Biofortification as a Vitamin A Deficiency Intervention in Kenya By: Angela Mwaniki

CASE STUDY #3-7 OF THE PROGRAM: "FOOD POLICY FOR DEVELOPING COUNTRIES: THE ROLE OF GOVERNMENT IN THE GLOBAL FOOD SYSTEM" 2007

Edited by: Per Pinstrup-Andersen (globalfoodsystem@cornell■edu,) and Fuzhi Cheng Cornell University

In collaboration with: Soren E. Frandsen, FOI, University of Copenhagen Arie Kuyvenhoven, Wageningen University Joachim von Braun, International Food Policy Research Institute Executive Summary Vitamin A deficiency is a serious global nutritional • designing a feasible distribution system problem that particularly affects preschool-age that ensures that OFSPs are economically children. Current efforts to combat micronutrient and physically accessible to all households; malnutrition in the developing world focus on and providing vitamin and mineral supplements for • promoting consumer acceptance by creat­ pregnant women and young children and on forti­ ing awareness of its benefits and develop­ fying foods through postharvest processing. In ing innovative products. regions with a high prevalence of poverty, inade­ quate infrastructure, and poorly developed markets Your assignment is to recommend a set of policies for food processing and delivery, however, these to the government of Kenya that would facilitate methods have had negligible impact, and biofortifi­ greater production and consumption of biofortified cation has been proposed as a more effective inter­ sweet potatoes, taking into account the interests of vention. various stakeholder groups. State the assumptions Inadequate dietary intake is the main cause of made in your argument. micronutrient malnutrition in Kenya. It is directly correlated with poverty. Micronutrient malnutri­ Background tion is directly linked to 23,500 child deaths in Kenya annually. Seventy percent of children under More than 40 percent of the world's population age six have subclinical vitamin A deficiency. The suffers from micronutrient malnutrition, including situation is aggravated by a high prevalence of vitamin A, iron, iodine, and zinc deficiencies [Misra diseases and conditions that directly interact with a et al. 2004], A large proportion of this population patient's vitamin A status, such as malaria, measles, is in developing countries. The consequences of HIV/AIDS, and deficiencies of other micro­ malnutrition impose immense economic and nutrients such as iron and zinc. societal costs on countries. Micronutrient malnutri­ tion greatly increases mortality and morbidity Orange-fleshed sweet potatoes have been scienti­ rates, diminishes children's cognitive abilities and fically determined to be a feasible tool for alleviat­ lowers their educational attainment, reduces labor ing vitamin A deficiency. In Kenya the bulk of productivity, hinders national development efforts, sweet potato cultivation is carried out in the and reduces the livelihood and quality of life of all western part of the country, and western Kenya those affected [Welch and Graham 2002], Micro­ also has the highest poverty and vitamin A defi­ nutrient malnutrition interventions may be broadly ciency prevalence. The region was therefore categorized into poverty alleviation strategies, clini­ selected for the first orange-fleshed sweet potato cal interventions, and nutritional interventions. [OFSP] pilot project. Nutritional interventions include dietary diversifica­ Success will have been achieved when Kenya can tion, fortification, supplementation, nutritional offer nationwide use of OFSPs as a vitamin A defi­ education, and, more recently, biofortification. ciency intervention. Options for achieving this Current efforts to combat micronutrient malnutri­ objective may include: tion in the developing world focus on providing vitamin and mineral supplements for pregnant • increasing investments in agricultural women and young children and on fortifying foods research and decentralizing the production through post-production processing. In regions of new sweet potato varieties; with adequate infrastructure and well-established • educating farmers on optimal cultivation markets for food processing and delivery, food practices for OFSPs; fortification has greatly improved the micro­ • providing incentives for farmers to adopt nutrient intake of vulnerable populations, particu­ OFSPs, including a ready market, and larly the urban poor. In cases of inadequate infra­ removing limitations that lead to producer structure, decentralized processing units, and a nonacceptance; high prevalence of poverty, however, fortification programs have not had sustainable impact. In Kenya it is estimated that 23,500 child deaths preventable blindness, but also leads to increased annually are directly linked to micronutrient malnu­ morbidity and risk of mortality. trition and that 70 percent of the children under age six have subclinical vitamin A deficiency Vitamin A deficiency is mainly caused by an inade­ [Micronutrient Initiative and UNICEF 2005], quate dietary intake of the micronutrient. Rapid growth and frequent infections are also critical More than 70 percent of the food-insecure popula­ factors [Underwood 2004], Other micronutrients tion in Africa lives in the rural areas [Heidhues et also affect vitamin A deficiency. The initial signs of al. 2004], Ironically, smallholder farmers—the vitamin A deficiency are night blindness and producers of more than 90 percent of the con­ impaired epidermal integrity manifested by hyper­ tinent's food supply—make up the majority of the keratosis. If left untreated, night blindness is rural food-insecure population. The rest of the followed by xerophthalmia, a disease associated food-insecure population consists of the landless with structural changes in the cornea. Epidemio­ poor in rural areas [30 percent] and the urban logical studies show that consumption of vitamin A poor. Throughout the developing world, agricul­ and carotenoids is inversely correlated with devel­ ture accounts for around 9 percent of gross opment of several types of cancer. Vitamin A defi­ domestic product [GDP] and more than half of ciency during gestation has been shown to induce total employment. In countries like Kenya, where fetal malformations in animals and is likely to have more than 34 percent of the population is under­ similar outcomes in humans. nourished, agriculture represents 30 percent of GDP, and nearly 70 percent of the population Vitamin A deficiency interventions include dietary relies on agriculture for their livelihood [FAO diversification, food fortification, supplementation, 2003], Because rural areas are home to more than nutrition education, food production, and, more 70 percent of the poor and the largest proportion recently, biofortification. The dietary sources of of the food insecure, significantly and sustainably vitamin A are preformed vitamin A and provitamin reducing food insecurity will require transforming A carotenoids. Preformed vitamin A is found in the living conditions in these areas. It is possible, foods of animal origin, whereas provitamin A however, to improve the health status of this carotenoids are found in yellow- and orange-fleshed population through biofortification while at the fruits and vegetables and in dark-green leafy vege­ same time working on long-term poverty alleviation tables. Palm oil is the universal source of pro­ strategies. vitamin A for the pharmaceutical industry.

Vitamin A Deficiency Vitamin A Deficiency Alleviation Projects in Vitamin A deficiency is a serious worldwide nutri­ Kenya tional problem that particularly affects preschool- Current vitamin A deficiency interventions include age children. It has been estimated to cause about fortification and supplementation. Although these 70 percent of cases of child blindness worldwide interventions have had significant impact in projects [Underwood and Arthur 1996], Worldwide, 140 where they are administered, the results have not million children under five years of age, of whom been sustainable in the long run, especially in about 70 percent live in South Asia and Sub- resource-poor communities. This is because Saharan Africa, have low serum retinol concentra­ resource-poor households consume an insignificant tions [< 0.7 pimol/L], East and Southern African amount of processed foods, limiting the use of countries have the highest prevalence [37 percent] fortification. In addition, they tend to be situated in of preschool children with low serum retinol con­ remote areas characterized by poor infrastructure, centrations [Mason et al. 2001], The vitamin and its inadequate health care, and insufficient public metabolites are essential for vision, reproduction, funds. This situation limits the use of supple­ and immune function. They play important roles in mentation as a sustainable intervention. Dietary cellular differentiation, proliferation, and signaling. diversification is still the best way to alleviate mal­ Vitamin A deficiency in Kenya is most prevalent in nutrition. It aims at ensuring that the available diet children between the ages of 23 months and 6 is adequate in every nutrient. Dietary diversification years [Ngare et al. 2000] and in western Kenya. is a long-term objective, but it provides some indi­ Vitamin A deficiency not only contributes to cators about what strategies may be sustainable. NGOs, governments, and companies continue to vegetable technology are mushrooming around the make concerted efforts to control vitamin A defi­ country. ciency, especially in resource-poor households that have only limited access to a variety of vitamin A - Vitamin A from mangoes. Vitamin A from rich sources. Although a variety of dietary inter­ Mangoes [VitAngo] is a partnership between non­ ventions continue to be implemented, this case governmental organizations and a network of pri­ study will concentrate on three examples of dif­ mary and secondary schools. Partners in this ferent approaches to the problem. project are the World Agroforestry Centre, the Lake Victoria Schools Agroforestry and Environ­ Dried traditional green vegetables. Most vitamin A mental Education Network, the Kenya Organization consumed in Kenya is obtained in the provitamin A of Environmental Education, and the Kenya Youth form from traditional green leafy vegetables [Oiye Education and Community Development Program. and Shiund 2005], More than 70 percent of The objective is to reduce vitamin A deficiency and Kenya's agriculture is rainfed, however, so these generate income by promoting preservation, use, green vegetables are available and affordable to and marketing of mangoes in an environmentally resource-poor households only seasonally. The friendly and sustainable way. The partnership chose problem is amplified by the fact that 70 percent of mangoes because they have the highest provitamin Kenya's land is classified as arid and semi-arid A content of all the tropical fruits. [ASAL]. One solution to the problem is to dry the vegetables for storage and consumption during The problem is that mangoes are harvested only seasons when they are not available in the market­ once a year and at about the same time country­ place. Various organizations have been involved in wide. The fruit is highly perishable, and hence this approach, including the International Plant farmers are forced to sell their produce at the Genetic Resources Institute [IPGRI], the National market price. In most cases farmers make no Museums of Kenya, and the Appropriate Rural profits from their sale. More than 50 percent of Development Agriculture Program [ARDAP] in the mango harvest is lost through postharvest Busia, a district in western Kenya. ARDAP spoilage of the fruit. The VitAngo partnership produces vegetables, processes them, packages seeks to address these challenges by preserving them, and test-markets the dried traditional green mangoes through solar drying and storage tech­ vegetables. Their most famous innovation is niques. In addition, they seek to promote the "instant m bogf [mboga is the Swahili word for expansion of existing earlier- and later-ripening vegetable), which consists of dried vegetables mango varieties. The partnership will produce dried packed with dried groundnuts, onions, tomatoes, mango snacks like those readily available in the and s i in sim sauce. The aim of this project is to not Philippines. Production of other mango products, only to prolong green vegetable availability by such as mango juice and mango concentrate, is a increasing its shelf life, but also to add value and technological option not addressed by this organi­ convenience to the products to secure some zation. The results of this project have yet to be market share in urban areas. In so doing, ARDAP realized. hopes to help alleviate vitamin A deficiency and poverty in rural areas by stimulating farmers to There is a high demand for good-quality mango grow more green vegetables and consequently varieties with high product yield, juice, and flesh, helping them make money to buy other food such as ngow e and apple mango. Cooperative-run crops. farms and large-scale farmers with export and factory connections typically deal in these high-end In addition, the organizations involved in this effort mangoes, which are available in select markets year- create awareness of the benefits of consuming what round. The mangoes are relatively expensive and they refer to as African green leafy vegetables beyond reach for resource-poor households. On (ALV). They broadcast television shows on how to the other hand, the smaller, hardy, stringy mangoes prepare tasty home-cooked meals, and there is even that require less input are typically grown on a cookbook in press. There have been awareness smallholder farms for fruits and aesthetic value. walks, lectures, and entertainment, including tradi­ These varieties have a low product yield and are tional dances and plays with the same message. As a available seasonally in the local markets. If the result, cottage industries based on dried green VitAngo partnership is to succeed, it will need to find interventions that ensure that their end Biofortification has many advantages as a nutritional products, especially new varieties that they develop, intervention: are physically and economically accessible to their target group, resource-poor households. 1. It does not require a change in behavior by farmers or consumers where the crops Orange-fleshed sweet potato projects. Many inter­ are already widely produced and consumed ventions start out with the intention of reaching by poor households in the developing resource-poor rural households but end up bene­ world. The introduction of the orange- fiting middle- and high-income households. To fleshed sweet potato in regions where the avoid this outcome, HarvestPIus and its partners white-fleshed sweet potato is traditionally propose the biofortification of existing staple consumed, however, may pose a challenge crops. In Kenya this approach takes the form of or an opportunity, depending on the orange-fleshed sweet potato projects that use bio­ perceptions of the target population. fortification as a tool to alleviate vitamin A defi­ 2. Biofortification capitalizes on the regular ciency in the targeted population. The primary dietary intake of a consistent and large target population consists of resource-poor, small­ amount of food staples by all family mem­ holder farm households. The secondary target bers, ensuring an increase in nutritional population consists of landless, resource-poor status of the household households in rural areas and the urban poor. 3. The multiplier aspect of biofortification OFSP projects also hope to increase the dietary across time and distance makes it cost- diversity of tertiary populations by adding to avail­ effective. After the initial investment to able dietary options. Because vitamin A deficiency develop seeds that produce plants that is linked with poverty, the tertiary population fortify themselves, recurrent costs are low provides a potential market. and germplasm can be shared inter­ Biofortification is the process of producing food nationally. In addition, since propagation crops that are rich in bioavailable micronutrients of sweet potatoes is through vines, farmers [Graham et al. 2001; Bouis 2003], It may involve can [and do] informally disperse the varie­ adding a nutrient that does not originally exist in ties to neighbors and friends. the crop [as is the case with "golden rice"], 4. Biofortification provides a feasible means increasing the content of an existing nutrient [such of reaching undernourished populations in as iron and zinc in maize], or making an existing relatively remote rural areas. It delivers nutrient more bioavailable [bioavailability is defined naturally fortified foods to people with as the amount of a nutrient in a food that is limited access to commercially marketed absorbable from a typical diet and utilizable within fortified foods. It is this aspect of bioforti­ the body to perform metabolic functions]. Devel­ fication that makes it a suitable inter­ oping orange-fleshed sweet potato varieties can vention for Kenya. incorporate one or all of these strategies, depend­ ing on the variety. Research has demonstrated that As with any model, assumptions made must hold micronutrient enrichment traits are available within true to achieve success. The following assumptions the genomes of major staple crops that could allow are made with regard to biofortification: for substantial increases in iron, zinc, and pro­ vitamin A carotenoids without reducing yield 1. The target population already consumes a [Welch and Graham 2002], In fact, OFSPs have non-biofortified variety of the crop to be been scientifically determined to be a feasible tool introduced. in alleviating vitamin A deficiency due to inade­ 2. The vulnerable target group has both eco­ quate intake [van Jaarsveld et al. 2005], Apart from nomic and physical access to the bioforti­ being a precursor of vitamin A, beta-carotene [of fied crop. which OFSPs are an excellent source] is said to 3. The target group will continue to consume increase the bioavailability of iron from the diet the staple in sufficient quantities after bio­ [Garcia-Casal et al. 2000], fortification. 4. Preparation of the biofortified crop as Initial OFSP projects faced many challenges. First, food will not reduce the amount or bio- there was the need to develop varieties that would availability of the micronutrient in the adapt to Kenya's climatic conditions and yet be food. resistant to sweet potato virus diseases. Conven­ 5. The added or increased micronutrient will tional breeding techniques were used, and these have synergistic rather than negative inter­ challenges have been overcome. The next step was actions with other micronutrients already to identify farmers who were financially able to in the food matrix. grow OFSP, had available extra land, and were willing to grow the crop. In some places the project 6. Biofortification will not worsen the flavor took the form of establishing demonstration plots of the food crop. in schools or community development centers. 7. The farm yield of the biofortified crop will Project implementation has gone a step further by be equal to or better than that of the non- creating awareness through education and new biofortified crop being replaced. product development. These products include 8. The tools used for biofortification, such as cakes, breads, and homemade pastry products such classical plant breeding and genetic engi­ as ch a p a tti and m andazi that have OFSPs in their neering, are legally acceptable in the coun­ composite flour, OFSP flour in a child supplement, tries where the target population lives. and home-cooked meals containing OFSP. There is 9. It is economically feasible for farmers and currently an OFSP flour in the supermarkets. markets to deal in biofortified crops. Policy Issues In Kenya the white-fleshed sweet potato is con­ sumed mainly in western Kenya but is available in many markets countrywide. The production of the The policy issues facing biofortification in Kenya OFSP on farm households ensures physical and may be classified into implementation issues, struc­ economic access. Sweet potatoes are consumed tural issues, and exogenous issues. The issues dis­ boiled whole, mashed with legumes, or eaten with cussed herein refer to the biofortification of not leafy vegetables, meat, or fish. The crop is widely only the sweet potato, but also any other crop in consumed in rural areas. Because sweet potatoes the future. The issues limiting Kenyan agricultural are a woman's crop, household access to the OFSP growth nationally affect sweet potato biofortifica­ is assumed. When women control both production tion and are bound to affect any other crop intro­ and consumption of a particular crop, an increase duced into the country. in household nutritional status is likely to be achieved, because women tend to keep most of the Implementation Issues crop for home consumption, whereas men tend to sell most of the crop [Sachs 1996], Even when OFSP projects in Kenya face four main challenges: women sell some of the crop, sales tend to be small and income earned remains under the control of 1. Poor infrastructure, especially in the the female producers, who channel it back to the resource-poor regions of the country, household [Quisumbing et al. 1998], There is no makes these regions inaccessible. evidence of negative nutrient bioavailability inter­ 2. Maize is the main staple food crop in the actions. Studies show that after processing, OFSPs country and hence a strong competitor still contain most of the nutrient. for land and resources, particularly in resource-poor households. To be selected as a potential fortification vehicle, a 3. Kenyans prefer white-fleshed sweet food should be commonly consumed by the target potatoes, resulting in high risk to farmers group, affordable, and available all year round. and traders who deal with the OFSP. Sweet potatoes are consumed as a secondary staple 4. Education, training, and marketing on the in Kenya [Hagenimana et al. 1999], Traditionally, use of OFSP as a vitamin A deficiency white-fleshed sweet potatoes are produced mainly intervention requires large investments of in western Kenya, the region with the highest money, time, human resources, and tech­ prevalence of vitamin A deficiency. Western Kenya nology. was thus selected as the first test site for OFSP. Some of the issues to consider are: How sustainable market, consumers in rural areas are quick to is the project? Is there an incentive for farmers to discriminate against produce that is comparatively grow biofortified foods? Who should control or inferior, hence farmers have, over time, adapted to lead the biofortification initiative? Can Kenyans selling only their better produce. This highly produce higher crop yields and more nutritious subjective process has worked traditionally. When foods from thinning soils, making food more the same farmer wants to sell produce to the urban affordable and accessible to increasing numbers of market, however, subjective standards no longer people? In addition, rainfed agriculture predomi­ work. The farmer is forced to meet relatively objec­ nates in Kenya, where only 25 percent of land area tive standards such as size, quantity, and quality. is arable. Stakeholders may need to [1] justify the addition of OFSPs on land where sweet potatoes are not currently grown and would be competing Exogenous Issues with other crops, and [2] contribute toward irriga­ Stakeholders may need to address and help alleviate tion projects so that OFSPs can be grown on land exogenous issues that are not in their jurisdiction that is currently not arable in places where some of but have a direct impact on their efforts. Disease the poor population lives. and infection continue to plague the country. Diseases such as malaria, tuberculosis, and Stakeholders also need to ensure that OFSPs are HIV/AIDS reduce the person-hours available to not only available, but also accessible to poor non­ agriculture and household food acquisition. This farming households. Interventions usually tend to situation is particularly serious for resource-poor benefit middle- and high-income households. This rural households that depend on the labor of every situation in turn creates barriers for resource-poor member of the family for their livelihood. Also, it households. Access to the OFSP is complicated not is mainly the poor who do not have physical or only by poverty, but also by lack of roads and economic access to health care. In Sub-Saharan infrastructure to move food swiftly from place to Africa AIDS is the leading cause of adult mortality place. Kenya also suffers from underinvestment in and morbidity. The Food and Agriculture Organi­ agriculture and agricultural research and develop­ zation of the United Nations [FAO] estimates that ment. Because there is no dominant farming system by 2020 the epidemic will claim the lives of 20 on which food security largely depends, various percent or more of the population working in agri­ approaches need to be created for the different culture in many Southern African countries. More farming systems. For example, where mixed farming than two-thirds of the total population of the 25 is practiced, animal manure may be used on sweet most-affected countries resides in rural areas, potatoes and sweet potato vines may be fed to the affecting agricultural production as well as farm and animals. Where only maize and beans are grown, an domestic labor supplies. Lack of resources also incentive to introduce the crop is needed. Stake­ makes it more difficult for HIV-affected households holders must identify what farming system or to supplement their diet by purchasing more nutri­ systems they want to pursue. Lastly, stakeholders tious and varied foods. The effect of malnutrition will need to seek solutions to the problem of post­ on food security is further exacerbated by the fact harvest losses since OFSP are highly perishable that individuals affected by disease and infection goods. have greater nutritional requirements.

Structural Issues Stakeholders The majority of sweet potato farmers are small­ holders who have problems gaining access to the Stakeholders in vitamin A biofortification in Kenya limited market available. These farmers face barriers include those who are interested in biofortification to market penetration caused by poor infra­ in general, those who promote OFSP projects, and structure that increases their transportation costs, a those who promote alternative interventions. limited resource base, lack of information, lack of or inadequate support institutions, poor policies, Women's Groups requirements for large initial capital investments, Women's groups are common throughout Kenya. and limited product differentiation. Whereas almost Because sweet potatoes are a woman's crop, any of the farm produce sells at a village-level women's groups in rural areas are a useful entry point for testing new varieties in on-farm trials. tion may be to introduce export crop production Women's groups are widely recognized as the schemes for sweet potatoes. Studies have shown grassroots units through which change can be that such schemes tend to encourage farmers to initiated and implemented, particularly with regard invest in modern inputs, primarily because these to family food production and nutrition. Although schemes are both profitable and stable and often each group is formed to achieve specific objectives, vertically coordinated in both input and output they all have an underlying objective of alleviating markets. If demand for sweet potatoes can be poverty through profit-generating projects, increased in areas of the country that do not grow improving health and nutrition in their households, sweet potatoes, then farmers in Western Kenya and and improving education. For this reason, women's other sweet potato-growing regions could grow groups are open to an intervention that would the OFSP, ensuring a sustainable supply. improve the health of their households. The key in maintaining their interest lies in meeting more than Demand for sweet potatoes in Kenya has, however, one of their objectives. In the past the most decreased. The main reason given for this decline is successful projects have been those that combine that people have become more modernized and nutritional benefits with income-generating prefer modern exotic foods to traditionally con­ projects. Evidence suggests that it would serve sumed foods. Sweet potato is an inferior good; OFSP projects well to involve women's groups, in demand for it decreases when the consumer's both the rural and urban areas, in new product income rises. A different school of thought, development and sale of products. Formal pro­ however, proposes that the decrease in cedures need to be established, however, to facili­ consumption is due to reduced supply. Some of the tate financing, quality assurance, and marketing. reasons leading to a reduction in sweet potato supply are tied to agricultural conditions and may provide opportunities for farmers. The reasons Formers given for reduced supply are: About 80 percent of all Africans depend on agri­ culture for their livelihoods. The agricultural sector 1. Farmers are planting fewer sweet potatoes also accounts for 70 percent of full-time employ­ than they did five years ago for many ment, one-third of total GDP, and 40 percent of reasons, including competition from maize, total export earnings (InterAcademy Council wheat, and other crops. 2004], Flence it constitutes the most important 2. Kenya's erratic and unreliable rainfall source of income and employment for the majority pattern has led to decreasing and unreli­ of households in Sub-Saharan Africa. Alleviating able sweet potato harvests, but more vitamin A deficiency in Kenya will require drought-tolerant varieties are now availa­ • more investments in the agricultural sector ble. to encourage the use of inputs; • an increase in agricultural productivity; 3. Poor crop husbandry practices, especially and in pest control, have led to lower produc­ • more efficient and better-functioning agri­ tion. cultural markets for both producers and 4. Increasing population size has resulted in consumers. increased land fragmentation and de­ creased landholding sizes. This fragmenta­ In the marketplace, the value of root crop produc­ tion makes it difficult to cultivate more tion is about 14.9 percent of the value of maize sweet potatoes since priority is given to production, 28.9 percent of the value of bean the main staple, maize. production, and 8.6 percent of the value of all food crop production [Alumira and Obara 1998], Hence 5. Not all areas of the country produce the there is a need for a financial incentive if farmers crop, and sweet potatoes are expensive in are to engage in active root crop production. For areas where they are not grown. example, the private sector has not provided input credit to farmers owing to its inability to enforce Finally, most of the farmers have very small plots, loan repayment and the high transaction costs of about 0.5 hectare on average. They therefore incur lending to dispersed, small-scale farmers. One solu­ high risks in taking up new varieties, especially in Kenya Agricultural Research Institute view of uncertain markets. KARI provides planting materials and agricultural extension agents and trains women in methods of Nongovernmental Organizations growing and harvesting sweet potatoes, postharvest The pioneer in the use of the OFSP in inter­ processing, and preparation techniques. They also ventions to combat vitamin A deficiency is the hold health and nutrition education sessions to International Potato Center (CIP), in collaboration heighten awareness of the contribution vitamin A with Vitamin A for Africa (VITAA). Their effort makes to children's health and development and to to develop and distribute OFSP varieties is partially encourage consumption of food products using funded by HarvestPlus, a program of the Consulta­ new sweet potato varieties. These are vital functions tive Group on International Agricultural Research that need to be implemented and monitored con­ [CGIAR] that seeks to alleviate micronutrient mal­ tinuously. If OFSP farming spreads nationwide, the nutrition through plant breeding by developing Ministry of Agriculture will need to take up these staple food crops that are rich in micronutrients. functions. HarvestPlus works through a global alliance of research institutions and implementing agencies in developed and developing countries. The organiza­ Policy Options tion currently focuses on three micronutrients: iron, vitamin A, and zinc. It is currently pursuing In view of the issues facing agriculture in Kenya, the first phase of research on beans, cassava, maize, distributing beta carotene-rich varieties of sweet rice, sweet potatoes, and wheat. potatoes and providing minimal agricultural sup­ port for production are not sufficient to ensure CIP, in collaboration with the Kenya Agricultural the sustainability of the projects. A number of Research Institute [KARI], continues to develop issues need to be addressed. OFSPs that are drought-tolerant, are resistant to viral infection, and have higher dry matter for increased consumer acceptability. VITAA is in Implementation Policies charge of nutritional education and product devel­ Kenya has many alternatives as far as the provision opment to ensure sustainability. The nutritional of dietary vitamin A-rich sources is concerned. It education highlights the importance of vitamin A may choose to nationalize the western Kenya OFSP in diets, especially for children. project. One approach would be to introduce OFSPs on all government-run school plots. The government could mandate this step for all schools The Kenyan Government through the Ministry of Education, and the plots The Kenyan government has been supportive of could serve as demonstration centers for neigh­ the biofortification program and permitted the use boring communities. Kenya used this model of genetically modified crops in the country. It between 1980 and the late 1990s as a means of even encourages research in this area. There is still improving national agriculture. a need for more work, however, if the OFSP project is to be a national success. The consump­ The biofortification interventions need to be sus­ tion of sweet potatoes has decreased since 2001 tainable within the context of vulnerable communi­ mainly owing to low production levels, increased ties. Therefore, biofortified food crop projects poverty, and a change in eating habits due to rural- should include applied biotechnology to enhance urban migration. In addition, agricultural markets yields in view of depleted soils and minimal inputs. have been crippled owing to poor infrastructure Scientific progress and political commitment are [roads, irrigation, communication networks, and key factors in ensuring success, but consumer and marketing services], limited access to rural credit, public acceptance is key for sustainable progress. limited upscaling of the implementation of research Achieving public confidence will require increased findings owing to an overstretched agricultural partnerships among scientists, policymakers, extension department, limited public expenditures community leaders, and consumers in the decision­ on agriculture, inadequate human capital develop­ making processes. Adoption of biofortified crops ment, and poor weather and soil quality. with visible traits will require that both producers and consumers actively accept the sensory changes in the crops, in addition to benefiting from good manufacturing practices is also necessary for equivalent productivity and end-use features. those who take up food processing. Extension Ensuring this acceptance will demand consumer workers would need to be hired for biofortification education and nonconventional product develop­ promotion alone. This group should be trained in ment that enhances the advantages of the visible nutrition and be supervised for quality-control trait. For those traits that are not visible, both the purposes. In addition, agricultural policies should consumer and producer will need added incentives subsidize sweet potato production to reduce the to make the necessary switch to "enriched" food risk taken by vulnerable farmers. crops. Hence, crop productivity and improved end- use features such as flour quality are very Land tenure needs to be addressed. Many poor important. households do not own the land on which they live and are therefore not inclined to use inputs. In Kenya also has the option of promoting OFSP as a addition, women have little control of the land region-targeted intervention in western Kenya. except on the small pieces allocated to them by Western Kenya is the region with the highest vita­ their husbands at the time of marriage. This situa­ min A deficiency and poverty prevalence. It also is tion limits the land available for sweet potato culti­ the region where the bulk of sweet potato produc­ vation. If the men's portion of the land is to be tion and consumption occurs. Although this made available for OFSP or other vitamin A-rich option makes economic sense, it is not ethical foods, there needs to be a well-functioning, ready unless other suitable interventions are designed for market for these crops. One way to help create the rest of the country, for evidence shows that such a market is to develop cottage industry the prevalence of vitamin A deficiency in rural opportunities or involve the food industry through areas in the rest of the country is not significantly product development. OFSP flour is already availa­ different. Hence, Kenya needs an intervention or ble in the market, but there is still room for expan­ set of interventions to ensure alleviation of vitamin sion. Other products could include composite A deficiency nationwide. weaning foods for consumption in urban areas, and sweet potato substitution in baked goods, A second approach is to promote the use of other mandazis, chapattis, bread, and buns on a large vitamin A-rich crops, such as pumpkins, green scale. leafy vegetables, papayas, carrots, and mangoes, that are already grown and consumed in the coun­ try. This approach would strengthen the efforts of Structural Policies groups that promote traditional green leafy vegeta­ The Kenyan government needs to eradicate the bles. A third option for Kenya may be to intro­ factors that inhibit agricultural expansion in the duce and promote the use of palm oil, as has been country. There is a need for improved infra­ done in West Africa. The oil could be obtained structure, including roads and transportation, from the coastal region. electricity and communication networks, storage and market facilities, research and extension The first two options do not require drastic programs, and market information systems. Nutri­ changes in the dietary habits of the population. In tional education should be provided through radio fact, promotion of more than one source of vita­ and local television programs and at agricultural min A is bound to be more sustainable. On the shows, which seem to set trends in the towns other hand, the promotion of palm oil has where they are held. Access to capital continues to industrial implications. The palm oil industry would be a limitation for the poor who do not have avail­ introduce employment opportunities and conse­ able assets. Providing incentives for microfinancing quently help alleviate poverty, but the unit price of institutions in the country would alleviate this the oil may be too high for poor and vulnerable problem. households. Whichever option is chosen, there is a need for Exogenous Policies health and nutrition education to promote con­ Measures need to be taken to ensure that vitamin sumption by at-risk populations, including young A deficiency alleviation measures continue to be children. Training on meeting health standards and physically and economically accessible to the poor Graham, R. D., R. M. Welch, and H. E. Bouis. 2001. households for whom they were designed. Addressing micronutrient malnutrition through enhancing the nutritional quality of staple foods: Principles, perspectives, and Assignment knowledge gaps. Advances in Agronomy 70: 77-142. Your assignment is to recommend a set of policies to the government of Kenya that would facilitate Hagenimana, V., M. Anyango-Oyunga, J. Low, S. greater production and consumption of biofortified M. Njdroge, S. T. Gichuki, and J. Kabira. 1999. sweet potatoes, taking into account the interests of The effects o f women farmers' adoption o f the various stakeholder groups. State the assump­ orange-fleshed sweet potatoes: Raising vitamin A intake in Kenya. Research Report Series No. tions made in your argument. 3. Washington, DC: International Center for Research on Women. Additional Readings Heidhues, F., A. Atsain, H. Nyangito, M. Padilla, G. Ghersi, and J.-C. Le Vallee. 2004. Development Hagenimana, V., M. Anyango-Oyunga, J. Low, S. strategies and food and nutrition security in M. Njdroge, S. T. Gichuki, and J. Kabira. 1999. A frica . 2020 Vision Discussion Paper 38. The effects o f women farmers' adoption o f Washington, DC: International Food Policy orange-fleshed sweet potatoes: Raising vitamin Research Institute. A intake in Kenya. Research Report Series No. 3. Washington, DC: International Center for InterAcademy Council. 2004. Realizing the promise Research on Women. and potential o f African agriculture: Science and technology strategies fo r improving agri­ Ruel, M. T. 2001. Can food-based strategies help cultural productivity and food security in reduce vitamin A and iron deficiencies? A A frica . Amsterdam. review o f recent evidence. IFPRI Food Policy Review S. Washington, DC: International Food Mason, J. B., M. Lotfi, N. Dalmiya, K. Sethuraman, Policy Research Institute. and M. Deitchler. 2001. The micronutrient report: Current progress and trends in the control o f vitamin A , iodine, and iron deficien­ References cies. Ottawa: The Micronutrient Initiative. Micronutrient Initiative and UNICEF [United Alumira, J. D., and C. M. Obara. 1998. Annex 4: Nations Children's Fund]. 2005. Vitamin and Post-harvest consumption analysis of sweet mineral deficiency: A global progress report. potato in Kenya: Survey. In Post-harvest sys­ Ottawa, Canada: Micronutrient Initiative. tems of potato and sweet potato in Kenya: Misra, B. K., R. K. Sharma, and S. Nagarajan. 2004. Final report. Kenya Ministry of Agriculture Plant breeding: A component of public health and Deutsche Gesellschaft fur Technische strategy. Current Science 86 [9]: 1210-1215. Zusammenarbeit [GTZ], Nairobi. Ngare, D., J. N. Muttunga, and E. Njonge. 2000. Bouis, H. E. 2003. Micronutrient fortification of Vitamin A deficiency in pre-school children in plants through plant breeding: Can it improve Kenya. East African Medical Journal 77 [8]: nutrition in man at low cost? Proceedings o f 421-424. the N utrition Society 62 [2]: 403-411. Oiye, S., and K. Shiund. 2005. Kenya: Young FAO [Food and Agriculture Organization of the researchers complete a vitamin A survey in United Nations], 2003. The state o f fo o d inse­ rural households in western Kenya. The W orld curity in the world2003. Rome. o f Food Science. Garcia-Casal, M. N., I. Leets, and M. Layrisse. http:/ / www.worldfoodscience.org/cms/?pid=l 2000. Beta-carotene and inhibitors of iron 003586. absorption modify iron uptake by Caco-2 cells. Quisumbing, A., L. R. Brown, L. Haddad, and R. Journal o f Nutrition 130 [1]: 5-9. Meinzen-Dick. 1998. Gender issues for food security in developing countries: Implications for project design and implementation. Canadian Journal o f Development Studies 19 [special issue on food security], Sachs, C. 1996. Gendered fields: Rural women agri­ culture and environment Boulder, CO: Westview Press. Underwood, B. A. 2004. Vitamin A deficiency dis­ orders: International efforts to control a pre­ ventable "pox." Journal o f Nutrition 134 [1): 23IS-236S. Underwood, B. A., and P. Arthur. 1996. The con­ tribution of vitamin A to public health. FASEB J o u rn a l10 [9]: 1040-1048. van Jaarsveld, P. J., M. Faber, S. A.Tanumihardjo, P. Nestel, C. J. Lombard, and A. J. S.Benade. 2005. Beta-carotene-rich orange-fleshed sweet potato improves the vitamin A status of pri­ mary school children assessed with the modified-relative-dose-response test. A m e rica n Journal o f Clinical N utrition 81 [5]: 1080-1087. Welch, R. M., and R. D. Graham. 2002. Breeding crops for enhanced micronutrient content. P lant a n d S o il 245 [1]: 205-214.