The challenge of addressing workers malnutrition

One in three people globally suffers from at least one type of malnutrition. 2 billion people lack key micronutrients, like iron and vitamin A, which are needed to grow properly, live active lives, and raise a healthy family. Malnutrition brings significant losses in productivity and potential, and poses challenges to employers in both high and low-income settings. Given that 58% of the world’s population will spend one third of their time at work during their adult life, occupational health is a critical determinant of overall well-being. The workplace – whether in urban or rural, high or low-income, corporate or supply chain settings – offers unique opportunities to address malnutrition.

A good proportion of workers are also women, which means they also have additional nutrient requirements – especially during pregnancy and while breastfeeding. Moreover, women may be subject to lower pay and are often responsible for the health and diets of their households.

GAIN believes that employers can play a fundamental role in their employees’ lives by contributing to the improvement of their diets, ideally as part of a broader approach to worker well-being and promotion of healthy lifestyles. Workplace programmes also allow reaching the employed sector of a population, individuals on whom many household members rely economically.

Employers benefit from effective workplace nutrition programmes. Long-standing evidence on the relationship between nutrition improvements and productivity exist. Iron deficiency[1][2][3], low or high body mass indices[4], and hypoglycaemia (from skipped meals)[5] all have been shown to lower work capacity or productivity. Providing healthy and varied food choices at work has been shown to be effective at reducing the risk of non-communicable diseases. Healthy food at work also provides enough energy and nutrients to perform tasks[6][7][8]. This reduces the rate of accidents and absenteeism, increases productivity, and decreases mistakes[3][4]. While evidence is still lacking on concrete return on investment, one study has shown a return of 6:1 on workplace health programmes – not specific to nutrition only – through savings in healthcare costs, productivity, employee retention and reduced absenteeism.[9]


[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] 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. 77:47-57.
[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. 59: 908-913.
[4] 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.
[5] Sommerfield AJ, Deary IJ, McAulay V, Frier BM. (2003). Moderate hypoglycemia impairs multiple memory functions in healthy adults. Neuropsychology. 17(1):125-32.
[6] Bezerra IW, Oliveira AG, Pinheiro LG, Morais CM, Sampaio LM (2017). Evaluation of the nutritional status of workers of transformation industries adherent to the Brazilian Workers’ Food Program. A comparative study. PLoS One. 12:e0171821.
[7] Wanjek C (2005) Food at work: workplace solutions for malnutrition, obesity and chronic diseases. Geneva, International Labour Office.
[8] Roberts N, Banerjee J, Smofsky A (2013) Wellness for a global workforce. Workplace wellness initiatives in low and middle-income countries. GBC Health and Sentinel Consulting.
[9]Berry LL, Mirabito AM, Baun WB (2010). What’s the hard return on employee wellness programs? Harvard Business Review. 88:104-112, 142.

GAIN’s contribution

Since 2013, GAIN has built its experience in workplace nutrition programmes in the garment, tea and cocoa sectors in countries across Africa and Asia, partnering with companies such as ECOM, Ferrero, Hershey, Kenya Tea Development Agency (KTDA), Lindt, Touton and Unilever. The Sustainable Trade Initiative (IDH), the Ministry of Foreign Affairs of the Netherlands, and the UK Department for International Development (DFID) have been our public sectors partners in this programme. Co-funded by the Ministry of Foreign Affairs of the Netherlands, the programme is currently implemented in the tea sector (India, Kenya, Malawi, and Tanzania), in the garment sector (Bangladesh) and in the cocoa sector (Ghana), targeting workers, farmers and their families. In Mozambique, the programme will be implemented in several sectors, with funding from the UK Department for International Development (DFID).

To date, GAIN’s Workforce Nutrition programme has reached over 133,000 workers, smallholder farmers and their families. Current programmes aim to reach another 99,600 workers, smallholder farmers and their families by 2020.

Over the next few years, GAIN hopes to generate much needed learning on how to implement cost effective and feasible workplace nutrition models across various sectors. In doing so, we hope to build a business case for improving nutrition at the workplace, to spark investment and strengthen our advocacy for sector transformation.

What We Work On

GAIN’s Workforce Nutrition programme focuses on improving workers’ access to – and demand for – healthier diets, using existing business structures. We prioritise improving access to healthy foods at work and providing nutrition education. We work with businesses to refine and develop programme models that are feasible, cost-effective, have the potential for impact, and can be integrated in the day-to-day operations of supply chains.

Our programme works through a variety of channels:

  • the provision of healthy food at work;
  • innovative strategies to improve rural markets for nutritious and safe foods;
  • creating demand for healthier diets through messaging and communication alongside our programme.

Our measure of success is the consumption of better diets. We are constantly enhancing our programme in order to identify – and implement – the most effective ways to improve diets.

Tea sector

We have developed much of our learning in the tea sector, where we have piloted several tea workforce programmes since 2013 in Kenya, India, Indonesia, Malawi, and Tanzania, with funding from the Ministry of Foreign Affairs of the Netherlands, the Sustainable Trade Initiative (IDH) and Unilever. Our latest pilot programme, called “Seeds of Prosperity”, worked through tea supply chains to improve workers’ diets and hygiene practices in India (Assam and Tamil Nadu), Kenya and Tanzania and reached over 71,000 estate workers, smallholder farmers and their families. GAIN is currently strengthening the design of the Seeds of Prosperity approach and aims to reach another 65,000 estate workers, smallholder farmers and their families in India (Assam) and Kenya by 2020. The expansion is funded by the Ministry of Foreign Affairs of the Netherlands. In Kenya, we are also partnering with the Kenya Tea Development Agency (KTDA).

Garment sector

In 2014, GAIN started its efforts in the garment sector in Bangladesh. This intervention significantly reduced the level of anaemia by improving lunches with fortified rice and providing iron and folic acid supplementation. Building on these efforts and with funding from the Ministry of Foreign Affairs of the Netherlands, we aim to contribute to healthier diets of over 20,000 garment workers by improving the ongoing food provision (by factories) and consumption (by workers) of nutritious and safe foods.

Cocoa sector

In the cocoa sector, GAIN has been working with programme partners in Ghana to design and prototype nutrition interventions that can be delivered through the existing private sector linkages within cocoa-growing communities. The objective is to find a model that will improve nutrition outcomes and that can be scaled up. In this programme, GAIN is partnering with ECOM, Hershey, Lindt, Touton and Ferrero to improve diet quality of smallholder farmers in their supply chains. GAIN aims to reach 9,000 people in cocoa farmer communities through interventions aimed at increasing both demand and access to nutritious foods. In some cases, partners have also chosen to include elements of maternal and child nutrition and/or water and sanitation.


In this section, you will find more information about the benefits of workforce nutrition.

Programme and evidence briefs


Get involved

If you would like to get involved in our workforce nutrition programme, please contact us.