Cracking the Egg Potential

Working to Reduce Child Stunting and Improve Rural Livelihoods

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Eggs are among “nature’s first foods”, designed to holistically support early life and development. They are among the richest sources of essential amino acids, protein, choline, and long- chain fatty acids (DHA).  They are also an important source of some vitamins and minerals, including vitamin A, B2, B5, B12, selenium, phosphorous and zinc, and contain other bioactive factors. In a symposium chaired by Chessa Lutter from RTI International and the University of Maryland School of Public Health and Saul Morris from the Global Alliance for Improved Nutrition (GAIN), and sponsored by the Child Investment Fund Foundation (CIFF) at the International Congress of Nutrition (ICN 2017) in Buenos Aires, the potential of eggs to improve child nutrition and rural livelihoods was debated. 

Eggs

The Science Behind the Egg

For a full-packed symposium hall, Lora Iannotti from Washington University, presented findings from the Lulun Project, a randomized controlled trial in Ecuador, where eggs were given to children 6 to 9 months of age.  After only 6 months, linear growth was improved and stunting was reduced by 47% in the group receiving eggs –  an effect larger than those of any other complementary feeding interventions to date. The trial also showed significant  improvements in concentrations of biomarkers associated with cognitive development including  choline, betaine, methionine and DHA.  Currently, a replication study is on its way in Malawi that also includes assessments of child development.

In rural Ghana, poultry-based income generation activities embedded in an integrated agricultural and nutrition education intervention also led to improved egg consumption, dietary diversity and linear growth among young children. Dr Grace Marquis from McGill University presented the preliminary results of this intervention, in which households with infants up to 12 months of age received multiple agricultural and infant feeding interventions, including education and training on poultry, home gardens and beekeeping. Dr Marquis and her team are currently working with district partners on the sustainability of the intervention by helping women form farmer associations, opening opportunities for access to credit from the local rural bank, and strengthening technical assistance from government health and agriculture extension services.

Creation of demand and overcoming social and cultural taboos preventing mothers and caregivers from giving eggs can be major barriers to overcome when promoting the use of eggs for young child feeding. A key element of the previously described RCT in Ecuador — an intensive social marketing strategy — was described by Carlos Andres Gallegos Riofrío of Washington University. The project was branded as “Lulun”, which translates into ‘egg’ in the local indigenous language, and symbolically tied the practice of giving eggs to young children with indigenous worldviews. The strategy followed a structured process targeting all the six P’s in successful marketing: people, product, place, price, promotion and policy change. Creating a successful brand, brand loyalty and empowerment of mothers and caregivers to take decisions on their child feeding were critical for the successful and continued behavior change and central to the success of the study in improving egg consumption and child growth.

Availability of Eggs

To make eggs available and affordable to low-income households, small holder poultry business models need to be viable. Klaus Kraemer of Sight and Life presented the findings from a scoping study in Kenya, Ethiopia, Malawi and India demonstrating the potential of four types of business models to be viable at-scale:  

(1)  Micro-Financing institutions that provide a small credit to underserved poultry entrepreneurs coupled with peer group support, technical, and business skill training. Such credit helps backyard poultry farmers set-up and operate micro-enterprises.

(2)  The Out-Grower Model: a partnership between smallholder poultry farmers and commercial players to improve the productivity of hens.  

(3)  In the Enterprise Development Model, an established local input supplier organizes smallholder farmers into groups and helps them invest in mid-size poultry enterprises. With relevant training, market support and funding, they manage businesses that not only generate profits, but also succeed in improving the availability of high quality eggs in their community.

(4)  The One-Stop Hub Model is a distribution and aggregation platform tailored for a rural environment. It is a combination of the above three models, and goes one-step further by providing a marketing channel for eggs to be accessible even in hard-to-reach rural areas.

All of these models were successful and in some contexts even hugely profitable. In Malawi, for instance, women farmers in the Enterprise Development Model, can each earn an average income of US$1130 per year!

Chicken

Finally, Emily Lloyd of the One Acre Fund demonstrated the importance of rigorous piloting before moving to scale to tackle issues with selection of the most appropriate chicken-breed in a particular setting, appropriate housing and vaccinations of chickens to prevent spread of poultry-related infectious diseases in the participating households, as well as distribution and financing challenges.

The Challenges

In a lively discussion, some important suggestions were raised by the audience. These included the potential to improve egg consumption in other vulnerable target-groups, in particular pregnant and lactating women, the need for behavioral change strategies and other interventions to prevent the spread of poultry-related infectious disease to the household, concerns about allergies, considerations of equity when rolling-out poultry business models and how to improve sustainability when these programs and interventions are further scaled-up.

Saul Morris, GAIN’s Director for Policy and Planning, concluded that the potential of egg and poultry interventions to impact child’s nutrition and improve rural livelihoods is ‘egg-citing’ and has been underexplored and appreciated. The symposium clearly demonstrated that together, interventions to improve young child egg intake and household and community egg production could radically reduce the global prevalence of stunting and improve livelihoods of the rural poor. The next challenge will be to bring these interventions to scale, and fulfill the promise that by 2020, 10 million eggs will be delivered to young children annually, as a key component of complementary feeding.

Watch the complete ‘Cracking the Egg’s Potential to Improve Child Growth and Development’ presentation from the 2017 ICN IUNS and access the linked research here on SecureNutrition’s website. For additional information on eggs read ‘Cracking the Egg Potential During Pregnancy and Lactation‘ featured in the Sight and Life magazine on Women’s Nutrition and ‘Eggciting Innovations‘ on our blog. 

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Eggciting Innovation

Eggs for Improved Maternal, Infant and Young Child Nutrition

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The statistics show the continued, and sadly in some cases growing, prevalence of malnutrition in a number of countries. The 2015 Global Nutrition Report (GNR) had as one of its key messages, “Although a great deal of progress is being made in reducing malnutrition, it is still too slow and too uneven.” And the 2016 GNR just launched this month, states that “Malnutrition and diet are by far the biggest risk factors for the global burden of disease: every country is facing a serious public health challenge from malnutrition.” Addressing nutrient (macro and micro) deficiencies amongst the most vulnerable, usually women and children is proving to be a ‘hard egg to crack’ and requires disruptive ideas and real innovation.

Eggs

Enter the humble egg

Eaten since the beginning of time; eaten almost everywhere in the world; relatively easy to obtain; adaptable to many different types of cooking techniques and; an affordable source of highly digestible protein, we believe that the time has come to re-think and innovate around the humble egg!

We are not alone in our thinking, and Iannotti et al. have written an excellent review article that eloquently positions the egg as offering real potential to improve maternal and child nutrition in developing countries. Studies promoting egg consumption for women and children as part of wider dietary improvements show that, child growth indicators are significantly improved in the intervention group compared to controls and a recent breakthrough research study shows that all nine essential amino acids were significantly lower in stunted children compared with non-stunted children. This is important because it tells us that stunted children are not receiving sufficient quality protein from their diets.

Did we put all our eggs in one basket?

Could this research point to the fact that in nutrition’s zeal, over the last four decades, to focus on ensuring that children received sufficient micronutrients (particularly vitamin A, iodine, iron, zinc, and folate), that protein fell off the agenda? It would seem that the widespread assumption that children were receiving enough protein from their basic diet was incorrect. Now is the time to realise that it is not ‘either/or’ but rather that optimal child growth and thus development, depends on addressing deficits of both protein and micronutrients. This calls for ensuring adequate micronutrient and protein in the diet especially during critical life stages – pregnancy, lactation, infancy and adolescence. We need to take a holistic approach and embrace the farm to flush approach anchored in food systems (take a look at this Sight and Life magazine focusing on food systems), so as not to neglect any of the nutrients as we look to future solutions that can be scaled up in order to have the impact that the 2016 GNR rightly puts under the spotlight.

Don’t count your chickens before they hatch

While eggs are a highly nutritious food source, both the productivity of laying hens and the nutritional content of their eggs are, to a certain extent, a function of the hen’s dietary intake. The reality is that for laying hens, an optimally micronutrient fortified diet improves egg production in numerous ways – increased egg numbers, improved egg weights, percentage lay and increased feed efficiency. Interestingly, for many micronutrients, egg content responds rapidly (within a few weeks) to dietary changes; transfer efficiency, from feed to egg, does depend on the micronutrient – high for vitamin A, selenium, iodine, and DHA; medium for vitamin D and E and; low for folic acid, niacin, and iron. This points, to a real opportunity to improve the nutritional value of eggs with only limited input in the feed and in egg eating populations requires no need for dietary behaviour change communication, which we know to be both costly and not always highly successful.

Projections from FAO suggest significant growth in egg consumption in developing countries. Even in countries considered to have largely vegetarian population, such as India, data shows that the diet of many Indian households is diversifying to include more animal source foods, a trend that has been particularly notable in rural populations. This makes the idea of tapping into the potential of eggs extremely eggciting. A ‘powdered’ micronutrient feed supplement for chickens could contribute to solutions for farmer through improved egg production and, for consumer by providing added nutritional value. An additional advantage of eggs is their environmentally friendly packaging. 

The proof of the pudding is in the eating

There is research to show the benefits of consuming fortified eggs. A 2009 study showed that feeding DHA-fortified eggs to infants and pregnant mothers improved infant visual acuity and attention and other studies have found that DHA fortified eggs were associated with increased gestational duration and infant birth size. In addition to DHA, there is literature to support the role of eggs in reducing deficiencies of iodine and vitamin A and even decreased anemia.

“Leaders don’t wait for problems to lay eggs before they attempt dealing with them.” 
– Israelmore Ayivor

A range of nutrients delivering various levels of their recommended daily allowance could relatively easily be added to eggs through the chicken feed. There are many avenues to explore, such as supplying micronutrient feed supplement directly to existing farmer networks or to women running poultry programs. Simultaneous social marketing campaigns could encourage egg consumption and an assessment over time could be undertaken to provide the evidence of impact…

Sight and Life is actively exploring these eggciting opportunities and would be interested in hearing from anyone keen to invest or partner with us, as we believe the egg just can’t be beaten.

To contact us regarding this project send an email to Kalpana.Beesabathuni@sightandlife.org

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