Challenges and Lessons in Selling Nutritious Foods to the Poor

By Ewan Robinson, The Institute of Development Studies

Challenges and Lessons in Selling Nutritious Foods to the Poor

Following the Nutrition for Growth event in June and the expansion of the New Alliance for Food Security and Nutrition, there is more interest than ever in using markets to tackle undernutrition, especially the so-called ‘hidden hunger’ of micronutrient deficiencies.

Some big businesses are trying to make low-cost products that are fortified with key nutrients, and to sell these to poor populations. Examples include Grameen Danone Foods in Bangladesh and Japanese multinational Ajinomoto’s venture with development donors in Ghana.

Early initiatives have shown that there are considerable challenges to be overcome. Despite operating for several years, Grameen Danone Foods hasn’t been able to turn a profit selling yogurt to rural mothers. In India, DuPont subsidiary Solae tried to market soy protein to poor women, but ended up closing the pilot due to inconsistent demand.

Obstacles to ‘selling nutrition’ to the poor
First off, very poor households already spend as much as 70% of their income on food, and are increasingly squeezed by volatile food prices. Social protection and getting people out of poverty has to be the first step. But for a number of reasons, it won’t be enough.

A second obstacle is that undernutrition is invisible. The groups who need nutrients most are babies and pregnant mothers (they also need to have access to water, sanitation, etc. so they can be healthy enough to use these nutrients). But the health benefits of good nutrition are years away. So you’re asking people to pay today for benefits in the future, which is always tricky.

And even if people know what nutrients they should be getting, it can be impossible to tell whether foods really contain these nutrients. (See this earlier blog post for more about the problem of invisible nutrients.)

People want much more than nutrients
This one is obvious: we choose to eat certain foods for many reasons: because they taste good, indicate our social status or connect with our identities. Most of the time, our main consideration is not nutrition.

Some recent research shows that once people move from extreme poverty to being able to afford enough rice, bread or cassava so they aren’t hungry, they don’t use any additional money to ‘buy nutrients’. A study in China’s Hunan and Gansu provinces found that when the prices of staple foods were subsidised, very poor consumers decided to buy products that tasted good (like fish), and cut back on ‘poor person’s foods’ (like bean curd and vegetables). As a result, they actually got fewer nutrients in their diets.

A fourth problem is how people use foods once they have access to them. Some foods must be eaten regularly to provide health benefits (this is especially true for infant foods). Will poor consumers – whose incomes could fluctuate week-to-week – be able and willing to buy fortified products daily or weekly?

In spite of all this, there is evidence that poor people will pay relatively high prices for foods when they perceive them to be necessary for health. In Ghana and Nigeria, many lower-income households buy Nestlé’s Cerelac, a fortified product aimed at infants above 6 months. They prefer it over local products, even though Cerelac’s high price means they can’t afford enough of it.

The challenge of creating consumer demand for nutrition

Convincing poor people of the value of nutritious foods – whether nutrient-rich vegetables or fortified products – will be crucial to donors’ and businesses’ efforts.

Current initiatives are trying to create this demand in a number of ways:
  • through social marketing channels (tried by Grameen Danone) that deliver products to where standard distribution systems don’t reach, while also providing information on nutrition (and promoting the product);
  • by integrating messages about products into nutrition and health behaviour campaigns (tried by USAID in Ghana);
  • by focusing on a narrow range of products, especially those targeted at infants 6 months to 2 years old.

Will these efforts be enough to change how people buy food? How do they square with rapidly changing food systems, where many people increasingly aspire to eat the processed and branded products associated with higher income lifestyles? We need more evidence to say conclusively. But it seems that, given the scale of the problem, we need more comprehensive approaches.

Share your experiences: What examples can we learn from?

There is much to learn from research and experience with how markets work in other areas. Large-scale evaluations have tested how charging a fee for vital products, such as vaccines and bed nets, affects people’s use of these products. (See this J-PAL Bulletin for a useful summary of several of these studies.) The key findings include:
  • Small changes in cost have a major influence on whether people buy a product.
  • Charging even a small fee can exclude a major portion of the poor.
  • Although programmes long assumed that if people paid for a product, they would be more committed to using it properly; this turns out not to be true.
  • Educating people about the benefits of a product doesn’t necessarily make them willing to pay for it. (This one is particularly worrying for nutritious foods.)

What about you? There are surely many more examples to learn from. Do you have experience promoting the use of nutritious foods? What can we learn from other markets, places and contexts? Share your thoughts in a comment below!

This post originally appeared on Globalisation and Development.

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6 Responses

  1. A very significant portion of the world’s poor are smallhholder farmers, who are at least partly (often mainly) self-provisioning in food from their land.  Any initiative on good nutrition for poor/disadvantaged/excluded people cannot focus just on ‘buying’ nutrition, and ignore people’s cultural sensitivities around food and diet and issues such as access to and use of land.  Any programme that ignores the potential of rural (and to an extent urban) people and communities to farm for sound nutrition is in my view doomed to fail.  Improving the conditions for small holder farmers should be a primary plank of any project to improve the nutritional status of poor communities.  These people in many respects feed themselves (and trade with each other) outside of mainstream ‘markets’. Mainstream markets can and do fail with respect to ensuring people’s rights to food and nutritional status is upheld.

    To me, none of the ‘key findings’ above are surprising.  Business will continue to fail to ‘create’ a demand for good nutrition among poor people, who are NOT ‘consumers’ but citizens, who need other non-market approaches (e.g. helping small farmers to conserve soils and improve soil fertility, raise yields, diversify their range of crops, increase the range and types of crops grown for household food security, improve local marketing infrastructures, etc). These people need to be involved in creating their own responses to the ‘problem’ of food security and good nutrition and not just be expected to act like good ‘consumers’.The above strikes me to be about the poor being the wrong kind of consumer, and if only they could be made into the right kind of consumer that the problem of good nutrition will somehow be solved.

    I am writing this over a lunch of banku, fish and peppe, prepared by a local smallholder farmer and sold to staff at Ministries, Suhum, Ghana, proud that my volunteer allowance (all 80 pence of it) is helping to support a local family.

  2. I agree with Laura completely. There are four disciplines for food gardens that complement traditional gardens, which might have included 150 to 250 or more varieties of plants, which protect and nourish each other and the people who grow them, and ripen progressively throughout the year. The disciplines are BioIntensive Gardening, which has strong footholds in the countries near Manor House in western Kenya, and in Mexico; Permaculture, which has a global following, Integrated Farming and Waste Management, based on traditional Chinese practices, and BioDynamic Gardening, which focuses on energetic aspects. In addition, Rewilding Earth encourages use of the 80,000 edible wild plants on earth; people now get 85% of their calories from just 18 plants, and that is a great loss compared to 500 years ago. Most of these wild plants are perennials, so they don’t need to be seeded every year. And many have very high levels of phytonutrients, as well as nutrients most government regulatory agencies recognize.

    One tree worth planting throughout the tropics is Moringa, which is chock full of nutrients and healing properties. The most commonly planted species around the world is Moringa oleifera, from India.

    Regards,

    Mark Roest

  3. Dear Laura and Mark,

    Thanks very much for your insights. You raise several important points in your comments:

    1. smallholder farmers and people who grow food
    2. “informal” markets provide food to much of the world’s population
    3. who “is a consumer” and how do people become consumers?

    You’re very right to point out that I don’t focus on the potential of people growing food for themselves in my post. That’s not because it’s not important. It’s because I think how people choose to grow foods themselves (and whether these foods are nutritious) faces a really very different set of issues than when people are buying food. There is lots of work on on-farm approaches to nutrition; check out this discussion paper from GAIN and IDS: http://www.gainhealth.org/reports/gain-ids-discussion-paper

     

    But we also need to think about the difficult problems involving food markets, since more and more people are buying food, and this overall trend won’t reverse anytime soon.

    You’re absolutely right to point out that many poor/excluded people get much of their food through “informal” markets, often not included in many statistics. Interestingly, informal markets are growing, not shrinking globally. And there are plenty of “formal” markets that completely fail to give people nutritious foods (think about many urban populations in the US).

    But informal markets don’t necessarily work well for the small farmers who sell to them (they can be controlled by transporters or wholesalers), and they don’t necessarily work for consumers (it can be hard to trace whether food is safe). We need to look at who controls food markets (too much centralized control is a very bad thing) and who wins and loses from different market structures.

    How do people become consumers? This is a really interesting question. As Laura said, large businesses are eager to convince low income people – who are rapidly moving to cities – to start to consume their products. My point in the post was that controlling consumer behaviour is a lot more difficult than many projects seem to assume.

    If you are concerned about equity/right to nutrition/social development, I don’t think you can ignore markets, how people behave as consumers, or the forces that shape our behaviour.

    Thanks again for your comments!

    PS. Laura, I’m jealous of your Ghana-sourced banku and pepper!

  4. Dear Laura and Mark,

    Thanks very much for your insights. You raise several important points in your comments:

    1. smallholder farmers and people who grow food
    2. “informal” markets provide food to much of the world’s population
    3. who “is a consumer” and how do people become consumers?

    You’re very right to point out that I don’t focus on the potential of people growing food for themselves in my post. That’s not because it’s not important. It’s because I think how people choose to grow foods themselves (and whether these foods are nutritious) faces a really very different set of issues than when people are buying food. There is lots of work on on-farm approaches to nutrition; check out this discussion paper from GAIN and IDS: http://www.gainhealth.org/reports/gain-ids-discussion-paper

     

    But we also need to think about the difficult problems involving food markets, since more and more people are buying food, and this overall trend won’t reverse anytime soon.

    You’re absolutely right to point out that many poor/excluded people get much of their food through “informal” markets, often not included in many statistics. Interestingly, informal markets are growing, not shrinking globally. And there are plenty of “formal” markets that completely fail to give people nutritious foods (think about many urban populations in the US).

    But informal markets don’t necessarily work well for the small farmers who sell to them (they can be controlled by transporters or wholesalers), and they don’t necessarily work for consumers (it can be hard to trace whether food is safe). We need to look at who controls food markets (too much centralized control is a very bad thing) and who wins and loses from different market structures.

    How do people become consumers? This is a really interesting question. As Laura said, large businesses are eager to convince low income people – who are rapidly moving to cities – to start to consume their products. My point in the post was that controlling consumer behaviour is a lot more difficult than many projects seem to assume.

    If you are concerned about equity/right to nutrition/social development, I don’t think you can ignore markets, how people behave as consumers, or the forces that shape our behaviour.

    Thanks again for your comments!

    PS. Laura, I’m jealous of your Ghana-sourced banku and pepper!

  5. Thanks Laura and Mark for your posts – I think those issues fold nicely into the discussion since often times they are dismissed for markets and economics, as Ewan just did after your posts, when in fact there is a larger whole we need to be addressing and thereby is interrelated to the issues of soil, conservation, justice, and equality to name but a few; and a more comprehensive analysis/approach incorporating additional forms of capital – human, social, natural, cultural, political, communal/community, etc. – must be adopted.

     

    I also wonder about the ongoing dialog of measuring parts of our society which might not necessarily need to be measured – ecosystem services, educational attainment, our values, etc. to name but a few – in order to capitalize on them in our financial system.  Why not shift GAAP or IFRS instead to better reflect those less measurable parts?  This brings to mind a quote by Antoine de St. Exupery:  

     

    It is only with the heart that one can see rightly; what is essential [to life] is invisible to the eyes.

     

    To answer more directly Ewan’s post, even with the current evolution of developing markets moving to consume packaged products, I think there is a lesson (really a few) to be learned with the US’s history between the USDA, the FDA, and the food industry.  Marion Nestle offers a comprehensive analysis of this in her book “Food Politics” and she highlights how tenuous a relationship these institutions have with each other.  Specifically, that when nutrition science has led us in one direction, the food lobby/industry has purposefully found ways to divert the truth from reaching consumers – and in the end we get weak and washed out policies that do nothing to protect the consumer but everything to confuse them and help industry sell more food.  She gets into the fortification process as well, and uncovers how little added value this provides for much of our food today – even though it was originally intended to provide for vitamins and minerals that were insufficient at one point in time, yet now we are getting too much of certain vitamins and minerals further complicating the issues.  See the FDAMA and DSHEA acts of 1997 and 1994, respectively, for further details.  

     

    So the very concept of selling nutritious foods to the poor appears as if it is coming from the firm view:  how can the company exploit the consumer to make money and sell more of their products?  And all this is happening when currencies are appreciating against the dollar in developing markets which also happen to be experiencing tremendous shifts in weather patterns (drought, too much rain, etc.) and when governance isn’t picking up the slack with insurance or other social welfare programs as food price spikes hit families just before the upcoming rain season.  With this type of relationship to the consumer, there’s not much to work with when considering all stakeholders.  Hafiz captures this nicely in his own words:  

     

    “Even after all this time,

    The sun never says to the earth,

    You owe Me.”

    Look what happens

    with a love like that,

    It lights the Whole Sky.”

     

    I believe the goal should not be to look at this issue solely from the firm (or market) view, but to consider all the stakeholders (including global ones) related to these issues at the local level and then build platforms for dialog on how best to address the issue – in the end empowering local solutions to issues of hunger or malnutrition – and NOT firm level or MNC oriented solutions of how best to create a product that a consumer would like to purchase.

  6. Dear Ewan,

    People become consumers through being unable to stay on their land (or it happened to their ancestors or, after WWII, by being exposed to a massive propaganda campaign, organized by Freud’s nephew, a pioneer in public relations and advertising, to teach people used to buying only what they need and can’t grow, to buy for psychological gratification. The campaign included the department stores, tobacco and alcohol interests, real estate, Hollywood movies and television. It was ubiquitous. It was (and is) also used as the model for turning other populations into consumers.

    A Kenyan who was a Stanford Digital Vision Fellow told me that the buyers offer $2 for 200 potatoes in a bag — about what it costs to grow them — “or you can watch your potatoes rot in the ground or turn green above the grount.” That is what breaks the back of rural economies, and causes farmers to leave their land in a desperate bid to support themselves in the city. But that is a later stage, after they have been persuaded or ordered to focus on cash crops instead of growing 200 or more different varieties of plants, in growing systems that may have been fine-tuned to that place for thousands of years. In other words, after they have been colonized.

    The straightest line to a solution is a combination of urban gardens, and building direct links to the foodshed around the community. The foodshed is basically the agricultural land for which a given town or city is the most convenient market for its crops. Few know today that Paris was a net exporter of food in the late 1800s, by growing on any horizontal surface, and on rooftops. The key to consumerist habits and identities is sharing other values that are more meaninful, and community organizing that nurtures people as whole beings.

    Regards,

    Mark

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