Globally, deaths attributable to poor diet have grown by 15 per cent since 2010, more rapidly than population growth. Poor diet comprises lack of optimal amount of food and nutrients in the plate, leading to malnourishment. One in three people suffers from at least one type of malnutrition, worldwide. We shall decipher the role of ’Workforce Nutrition’ programmes by the private sector and how it can benefit both employees and employers, with employees experiencing increased job satisfaction, reduced sick days, increased wage earnings, as well as higher consumption of healthy foods and better health.
In the context of India, 15.3 per cent of the population is undernourished, 24 per cent women and 22.9 per cent men are obese, and more than 57 per cent of women suffer from iron-deficiency anaemia, making malnutrition a public health challenge. Apart from this, more than 12 million deaths in adults are caused due to diet-related non-communicable diseases, globally. In India alone, non-communicable diseases cause 65.9 per cent of total deaths.
Malnutrition has consequences beyond individuals’ health and wellbeing and can negatively impact the economic potential of nations. A recent report by Chatham House reveals that malnutrition could be costing low and middle-income countries over $850 billion annually through loss in productivity. A similar study in 19 countries estimates that $8-38 billion per year is lost from reduced worker productivity due to employees being underweight, and $4-27 billion per year due to obesity.
The problem of poor nutrition is complex, encompassing lack of diversity and awareness about food, inadequate food intake, affordability, accessibility to nutritious food, and underlying factors related to poor water and sanitation. More recently, the COVID-19 pandemic has further added to these existing challenges. The partial or total national lockdowns severely affected the population working in small and medium-sized companies, and low-wage workers in the informal sector who had limited access to safety nets. Evidence around disruptions of the food supply chain during the pandemics shows that providing food security to the poor was a challenge. A survey of 12 states in India found that many households reduced the number of items in a meal and the overall number of meals in a day. Reports also indicated that rural India was already eating less food and less nutritious food. Failure to provide these basic nutritional intake to the vulnerable population results in failure to achieve the recommended daily levels of micronutrients leading to impaired performance, reduced productivity and absenteeism from work.
Role of private sector
While nations around the world continue their effort to combat malnutrition, there are opportunities for the private sector to play a catalytic role in sustaining a healthy and thriving workforce. Given that most of the working-age population will eat at least one meal a day at work; access to nutritious food in work settings is often inadequate – a missed opportunity given the strong connection between health, nutrition, and productivity. Private sector investment in human capital through workforce nutrition-sensitive programmes can not only reap benefits for employers but also impact national economies and global public health.
’Workforce Nutrition’, as defined by the Global Alliance for Improved Nutrition (GAIN), refers to a set of interventions that work through the existing structures of the workplace to address fundamental aspects of nutrition amongst employees and/or supply chain workers. These programmes aim to create improved access to, and demand for safe and nutritious food. Breastfeeding support programmes are included in this definition. Traditionally, governments have been accountable for taking initiatives and addressing health and nutrition issues. Workforce nutrition programmes by the private sector can benefit both employees and employers, with employees experiencing increased job satisfaction, reduced sick days, increased wage earnings, as well as higher consumption of healthy foods and better health. Businesses gain benefits in the form of reduced absenteeism, enhanced productivity, lower rates of accidents and mistakes, and improved brand reputation. Workforce nutrition programmes are cost-effective and straightforward to implement, fitting well with existing business structures and providing a high return on investment.
Nutrition-sensitive programmes
A global review of workforce nutrition initiatives found that businesses and employers have implemented nutrition-sensitive programmes in the following four broad areas:
- Creation of access to safe and nutritious foods within the work environments through the introduction of healthy food at work. Employers provide healthy food for free, with subsidies, or at full cost to employees.
- Generation of demand and behaviour change for healthier diets through the introduction of nutrition education programmes focused on changing attitudes and behaviour. Nutrition-sensitive communication strategies have been enabled to generate awareness.
- Provided the opportunity to access nutrition-focused health checks and counselling where relevant. This helped in the prevention of non-communicable diseases and aided employees to understand their health, nutritional risk factors, and lifestyle changes.
- Promotion of breastfeeding support to allow working parents to provide adequate nutrition to their infants and ensure the development of supportive environments for women employees catering.
The focus by ‘Workforce Nutrition’ programmes on introducing healthy food at work to increase access to nutrition at work, behaviour change interventions, nutrition-focused health checks, and supporting working mothers to optimally breastfeed, is an important aspect of workplace food systems that can have a positive on employees’ health and simultaneous positive business outcomes. The scientific evidence of the present systematic review shows that it is possible to positively influence work-related outcomes, especially absenteeism, through health promotion efforts.
Success in tackling malnutrition in all its forms can have a multiplier effect at both household and economic levels, improving health, boosting consumer incomes, and stimulating economic development. A recent World Bank analysis estimated that every $1 invested in interventions to meet the World Health Assembly nutrition targets would yield an economic return of between $4 and $35.
Awareness, access and consumption
At GAIN, the Workforce Nutrition programme is being implemented across four countries: India, Kenya, Bangladesh, and Malawi, catering to workers involved in the tea sector and garment factories. In India, the programme is tailored to improve the awareness, access, and consumption of nutritious food amongst tea estate workers and their families through behaviour change communication (BCC) interventions and market-based supply-chain interventions. The first phase of the programme has shown promising results with an increase in minimum dietary diversity by 15-24 per cent among farmers and tea estate workers, especially women, and improvement in knowledge about healthier diets among workers in Assam. Additionally, despite a nationwide COVID-19 lockdown, the market supply chain model in tea estates sustained its operations and expanded its range of nutritious food products to support the consumption of regular food among the tea estate families at the most difficult of times. The monthly order value of products by retailers, which started with Rs 7,400 in September 2019 increased to Rs 6,70,540 in September 2021 even after COVID-19 restrictions. This implies that both awareness and access resulted in increased consumption of nutritious food products such as fortified cooking oil, pulses, eggs, vegetables, etc which were less consumed previously.
Workforce nutrition policies and programmes need not be just one-off employee welfare activities, but an integral part of the sustainable business practices of the organisations. From an employer’s perspective, these programmes represent an investment in the well-being of employees and a win-win opportunity for the businesses and workers, due to its potential to increase productivity and revenue, positively impact worker health, and additionally contribute to attainment of the overall nutritional goals of the country.
Tarun Vij, Country Director, Global Alliance for Improved Nutrition (GAIN)