In February, the United Nations Standing Committee on Nutrition (UNSCN) released a discussion paper, titled “Urban-rural linkages for nutrition: Territorial approaches for sustainable development.” The paper reflects a growing awareness of the need to take urban-rural linkages into account when addressing issues of nutrition. The paper takes as a point of departure a set of guiding principles for integrated territorial development recently developed through a multi-stakeholder process led by UN-HABITAT.
The authors sat down to answer questions about the paper, connections between the rural-urban continuum and food system transformation, and what’s needed to ensure nutrition actions reflect the importance of rural-urban linkages in order to enhance their positive impacts on nutrition outcomes in low- and middle-income countries.
Q: You operate from the premise that we must consider a rural to urban continuum, rather than thinking of these areas as separate entities. Why is that?
Florence Egal, Freelance: The distinctions between rural and urban are artificial – they mean different things in different places. We need to see rural and urban areas both within a functional territory approach.
James Garrett, Alliance of Bioversity International and CIAT/A4NH: Goods and services and livelihoods and resources are not contained within some predetermined-by-humans boundary . They are dynamic and flow across this rural-urban continuum. They are not contained within something called “rural limits” and something called “urban limits.” Even if you draw lines, there are different ways to talk about what those definitions are. This is also true of natural systems. And people moving around in these systems are becoming ever more connected.
Q: Many still view urban and rural areas separately. What are the risks of this misunderstanding for nutrition, of continuing to view rural and urban as either/or?
Stineke Oenema, UNSCN: In the paper, we tried to approach the issues from a nutritional point of view. Nutrition is multisectoral, with many dynamic aspects. If you only approach the issue from a strictly rural or strictly urban perspective, you lose out on some of the underlying dynamics – good or bad – and so part of the reason we wrote the paper was to help avoid that. We also wrote it as an effort to shake hands between the nutrition and urban/rural communities. To really make change happen, we need to get out there and engage with people we’ve never engaged with before.
Riccardo Grigoletto, Alliance of Bioversity International and CIAT/A4NH: From a geographer’s perspective, looking at territorial development, if you plan separately, you’re not really addressing the underlying causes and drivers connecting these areas. You run the risk of wasting time, resources, and investments.
FE: If more than 50 percent of people are living in cities, the way they feed themselves has an impact on the whole food system, not only because what they buy determines what is produced, but also because what they eat is seen as modern and fashionable in rural areas, drawing people away from what they’ve eaten for generations and towards urban diets which may not make sense.
Q: What will it take to correct this thinking?
Thomas Forster, UNSCN: The divide is deeply entrenched, in institutions, in policy, and in mindsets. All three need to change together, yet the entry points for each are different. Having a common framework is really important for working together on all three aspects. Institutions working in this area – directly or indirectly – need to have a language they can use to look at the issues in a more integrated way. Changing mindsets will be the most complicated. Understanding that there are functional urban-rural relationships that transcend those boundaries and that must be treated in a spatial, social and political context.
RG: Policymakers need to identify the real issues they want to tackle. There is complexity not only in food systems but also in the rural-urban continuum. Still, most of the underlying determinants of nutrition, of food security, of other issues are the same regardless of whether you’re in a rural or urban area. I think by looking at the real issue a policymaker would understand that these issues are valid across rural and urban contexts.
Q: Who are you trying to reach with your messages?
JG: Hopefully the paper will make these points clear to the urban planner – to say “Oh, if I am being tasked with improving food systems to create a sustainable systems for a healthy diet, I have to start dealing with rural planning and work with rural populations.” From the other side, agriculturalists and rural populations need to think, “With rural transformation, what is going on with food system development? It involves developing these more urban markets. We also have to reach those markets with healthy products.” We hope it also will help nutritionists understand there are different ways to look at the issues, particularly as we get into food systems, rather than just health sector delivery, and that nutrition has multi-sectoral causes, so what they are proposing in terms of policy or program solutions also must have this rural-urban dimension, particularly in terms of governance and implementation.
TF: One of the inspirations for the paper stems is that the nutrition content of the Guiding Principles and Framework for Action is not as deep as we would like to see. The thematic deepening of that shared framework is a very new “a-ha” moment. The UNSCN taking the lead on deepening the nutrition content is really about the operating toolbox going forward, and is one of the reasons for this paper’s importance.
Q: Food systems are complex, and so are rural-urban issues. To consider them together in the context of improving nutrition, where do policymakers start?
FE: They need to start with common sense, looking at territorial areas, and putting people around the same table to get at the problem and what we should do. The conversations need to be interinstitutional and intersectional, linking global, national, and local stakeholders.
SO: There are so many different food systems – urban, urban-rural, national, subnational, territorial – and they all link back to rural areas. To me, this paper has really added to the understanding that food systems are highly interrelated, particularly through the rural-urban continuum, and you shouldn’t try to take them apart. Policymakers should look at food systems as part of their planning, with urban-rural linkages as part of the system. I see them all as interlinked systems. The point we are making is to look at territorial systems and territorial development.
TF: It has to be brought down to Earth, though – you can’t deal with it abstractly. If we’re looking for sustainable diets from a climate and nutrition perspective, start with assessing and mapping the challenges and opportunities in their spatial, social and political contexts because otherwise it’s too complex for countries to take on. That takes time. This paper comes out of a nearly two-year process and conversation that got distilled into the guide for action.
Q: What is the importance of the relationship between national and subnational policy actors in addressing nutrition?
JG: You have to look at the flows and dynamics across the continuum. National policymakers need to recognize this and look to the subnational level to understand it. The concept we put forward in the paper of integrated territorial development is one way to bring these policy actors together.
RG: Local and sub-national policy actors and health and nutrition structures and institutions are critical – they are where the rubber meets the road, and this is what we see from our examples in the paper. Nutritional issues differ across contexts because of different characteristics, and a big lesson from our work is that these processes related to territorial approaches need to start at the sub-national and local levels. We highlight efficiencies where there are already multi-sectoral, multi-dimensional nutrition and food policy structures that are trying to connect the national level with subnational, local, and regional levels. We need to avoid rigid top-down approaches that are usually applied to policymaking. They often take into account global factors but miss local and regional experiences that are driving everything related to nutrition.
FE: It’s very important that those at the national level look at what happens subnationally, and to also think in terms not of nations, but of bioregions. These contexts cross borders, but currently you have geographic elements that matter to how people are trying to survive, overlaid with currencies and borders that wreak havoc when you’re trying to create sustainable food systems.
Q: How does policy development at this level support issues of equity, and ensure no one is left behind?
TF: What does no one left behind mean in this context? People have to be at the table – balanced, participatory decision making is critical. Agency is really critical, particularly for women, youth, farmers, and indigenous people, to be sure final decisions are made in concert with policymakers. Cities also need to be invited, and this includes smaller cities, but there’s not always a clear way to ensure they are brought into the conversations at the different levels. We’re not only grappling with data gaps, but also gaps in processes.
FE: Local policies, whether in urban or rural areas, should look at what to do about including people who are currently excluded from the economic development process.
TF: The rural can’t get out from under the boot of urban reality. Inequality and disparity are the conditions of most urban-rural relations worldwide. If we’re talking about resilient, inclusive and functional urban world territories that embrace sustainable diets in the context of the challenges of climate and biodiversity, this is the search for that entry point.
JG: If we talk about reaching everyone everywhere, we need to develop capacity to bring in those representing the rural spaces, too.
RG: We also need to leverage the power and influence of cities that are reflective of their peri-urban and rural areas, so they can bring those issues to the table for the big global conversations.
Q: What other actors or sectors have critical roles to play?
JG: Any time you’re thinking about a change process, you need to start by considering the problem. How do we understand the problem? Does everybody understand what the problem is? How do we make sure the right people are now going to be at the table? We can take the Guiding Principles and turn them into something that’s relevant for action in nutrition.
SO: This follows on the point about having people at the table – different aspects are housed in different ministries and depending on the context you might need to know more from agriculture, or health, or education. The underlying factors may be the same, but what you need can vary based on where you are and your specific context. Looking back at the origin of the paper, the principles include being locally grounded and human rights-based, having participatory engagement and integrated governance. If we follow that, we can make sure the right people are at the table to get meaningful participation and positive outcomes.
FE: Agriculture, education, environment – it’s all important. We need intersectoral cooperation and that’s not practical at present because that’s not how things have worked. Pooling resources would be useful, but that means giving up control, but as long as we have this competition, we won’t get anywhere. We need local authorities here to get these others to work together by saying what they need. This is true for ministries, but also for other sectors. Academia, the private sector, and civil society are all also important, but there are barriers to working across sectors. Unless we can start figuring out how to make them play like instruments in the same symphony, rather than a group of soloists, the competition will continue. The systems are not following common sense.
TF: It’s important to get to a place where there’s a feeling that people are going to be treated equally or inclusively as they move together. If you don’t have a trusted convener for the rural communities, and you just have the urban leading, you are failing before you start. You need the technologies of balance and participatory decision making. There is now a flurry of effort to create tool kits that are useful for bringing both together in a common assessment of their needs, challenges, priorities, and data gaps. Agency is really critical. Who are the final decision makers in concert with policymakers? Because the operational level is not done by policymakers. It’s done not even by the technical civil servants of local governments, which are under-capacity almost everywhere. It’s the private sector. It’s the NGOs. It’s the farmers’ movements, women, youth, indigenous communities. They’re the ones that need agency.
Q: What can researchers do to support those looking to improve nutrition along the rural-urban continuum? What data gaps exist and are critical to fill?
JG: The issue of what to do seems very important to move this forward, and that will require platforms to share and connect cities, rural areas, the nutrition community, and others, to figure out what’s being done, share experiences, find out what experiments are being used and evaluated, what has worked and what hasn’t. I don’t see this in the literature yet, and it’s hard to have conversations about how to move forward if we don’t have a documentation of experiences. Additionally, most of our examples are still emerging from state or city government. I am wondering where the rural sector is in this.
TF: We also need to improve the toolbox, to help policymakers know where to start.
FE: Researchers need to understand what is happening in the field and what local actors, including civil society and NGOs, are doing. We need to work together to validate and support, and to develop more practice-based evidence.
TF: The research needs also to include process research. Not only data gaps but also research on the processes working for a multi-level approach to integrating urban and rural with a nutrition focus.
Q: Every situation is unique. Are there lessons to be learned across experiences?
TF: One of the big blocks to moving forward is the difficulty of aligning ministries across sectors with a territorial approach. It’s typical that one sector, like agriculture, is “leaning over” the others, and that perspective or approach is something the other sectors need to buy into. Another emerging area of discourse related to this is how territorial approaches can be adopted at national levels without losing the agency of territorial actors, but the territorial approach is rare worldwide. Improvements will take time and investment and the right conveners – bringing interventions at the national level to city-region or territorial meetings. The country of Colombia is an interesting example, part of the peace process, with the principle of allowing self-grounded or locally crafted interventions coupled with deep participation so that territorial actors define their own territorial boundaries and then link them with administrative boundaries. And there are thousands of units, these very small administrative units that are brand new, that have been given the opportunity to have territorial plans.
FE: Every situation is unique, but if you’re trying to figure out in a given territory what food can be obtained, how we can get it and build on local cultures and traditions, how we can figure out what is missing and how to fill it in – those are similar experiences. There is a lot happening at the city-to-city level in sharing information and approaches already, and I believe we will learn a lot about how to operationalize the SDGs by looking at the interesting experiences at the territorial level. We need to start with local and build up to international, rather than deciding at international level and making it fit.
SO: Through the process of writing the paper, we got back some interesting examples of shared learning, but not many. However, as I talk to others outside the nutrition community, and especially among those working on rural-urban issues, I’m struck by two things: first, even if something doesn’t explicitly include nutrition to begin with, if you shift thinking just a little, you’re there. Second, the lessons are there to be learned, and people are interested and curious about them, about taking nutrition more into account. We’re still working on it, but I believe we’ll have many more examples soon. We can bring it this next step further and, with some more planning, we can identify those ways forward.
TF: There are already now stakeholder networks at multiple levels, within frameworks of local, regional and sub-national governments, and there are subsets of local authorities. There are new ways of working that pick up on ways networks of academics and NGO actors work, with demands from the cities directly. What Florence and I keep urging and urging is to bring the leading cities in at the very beginning on the discussions of nutrition interventions that are really very model interventions both in the global south and the global north and find out who is who institutionally, who their key allies are, a mix of academic, donor and social institutions. It’s a rethink of how we work with these networks, not creating a new network. We could have a benchmark for rethinking how these different levels work in multi-level integration.
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