AGRICULTURE GLOBAL PRACTICE TECHNICAL ASSISTANCE PAPER IMPROVED NUTRITION THROUGH AGRICULTURAL EXTENSION AND ADVISORY SERVICES CASE STUDIES OF CURRICULUM REVIEW AND OPERATIONAL LESSONS FROM INDIA Suresh Chandra Babu, Meera Singh, T. V. Hymavathi, K. Uma Rani, G. G. Kavitha, and Shree Karthik WORLD BANK GROUP REPORT NUMBER 94887-IN FEBRUARY 2016 AGRICULTURE GLOBAL PRACTICE TECHNICAL ASSISTANCE PAPER IMPROVED NUTRITION THROUGH AGRICULTURAL EXTENSION AND ADVISORY SERVICES Case Studies of Curriculum Review and Operational Lessons from India Suresh Chandra Babu, Meera Singh, T. V. Hymavathi, K. Uma Rani, G. G. Kavitha, and Shree Karthik © 2016 World Bank Group 1818 H Street NW Washington, DC 20433 Telephone: 202-473-1000 Internet: www.worldbank.org Email: feedback@worldbank.org All rights reserved This volume is a product of the staff of the World Bank Group and the International Food Policy Research Institute. 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CONTENTS Acknowledgments v Abbreviations and Acronyms vii Executive Summary ix Chapter One: Introduction 1 Chapter Two: A Conceptual Model for Integrating Nutrition into Agriculture Extension 5 Chapter Three: Research Methods and Approaches 9 Chapter Four: Results and Discussion 11 Mapping Institutions for Integrating Agriculture and Nutrition 11 Case Studies of State Agricultural University Curriculum Reviews 13 Operational Strategy for the Development of Nutrition-Smart Extension and Advisory Services 16 Chapter Five: Specific Lessons and the Way Forward 19 Chapter Six: Concluding Remarks 21 References 23 Figures Figure 4.1: Mapping of Channels of Food, Agriculture, Nutrition Linkages from National to Village Levels 12 Figure 4.2: Strategy for the Development of a Nutrition-Smart Agricultural Extension Curriculum 17 Figure 4.3: Curriculum Strategy at the District Level Using Nutrition Security Conceptual Framework 18 Table Table 2.1: Conceptual Framework for Developing a Curriculum to Achieve Agriculture-Nutrition Linkages 7 Case Studies of Curriculum Review and Operational Lessons from India iii ACKNOWLEDGMENTS The activities documented in this report were conducted under the guidance and encouragement of Eija Pehu (Task Team Leader) and Terhi Havimo (Team Mem- ber) of the Global Practice of Food and Agriculture (GFADR) of the World Bank. Thorough reviews and suggestions by peer reviewers Lynn Brown (Consultant, GFADR) and Iftikhar Mostafa (Senior Agriculture Economist, GFADR) are grate- fully acknowledged. Any remaining errors and omissions are the responsibility of the authors of the report. This work was funded by the South Asia Food and Nutrition Security Initiative (SAFANSI) supported by the World Bank and the UK’s Department for International Development. Case Studies of Curriculum Review and Operational Lessons from India v ABBREVIATIONS AND ACRONYMS ATMA Agricultural Technology Management MANAGE National Institute of Agricultural Extension Agency Management EAS Extension and Advisory Services NFHS National Family Health Survey ICAR Indian Council of Agricultural Research PDS Public Distribution System ICDS Integrated Child Development Services SAFANSI South Asia Food and Nutrition Security IFPRI International Food Policy Research Institute Initiative KVK Farm Science Center (Krishi Vigyan Kendra) SAU State Agricultural University Case Studies of Curriculum Review and Operational Lessons from India vii EXECUTIVE SUMMARY Even after several decades of green revolution, malnutrition continues to be a major development challenge in much of South Asia, and India has a major share of the malnourished people in the region. The nutritional issues in India are complex and therefore require a multifaceted, multidisciplinary solution. One facet of the solution is increasing knowledge about the causes of and solutions to malnutrition at the farm household level through agricultural extension. Disseminating nutrition-sensitive agri- cultural knowledge is not currently an activity of agricultural extension in India, but there is great potential for integrating it through the well-established network of exten- sion officers. For nutrition goals to be integrated into extension, the curricula provided to current and future agricultural extension agents must be revisited. As part of the South Asia Food and Nutrition Security Initiative (SAFANSI), this paper focuses on approaches to incorporating such nutrition content into the agricultural extension cur- riculum. Three state agricultural universities in Tamil Nadu, united Andhra Pradesh, and Bihar were used as case studies for the curriculum review. Through these case studies, face-to-face consultations at the national level down to program implementa- tion at the village level have been developed. These include consultative workshops, and a conceptual framework and strategy for incorporating nutrition into extension curriculum development to improve nutrition outcomes. This strategy, detailed in this report, includes opportunities for collaboration from the national level to the com- munity level. Specific lessons and follow-up actions are outlined that may be useful for other South Asian countries. Case Studies of Curriculum Review and Operational Lessons from India ix CHAPTER ONE INTRODUCTION Achieving nutritional and health objectives through agricultural development has picked up momentum recently after the realization that food production and food and nutrition consumption must be effectively integrated (Ruel, Alderman, and the Maternal and Child Nutrition Study Group 2013). This is largely because agricultural production gains in the past did not result in the nutritional transformation needed for reducing high levels of malnutrition. The case of India is typical. This paper explores how increasing nutritional knowledge through agricultural interventions can help improve agriculture-nutrition outcomes. It focuses specifically on approaches to improving the content and delivery mechanism of extension and advisory services to more effectively integrate agriculture-nutrition information. In general, agricultural programming could be better integrated with nutrition goals and outcomes in two broad pathways. First, as part of the multisectoral approach to nutrition, the agriculture sector has a role to play at various levels—from the policy design stage to program implementation. Second, agricultural interventions could be made nutrition sensitive and nutrition smart more directly through better assessments of the nutritional situation in communities and improving the design of agricultural systems that meet nutritional goals. This paper focuses on the latter approach to integration of agriculture and nutrition through improving the curriculum of the extension and advisory services (EAS) and thus increasing the effective delivery of nutrition knowledge. Nutrition-sensitive agricultural interventions have been recommended for some time to address the shortcomings of agricultural transformations that did not fully address food insecurity and malnutrition in several developing countries (Kataki and Babu 2002). Yet serious attempts to understand how agricultural and food production improvements could be fully translated into increased food and nutri- tion security at the household level remain limited (Levinson and Herforth 2014). Making food and agricultural systems and program and policy interventions more nutrition sensitive requires identifying opportunities for improving the inten- sity of nutrition knowledge use at various stages of production, marketing, and Case Studies of Curriculum Review and Operational Lessons from India 1 consumption. Agricultural transformation that occurred countries (Babu, Gajanan, and Sanyal 2013; Feder, in several developing countries, particularly in South Willett, and Zijp 2001). For example, the traditional Asia, largely ignored nutritional transformation. Achiev- role of extension in transferring research and technol- ing nutritional transformation along with agricultural ogy to farmers through farmer training programs has transformation requires making agriculture and food evolved to include services such as organizing farmers systems nutrition sensitive in all subsectors of agriculture for collective action, joint processing and marketing, and (Herforth, Jones, and Pinstrup-Andersen 2012). public-private partnerships (Yuan and Babu 2015). The changing role of EAS from a technology transfer para- Several institutional innovations are needed to make the digm to a need-based, demand-driven model has also food and agricultural system nutrition sensitive. A stra- helped EAS address the vast information and knowledge tegic intervention for translating the foods produced at needs of the rural population, including natural resource the farm level into increased nutrition in rural households management, climate change, human immunodeficiency is through teaching how to effectively use the foods con- virus (HIV)/AIDs, and value chain development. Open- sumed to achieve better nutritional outcomes. Nutrition ing up EAS to other areas must be recognized as neces- knowledge needs to be effectively shared with the rural sary and must be effectively capitalized to achieve the households in the context of food and agricultural sys- Millennium Development Goals, including the needed tems and along commodity value chains. A major oppor- nutritional transformation. However, it is not clear how tunity for such knowledge transfer could be through the to reorganize and reeducate the actors and players of EAS that reach out to the rural population, albeit with EAS in developing countries to respond to the increas- varying degrees of efficiency and effectiveness. However, ing and new demands on their services (Sulaiman and there are several operational challenges, discussed below, Davis 2012) to enhancing the nutrition knowledge of the EAS and using them to effectively transfer the knowledge. Little is Agriculture-nutrition integration, in terms of increasing known about how EAS could be used as a delivery mech- content related to nutrition security and reducing over- anism for integrating agriculture and nutrition (Fanso nutrition, can be facilitated through EAS. However, EAS et al. 2015). participants need to acquire current knowledge concern- ing how to meet nutrition needs and learn new approaches The role of EAS in enabling agricultural transformation to delivering such knowledge. They must also learn inno- has been recognized, and efforts are under way to revive vative methods of designing and implementing agricul- their role in several developing countries (Sulaiman tural nutrition interventions that address local agricultural and Davis 2012). In essence, EAS encompass a set of challenges. In this paper, we develop an operational strat- organizations and their activities that deliver knowl- egy to incorporate such nutrition knowledge in EAS in edge, information, and services that are demanded by India. Based on case studies of three states with differing the rural population, including farmers and other actors nutritional challenges, we develop operational lessons for who use such services to enhance their productivity and developing countries for integrating nutrition transforma- livelihoods (GFRAS 2010). EAS in developing countries tion objectives into their EAS. continue to be provided by the public sector, although they are increasingly becoming pluralistic in nature, with In India as a whole, an estimated 300 million people do the private sector and nongovernmental organizations not have access to a food supply that sufficiently meets playing important roles (Yuan and Babu 2015). Depend- their basic energy needs, and over half of the population ing on the farming system and agricultural development is deficient in essential micronutrients such as iron, vita- goals, the roles of EAS are also changing (Anderson and min A, and iodine (World Bank 2012). Adequate nutrition Feder 2007). Even the public sector provision of EAS not only increases well-being but also aids mental devel- has gone through several changes to meet the needs of opment and growth, leading to increased learning poten- the agricultural development interventions designed tial. For this reason, increased nutrition has direct links to and implemented by the governments of developing increased productivity and economic growth. 2 Improved Nutrition through Agricultural Extension and Advisory Services The problem of malnutrition in India is complex and, revised curriculum in capacity development programs therefore, requires a multidimensional approach. The both in universities and midcareer training activities. combination of a high rate of poverty with recent eco- nomic growth in India has led to the coemergence of Undertaken as part of the World Bank–sponsored South malnutrition, undernutrition, and hidden hunger in terms Asia Food and Nutrition Security Initiative project on of micronutrient deficiencies and overnutrition, lead- introducing nutrition content into tertiary extension ing to rises in obesity and long-term health risks such as education, this study begins with the objective of incor- diabetes and other noncommunicable diseases. Another porating nutrition-related content in the curriculum of major cause of malnutrition in India is gender inequality. agricultural extension education at select state agricul- The low social status of women leads to a lack of qual- tural universities (SAUs) to address agricultural-nutrition ity and quantity in their diets. In addition, girls often lack integration in India. The specific objectives of the paper proper nutrition education; therefore, mothers do not have are to map the institutional architecture for agriculture- the proper knowledge of key nutritional and child feed- nutrition integration, select three SAUs, and review ing practices such as breastfeeding, leading to inadequate the curricula of both preservice and in-service training nutrition in children. to assess how much nutrition instruction is received by extension workers or those training to be extension work- Although integrated rural development programs, child ers. Finally, following this assessment, the study provides nutrition interventions, and primary health care programs recommendations and develops a strategy for incorporat- address nutrition education for pregnant and lactating ing nutrition-related content into the agricultural educa- mothers, a major opportunity in rural India, however, is to tion curricula. An action plan to develop nutrition content link nutritional goals and challenges to agricultural inter- for SAU curricula was developed and field-tested through ventions. EAS provide a major opportunity for improving stakeholder consultations at various levels. agricultural programming and knowledge sharing, which could be an effective pathway to address nutritional chal- The rest of the paper is organized as follows. The next lenges. However, it is not clear who the actors and players chapter reviews current literature on agriculture-nutrition are within the institutional architecture for agricultural linkages to develop a conceptual framework for integrating intervention and programming in EAS. Little is known nutrition into agricultural extension programs. Research about the extent to which such nutrition content is cov- methods and approaches are given in chapter 3. Results ered by the agricultural education curriculum. Further, and discussions are given in chapter 4. Lessons from the to guide policy makers in reforming current agricultural case studies are presented in chapter 5, and chapter 6 education, an operational strategy is needed for using the consists of concluding remarks. Case Studies of Curriculum Review and Operational Lessons from India 3 CHAPTER TWO A CONCEPTUAL MODEL FOR INTEGRATING NUTRITION INTO AGRICULTURE EXTENSION Although nutrition goals have been identified as part of agricultural research and development programs for the past 40 years (Pinstrup-Andersen, de Londoño, and Hoover 1976), explicitly integrating nutrition goals as part of interventions has not been given serious consideration until recently (Kataki and Babu 2002). Integration of nutrition objectives as part of EAS is much more recent (Sulaiman and Davis 2012). A major intervention approach to achieving nutrition goals through agriculture has been the home garden, which required nutritionists and horticulturists to collaborate to identify nutritional problems, develop plant-based interventions, and train rural households to grow nutrient-rich crops. Although successful pilots have been reported in the past three decades, it has been extremely difficult to scale up plant-based nutri- tion intervention, partly because of poor mainstreaming of nutrition-sensitive agricul- ture interventions in agricultural EAS (Babu 2002). Integrating nutrition into EAS has been attempted at various levels. At the national level, nutrition policies have recognized the need to teach farm and rural households the importance of nutrition- and plant-based interventions. However, much of this remains to be accomplished. Despite helping transfer technology relevant to specific crops already grown, extension services have not helped much to diversify crops so that growers can gain higher incomes and better nutrition (Yu and Mwangi 2015). Exten- sion departments and the sectors addressing nutritional challenges such as health and social welfare did not converge at different levels. Convergence is a major challenge for the sectors involved in nutrition, even leaving EAS out of efforts to coordinate action. There have been some efforts to integrate EAS in regions where malnutrition is high. For example, Integrated Child Development Services (ICDS) in some areas of Tamil Nadu State in India were able to interact with agricultural extension workers to identify foods that are available in abundance and at the lowest cost to use as part of a diet developed for nutrition interventions (Pandi 2014). However, the development of comprehensive programs at the national level that will integrate EAS at the policy, program, and project levels remains limited. Case Studies of Curriculum Review and Operational Lessons from India 5 There are several reasons for such poor integration of has been accumulating, particularly in Africa, and have nutrition into EAS. First, extension systems in developing not been systematically considered as part of the larger countries have focused on the production aspect of food nutrition agenda. security, yet achieving food security at the individual level also depends on access to food; the proper use of food; Fifth, earlier attempts toward income diversification and clean water, sanitation, and hygiene (Babu, Gajanan, though moving from subsistence farming to commercial and Sanyal 2014; FAO 1996). The challenges of food agriculture has shown the negative effects of commer- access and other elements of food security are considered cialization (Kataki and Babu 2002). Although this gave beyond the scope of EAS, as there may be overlap at the the EAS system an opportunity to correct this imbalance village level because of the presence of primary health by emphasizing nutrition in its work, the opportunity and social welfare departments. was missed because of a lack of capacity in the system to address nutrition. This continues to be a challenge even Second, failures of home gardens in some areas and the now, but awareness has recently increased among devel- limited success of attempts to scale up such efforts indicate opment partners of the desirability of using EAS as a that EAS may also fail if additional nutrition goals are vehicle for nutrition education (GFRAS 2010). introduced. This fear, combined with existing inefficien- cies, made policy makers reluctant to discuss additional Finally, recent advances in the breeding of food crops responsibilities for the extension system. to enhance their nutritive value through biofortication has brought to the forefront the need for new extension Third, the emphasis of EAS on activities that helped in approaches for such crops (Low et al. 2007). In addition, technology transfer—following the Green Revolution agricultural programming could help increase the accessi- model of extension—kept food consumption and nutri- bility of safe foods (for example, foods free of mycotoxins), tion goals out of EAS as production and availability goals increase water use efficiency and make clean water avail- continued to dominate EAS. The recent concept of nutri- able for households, and encourage better land manage- tion value chains shows some promise of enhancing the ment to incorporate complementary outputs such as fuel nutritional content of food by addressing the processing for improved food preparation. In summary, although the methods to preserve the nutritive value of crops produced agriculture sector has long been recognized for its contri- and consumed by rural poor and malnourished people. bution to food security, because of the multidisciplinary However, this effort in the context of EAS is entirely new. nature of nutritional challenges, its role in achieving As part of their nutrition education programs, several nutritional goals has not been adequately emphasized in countries have deployed home economists who spend agricultural programming in general, and EAS in particu- most of their time developing recipes that do not reach lar, in developing countries. the farming communities. For example, the CGIAR centers have been investing in food processing scientists The conceptual framework shown in table 2.1 illustrates over the years with limited transfer of their knowledge to the process of using a multidisciplinary and nutrition- local institutions. Agricultural universities have food and smart extension curriculum to strengthen the links nutrition faculties that routinely develop new recipes and between agriculture and nutrition in the context of India. approaches to preserve nutrition in key crops consumed Agricultural production strategies in India have resulted in by poor households. However, as a result of poor integra- food self-sufficiency over the past 30 years, and yet nutri- tion of research and home economics extension, the reach tional challenges remain, with more than one-quarter of of these nutrition-sensitive approaches has been limited. malnourished children in the world calling India their home (Gillespie, Harris, and Kadiyala 2012). Fourth, new efforts to introduce nutrition-rich foods have had some success in selected developing countries (Babu The development outcomes of strengthened agricul- 2000, 2002). However, such approaches seem to have ture-nutrition linkages include increased production and made progress on a few selected crops for which evidence household income as well as better-balanced diets and 6 Improved Nutrition through Agricultural Extension and Advisory Services TABLE 2.1. CONCEPTUAL FRAMEWORK FOR DEVELOPING A CURRICULUM TO ACHIEVE AGRICULTURE-NUTRITION LINKAGES Nature of Nutritional Agricultural Nutrition- Challenges of Agriculture- Locality-Specific Extension Systems Informed Agricultural Nutrition Design of the and Nutrition Agricultural Communities Curriculum Curriculum Programming Communities Contextual Factors for Problem Identification Content/Curriculum Needs Conditioning Factors Inclusive Extension Developmental Outcomes Obesity: men, women, Nutritive value of food Subsistence/ Agricultural extension Increasing children commercialization of department (state Production and agriculture government) Income Consumption Monitoring nutritional Systems of organization Farm science centers pattern changes: status/indicators of of production activities (KVKs; Krishi Vigyan high-value agriculture, nutrition (for example, contract Kendra) at central, state, fat, sugar farming, public and district government procurement) levels Children under 5 Study of consumption Agroecology/natural Integrated child Agriculture and years of age: stunting, patterns/nutritional resource constraints (for development services Nutrition Outcomes wasting, underweight intake through dietary example, endowment, (social welfare at the surveys water, soil, rainfall) village level) Balanced diet: food Biofortification Market linkages to Nongovernmental and nutrition security principles and solutions nutritive foods and their organization/private supply sector actors Specific vitamin Contextualization and Locality-specific University extension/ Balanced Diet and deficiencies: iron, decentralization of (decentralized) outreach programs Nutrition vitamin A, iodine nutrition problems and nutritional issues and (research stations, nutrition solutions their potential solutions district level) General Market-based solutions Currently existing Agricultural Technology micronutrient to address nutrition nutrition intervention Management Agency malnutrition: challenges (for example, programs (for example, (ATMA)—state district/ “hidden hunger” value chain approach) for children, pregnant/ block levels lactating mothers, elderly population) Agriculture Systems thinking to link Local institutions Other sectors and nutrition agriculture system to (nature of, functions) interacting with interaction: creating a nutrition challenges and agriculture nutritional imbalance in outcome communities Case Studies of Curriculum Review and Operational Lessons from India 7 increased nutrition. To address the nutritional challenges consumption. The curriculum developed should consider of agricultural communities, extension curricula must be agroecological and natural resources constraints in the tailored to the local context. To design a relevant and effec- area that may affect the availability of nutritious foods. tive curriculum, we must first apply it to a specific problem Nutritional programming that could benefit from a mul- at the lowest administrative level (block or village level). For tidisciplinary curriculum in India could include ICDS, each development problem, we can identify information which provide social welfare to households at the village gaps that need to be filled to design context- and locality- level through identifying the malnourished children and specific curricula to meet development outcomes. providing nutritious snack supplements. The conceptual framework begins with the nutritional Most agricultural development efforts have focused pri- challenges in the first column of table 2.1. For example, in marily on increased production to increase caloric intake, recent years, obesity in India has been increasing, causing neglecting underlying hidden nutrition challenges. Micro- serious health risks. To address this problem, an effective nutrient malnutrition and vitamin deficiencies such as curriculum should inform beneficiaries about the nutri- those in iron, vitamin A, and iodine are prevalent among tive value of food. The curriculum needs to consider the rural poor in India. The contextualization and decen- conditioning factors specific to the village’s or block’s agri- tralization of nutrition challenges and their potential solu- cultural system—for example, subsistence agriculture or tions are important for creating an effective curriculum. commercialized market-oriented production. In addition, The design of the curriculum needs to consider existing the curriculum should consider the nature of the local agriculture and nutrition intervention programs at the agricultural ecological and production systems and the local level (for example, value chain, child nutrition inter- opportunities they provide for improving the nutritional ventions, lactating mother programs) to make it locality content of local diets. Institutional interventions through specific and to identify opportunities for areas in which the agricultural extension departments at the state or district curriculum could be used. This might occur through state level need to be studied for their intervention approaches university outreach and extension programs or through to and methods of nutritional problem solving. Agricultural Technology Management Agency programs at the state, district, and block levels. To change food consumption patterns, particularly away from processed foods high in fat and sugar, the curriculum We use the above conceptual framework to understand the should include content covering the important indicators challenges, constraints, and opportunities for effectively of nutrition consumption and other methods of monitor- integrating nutrition goals, challenges, and agricultural ing nutritional challenges that could be addressed through approaches into EAS for enabling a nutrition transforma- agricultural interventions. The curriculum should pay tion in rural India. We accomplish this through three sets attention to what agricultural extension system operates of analysis. First, we systematically map the actors and in the area, such as farm science centers, for the train- players in the institutional architecture that links agricul- ing of the trainers and the development of course content tural and nutrition challenges to EAS in India. Second, relevant to the locality, particularly for the in-service train- we undertake a systematic and an analytical review of ing programs and the training offered to the extension the current agricultural and nutrition curriculum in three staff on a regular basis as part of the research-extension states that have attained varying degrees of progress in continuum. their nutritional outcomes—Tamil Nadu, with the high- est level of progress; united Andhra Pradesh, with moder- Many early childhood nutritional indicators—such as the ate progress; and Bihar, which is one of the states most prevalence of stunting, wasting, and underweight—have affected by malnutrition. Third, using personal interven- been explicitly included in development goals. To address tions and consultative group discussions at various levels, these issues, village-level dietary surveys need to be con- we develop an operational strategy for a nutrition smart ducted to determine nutritional patterns and levels of EAS in India. 8 Improved Nutrition through Agricultural Extension and Advisory Services CHAPTER THREE RESEARCH METHODS AND APPROACHES To identify opportunities to effectively integrate nutrition goals into EAS, several sets of discussions and interviews were conducted in various parts of India. The first con- sisted of community-level consultations through focused group discussions. Several rounds of focused group discussion were held between 2010 and 2014 in more than 30 villages in Tamil Nadu. The discussions revolved around information needs of the farming community and how extension services could be better organized to provide the knowledge and information needed to improve the income and welfare of rural households. Consultations were then conducted with the various levels of EAS in the southern states of united Andhra Pradesh, Karnataka, and Tamil Nadu to understand the information sources, capacity levels of EAS functionaries, and the ability of the system to meet the nutrition education needs of rural communities. Further, interviews were conducted with scientists who are involved in adoptive research in the KVKs to understand their perspectives on the nutritional challenges, how they addressed these challenges in their research, and how their research results are translated into exten- sion messages in rural communities. This was followed by the mapping of the various approaches and pathways to nutri- tion education in the current system of pluralistic extension services operating in India. This process used the Net-Map method though consultations with various extension functionaries and policy makers through both individual interviews and joint discussions. The net-mapping process helps reveal the institutional architecture of EAS in the context of policy making, program design, and implementation and also helps show who is involved in decision making at various levels, their power rela- tions, and how they are linked to various elements of EAS at the state and at central government levels. To revise agricultural extension and nutrition curricula effectively to increase nutri- tional impact, it is important to understand the key actors and players involved in translating nutrition goals into nutrition and agricultural programs that have greater impact in the field. Agricultural universities are the primary medium for training future extension agents, researchers, and trainers in the field (Glendenning, Babu, Case Studies of Curriculum Review and Operational Lessons from India 9 and Asenso-Okyere 2010). Case studies were conducted State-level curricula in nutrition at the university level and in three states of India—Tamil Nadu, united Andhra for preservice training were also evaluated, based on spe- Pradesh, and Bihar—and three local collaborators from cific criteria, including the following: the corresponding SAUs were selected to methodically » Opportunities for integrating nutrition curricu- conduct the studies. lum and the good practices followed by the faculty members and the extension systems into the agri- The next part of the project involved face-to-face con- cultural education system sultations with relevant ministry officials, faculty mem- » Pathways for effectively transferring nutrition bers, and program managers of nutrition interventions knowledge into EAS based on agriculture. These consultations were critical » Specific programs for enhancing the capacity for in obtaining these actors’ respective nutrition objectives, nutrition extension approaches, and experiences. In Hyderabad, a training » Current capacities of faculty of SAUs and staff of relevant program man- » Future needs agers was conducted to obtain feedback on the strategy » Existing gaps in universities and state agricultural for revising the curriculum. A workshop was organized on departments for nutrition integration in training November 10, 2014, in New Delhi to bring together agri- programs culture and nutrition experts, program implementers, and » Opportunities for integrating cross-disciplinary policy makers to reflect on the findings of these studies levels at the district and state levels through col- and recommend ways to enhance the quality of nutrition- laboration among the ministries smart curricula in the university and extension systems. » The role of EAS in reaching out to rural women 10 Improved Nutrition through Agricultural Extension and Advisory Services CHAPTER FOUR RESULTS AND DISCUSSION MAPPING INSTITUTIONS FOR INTEGRATING AGRICULTURE AND NUTRITION Although agriculture (that is, food production) is very closely linked to nutrition (that is, food consumption) in theory, in most program implementations of education and extension, the two concepts are presented and pursued separately. The agriculture- nutrition-health continuum is increasingly recognized as the paradigm for nutrition interventions in rural areas of developing countries. However, until recently, agricul- ture has rarely been explicitly leveraged as a tool for improving health and nutrition. The first 40 years of development efforts and interventions focused primarily on the Green Revolution and the increased production of staple foods. Although these efforts did lead to major improvements in food security in terms of caloric availability at the national level, this has not been sufficient to improve nutrition security. Nutrition is a multidisciplinary issue with dimensions of health, social welfare, and agriculture and should therefore be addressed in some capacity by all key actors and stakeholders in these areas. However, although the need to address nutrition chal- lenges has been recognized, a paradigm shift is still needed so that increased nutrition security is seen as a goal of all agricultural programs. Many nutrition intervention programs already exist in India; however, these are sectoral in nature and typically work with limited coordination. To create a multidisciplinary nutrition curriculum for agricultural extension, it is important first to understand how communities and indi- viduals receive their nutrition information. Figure 4.1 maps the common channels of agricultural-nutrition linkages from the national level to the village level. At the national level in India, nutrition challenges are addressed through four main government entities: the Ministry of Agriculture; the Ministry of Consumer Affairs, Food, and Public Distribution; the Ministry of Social Justice and Empowerment; and the Ministry of Health and Family Welfare. The Ministry of Agriculture oversees the national and state departments of agricultural extension. The National Institute of Agricultural Extension Management (MANAGE) is run by the central Ministry of Agriculture and is primarily responsible for the training and education of future and Case Studies of Curriculum Review and Operational Lessons from India 11 FIGURE 4.1. MAPPING OF CHANNELS OF FOOD, AGRICULTURE, NUTRITION LINKAGES FROM NATIONAL TO VILLAGE LEVELS National Level State Level District Block Village ICAR* SAUs* KVKs* Farmers* Department of State District Ministry of Block Farmers agriculture department of agriculture agriculture* extension* friend extension* extension* officer* ATMA* ATMA* ATMA* ATMA* Ministry of consumer Block-level PDS/food PDS based on District PDS Household nutrition security affairs, food, district plot PDS outlets* and public stocks and poverty levels office* centers* distribution Ministry of Nation social District-level Block-level Primary, social justice Noon meal welfare monitoring extension middle, and and scheme program system* officers* high schools* empowerment Child nutrition programs* Primary health care State-level material* Ministry of National health District health Primary health and health/disease programs centers health care family prevention maternal/ facility welfare program children ICDS centers* Notes: ICAR = Indian Council of Agricultural Research *Face-to-face consultations with relevant officials for the study. current extension officers. In addition, the ATMA pro- The Ministry of Social Justice and Welfare is responsi- grams form a key potential outlet to disseminate locality- ble for the organization of the National Social Welfare specific nutrition messages at all levels. At the block and Program as well as state-level health programs for chil- village levels, block-level extension officers and Farmers’ dren and mothers. In terms of health intervention, the Friends are the primary sources of agricultural advisory ICDS program is a social welfare initiative that focuses services in the field. The Ministry of Consumer Affairs, on improving the health of preschool children aged Food, and Public Distribution, through its Public Distri- 6 years and under and their mothers. Similarly, the bution System (PDS), provides food at subsidized prices to Mid-Day Meals program also focuses on improv- households below the poverty line, yet it does not empha- ing the nutrition status of school-age children through size the nutritional content of food packages. Determina- better school lunches. However, this program is pri- tion of the recipients of this program is based on poverty marily concerned with increasing caloric intake and is rates at the village or block level. less concerned with the nutritional quality of the food 12 Improved Nutrition through Agricultural Extension and Advisory Services provided. The Ministry of Health and Family Welfare food science courses. However, most future extension offi- runs district health centers as well as primary health care cers pursue bachelor’s degrees in agriculture, a depart- facilities at the block and village levels. These facilities ment that does not offer any nutrition classes. This lack of are the primary way in which rural communities receive coordination creates gaps in knowledge within the exten- health information. This is an opportunity to disseminate sion system of nutrition and health outcomes. nutrition messages through actors not primarily involved in extension and advisory services. The agricultural extension system in Tamil Nadu and the existing network of extension officers present an oppor- CASE STUDIES OF STATE tunity to address nutrition challenges through incorpo- rating the nutrition curriculum into the state extension AGRICULTURAL UNIVERSITY training programs. Increasing the nutrition content of CURRICULUM REVIEWS extension education helps ensure that more children The following three subsections cover the state-specific grow to have healthy adulthoods, which leads to higher challenges of nutrition and motivations for revising cur- levels of productivity. ricula at the respective SAUs. Also contained are the key elements needed for the revised curriculum to make the The curricula at Tamil Nadu Agricultural University greatest nutritional impact in that state through the agri- should be revised as follows. The courses on common cultural extension system. nutrition problems, nutrient content of foods, and nutri- tion planning and programming need to be taught at the diploma and BSc levels. Courses on nutrition extension, HIGHLIGHTS OF THE TAMIL NADU nutrition for vulnerable groups and nutrition monitor- CASE STUDY ing and evaluation, nutrition program impact assess- Major nutritional challenges in Tamil Nadu include high ment, and analysis of socioeconomic and nutrition data levels of child malnutrition among the poor and tribal should be taught at the MSc level. Some of these courses populations, and anemia levels are high, especially among should be made mandatory for the agricultural econom- pregnant and lactating mothers. The extension system ics and agricultural extension curricula at the BSc and does not disseminate any messages related to nutrition MSc levels. goals, challenges, and solutions that could be addressed through agricultural interventions. Extension services The SAUs are not the only opportunity for strengthening continue to focus on production-oriented messages and nutrition and agriculture linkages in extension curricula. recently have moved slowly toward water conservation District KVKs can also provide more multidisciplinary and marketing messages. Even if the policies are changed training to midcareer extension officers as well as those to incorporate the nutrition messages, the capacity for involved in agriculture interventions in the field. disseminating nutrition messages does not exist in the extension system. However, this is slowly changing, with some district-level extension officers undergoing food HIGHLIGHTS OF THE UNITED ANDHRA security and nutrition training through midcareer train- PRADESH CASE STUDY ing programs. In united Andhra Pradesh, although the nutritional status of children has improved slightly since the last National At Tamil Nadu Agricultural University, there are weak Family Health Survey (NFHS) by some measures, chronic linkages between nutritional and agricultural learning. malnutrition and acute undernutrition in children are For example, the Horticulture and Home Science depart- still widespread. In addition, micronutrient deficiency ments offer courses on nutrition topics such as nutrition in the state is estimated to have risen between NFHS-2 classification and the nutritive value of horticultural crops and NFHS-3.1 Major nutrition-related challenges in the as well as laboratory classes on nutrition and kitchen gar- dens. The Home Science department offers courses in fundamental and therapeutic nutrition, along with six 1 http://hetv.org/india/nfhs/india1.html Case Studies of Curriculum Review and Operational Lessons from India 13 agricultural communities of Telangana and Andhra In SAUs in Andhra Pradesh and Telangana, recommenda- Pradesh include malnutrition in children under 5 years tions for curriculum and course content changes to reach of age, infant mortality, maternal and child anemia, acute rural and farming communities include the following: undernutrition, diabetes, and obesity. » A broad course on human nutrition must be man- datory for all agriculture undergraduate students. Promoting nutritional goals knowledge in farming com- Such a course was offered in the 1980s and 1990s munities that could be attained through existing extension when most of the home science faculty members activities could be a sustainable approach to improving were still with the College of Agriculture. nutritional content of food access in the state. Extension » In addition, courses related to nutrition problems, agents could help disseminate educational messages on nutrition planning and programming, monitor- adequate nutritional requirements, crop diversification ing and evaluation of nutrition programs, impact for health, and causes and symptoms of nutritional dis- assessment of nutrition programs, and crop plan- orders and deficiencies. It is important that nutritional ning for nutritional outcomes are some of the education messages be tailored at the village or block level courses that could be designed and offered at the to promote the consumption of locally available, nutri- undergraduate level. ent-dense foods. In Andhra Pradesh, although the ATMA » Courses related to designing agricultural systems approach to extension is slowly being adopted, monthly that help in achieving better access to diversi- research extension meetings continue to be held, which fied diets need to be taught as part of extension provide the opportunity for extension agents to incorpo- curriculum. rate nutrition content in the messages of the traditional » Courses related to nutrition planning and pro- extension system. gramming and nutrition economics should be made mandatory for postgraduates in agricultural Although the extension curriculum at SAUs is com- extension and agricultural economics. prehensive in terms of agricultural aspects, little to no » Courses in the diploma training should involve nutrition-related content is included. Recommenda- nutrition problem identification, nutrition solution tions for curriculum revision include an undergraduate through agriculture and crop planning, and moni- course in the fundamentals of human nutrition. Also, toring and evaluation of nutrition interventions. existing undergraduate courses in agricultural econom- These could be taught as special courses or as part ics should include content on the per capita availability of the curriculum. of food and food consumption trends as well as content » Because ATMA officials are trained through on household food security, including the health impacts the state extension training centers, the trainers of food and their subsequent impact on nutrition. Post- in these centers have to be trained in nutrition graduate courses on extension education should high- courses as well. To begin with, the curriculum light the health benefits of crop diversification. SAUs taught at the diploma level could be introduced in also offer a Rural Work Experience program. This state-level training programs of extension officials program should include nutrition-oriented activities to in ATMA. give future extension agents more practical experience » At the district level, there is a close collaboration on nutrition issues. It is highly recommended that the and coordination of the food and nutrition train- curriculum of non–formal education activities, such as ing activities of the KVKs and the ATMA training in-service training courses for extension agents, include programs through farmers’ field schools. The food content such as household food security, national policies and nutrition program officers of KVKs should affecting food and nutrition security, nutrition policies, offer specialized nutrition courses to the block and methods of preventing and combating micronutri- technology officers and the farmers’ friends in the ent malnutrition. ATMA system. 14 Improved Nutrition through Agricultural Extension and Advisory Services HIGHLIGHTS OF THE BIHAR on the nutrition of children and mothers. For example, CASE STUDY nutrition education messages could be shared through Bihar, with a population of approximately 83 million, is the Rajiv Gandhi Scheme for Empowerment of Ado- the third most populous state in India. The most recent lescent Girls, which focuses on improving the nutritional National Family Health Survey revealed that 58 per- and health status of girls aged 11 to 18 through educa- cent of children there are malnourished. The number tion in life skills, health, and nutrition. When revising of children showing signs of wasting has also increased. the curriculum to focus on mothers and young children, In addition, the prevalence of anemia among children coordination is needed with the Indira Gandhi Matritva is as high as 88 percent and is approximately 60 per- Sahyog Yojana, which aims to promote better health care cent among pregnant women. Micronutrient deficiency, practices for young women during pregnancy, delivery, or “hidden hunger,” is often overlooked by nutrition and lactation. In addition, the Mid-Day Meal program in interventions as well as agriculture interventions. Major Bihar aims to improve school enrollment and attendance micronutrients deficiencies in Bihar include chronic defi- rates and lower dropout rates in rural areas by provid- ciency of vitamins and minerals such as iron, vitamin A, ing more nutritious lunches. The school teachers who are iodine, and zinc. responsible for providing the nutritious meals could use lunch time to inculcate nutrition messages to the adoles- In Bihar, the major areas of nutrition education for exten- cent girls once a week or five minutes a day during the sion programs include breastfeeding practices; kitchen weekdays when school lunch is provided. gardening; community farming of horticultural products; and water, sanitation, and hygiene. Opportunities exist for In addition, Bihar is one of the focus states in the National the current extension system to address the state-specific Rural Health Mission. Key components of this program nutritional challenges identified above. The current agri- include village-led health plans and the integration of culture education curriculum at the SAU includes little vertical health and family welfare programs to strengthen nutrition content. However, opportunities exist to reintro- health care delivery systems. More specific programs, duce nutrition courses in the university, diploma, and post- such as the National Iodine Deficiency Disorder Con- graduate curricula. To increase the impact of the extension trol Programme, provide an opportunity for coordinated system’s nutrition education efforts, the curricula should nutrition interventions through extension. include content relevant to nutrition problem identifica- tion, provision of nutrition solutions, nutrition planning NATIONAL PERSPECTIVE ON LINKING and coordination, program implementation and delivery, AGRICULTURE AND NUTRITION monitoring and evaluation, and impact assessment. THROUGH EXTENSION Existing nutrition extension in India is conducted mostly Options for operationalizing the revised curriculum and by the Ministry of Women and Development; however, putting it to practical use in the field include the forma- the content of these interventions is specifically health tion of a state-level committee on nutrition education that related. They do not address the potential linkage of comprises the agricultural faculty, home science faculty, agricultural interventions to nutrition improvements. In department of agricultural extension, and state-level addition, there is very little emphasis from the agricultural ATMA officials. This committee will undertake a rapid ministry on nutrition, as the major focus of this ministry assessment of the entry points for nutrition education in continues to be agricultural production. all aspects of agricultural extension and identify the cur- riculum appropriate for university and midcareer courses Despite the fact that the extension system is increasingly in nutrition taught to agricultural professionals. addressing issues related to natural resource management and sustainability, nutrition as a final goal of food pro- These curriculum development activities could be under- duction is yet to be taken up seriously by extension func- taken in close coordination with existing nutrition inter- tionaries. However, there is now a recognition that at the vention programs in Bihar, including ICDS, which focuses national, state, and district levels agricultural extension Case Studies of Curriculum Review and Operational Lessons from India 15 has the potential for integrating nutrition extension the programs, and refining the nutrition programs and through its network of established outreach channels that policies at the central and state levels. connect with farmers. State agricultural universities, state departments of agri- Finally, it is important that these extension efforts address culture, and KVKs will need guidance on where to invest women specifically, particularly female farmers, for two and how much resources to invest to achieve the goals of reasons. First, women in households produce, prepare, and curriculum change and integrating nutrition into exten- provide the food for the entire family and therefore have sion programming. This guidance and support needs to the most control over nutrition. Second, female-headed come from a state-level committee that will be established households in India typically have a higher incidence of and will function for the next five years. There is also a nutrition and food insecurity. Thus, gender mainstream- need for setting up a monitoring and evaluation system to ing of the nutrition curriculum in agricultural extension is track curriculum and capacity development in the univer- a key strategy for addressing rural malnutrition. sity and extension systems. Curriculum revision at the national level is organized OPERATIONAL STRATEGY through a national dean’s committee responsible for FOR THE DEVELOPMENT reporting to the Deputy Director General (Education) of OF NUTRITION-SMART ICAR. Under this committee, several subcommittees and task forces deal with specific thematic areas. A nutrition EXTENSION AND ADVISORY task force has been formed to undertake a needs assess- SERVICES ment at the national level and to assess specific contextual A strategy for capacity strengthening through revising the needs and opportunities at the state level. Integration of curriculum of extension education programs to increase nutrition into the extension system will require further nutrition-related content was presented during the New identification of short-, medium-, and long-term strategic Delhi workshop on November 10, 2014, in collaboration training activities that could be incorporated into the state with Digital Green. extension systems. To develop a strategy for capacity development for inte- Figure 4.2 illustrates the curriculum development strat- grating nutrition in the extension system, the first step is egy based on the case studies, consultations, and feedback to map the current set of capacity development activities from local stakeholders. This figure maps how the pro- offered to extension professionals through SAUs, KVKs, posed curriculum design opportunities are linked to the and other Indian Council of Agricultural Research insti- appropriate extension and training institutions at different tutions. The next step is to identify what capacities are levels. At the national level, ICAR, the National Acad- needed for the successful integration of nutrition in agri- emy of Agricultural Research Management, and MAN- culture education programs in these institutions. Specific AGE should be involved in the curriculum development training and learning activities could then be recom- to identify national nutrition challenges and curriculum mended to develop and strengthen the required capacities. needs. The course content and instructional methods will be developed by the faculties of agriculture and home Because nutrition challenges require multiple sectors to sciences at SAUs and state ATMA offices. Comprehen- work together, the development of the curriculum to meet sive course content will be developed by universities for the knowledge needs of the extension professionals will courses at the bachelor’s, master’s, and doctorate levels, have to take a long-term perspective, looking ahead 5 to and as continuing learning courses by state extension 10 years in terms of problems and potential solutions. training centers. Next, the curriculum will be contextual- The curriculum must take into account issues related to ized at the district level by the SAUs and KVKs to reflect identifying problems, developing contextual solutions, local challenges. These institutions can connect the avail- implementing interventions, monitoring and evaluating able courses and educational materials to problem solving 16 Improved Nutrition through Agricultural Extension and Advisory Services FIGURE 4.2. STRATEGY FOR THE DEVELOPMENT OF A NUTRITION-SMART AGRICULTURAL EXTENSION CURRICULUM Curriculum design opportunities Extension functionaries Training institutions/functions and options Curriculum development/ National level/ministry of ICAR institution/ dean’s committee agriculture NAARM/MANAGE Nutrition/Agriculture extension/State State ATMA/extension SAUs/State training universities/Faculties of agriculture/ system/training scheme centers Home science colleges Curriculum designed for District-level agriculture KVKs district farms training the district by SAUs and extension/ATMA centers/training/programs for KVKs committee block-level extension workers Curriculum contextualized Block-level agriculture Training of trainers/ for the block and village extension/technology farmers friends levels officer Farmers friends/ village extension workers Village level Farmer field schools Training programs Household nutrition status Source: Authors. Note: NAARM = National Academy for Agricultural Research Management at the district level. Block-level extension officers and those challenges, and solutions that prevail at the district level. in the Farmer Friends program will then further contex- Thus, two broad streams of curriculum are needed: the first tualize the universal curriculum content with examples of covering broad nutrition issues and solutions and the sec- block-level challenges and solutions. ond containing context-specific issues and solutions. Both should be taught at the state and district levels and in regu- Figure 4.3 uses the conceptual framework outlined in lar university courses and midcareer training programs. chapter 2 to illustrate how the curriculum strategy should be developed. This conceptual framework was originally A module development plan for a 2-hour session is given developed by UNICEF in the early 1990s to examine child at the bottom of figure 4.3. This plan is based on the malnutrition and was further improved upon by several length a typical farmers’ training program or farmers’ researchers based on the need to analyze specific nutri- field school meeting, which lasts 2 hours and 30 minutes, tional issues (Babu, Gajanan, and Sanyal 2014; Smith including a 30-minute snack break. and Haddad 2000, 2015). We further use this framework to identify context-specific nutritional issues and develop Discussion among state-, district-, and block-level exten- solutions at the local levels. The strategy suggested here sion officials, KVK scientists, and SAU faculty members calls for developing a curriculum in line with the issues, points toward the need for specific sets of modules to be Case Studies of Curriculum Review and Operational Lessons from India 17 FIGURE 4.3. CURRICULUM STRATEGY AT THE DISTRICT LEVEL USING NUTRITION SECURITY CONCEPTUAL FRAMEWORK Nutrition security Food security Dietary intake Health status macronutrients Immediate micronutrients causes Access to food Maternal Health environment and child care and services Household income/expenditures Quality and quantity Access and quantity in food of care of quality of health, sanitation, and water Intermediate causes Policies that encourage Policies and programs that Policies that improve increase – Food production – Caregiver access – Adequate sanitation – Income generation – Caregivers’ resource control – Safe water supply – Transfer food in-kind – Caregivers’ knowledge, – Health care availability – Adoption, and practice – Environment – Safety/shelter Basic causes Basic Intermediate Immediate (20 minutes) (20 minutes) (20 minutes) Module 1 on basic Module 2 on Module 1 on Module 2 on Module 1 on Module 2 on Causes causes basic causes intermediate causes intermediate causes immediate causes immediate causes modules Module 1 on basic Module 2 on Module 1 on Module 2 on Module 1 on Module 2 on Solutions solutions basic solutions intermediate intermediate immediate solutions immediate solutions modules solutions causes solutions causes Source: Adapted from Babu, Gajanan, and Sanyal 2014. developed for addressing nutrition as a development chal- of malnutrition and the associated causal factors. lenge. These sets will include the following: (Four 10-minute modules.) 1. Identification of nutrition issues and 3. Develop interventions and actions. This set challenges. This set of modules will focus on the of modules will focus on how to develop interven- assessment of undernutrition and overnutrition, tions based on the identification of causal factors including micronutrient malnutrition. Assessment and the analysis of the nutrition situation. Inter- methods will be taught, including the identifica- ventions will be developed based on the informa- tion of nutrition problems in communities through tion analyzed in the above two sets of modules. rapid assessments and interpretation of anthropom- etry data for designing agricultural interventions. In Although the above sets of modules are indicative of and addition, assessment will include the causal factors have emerged from the reviews and the discussion with specifically contributing to the challenges in the spe- the state universities and ICAR officials, further consulta- cific states and districts. (Four 10-minute modules.) tion and participatory discussion are needed to refine the 2. Analysis of the causal factors. This set of contents of the modules and make them meet the stan- modules will introduce basic methods that will help dards required at various levels. This must be pursued as the field extension officials analyze the indicators the next step in the process. 18 Improved Nutrition through Agricultural Extension and Advisory Services CHAPTER FIVE SPECIFIC LESSONS AND THE WAY FORWARD Several specific lessons emerge from the curriculum review exercise and the consulta- tions undertaken for this project: » Nutrition as a subject is largely missing in the curriculum of the agricultural universities that train agricultural extension professionals who could integrate nutrition as a final outcome of the agricultural production process. » The current extension reforms undertaken under the rubric of ATMA should be used as an opportunity to integrate nutrition into the extension process. This will create the needed demand for the curriculum development. Without such demand from the extension system, there is little incentive for the curriculum of the universities to change. » Midcareer training of the agricultural extension workers does not include nutri- tion courses, and this has created a vacuum in the extension system in terms of nutrition content. » Training of the farmers in KVKs at the district level recognizes the nutrition challenges, but this program does not have a systematic way of training at the block, community, and farmer level or at the extension worker level. » At the university level, nutrition is taught in home science colleges, but the graduates of this program do not directly enter the extension services. Conversely, future agricultural extension professionals are not trained in the contents of nutrition-related courses. » Nutrition as a development challenge also needs to be taught to agricultural and social sciences students, given the slow progress made in reducing mal- nutrition levels. This challenge is often highlighted in national discussions on agriculture links to nutrition security, but the next step toward confronting this challenge through the development of capacity for addressing nutritional chal- lenges has yet to gain momentum. » Discussions with the Ministry of Agriculture and ICAR indicate that this is also the appropriate time to initiate and guide the curriculum review process as part of the proposed World Bank–funded National Agricultural Education Project. Case Studies of Curriculum Review and Operational Lessons from India 19 » Curriculum development in nutrition-related education and nutrition task force of the dean’s extension should consider context-specific prob- committee is essential for this process to start. lems and potential solutions at the district and 2. Several nutrition courses that are offered through block levels. Close collaboration between the agri- home science colleges could be further revised cultural departments and the KVKs is crucial for and offered through the agricultural colleges of the development and implementation of nutrition the SAUs. Specific curriculum development work- training programs in the extension systems. shops need to be organized under the auspices of » In developing the university-level curriculum, the Decentralized Distributed Generation education recognition of the central and state government of and MANAGE for this process to get started. Funds the courses proposed and curriculum developed is could be allocated from the National Agricultural crucial, as this endorsement will serve as the incen- Innovation Project, and continued funding from tive for universities to develop the courses and for SAFANSI could be identified for this purpose. the students who will opt for nutrition courses as 3. In all the pilot states, the ATMA implementation part of their course work. needs to start as a pilot program to integrate spe- cific nutrition courses for extension professionals as The next step in taking the process forward is to support a midcareer training program at their state exten- the following activities: sion training institute, which should be given the 1. The three states that are already involved in the responsibility of developing the course content for process to develop the curriculum and course the extension functionaries in line with the broad content for the specified courses that could be courses agreed upon for the university levels. offered through their agricultural colleges and to 4. The trainers and course content developers should the students of agriculture should be given assis- be trained at the national level through MANAGE tance with this process. This will help standardize through regular two-week training programs. MAN- the course content throughout the country. This AGE already conducts similar programs in food and could be undertaken as part of the dean’s commit- nutrition security. With some additional financial tee review that has begun for the overall review of support and technical guidance, this could be made the courses in the SAUs. Close working relations a mission-oriented effort under SAFANSI or as part with the Decentralized Distributed Generation of the National Agricultural Innovation Project. 20 Improved Nutrition through Agricultural Extension and Advisory Services CHAPTER SIX CONCLUDING REMARKS To address the large disconnect between agricultural growth and nutrition outcomes that currently exists in several developing countries, the paper focused on approaches to incorporating nutrition content into agricultural extension curriculum. To achieve better agriculture-nutrition integration, there is a clear need for making agricultural extension and other intervention programs more nutrition sensitive. This requires understanding of the channels of knowledge flow from the national to the community and household levels and the demand and opportunities for knowledge-based inter- vention through these channels. Agricultural education as currently designed in India does not prepare future extension and other knowledge workers for such integration. A review of agricultural curriculum with a nutrition focus revealed large gaps and opportunities to address them. In the process of operationalizing the revision of nutri- tion content and designing capacity-strengthening programs to enhance the knowl- edge base of midcareer professionals, several lessons emerged for other developing countries that face similar challenges. 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