Purpose of this manual 

• To equip health and agriculture workers at communities level with the knowledge, attitude and communication skills. 
• Create awareness on nutrition component of agriculture-nutrition interventions that provides appropriate services, including well-tailored and comprehensive nutrition education, to address specific, local malnutrition issues. 
• Describe the type of interventions that promote nutrition-sensitive agriculture and how to integrate them into their daily activities. 
• Use the tools to counsel farmers on nutrition-sensitive agricultural interventions. 

Training-of-Trainers Facilitator's Guide

This three-day workshop on nutrition aims to increase participants’ nutrition knowledge in the context of agricultural training. The main purpose is to promote adoption of key nutritional messages among farmers through the use of appropriate analogies. As such, this workshop trains lead farmers (LF) through a training-of-trainers (ToT) format. After the ToT, LFs will train other farmers who are members of their cooperatives on key nutrition topics. 

An "agriculutre-nutrition gap" exists due to agricultrual development primarily focusing on poverty alleviation and not focusing on producing adequate nutrients to improve the household nutrition. Community development workgers have seen agricultural yields and household incomes increase but high malnutrition is still prevalent in communities where they work (Jayakumar 2014). Women play a key role in maintaining and improving household practices leading to good helath. Additionally, they need adequate groth-nutrients like protein, zinc, sulfur, and magnesium from early childhood onwards and from pregnancy to their children's early childhood. A well-nourished mother can then pass on health benefits to her children particularly in the first 1000 days of life, where lack of nutrition will significally impact a child's ability to fight infections and develop cognitive abilites into their adulthood.

The PATH-led Infant & Young Child Nutrition (IYCN) Project has developed the Nutritional Impact Assessment Tool for project designers to use during the design phase of agricultural projects. Much as environmental and gender impact assessments are now standard practice in project planning to prompt consideration of the project’s likely impacts in those areas, a nutritional impact assessment prompts consideration of a project’s impacts on the nutrition of vulnerable groups.

This tool assists agriculture project designers in assessing an agriculture project’s likely impacts on the nutrition of vulnerable groups. Please refer to the accompanying Nutritional Impact Assessment Tool Guidance for instructions on how to use the tool.

The perceived lack of success of public agricultural extension systems in many countries has resulted in new approaches being tried in reorganizing extension services. In some countries, such as India and China, public extension systems have been decentralized to the district/county level and these public extension systems are now pursuing a more market-driven approach. In other countries, different models have been tried, involving both private-sector firms and civil society organizations (CSOs), in an attempt to find more effective approaches of providing basic extension services. Also, in some countries, there have been attempts to shift more of the cost of extension services to the farmers themselves, with limited success. This paper provides a framework for analyzing the success or failure of different approaches within the agricultural development process in providing particular extension services to different categories of farmers.

Nutrition-sensitive agriculture (Box 1) has the attention and is increasingly promoted by national governments and the global development community. This is exemplified in Feed the Future (FTF), the U.S. Government’s initiative to sustainably reduce global hunger and poverty. It is embodied in FTF’s twin objectives: inclusive agricultural sector growth and improved nutritional status especially of women and children. Nutrition-sensitive agriculture is a means towards achieving these objectives (Ruel, Alderman, & the Maternal Child and Nutrition Study Group, 2013).

Experience in nutrition interventions points to several design characteristics of field programmes which could improve their effectiveness. Regular government extension services have the potential to reach large numbers of people, yet staff will require additional training to respond to the changing demands of field work. A new approach to training such staff has been developed by the Food and Agriculture Organization. The approach provides staff with information and managerial skills that are common to all extension work. The practical examples used to introduce these techniques illustrate nutritional problems that fieldworkers face and give a measure of confidence in finding solutions. Training materials based on this approach are presently used by several governments.

A growing number of governments, donor agencies, and development organizations are committed to supporting nutrition-sensitive agriculture (NSA) to achieve their development goals. Although consensus exists on pathways through which agriculture may influence nutrition-related outcomes, empirical evidence on agriculture’s contribution to nutrition and how it can be enhanced is still weak. This paper reviews recent empirical evidence (since 2014), including findings from impact evaluations of a variety of NSA programs using experimental designs as well as observational studies that document linkages between agriculture, women’s empowerment, and nutrition. It summarizes existing knowledge regarding not only impacts but also pathways, mechanisms, and contextual factors that affect where and how agriculture may improve nutrition outcomes. The paper concludes with reflections on implications for agricultural programs, policies, and investments, and highlights future research priorities.

There is growing interest in better leveraging agricultural extension and advisory services (AEAS) for nutrition-sensitive agriculture (Fanzo et al. 2015; GFRAS 2016a). Pluralistic AEAS (defined in Box 1) includes public, non-governmental organization (NGO), and private sector entities that regularly interact with millions of farmers. For readers who are more familiar with health programming, AEAS play a role similar to community health workers (CHWs). It should be noted, however, that AEAS typically engage farming households with the potential to produce a marketable surplus (USAID 2016), whereas CHWs focus on populations most vulnerable to poor health. Enlisting AEAS as vital partners in the UN Decade of Action on Nutrition is essential to realizing the Sustainable Development Goals and 2025 World Health Assembly targets. They are the foot soldiers positioned to play a key role in realizing healthier food systems. Their specific contributions, however, must build on their core competencies and will only be realized when there is alignment between programmatic, market and policy incentives.