A food plate in transition : implications for food and nutrition security in rural Southwest Kenya

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A Food Plate in Transition:

Implications for Food and Nutrition

Security in Rural Southwest Kenya

Anna-Lisa Noack

June, 2013

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Cover Photo Left: New sweet potato harvest, Luchululo, Samia District, Kenya (Anna-Lisa Noack, 2012) Cover Photo Right: Array of traditional crop varieties, Luchululo, Samia District, Kenya (Anna-Lisa Noack, 2012).

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A Food Plate in Transition:

Implications for Food and Nutrition Security

in Rural Southwest Kenya

University of Amsterdam, Graduate School of Social Sciences International Development Studies

Research Master Thesis Student: Anna-Lisa Noack Student Number: 10258906 E-mail: noack.annalisa@gmail.com

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Supervisor Dr. Nicky R.M. Pouw

Assistant Professor, Research Master International Development Studies Graduate School of Social Sciences

University of Amsterdam Nieuwe Prinsengracht 130 1018 VZ Amsterdam The Netherlands Phone: +31(0)20-5254105 E-mail: n.r.m.pouw@uva.nl http://home.medewerker.uva.nl/n.r.m.pouw/ Second Assessor Dr. Hebe J.L.M. Verrest

Director, Research Master Urban Studies Graduate School of Social Sciences University of Amsterdam Nieuwe Prinsengracht 130 1018 VZ Amsterdam The Netherlands E-mail: h.j.l.m.Verrest@uva.nl http://home.medewerker.uva.nl/h.j.l.m.verrest/ Local Supervisor Dr. Hannington Odame

Centre for African Bio-Entrepreneurship Family Health Plaza Off-Langata Road P.O. Box 1285 Nairobi

Kenya

Phone: +254 (0)20600040 E-mail: hsodame@gmail.com

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~Forward~

Before delving into the body of this thesis, I would like to acknowledge a number of people who have made it possible for me to follow my passion for development and food-related issues, to pursue a Master’s degree at the University of Amsterdam where I have further developed the skills to critically challenge axiomatic social

structures, and to not only spend two years studying in the beautiful city of Amsterdam but also to live five months in Kenya, a dream I never thought I could fulfill so early in life.

This work would not have been possible without the participation and openness of the residents of Luchululo and Samia at large. You opened your homes, hearts, and hearths to me, you provided me with the material to write this thesis, and also the opportunity to learn more than a classroom could ever offer. To Hillary, Perus, and Godfrey specially, you are an inspiration for so many in Samia and beyond. Your dedication to your work and community are remarkable and I wish you all the very best in your continued engagement. I would like to extend my sincerest thanks to Hannington Odame who not only served as my second supervisor but also opened his home to me in Kenya. My fieldwork, let alone access to the field, would not have been nearly as smooth or enjoyable without you. Your family’s hospitality and care allowed for a lovely stay in Kenya and has left me with

unforgettable and beautiful memories. Also Wilba, you served as an incredible friend, guide, and teacher. I also deeply appreciate the help and constant willingness for supervision demonstrated by the CABE family. The five months spent in Kenya will forever remain one of my fondest memories of my studies and a turning point for personal and academic growth.

I would like to extend my sincere thanks to Nicky Pouw, my supervisor, for her undivided attention, constant encouragement, and guidance throughout my two years at the UvA. Your meticulously planned lessons, supportive feedback, and gentle supervision have made me a better student and thinker. I look forward to our continued work together in the near and distant future. Hebe, I appreciate your supervision and knack for organization and communication and thank you for serving as my second reader.

I would like to express my deepest gratitude to my parents and sister who have been my rock and anchor through the highs and lows of moving across oceans and have truly made this journey possible. Mama, you shaped and always shared my deeply founded love for cooking and interest for wellbeing; Papa, you inculcated in me a deep appreciation for the soil and continue to share your extraordinary attention and interest for the complexities of development; and Julia, your energy continues to surprise me and your passion for the overlap between plant and human growth is something I hope you will always share with others. Your love, patience, and kindness are a constant inspiration to me. I cannot thank you enough.

I would like to acknowledge my extended family and especially Birgit, Jürgen and Bonne-Maman who have always supported me and inculcated a work ethic that has facilitated invaluable cross-cultural understandings. I

appreciate your guidance, support, and love so very much. I cannot thank Tanja and Klaus enough for instigating my interest in sub-Saharan Africa- its people, history, and biodiversity. Your faith in me has been invaluable for where I am today; I hope you know how integral your role has been for pursuing my dreams.

To my dearest friends near and far, I am so grateful for the paths we have travelled together and insatiable hunger we have shared for food-related issues. To Liz, you have always been a source of inspiration and an anchor no matter the distance or time that has passed between us. The culmination of years of reflection and a full year and a half of work dedicated to this thesis would not have been possible nor nearly as enjoyable without my dear friends here in Amsterdam- especially Donya, Tanya, Susu, and Josefine. You are my family here and my stability. I hope you know how much you have contributed to my personal growth and wellbeing. Josie, you were my second half during our five months of fieldwork. May our many memories be a constant reminder of our own personal and shared development. Lastly, I would like to say a very special thank you to Susu for being like a sister during the past two years and for making the thesis writing unbelievably well-balanced, fulfilling, and needless to say, very lekker. I am profoundly grateful.

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Abstract

Food security and malnutrition are often lauded as crises that threaten to compromise human and ecological health and to exacerbate economic and social inequalities within and between developing and developed countries. Despite being integrated, multi-disciplinary, and multi-scalar issues, they are often tackled in isolation through single-sector

interventions to maximize immediate impact and cost-efficiency - e.g. production-based agricultural interventions to curb macro nutrient deficiencies and health programs that distribute supplements to reduce micro nutrient deficiencies. These technical approaches reflect a simplified conceptualization of food and nutrition security as micro and macro nutrient deficiencies largely ignoring the social dynamics and historical trends that often underlay the immediate causes and effects of food and nutrition insecurity. Due to the continued prevalence of under-nutrition in sub-Saharan Africa, where twenty-seven percent of the population is deemed undernourished (FAO, 2012), integrated food-based and nutrition-sensitive approaches are increasingly recognized and imperative;

furthermore, this thesis calls for a socially-cognizant approach.

Drawing on five-months field-research in 2012 in Luchululo sub-location among a

population of poor smallholder farmers in rural Southwest Kenya, this study is framed by the Human Wellbeing Approach to capture the social dynamics of food (in)security in an area where the food plate is rapidly narrowing towards a high-calorie low nutrient diet and where over 80% of households experience food shortages at least once a year. Conclusions suggest that conventional approaches inadequately capture the social significance of food preferences and underestimate how the local function of food and the practices that emerge therefrom (e.g. food conservation measures) can affect the regularity of meals and their composition. The findings allow us to re-examine the concept of food security and to complement emerging research and program development for a more cohesive approach to tackle food and nutrition insecurity.

Keywords: Food Security, Nutrition, Food Transition, Human Wellbeing, Kenya, Agricultural Development

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Chapter 1: Introduction

According to the State of Food Insecurity in the World published by the FAO in 2012, 870 million people are deemed undernourished in the world and the great majority, 852 million, are living in developing countries (FAO, 2012). Furthermore, it is estimated that 2 billion people suffer from the consequences of vitamin and mineral deficiencies, resulting in a host of non-communicable diseases (Johns et al., 2004) and undermining overall growth and development (WHO, 2009; Fanzo et al., 2010). In sub-Saharan Africa, 27% of the population is considered undernourished, the highest percentage of any region in the world (FAO, 2012). Of these 27%, the majority is at the heart of food production (FAO Global Hunger, 2010); one-third of the total population relies on rural peasant farming and simultaneously suffers from a malnutrition rate of 1 in 3 (FAO, 2008; Kidane et al., 2006). Extensive research and policy work is seeking a silver bullet; templates have often focused on technical, economic, and medical interventions to increase yields and dietary intake in order to tackle a very heterogeneous and complex dilemma. The implications and

consequences of this type of approach in Kenya and beyond are manifold (Johns et al., 2004; Popkin, 1993; Frison et al., 2011; Ruel, 2003; Raschke et al., 2008; Fanzo et al., 2010) but are rooted in the elusive and contested understanding of food and nutrition security in academia and development at large.

While food security has been widely framed and defined as the technical composition of availability, access, and proper usage of food (largely ignoring micro nutrient deficiencies), a paradigm shift appears to be taking place stemming from the recognition that food security cannot be viewed in isolation from the wider food system including agriculture, nutrition, and even culture1_{. Drawing on a year of literature review, five months of field} research in rural Southwest Kenya, and months of reflection and analysis, this study is

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Only very recent studies highlight these dimensions including: FAO (2013). The State of Food and Agriculture. Headquarters, Rome. Lancet Reports (2013, June 6). Maternal and Child Nutrition.

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situated at the heart of these debates. A predominantly qualitative approach was adopted to capture the voices of those who experience food insecurity and to compare and contrast these stories with orthodox and emerging definitions and methodologies. As will be discussed in the ensuing work, based on the empirical evidence collected in Luchululo sub-location, it may be inferred that the widely-cited three pillars of food security are

thoroughly mediated and shaped by social processes. Furthermore, the local understanding and practice of food cultivation, preparation, and consumption appears to have wider implications for the security of access and availability of food as well as local micro and macro nutritive intake. Findings suggest that a nutrition transition is taking place from a more varied diet to one composed of socially-aspired types and compositions of food in part, a result of wider social processes. Contributing to the current emerging discussion that is founded on nearly four decades of conceptualizations and interventions, this thesis calls for an amended conceptualization of food and nutrition security to consider processes of production to consumption as non-sequential, and rather historically and socially

embedded. A human wellbeing approach is applied to comprehensively and inductively unpack the multiple dimensions of food and nutrition security, from its underlying causes to the implications of its outcomes.

The thesis is divided into seven chapters. Following this introduction, chapter 2 presents an in-depth overview of the existing literature and work on food and nutrition security; chapter 3 discusses the research design deployed to conduct this study; chapter 4 describes the research context zooming in from a national scale to the fieldwork location; chapter 5, the first of two results chapters, unpacks the food culture of Luchululo, processes of decision-making, local understandings of food and nutrition, and the perceived

consequences of the composition of the food plate; and chapter 6 delves into the practices of farming, food processing, and conservation methods as well as associated cultural changes and their consequences. These two penultimate chapters build on one another to exhibit the interconnectivity of understanding and practices for food and nutrition security outcomes. Each chapter points to some of the implications of ongoing processes and changes taking place for food and nutrition security. The final chapter offers concise responses to the posed research questions, revisits the concepts deployed, provides

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reflection for further research, and suggests some potential policy initiatives to tackle food and nutrition security in Luchululo, rural Southwest Kenya.

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Chapter 2: Theoretical Framework

The purpose of this chapter is to provide an in-depth overview of the concepts presented in this thesis, introduce previous research conducted on topics related to food and nutrition security, and introduce the theoretical underpinnings of the ensuing analysis. The chapter is divided into 6 sections with a conclusion at the end that brings the following themes and concepts together: section 2.1 unpacks food security as a concept; 2.2 discusses orthodox paradigms to tackling food security and how some scholars are beginning to question these; 2.3 unpacks nutrition security as a concept; 2.4 explores the nutrition transition; 2.5 looks at the link between agro-biodiversity and nutrition; and finally 2.6 suggests human wellbeing as an approach to understand the dynamic complexities of a food system.

2.1. Foundations of Food (In)Security as a Concept

To understand the predicament and complexities of food security, this sub-section will present a chronological overview of the changing conceptualization of food security from the 1970s to present. The concept was first truly institutionalized at the World Food Conference in 1974 in response to world price hikes and supply shortages widely

experienced in the Union of Soviet Socialist Republics (USSR). In haste to tackle the causes of the crisis, the United Nations termed food security as the

“…availability at all times of adequate world supplies of basic food-stuffs… to sustain a steady expansion of food consumption… and to offset fluctuations in production and prices (UN, 1975 as quoted by Maxwell, 1996: 156).

It was acknowledged that chronic or cyclical deficiencies of food supplies were a result of these price increases, and so the intuitive response was to expand production at the national level (Clover, 2003). The “optimal” calorie count was standardized for men and women according to size, climate, and physical work, but did not differentiate between food groups (i.e. grains, legumes, proteins etc.). It also neglected micro-nutrients as a constituent of food security whether on a national, household, or individual level. This “availability-driven” approach, largely referred to as the first pillar of food security, largely

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remains a template for interventions especially in sub-Saharan Africa today (Maxwell, 1996: 156).

Amartya Sen (1981) has been credited for the first major shift in the conceptualization of food security that was catalyzed by Poverty and Famines, a book in which he argued that food security can only be realized if food is also accessible, as determined by a person’s entitlements2_{. Sen posited that the world is home to sufficient food supplies but that their} distribution on the micro level is the crux of the issue; in short, food accessibility is not necessarily determined by its availability. There is no consensus today regarding this statement, but many academics support Sen’s work by arguing that “enough food is being produced to meet energy and protein requirements of the current world population, if food were distributed according to needs” (Andersen, 2003: 1). The addition of this second pillar has been cause for increased complexity in the term ‘food security’. However, accessibility remains widely simplified as an issue of affordability and more generally associated with poverty (Johns et al., 2004).

Building on Sen’s contribution, the World Bank offered another definition that placed more emphasis on the underlying and often assumed component of time for both accessibility and availability (rather than suggesting it as a lone standing pillar). It specified that “Food

security is access by all people at all times to enough food for an active, healthy life (World

Bank, 1986: 1). A principal conjecture made in food security literature is that people cannot be deemed food secure if they face seasonal shortages. Security of dietary intake (of macro and micro nutrients) is essential to prevent morbidity and mortality (World Cancer

Research Fund, 2007). A distinction can be made between transitory, cyclical, and chronic food insecurity where each bears with it an additional degree of severity (Maxwell et al., 1992). Transitory and/or cyclical food insecurity can be often curbed by conserving or sharing food supplies for a limited amount of time. However, these are not so differentiated in practice as the “excessive exposure to temporary, but often severe stress may increase

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“Sen’s entitlement framework provides a systematic approach to the definition and assessment of vulnerability. An individual’s entitlement is rooted in his/her endowment- the initial resource bundle- which is transformed via production and trade into food or commodities which can be exchanged for food. If the entitlement set does not include a commodity bundle with an adequate amount of food, the person must go hungry; in Sen’s terminology, the individual has suffered an entitlement failure. In a private ownership market economy, the entitlementrelations of individuals are determined by what they own, what the produce, what they can trade, and what they inherit or are given” (Maxwell et al., 1992: 11).

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the vulnerability of the household to chronic food insecurity” (Maxwell et al., 1992: 17). However, long-term security is often assumed but not a primary objective in development interventions.

Since the 1990’s, a third pillar was adopted to compose the contemporary triad of availability, accessibility, and appropriate quality. Malnutrition, the lack of adequate nutrients, is a fundamental component of food (in)security; despite sufficient amounts of grains for example, people can still face food insecurity and suffer from nutrition-related diseases. The consequences are clear as insufficient nutrient intake can cause illness, stunted growth, lack of productivity, and even death. A common proxy measure for malnutrition is food intake of children under five years of age (Dutch Ministry of Foreign Affairs, 2011: 38) but additional indicators and measurement tools are still developing as is depicted by the outcomes of new estimates and projections of undernourished people worldwide, 1990-2015 (see appendix 2) (FAO, 2011). This pillar remains widely under-operationalized and simplified in terms of food safety or sanitation.

Most contemporary definitions of food security rest on the following three pillars:

 Availability: Sufficient quantities of appropriate food throughout the year from household production, commercial imports or food assistance etc.

 Access: Obtain adequate and appropriate food throughout the year through home production, purchasing, bartering, food assistance etc.

 Utilization: Properly processed and stored food in a sanitary environment for adequate nutrition and child care throughout year. Utilization is household sensitive, relies on biological needs, and links to a person’s health.

Unfortunately nutrition is often only vaguely implied (usually in terms of macro nutrients) and cultural appropriateness is only included as an addendum; rarely are these dimension separately unpacked and fully integrated into orthodox frameworks. Dietary quality and utilization remains highly elusive as it combines physical, social, and psychological needs and preferences. For example, while many definitions include ‘appropriate’ foods in the third pillar, country and culturally-specific food baskets are rarely generated as security

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indicators. These vaguely recognized concepts are captured in the following oft cited definition from the International Conference on Nutrition (ICN) held in Rome in 1992 and the 1996 Rome Declaration on World Food Security respectively:

“Food security is the physical, social and economic access by all people at all times to

sufficient, safe and nutritious food which meets their dietary needs and food preferences for an active and healthy life” (World Health Organization, 1992). “Food that is available at all times, to which all persons have means of access, that is nutritionally adequate in terms of quantity, quality and variety, and is acceptable within the given culture” (1996 Rome Declaration on World Food Security)

These extensively referenced definitions remain complex to measure and elusive for policy and research alike as the concept of food security has multiplied and merged with other concepts to embody a cornucopia of ideas. The Food and Agriculture Organization of the United Nations (FAO), at the helm of some of the most advanced works on food security, claims to have improved its data and methodology as a result of various conferences and symposiums since 20103_{, to understand the prevalence of undernourishment (FAO, 2012).} While calling for a comprehensive and multi-disciplinary approach however, the FAO still widely relies on measurements based on availability, physical access, economic access (affordability), and utilization (simplified to water sources and access to sanitation

facilities rather than cultural appropriateness) as determinants of food security. Outcomes are measured by access to food (prevalence of undernourishment) and utilization

(percentage of population underweight, stunted, and wasted). These are mediated by vulnerability and stability measures (FAO, 2012). Even this UN organ however, dedicated specifically to issues of food security, continues to struggle to define, measure, and develop programs to tackle food security (Gennari, 2011; FAO, 2012).

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G8 Summit (2009, June 8-10), L’Aquila Food Security Initiative (AFSI) National Academy of Sciences in Washington, DC in February 2011, Round Table of the Committee on World Food Security in Rome in September 2011, International Scientific Symposium on Food and Nutrition Security Information in Rome in January 2012 (FAO, 2012).

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The past four decades have seen major shifts in the definition of the concept, nearly each decade contributing another dimension. However, indicators continue to change and to be improved as they fall short of capturing the processes and the full spectrum of

determinants, outcomes, and effects of food (in)security (FAO, 2012).

2.2. Tackling Supply Shortages and Rethinking Orthodox Paradigms

Despite increasing interest and concern for global food (in)security, understanding of and research on food systems remains unsaturated. Attention is often granted to the magnitude and imminence of food insecurity where sub-Saharan Africa (SSA) is deemed the only region on the planet expected to experience an increase in the number of hungry people (Kidane et al., 2006: xii). In Maslow’s pyramid of needs, food consumption is considered a bare minimum to facilitate all other developmental faculties such as freedom and

democracy. But in the face of ‘urgency’, the question of hunger is often simplified as a challenge of insufficient quantities (Toeniessen et al., 2008); ‘how to feed 9 billion?’ is frequently proclaimed as the sum-all question (see e.g. Godfrey et al., 2010). From this limited comprehension, supply-side technical fixes and economic solutions (Scoones, 2005), initiatives to increase crop yields and caloric intake by way of policy and

investments (Rosegrant et al., 2003) or research and development of e.g. improved seeds and other farming inputs often emerge (Toenniessen, 2008). Together with the Rockefeller Foundation, the Bill and Melinda Gates Foundation founded the Alliance for a Green

Revolution in Africa (AGRA) in 2006, which has been at the vanguard to stimulate a ‘Green Revolution’. According to AGRA, the majority of “poverty and hunger is rural, and the root cause is lack of sufficient food production and income generation from small-scale farming. Low farm productivity in Africa has many causes, including the use of traditional crop varieties, increasingly depleted soils, shrinking plots of land, scarce and unreliable water supply, crop losses from pests and diseases, inequitable land-distribution patterns, inefficient and unfair markets, and poor agricultural and transportation infrastructures” (Toenniessen et al., 2008). Instead of calling for a one-size-fits-all model, which no longer appears likely to catalyze a Green Revolution in Africa (increasing the production of a few select crops and increasing their resilience to a drought, flooding or a particular pest or disease), the Alliance calls for a ‘Rainbow revolution’ of improved seeds to face a diversity

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of exogenous pressures including soil infertility, erratic weather patterns, pests and diseases (Toenniessen et all, 2008).

However, a burgeoning body of literature suggests that “Improving yields, especially of the major nutrients such as proteins and calories, is not currently the most pressing challenge to food security” (Frison et al., 2011: 244). Building on work by Dewey (1989) and Von Braun (1995) in response to a common modernization strategy to cultivate a single crop for the double purpose of cash and food, these authors concluded that “Commercial mono-cropping can offer economic benefits to rural populations and reduced food costs to consumers, but it has mixed impacts on nutritional status, in part because of reduction in traditional dietary diversity” (Johns et al., 2004: 145). Mono-cropping is typically not a preferred strategy of smallholder farmers as the reliance on a single food can often

increase risk throughout the year. Furthermore, the over-reliance on a single crop does not allow for nutrient diversification. This example highlights the difference in perceptions of security between poor smallholder farmers themselves and development initiatives. There is little question that poverty reduction is part and parcel of the alleviation of

under-nutrition “as it increases options for purchasing food and diversifying diet [which] is

critical to overcoming malnutrition and improving health” (Johns et al., 2006: 183) and that economic and technical fixes have their merits. However, as the subtitle of the 2012 State of

Food Insecurity in the World warns, “Economic growth is necessary but not sufficient to

accelerate reduction of hunger and malnutrition” and concludes that “economic and agricultural growth should be ‘nutrition-sensitive’” (FAO, 2012; also suggested by Fleuret et al., 2008). For example, studies have shown that a growth in income can also lead to an increase in caloric sweeteners consumed as well as processed foods, altering the diet to have negative health effects (Popkin, 2004). Furthermore, while increases in agricultural production can at time be linked with increased food and nutrition security, this is not always the case (Frison et al., 2011) as it unleashes other market, environmental, and societal consequences (Fleuret et al., 2008). Rather than replace working malleable definitions of food security, the following sub-chapters offer complementary and over-lapping concepts to better capture the intricacies, dynamics, and multiple scales and dimensions of food security. This thesis argues that the inclusion of these concepts

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provides a more comprehensive understanding of food security as inherently multi-dimensional and deeply social, environmentally, and institutionally embedded (Fleuret et al., 2008) and thereby also a platform for affective future interventions. It appears that significant mismatches between food insecurity experiences and perceptions of the affected on one hand and those implementing policies to eradicate hunger on the other persist and have largely prevented the alleviation of food insecurity. This mismatch is an important motivation for conducting this research.

2.3. Nutrition Security

Despite establishing secure access to adequate food for energy, a person can be

micronutrient deficient (Doak et al., 2000). Presently a paradigm shift seems to be taking place that encourages the full integration of nutrition security in food security rather than implicitly implying its inclusion (see e.g. the recently published The State of Food and

Agriculture (FAO, 2013)). According to the FAO, “Micronutrient deficiencies (‘hidden

hunger’) still affect over 30 percent of the world’s population, causing increased morbidity and mortality, impaired cognitive development and reduced learning ability and

productivity, reduced work capacity in populations due to high rates of illness and

disability, and tragic loss of human potential. Overcoming micronutrient malnutrition is a precondition for ensuring development” (FAO, 2012: 23). The most critical deficiencies include vitamin A (which can cause mortality and blindness), iron (which can result in anemia and builds resistance to infection), zinc (the lack of which can lead to diarrhea and stunting), salt iodization (that promotes cognitive development), and folic acid (which prevents disability) (WHO, 2009). Nutrition deficiencies are often the product of a shortage of food or inadequate access to a proper diet but can remain ‘hidden’ as their deficiency may have more long-term implications. According to the WHO (2009), “Vitamins and minerals occur naturally in food. A varied diet of meat, eggs, fish, milk, legumes, fruits and vegetables is the best basis for obtaining adequate vitamin and mineral nutrition” (p. 12). But as the pillars of Nutrition Studies suggest (food, health, and care conditions/sanitation (IFPRI, 2000)), dietary intake is not always sufficient for nutrients as the body must have the capacity to absorb nutrients based on the pairing of the foods consumed and the condition of the body (World Cancer Research Fund, 2007). The following scheme depicts

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the importance of nutrition security throughout a person’s lifecycle; evidence suggests that even fetal under-nutrition may have significant consequences for health later in life (IFRPI, 2000).

Figure1: Nutrition Throughout the Life Cycle

(Source: IFRPI, 2000)

Interventions to curb micronutrient deficiencies (vitamins and minerals; see appendix 1) have typically adopted a medical approach rather than a food-based approach to ensure quick action and cost-effectiveness (Frison et al., 2011). Micronutrient supplements for children especially vitamin A and zinc are often issued by programs to curb malnutrition and is listed as a priority on the Doha Development Agenda as a solution to curb ‘hidden hunger’ (WHO, 2009). Other approaches to curb micro and macro nutrient deficiencies have included technical fixes aimed to scale up agricultural production of particular crops containing certain vitamins or modified to have a higher nutrient content. Examples of such interventions include the distribution and promotion of orange-fleshed sweet potato, bio-fortified with vitamin A (WHO, 2009). The impact of such nutrient-specific programs that distribute supplements, fortify foods, and bio-fortify seeds have been exponential in

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curbing illnesses and preventing mortality particularly among children (WHO, 2009) but are also criticized for being culturally insensitive, unsustainable, and incomprehensive (Johns et al., 2004; Raschke et al., 2008). In sum, interventions to tackle nutrition insecurity have largely prioritized medical solutions whereas approaches to curb food security,

frequently considered an issue of inadequate calorie intake, have often focused on boosting agricultural production. These two, while fundamentally intertwined, have rarely been tackled together.

Recent studies are increasingly calling for a food-based approach to food and nutrition insecurity, naturally linking the two (Ruel, 2003; WHO, 2009; IFPRI, 2000). “In spite of the strides made globally in reducing hunger, the problems of micronutrient deficiencies and coexisting obesity and related cardiovascular and degenerative diseases constitute a formidable challenge for the future. Attempts to reverse this trend with single-nutrient intervention strategies have been met with limited success, resulting in renewed calls for food-based approaches” (Frison et al., 2006: 167). This is supported by scholars in the natural-science community such as the World Cancer Research Fund (2007), who argue that “inadequacy of intake of nutrients is best resolved by nutrient-dense diets and not by supplements, as these do not increase consumption of other potentially beneficial food constituents”, which are often needed for the body to absorb the specific nutrients (FAO Factsheets, 2009). Extensive empirical evidence suggests that increasing the variety of (whole) foods consumed could eliminate most essential nutrient deficiencies (Ruel, 2003; Raschke et al., 2008; World Cancer Research Fund, 2007) and serve further functions of hunger alleviation, socio-cultural purposes, and livelihood improvement (Johns et al., 2004). However, while it appears clear that nutrient-specific interventions are less effective than ‘nutrition-sensitive’ approaches to agricultural development and

environmental conservation, they remain underexplored due to their inherent complexity (Fanzo et al., 2010).

Challenges remain regarding the relationship between food and nutrition security; while they appear unequivocally linked, there is little consensus on how the concepts can be integrated and tackled together (Committee on World Food Security, 2012). Recent

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developments in nutrition and food security studies suggest that incomprehensive understanding of nutrition and food security may in part be attributed to a lack of knowledge regarding the ‘malnutrition problem’ as not simply a lack of nutrients but as contextually embedded (Fleuret et al., 2008). Based on discussions from the International Conference on Nutrition it is concluded that “The roles of micronutrients in health and well-being and the synergies in their physiologic functions are now being increasingly recognized, supporting the notion that micronutrient deficiencies rarely occur in isolation and calling for dietary diversification and nutritional interventions to be food based” (Frison et al., 2006: 145)…. “Unless policies and programs for food security consider the food system and nutrition in their entirety, they will exacerbate malnutrition and disease in the long term” (Johns et al., 2004: 146). As food in rural poor areas is often sourced locally and even from the homestead, food-based strategies suggest that it may be best to support the cultivation and purchase of foods that are available within a local environment as much as possible and only supplement these with foods sourced from elsewhere to tackle

particular deficiencies. Nutrition-sensitive strategies to food security according to a growing body of literature will directly reduce the prevalence of under and over-nutrition and their manifestation in stunting and non-communicable diseases (Frison et al., 2006; Abrahams et al., 2011).

2.4. The Nutrition Transition

Over millennia, human diets have changed in composition and quality congruent with shifting lifestyles, environmental pressure, culture, demographic changes, transportation, technological developments, epidemiological transitions (Popkin, 1993; World Cancer Research Fund, 2007), high input agriculture (Johns et al., 2004), and globalization

including trade, foreign direct investments, and advertising (Hawkes, 2006; Popkin, 2004). Following food trends in North America and Western Europe, diets in developing countries are presently shifting at an accelerated pace (Popkin, 2006) towards a simplified high-energy but low-nutrient ‘Western diet’4_{. These trends are often associated with the}

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According to the World Cancer Research Fund, “‘Western’ dietary patterns are energy dense, and increasingly made up from processed foods. They are high in meat, milk and other dairy products, fatty or sugary foods such as

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increased consumption of sugars, oils and fats, meat, and prepared food stuffs that are known to weaken the functioning of human organs (Popkin et al., 2003; Lairon, 2010; Hawkes, 2006) and a reduction in fiber, vegetable, and fruit intake (Popkin, 2002: 210). The consequences of the current rapid nutrition transition are troubling as they include, among other impacts, non-communicable or non-hereditary/non-contagious diseases that exacerbate and add to pre-existing health concerns especially in developing regions of the globe (Raschke et al., 2008).

While the simplification of diets as such is not a new phenomenon (Frison et al., 2006), the notion of a ‘nutrition transition’ was first introduced by Barry Popkin in an article titled

Nutritional Patterns and Transitions (1993) where he explored nutritional changes in

relation to economic, social, demographic, and health changes. Building on previous literature linking income to under-nutrition (Ravillion, 1990), Popkin presented the

complexities and consequences of the nutrition transition, which still remain elusive today (FAO, 2012). The growing body of interdisciplinary research attempts to make sense of the mounting prevalence of both under and over-nutrition (obesity) and suggests that adverse effects of the nutrition transition include non-communicable diseases (hereto referred to as NCDs) (World Cancer Research Fund, 2007; Popkin, 2002; Popkin, 2006; Hawkes, 2006). “Over the past few decades, epidemics of non-communicable diseases (NCDs) have rapidly emerged as the latest threat to the very existence of the indigenous African population, adding significantly to the existing disease burden caused by HIV/AIDS, poverty, and malnutrition” (Raschke et al., 2008: 662). These consequences “seem to originate in the erosion of the traditional ways of life and culture as the new ‘Western/North American’ food model and system spreads over the world” (Lairon, 2010: 31) and are amplified by decreases in physical activity and changes in body composition (Popkin, 2004).

processed meats, pastries, baked goods, confectionery, sugared and often also alcoholic drinks, with variable amounts of vegetables and fruits. The starchy staple foods are usually breads, cereal products, or potatoes. A feature of the global ‘nutrition transition’ is that ‘western’ dietary patterns are becoming ‘exported’ globally with accelerating speed. ‘Western’ diets defined in this way are associated with overweight and obesity, type 2 diabetes, cardiovascular disease, stroke, some cancers, and other chronic diseases. However, the term ‘western diet’ is potentially confusing: variations of such diets consumed within ‘western’ countries can and do have very different nutritional profiles” (World Cancer Research Fund, 2007: 192).

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Based on pre-existing data sets and large-scale regression analysis, Popkin (1993) presents a heuristic framework in which he outlines five chronological transitions that correspond with changes in nutritional intake; these transitions progress from hunting/gathering food, to famine, to receding famine, to degenerative diseases, to behavioral change and increased awareness of food-based disease prevention. The significance of these stages is captured in the example of the increased consumption of sweeteners attributable by 82% to

urbanization and income growth alone (based on food disappearance data in 103 countries in 1962 and 127 in 2000) (Popkin et al, 2012). Drawing on existing health and nutrition data from 43 countries, authors conclude that “The nutrition transition appears to be accelerating in [sub-Saharan Africa] from the receding famine stage to the nutrition related non-communicable disease stage” (Abrahams et al., 2011: 1).

Figure2: Patterns of the Nutrition Transition

(Source: Popkin, 2004)

While more ethnographic research is important to understand the dynamics, complexities, and variations within these ‘stages’ and the linkages with changing diets, this framework has been further elaborated in the two decades following its premier to include more exogenous and endogenous factors that shape both demand and supply (Popkin, 2004;

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Abrahams et al., 2011). The value of this framework lies with its prediction of

consequences of the nutrition transition and the importance of behavior change and awareness-raising for consumer choices. This outline, while perhaps over-simplistic and deterministic as such, could provide impetus for intervention at an earlier stage combining nutrition and food security.

Food plates have changed even in the most rural and seemingly isolated places on the planet as a result of both the convergence and adaptation of food plates to a more ‘Western’ diet (Hawkes, 2006; Zimmet, 2000; Leatherman et al., 2005). The social dynamics

associated with the replacement and accompaniment of ‘foreign’ foods in local nutritional intake requires research to go beyond a simple description of taste where it is possible to deduce that “Fat and sugar are two of the more pleasurable elements of the [Western] diet” (Popkin, 2006: 296). However, much of the literature ignores the values and social

dynamics attached to a changing diet related to color, taste, and composition. Linking the nutrition transition to orthodox approaches to food security, it can be surmised that making staple foods inexpensive or emphasizing only yields of commodities to address hunger can further stimulate the nutrition transition and aggravate the already increasing prevalence of non-communicable diseases (Hawkes, 2006). Rather than focus on ways to enhance caloric or particular nutrient-intake, the nutrition transition highlights the importance of linking and integrating production with consumption more holistically.

2.5. Linking Agro-biodiversity and Nutrition

The link between production and consumption of food is perhaps most visible in remote developing regions where limited market access highlights the importance of

agro-biodiversity, the basis of the food chain, for nutrition. Differing climates and tastes largely dictate the types of crops cultivated and gathered and studies suggest that large agro-biodiversity has great health benefits (Frison et al., 2006; Raschke et al., 2008: 4; World Cancer Research Fund, 2007). Agro-biodiversity can enhance resilience, ensure food security, deliver a diverse diet for nutrition security, and can benefit human wellbeing and livelihoods (Frison et al., 2011; Johns et al.; Convention on Biological Diversity, 2013). However, while “30,000 terrestrial plants are known to be edible [and] 7,000 are cultivated

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or collected by humans for food,[only] 30 crops feed the world [and] 5 cereal crops provide 60% energy intake of the world population” (Commission on Genetic Resources for Food and Agriculture, 2013). The recent FAO report titled Sustainable Diets and Biodiversity (2012), recognizes that “Biodiversity loss is not a separate issue from the core concerns of society, including issues of nutrition, food security and sustainable development” and wellbeing (Campbell et al., 2010: 43), which challenges the rigor of each of these concepts as individual entities and in their relationship. Among others, the underlying determinants of this loss of biodiversity include the nutrition transition, which threatens both human health and environmental sustainability (Campbell et al., 2010) as well as agricultural intensification as has been extensively argued (Geertz , 1963; Cohen, 1989). In recognition of the intrinsic value of biodiversity and its crucial importance for the environment, the economy, human health, and cultural preferences and traditions, the United Nations General Assembly, has called the period from 2011 to 2020 as the United Nations Decade on Biodiversity (Campbell et al., 2010).

While there are many approaches to food security, agro-biodiversity and nutrition appear complementary and imperative to understanding the system that ensures food security (Johns et al., 2006). It is widely agreed that research is needed to better understand the integral role of agricultural biodiversity for nutrition particularly in agrarian-based regions (Johns et al., 2006). This is the case especially “in the developing world, where diets consist mainly of starchy staples with less access to nutrient-rich sources of food such as animal proteins, fruits and vegetables. Diet diversity is a vital element of diet quality – the consumption of a variety of foods across and within food groups, and across different varieties of specific foods, more or less guarantees adequate intake of essential nutrients and important non-nutrient factors” (Fanzo et al., 2010: 50). While many have recognized the inter-linkage of nutrition and (agro)biodiversity, there is still a call for information to understand, conceptualize, and develop effective interventions (Convention on Biological Diversity, 2013; Johns et al., 2006).The difficulty of understanding these interconnections is a product of the fact that they are part of a dynamic system (McMichael et al., 2011) that combines natural resources, social structures, cultural institutions, and human beings, which is captured in part, in the following conceptual scheme.

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Figure3: Population-level synergies linking biodiversity conservation and human nutrition in developing countries

(Source: Johns et al., 2004)

This widely deployed conceptual scheme illustrates that “… biodiversity, markets, and culture are all essential components of intact food systems that support the health and nutrition of populations, and they are in turn enhanced by a positive impact of biodiversity on nutrition” (Frison et al., 2006: 175). Food security is not simply a product of a linear input-output, production-consumption sequence but a process and product of a dynamic food system shaped by a myriad of micro and macro actors, structures, and forces (Sobal et al., 1998). In the face of environmental stresses, changing diet preferences, an increase in non-communicable diseases, and chronic food insecurity, agro-biodiversity has re-emerged as an important and perhaps more relevant tool to meet local and indigenous needs and wants (Convention on Biological Diversity, 2013), food security, and sustainable

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In the face of 800 million people deemed ‘food insecure’ and about two million considered ‘nutrition insecure’, biodiversity could greatly improve dietary options (Johns et al., 2006). “Simply feeding the world’s growing population by 2030 brings a threat of large-scale natural destruction…. Solutions are neither obvious nor realistic when taken in isolation. A biodiversity-focused strategy therefore has relevance within a multipronged approach”… “International and national policies that build on the biodiversity and cultural strengths inherent in traditional food systems optimize the chances for vulnerable populations to adapt to changing conditions in a sustainable manner” (Johns et al., 2004: 144). These cultural and social dimensions, underlying and largely determining food security, agro-biodiversity, nutrition security, and the nutrition transition are frequently neglected and left unmentioned due to their overwhelming complexity. However, capturing the social dimensions of the food system and the dynamics that shape and change food (in)security could serve as a tool for re-examining food security more holistically to allow for more grounded interventions that include biodiversity, nutrition, and preferences.

2.6. Framing Food Security from a Human Wellbeing Approach

“Life is not only a question of survival” (K’Okul, 1991: 13)

The Human Wellbeing Approach (hereafter referred to as the wellbeing approach),

launched at the University of Bath, UK in 2002, suggests wellbeing as a way to understand the outcomes and processes of development. Rather than infer wellbeing or development with proxies such as income, the approach is multi-dimensional; it posits that wellbeing is based on three interconnected pillars of physical, social, and psychological wellbeing. As it considers agency, social embeddedness, and context-specific subjective aspirations, it offers a comprehensive approach to study the complexity and social dynamics of food security rather than rely on the assessment of technical ‘needs’.

Wellbeing builds upon the Capabilities Approach and the Sustainable Livelihoods Approach and can be succinctly defined as “an interplay between the resources that a person is able to command; what he/she is able to achieve with those resources; and the meanings that frame these and that drive his/her aspirations and strategies” (Gough et al., 2007: 321). The interdisciplinary approach firmly rests on five convictions:

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 Humans are social beings and not simply rational, utility-maximizing actors.  Humans have basic needs that are physical such as nutrients and calories but also

social and psychological; the subjective satisfaction of the meeting of these needs must complement the more orthodox objective of hierarchizing needs that largely inform policies rather than vice versa.

 Livelihoods and traditions are meaningful activities and represent core aspects of people’s cultural identity including the reproduction or transmission of cultural knowledge systems.

 Outcomes and processes are important to distinguish; while outcomes such as resources available (e.g. physical, human, financial, cultural, social, and natural) are important, they are a ‘snapshot’ of the ‘movie’ (McGregor, 2007: 332). Processes (e.g. calendars, clocks, rhythms, and histories), mediated by institutions such as gender differences or social values are often just as important.

 Humans are resourceful and not only passive ‘victims’ of their fate (McGregor, 2007: 321).

The second pillar deserves some extra attention as food security is often normalized as a ‘basic need’; ‘needs’ are often prioritized over ‘wants’ where basic needs are referred to as a descriptive target, a “requisite for achieving an objective”, or a “normative priority” (Gasper, 2007: 54-55). In this case, “needs refers (implicitly if not explicitly) to a particular category of goals that are believed to be universalizable, whereas wants are goals that derive from an individual’s particular preferences and cultural environment” (Gough, 2004: 292). However, needs and wants are dynamic, multi-dimensional, and heterogeneous; they differ significantly between countries, cultures, communities, and even within households. As will be explored in this paper, food wants often determine how people will strive to ensure their food ‘needs’. Drawing on the wellbeing approach, it is possible to capture subjective food needs and wants of people while also relating them to larger conceptual definitions of food security. Such a definition was suggested by Maxwell et al., (1992), which also reflects the five pillars of the wellbeing approach:

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“The highest state of food security requires not just secure and stable access to a sufficient quantity of food, but also access to food that is nutritionally of adequate quality, culturally acceptable, procured without any loss of dignity and

self-determination, and consists with the realization of other basic needs … In this view, food insecurity is not an objectively defined level of access to food or quality thereof, but rather the level or quality that people perceive to be inadequate” (Maxwell et al.,

1992: 41).

Instead of searching for technical or economic panacea for food and nutrition (in)security or the categorical capitals that could allow for rural strategies as the sustainable livelihoods approach would suggest, an approach is needed that also captures food and nutrition security from a socio-relational perspective, in which food preferences and practices, meanings and values, ‘needs’ and ‘wants’ are integral. The wellbeing approach is fitting as it argues for a human ontology, which “recognizes that people are whole persons with a biological, psychological and emotional constitution; that they are also social beings; that they are actively engaged in the reception, interpretation and construction of meaning; that persons are different from each other, both in their internal constitution and their social being; and that they live in time” (McGregor, 2007: 324). Social practices and cultural heritage are essential to understand a food system from crop choices to nutrient

absorption; “Cultural heritage, food quality and culinary skills are key aspects determining sustainable dietary patterns and food security” (Lairon, 2012: 32). Food security, as shaped by and seen as a physical, socio-relational, and psychological need, begs extensive

exploratory research from the bottom up. Instead of adopting a rigid theoretical framework or methodology, the wellbeing approach lent itself as an overall guiding lens to conduct more inductive research.

2.7. Conclusion

Despite over 200 definitions of food security, those most commonly implemented focus primarily on availability and select aspects of accessibility, deriving from

conceptualizations presented in the 1970’s and 80’s (Maxwell, 1996). Interventions based on the simplified understanding of food security and nutrition security (in separation) as

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the secure intake of sufficient calories and adequate nutrients naturally assume a productivist or medicalized approach. These ‘solutions’ are derived from a simplified understanding and ultimately render the food system vulnerable to internal instability and external shocks (Lairon, 2012; Scoones, 2005; Brinkman et al., 2010). To place emphasis on the complexity and importance of micro-nutrients for food security, this concept will be referred to hereon as food and nutrition security. The recognition that food security is a multi-dimensional and multi-scalar challenge that threatens the physical, social, and

psychological wellbeing of farmers and net purchasers around the globe has made room for discussions regarding environmental sustainability, food systems in their entirety, human wellbeing, and social mediators of long-term change. As of yet, few studies have provided empirical evidence of the complexities of the social dynamics and processes in determining food security or presented integrated approaches to complement or to move beyond

technical fixes (FAO, 2012; Maxwell, 1992). By adopting a human wellbeing approach (McGregor, 2007) it is possible to unpack the complexities of seasonal food plate compositions from the food insecure themselves- from the ‘bottom-up ’.

Considering the sustained prevalence of food insecurity and poverty in sub-Saharan Africa, there is an undeniable need for grounding policies in a more comprehensive understanding of local processes and outcomes (Ellis, 2000; Hebinck, 2004; Scoones et al., 2005; Narayan et al., 2009; and Ploeg, 2010). Some have called for food-based or nutrition-sensitive approaches as suggested above but a socially-cognizant approach, which could serve as a complementary point of analysis, remains largely unexplored. The aim of this paper is to unpack some of the social dynamics associated with a changing food plate in a rural area of Southwest Kenya as these appear to have widespread implications for food security as deduced from both quantitative and qualitative data gathered in the field. The human wellbeing approach will allow for comprehensive analysis of these dynamics and the identification of mismatches between widely-cited definitions and local understandings and practices of food (in)security.

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Chapter 3: Research Design

This chapter is divided into 10 sections unraveling the process of conducting research and digesting this data to craft a thesis. Section 3.1 will firstly outline the epistemological position that guided the research planning process, operationalization, and analysis; 3.2 presents the principle and subsidiary research questions; 3.3 unpacks the concepts

deployed and how they were operationalized; 3.4 offers an elaborated conceptual scheme and describes the studied relationships; 3.5 discusses access to the research locale; 3.6 describes in-depth the multiple methods deployed for data collection during fieldwork; 3.7 presents some characteristics regarding the research population and explains the sampling technique; 3.8 briefly discusses the ethics and challenges; and finally, before concluding, 3.9 presents some of the tools used for data analysis. Both quantitative and qualitative

methods were deployed to collect and triangulate data in Luchululo sub-Location, Nangosia Location, Busia County, Western Kenya.

3.1. Epistemology and Research Methodology

The design for this study was generally directed by the understanding that past research on food security has been guided by technical agricultural and medical approaches. A

subjective epistemological positioning with borrowed elements of critical realism guided this study. As the aim was to tease out local perceptions and rural dynamics of food and nutrition security, emphasis was placed on the empirical (the subjective experience,

perception, and meaning associated with food security) with lesser focus on the actual (the events or strategies adopted that seem to be coincide with changes in food security), and the real (the dynamics that may have facilitated or compromised food security) as

distinguished by Bhaskar (2008). However, these levels of reality were primarily teased out by focusing on the agent as there appeared to be a distinct mismatch between the local meanings and practices and the macro and meso discourses on food security. This required extensive exploratory fieldwork driven by a bottom-up approach.

To unpack meanings and socio-culturally embedded understandings in conjunction with exogenous forces that shape the local food system, an approach was adopted that allowed

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me to start from the perceptions and stories of local smallholder farmers. To guide this subjective positioning, the human wellbeing approach was selected to allow me to go beyond the dichotomy of teleological or functionalist versus postmodern discourses in the constitution of agricultural development paradigms to find a grounded position that reflects and considers subjective realities and community-based opinions without

neglecting the opinions and discourses of key informants. Wellbeing as such complements previous food and nutrition security approaches to highlight people’s experiences, what they have instead of focusing on their deficits, incorporates physical, social, and

psychological indicators, and adopts a grounded approach to understand the local context (Jones et al., 2009). Instead of focusing on the ‘rational’ choices of farmers to increase their yields and/or crop diversity or fixating on their characteristics, the conditions of people in Luchululo were unpacked, a distinction made by Narayan (2009) with regards to poverty in general.

To capture local complexities and dynamics, an inductive methodology was adopted

drawing on three assumptions that underscored research conducted for the World Bank by Narayan and Petesch (2005) for the vast Moving out of Poverty study. These three pillars include that “each individual is the expert on her or his own life”, which may be explored with methodological pluralism; that “local context matters” shaped by institutions and agents dialectically; and that there is “change over time, in the dynamics of poverty mobility” (Narayan, 2009: 9). This initial positioning allowed for a more comprehensive approach to understand the region’s history, society, traditions, and geography especially as a researcher from a foreign context unacquainted with local customs and norms. To fully explore dimensions of nutrition and food security, the dynamics therein, and their

perceived determinants and outcomes, complementary quantitative and qualitative data collection methods were deployed.

3.2. Research Questions

As a result of the subjective focus and the methodology that stemmed therefrom, the questions that guided this study naturally changed during the course of fieldwork and analysis. While household strategies were the initial focus of the research design followed

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by access and flow of information regarding agriculture, food preparation, and nutrition, half-way through the fieldwork process it became evident that the social dynamics were the most important to unpack in order to understand change. The following questions emerged and guided much of the fieldwork and analysis.

3.2.1. Main Research Question

The primary research question developed for this fieldwork research is as follows:

How are food and nutrition security understood and practiced in

Luchululo, rural Southwest Kenya by smallholder farmers and what are the implications?

3.2.2. Subsidiary Research Questions

To unpack this question, the following three supporting questions were posed:

 How do smallholder farmers understand local food (in)security and how does this fit into the global debate?

 How do smallholder farmers make sense of how and what food is accessed, used, and consumed in Luchululo?

 What are the implications of this understanding and these practices for local food and nutrition security?

3.3. Concepts Deployed

This section presents the conceptual framework that emerged from the secondary

literature analysis – capturing both orthodox definitions and more recent paradigm shifts; firstly the key concepts are described as well as their operationalization, secondly, the conceptual scheme is illustrated, and thirdly, the studied relationships are elucidated.

3.3.1. Key Concepts and Operationalization

A food plate in transition : implications for food and nutrition security in rural Southwest Kenya

A Food Plate in Transition:

Implications for Food and Nutrition

Security in Rural Southwest Kenya

Anna-Lisa Noack

June, 2013

A Food Plate in Transition:

Implications for Food and Nutrition Security

in Rural Southwest Kenya

Table of Contents

Chapter 1: Introduction

Chapter 2: Theoretical Framework

Chapter 3: Research Design