Translating GeoNutrition (TGN): Reducing mineral micronutrient deficiencies (MMNDs) in Zimbabwe

Lead Research Organisation: University of Nottingham
Department Name: Sch of Biosciences

Abstract

Mineral micronutrient deficiencies (MMNDs) remain a global challenge affecting the growth, development, health, and livelihoods of more than 2 billion people. MMNDs are especially prevalent in Low Income Countries of sub Saharan Africa (SSA) and South Asia. Women and children are at particular risk of MMNDs due to unequal access to nutrient-rich foods within the home. Constraints to reducing MMNDs, especially in SSA, include: (1) baseline data on the distribution of MMNDs, especially within a country; (2) national research capacity to get the information needed to provide a sound evidence base, and potential solutions, for policy makers, private sector investors, and other interested parties (citizens, donors, public health professionals).

We have built up substantial knowledge on how to approach this challenge based on ongoing research, and lessons learned, from an existing portfolio of Global Challenge Research Fund (GCRF, and other ODA and institutional) funding, which seeks to, (1) reduce the impact of MMNDs by understanding local nutrition from the soil through to the person via complex food systems pathways (a 'GeoNutrition' approach), and (2) strengthen research capacity in SSA.

The work will be undertaken with partners in Zimbabwe, where >50% of the population are affected by MMNDs. The Government of Zimbabwe (GoZ) plans to embed a full MMND survey in a wider health survey in 2020/21. There is therefore a window of opportunity for impact by: (1) informing the design of this GoZ survey, specifically by translating GCRF-funded 'GeoNutrition' research findings from Malawi, and (2) promoting new policy and commercialisation pathways through research capacity strengthening. This project has the highest-level support from the GoZ, including from the Ministry of Health and Child Care, and the Ministry of Higher Education. The project has been co-designed with the University of Zimbabwe (UZ).

Translating GeoNutrition Aims:
1. To co-design a national surveillance programme to establish baseline MMNDs in Zimbabwe
2. To improve institutional and individual research capacity in Zimbabwe, including to test policy interventions for alleviating MMNDs and to promote private sector engagement

Aim 1 will be delivered through activities in two (parallel) Work Packages (WPs), linking the Nutrition (WP1) and Agriculture (WP2) sectors. These can be scaled up as required.

WP1: Biomarker Survey Pilot, to support mapping of MMNDs, and to inform the design of the full MMND surveillance programme. The activity sequence includes: (i) design, (ii) area selection, (iii) data sharing, (iv) ethical approvals, (v) training and sensitisation, (vi) logistics/risk assessments, (vii) sample collection and processing (blood, urine), (viii) storage/shipping, (ix) lab. analyses, (x) data management, (xi) data analyses, (xii) communication.

WP2: Agricultural Survey, to link agriculture and nutritional policies, by mapping parts of the Food Systems which affect MMNDs, and to identify new market opportunities. Activities include those described above, with sample collection focusing on soils and crops.

Aim 2 will be delivered via WP3, which will be designed to include interim and final evaluations, within a Theory of Change. Of particular focus will be improving skills in data management, statistics, ethics, lab. analyses, finance systems, Higher Education curriculum development, and training-of-trainer (ToT) systems. An important component of research capacity strengthening is how research cultures and systems are developed; what works, for whom, when, and why, including how gender and social inclusion strategies are operationalised. Beyond the award, we shall use institute investment to co-develop a joint PhD programme between UoN and UZ, based on new UoN/Malawi models, which shall help to incentivise private sector engagement in the food, nutrition, and agri-services sectors.

Planned Impact

The primary intended beneficiaries of impact from this work are populations living with the multiple burdens arising from chronic mineral micronutrient deficiencies (MMNDs) in sub-Saharan Africa (SSA). Our translation award focuses on Zimbabwe, where >50% of the population are estimated to be affected by MMNDs based on proxy date (e.g. anaemia, stunting). A successful translation of research via this award would include the delivery of an economic, effective and efficient ('3Es') micronutrient surveillance programme design for the Government of Zimbabwe (GoZ). This would enable - for the first time - the GoZ to make reliable estimate of baseline MMNDs which is essential for effective policy making, including the prioritisation of potential interventions, and private sector investment. By building on specific research activities in Malawi, and by including Malawi partners in this translation project, we are looking at wider regional potential benefits in the short-to-medium term.

We contend that a major constraint to the alleviation of MMNDs in SSA is a lack of research capacity in national institutions (Higher Education and Government Research Organisations). By embedding a research capacity strengthening component to this translation activity, and guided by a Theory of Change and robust evaluation framework, we shall directly benefit research institutions in Zimbabwe to sustain impact. This component of the project includes consideration of multiple levels of agency, including students, research support staff, academics, and technical specialists, working together with institute-level leaders.

This project has the highest-level support from the GoZ, including Permanent Secretary and Ministerial letters of support, from the Ministry of Health and Child Care, and the Ministry of Higher Education, respectively.

By strengthening UK-Zimbabwe relationships, at both institute and individual levels, there is the potential to secure wider benefits in terms of global prosperity and stability. One specific example of how we plan to contribute to this wider agenda is through extending a joint PhD programme, based on fee-sharing and common aspirations, as developed previously between UoN and LUANAR in Malawi. There are currently fewer than 50 researchers per million population (according to Frascati Definitions, including PhD students) based in most countries in SSA, including Malawi and Zimbabwe, compared to >4000 in the UK. Yet there a pressing need to develop evidence in SSA to support progress towards the Sustainable Development Goals by 2030 as we embrace a period of rapid population growth (Africa's Demographic Dividend) and environmental change over the coming decades.

Publications

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Manzeke-Kangara M (2021) Good soil management can reduce dietary zinc deficiency in Zimbabwe in CABI Agriculture and Bioscience

 
Description Translating GeoNutrition (TGN): Reducing mineral micronutrient deficiencies (MMNDs) in Zimbabwe
Amount £813,300 (GBP)
Funding ID EP/T015667/1 
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 09/2019 
End 03/2021
 
Description Zimbabwe National Statistics Agency (ZIMSTAT): Household Enumerations to Support Survey Work 
Organisation Zimbabwe National Statistics Agency (ZIMSTAT)
Country Zimbabwe 
Sector Public 
PI Contribution New collaborations with the Zimbabwe National Statistics Agency (ZIMSTAT) were established to support the project with household listing in eight Districts in Zimbabwe. The University of Zimbabwe (UZ) team in the Faculty of Science and Faculty of Agriculture established links with ZIMSTAT and ensured collaborative agreements between UZ, the University of Nottingham (UoN) and ZIMSTAT were signed. Dr Kangara assisted with organizing a pre-planning meeting between the UoN team (led by Professor R.M. Lark) and the ZIMSTAT statistician assigned to the project. The UZ team contributed to in field work during the household listing exercise and ensuring all files were sent to the wider project team. Constant updates from UZ were provided to the wider team during weekly update meetings.
Collaborator Contribution ZIMSTAT was responsible for conducting the household listing exercise in eight Districts in Zimbabwe. Shape files (for GIS mapping) from this exercise were shared by ZIMSTAT to the wider project team. The household listing exercise will support the team to conduct household and agricultural surveys (i.e. sampling) in the respective districts in 2021.
Impact The outputs and outcomes will be delivered following biomarker and agricultural surveys, to be completed in 2021.
Start Year 2020
 
Description Zimbabwe Council for Higher Education (ZIMCHE): Doctoral Training Landscape in Zimbabwe 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact New collaborations with the Zimbabwe Council for Higher Education (ZIMCHE) were established to evaluate Doctoral training programmes in >10 universities in Zimbabwe. The evaluation is led by the University of Nottingham's School of Education with Zimbabwe-lead from ZIMCHE. Dr Kangara was part of the inception meeting which introduced the project to the Chief Executive Officer (CEO) and Deputy CEO of ZimCHE. She supported the School of Education team (led by Dr Juliet Thondhlana and Dr Kamel Mansi) with developing questionnaires to interview different participants (including Quality Assurance Directors, Research Directors, supervisors and students) on current doctoral training programs in Zimbabwe. A stakeholder event was completed in November 2021 to discuss outcomes of the evaluation, which was attended by all 10 institutions and policy makers. A draft green paper has been prepared and an accompanying academic paper will be submitted in Q2 2022.

ZIMCHE's roles include establishing links between the University of Nottingham and the 10 Universities where the interviews are being conducted. ZIMCHE (through the former Deputy Director-Dr Evelyn Garwe) is also involved in conducting interviews with Directors and Vice Chancellors in the 10 Universities with support from Dr Thondhlana.
Year(s) Of Engagement Activity 2020,2021