Nutrition-Sensitive Agriculture: A Systematic Review of Impact Pathways to Nutrition Outcomes

Research output: Contribution to JournalArticleAcademicpeer-review


The role of agriculture in reducing undernutrition is widely recognized, yet there is also consensus on the need to make the sector nutrition-sensitive. Evidence on the impact pathways from nutrition-sensitive agriculture (NSA) interventions, agricultural interventions with specific nutrition objectives, and actions detailing each temporal stage to reach nutrition outcomes is limited, however. We thus synthesized study results regarding impact of NSA interventions on nutrition outcomes relating to undernutrition, and constructed an impact pathway by mapping the evidence on each temporal stage from interventions to nutrition outcomes. We used Preferred Reporting Items for Systematic Reviews and Meta-Analyses to conduct and report our systematic review of studies on NSA interventions implemented in low- and lower-middle-income countries. Forty-three studies that met the inclusion criteria were extracted and synthesized across impact and pathways analyses. We carried out a thematic analysis of the effect of NSA interventions using evidence-based indicators and constructed the pathways by adopting a published framework on agriculture to nutrition pathways. Our findings reveal that NSA interventions can significantly improve dietary practices, and have the potential to enhance care practices and reduce occurrence of diseases, indicating their effectiveness in simultaneously addressing multiple determinants of undernutrition. However, NSA interventions have a lesser impact on nutritional status. NSA interventions lead to nutrition outcomes through 5 key pathways: food production, nutrition-related knowledge, agricultural income, women's empowerment, and strengthening of local institutions. We emphasize the need to carefully design, implement, and evaluate interventions with consideration for factors affecting impact pathways. Future research should focus on the effect of interventions combining multisector components, and pathways through non-food-production-related income, women's empowerment, strengthening of local institutions, food prices at intervention level, and expenditure on health care.
Original languageEnglish
Pages (from-to)251-275
Number of pages25
JournalAdvances in Nutrition
Issue number1
Early online date24 Sept 2020
Publication statusPublished - Jan 2021

Bibliographical note

Publisher Copyright:
© The Author(s) 2020. Published by Oxford University Press on behalf of the American Society for Nutrition.

This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine


This systematic review is part of the first and second authors'PhD research; IKS is supported by the Erasmus Mundus Joint Doctorate Programme and SDP by the Netherlands Organization for Scientific Research.

FundersFunder number
Nederlandse Organisatie voor Wetenschappelijk Onderzoek


    • diet
    • food
    • impact
    • low- and middle-income countries
    • multisector nutrition
    • nutrition education
    • nutrition-sensitive interventions
    • pathway
    • systematic review
    • undernutrition


    Dive into the research topics of 'Nutrition-Sensitive Agriculture: A Systematic Review of Impact Pathways to Nutrition Outcomes'. Together they form a unique fingerprint.

    Cite this