The challenge of addressing workers malnutrition

In low and middle-income countries (LMICs), many farmers and industry workers are women who remain nutritionally at risk despite the income they earn. The risks include acute or chronic undernutrition, micronutrient deficiencies as well as overweight and obesity. Their diets tend to be monotonous, consisting largely of staple foods which often lack essential micronutrients. Employers can play a fundamental role in their employees’ lives by contributing to the improvement of their diets. If the model is replicated, employers millions of women, men, and children consume more healthy and nutritious foods. There are several factors that make workplace nutrition a unique entry point to improve diets in LMICs:

  • Fit with core business: Many companies recognize the importance of the general health and well-being of their employees. Some already go beyond paying a wage, improving working conditions and addressing broader socio-economic needs of workers and their families as part of their wider “licence to operate”. They do so by supporting education, employment or health facilities. Addressing workers’ nutrition can be done through existing worker management, company policies and/or systems.
  • Productivity, loyalty and bottom-line return: Improved diets and nutrient intakes result in better health. It has been proven that a better nutrition will reduce fatigue, increase energy levels and motivation at the workplace. From an employer’s point of view, this can be seen as a direct return on investment in which the employer will get higher productivity, reduced absenteeism and better health from employees.
  • Sustainability: The goal of sustainability in nutrition can be only be achieved if nutrition becomes part of companies HR and/or procurement systems.

Despite the scientific evidence about the relationship between nutrition and productivity[1][2][3][4][5][6], nutrition interventions in the workplace have not progressed or gained traction at the expected rate. We believe this is due to the fact that nutrition is technically challenging – even large multinational companies have required nutrition advice on appropriate interventions that are impactful, cost-efficient and can be integrated into their daily operations. In many cases throughout the industrial sector, enterprises have small workforces, or employment is outsourced (e.g. cocoa supply chain), making improving nutrition even more challenging.    

[1] Edgerton, V.R., et al., Iron-deficiency (1979) Anemia and Its Effect on Worker Productivity and Activity Patterns. British Medical Journal. 1979, 2:1546-1549.
[2] Basta, S, Karyadi D, Scrimshaw NS (1979). Iron deficiency anemia and productivity of adult males in Indonesia. Am J Clin Nutr 32:916-925.
[3] Li, Ruowei, et al (1994)., Functional Consequences of Iron Supplementation in Iron-deficient Female Cotton Mill Workers in Beijing, China. American Journal of Clinical Nutrition, 1994, 59: 908-913.
[4] Scholz BD, Gross R, Schultink W, Sastroamidjojo S (1997). Anemia is associated with reduced productivity of women workers even in less-physically-strenous tasks. British J of Nutrition (1997), 77:47-57.
[5] Untoro J, Gross R, Schultink W, Sediaoetama (1998). The association between BMI and hemoglobin and work productivity among Indonesia female workers. Eur J Clinical Nutrition 52: 131-135.
[6] Haas, Jere D., and Brownlie, Thomas IV (2001), Iron Deficiency and Reduced Work Capacity: A Critical Review of the Research to Determine a Causal Relationship. American Society for Nutritional Sciences. 2001, 131:676S-690S.

GAIN’s contribution

Lessons learned

During the period 2014-2017, GAIN and partners have piloted a number of workplace projects in the garment, tea and horticulture industries Bangladesh, India, Indonesia, Kenya and Malawi. These projects provide some early lessons:

  • The range of potential interventions is large. In order to select a suitable set of interventions, some tailoring is required.
  • The approach should be kept as simple and concise as possible. Cost per worker/farmer is a critical success factor for scalability and sustainability.
  • In large industries, such as tea or garments, tailor-made projects serve as demonstration models how to implement workplace nutrition. However, in more fragmented industries (e.g. horticulture), smaller companies cannot afford to pay for a technical assistance partner to tailor programs to their needs. Hence, our aspirations to ultimately develop a “Do-it-yourself toolkit” approach for nutrition at the workplace.
  • There is a need to conceptualise metrics and outcomes relevant to the malnutrition burden. The aim is to generate robust data on a range of metrics, including productivity, absenteeism and/or loyalty.
  • Advocacy mechanisms could draw on evidence of impact on worker wellbeing, health and productivity as well as successful demonstration projects.

What We Work On

GAIN and its partners continue the collaboration with the garment and tea industries to implement, develop and consolidate interventions to improve nutrition of worker populations. We are also focusing on the cocoa industry, as a case study of how the workforce nutrition approach can work in large agricultural commodity industries characterised by decentralised workforce structures. Furthermore, GAIN will test the feasibility for a “Do-it-yourself toolkit” approach. An important part of the Workplace Nutrition program is building from the lessons learned and testing the model repeatedly. Sharing this knowledge with interested stakeholders and potential partners is also essential to the program. Learnings will be captured cross-industry as well as cross-country. They will be shared via events, publications and through organizing global expert and global learning workshops. Furthermore, we will study how investments into nutrition programs may result in a direct business benefit for the private sector. The entire pool of industry projects in a variety of settings will generate the evidence and practical know-how to support advocacy for further roll-out in many more countries and industries.

Our main goals include:

  • We can demonstrate that diets of worker/farmer households improve through workplace nutrition interventions pilot projects that diets of worker / farmer households improve.
  • Policies on workplace nutrition are adopted by Ministries of Industry, Agriculture and Labour.
  • Workplace nutrition interventions are included in the Code of Conduct of industries, national business associations and/or individual businesses.
  • Businesses invest in nutrition interventions to improve diets of worker / farmer households.