NIHR Global Health Research Group on Community Food for Human Nutrition and Planetary Health in Small Islands (Global CFaH)

Research question:

What is the potential for improving household diet, nutrition, and food security, and reducing the burden of nutrition related diseases by promoting increased community-based food production (CFP) based on agroecological principles in small island countries? Background:

Small island countries of the Caribbean, South East Asia and the Pacific are increasingly dependent on food imports (most of low nutritional density), accounting for around two thirds of food consumed. This trend has been associated with a decline in local food production, compounded by the vulnerability to increasingly frequent extreme weather events associated with climate change.

All have high burdens of malnutrition: micronutrient deficiencies and overweight /obesity related non-communicable diseases. Anaemia in women of reproductive age ranges from 15.7% (Philippines) to 31% (Fiji) and obesity (BMI > 30kg/m2) from 5.2% (men in Philippines) to 35.3% (women in Fiji). In the Philippines 3 in 10 children aged <5 suffer from stunting.

The UN Food and Agriculture Organization’s ten elements of agroecology set out a framework for creating sustainable and resilient CFP for improved human and ecosystem health. Methods:

Our interdisciplinary research group will work in four countries, Fiji, the Philippines, Dominica and St. Lucia, on the following interrelated work packages (WPs).

WP1 - Systematic review and critical appraisal of evidence for small island countries on dietary quality, nutrition-related diseases, where and why food is sourced, and the extent to which current CFP conforms to an agroecological approach.

WP2 - New quantitative and qualitative data collection, guided by evidence gaps identified by WP1, on: population and household diet and nutritional status; contribution of food sources, including CFP, to diets; socio-cultural, historical and economic contexts; enabling factors (e.g. local and national governance and policy frameworks).

WP3 - Co-innovation for improved diets and nutrition. We will work with local communities and local food producers to assess their needs, develop ‘living labs’ to codesign, deliver and evaluate interventions to increase local sustainable food production for better household nutrition and health.

WP4 - Impact modelling of long-term human and ecosystem health benefits, guided by agri-food system maps derived with local stakeholders in group model building exercises, comparing ‘business as usual’ and scaling up interventions developed in WP3 to inform national and regional policies. Timelines of delivery:

Yr1: Agreements, protocols and ethics, identification of project settings, community engagement activities (for WP2 new data collection and WP3 establish communities of practice), evidence synthesis (WP1); Yr2: new data collection (WP2); Yr2-4: intervention co-creation and living labs (WP3); Yr4 modelling (WP4); Yr1-4: engagement, dissemination and developing of web resources.

Anticipated impact:

We will 1) develop a web-based repository of materials and guidance to support dissemination and further development of applied research beyond project completion, 2) provide policymakers with well-defined, evaluated, interventions designed to improve household nutrition, 3) enhance learning, collaboration and strengthen capacity across academic institutions, 4) build and strengthen relationships between researchers, local NGOs and governments.