APPENDICES

Appendix I. List of Participants

Appendix II. Opening address by R.B. Singh, Assistant Director-General and FAO Regional Representative for Asia and the Pacific

Madam Chairperson,
Distinguished Participants, FAO colleagues,
Ladies and Gentlemen,

I am pleased to welcome you on behalf of the Director - General of the Food and Agriculture Organization of the United Nations, Dr Jacques Diouf, and on my own behalf to the Regional Expert Consultation of the Asia Pacific Network for Food and Nutrition on “Reviewing Implementation of the National Food based Dietary Guidelines (FBDGs)”.

I am delighted to welcome the national participants from Asia and the Pacific. From Asia we have distinguished participants from Bangladesh, India, Indonesia, Malaysia, Nepal, the Philippines, Thailand and Viet Nam. Unfortunately China and Sri Lanka withdrew at the last minute, although their papers are with us. We are particularly happy to note that we have representatives from the Pacific island, namely Fiji and Vanuatu and also from the South Pacific Commission.

I extend a warm welcome to our resource persons Dr. Barbara Schneeman, Professor of Nutrition, University of California, Davis and Ms. Wendy Snowdon, Nutrition Education and Training Officer, Lifestyle Health Section, South Pacific Commission, New Caledonia. They have been close technical partners in the FBDG process with FAO, and I am confident that they will make enriching contributions in the Consultations.

This Consultation is being held in the context of the overall mandate of FAO to promote production, distribution and marketing of safe, wholesome and nutritious food in order to raise the levels of nutrition and standards of living for people. FAO’s concept on food security has been evolving. It is not only food production in sufficient quantity, economic and physical access to food, but also nutritional adequacy and security, including hygiene, safe and balanced food. After having achieved adequate dietary energy intake at national levels, increasing attention must be paid to the sources of energy, the carbohydrate: protein and fat balance, micronutrients and vitamin (especially vitamin A) contents and balances.

As you are aware, the World Food Summit (WFS) held in 1996 attended by 186 governments resolved to reduce the number of undernourished people in the world by at least 50 percent by the year 2015 with the longer-term goal of eventually eradicating hunger and achieving food security and nutritional well being for all. It is estimated that about 815 million people are undernourished of which 777 million are in the developing world and remaining 38 million are in the developed world. It is important to note that Asia and the Pacific region with 497 million undernourished people is home to 65 per cent of the world’s chronically hungry people. Over the past decade, the total number of chronically malnourished in the developing world has fallen annually only 6 million, against the targeted reduction of 20 million people per year. In order to achieve the WFS target, the annual reduction required in the number of hungry people is 2.2 million. With business as usual, it would take more than 60 years to reach the target.

Among the sub-regions, the problem is most serious in South Asia, which houses over a third of the world’s undernourished and two-fifths of the world’s poor. South Asia is also home to nearly half of the world’s malnourished children. Overall, in the Asia-Pacific Region, it is not only that the number is high, but most disturbingly it remains stubbornly high and in fact has increased by a few millions in the recent years. To meet our pledge of the WFS, the ranks of the region’s hungry must be reduced by at least 15 million people per year instead of the 13 million set at the time of the Summit in 1996. Agendas at national and international levels therefore must give highest priority to ensuring food to the hungry and elimination of the fear of starvation.

As we understand the food production - consumption chain, we realise how it can drive food consumption decisions and in formulation of agricultural policies which promote food and nutrition security. Indeed, growth in food production in Asian countries over the past two decades has been remarkable, and its implications for direct human consumption are expected to be positive, in much of Asia. However, dietary energy supply (DES) which is a widely used indicator of aggregate food and nutrition situations and expresses the availability of food in kilocalories (kcal) per capita per day, shows that in spite of adequacy of DES in many of the Asian countries, it is important that dietary energy comes from a diverse variety of foods sources. Asian diets remain deficient in sources of protein as compared to carbohydrates whereby almost (70%) of total energy comes from carbohydrates and only 10% from protein. This lack of food (dietary) diversification gives rise to protein energy malnutrition (PEM) which is widespread in Asia and particularly among the vulnerable groups of pregnant women and young children. Of an estimated 192 million children affected by PEM worldwide, over ¾ (79%) are from Asia. What is urgently needed is availability and accessibility to food diversification and dietary variety. In our multiple efforts to address the situation of food insecurity, we need to augment strategies that can bring about a situation by which all people (larger sections) at all times secure access to sufficient amounts of safe and nutritious food for normal growth and development and active healthy life.

The State of Food Insecurity in the World Report (SOFI) 2000 by FAO, pointed out that the daily diets of the 826 million chronically hungry people lack an average of 100 to 400 kilocalories. The greater the lack of energy, the greater is the susceptibility to nutrition related health risks and thereby limiting their ability to lead an active life. In the Asian region, the depth of hunger is particularly serious in Bangladesh, DPR Korea and Mongolia. Specifically, moderately high hunger (the diets falling short by 250 to 300 kcal/person/day) is prevalent in several Asian countries, namely, Cambodia, China. India, Lao PDR, Nepal, Pakistan, Papua New Guinea, Philippines, Sri Lanka, Thailand and Viet Nam.

While lack of dietary energy and lack of food diversification gives rise to PEM, it also gives rise to micronutrient deficiencies, which are of immense public health significance in Asia. These largely include iron deficiency anemia (IDA); iodine deficiency disorders (IDD) and vitamin A deficiency (VAD). In South and Southeast Asia 76% of pregnant women and 63% of preschool children are anemic and in particular, South Asia accounts for 50% of the world’s anemic women.

Asia-Pacific is an economically diverse region, with its agricultural production and food security situation having important impacts on nutritional security. For example, analysis of the changes in the commodity composition of food by country groups brings out the relative emphasis to be given between crops and animal production systems in the sub-regions. Typically, the share of pulses in South Asia - a major source of protein in the diet and an important group of crops in crop rotation is expected to decrease, which has negative implications for nutrition and soil fertility.

During the past 35 years, food production in the Region had more than doubled. Despite the addition of 1.3 billion people to the Region, the per capita consumption in the Region had increased from 2000 kcal/person/day to over 2600 kcal/person/day, an increase of 30 percent. The incidences of poverty and hunger had also halved. These trends give no optimism for future growths. But the paths of the growth will need to be changed for ensuring balanced and equitable growth. It would be useful to understand the impact of Green Revolution on distortion of the dietary energy balance.

Designer crops with desired combinations of nutritional quality combinations (carbohydrates, protein, fat, amino acid and fatty acid profiles, micronutrient and vitamin contents) can be produced by both conventional and nonconventional (biotechnology) approaches, such as opaque and floury (high protein) maize, canola of desired fatty acid composition and much talked about Golden Rice. As we know, rice has been genetically engineered to contain pro-vitamin A (beta - carotene) and iron, which could help to meet the requirements of these nutrients in the diets of many developing country populations where the prevalence of vitamin A deficiency (VAD) and iron deficiency anemia (IDA) is high. Appropriate use of biotechnology could be increasingly considered to address the challenges of unmet food and nutrient needs of the hungry. FBDGs could consider the potential possibilities for examining the biosafety, food safety, consumer acceptance, value and promotion avenues in the near future, depending on the progress made. Indeed, the benefits of biotechnology would need to be optimized through balanced means using science based evidence of positive and negative points and for using it as a novel support to address problems of food security. The pricing and marketing aspects of genetically engineered food sources will also need to be analysed.

Rightly, this year’s SOFI Report (2001) reiterates the way ahead for commitment followed by resources and action to address the symptoms and the more fundamental causes of undernourishment and poverty. It asks what we have to show and put forward to countries as strategies in order to address these preventable problems of malnutrition. To highlight briefly, it asks if food aid is available; are there any safety net programmes; are long term research and development efforts underway to increase and sustain the productivity of the natural resource base; are educational programmes in place to improve health and hygiene practices etc.? And how can these be mobilized and are countries taking action to mobilize them? It is the last two questions that are highly relevant in the context of the theme of this Expert Consultation.

The International Conference on Nutrition(ICN), convened by FAO/WHO in 1992 aimed basically at identifying and adoption of strategies and actions to improve nutritional well being and food consumption throughout the world. It adopted the World Declaration and Plan of Action for Nutrition which includes among its goals the elimination or substantial reduction of famine and famine related deaths, chronic malnutrition, micronutrient malnutrition, and diet related communicable and non-communicable disease. Where this last category is concerned, promoting appropriate diets and healthy lifestyles was highlighted as an appropriate strategy. This strategy calls upon governments “on the basis of energy and nutrient recommendations, to provide advice to the public by disseminating, through use of mass media and other appropriate means, qualitative dietary guidelines relevant for different age groups and lifestyles and appropriate for the country’s population”.

It may not be out of place to refer to the recent deaths in Assam arising from reportedly from an overdose of (allegedly overaged) vitamin A to infants and young children. Apart from going into the details and depth of the issue, after controversial, one point that clearly emerges is the need for promoting the food based approach rather than the short sighted use of the supplement approach (which focuses on just a vitamin rather than various micronutrients and which can be obtained from a diversified diet). It has also been reported about the effects being exacerbated in a situation of malnutrition, which is what the infants were in. There is an urgent need for urgently and rigorously advocating the need for preformed vitamin A foods (milk) and provitamin A foods (green leafy vegetables and yellow orange vegetables &fruits) (approximately ½ litre milk/d/child and a serving of DGLV can provide the child’s vitamin A requirements) which can be obtained through dietary improvement, in which case there would be little need for resorting to supplements!

Successful experiences from Thailand, Viet Nam, Indonesia (prior to the crisis), certain parts of Bangladesh and States in India (Andhra Pradesh, TN) have pointed to the decline in the incidence of vitamin A deficiency as a result of sustained dietary improvement. It is appropriate that FBDGs are vigorously promoted, food behaviour and change in nutritional status assessed, making a clear case and providing evidence for nutrition and health improvement by judicious food habits, eating and better nutrition.

Madam Chairperson:

As you are aware, the Declaration and Plan of Action for Nutrition also calls for the dissemination of nutrition information through “sustainable food based approaches that encourage dietary diversification through the production and consumption of micronutrient rich foods including appropriate traditional foods”. In pursuance of these goals, FAO along with WHO jointly convened an Expert Consultation in March 1995 in Cyprus, which set the rationale and made useful recommendations for the development and implementation of food based dietary guidelines at the national level.

A people’s diet is very much a part of their culture. The idea that health and illnesses are related to the types of food we eat has been firmly established as part of our cultural beliefs. This belief applies not just to the consumption of expensive and exotic foods but to the consumption of everyday fare. The term food based dietary guidelines is used to express the principles of nutrition education mostly as foods. They are intended for use by individual members of the general public. FBDGs play an important role in recommending appropriate intake of food and also in providing the public information about the right types and amounts of food to eat to meet our nutrient requirements and about healthier ways of food preparation.

Food based dietary guidelines thus are an educational instrument that converts scientific knowledge of nutrient requirements and food composition into practical messages that facilitate healthy food selection and consumption for different people. Indeed, the concept of disseminating information through FBDGs is then inherently sensible since it enables consumers to think in terms of foods rather than nutrients. Equally, the concept of FBDG can take account of considerable epidemiological data linking specific food consumption patterns with low incidence of certain diseases, while not requiring a complete understanding of the biological mechanisms responsible for such a protective property. In the modern era, we observe a low incidence of certain diseases in specific communities with particular eating habits and while we rightfully search for an explanation of biochemical mechanisms, dietary recommendations based on these food patterns are warranted. An example is the association of high fruit and vegetable consumption with reduced risk of certain non-communicable diseases (NCDs) and the emerging awareness that several components of these foods and the diets containing them contribute to lower risk. It will be useful to undertake studies at the grassroot level to clearly demonstrate the relationship between the prevalent agricultural production systems, diversities of food products and the nutritional and health status of people.

I am told that many of the countries in the Asia Pacific region have made good progress in developing such FBDGs given the role that food consumption and dietary practices play in nutrition-related disorders, whether of deficiency or excess. While FBDGs have been developed at national levels, these need to be communicated to the larger sections of the population so as to respond to their essential and varying food and nutrition needs. Some key previous meetings have been organized by FAO in co-ordination with International Life Sciences Institute (ILSI), in Singapore in 1996, in India 1998, and also in other regions. In fact, the new initiative of FAO entitled Feeding Minds to Fight Hunger embraces a broader educational framework to sensitise children of the needs and possibilities of nutritional adequacy and health.

While the development and popularisation of food based dietary guidelines (FBDGs) serves as one of the potent information, education and communication (IEC) tools help to improve food and nutrition behavior over the long term, and help to address problems of both chronic energy deficiency and micronutrient malnutrition, an assessment of the impact of FBDGs is to be envisaged, and a functional tool for its use is also needed. Measurable nutrition and food security indicator information would need to be developed and used by populations and communities to help assess the success of such approaches by a feedback mechanism. An effective linkage through judicious use of ICT in connecting communities, extension agents, nutritionists and policy makers is essential. Rural and grassroot institutions for implementing the policies will be needed for achieving widespread impacts of the various interventions.

Specifically, dietary diversification through a variety of practical food based approaches can help to reduce vulnerability to household food insecurity as well as disease, which are seen especially as problems in Asia. This should be implemented with a commitment to inter-disciplinary approaches so that development can be achieved with adequate food production conducive to food security and economic improvement.

Community based food production would need to necessarily become an essential component of community based programmes. For instance, local production of foods could serve as indigenous sources for preparation of complementary foods for young children, supplementary foods for pregnant women as well as adolescent girls. Rightly then IEC strategies through FBDGs would need to specifically address the dietary and nutritional needs of these vulnerable groups where problems of malnutrition are high.

In implementing FBDGs, there is a need to direct efforts towards a shared vision of communities in addressing food insecurity and nutritional inadequacy and related concerns. Individuals, households and communities must be recognized as having a primary role in efforts to alleviate food insecurity and improve nutrition. Local government and non-government personnel need to support and facilitate nutrition education and community efforts without creating dependency. Strategies would also need to integrate multi sectoral services in consonance with local capacities and efforts. Such processes ultimately would call for major institutional challenges, because they link top-down policy decisions with bottom up planning from the community. It is possible, that this can be achieved through a people’s participatory process through community based nutrition programmes where the potential for change and impact is likely to be the greatest.

An explicit focus on women is essential to successful strategies and mechanisms. Recognition of the need to involve women in their design evolves not merely from a limited concern about equity of women with men as beneficiaries and contributors to development, rather women need to be active participants because they have experience with successful achievements in ensuring household and community food and nutrition security evolving throughout centuries in the socio-cultural contexts of Asian countries. Asian women offer cumulative, indigenous knowledge, but their potential remains untapped. The involvement of poor and rural women thus becomes most essential. Overcoming basic and functional literacy, especially among girls and women is an essential component of successful programmes. Overcoming rural, urban disparities in access and quality of education is also essential. The production and use of educational materials and curricula reflecting rural perspectives, and including emphasis on rural concerns with a focus on women for achieving nutritional security are essential elements. Studies have shown that education of women and enhancing their access to health care have the greatest bearing on nutrition, especially improvement of child nutrition.

Madam Chairperson, Ladies and Gentlemen:

Scientific organizations and government agencies which you all represent, need to ultimately reach out to and work with the community, to move food security and nutrition improvement strongly up the political agenda if we are to achieve equitable access to adequate, safe and nutritious food as the most basic of all human needs. Linkages between knowledge and practice (action) are vital, where informed knowledge needs to be best used.

I note that you have planned an interesting agenda for deliberation at the Consultation. I believe you will be examining country initiatives on the status of implementation of FBDGs at various levels, discussing processes that are appropriate for effective implementation and also to intensify the particular involvement of multi sectors in this context.

I urge you to come up with your forthright recommendations and contribute to the coalition and fruition of efforts that we are undertaking in promoting and implementing the use of appropriate diets and healthy lifestyles towards meeting our goal of food security and nutritional well being for all. I wish you a fruitful meeting and a pleasant stay in Bangkok.

Thank you.

Appendix III. Agenda

1. Overview on implementation of the national food based dietary guidelines - An FAO perspective

2. Forging nutrition and agriculture links through food based dietary guidelines

3. Review of country status with regard to implementation of FBDGs and identification of future actions.

4. Working group sessions

5. Update on Implementation of ICN/NPAN/WFS Follow up activities

6. Any other matter (Discussion on Implementation of FAO’s Nutrition Education Initiative - Feeding Minds, Fighting Hunger in countries of the region).

Appendix IV. Timetable

DAY 1
Tuesday, November 20, 2001

Technical Session 3

DAY 2

Wednesday, November 21, 2001

Technical Session 4

DAY 3

Thursday, November 22, 2001

DAY 4

Friday, November 23, 2001

Session 6

Appendix V. Working Group I: Outputs

Facilitator: Barbara Schneeman

Topic I: To identify enabling factors and the types of specific strategies that strengthen implementation of FBDGs.

These include:

i. Advocacy to support the process among policy makers and implementers.

ii. Social Mobilization among local groups. Specific efforts can be targeted toward the food service sector such as food vendors, caterers, and food markets.

iii. Dissemination of information through use of ITC (Information for Technology Change), IBC (Information for Behavioral Change) and IEC (Information for Educational Change) to convert the information in FBDGs into behavior-oriented messages that can be assimilated by the relevant communities. In this process it is important that messages are evaluated for consistency with the FBDGs.

iv. Development of specific process and impact indicators (Group II addressed this topic).

v. Throughout the process it is important to obtain feedback from the stakeholders as a part of the monitoring and evaluation system.

vi. Special efforts will be needed that are specific to the different sectors (government, industry, agriculture) involved with implementation of FBDGs. For example, governments would need to consider food laws, import/export policies, support for food labeling; industry should evaluate food processing methodology and product development; agriculture would need to consider diversification of crops, breeding and selecting for nutrient rich foods, and biotechnology.

vii. Efforts need to be coordinated both horizontally and vertically

viii. Use of monitoring and evaluation. (see Group II)

ix. Developing funding and relevant resources.

i. Government funding is necessary, but the group assumed it will be limited.

ii. The funding priorities of research and scientific organizations and institutes should include nutrition priorities.

iii. Funding from international organizations should be used to leverage more limited government funds.

iv. Private funding or NGO funds can be used for specific projects; however, important criteria include the integrity of the messages and review for consistency with FBDGs.

v. Capacity building at all levels is an essential component for success in the implementation of FBDG.

Topic II: Process of expressing the principles of FBDG in quantitative terms through a food guide.

The following recommendations were made:

a. Quantitative measures should be made in household measures that are relevant to the country, i.e. include cups, spoons, weights, bunches, numbers, servings, etc.

b. The recommendations should be linked to energy levels as well as include adjustments for age and sex. For certain vulnerable groups, information on the frequency of consumption of certain food groups to insure nutrient adequacy should be included.

c. Applied studies may be needed to normalize or standardize the household measures and recipes. Pictures or graphics of typical servings can be used in educational programmes.

d. The focus should be on FOODS not on the food components (e.g. % energy).

e. Information on recipes, cooking methods and food handling for improved nutrition can be included.

f. Methodology issues that were identified include:

i. Standardizing relevant household measures and recipes or mixed dishes.

ii. Reliable estimates of the foods as consumed in a manner that accounts for cooking and preparation

iii. Insuring that it is possible to meet nutrient needs from the recommended food guide.

g. Food guides from different countries have some common themes; however, it is important that the guide is developed in a country specific manner to be most effective for the population.

Topic III: Promoting strategic implementation of the FBDGs.

The key factors identified include:

a. Political commitment or will

b. Strong initiative and involvement from professionals.

c. Strong commitment from the international and national communities.

d. Frequent sharing of experience and learning from each other is an important mechanism to help build inter-sectoral cooperation and multi-sector linkages.

e. To be strategic in the implementation, the FBDGs should target vulnerable groups by integrating the FBDGs into related national programmes for children and pregnant women.

f. FBDGs could be strongly considered for incorporation into the course curricula at all levels.

g. The FBDGs would need to be integrated into the planning and implementation of the plans for National Food Security, which incorporates adequacy, quality, safety, accessibility, availability, affordability and distribution, which can be stated as:

• Food that is available would need to be accessible and acceptable in ways that are affordable and in the form that meets nutritional needs.

• The agricultural sector needs to understand the nutrition issues from a food perspective.

h. During implementation health/disease factors that affect nutrient availability must be addressed.

i. Small and home scale food production and technologies that encourage gardening, development of livestock, seeding community fish ponds and preservation of food would need to be encouraged.

Appendix VI. Working Group II: Outputs

Facilitator: Wendy Snowdon

To strengthen implementation of FBDGs with a specific consideration for monitoring and evaluation.

The following includes summaries of issues that were deliberated.

FBDG’s have a role as a tool to improve people’s knowledge and it is recognised that a change in knowledge is an acceptable indicator to evaluate for effectiveness of FBDGs. But as knowledge change does not necessarily lead to behaviour change, the impact of other factors apart from knowledge on behaviour should be recognised by all. Changing knowledge is a valid end-point to be used for monitoring as realistically as possible; FBDGs cannot be expected to affect or even change practice in the short term.

Monitoring and evaluation would need to be included during the planning of FBDGs. Monitoring and evaluation should include process, outcome and impact evaluation. Process evaluation looks at the actual FBDGs and their implementation such as format, wording etc. Outcome evaluation looks at short-term effects such as knowledge changes. Impact evaluation looks at the long-term aims of FBDGs to improve diets and health. Survey, questionnaires, focus discussions are some of the ways that FBDGs can be evaluated.

FBDGs also have a role to play in influencing agriculture, education and trade and commerce activities. Evaluation should look at the use of FBDGs by relevant sectors, agencies and planning.

There is a need for developing guidelines on evaluation of FBDGs which should indicate methods, indicators and areas for evaluation. There is also need for developing evaluation tools. For instance the Philippines has used an opinion survey to determine whether there is increased awareness of salt iodization. Similarly, it would be useful to identify the choice of foods by consumers which are often guided by cost factors rather than nutrition principles. Other process indicators such as the media usage of FBDGs, number of IEC materials distributed, etc. can be used. The annually compiled selected indicators publication from FAO which indicate food availability and supply at national levels could also be considered for use as broad indicators to reflect national level monitoring and evaluation which could have application for FBDG implications in agriculture.

As a number of partners are involved actively in evaluation activities, it is important to converge efforts in the process so that the multi-sectoral inputs that go into the implementation of the FBDG process are optimized.

Based on the discussion from the two working groups, a set of core principles for implementation of FBDGs was identified. These principles are:

a. National Development Plans should include nutrition objectives to achieve national development goals.

b. FBDGs are a policy tool for coordinating food, health, and education initiatives.

c. Multi-sector approaches are essential for improving nutrition and successful implementation of FBDG.

d. Nutritional status is a socio-economic issue and not simply a health issue.

e. Food based strategies for health promotion and disease prevention should be sustainable.

f. Both top-down and bottom-up efforts are needed for implementation of FBDGs.

g. A focal (nodal) agency or ministry, such as Agriculture, Health, Education, Women and child Development, should have leadership for nutrition.

h. FBDGs are a key component of national food security.

From these principles the Consultation identified potential actions that can be undertaken at various levels. These actions include:

a. Extract lessons on food, nutrition and agriculture from key reports of international agencies and meetings/workshops addressing issues on agriculture and nutrition.

b. Advocacy efforts for nutrition and FBDGs at appropriate level should be sustainable.

c. Quality of foods for export must be equivalent to the quality for local consumption.

d. Build capacity for monitoring and evaluation of FBDGs. This can be accomplished through training workshops, sharing experience and tools developed etc.

e. Country reports for WFS 5 years later would need to appropriately include a statement about FBDGs and their relationship to agriculture in contributing to the quality of life in the country.

f. Progress from ICN follow up report at WFS 5 years later.

Constraints and issues:

The resolution of these constraints may vary by country and is related to the principles and actions identified above. However, FAO can facilitate the understanding and ability to address these issues at the country level.

A constraint in implementing multi-sector programmes for FBDGs is the lack of qualified personnel with nutrition expertise in the relevant agencies, and the fact that nutrition may not be recognized as a key area of expertise to be promoted within these agencies.

In some regions, the understanding of nutrition is often limited to PEM. This limited view may result in a poor understanding of how nutrition objectives are linked to the primary objectives and goals of various agencies. A challenge for nutrition experts is to understand the specific goals and objectives of the ministerial agencies so that nutritional targets can be linked to these outcomes.

Nutrition is multi-dimensional and complex; consequently it is difficult to identify single or simple and sensitive indicators to demonstrate accomplishments. Systems to monitor and evaluate the effectiveness of FBDGs have not been well defined. Donors often focus on the final health outcome for evaluation rather than the intermediate steps that are needed for behavior change such as knowledge/awareness, attitudes and practices.

The Ministry of Agriculture should have a central role in implementing FBDGs but often their focus is on cash crops or export crop rather than food production related to meeting the food security needs. It should also serve to link up with the FBDGs and the food and nutrition priorities of the population. A consequence of this disconnect may be that high quality foods are exported and poorer quality foods remain in the country or foods that are encouraged for consumption in the FBDGs are expensive, while foods of poor nutritional quality are readily available at low cost.

There is a need for examining the extent to which the National Plan of Action for Nutrition and FBDGs have been included into National policies for development and food security.

There is a distinct need for linking up FBDGs to be through community based programmes and grass root level operations in developmental programmes where nutrition increasingly needs to become an integral component.