<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article  PUBLIC "-//NLM//DTD Journal Publishing DTD v3.0 20080202//EN" "http://dtd.nlm.nih.gov/publishing/3.0/journalpublishing3.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="3.0" xml:lang="en" article-type="research article"><front><journal-meta><journal-id journal-id-type="publisher-id">AS</journal-id><journal-title-group><journal-title>Agricultural Sciences</journal-title></journal-title-group><issn pub-type="epub">2156-8553</issn><publisher><publisher-name>Scientific Research Publishing</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.4236/as.2022.137055</article-id><article-id pub-id-type="publisher-id">AS-118762</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Biomedical&amp;Life Sciences</subject><subject> Earth&amp;Environmental Sciences</subject></subj-group></article-categories><title-group><article-title>
 
 
  Linkages between Agricultural Diversification, Dietary Diversity, and Nutrition Outcomes in Sub-Saharan Africa: A Systematic Review
 
</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Sidney</surname><given-names>Lulanga</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Pamela</surname><given-names>A. Marinda</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Christopher</surname><given-names>Khayeka-Wandabwa</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib></contrib-group><aff id="aff2"><addr-line>Department of Food Science and Nutrition, School of Agricultural Sciences, University of Zambia, Lusaka, Zambia</addr-line></aff><aff id="aff3"><addr-line>School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, Tianjin, China</addr-line></aff><aff id="aff1"><addr-line>School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia</addr-line></aff><pub-date pub-type="epub"><day>01</day><month>07</month><year>2022</year></pub-date><volume>13</volume><issue>07</issue><fpage>879</fpage><lpage>896</lpage><history><date date-type="received"><day>22,</day>	<month>April</month>	<year>2022</year></date><date date-type="rev-recd"><day>24,</day>	<month>July</month>	<year>2022</year>	</date><date date-type="accepted"><day>27,</day>	<month>July</month>	<year>2022</year></date></history><permissions><copyright-statement>&#169; Copyright  2014 by authors and Scientific Research Publishing Inc. </copyright-statement><copyright-year>2014</copyright-year><license><license-p>This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/</license-p></license></permissions><abstract><p>
 
 
  An enabling policy environment and good governance are fundamental drivers for agriculture and food systems, framing how they work and for whom in the global efforts to achieve Sustainable Development Goal 2 and food justice for all. The review examined the policy environment in sub-Saharan Africa in relation to linkages between agricultural diversification, dietary diversity, and nutrition. The systematic review of literature entailed searching Ovid MEDLINE, PubMed, Embase, African Journals Online and PsychINFO databases from Jan 1, 2010, to Feb 30, 2021, for eligible studies and technical reports. Publications reporting on agricultural diversification, dietary diversity, and nutrition outcomes in relation to policy environment were included. Qualitative synthesis of the abstracted evidence was conducted. SSA countries recognise the crucial role of agricultural diversification as a pathway to achieving food security with increasing emphasis on smallholder farmers. There is a rich base of policies that are complemented by lived experiences and best practices which can strengthen linkages between agricultural diversification, agribusiness and dietary diversity. For instance, the application of precision farming, agro-ecological zones targeted agricultural intensification and gender sensitive land administration, access and tenure in countries experiencing declining farm size could potentially ensure the youth, men and women have equitable and innovative opportunities of access to elements of improved agricultural systems. Smallholder farmers with the majority in rural settings, maintain 
  <em>de facto</em> agricultural diversity. It is essential for any policy design or intervention to take into account the specific country’s context; pay particular attention to socioeconomic capabilities of the rural population along with fiscal capacity and trade-offs. Empirical evidence on the nexus between agricultural diversification and nutrition is mixed and limited.
 
</p></abstract><kwd-group><kwd>Agricultural Diversification</kwd><kwd> Dietary Diversity</kwd><kwd> Sub-Saharan Africa</kwd><kwd> Policy</kwd><kwd> Nutrition</kwd></kwd-group></article-meta></front><body><sec id="s1"><title>1. Introduction</title><p>Since the 1980s, a better understanding of the prospective pathways linking agriculture and nutrition has led to a noteworthy increase in research on the design, feasibility and impact of nutrition-sensitive agricultural interventions. These interventions have aimed at improving the underlying determinants of nutrition outcomes through targeting dietary diversity and quality, household food security, small-farm production and income empowerment [<xref ref-type="bibr" rid="scirp.118762-ref1">1</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref2">2</xref>]. In September 2015, the United Nations general assembly adopted the 2030 agenda for Sustainable Development which entails 17 Sustainable Development Goals (SDGs). The second SDG, on zero hunger, focuses on ending hunger, achieving food security and improving nutrition and promoting sustainable agriculture [<xref ref-type="bibr" rid="scirp.118762-ref3">3</xref>]. In line with SDGs 1 and 2, when appropriately interlinked, agricultural diversification and dietary diversity constitute a common galvanizing approach to attaining food and nutrition security [<xref ref-type="bibr" rid="scirp.118762-ref3">3</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref4">4</xref>].</p><p>It is estimated that ~795 million people suffer from undernutrition globally [<xref ref-type="bibr" rid="scirp.118762-ref5">5</xref>] with ~780 million of these living in developing nations [<xref ref-type="bibr" rid="scirp.118762-ref6">6</xref>]. Moreover, about 2 billion people suffer from low intakes of vitamins and minerals such as iron and zinc [<xref ref-type="bibr" rid="scirp.118762-ref7">7</xref>]; these nutritional deficiencies are a result of low food quantities consumed and/or poor dietary quality. Thus, it is envisioned that diversified agricultural production is likely to provide a wide range of different types of foods to the most vulnerable population segments [<xref ref-type="bibr" rid="scirp.118762-ref8">8</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref9">9</xref>]. In SSA, by 2018 about 237 million people were undernourished [<xref ref-type="bibr" rid="scirp.118762-ref10">10</xref>]. Organizations including the World Health Organization (WHO), the Food and Agriculture Organization (FAO) of the United Nations, the Consultative Group on International Agricultural Research (CGIAR) and HarvestPlus have advocated for dietary diversity strategies to tackle the burden of micronutrient malnutrition [<xref ref-type="bibr" rid="scirp.118762-ref11">11</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref12">12</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref13">13</xref>]. This is driven by empirical evidence which suggests that dietary diversity is a proxy of diet quality and the consumption of a variety of foods across and within food groups and across different varieties of specific foods is a precondition for adequate intake of essential nutrients [<xref ref-type="bibr" rid="scirp.118762-ref14">14</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref15">15</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref16">16</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref17">17</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref18">18</xref>].</p><p>While undernutrition and low dietary diversity remain big problems in many developing countries [<xref ref-type="bibr" rid="scirp.118762-ref5">5</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref6">6</xref>]; a large proportion of the people affected are smallholder farmers. Therefore, it is often presumed that further diversifying small-farm production would be a good strategy to improve nutrition, but the evidence is mixed. Moreover, the interplay between an enabling policy environment and research evidence on the potential impact of interventions in agriculture on nutrition outcomes is of particular relevance in sub-Saharan Africa context where agriculture-related activities are a major source of livelihoods for majority of the population, and where malnutrition afflicts a high proportion of the population. To this end, the review seeks to evaluate the linkages between agricultural diversification, dietary diversity, and nutrition outcomes with a focus on; examining how different agricultural diversification policies and dietary diversity affect or impact on nutrition outcomes and identify factors that influence the magnitude of this relationship. Second, the insights aim to demonstrate the critical role of policy in guiding the structural transformation in agriculture to help realize multiple goals, including the affordability and availability of diverse food supply, safe and high quality diets, and rural income growth, especially for vulnerable groups like women and children. Thirdly, we present policy implications for addressing challenges associated with malnutrition in SSA.</p></sec><sec id="s2"><title>2. Methods</title><sec id="s2_1"><title>2.1. Search Strategy</title><p>An extensive search of numerous sources was conducted to ensure an unbiased sample of both published and grey literature for the period Jan 1, 2010, to Feb 30, 2021. The timeline was purposely chosen as it represents an overlap between the last five years phase of Millennium Development Goals (MDGS) implementation and the first phase of Sustainable Development Goals (SDGS) which provides a desirable comprehensive transition interphase in terms of policies and strategic plans appraisal, re-formulation or formulation while addressing unfinished agenda with the shift to SDGs [<xref ref-type="bibr" rid="scirp.118762-ref3">3</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref4">4</xref>]. The method used adopted guidelines on preferred reporting for systematic reviews [<xref ref-type="bibr" rid="scirp.118762-ref19">19</xref>] and the Cochrane principles [<xref ref-type="bibr" rid="scirp.118762-ref20">20</xref>] where applicable. We searched Ovid MEDLINE/PubMed, Embase, African Journals OnLine (AJOL) and PsychINFO databases for relevant articles. Database and repository searches were conducted in English language. An asterisk (*) was used to pick up multiple word endings for instance Afric* to pick up Africa and African and the following keywords/phrases were identified and used in various combinations with boolean operators (and, or): “sub-Saharan Afric*” or Afric* or “Afric* countries” and agricultural diversification or agriculture diversity and policy*; dietary diversity or dietary assessment or nutrition diversity or nutrition assessment and policy*; diet* and assess* and policy*; nutrition* and assess* and policy*. With regard to AJOL, the search string was modified due to differences in database functionality to “sub-Saharan Africa” and “agricultural diversification policy” or “dietary diversity policy” or “nutrition diversity policy”. Building on the experience of prior research on systematic review of grey literature and its significance [<xref ref-type="bibr" rid="scirp.118762-ref21">21</xref>], additional technical reports with a focus on sub-Saharan Africa were retrieved from relevant institutional websites (like the Africa Union, Agriculture for food security 2030 (AgriFoSe2030) and Food and Agriculture Organization of the United Nations (FAO) in January 2021. The search outputs were exported to endnote for review of titles and abstracts. A total of 1113 relevant research articles outputs (<xref ref-type="fig" rid="fig1">Figure 1</xref>) were collected in the initial search.</p></sec><sec id="s2_2"><title>2.2. Selection of Articles</title><p>The inclusion criteria were applied by the reviewers to all studies at title and abstract level. Whenever it was not clear whether a study met the criteria, the reviewers consulted further. Relevant studies included all studies that have reported on policy and agricultural diversification, dietary diversity or nutrition outcomes in sub-Saharan Africa context. Besides, for each study to be included, it had to pass the following specific criteria: 1) relevant policy direction in relation to agricultural diversification, dietary diversity, and impact and/effect on nutrition; 2) relevant subject: precision agriculture used in the general areas of agriculture and/or diversification, nutrition and/or diversification, agriculture and/or economic outcomes.</p><p>The exclusion criteria were applied at both title and abstract level. The studies were excluded at the title level if the title was outside the geographic scope of SSA or the title was not within the general topics of agricultural diversification,</p><p>dietary diversity, and nutrition. At the abstract level, studies were excluded if the abstract was not in English, abstract not available, abstracts outside the general topics of agricultural diversification, dietary diversity, and nutrition, abstracts that mention agricultural diversification, dietary diversity, and nutrition concepts without any policy component on their findings and application in SSA. The applied selection criterion is summarized in <xref ref-type="fig" rid="fig1">Figure 1</xref>.</p></sec><sec id="s2_3"><title>2.3. Analysis and Synthesis</title><p>A qualitative synthesis of the information was conducted, and information obtained categorized in three main themes. First, identified agricultural diversification policies in relation to dietary and nutrition diversity was reviewed, synthesized and described. Next, policy outlook in guiding structural transformations in agriculture is presented. Finally, an exploration of policy implications for addressing challenges associated with malnutrition in SSA was done. The findings are presented using narrative summaries.</p></sec></sec><sec id="s3"><title>3. Results and Discussion</title><sec id="s3_1"><title>3.1. Agricultural Diversification Policies in Relation to Dietary and Nutrition Diversity</title><p>It is evident, agricultural development policies, implementation strategies, guidelines and action plans are cognizant of the fact that, there is no one-size-fits-all solution for fostering agricultural diversification in SSA as an entry point for stimulating agricultural modernization and enhanced productivity particularly for the smallholder farmers who are the majority. At regional and national level, the various policy documents and related monitoring and/or implementation research evidence address different but thematically inter-related dimensions of agricultural diversification vis-a-vis dietary and nutrition diversity [<xref ref-type="bibr" rid="scirp.118762-ref4">4</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref10">10</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref22">22</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref23">23</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref24">24</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref25">25</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref26">26</xref>]. The interlinked dimensions of focus as observed in our review entail: 1) governments commitment in supporting subsidies and enhancing public expenditure in agriculture diversity, 2) more efforts directed towards creating an enabling environment for competitive market locally and globally, 3) increased investment in agricultural research and development, 4) the need to strengthen nutritional awareness advocacy, 5) better land administration in terms of land and water tenure policies and laws to ensure equitable access and tenure security, and 6) more resilient agroecosystem through on-farm diversification aimed at invigorating climate shocks adaptation resilience, better dietary diversity at household level and agribusiness incentives [<xref ref-type="bibr" rid="scirp.118762-ref4">4</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref10">10</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref22">22</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref23">23</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref25">25</xref>] - [<xref ref-type="bibr" rid="scirp.118762-ref31">31</xref>].</p><p>Smallholder farmers across the region maintain de facto agricultural diversity with a strong association between small scale production diversity and self-consumption for food and to a large extend cash income [<xref ref-type="bibr" rid="scirp.118762-ref4">4</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref10">10</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref22">22</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref27">27</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref28">28</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref30">30</xref>]. Subsequently, policy decisions to improve food security in SSA have significantly enhanced a positive interplay between agriculture diversity and household dietary consumption behaviors thus positively influencing household nutrition outcomes and agriculture related climate change resilience due to alternative paths for food and income security [<xref ref-type="bibr" rid="scirp.118762-ref4">4</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref10">10</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref24">24</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref27">27</xref>]. On the other hand, implementation assessment of the policies, strategies, guidelines and action plans across different nations in SSA reveal that, mechanism by governments in supporting subsidies, ensuring access to agricultural technologies, agricultural advisory services, training, timely and relevant information as well as trickledown effect of public expenditure targeting smallholder cadre of farmers who are majorly in remote rural settings remain poorly streamlined for farmers access and benefit [<xref ref-type="bibr" rid="scirp.118762-ref8">8</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref10">10</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref25">25</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref30">30</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref31">31</xref>]. Even though implementation of some of the policies and guidelines has uplifted agribusiness, they have equally fallen short of actualizing enabling environment for market access. The persistent and much needed enabling agricultural diversification stimulus environment across the region is in two domains. First, the need of an enabling physical investments and support that entail rural-rural and rural-urban transport connections in terms of road networks, communication services like mobile and internet network, climate change prediction information flow, quality of farm inputs and favourable costs and guaranteed human and agribusiness investments security. Secondly, provision of agricultural extension advisory services, training and timely and relevant information, tailored to different types of farmers across regions within a nation in order to sustain existing and emerging interest of investment in agricultural diversification at large.</p>Household Dietary Diversity and Production Diversification Effects on Nutritional Outcome<p>The existing empirical evidence with regards to establishing the direct causal link between agriculture diversification and nutrition is mixed. For instance, in Kenya, small livestock assets such as poultry, cattle ownership and milk consumption as well as pulses farming among the ultra-poor labour-constrained farmers were positively correlated to household nutrition [<xref ref-type="bibr" rid="scirp.118762-ref32">32</xref>]. Besides, in Ghana, agriculture production diversity has been demonstrated to be important for household dietary diversity and nutrition with much attention linked to its value for an income effect [<xref ref-type="bibr" rid="scirp.118762-ref33">33</xref>]. Among rural small holder farmers in Zambia, while agricultural diversification was associated with the household dietary diversity score, the relationship was not significant and that behavioural change communication should be factored as a critical component of agricultural diversity advancement programs [<xref ref-type="bibr" rid="scirp.118762-ref34">34</xref>]. The behavioural change advanced, resonates with the fact that, food seeking behaviours influence individual food consumptions patterns and dietary diversity, hence the need for a better understanding of the link between dietary diversity, nutrition security and the associated factors [<xref ref-type="bibr" rid="scirp.118762-ref35">35</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref36">36</xref>]. In Mali, findings on impact of crop diversification on household nutrition, socioeconomic influences were proven to have a positive influence on food consumption and household nutritional security [<xref ref-type="bibr" rid="scirp.118762-ref37">37</xref>]. Thus, to improve crop diversification and the nutritional quality, there is need to invigorate diversification through subsidies among other measures that can then translate to impactful nutritional status [<xref ref-type="bibr" rid="scirp.118762-ref37">37</xref>]. The mixed outcomes outlined by the case examples demonstrate that agricultural diversification alone is not adequate to contribute to a positive change in nutrition outcomes, and mirrors the inherent needs, challenges and opportunities as concerns African Agriculture and its effect on food security resilience and nutrition [<xref ref-type="bibr" rid="scirp.118762-ref23">23</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref38">38</xref>].</p></sec><sec id="s3_2"><title>3.2. Policy Outlook in Guiding Structural Transformations in Agriculture</title><p>Globally, agricultural production transformation has been shaped by forces of globalization while related policies and programs are established in particular political, social and economic contexts with a broader aim to bring nutritious diets within reach of the poor [<xref ref-type="bibr" rid="scirp.118762-ref39">39</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref40">40</xref>]. Therefore, examining policy and programmes interplays that shape agriculture production can contribute to better understanding of policy implementation, uptake and impact by identifying policy levers, obstacles and windows of opportunity [<xref ref-type="bibr" rid="scirp.118762-ref39">39</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref40">40</xref>]. Across the SSA nations, there is a great variety of agroecological zones and large differences in land, labour and other resources but there is a wide overlap in the national and regional agricultural policies in place [<xref ref-type="bibr" rid="scirp.118762-ref41">41</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref42">42</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref43">43</xref>].</p><p>Overlaps observed largely driven by regional agricultural policies as envisioned by regional economic communities (RECs) which have overlapping memberships [<xref ref-type="bibr" rid="scirp.118762-ref42">42</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref44">44</xref>]. For instance, Agriculture for food security 2030 (AgriFoSe2030), a think-tank programme that targets the UN Sustainable Development Goal 2 in low-income countries, in its focus on SSA, synthesizes and translates existing science into policy and practice, and develops capacity to achieve the goal [<xref ref-type="bibr" rid="scirp.118762-ref41">41</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref45">45</xref>]. Yet, in its membership and thematic scope for example in theme 1 (social and economic dimensions of smallholder based agriculture and food security) in the focus countries for example, there is Tanzania being both a member of EAC and SADC while Kenya being a member of both EAC and COMESA, and Malawi and Zambia being a member of both COMESA and SADC among others [<xref ref-type="bibr" rid="scirp.118762-ref41">41</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref42">42</xref>]. By virtue of these overlaps, harmonized implementation of various structural transformations such as those aimed at raising smallholder productivity, combating hunger and improving rural livelihoods through improving technology use to enhance women’s participation and stimulate inclusive and efficient markets is hampered by factors like variable scale of technological advancement in the different countries [<xref ref-type="bibr" rid="scirp.118762-ref46">46</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref47">47</xref>].</p><p>Even so, right through the respective national and regional economic communities policies, the aim of the various policy and implementation strategies in guiding the structural transformation in agriculture to help realize multiple goals (including affordability and availability of diverse food, ensuring high quality and safe food for the population, especially the vulnerable groups) is centered on agriculture commercialization and intensification [<xref ref-type="bibr" rid="scirp.118762-ref47">47</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref48">48</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref49">49</xref>]. In the same framework, other than focusing on smallholder farmers, there is gradual integration of women and youth in order to actualize sustainable intensification geared towards enhancing food security. The SSA context of policy support in agricultural diversification, guiding structural transformations, dietary and nutrition diversity is summarized in <xref ref-type="table" rid="table1">Table 1</xref>. While empirical analyses have shown clear relations between farming diversity and food security, and a linkage to nutritional diversity in SSA, mixed findings have been reported on how market orientation influences the relationship [<xref ref-type="bibr" rid="scirp.118762-ref27">27</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref33">33</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref50">50</xref>]. Therefore, is need for a strong private public partnership multi-sectoral approach to focus on niche product markets, certification schemes, price and credit incentives to promote diversification, while intensifying production systems [<xref ref-type="bibr" rid="scirp.118762-ref23">23</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref28">28</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref33">33</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref38">38</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref50">50</xref>].</p><p>On the other hand, despite enormous potential in agriculture, many SSA nations are struggling to meet their food needs [<xref ref-type="bibr" rid="scirp.118762-ref51">51</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref52">52</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref53">53</xref>]. According to African development bank, 65% of the world’s arable land is in Africa despite the continent being a net importer of food with $35 billion expenditure on food imports annually. Over 80% of 874 million hectares of land that is considered suitable for agricultural production suffers from serious soil fertility challenges or other limitations to achieving high and sustained productivity [<xref ref-type="bibr" rid="scirp.118762-ref54">54</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref55">55</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref56">56</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref57">57</xref>]. While climate change is predicted to significantly affect arable land health and agricultural output, the demand for food in Africa is expected to rise by over 60% by 2050 due to population growth and improvements in nutrition [<xref ref-type="bibr" rid="scirp.118762-ref54">54</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref55">55</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref56">56</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref57">57</xref>]. Africa requires a significant improvement in agricultural productivity and resilience to achieve sustainable growth and development. Accelerating key elements highlighted in <xref ref-type="table" rid="table1">Table 1</xref> would guarantee improved agricultural systems in SSA countries in tune with the targets of SDG 1 and 2.</p><table-wrap id="table1" ><label><xref ref-type="table" rid="table1">Table 1</xref></label><caption><title> Extent of policy support in structural transformation in agriculture for agricultural diversification, dietary and nutrition diversity in SSA</title></caption><table><tbody><thead><tr><th align="center" valign="middle" >Regional/Country and/or IREC priority umbrella</th><th align="center" valign="middle" >Policy framework and strategic plans initiative</th><th align="center" valign="middle" >Structural transformation in agriculture</th><th align="center" valign="middle" >Reference</th></tr></thead><tr><td align="center" valign="middle" >-SSA under AgriFoSe2030 memberships. -Case studies of SSA advanced pilot reports for adaptation and replication across the region as seen from work in Nigeria, Kenya and South Africa.</td><td align="center" valign="middle" >-Precision agriculture (PA) or precision farming. -Mobile technology and other smart technologies deployment to drive all processes, from tilling to post-harvesting.</td><td align="center" valign="middle" >-To adapt cultivation and animal husbandry practices to local or even within-field conditions rather than to use general recommendations. -Target increased productivity among smallholder farmers in Sub-Saharan Africa through attaining appropriate management strategies in terms of efficiency and effectiveness of resource use. -Application of mobile technology devices to create opportunities for agribusiness, banking, commerce and investment. -Invigorate sustainable agricultural intensification among smallholder-based farmers.</td><td align="center" valign="middle" >[<xref ref-type="bibr" rid="scirp.118762-ref40">40</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref41">41</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref45">45</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref47">47</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref48">48</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref51">51</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref54">54</xref>]</td></tr><tr><td align="center" valign="middle" >-Action plans related to national vision documents across SSA countries (e.g., South Africa Vision 2030, Nigeria Vision 2030, Kenya Vision 2030, Rwanda Vision 2020, Senegal Vision 2035, Cameroon vision 2035 etc).</td><td align="center" valign="middle" >-Food Security and economic policies. -Agricultural diversification, dietary and nutrition diversity. -Eco-conscious agricultural production. -Youth and women empowerment and entrepreneurship with a focus on agribusiness. -Gender sensitive land administration, access and tenure in countries experiencing declining farm size. -Agro-ecological zones targeted agricultural diversification and intensification.</td><td align="center" valign="middle" >-Increase government support to timely access of improved and good quality agro-inputs like seeds promote sustainable use of fertilizers and development of sustainable irrigation systems. -Accelerate key elements of improved agricultural systems; improving food trade and market integration through enhanced transport systems infrastructure and information systems at rural-urban, rural-rural and intra-Africa as well as internationally that allow for a better functioning of markets for both staples and non-staples especially for perishable products such as fruits, vegetables and livestock products, etc. -Private and state trade support and public buffer stocks. -Improve farmers’ skills and technical expertise in modern food production systems especially in rural settings and promote diversification into multiple enterprises, such as fisheries, livestock, apiculture, snail and mushroom production etc. -Adopting and advancing modern research approaches to adapting existing crops to the changing climate in order to meet food needs. -Harnessing biotechnological tools proactively to enhance long-term improvement in breeding, developing and promoting adaptive cultivars, encourage climate resilience in the gene pool, and catalyse a move away from over-dependence on land and exposed cultivation systems. -Enhancing legal infrastructure, awareness, administrative and technical capacity in implementing statutory laws related to land tenure and ownership while remaining alive of cultural, communal and religious barriers that can facilitate or limit optimal land use for agriculture production without gender bias.</td><td align="center" valign="middle" >[<xref ref-type="bibr" rid="scirp.118762-ref4">4</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref22">22</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref23">23</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref24">24</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref27">27</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref28">28</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref29">29</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref31">31</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref33">33</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref38">38</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref40">40</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref41">41</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref43">43</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref47">47</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref48">48</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref52">52</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref53">53</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref54">54</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref58">58</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref59">59</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref60">60</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref61">61</xref>]</td></tr><tr><td align="center" valign="middle" >African Union Institutional capability.</td><td align="center" valign="middle" >-Comprehensive African Agricultural Development Programme (CAADP); Implementation of Agriculture, Rural Development, Blue Economy and sustainable environment policies, programs and strategies in line with the aspirations of Agenda 2063.</td><td align="center" valign="middle" >-African governments to allocate at least 10% of national budgets to agriculture and rural development, and to achieve agricultural growth rates of at least 6% per annum. -Reducing poverty and malnutrition, for increasing productivity and farm incomes, and for improvements in the sustainability of agricultural production and use of natural resources. -Enhance resilience to climate variability through development of disaster preparedness, early warning response systems and social safety nets. -Trade and financial integration to incentivize manufacturing and agricultural sector value additions.</td><td align="center" valign="middle" >[<xref ref-type="bibr" rid="scirp.118762-ref41">41</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref61">61</xref>] - [<xref ref-type="bibr" rid="scirp.118762-ref67">67</xref>]</td></tr></tbody></table></table-wrap></sec><sec id="s3_3"><title>3.3. Policy Implications for Addressing Challenges Associated with Malnutrition in SSA</title><p>Although climatic and/or biophysical, socio-economic, markets, institutional and policy factors greatly influence agricultural diversification decisions, it is often policies, both national and international, that have a decisive impact on agricultural diversification, dietary diversity and nutrition outcomes [<xref ref-type="bibr" rid="scirp.118762-ref68">68</xref>]. Thus, we further examine policy implications for addressing challenges associated with malnutrition in SSA in which we group policies into three (3) broad categories under policies and programmes for improving nutrition: 1) international initiatives - making nutrition a development priority; 2) national initiatives - policies and programmes; and 3) priorities and approaches for responding to threats to nutrition from climate change and biofuel demand.</p><p>The majority of international commitments support nutrition programs that reduce infant and maternal mortality, advance women and girls empowerment, and promote lifelong health development. In light of the shifting nutrition environment, the COVID-19 and other potential pandemic related challenges and impact, modern agricultural productivity, population shifts, and climate change, a larger, “multi-sectoral food systems approach” is required to establish robust food systems with beneficial nutrition and health outcomes [<xref ref-type="bibr" rid="scirp.118762-ref69">69</xref>]. Almost all countries have action plans related to agricultural diversification, dietary diversity and nutrition, as well as overall national vision documents (e.g., South Africa Vision 2030, Nigeria Vision 2030, Kenya Vision 2030, Rwanda Vision 2020, Senegal Vision 2035), national development plans, national green growth development strategies, all often based on international declarations or strategies [<xref ref-type="bibr" rid="scirp.118762-ref10">10</xref>]. Many have also put in place sectoral food security, agriculture and climate change policies and strategies that indicate their treatment of nutrition. Most countries recognise the value of agricultural diversification for dietary diversity and improved nutrition, yet some have declared the pursuit of agricultural specialisation and intensification as important for national economies, while some advertently or inadvertently promote specialisation under the pretext of improving national food security.</p><p>Evidence demonstrates that national agricultural systems in SSA as well as individual farmers and communities are not sufficiently diversified which undeniably leads to vulnerability to malnutrition [<xref ref-type="bibr" rid="scirp.118762-ref52">52</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref70">70</xref>]. Low productive diversification, alongside frequent lack of assets to buffer against risks, exposes farmers to risks of income variability, crop failure, and consequently malnutrition. In some extreme cases, disturbances in production lead to severe malnutrition since poor farming households have low purchasing power to compensate for missing required nutrients especially for children and mothers. Unsurprisingly, poor undiversified farming households also struggle to ensure dietary diversity and nutrition as they have limited resources to supplement the consequential shortfall in dietary diversity and nutrition [<xref ref-type="bibr" rid="scirp.118762-ref10">10</xref>].</p><p>Since agricultural diversification, dietary diversity and nutrition features prominently in food security, health and resilience strategies of SSA countries, there is greater need to improve awareness and strengthen agricultural extension with inclusion of nutrition messages. Knowledge and awareness on agricultural diversification are increasingly recognised as a key factor in achieving food security objectives in SSA countries. Though, nutrition outcomes are not always met, especially when the agriculture production is dominated by the production of few crops and/or in some cases one major crop. Maize, for example, accounts for almost half of the cultivated land in six countries: Lesotho (61 percent), Zimbabwe (51 percent), Zambia (49 percent), South Africa (49 percent), Botswana (43 percent), and Malawi (43 percent) [<xref ref-type="bibr" rid="scirp.118762-ref10">10</xref>].</p><p>It therefore follows that; policies need to take into account the diversity of conditions in which farmers in Sub-Saharan Africa farm by virtue of respective regional blocks and at national level, if they are to nudge them in the right direction on agricultural diversification. Governments should aim at creating an enabling environment for agriculture where diversification is complementary: as sometimes necessary to boost dietary diversity and nutrition, while other times needed as a step towards greater economic efficiency, higher-added value and ultimately structural transformation. Within this space, public policy should aim to find balance, mindful of important implications that agricultural diversification has for dietary diversity and nutrition, as well as acknowledge the fiscal constraints that might at times argue in favour of alternative interventions.</p><p>It is, therefore, important to note that farmers in SSA ’s decision, for example, to diversify does not only rest on their understanding of the resulting impacts but is influenced by the specific context in which the consideration is made. They are mainly constrained by the realities of the environment around them, by the changing public policies and market infrastructure, and by factors specific to the organisation of society and economy in which they live and operate [<xref ref-type="bibr" rid="scirp.118762-ref10">10</xref>]. These specific conditions generate drivers of production decision and nudge the farmer either towards diversification. These drivers would be of particular importance to policy makers since they can be influenced or prepared for by policy decisions and the set-up of institutions. These drivers would be grouped into three broad categories:</p><p>1) Environmental drivers—that take cognisance of the climatic or biophysical factors &amp; agro-ecological zones, climate, natural resources, the prevalence of pests/diseases and environmental shocks.</p><p>2) Policy and market drivers—that take cognisance of the measures put into place that promote national food security, productivity enhancement and commercialisation, as well as regulatory measures that condition market access.</p><p>3) Socio-economic and institutional drivers—that take cognisance of the rules &amp; regulations, subsidies &amp; incentives, practices, factor endowment, power distribution, education, gender and broad conditions within the community(ies).</p><p>In the appraisal of various policies, we actualize the fact that, in order to create better performing programmes, policy makers and think-tanks programmes that synthesize and translate existing science into policy and practice, and develop capacity to achieve the goal can take the following lessons learned into account. First, the Agricultural Input Support Programmes (AISPs) need to be clearly and unequivocally aligned with national food security, resilience and nutrition objectives, while reconciling the arguably competing objectives of increasing productivity as well as increasing agricultural diversity. Second, procurement and distribution of subsidised inputs should facilitate the development of competitive private sector-led input markets. Third, parallel investments in the development of relevant infrastructure that promotes overall market-functioning improvements (e.g. roads, market centres, storage facilities, transport and processing equipment for a wide variety of agricultural products) particularly in rural areas will likely enhance the outcomes of AISPs. Finally, subsidies should be part of a holistic approach to enhancing the use of a wide variety of improved inputs and not only fertilizer through the provision of complementary services (e.g., research and extension, irrigation, credit), social policy measures (e.g., productive safety nets, cash transfers) and private sector-led market development (e.g., policy reforms, infrastructure development) [<xref ref-type="bibr" rid="scirp.118762-ref70">70</xref>] [<xref ref-type="bibr" rid="scirp.118762-ref71">71</xref>].</p></sec></sec><sec id="s4"><title>4. Conclusion and Policy Message</title><p>It is apparent; most countries in Sub-Saharan Africa recognise the crucial role of agricultural diversification as a pathway to achieving food security and consequently meeting nutrition and dietary diversity needs of the people. There is a rich base of policies and related lived experiences which in combination can guide the scaling up of some best practices and incentivise the linkage between agricultural diversification, agribusiness, dietary diversity and nutrition outcomes. For instance, among other factors, the application of precision farming, agro-ecological zones targeted agricultural intensification and gender sensitive land administration, access and tenure in countries experiencing declining farm size would potentially ensure the youth, men and women have equitable and innovative opportunities of access to elements of improved agricultural systems. More considerations about the importance of dietary diversity and nutrition need to be built into policies beyond those directly treating agriculture productivity and its diversification. Such efforts should consider a greater focus on smallholder farmers across the regions within SSA who as a matter of fact, maintain de facto agricultural diversity. Empirical evidence on the nexus between agricultural diversification and nutrition is mixed and limited.</p></sec><sec id="s5"><title>Conflicts of Interest</title><p>The authors declare no conflicts of interest regarding the publication of this paper.</p></sec><sec id="s6"><title>Cite this paper</title><p>Lulanga, S., Marinda, P.A. and Khayeka-Wandabwa, C. (2022) Linkages between Agricultural Diversification, Dietary Diversity, and Nutrition Outcomes in Sub-Saharan Africa: A Systematic Review. Agricultural Sciences, 13, 879-896. https://doi.org/10.4236/as.2022.137055</p></sec></body><back><ref-list><title>References</title><ref id="scirp.118762-ref1"><label>1</label><mixed-citation publication-type="other" xlink:type="simple">Ruel, M.T. and Alderman, H. (2013) Nutrition-Sensitive Interventions and Programmes: How Can They Help to Accelerate Progress in Improving Maternal and Child Nutrition? 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