How to Scale and Sustain Access to More Nutritious Foods?

In order for us to build an enabling environment that supports the availability of diverse and nutritious food items, we at GAIN feel that first of all, thereis need to properly understand the barriers that families and households face in accessing and consuming nutritious foods.

In collaboration with in-country and international researchers, we have applied innovative tools to identify specific nutrients that are missing in specific communities and age-cohorts 6-23 months (in select countries) so that interventions and advocacy efforts are geared to towards a problem that is clearly defined in direction and magnitude. By coming up with such accurate problem analysis, advocacy becomes much easier and allocation of resources to address such issues is much faster.

In addition, with such evidence, even when demand of nutritious foods has been latent due to lack of knowledge about their importance in the diet, demand creation and evidence-based marketing efforts are more likely to succeed.

In short, successfully building an enabling environment will include: creation of a solid evidence base for interventions in the agriculture and nutrition space, establishing mechanisms and models that bring nutritious foods to market, creating market demand for nutritious foods and ensuring that small- and medium-sized food and nutrition companies can access appropriate forms of capital to grow the well-planned businesses – a key constraint for many companies.

Scaling up of markets is ensured when they are private-sector led. With their deep penetration and understanding of distribution channels, the private sector is the driver of any sustainable marketing efforts. Since most of the would-be buyers of the nutritious foods are low income consumers with inelastic incomes, there is only so much that they can buy even when they have the right nutrition awareness. Innovations on packaging size and distribution are critical to ensuring access to most of these consumers. In Kenya, we are seeing many versions of these innovations targeting slum dwellers.

At GAIN, we are also learning that in addition to supporting companies with funds to pilot or scale their business innovations, investment is needed to provide the necessary technical assistance (product formulation, marketing, financial management etc.) to ensure that companies are adequately equipped to run successful and therefore, sustainable, businesses.

Agree with many of these points Ewan.

We need a business case - and in many cases, businesses need partners to co-invest or work with them to de-risk their investment. For example, NGOs, aid agencies can help build demand for products, or provide the distribution networks for a product, making the business model more viable than if the business was going for it alone. This type of partnership will be really important to get to the very poorest communities.

When you say that countries want to integrate their agriculture and nutrition plans, does that mean they are looking for education as to what it takes to ensure the right mix of nutrients to keep their populations healthy? And with that knowledge, they can be better able to manage their supply chain to ensure this mix is available to everyone? Also, do you think, if this was achieved, that nutrition could be achieved without fortified foods? I sometimes wonder if this could be the goal...increase yield and varieties so people are able to achieve the right balance. Do you think it is possible?

I think the finance issue is really interesting. Is the problem that institutions are reluctant to finance SMEs in general? What about companies making (non-nutritious) foods? Are there factors about a business model around nutrition that make it more difficult to access finance?

Thanks Clement. Are there SME hubs that provide a good example to follow? Has anyone tried this for nutrition yet?

Thanks for the questions Rachael,

These are really pertinent questions. Thinking about both demand and supply is imperative for a healthly private sector initiative. One thing is packaging in too large a quantitiy. For people on really low incomes shifting to produce that can be consumed on a daily basis can help i.e. smaller packaging.

Another is creating the demand in the first place by providing evidence on the benefits these types of supplements can bring.

Hystra have some some research on "Marketing foods to the Base of the Pyramid", which provides some useful insights.

Thanks Jonathan. I know you have worked with quite a few different partnership models. It's especially to learn from those that have been going for a few years. I think this reveals a lot as to what the forces are shaping the sustainability of the model.

Hi all - really interesting to see this discussion. One question I think would be applicable around the world, across income segments, is what makes people want to eat nutritious food - even when incomes allow, and nutritious options are available. Has there been research on the drivers for consumption of nutritious foods?

Also - are there lessons in this respect we can learn from the clean water space?

Those are very real challenges, my question is what sort of partnerships are we talking about and how will they address the problem. Any examples from the projects you have researched

Ewan, I don't know of any but Maziwa King would be glad to explore this idea. We have been in discussions with a company that sells chicken in low income areas and we are currently exploring opening a joint outlet. If this works especially in creating cross sales then we can increase the offering in these outlets.

Thanks Helen. Here's the weblink: http://hystra.com/marketing-nutrition/

What about approaches combining public distribution to the poorest households, while also trying to get affordable products on the market for those with more spending power? This has been discussed quite a bit. Looking at a few of these products, it seems it hasn't always worked though, especially with problems of immitation products.

Helen, great - Hystra tend to write very good reports.

Thanks for all the comments so far. Let's move on to the next question:

Q3: Where are the innovations happening to support greater supply of and demand for nutritious foods, and what are we learning about what works?

Hi Beth. Great question! Unfortunately I don't have a direct answer. I'm very interested to hear what others have learned.

There is research showing that for very poor households, social marketing or awareness raising don't seem to work. And even when relative buying power increases a bit, people don't necessarily buy healthier (usually they opt for tastier and higher status). I've written more here:

http://www.globalisationanddevelopment.com/2013/08/paying-for-nutrition-challenges-and.html

It strikes me that without really strong leadership and investment from the public sector in putting in place effective policies (eg on fortification) and standards agencies for quality control etc, that its almost an impossible task. Can you point to the countries where the governement really has provided the leadership and resources to see significant progress in this area?

Innovations are taking place at different sections of the value chain and especially in packaging, distribution and delivery modes. My company, Maziwa King, is just one example that targets lower end consumers:

Maziwa King was established in Nairobi, Kenya in 2011, to distribute pasteurized full-cream milk using coin-operated milk dispensing technology, from as little as KSh5 (USD$0.05) per purchase. The product is not packaged, but dispensed directly into a container brought by the customer. This presents a solution for low and middle-income populations, and mothers with young children, who seek to buy full cream milk, which is both affordable (affordable in that the machine dispenses to you the quantity of milk based on how much money you have) and safe to consume.

Its a question I ponder daily, Beth. I am not aware of any research on the drivers for the consumption of nutritious foods (would appreciate references if anyone has them) but based on anecdotal evidence, I think that there is a general lack of awareness or acceptance that the consumption of nutrious foods truly impacts health. Food is food. As long as your belly feels full, than there are no problems. I think, particularly in light of the research that has just started on hidden hunger (particuarly in places like the US), that paradigm is definitely changing and I anticipate that we should have greater clarity as to what it takes to achieve a nutritious balance and the direct benefits that can be realized from the intake of nutritious options.

Dear Beth. This is great question because indeed even when these foods are available and thay can afford them, their choices may be not to. However, the greatest number of those at risk and those that are our primary focus for now have no means at all because the prices are either too high or the foods are not available in the first place.