Boosting Egg Production to Reduce Malnutrition in Malawi

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On a quiet morning in rural Mchinji, a small district in Malawi, Grace wakes up and walks over to the house she constructed just a year ago. She inspects her 1,200 chickens carefully – they are all hale and healthy! It will soon be time for their breakfast – a specially formulated meal with the right mix of carbohydrates, protein, vitamins and minerals so they can lay healthy and fresh eggs. All of this is thanks to the egg hub – a  Maeve, Lenziemill and Sight and Life project that aims to increase the income of farmers like Grace by providing high quality and affordable inputs, credit, training, and access to markets; as well as increase availability and affordability of eggs in Malawi. 

Challenges to improving egg consumption in Malawi

As a source of high-quality protein, vitamins and minerals and fatty acids, eggs have the potential to dramatically improve nutrition outcomes for vulnerable populations. Yet, in many parts of the world eggs remain inaccessible to those who need it the most. At the same time, the poultry industry is growing exponentially in many low- and middle-income countries (LMICs), making it an important source of income for poor households.

In Malawi, 37% of children under five are chronically malnourished (stunted), and about 86% of the population lives in rural areas, where most people practice smallholder subsistence farming. The rural poor are particularly affected by malnutrition despite increases in caloric consumption across all socioeconomic quintiles. Although eggs have proven nutrition benefits, eggs continue to be scarce and costly in Malawi – the average per capita annual consumption is only 27 eggs, compared to 180 globally. 

This is due to multiple demand and supply side challenges, notably disease and mortality among chickens, cost and quality of production inputs, and access to credit and markets leading to high egg cost (8-11x the price of cereals, compared to 1.6x in the US and 3.4x in Europe) and low availability. Cultural beliefs and taboos also undermine egg consumption. For example, in some Malawian communities, eating eggs is associated with stomach pains, or even with babies becoming bald.

Increasing egg production using the Egg Hub model 

In Malawi, there is a huge unmet domestic demand for chicken meat and eggs; and the Government of Malawi is committing to improving food security and nutrition through progressive national livestock strategies.

Against this background, interventions and innovations across the poultry value chain that consider the role of poultry for society and the prevailing farming systems are increasingly being implemented. The Maeve/Lenziemill/ Sight and Life egg hub projectwas launched in 12 villages in central Malawi to set up and develop bird poultry farms with 3-year break even period.This project has brought together various partners to support poultry farmers, who are organized into groups of five. In addition to receiving specialized feed, the groups also receive all important vaccinations for the birds, which are ready to lay when they arrive at the farms, training, and continuous supervision.

Since the project was initiated in September 2018, 60 farmers have been registered, received training, established farms and started egg production; and a total of 12,000 birds were placed in these farms to start egg production. The program aims to produce 3.5 million eggs annually. Sight and Life has also built a digital platform for the farmers to track progress, program outcomes and biosecurity protocols.

Not only has the project led to increased egg production and consumption among participants like Grace and their families, but it has also increased their incomes as the eggs are also being sold in local markets.

There has been a surge of excitement and interest in the villages to the point where we have had current farmers also asking for more chickens to meet their local demand. It is very exciting to see the overall demand and drive the farmers.” – Maya Stewart, fund recipient & Director of the Maeve project

The way forward

In addition to addressing supply side concerns, Sight and Life will also create demand through a targeted social marketing campaign, making eggs aspirational and desirable for caregivers of young children, pregnant and lactating women. Sight and Life is on a quest to end malnutrition, and we believe in the power of eggs to improve health and nutrition for all.

Read more about Sight and Life Eggciting Project at: https://sightandlife.org/resources/#publications&id=5786&f=2019

And visit the NEW egghub.org to find information on egg production and consumption in LMICs and aims to improve the collaboration and innovation around eggs.

 

 

Eggs and EGG-sternalities

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On August 6th, at the 2019 Asian Congress of Nutrition in Bali, Sight and Life organized a symposium on the topic of eggs, which represents one of its flagship programs. The session entitled “Achieving Improved Nutrition in a Sustainable Way – The Case of Increased Egg Consumption” gathered experts in the field of nutrition, sustainable business models, environmental sustainability, science and research and was skillfully moderated by Dr Regina Moench-Pfanner (ibn360).

The session made an important case on how crucial it is to go beyond nutrition and to increasingly account for externalities in our way of thinking and in the way we implement programs and projects. This shift in thinking has become necessary in light of pressing global issues such as climate change. Eggs provide a useful example to start unpacking some of these challenges.

The science can no longer be EGG-nored

The days where eggs were blamed for driving up cholesterol levels are thankfully over. Evidence is mounting regarding the benefits of eggs for child nutrition and potential benefits for women during pregnancy and birth outcomes. This power food is at last getting the attention it deserves.

Think of it – there is no food such as the egg. Dr Jeya Henry of the Clinical Nutrition Research Center in Singapore reminded the audience of the astonishing properties of this functional food: “from gelling, to emulsifying, to thickening and foaming properties, eggs’ form of proteins is simply incredible” he adds that “an average egg is roughly 50-60 g in weight. No other food on the planet has almost all the micronutrients and the most significant amino acid patterns packed in such a small quantity”.

Ms Gulshan Ara from icddr,b shared the recent and fascinating results from a trial conducted in Bangladesh where the effect of an egg-based nutritious snack was tested on child growth. Results showed that on average, intervention children became 2.55 cm taller compared to control children. Egg based nutritious snacks contribute to improving both linear growth and cognitive development in children <2 years of age.

Yet, although eggs’ nutritional value is undebatable, it would be presumptuous to assume they are the magic bullet… 

Indeed, there is an array of known and unknown externalities that come along the way and must be understood; acknowledged; and addressed.

“Eggs have the potential to be considered in 2020s as a sustainable and irreplaceable animal source food for improved nutrition.” Dr Klaus Kraemer

Environmental consequences of egg production

One of the key obstacles relates to the environmental consequences of the production of eggs, but also animal welfare issues. Using Life Cycle Assessment (LCA) methods, a recent study by Abín et al, conducted in Spain revealed that natural land transformation, terrestrial ecotoxicity and freshwater ecotoxicity were the top three most notably affected categories and that the highest source of environmental impact was production of hen feed (specifically soybean and palm oil cultivation), but also the breeding of young chicks to replace the exhausted laying hens. Such findings encourage the development of innovative triple duty solutions addressing the environmental externalities, without failing to address the over and under nutrition components.

“It’s time for nutritionists to design and adapt their solutions in the context of the entire supply chain and the environmental consequences of it.”  Dr Martin Bloem

Luckily, there are solutions. During the session, one of these solutions was shared by Srujith Lingala from Sight and Life. Through its Eggciting project, Sight and Life is working on making eggs available and affordable to low income households by supporting the introduction of innovative poultry business models in Ethiopia, India, Indonesia, and Malawi.

The Egg Hub

The ‘Egg hub’, one of Sight and Life’s recent innovations, is a centralized unit offering farmers high-quality, affordable inputs, extension services, training and market access. Through aggregation, egg hubs solve the supply-side challenges typically faced by small- and medium-

scale poultry farms. They can help countries with low-yield production systems make the transition to the efficient, high-yield systems that are associated with much lower market prices.

In Malawi, where the egg hub model was tested, initial findings point towards the fact that the egg hub has enabled 60 farmers to receive inputs and produce 4.5 million fresh eggs every year, but also to resell them within their communities. Each farmer makes a net income of USD 922 per year, 2.3 x the minimum wage in Malawi. Innovative farming models such as the egg hub are an effective and sustainable means of improving nutrition and increasing incomes of small and medium scale farmers.

In the present landscape where commitment for nutrition is at its peak and where the climate change debate is ever increasing, economically viable and sustainable solutions are welcomed as the interest to invest in these is significant.

Filling the egg gap

Public solutions exist as well. Dr Saskia de Pee (Fill the Nutrient Gap, WFP) shared the example of Indonesia where a social safety net program called Bantuan Pangan Non-Tunai (BPNT), that enables poor households to buy 15 kg of rice per month at a very low price, is transitioning to a commodity specific e-voucher. Following a cost of the diet analysis, FNG analyzed which locally available foods should be included in BPNT’s pre-determined local food basket to meet the household members’ recommended nutrient intake in the most cost-effective way. The results showed that the cost of a nutritious diet was approximately 1.2 million IDR/month per household, and the voucher value of 110 000 IDR/month per household (10% of the cost of nutritious diet). Eggs, rice, and green leafy vegetables were identified as the foods able to meet the most nutritional requirements for the lowest cost. Since then, they have been selected for the ‘Nutritious Package’ that was modeled for the BPNT program.

Watch out for unknown EGG-sternalities

What about other readily solutions that are coming to the market, such as JUST Egg and Impossible Burgers? Dr Martin Bloem, Director of the John Hopkins Center for a Livable Future, warns that “there are many unknown unintended consequences related to the production of these types of alternative forms of meat, particularly in terms of their nutrient composition, their use of antibiotics and water, as well as other chemical properties”. From a nutritional and environmental perspective, these alternative forms of meat need to be critically assessed.

Prioritize and compromise

Whilst animal welfare may be a priority in higher income countries, Environmental Enteric Dysfunction (EED) for instance, is more prevalent in lower resources settings and therefore present a higher priority to address. “At this stage, cages are critical to help reduce contact with feces and other hazards” explains Dr Klaus Kraemer from Sight and Life. “Chicken feces can affect the gut microbiota of children, and the difficulty of avoiding contact of children with feces can lead to chronic inflammation causing the gut to leak whereby the body burns the nutrients instead of using them for growth”. Klaus argues for the need to price externalities and to innovate even further for improved caging to successfully separate chickens from the children. It is our duty as nutritionists not only to help decision makers prioritize actions but to ensure the access of this power food to those who need it the most.

Are eggs EGG-citing?

Last but not least, consumer insights are primordial. Cultural factors play a role in many nutrition practices, including taboos or beliefs around egg consumption. Some of these insights were uncovered by Dr Maria Adrijanti from World Vision Indonesia, who throughout her presentation, made the case of increased egg consumption in Indonesia. The Eggciting project, a collaboration between Sight and Life, World Vision and DSM aims to increase availability, accessibility and consumption of eggs in Indonesia at the household level by addressing bottlenecks in the supply chain and boosting consumer demand. In terms of consumer demand, the project uses a social marketing approach to better understand some key issues including but not limited to: understanding household food purchasing power and decision-making; understanding how eggs are used in the daily diet; examining the awareness, knowledge, attitudes and beliefs around egg consumption; identifying key community influencers, their role and motivations in offering dietary advice, and specifically their view on eggs.

One initial insight regarding the traditional Indonesian diet and Sulawesi diet and egg consumption revealed that there are two kinds of chicken eggs that are popular in Indonesia – the native egg and the ‘broiler’ egg. The former is perceived as more delicious, and fresher compared to the broiler eggs and is usually used as medicine.

Thinking in systems

Daring to think beyond our current actions, daring to imagine the far-reaching and unintended dramatic consequences of our actions can be daunting and uncomfortable. A systems way of thinking isn’t easy for those of us who’ve been programmed to think in siloes, but our attitude of denial is catching up with us. The nutrition community can no longer play deaf towards the ever-increasing global environmental cries and concerns of the planet, which must go hand in hand with what we are trying to achieve. The fight against malnutrition is a complex one, which requires innovative solutions which can address that complexity. Learning from our mistakes isn’t just the cumbersome thing to do, it’s the ethical thing to do. This session was an egg-cellent example of the kinds of conversations we should increasingly be having – conversations that aim to understand the perspectives of the different sectors involved, and whose objective is to not only design new solutions but to adapt and re-adapt existing ones to the current context.

The egg isn’t unbeatable, it’s adaptable

“The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn, and relearn” – Alvin Toffler

ACN 2019

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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