Diet quality and micronutrient intakes in nutritional value chains: A synthesis and suggestions for further research

• Both production diversity and market access work in tandem to improve diet quality. • Incomes and prices affect consumption; healthy diets are unaffordable for many. • The poor are most sensitive to changes in relative prices of micronutrient-rich foods. • Social context mediates the relationship between women’s empowerment and diet quality. • Supply and demand side interventions can be successful if adapted to local contexts. This paper provides an overview of a virtual collection of papers analyzing drivers of diet quality and micronutrient intakes, and what has been learnt from various interventions to address micronutrient malnutrition, the contexts in which they succeed, and factors that affect their impact. We frame this using a micronutrient value chain, to highlight the important linkages from farm to plate. Our focus is on representative studies along this value chain in low and middle income countries where micronutrient malnutrition is most prevalent. The papers reviewed suggest that (a) both production diversity and market access work hand-in-hand to improve dietary quality. (b) However, the evidence on whether commercialization improves or reduces diet quality is context-specific and depends on whether markets exist for goods to be sold and micronutrient-rich foods purchased. (c) Not surprisingly, incomes and prices emerge as key factors affecting consumption decisions, with the cost of a healthy diet remaining unaffordable for many. Furthermore, the poor are most sensitive to changes in the relative prices of micronutrient-rich foods. (d) Also important is how food is consumed within the household: the review suggests that social context matters greatly in assessing relationships between women’s empowerment and diet quality. We then review several supply and demand side interventions, and note that while many are successful, not all are easily transferable, and thus may need adaptation to local contexts. We conclude with a set of ten areas that remain open for further research.