacists, families and others on nutrition-

agriculture activities. The NAFSP is increasing capacity dramatically in the country in

partnership with FAO. This year, 200 project facilitators will be recruited in each VDC. These

facilitators will have expertise in crops and livestock. There will also be 59 mid-level officers

recruited with expertise in health, agriculture and nutrition.

Academic Institutions

In the formal education sector, agriculture training, and curricula at the bachelor’s and master’s

level provides a solid background in agriculture, but curricula can be improved by including

courses on human nutrition and the necessary links between agriculture and nutrition (Global

Nutrition CRSP 2012b). However, short�term solutions such as trainings should also be

required for those not continuing to university. Nepal also offers degrees related to public health

and clinical nutrition at both the undergraduate and master’s degree level but the demand and

supply issue is off balance. Increased investment and scaling-up efforts require more and more

trained nutrition staff. The current degree granting programs could be expanded and new

programs created in additional universities and institutions that may utilize distance learning

(Global Nutrition CRSP 2012a).

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Where the Rubber Meets the Road: Case Study of Kapilvastu

As the MSPN, the ADS and the FNSP are planned and

rolled-out, it will be important to take a deep dive look

into the ability for districts to plan, coordinate and

implement. As part of this study, the research team

visited Kapilvastu, one of the districts where the MSNP

was recently launched.

Kaplivastu district is one of the districts of Lumbini

Zone, in the Western region of Nepal. It is considered

the plain low lands of Terai and low Chure hills.

Kapilvastu comprises 77 Village Development

Committees (VDCs), one municipality and five electoral constituencies, with its District

Headquarters (DHQ) in Taulihawa. The majority of Kapilvastu is flat lowland, yet only 48% is

suitable for cultivation. Nearly all of this land is being cultivated, but only 29% of this land is

irrigated (MoAC 2010; DDC 2012). The main crops cultivated in Kapilvastu are paddy, wheat,

oilseed, sugarcane, banana and vegetables. Animal husbandry includes buffalo, cattle, goats,

sheep, pigs and poultry, and the main livestock products are milk and meat. Agricultural

production has been affected in recent years due to out-migration.

Kapilvastu is among the districts with a high prevalence of stunting and anaemia in children

under five (NDHS 2011). Many of these children receive pre-lacteal feeding, thereby being

exposed to increased risk of infection and limited nutrient intake. A third of women of

reproductive age is anemic, and over a fifth of them are underweight.

The government decided to implement the MSNP in 6districts during its first phase. The MSNP,

the first of its kind, brought key stakeholders—7 government and some non-government

agencies together and will be first implemented in the Jumla, Bajura, Achham, Kapilvastu, Parsa

and Nawalparasi districts. Within the five years of implementation, the programme plans to

cover all the 75 districts. As part of this study, the consultant visited the district to determine progress since the launch of the MSNP. Various stakeholders were consulted (see Annex 1).

Some of the observations that emerged from that trip are:

• There is great interest in nutrition at the district level and sectors and their various staff

are very willing to collaborate and coordinate. The spirit of multi-sectoralism for nutrition

is clearly present.

• Although the Local District Officer has demonstrated leadership in ensuring nutrition is

considered, the MSNP is not a high priority among stakeholders. In fact, some of the key

stakeholders in various sectors had not even heard of the MSNP, or had not read the

MSNP. Thus, the MSNP was launched on a small-scale there is a greater need to

advocate for nutrition and ensure that all stakeholders are aware and understand their

role in the implementation and planning of the plan, and their accountability to ensuring

that nutrition activities are delivered effectively in their districts.

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• Because the MSNP is just getting underway, the district plan for MSNP was submitted

quite late in the central budgeting process. Thus, the NPC has to make an emergency

exception for the district to receive funds this coming 2014 for MSNP activities. It

remains unclear where these funds will come from.

• There is a nutrition focal point, but as stated in the capacity section, this person is very

overextended and works with other health issues as well. There does not seem to be

one dedicated person who can focus on technical as well as management issues.

• The MSNP indicated that a baseline survey would be done in each district. From the

consultations, it is unclear if any baseline assessment on the nutrition situation was

completed in Kapilvastu and if any NGOs will fill that knowledge gap.

• From the stakeholders perspectives, on-going work will continue regardless of the

MSNP. Most of the work is focused in health, such as Integrated Management of Acute

Malnutrition or in agriculture, such as home gardens. This work is done more in sector

isolation. Thus, it will be important to observe if the MSNP changes the way sectors work

and if the interventions focused on change beyond the already existing core work.

• One concern is to ensure that history does not repeat itself from previous attempts at

multi-sectoralism as the NAGA (2011) noted. District and VDC support is needed. This

includes technical, administrative and management support.

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5.5 POLICY PROCESSES AND ALIGNMENTS

5.5.1 CROSS SECTORAL COORDINATION History Lessons

The Nepal Nutrition Assessment and Gap Analysis (2011) provided analysis on the history of

nutrition planning over the last four decades. Their substantive analysis provides reminders and

guidelines for Nepal today, as their food, agriculture and nutrition plans are being scaled and

rolled out to the districts. Some highlights from the past:

• The 1977 Joint Nutrition S Plan in 5 districts: “Programme was abandoned midway due

to various problems in its implementation.”

• The 1993 NNPCC: “The support mechanisms for creating an enabling environment for

proper functioning of the committee did not seem to exist.”

• The 1998 NPAN: “Outside of health…few of the proposed actions for the line ministries

were implemented as planned.”

• The 2004 NNPS: No priorities were set and document is more a list of options.

Coordination

Vertical Coordination

Different levels of government must cooperate to tackle undernutrition through agreed upon

legal frameworks, technical capacities and incentives to transfer resources and share

information for accountability sake (Mejia Acosta and Fanzo 2012). At the central level, the High

Level Nutrition Steering Committee is part of the National Planning Commission. The National

Food Security Steering Committee of the NPC has also joined to form the High Level Nutrition

and Food Security Steering Committee (HLNFSSC). The NPC has established a Nutrition and

Food Security Secretariat, which represents some capacity to facilitate the nutrition coordination

and provide technical support to the HLNFSSC. Coordination activities and accountability are

built into the MSNP and the ADS. Some in the country are concerned that the NPC and ADS

Commission will act as parallel structures and this will create confusion. It is best to build the

capacity at the NPC level to oversee all coordination of food and nutrition security actions in the

country. Executive involvement, through the NPC, helps raise public awareness of

undernutrition, coordinates the efforts of different line ministries and hopefully, will protect

funding allocations. With the NPC as the leading coordination, the mechanisms of how all three

plans –- the MNSP, the ADS and the FNSP-- will coordinate vertically from central to regional to

district to VDC must be clarified. The NPC should oversee at the central level the allocation of

funding, monitor progress on outcomes, and bring the ministries together, frequently to assess

and re-focus. However for this to work, the NPC needs high-level political support and

appropriate funding. The national and local governments could create legal frameworks,

technical capacities and incentives to transfer resources, share information and to remain

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accountable to one another (Haddad et al 2012).

There may be a need to re-think about the structure of where “nutrition” sits in the government.

Currently, the main nutrition body sits in the MoHP in the Child Health Division. However it is

clear that nutrition is more than just a health issue and is more than a child issue. Although a

National Nutrition Center is being proposed, it will still sit in the MoHP. Perhaps Nutrition should

be moved out of any one sector and instead sit under the NPC or Prime Minister’s office to

elevate its status and creates a unified, multi-sectoral vision for nutrition.

Horizontal Cooperation

Government sectors and nongovernment agencies must cooperate to achieve undernutrition

reductions (Haddad et al 2012). There is a lot happening in Nepal right now on nutrition sensitive agriculture and there are large-scale programmes on-going (Annex 4). How these will

fit into the large-scale government plans and cooperate to ensure that outcomes are achieved is

being coordinated within the Child Health Division of the MoHP for the MSNP.

Think Multi-Sectorally, Act Sectorally

How do sectors work together?

What are the joint themes that

require them to work together? For

Nepal, there are sectors that need

to be more engaged in the plans for

nutrition sensitive agriculture. Many

stakeholders perceive the MSNP

for example, to be strictly led by the

MoHP, which to many stakeholders

is a disadvantage for true

coordination responses. At the

moment, ministries, such as Education, Urban Development and Women, Children and Social

Welfare, and Local Development are seen as secondary. Furthermore, many did not know their

role in the MSNP and ADS plans. In the FNSP for example, the MoE plays no role, which is

unfortunate. If a multi-sectoral response to nutrition will truly happen, these sectors need to be

considered primary, and be engaged. This will involve providing incentives and accountability

structures for these plans. The sectors themselves need to understand how they will benefit if

they get involved.

Budget Coordination

How will these plans coordinate with each other in their structures, capacity and budgeting? It

will also be important to understand how the Ministry of Finance will coordinate money flows

and expenditures through these different funding streams. GoN must create one financial

mechanism for nutrition (across the three plans) to protect and earmark nutrition funding and

Agricultural growth, which may be critically important, may not be a sufficient condition to improve child nutrition. Ensuring adequate food alone will not address the problem of hunger and undernourishment in Nepal. Investments are required to improve the poor’s access to food. At the same time efforts have to be made to improve food absorption and utilization. For that, Nepal will have to invest in female education, general sanitation, basic health care, and some selected direct nutrition interventions. Multi-sectoral efforts are needed to improve preventive measures, and improve management of simple infections (USAID/IIDS/IFPRI, 2010).

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use it in a transparent way (Haddad et al 2012).

5.5.2 SUSTAINABILITY

At the end of the day, Nepal will need to demonstrate sustainable progress beyond the

strategies, policies and plans on paper. Governments that have strong executive leadership to

promote effective inter-sectoral cooperation to improving food and nutrition security in their

countries are those that are the most successful (Haddad et al 2012). High-level government

officials play a decisive role by coordinating actions across ministries and government offices,

channeling donor and civil society efforts, and developing compelling narratives around nutrition

as a poverty reduction priority. However, an issue that emerged time and time again was that

the government is transient and mandates change. This poses an issue for Nepal. Without a

constitution (with a right to food mandate) and a stable government and long-term positions in

ministries, priorities shift. Governments such as Brazil sustained their commitments to ending

hunger by their demonstrative successes, even after President Lula left office. If Nepal can

show a big impact in a short time with these new plans, it will be in the best interest for

Presidents to continue the work. It is also important for food and nutrition security to be

embraced as a major objective of long-term national development strategies.

Lastly, long lasting change takes time. These food and agriculture plans are ambitious, which

should be commended. At the same time, Nepal is a young country, and on a long path towards

development and economic security. Undernutrition reductions take time. Goals and targets

should be aggressive, but also realistic and achievable in the appropriate time scales. Nutrition

should be seen as important to development overall for Nepal, not the other way around in

which development will improve nutrition.

5.5.3 USE OF TERMINOLOGY

In an effort to focus attention on the point that nutrition security is only achieved when

individuals actually consume the food they need rather than simply having access to it (as in the

currently-accepted definition of food security) it has been recommended that the Committee on

World Food Security (CFS) use, as appropriate, the following definition of “food and nutrition

security”: “Food and nutrition security exists when all people at all times have physical, social

and economic access to food, which is safe and consumed in sufficient quantity and quality to

meet their dietary needs and food preferences, and is supported by an environment of adequate

sanitation, health services and care, allowing for a healthy and active life.”

In Nepal, there is a large consensus that nutrition is a central part of food security. Most of the

policies and action plans demonstrate this in the language. The Agriculture Development

Strategy has the “Food and Nutrition Security Action Plan” as one of the core elements to the 20

year strategy. Also, the National Planning Commission formed a Food and Nutrition Security

Secretariat to help facilitate nutrition activities at the central level.

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5.6 ANALYSIS OF MONITORING AND EVALUATION APPROACH IN THE POLICIES

Having reliable nutrition data and performance indicators can lead to better delivery. This often

means that local ownership of outcome data on the nutrition programmes can be important and

should be encouraged. However this ownership requires data collection at regular intervals.

Increased frequency of data observations to monitor progress to ensure that accurate and

timely data can provide better response times to re-evaluate programmes.

The Frameworks

When examining the frameworks of Nepal’s food, nutrition and agriculture plans, it is important

to ask What is the evidence base for the activities and what outcomes are most practical to

collect on? In the MSNP, some of the indicators (consumption of junk food, strengthened food

systems etc.) will be difficult to collect due to their vagueness, qualitative nature and lack of

validation. Furthermore, within the agriculture sector focus of the MSNP, the indicators for work

performance different from the indicators in output 6, which is quite confusing. Lastly, if

improved consumption of nutritious foods is used as an indicator, there will be a need to collect

and conduct dietary assessment surveys in the country at baseline to assess change and

impact. These types of surveys have not been collected systematically throughout the country

and this will need to be done in the very near future with the rollout of the MSNP and the ADS.

The ADS and MSNP five-year targets for nutrition are aligned, which is a great step forward.

However, how can the frameworks across the plans be better synergized? With regard to

nutrition-related aspects, perhaps one unified framework should be established with a set of

core indicators to track. The FNSP and MSNP food and agriculture related indicators, sampling,

and methodologies should be the same. The indicators should be limited to 5 to 10 core

indicators that address the broader aspects of what is to be achieved. Currently, there are too

many.

Data Collection and Analysis

Overall, there are many indicators that need to be collected on for the MSNP and the ADS. The

FNSP has not yet provided a framework but it is assumed this will increase the number of

indicators collected in the 75 districts in the country. At the moment, the capacity does not meet

the demands for the vast number of data collection points needed collecting in the 75 districts.

The MSNP also indicated that baseline data collections would be done in all 75 districts. It is

unclear when this is going to happen and if NGOs and others fill this gap, what type of data will

they collect? Will the data collection by systematized across all districts or will NGOs collect on

the data that is relevant for their own projects in distinct sampling frames? This could create

confusion, and a real lack of understanding impact in five years time.

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Many stakeholders argued that more focus and planning needs to take place beyond just data

collection. Those working on these plans need to ensure that analysis, sharing and transfer of

data knowledge occur as well. Sharing could be done by encouraging local and district-level

ownership and accountability of data analysis and sharing with communities.

Information Systems

There are a number of systems in Nepal that are involved in food and nutrition security

monitoring and evaluation.

Household surveys, such as the Nepal Living

Standard Surveys, the Multiple Indicator Cluster

Survey and the Nepal Demographic and Health

Surveys, conducted every five years or longer,

provide a comprehensive food and nutrition security

analysis at a given point of time and serve as the

baseline for information generated through different

assessments, monitoring and surveillance activities.

Censuses (Population and Housing Census,

Agricultural Census) are implemented every ten

years, which provide relevant information on food

and nutrition security indicators. There are also

other reports such as PAF progress reports, NFC

progress reports and NPC and MDG tracking

reports.

The MSNP will use the existing nutrition information

systems of the various sectors, which is considered

extensive (MSNP 2012). However the MSNP notes

that these systems are complex, and there is

concern on who can manage the increased volumes

of data for regular monitoring purposes. There is a

designated information unit within the NPC that will help coordinate the MSNP, but it remains

unclear how it is staffed. There will be a need for a larger M&E expert team to coordinate this

work at the various levels of national, district and VDC.

Within the ADS, M&E is a main output of the governance component of the Strategy. According

to the ADS, “a specific system for monitoring and evaluation at the central and district level will

be formulated at the beginning of the ADS and monitoring capacity of central and district level

institutions will be strengthened.” This new system will link to existing systems including the

Nepal Khadya Suraksha Anugaman Pranali (NeKSAP: Nepal Food Security Monitoring System)

and the District Poverty Monitoring System (DPMAS). How this linking will happen is unclear

and perhaps it would be better to just build onto the existing NeKSAP system instead of creating

a new system entirely. The FSNP will mainly provide support to the NeKSAP system within the

Food and nutrition security is a cross-sectoral issue and its monitoring requires a multi-sectoral approach. Such approach needs to be guided by coherent principles to ensure that the different efforts implemented are linked together to achieving an efficient and effective implementation of food and nutrition security monitoring system. The system is to be guided by a clear and strong statement of what a comprehensive food and nutrition security monitoring should consist of, and how it should be used. Food and nutrition security is a cross-sectoral issue, which does not fall under the mandate of a single ministry and requires a leadership with a solid inter-ministerial coordination capacity. Ensuring the functional linkages among existing systems between different levels, central and local levels as well as policy and technical levels, is another area of further enhancement (ADS Assessment Report 2012).

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MoAD (funded by WFP).

All of the ministries are tapping into large information systems but these systems are siloed by

sectors and mandates. Thought and time should be taken to integrating data into one food and

nutrition security database system, and building capacity to manage these systems, and act on

data as opposed to just collecting information.

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VI. CONCLUSIONS

6.1 NUTRITION-SENSITIVE ANALYSIS OF NEPAL’S FOOD AND AGRICULTURE POLICIES

Overall, the most recently drafted nutrition, food and agriculture policies and plans for the

country of Nepal are nutrition sensitive and multi-sectoral. There has been great advocacy for

improving food and nutrition security in the country, illustrating commitment at the national and

community level and among Nepal’s donors and development partners. The plans over the next

ten years are ambitious for Nepal with complex interventions and frameworks. In providing

lessons of what is an on-going process, it helps to re-examine the principles of nutrition-

sensitive agriculture.

Overall, all three plans have:

• Explicit nutrition objectives in their design.

• Elements of doing no harm, particularly to women.

• Nutritional impact measurements in their M & E systems.

• Opportunities to maximize through multi-sectoral coordination.

• Targeted the most vulnerable (particularly the FNSP).

All the plans include activities, and in some way, shape, or form activities and interventions that:

• Diversify production and livelihoods for improved food access and dietary diversification,

natural resource management, risk reduction and improved income.

• Increase production of nutritious foods, particularly locally adapted varieties rich in

micronutrients and protein, chosen based on local nutrition issues and available

solutions.

• Reduce post-harvest losses and improve processing.

• Increase market access and opportunities, especially for smallholders.

• Reduce seasonality of food insecurity through improved storage and preservation and

other approaches.

• Target household income to improve nutrition, mainly by increasing women’s income.

The three main plans as well as the secondary plans could be strengthened in the following

three areas:

• Empowering women, the primary caretakers in households, through: increasing income;

access to extension services and information; avoiding harm to their ability to care for

children; improving labor and time-saving technologies; and supporting their rights to

land, education and employment. This is particularly true for the issues of land rights and

employment.

• Incorporating nutrition education to improve consumption and nutrition effects of

interventions; in addition to employing agricultural extension agents to communicate on

nutrition. The MoE must be more engaged in all nutrition plans.

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• Managing natural resources for improved productivity, resilience to shocks, and

adaptation to climate change. There must also bemire equitable access to resources

through soil, water and biodiversity conservation. These areas are largely neglected in

these plans with the exception of the biodiversity strategy, which doesn’t provide direct

links to nutrition.

The plans are weak in:

• Assessing the context and causes of malnutrition at the local level, to maximize

effectiveness and reduce negative side effects. For this reason, there must be improved

local surveillance and understanding of situational and causal analysis at the VDC and

district level.

• Increasing equitable access to productive resources. Although the FNSP tries to target

the bottom of the pyramid, the equity issues around food distribution and access remain

vague in all the plans.

• Assessing the resource management gap and mobilization plan to bridge the gap

Concerns remain on the lack of adequate supportive environment across all three plans.

These areas include:

• Policy coherence across all policies and plans to support nutrition, including food price

policies, subsidies, trade policies and pro-poor policies. The ADS is of particular concern

with its focus on commercialization.

• Sufficient governance for nutrition, by drawing up a national nutrition strategy and action

plans, allocating adequate budgetary resources and implementing nutrition surveillance.

Although plans are currently in place, they are left primarily to the NPC to coordinate. It

remains to be seen if this governance can be effective in the long-term.

• Capacity in ministries at national, district and local levels. Capacity at all levels for these

ambitious plans remains the lynch pin for their ultimate effectiveness, sustainability and

impact.

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6.2 RECOMMENDATIONS AND KNOWLEDGE GAPS

Impact on Nutrition Outcomes

It is too early to assess the impact of these policies and plans on nutrition outcomes for Nepal. It

can be assumed that in the past, Nepal’s nutrition plans failed in many aspects. Overall, It is

safe to say that agriculture has been underfunded and not engaged in nutrition activities;

however, with new plans in place this could change. Even still, there are drivers that are beyond

the plans and policies that Nepal will inevitably face, inhibiting better nutrition (or perhaps

improving it in some cases) as Nepal continues to develop. These drivers include: remittances

and outmigration and their impacts on the feminization of agriculture, the impact of rice

consumption, commercialization of agriculture, equitable distribution of food and access to hard

to reach populations, land grabbing and the role of the private sector in the nutrition transition

and dietary shifts.

Some lessons that are revealed through this analysis that should be noted and enhanced in all

three plans in order to successfully assess nutrition impacts include:

• Know your local epidemiology: Planning must involve a better understanding of the

causal and situational analysis of nutrition in local districts. This requires developing new

capacities of district level staff. By knowing your local epidemiology, program design,

planning and budgeting will be more focused and impactful.

• Focus: All of the plans are ambitious with many outcome measures and target groups.

To make substantive improvements, Nepal must focus on several key populations –

children under two, pregnant and lactating women and the landless. If nutrition actions

focus on these three populations within Nepal, coordination and impact of the plans will

be optimized.

• Incorporate Education and BCC: With nutrition sensitive approaches involving food-

based actions, education and behavioral-change communication interventions are key to

making substantive improvements. Without this piece, interventions have been shown to

be ineffective. This means engaging the MoE in a more thoughtful and substantive way

is crucial to the success of these plans. • Go beyond gardens: Most of the food–based interventions proposed involve home

gardens. Although important, we need to go beyond gardens and begin thinking about

nutrition sensitive value chains and consumer demand driven interventions. Most of the

plans have very little on value chains.

• Know the Nepalese diet: All the plans aim to improve dietary diversity; however,

without data on consumption patterns and nutrient composition in Nepal, programmers

and planners are working in a black box. Consumption data should be collected,

analyzed and shared as part of baseline data collection and larger scaled national

surveys, Furthermore, the data should also reflect districts and communities in addition

to regions.

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Funding

From these short summaries of financial mechanisms, it is clear that there are three separate

pots of money that are allocated for nutrition purposes in Nepal. It remains a concern how the

districts will handle these separate pots: the DDF, the ATF and the PAF. Also, It will be difficult

to understand how funds are spent across the agriculture sector and on what activities since

different funding pots are allocated for specific activities. Furthermore, this may cause confusion

among donors that want to contribute to the MSNP mission but whom only want to focus on the

BPL populations. There must be a co-funding mechanism for food and agriculture investors that

want to fund MSNP-specific activities that the MSNP can work through, but have the ability to

focus on the ultra poor populations that FSNP targets. As they stand, separate funding pots are

confusing and difficult to manage at the country level and donors may worry about absorptive

capacity. Perhaps, one unified framework and source of funding for nutrition-related work should

be instituted to remedy this issue. Lastly, the budget for the Agriculture Sector has been too low

for too long. The GoN has increased its allocation but it is still not enough to match the role of

agriculture's contribution to the country’s overall GDP. To improve food and nutrition security in

the country, funding must be substantially increased.

Implementation

International and local NGOs are essential partners in the design, planning and implementation

of Nepal’s various nutrition-sensitive plans. The NPC and other government structures must

oversee and manage the coordination of multiple layers of organizations working in nutrition

sensitive agriculture and food-based approaches. With the many activities proposed, progress

tracking platforms and accountability mechanisms must be instilled to ensure smooth

implementation. In addition, the three strategies and plans have distinct implementation

mechanisms that must be coordinated by the NPC, making it unclear if this coordination will

streamline activities or simply create additional complications.

Capacity

For implementation to be effective, there is a need for increased capacity from the bottom to the

top. The lack of nutrition-related human resources remains an obstacle for implementing

nutrition sensitive interventions. This involves the sheer number of staff available to carry out

functions but also, the knowledge and skillsets needed to design, implement and monitor more

complex multi-sectoral nutrition plans. It is clear that the GoN understands the dearth of

capacity in the country and many within the donor community and amongst NGOs are working

to help build the necessary capacity by the scaling up of nutrition activities. The MSNP and ADS

have included comprehensive capacity objectives and activities into their overall plans. Various

levels are analyzed from the central, district and community levels, as well as academic

institution involvement for longer-term capacity development.

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Coordination

There is much that can be learned from past efforts to improve food and nutrition security. In

Nepal, there are multiple sectors that need to be more engaged in the plans to improve nutrition

sensitive agriculture. For example, many stakeholders perceive the MSNP to be strictly led by

the MoHP. To many, this leadership is considered a disadvantage for achieving true

coordination responses. At the moment, ministries, such as Education, Urban Development and

Women, Children and Social Welfare, and Local Development are seen as secondary.

Furthermore, many stakeholders are unaware of their role in the MSNP and ADS plans. For

instance, in the FNSP, the MoE unfortunately does not play a role. For a multi-sectoral response

to nutrition to be feasible, these sectors must become primary, engaged entities. This will

involve providing incentives and accountability structures for these plans. Furthermore, these

individual sectors need to understand the advantages to their involvement in nutrition sensitive

plans.

With the NPC leading the coordination of the three main plans –- the MNSP, the ADS and the

FNSP—mechanisms that will vertically coordinate central, regional, district and VDC must be

clarified. At the central level, the NPC should frequently assess and refocus their efforts by

overseeing the allocation of funding, monitoring progress on outcomes, and integrating

ministries. For this analysis to be successful, the NPC needs high-level political support and

appropriate funding. The national and local governments should create legal frameworks,

technical capacities and incentives to transfer resources, share information and remain

accountable to one another.

Monitoring and Evaluation

Having reliable nutrition data and performance indicators can lead to better delivery. Often, this

means that local ownership of outcome data on nutrition programmes are important and should

be encouraged. However, this ownership requires data collection at regular intervals. Increased

frequency of data observations required to monitor progress and ensure accurate and timely

data can improve response times to re-evaluating programmes.

The ADS and MSNP five-year targets for nutrition are aligned, which is a great step forward.

However, how can the frameworks across the plans be better synergized? With regard to

nutrition-related aspects, perhaps one unified framework should be established with a set of

core indicators to track. Additionally, the FNSP and MSNP food and agriculture related

indicators, sampling, and methodologies should be consistent. More specifically, their indicators

should be limited to 5 to 10 core measures that reflect the broader aspects of what is to be

achieved. Currently, there are too many indicators included in the design of these plans.

Also, many stakeholders argued that more focus and planning needs to take place beyond data

collection. Those working on these plans need to ensure analysis, sharing and transfer of data

knowledge occur beyond data collection. Data analysis and sharing within communities can be

achieved by encouraging local and district level ownership and accountability.

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Sustainability

High-level government officials play a decisive role in these plans. They must coordinate all

actions across ministries and government offices, channeling donor and civil society efforts, and

developing compelling narratives around nutrition as a poverty reduction priority. However,

issues that repeatedly emerge include transient government and mandates which prove

challenging for Nepal. Without a constitution (with a right to food mandate) and a stable

government and long-term positions in ministries, priorities shift. Governments such as Brazil

sustained their commitments to ending hunger by their demonstrative successes, even after

President Lula left office. If Nepal can make a measurable impact in a short time with these new

plans, it is in the best interest for Presidents to continue the work. It is also important for food

and nutrition security to be embraced as a major objective of long-term national development

strategies.

Finally, long lasting change takes time. Nepal’s current food and agriculture plans are ambitious,

and commendable. At the same time, Nepal is a young country, and faces a long path towards

development and economic security. Undernutrition reductions take time. With that said,

nutrition goals and targets should be aggressive, but also realistic and achievable in the

appropriate time scales.

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VIII. REFERENCES

ADB 7762- NEP (2013) Draft Final Report. Technical Assistance for the Preparation of the

Agricultural Development Strategy (ADS), Asian Development Bank.

Bajagai YS (2013).http://www.foodandenvironment.com/ Accessed 20 July 2013.

District Development Committee (2012/2013), Annual District Development Plan. Nepal.

District Livestock Service Office (2011/12), Annual Progress Report. Nepal.

FAO (2010) Assessment of Food Security and Nutrition in Nepal.Pulchowk, Nepal: United

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FAO (2013) State of Food and Agriculture. Rome, Italy

Feed the Future Innovation Labs (2013). Nepal Innovation Labs.

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GAFSP (2013). NAFSP. http://www.gafspfund.org/content/nepal Accessed 13 July 2013.

Global Nutrition CRSP (2012a) Nutrition Degree Programs In Nepal: A Review of Current Offerings and Gaps.

Nutrition CRSP Research Briefing Paper No. 9. Boston, MA.

Global Nutrition CRSP (2012b) Stocktaking: Agriculture Degree Programs in Nepal. Nutrition

CRSP Research Briefing Paper No. 11. Boston, MA.

GoN (2007) Interim Constitution of Nepal 2063. Nepal.

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Priority (NASDP) for the Medium-Term (2010/11-2014/15). Kathmandu, Nepal, July 2010.

GoN, National Planning Commission, Central Bureau of Statistics (2013). Nepal Thematic

Report on Food Security and Nutrition. WFP/ WB/ AusAID/ UNICEF.

GoN, NPC, CBS (2011). Nepal Living Standards Survey 2010/11.Statistical Report Volume

Two.Thapathali, Kathmandu, Nepal, November 2011.

GoN/MoAC (2010) National Agriculture Sector Development Priority (NASDP) for the Medium-

Term (2010/11-2014/15). Kathmandu, Nepal, July 2010.

GoN/MoAD (2013) Agriculture Development Strategy. Nepal.

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GoN/MoAD (2012) Agriculture Development Vision. Nepal.

GoN/MoAD (2012).Agriculture Development Assessment. Nepal.

GoN/MoAD (2013) Food and Nutrition Security Plan of Action (FNSP): A National Programme

for Food Security. December 2012.

GoN/MoAD (2012) Nepal Agriculture and Food Security Project: Environment Management

Framework. July 2012.

GoN/MoFSC (2002) Nepal Biodiversity Strategy. Supported by GEF/UNDP.

GoN/MoHP (2011) Nepal Demographic and Health Survey. Kathmandu, Nepal:

GoN/NPC (2007) Three-Year Interim Plan Approach Paper (2064/65-2066/67). Kathmandu,

Nepal, July 2007.

GoN/NPC (2012) Multi-sector Nutrition Plan for Accelerating the Reduction of Maternal and

Child Under-nutrition in Nepal 2013-2017 (2023). Kathmandu, Nepal.

GoN/NPC/CBS (2011) Nepal Living Standards Survey 2010/11.Statistical Report Volume

Two.Thapathali, Kathmandu, Nepal.

GoN/NPC/CBS (2013). Nepal Thematic Report on Food Security and Nutrition. WFP/ WB/

AusAID/ UNICEF.

Haddad, L, Mejia Acosta, A, and Fanzo J (2012) Accelerating Reductions in Undernutrition. IDS

In Focus Policy Briefing Issue 22. Brighton: IDS.

Herforth, A, Jones, A and Pinstrup Andersen P (2012) Prioritizing Nutrition in Agriculture and Rural Develo0ment: Guiding Principles for Operational Investments. The International Bank for Reconstruction and Development / The World Bank, Washington, DC. Hill, Renée; Gonzalez, Wendy; Pelletier, David L. (2011) The formulation of consensus on

nutrition policy: Policy actors' perspectives on good process. Food & Nutrition Bulletin, Volume

32, Supplement 2. 92S-104S.

IFPRI (2013). Suaahara Project. http://www.ifpri.org/book-741/node/7460 Accessed 13 July

2013.

Intensive Study and Research Centre, District and Village Development Committee Profile of

Nepal 2013; Data from Ministry of Agriculture and Cooperatives.

Lokshin, M, Bontch-Osmolovski, M and Glinskaya. (2007) Work-related migration and poverty

reduction in Nepal, World Bank Policy Research Working Paper 4231. Washington DC :

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World Bank.

Mejía Acosta, A.; Fanzo, J. and Haddad, L. (2012) Fighting Maternal and Child Malnutrition:

Analysing the Political and Institutional Determinants of Delivering a National Multi-Sectoral

Response in Six Countries, Brighton: IDS.

Micronutrient Initiative (2013). Flour Fortification Initiative.

http://www.micronutrient.org/English/view.asp?x=656&id=49. Accessed 13 July 2013.

Pokharel, R.K. et al; Nutrition Assessment and Gap Analysis (2011) Nutrition Assessment Gap

Analysis (NAGA), Nepal.

Nepal Demographic and Health Survey (2011) Department of Health Services Annual Report

2010/11. Nepal.

NPC (2013) Multi-sector Nutrition Capacity Assessment for the National and District Levels in

Nepal.Government of Nepal, Kathmandu, Nepal.

Pelletier, David L.; Menon, Purnima; Ngo, Tien; Frongillo, Edward A.; Frongillo, Dominic. (2011)

The nutrition policy process: The role of strategic capacity in advancing national nutrition

agendas. Food & Nutrition Bulletin, Volume 32, Supplement 2 Pp 59S-69S.

Ruel, MT, Alderman H and the Maternal and Child Nutrition Study Group (2013) Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet. http:// dx.doi.org/10.1016/S0140-6736(13)60843-0. Shrestha S, Manohar S, Klemm R (2012) Agriculture, Food Security and Nutrition in Nepal:

Taking Stock and Defining Priorities. Proceedings of the First Annual NUTRITION CRSP

Scientific Symposium, Kathmandu, Nepal, March 21/22, 2012. Nutrition CRSP Research

Briefing Paper No. 7. Boston, MA: Tufts University.

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USAID (2010) Food Utilization practices, beliefs and taboos in Nepal. An Overview. Washington

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Exercise. International Food Policy Research Institute: New Delhi.

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ton=Go. Accessed May 2013.

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1000-days?lang=en. Accessed 13 July 2013.

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IX. ANNEXES

ANNEX 1: PERSONS INTERVIEWED AND FOCUS GROUPS Interviews at National Level Government National Planning Commission: Mr Radha Krishna Pradhan - Programme Director, Mr Mahesh Kharel - Joint Secretary, Mr Bhava Krishna Bhattarai - Programme Director; Mr Chandika Paudel – Planning Officer National Nutrition and Food Security Secretariat: Dr Ingo Neu and Jhabindra Bhandari Child Health Division, Department of Health Services, Ministry of Health and Population: Dr Tara Nath Pokhrel - Director and Mr Raj Kumar Pokharel – Nutrition Section Chief Ministry of Health and Population: Dr. TR Burlakoti – Chief Specialist, MoHP Department of Health Services: Dr MingmarGyalzen Sherpa, Director General Education, Food for Education Project: Mr Ravi Raj Upreti and team Department of Education, Ministry of Education: Rakesh Shrestha – Deputy Director, Department of Education Ministry of Agriculture Development: Mr Uttam Kumar Bhattarai – Joint Secretary, and Ms Jyotsna Shrestha - Under Secretary Ministry of Agriculture Development, Department of Food Technology and Quality Control: Mr Pramod Koirala Ministry of Agriculture Development, Department of Agriculture: Mr Kanchan Raj Pandey Ministry of Urban Development: Mr Kedar Prajapati (Er = Engineer) Ministry of Federal Affairs and Local Development: Mr Tek Raj Niraula – Under secretary and Ms Indu Ghimire - Section Officer Ministry of Women, Children and Social Welfare: Mr Laxmi Tripathi – Joint secretary The UN WHO: Dr. Lin Aung, Mr. Ashok Bhutryal, Mr. Terrence Thompson FAO: Dr. Binod Saha – Assistant FAO Representative, Mr Shrawan Adhikary – Programme Officer WFP: Nicole Menage – WFP Representative, Pramila Ghimire – Country Programme Coordinator, Leela Raj Upadhyay, Dr Madhu Subedi, Mr Amrit Bahadur Gurung – Mother and Child Health Care Focal Point, Mr Pushpa Shrestha, Dr Shridhar Thapa UNICEF: Ms Saba Mebrahtu – Chief of Nutrition Section, and Mr Pradiumna Dahal – Nutrition Specialist UN REACH: Dr Ingo Neu – REACH International Facilitator and Mr Jhabindra Bhandari – REACH National Facilitator Donors and NGOs External Development Partners for Health, Chairs: Natasha Mesko, DFID and Shanda Steimer, USAID Food and Nutrition Security Project (GASFP): Dr. Yadav R. Bajagai Micronutrient Initiative: Macha Raja Maharjan, Country Director Women’s Reproductive Rights Program, Centre for Agro-Ecology and Development: Samita Pradhan – Executive Director and Dushala Adhikari – Advocacy and Documentation Officer

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Academia, Research, Experts Dr. Aruna Aprety, Independent Expert, Technical Advisor, Britain Nepal Medical Trust Institute of Medicine: Dr Prakash Sunder Shrestha – Professor of Paediatrics, Dr Sharad Onta – Professor and Assistant Dean and Dr Madhu Dixit Devkota – Professor of Family Health Patan Academy of Health Sciences: Dr Kedar Prasad Baral - Professor and Rector, PAHS Johns Hopkins University, Nutrition Innovation Lab: Swetha Manohar - Project scientist Interviews at District Level in Kapilvastu

Participants in Integrated Joint meeting with District Development Committee (DDC) Ram Prasad Pandey, District Development Committee (DDC) - Local Development Officer Bishnu Poudel, District Health Office - Nutrition Focal person Thaneswor Ghimire, District Education Office - Undersecretary Kalawati Ojha, Women and Children Office - WDO Ramendra Singh Rawal, Kalika self-reliance Social Center - Executive Director Praveen Kumar Srivastava, NGO federation - President Raj Kishor Yadav, DLSO - Sr LDO Anand Kumar, Maxpro - District coordinator Prasanna Sharma, DHO - IMAM-coordinator Rajesh Kumar Gupta, Kapilvastu Integrated Development Services (KIDS) - Board Member Rajan Kumar Pokhrel, District Development Committee - Information Officer Dipendra Regmi, District Development Committee - Planning Officer Durkhed Mahamad Khaa, District Agriculture Office - Agriculture Officer

Focus Groups at National Level

I. Introductory focus group with relevant stakeholders: • Government: CHD, DoHS, DoA, NNFSS, NPC, AFSP/MoAD • UN: WHO, WFP, REACH • Donors: World Bank, EU, MI • NGOs and Academia

[Pls see attachment] II. Reporting of findings focus group with relevant stakeholders:

• Government: CHD, MoAD • UN: WHO, WFP, REACH • Donors: MI, USAID • NGOs and Academia

[Pls see attachment]

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ANNEX 2: INTERVIEW GUIDE

Purpose:

To identify recurrent features related to the nutrition impacts of the food and agriculture policy

process through qualitative research methods. The research will try to map out key concepts

and/or plausible and/or evidence based causal relationships using a diverse range of interviews,

documents, observations and secondary source of data. The data collection and interpretation

will be guided by the guideline and conceptual framework of impact pathways that has been

provided and the search for new concepts or recurrent dynamics in the data (adapted from

Pelletier et al 2011). Method:

• Semi-structured interviews with purposive snowball sampling. This is designed to elicit a

combination of unprompted and prompted responses based on good decision-making

process (See figure below; Hill et al 2011).

• Discussion notes (need to F/U with interviewees on usage of quotes).

• Each interview should be an hour or less.

Types of Interviewees:

Interview actors involved in the country food and agriculture policy community, and the nutrition

community. This would include:

• Food and agriculture, nutrition practitioners at the national level

• Food and agriculture, nutrition practitioners at the international level

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• Government ministries, and multi-sectoral mechanisms, informants from donor agencies,

UN organizations, nongovernmental organizations (NGOs), and civil society groups.

• Staff and public sector directors from food and agriculture, nutrition, health, environment,

social protection, gender, education

• Elected officials

Main Questions:

• What are the most important food and agriculture policies and plans in Nepal that are

addressing food and nutrition security?

• Are these policies and plans “nutrition sensitive”? If so, why? If not, why?

• How have these policies impacted nutrition outcomes?

• How are nutrition-sensitive agriculture and food plans are being implemented?

• How are nutrition-sensitive agriculture and food plans are being funded?

• Is there political commitment and/or champions for nutrition sensitive agriculture?

• What are the policy processes and alignments for nutrition sensitive agriculture?

• What are the institutional arrangements for convening, coordinating and overseeing

progress?

• What is the current knowledge of nutrition sensitive agriculture in the country? Is there

consensus on the meaning, priorities, roles and responsibilities to deliver nutrition

sensitive approaches?

• Is there implementation capacity to deliver?

• Are the monitoring and evaluation systems in the policies/plans addressing nutrition

sensitive agriculture and are there specific indicators to track over time?

Additional Questions:

1. How can the country galvanize political commitment at the appropriate high level to

support nutrition sensitive agriculture?

2. What are the most effective mechanisms for identifying and developing capacities in the

country to roll out nutrition sensitive approaches?

3. How can nutrition sensitive approaches be better formulated, more clearly with concrete

deliverables and outcomes in the national nutrition plan or is it fine as is?

4. How can the country move from policy and strategy formulation to a robust programming

with investment plans able to generate action for nutrition sensitive agriculture?

5. What would be the success factors or bottlenecks for nutrition sensitive agriculture with

regard to institutional arrangements, coordination, overall M&E and accountability?

6. What can donors support in the area of nutrition sensitive agriculture?

What is your opinion on each of the following statements:

a) Agriculture is impacting nutrition status of the population

b) Agricultural growth improves nutritional outcomes

c) Growth in the food industry increase nutritional status of the population

d) Food production is important for nutrition

e) Income generation from agriculture increase nutritional status of the population

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f) Agricultural production of a diverse set of commodities is beneficial for the nutritional

status of the population

g) Improved nutritional status is the ultimate purpose of agriculture

Mechanisms that you would consider effective to increase an improved nutrition

outcome of agriculture:

a) Biofortification

b) Home gardens and household food production

c) Community food production

d) School-based nutrition programs / school feeding programs

e) Alternative marketing and retail channels

f) Food price monitoring

g) Fisheries

h) Dairy development

i) Animal husbandry

j) Nutrition education programs

How do we realize the potential of agriculture to maximize the nutritional impact on the

population of Nepal?

a) Effective policies

b) Effective national strategies and investment plans

c) Political commitment and champions

d) Consensus on meaning, priorities, roles and responsibilities

e) Monitoring and evaluation of nutrition in the country

f) Innovation in institutional arrangements for convening, coordinating overseeing

progress, overall monitoring and evaluation

Knowledge gaps that you would consider important to address in order to increase an

improved nutrition outcome of agriculture:

a) The direct effect from agricultural inputs to nutrition outcomes

b) The indirect effect of change in income from agriculture to nutrition outcomes

c) The effects of agricultural policy on nutrition as mediated through the value chain

d) Governance, policy processes and political economy as it relates to the development of

agriculture-for-nutrition policies and programs

e) The way research on agriculture and nutrition is conducted, such as the development of

methodologies and appropriate metrics

f) Consumers as a broader target group, notably rural workers and non-rural populations

g) The rural and urban poor at risk from nutrition-related non-communicable diseases

h) Cost-effectiveness

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ANNEX 3: GUIDING PRINCIPLES OF NUTRITION SENSITIVE AGRICULTURE Agricultural programmes and investments can strengthen impact on nutrition if they:

1. Incorporate explicit nutrition objectives and indicators into their design, and track

and mitigate potential harms, while seeking synergies with economic, social and

environmental objectives.

2. Assess the context1at the local level, to design appropriate activities to address the types

and causes of malnutrition2. 3. Target the vulnerable3 and improve equity through participation, access to resources,

and decent employment.

4. Collaborate and coordinate with other sectors (health, environment, social protection,

labor, water and sanitation, education, energy) and programmes, through joint strategies

with common goals, to address concurrently the multiple underlying causes of malnutrition. 5. Maintain or improve the natural resource base (water, soil, air, climate, biodiversity),

critical to the livelihoods and resilience of vulnerable farmers and to sustainable food and

nutrition security for all. Manage water resources in particular to reduce vector-borne

illness and to ensure sustainable, safe household water sources. 6. Empower women by ensuring access to productive resources, income opportunities,

extension services and information, credit, labor and time-saving technologies (including

energy and water services), and supporting their voice in household and farming

decisions. Equitable opportunities to earn and learn should be compatible with safe

pregnancy and young child feeding. 7. Facilitate production diversification, and increase production of nutrient-dense

crops and small-scale livestock (for example, horticultural products, legumes, livestock

and fish at a small scale, underutilized crops, and biofortified crops). Diversified production

systems are important to vulnerable producers to enable resilience to climate and price

shocks, more diverse food consumption, reduction of seasonal food and income

fluctuations, and greater and more gender-equitable income generation. 8. Improve processing, storage and preservation to retain nutritional value, shelf-life, and

food safety, to reduce seasonality of food insecurity and post-harvest losses, and to make

healthy foods convenient to prepare. 9. Expand markets and market access for vulnerable groups, particularly for

marketing nutritious foods or products vulnerable groups have a comparative

advantage in producing. This can include innovative promotion (such as marketing based

on nutrient content), value addition, access to price information, and farmer associations. 10. Incorporate nutrition promotion and education around food and sustainable food

systems that builds on existing local knowledge, attitudes and practices. Nutrition

1 Context assessment can include potential food resources, agro-ecology, seasonality of production and income,

access to productive resources such as land, market opportunities and infrastructure, gender dynamics and roles,

opportunities for collaboration with other sectors or programmes, and local priorities. 2 Malnutrition includes chronic or acute undernutrition, vitamin and mineral deficiencies, and obesity and chronic

disease. 3 Vulnerable groups include smallholders, women, youth, the landless, urban dwellers, the unemployed.

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knowledge can enhance the impact of production and income in rural households,

especially important for women and young children, and can increase demand for

nutritious foods in the general population.

Food and Agriculture Policies can support food security and nutrition if they:

1. Increase incentives (and decrease disincentives) for availability, access, and

consumption of diverse, nutritious and safe foods through environmentally

sustainable production, trade, and distribution. Focus on horticulture, legumes, and

small-scale livestock and fish – foods which are relatively unavailable and expensive, but

nutrient-rich – and vastly underutilized as sources of both food and income. All people

should be able to access diets recommended by dietary guidelines. 2. Monitor dietary consumption and access to safe, diverse, and nutritious foods. The

data could include food prices of diverse foods, and dietary consumption indicators for

vulnerable groups.

3. Include measures that protect and empower the poor and women: Safety nets that

allow people to access nutritious food during shocks or seasonal times when income is

low; land tenure rights; equitable access to productive resources; market access for

vulnerable producers (including information and infrastructure). Recognizing that a

majority of the most vulnerable are women, ensure equitable access to all of the above for

women. 4. Build capacity in human resources and institutions to improve nutrition through the food

and agriculture sector, supported with adequate financing. 5. Support multi-sectoral strategies to improve nutrition within national, regional, and

local government structures.

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ANNEX 4: ON-GOING PROGRAMMES IN NEPAL

It should be noted that there are several large-scale agriculture, food and nutrition security

programmes on-going in the country in parallel with the GoN’s larger strategic plans on

agriculture and nutrition. How these programmes align with these new strategies, and their own

progress is not analyzed in this report, however it should be noted that there is substantive

activity focusing on food system approaches in the country. Some large-scale programmes

include:

I. Feed the Future, USAID

Feed the Future (FTF) aims to increase inclusive growth in the agricultural sector and improve

nutritional status, especially of women and children. FTF will assist an estimated 165,000

vulnerable Nepali women, children and family members—mostly smallholder farmers—escape

hunger and poverty. In conjunction with the Global Health Initiative, more than 393,000 children

will be reached with services to improve their nutrition and prevent stunting and child

mortality. Significant numbers of additional rural populations will achieve improved income and

nutritional status from strategic policy engagement and institutional investments. Through an

integrated whole-of-government approach, FTF Nepal will concentrate on agriculture and

nutrition investments in a geographically-defined target area and will make supporting

contributions in cross-cutting areas. In the targeted geographic focus area, FTF Nepal will invest

in three main components (USAID 2013):

• Commercially-driven agricultural transformation of smallholder farmers

• Capacity building program to deliver nutrition and hygiene education to targeted

households

• Literacy and entrepreneurship training led by local leaders and targeting the most

vulnerable individuals in the community

II. Suaahara, USAID

Suaahara is a five-year USAID-funded integrated nutrition program that uses a comprehensive,

household-based approach to improve access to, and consumption of, nutritious foods in areas

with very poor nutrition indicators. Its main objective is to improve the nutritional status of

pregnant and lactating women and children under two years of age directly addressing the

vulnerable points of development which result in stunting. The program will focus on improving

nutrition; maternal, newborn, and child health services; family planning services; water,

sanitation and hygiene; and home-based gardening. Behavior change communications and

continued support for micronutrient supplementation will be key components of Suaahara’s

strategy. The program will also work with health facilities to improve nutritional counseling and

care services and connect families to reproductive health and MNCH services. One of the

distinguishing elements of Suaahara is the integration of various sectors—including

agriculture—to achieve improved nutrition for vulnerable populations (IFPRI 2013).

III. The Nepal Agriculture and Food Security Project (NAFSP), World Bank

The NAFSP is to enhance food and nutritional security of vulnerable communities in selected

locations of Nepal. Food security will be realized through increased food availability, made

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possible by increasing productivity of agriculture (both crop and livestock); and nutrition security

through improved nutrition, made possible by promotion of diversified diets and improved

feeding and caring practices for pregnant and nursing women and children up to 2 years of age.

The project will directly benefit approximately 150,000 small and marginal farmers, 50,000

young mothers, children and adolescent girls, and 25,000 agricultural wage workers (GAFSP

2013).

IV. Sunaula Hazar Din (Community Action Lab), World Bank

The objective of Sunaula Hazar Din is to improve attitudes and practices known to improve

nutritional outcomes of women of reproductive age and children under the age of two. There are

two components to the project. The first component is rapid results for nutrition initiatives at the

ward level. This component will support the entire Rapid Results for Nutrition Initiative (RRNI)

process. It will start at a Ward Citizen Forum where, invited by the Local Governance and

Community (LGCDP) social mobilizer, key nutrition challenges of the community will be

discussed. Assisted by a coach at the ward level, the Ward Citizen Forum will select a nutrition

relevant goal from a menu of goals. A RRNI team will be formed at the ward level that will set an

appropriate and realistic target for meeting the goal and pledge to achieve the goal within a 100-

day period by mobilizing the community and finding the best approach to achieving the target in

their particular context. Results of the initiatives will be recorded and maintained by Nutrition

and Food Security Steering Committee (NFSSCs) and lessons of successful and innovative

projects will be disseminated to other communities to ensure maximum learning. The second

component is project management, capacity building, monitoring and evaluation. This

component will provide support for the implementation of first component under three sub-

components: (i) capacity enhancement of the project management team, including cluster units,

and NFSSCs, as well as of coaches and social mobilizers. This includes financing of a mid-line

and end-line survey as well as financing annual conferences where findings and innovations of

successful RRNI teams will be presented as well as whether the expected outcomes of the

rapid results initiatives were achieved. Evaluation of the program is one of the primary aims

during implementation (World Bank 2013).

V. Nepal Innovation Lab (CRSP), USAID

The Feed the Future Innovation Lab for Collaborative Research on Nutrition is a USAID funded

project implemented by the Friedman School of Nutrition Science and Policy at Tufts University.

The mission of the Nutrition Innovation Lab is to discover how integrated interventions of

agriculture, nutrition and health can achieve large-scale improvements in maternal and child

nutrition in Asia and Africa and enhance institutional and human research capacity around

agriculture, health and nutrition in Africa and Asia through graduate level training (MS and PhD)

and support for short courses and conferences. Partners in Nepal include the Schools of Public

Health at Harvard University and Johns Hopkins University, the College of Agriculture at Purdue

University and the College of Agricultural, Environmental, and Natural Sciences at Tuskegee

University, the Institute of Medicine at Tribhuvan University, Development Alternatives, Inc., the

Nepal Technical Advisory Service, Heifer International and Helen Keller International (FTF NIL

2013).

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VI. Kisan, Winrock International

DEPROSC-Nepal has entered into a five-year project with Winrock International (WI) to

implement KISAN Project, which will cover 20 districts of far western, mid western and western

development regions. Overall goal of KISAN is to sustainably reduce poverty and hunger in

Nepal by achieving inclusive growth in the agriculture sector, increasing the income of farm

families, and improving nutritional status, especially of women and children. WI is working with 5

national NGOs like DEPROSC, which is responsible for Credit & finance, Micro irrigation and

Disaster Risk Reduction activities.

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ANNEX 5: TERMS OF REFERENCE FOR NEPAL CASE STUDY Objectives

The descriptive review of food and agricultural policies in Nepal will contribute to advance the

discussion on nutrition-sensitive agriculture. The study will provide answers to some of the

emerging questions on:

• the specific nature and range of policies and other actions to improve nutrition through

food and agriculture (for various populations and geographies), including the

characteristics of the system, at what point these policies and other actions engage with

the food and agricultural system, and how; through what actors and institutions; and with

what known or potential effects;

• the potential process and impact indicators related to actions that enhance the impact of

food and agriculture on nutrition and methods of measuring both;

• key knowledge gaps in the relationship between the shape and operation of food and

agricultural system and nutrition.

Specific Objectives

• To perform a situation analysis, describing the current nutrition agriculture and

environment situation; current food system from food consumption to food supply, diets

and stage of the nutrition transition; existing problems that are being prioritized by

national policies and strategies; main policy frameworks of the current agriculture and

food policies; and how nutrition is referred to in the national food and agriculture policy

documents.

• To analyse the nutrition sensitivity of the specific agriculture and food policies/

frameworks/programmes chosen by the country representatives, investigating to what

extent they impact or consider nutritional outcomes, how far they are being planned or

implemented effectively and describing at what point the food and agricultural system

engages/links with relevant policies of other sectors.

• To describe the relevant policy processes and alignments, including an analysis of

supporting factors and constraints (M&E systems and indicators, implementation

capacity, coordination and funding).

• To propose recommendations on how to make the selected policies/programmes more

nutrition-sensitive, identifying gaps that them from being more nutrition-sensitive and

points of entry for nutrition to facilitate the effective implementation of nutrition-sensitive actions. (More details on the specific objectives can be found in Annex 4).

Deliverables

• A review of the current nutritional, agricultural, and environmental situation in Nepal

including nutrition status, food supply, consumption and dietary patterns, access and

affordability, and current influences and determinants.

• An analysis of the “nutrition sensitivity” of Nepal’s main food, agriculture, environment

and nutrition national policy frameworks and their relevant implications on programs and

implementation strategies.

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• A “nutrition sensitive” analysis of the current multi-sectoral nutrition strategy for Nepal

and an assessment of the interventions, targets and cost of the proposed nutrition

sensitive actions.

• A description of the current political economy and environment supporting nutrition

sensitive strategies in Nepal.

• Formulate recommendations for improvement to ensure policies are nutrition-sensitive.

Methods

The country analysis includes a secondary data analysis, a literature review, snowballing

interview approach, and a country visit to the assigned country/countries. Relevant country

policy and programme documents will be reviewed to seek out relevant information on

strategies, policies and investments in food and agriculture, their impact pathways on various

nutritional outcome, direct and indirect ones, institutional capacities, stakeholder participation,

alignment, cross-sectoral collaboration processes, and others.

The literature review will provide further insights and background information. It will build on

country papers developed in preparation for the International Conference on Nutrition (ICN2) as

well as use data in existing databases or country profiles (e.g. the NLIS (WHO) or FAO country

profiles, World Bank, UNDP). The consultant will liaise with national government focal points

and experts in the specific sector areas using a predefined set of guidelines and interview guide.

Country visit: The country visit will give opportunity for more in-depth interviews with national

partners and experts. Potential partners to interview include: the government focal point,

representatives from the Ministry of Planning, Ministry of Agriculture, Ministry of Health, national

level SUN movement stakeholders, REACH facilitators and UN country teams (if applicable),

international and local NGOs and CSOs, and donors in country including the donor convener (if

applicable). According to the context this list is not exclusive. The information and its analysis

will be included in a final country report.

Reporting

The final report will include the description of the methodology, of the relevant policy areas, an

analysis of their sensitivity to nutrition, lessons learned and good practices, and

recommendations for ‘how to do nutrition-sensitive agriculture’ and potentially ‘how not to do it’.

It will also include the timetable of the consultancy, the country visit and a list of people that

were contacted and/or interviewed, a list of references and relevant policy documents.All

documents will be written in English and references well documented. The final report will be

delivered in English.

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UNITED NATIONS SYSTEM

STANDING COMMITTEE ON NUTRITION

The United Nations System Standing Committee on Nutrition (UNSCN) is the food and nutrition policy harmonization forum of the United Nations. Its vision is a world free from hunger and malnutrition, where there are no longer impediments to human development.

UNSCN UNSCN UNSCN UNSCN

Chair: Ramiro Lopes da Silva

c/o World Health Organization

20 Avenue Appia, CH 1211 Geneva 27

Switzerland

Telephone: +41-22 791 04 56

[email protected]

www.unscn.org