Food security in Paraguay: access barriers to a healthy diet
“Food security” is a right for all people to physical and economic access to adequate nutrition at all times.
“Food security” is a right for all people to physical and economic access to adequate nutrition at all times. In the year 2020, around 768,000,000 people went hungry because they did not have access to sufficient food at home throughout the year (FAO, 2021). The latest report on the state of food security in the world indicates that after five years without changes, hunger increased by 1.5% in 2020, making it difficult to meet the goal of zero hunger by 2030 (FAO, IFAD, WHO, WFP and UNICEF, 2021). In a scenario where the COVID-19 pandemic generated negative effects that we cannot yet quantify, but that we can already feel, it is essential to generate lessons learned to strengthen public policies related to food security in Paraguay.
In this context, the National Innovation Strategy (ENI) and the UNDP Acceleration Laboratory, within the framework of the Wendá 2.0 initiative, are developing a learning loop linked to the challenge of food security as a focus of social innovation. In the discovery phase of this loop, we identified barriers to the economic and physical access to food and healthy diets. As a consequence of the negative impact of the pandemic on the economy, we observed a reduction in household income and a rise in food prices. In this scenario, Paraguayan households are resorting to low-diversity diets, prioritizing foods of high caloric content and low nutritional quality.
Uncovering barriers in accessing a healthy diet
According to the World Health Organization (WHO, 2018), a healthy diet is balanced, diverse, contains an appropriate selection of foods and protects against malnutrition. It should include legumes, whole grains, nuts and a minimum of 400 grams of fruits and vegetables per day. In addition, the percentage of calories in the form of fat should not exceed 30%, and saturated and trans fats should be restricted. Calories from sugar should be less than 10% and 5 grams of salt per day should be avoided. Based on this, and considering the individual characteristics, cultural context, customs and products available in Paraguay, the National Nutrition Institute developed the Paraguayan Food Guidelines (INAN, 2015), whose classification of food groups and recommendations we took as a reference for the conceptualization of a healthy diet in the framework of this learning loop.
In order to measure the magnitude of the problem, it is useful to reflect on food security in the context of the official figures that measure poverty and extreme poverty in Paraguay. For the year 2020, a little less than 2,000,000 people were poor, while approximately 300,000 people belonged to the extreme poverty category (INE, 2020). For the same year, more than 1.3 million people were unable to finance a healthy diet that combines sufficient calories and nutrients, and more than 600,000 people were undernourished or hungry.
Because food security is a complex and multidimensional problem, resulting from multi-causal processes and with many additional effects on the quality of life of the population, we decided to limit our analysis to the barriers for economic access, assuming that poverty and inequality are underlying and structural causes of all forms of food insecurity.
In this sense, it is understood that income inequality increases the probability of food insecurity and undermines the positive effect that any economic growth has on household food security (FAO, IFAD, PAHO, WFP, & UNICEF, 2020). In this learning cycle, we chose this structural issue as a starting point for future learning activities around food security in Paraguay.
Percentage of the population that cannot economically access a healthy diet, in countries of the region*
As long as healthy diets remain unaffordable, lower-income households will tend to buy high-calorie foods to meet their minimum requirements, without meeting their other nutritional needs. As of August 2021, an energy-dense diet that covered only basic needs cost US$0.95/day while a healthy and diverse diet, combining sufficient calories and nutrients, could cost as much as US$3.89/day.
The Central Bank of Paraguay (BCP, 2021) reported an annual inflation rate of 5.6% in August 2021, which had an impact on the increase in prices of the basic family basket. This situation, added to seasonal factors that affect food production at this time of the year, makes access to healthy diets increasingly restricted.
It should be considered that poverty and inequality intensify the barriers in access to healthy diets, mainly in households whose income depends on activities that were affected by restrictive measures in the framework of the pandemic. Barriers in access to a healthy diet are associated with an increase in food insecurity and all forms of malnutrition, particularly stunting, wasting, overweight and obesity. This situation translates into a public health problem due to the persistence of diseases derived from diets of low nutritional value and low diversity. The current scenario urgently demands public policies that propose intervention strategies to ensure access to healthy food to the most vulnerable Paraguayan households.
Considering the increase in food prices, the greatest barriers to economic access were observed in relation to fresh foods such as fruits, vegetables and meat. Based on this observation from its “discovery phase”, the Wenda 2.0 initiative moved into the next phase of “exploration” where we focused on a research question:
How can we improve the dietary diversity of households located in urban and peri-urban areas, ensuring economic access to food of high nutritional value in a sustainable manner and based on local production?
Based on this question, the following experimental hypothesis was constructed:
Based on this hypothesis, the present learning loop aims to generate scientific evidence on the effects that the provision of food vouchers on the dietary diversity of households with different income levels. This hypothesis also contemplates provided a supply of fruits and vegetables by promoting “short marketing circuits,” in this case, via local farmers’ markets. In this way, we seek to show the causal relationship that exists between improved economic access to fruits and vegetables and increased nutritional quality of the diets of these households. These lessons learned will provide scientifically rigorous information to strengthen public policies already in place or in the process of design for food security in Paraguay.
In the next edition of this blog, we will go into more detail about the exploration process and the intervention we developed. This intervention consisted in providing coupons for households in the urban and peri-urban area of San Juan Nepomuceno (Department of Caazapá) to exchange for fruits and vegetables at local farmers’ markets. We implemented this as the experimentation phase of our food security learning loop and as a focus of social innovation within the framework of the Wendá 2.0 initiative.
By Cristian Escobar Decoud, Ana Lucía Giménez, Jorge Garicoche y el Equipo del Laboratorio de Aceleración del PNUD.
This blog was originally published at National Innovation Strategy's page. For the original publication, click here.