A Sweet (Potato) Solution to Malnutrition

Betty Nabiteeko is trying to save lives in Mityebili, Uganda.

The 38-year-old mother of five has been tracking the health of 75 families in this town close to the Tanzanian border since early 2014.

“I want to see this generation vibrant and much healthier,” she said in June, as several women and young children arrived at her home.

The mothers sat attentively as Nabiteeko told them about the signs of malnutrition and how to select nutritious food for their children.  When she finished her talk, the women asked for and joyfully received sweet potatoes from a large bag in the corner. 

Nabiteeko is a “community health promoter,” earning a small stipend through a $3 million pilot project funded by the Japan Social Development Fund at the World Bank and implemented by the non-governmental organization BRAC Uganda, a branch of Bangladesh-based BRAC.

The project encourages local people to grow and eat the orange-fleshed sweet potato and other nutrient-rich crops to combat child stunting — the failure to reach one’s full growth potential.

At the same time, the project is designed to help female farmers grow, market, and sell the crop, with an eye to boosting their economic and decision-making power in the process.  Women are the main care givers and producers of family food crops in these rural areas, but rarely own land, farm profitable cash crops, or control family finances.

Stunting has long-term detrimental effects on an individual’s health, productivity, and cognitive development and impacts a country’s growth and development. While stunting rates are dropping globally, there has been a 23% rise in numbers in Africa since 1990, according to a recent report by UNICEF, the World Health Organization, and the World Bank Group. 

The orange-fleshed sweet potato, as a bio-fortified crop, is seen as one solution to the problem. The vegetable, which is not native to Uganda, can deliver a child’s daily requirement of Vitamin A in as little as 50 grams (less than 2 ounces).

Part of the problem is lack of awareness about which foods are the most nutritious, particularly for babies and pregnant women, said Francis Bbosa, a BRAC research associate who often travels to rural areas to check on the progress of the project.

Bbosa says people in Uganda eat a lot of matooke, a starchy plantain banana and a staple food. But matooke does not supply some essential nutrients people commonly lack. “Farmers need incentives to grow something else,” he said.

BRAC Uganda, the largest NGO in the country, with health, microfinance, and agricultural services, set up a network of female farmers to propagate orange-fleshed sweet potato vines and teach other farmers how to grow and care for the crop. At the same time, community health promoters like Nabiteeko provide nutritional advice and monitor and promote the growth of children under 2.

The women are compensated for their work in the two-year start-up phase of the project, after which it is hoped that demand for the crop will make production self-sustaining. The project offers farmers crop insurance and access to microcredit to promote the production of the orange-fleshed sweet potato.

Demand for the new variety of sweet potato is high at the market, said Irene Nakityo, 48, a community agriculture promoter in Bugonzi Village, Kalungu District. “If you take it there, people will buy it,” she said. People like it because it’s nutritious and sweet, she added.

The orange-fleshed sweet potato project also seems to be making a difference in the lives of the women it has touched.

Florence Namatovu, 46, said the money she earns from selling sweet potato vines is not shared with her husband, and this has been empowering. She can take care of her mother, pay school fees, and other expenses. The farmer and mother of eight in Mukako town, Kalungu District, said she is considering opening a bank account for the first time in her life.

BRAC began introducing the orange-fleshed sweet potato in the central and southwestern regions of the country in 2014, with the goal of improving the nutrition of about 19,200 vulnerable and poor households. While Uganda’s stunting rate of 33% is one of the highest in the world, stunting rates in the two regions averaged nearly 47% for boys and about 35% for girls under 2, according to a survey of 7,694 households in April-July, 2014.

Experts say Uganda is a nutritional paradox: Under-nutrition occurs even in agriculturally productive, relatively prosperous regions — and despite the fact Uganda is the dominant exporter of food staples in eastern Africa.

Sarah Nakyngwe, 38, said she used to have to beg for food to feed her seven children, but her life has changed since she got a job promoting the orange-fleshed sweet potato.  Nakyngwe joined BRAC’s microfinance group and leased a more productive 1.5-acre plot of farmland. She also began working in a beauty salon in the village. Now, there is enough money and food to go around, and an added benefit:  Nakyngwe’s husband sees her in a new light and supports her efforts to earn a living outside the home, she said.

The Ugandan government is preparing a large-scale $30 million project to build on BRAC’s work and jumpstart cultivation of the crop throughout the country. The new project is financed by a grant from the Global Agriculture and Food Security Program housed at the World Bank and funded by multiple countries.

The World Bank Africa Gender Innovation Lab is also studying the impact of the BRAC pilot project, to learn whether women are more likely to adopt the crop for its nutritional value or its market potential, said economists Markus Goldstein and Niklas Buehren.

“One of the big issues in Africa is that women earn significantly less than men in agriculture,” said Goldstein. The Gender Innovation Lab study is “trying to figure out how to close that gap.”

Data from six countries in Africa indicate that female farmers get less yield per hectare than male farmers, partly because women’s farms have less male labor.

In Uganda, women usually don’t have enough money to hire labor, while men grow more labor-intensive cash crops such as coffee and sugarcane, according to a report on gender and intra-household dynamics in the sweet potato project areas.

Most landowners are men and men also have greater access to farming tools, fertilizer, and other inputs than women, said the report. It added that men “tended to take over the control of the crops that are classified as female preferred if these attracted big commercial value and return.”

The Gender Innovation Lab study will look at whether female farmers’ head start with the orange-fleshed sweet potato in Uganda can give them an advantage as the crop becomes more popular and profitable.

Adoption of the crop is the first thing that needs to happen, said Buehren. “Everything else cascades from that.”