scholarly journals Measuring the Impact of Nutrition Sensitive Interventions on Diet: A Systematic Review of Tools and Indicators (P10-133-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ines Gonzalez Casanova ◽  
Amy Webb Girard ◽  
Sakshi Mehta ◽  
Usha Ramakrishnan
Keyword(s):  
Dietary Diversity ◽  
Monitoring And Evaluation ◽  
Biological Indicators ◽  
Assessment Tools ◽  
Sub Saharan Africa ◽  
Food Groups ◽  
Causal Pathway ◽  
Women And Children ◽  
Nutrition Sensitive ◽  
The Impact

Abstract Objectives Nutrition sensitive interventions (NSI), which target underlying causes of undernutrition, have been identified as essential to reduce the burden of malnutrition, which disproportionately affects women and children living in low to middle income countries. However, evaluating the impacts of NSI using anthropometry and/or biomarkers remains challenging due to lack of sensitivity. For agriculture NSI in particular, researchers increasingly recommend using indicators that assess dietary changes that lie on the causal pathway to improved biological indicators. We aimed to identify tools and indicators that can be used to assess the impact of agriculture-focused NSI on the diets of women and children. Methods Using Pubmed, Web of Science, and Agricola, we conducted a systematic search of the literature for NSI that assessed the impact on the diet of women and children (under 18 years) and were published after 2010. Twenty-three studies representing unique NSI or programs met inclusion/exclusion criteria. We systematically abstracted data from these studies into a standardized form. Results Included NSI were conducted in Sub-Saharan Africa (n = 18), South Asia (n = 3), Southeast Asia (n = 3), and Latin America (n = 1), with one conducted in three regions. The most common tools were food frequency questionnaires, 24-hour recalls, and household inventories. Dietary diversity (DD) scores were the most common indicators. These varied on the number of items and the duration of the recall period and included household DD (n = 7), women's DD (n = 5) and children's DD (n = 11); twelve studies assessed more than one outcome. Other indicators of children's diet, such as meal frequency, number of foods or food groups consumed, or minimum acceptable diet were assessed in nine NSI. Two and four studies reported nutrient intakes in women and children, respectively. Conclusions Diet assessment tools and indicators have been used successfully to assess the impact of NSI. We recommend including these measurement tools as part of the monitoring and evaluation of NSI, in particular DD was a frequently used indicator that was sensitive to the interventions. It will also be important to improve the reporting of the method used to improve interpretability and comparison across studies. Funding Sources Supported by the Bill and Melinda Gates Foundation.

scholarly journals Seasonality and Nutrition-Sensitive Agriculture in Kenya: Evidence from Mixed-Methods Research in Rural Lake Naivasha Basin

2019 ◽  
Vol 11 (22) ◽  
pp. 6223 ◽  
Author(s):  
Maria Sassi
Keyword(s):  
Mixed Methods ◽  
Fixed Effects ◽  
Food System ◽  
Dietary Diversity ◽  
Interesting Case ◽  
Policy Implications ◽  
Sub Saharan Africa ◽  
Lake Naivasha ◽  
Nutrition Sensitive ◽  
The Impact

This study investigates the impact of seasonality within the debate on nutrition-sensitive agriculture focusing on rural Lake Naivasha Basin in Kenya, which presents an interesting case study of the food system in East Africa. Seasonality shapes food and nutrition security in sub-Saharan Africa, dominated by a rain-fed system; however, lack of monthly data hampers understanding. Using mixed methods, this study constructs a monthly dataset of a representative sample of households from February 2018 to January 2019. A fixed-effects analysis highlights the association between three pathways from agriculture to nutrition while controlling for the hunger and harvesting seasons by crop. Supported by qualitative information from focus groups, the results suggest that seasonality is an important dimension of the agriculture–nutrition link and promote understanding of the complexity of the pathways suggested by the literature, including the association between crops and dietary diversity, with relevant policy implications.

scholarly journals Impact of a Homestead Food Production Program on Dietary Diversity: Seasonal and Annual Results from the FAARM Trial in Sylhet, Bangladesh

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 694-694
Author(s):  
Jillian Waid ◽  
Amanda Wendt ◽  
Sabine Gabrysch
Keyword(s):  
International Development ◽  
Repeated Measures ◽  
Food Production ◽  
Dietary Diversity ◽  
Controlled Trial ◽  
Food Groups ◽  
Post Intervention ◽  
Production Program ◽  
Women And Children ◽  
The Impact

Abstract Objectives We examine the impact of a nutrition-sensitive agricultural program on the dietary diversity of women and children enrolled in the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) cluster-randomized controlled trial in rural Habiganj, Sylhet, Bangladesh. The homestead food production intervention, implemented by Helen Keller International, began in mid-2015 and ended in December 2018. Methods We use four data sources: 1) baseline data (all women and their youngest child, March-May 2015); 2) surveillance data (every two months - all children 6–18m and a rotating random third of women and children 19–37m,  September 2015-August 2019); 3) endline data (all women and children 6–23m,  September 2019-February 2020); 4) phone survey during the COVID-19 lockdown (a random two-thirds of women, May-June 2020). We calculated dietary diversity for women (MDDW-10) and children (WHO IYCF). Our analysis included 24,931 observations of 2,701 women and 17,445 observations of 2,162 children (6–37m). We estimate the impact of the intervention on dietary diversity using multi-level regression, controlling for clustering by settlement and repeated measures. Results Dietary diversity scores and the proportion of women and children classified as consuming adequate diets varied greatly over the year, peaking in May/June with 5.3 food groups for women (out of ten) and 3.8 food groups for children (out of seven). Over all program years, intervention women had 1.8 higher odds of consuming an adequate diet compared to control women (p < 0.001). However, this benefit varied from 1.3 in the first year of the intervention (p = 0.015) to 2.3 in the last year (p < 0.001), before falling to around 1.9 in the post-intervention years (p < 0.001). We saw a nearly identical pattern in children. Dietary improvement was driven through incremental increases in nearly all food groups. Conclusions The intervention successfully increased dietary diversity in women and children, and these impacts persisted after the project closed, including during the COVID-19 lockdown period. Funding Sources The German Ministry for Education and Research (BMBF) is the primary funder for the FAARM trial. The U.K. Department for International Development (DFID) supported the design of the surveillance system.

scholarly journals Neighbour home gardening predicts dietary diversity among rural Tanzanian women

2019 ◽  
Vol 22 (09) ◽  
pp. 1646-1653
Author(s):  
Mia M Blakstad ◽  
Alexandra L Bellows ◽  
Dominic Mosha ◽  
Chelsey R Canavan ◽  
Killian Mlalama ◽  
...  
Keyword(s):  
Dietary Diversity ◽  
Reproductive Age ◽  
Home Garden ◽  
Food Groups ◽  
Cross Sectional ◽  
Home Gardening ◽  
The Individual ◽  
Nutrition Sensitive ◽  
The Impact ◽  
Minimum Dietary Diversity

AbstractObjectiveThe present study’s aim was to assess the impact of a nutrition-sensitive intervention on dietary diversity and home gardening among non-participants residing within intervention communities.DesignThe study was a cross-sectional risk factor analysis using linear and logistic multivariate models.SettingIn Tanzania, women and children often consume monotonous diets of poor nutritional value primarily because of physical or financial inaccessibility or low awareness of healthy foods.ParticipantsParticipants were women of reproductive age (18–49 years) in rural Tanzania.ResultsMean dietary diversity was low with women consuming three out of ten possible food groups. Only 23·4 % of respondents achieved the recommended minimum dietary diversity of five or more food groups out of ten per day. Compared with those who did not, respondents who had a neighbour who grew crops in their home garden were 2·71 times more likely to achieve minimum dietary diversity (95 % CI 1·60, 4·59; P=0·0004) and 1·91 times more likely to grow a home garden themselves (95 % CI 1·10, 3·33; P=0·02). Other significant predictors of higher dietary diversity were respondent age, education and wealth, and number of crops grown.ConclusionsThese results suggest that there are substantial positive externalities of home garden interventions beyond those attained by the people who own and grow the vegetables. Cost-effectiveness assessments of nutrition-sensitive agriculture, including home garden interventions, should factor in the effects on the community, and not just on the individual households receiving the intervention.

scholarly journals Market food diversity mitigates the effect of environment on women’s dietary diversity in the Agriculture to Nutrition (ATONU) study, Ethiopia

2019 ◽  
Vol 22 (11) ◽  
pp. 2110-2119 ◽  
Author(s):  
Ramya Ambikapathi ◽  
Nilupa S Gunaratna ◽  
Isabel Madzorera ◽  
Simone Passarelli ◽  
Chelsey R Canavan ◽  
...  
Keyword(s):  
Food Availability ◽  
Market Access ◽  
Dietary Diversity ◽  
Diversity Index ◽  
Food Groups ◽  
Cross Sectional ◽  
Village Level ◽  
Food Diversity ◽  
The Impact ◽  
The Village

AbstractObjectiveIn Ethiopia, women’s dietary diversity is low, primarily due to poor food availability and access, both at home and market level. The present study aimed to describe market access using a new definition called market food diversity (MFD) and estimate the impact of MFD, crop and livestock diversity on dietary diversity among women enrolled in the Agriculture to Nutrition (ATONU) trial.DesignBaseline cross-sectional data collected from November 2016 to January 2017 were used for the analysis. Availability of foods in markets was assessed at the village level and categorized into nine food groups similar to the dietary diversity index for women. Bivariate and multivariate mixed-effects regression analyses were conducted, adjusted for clustering at the village level.SettingChicken-producing farmers in rural Ethiopia.ParticipantsWomen (n 2117) aged 15–49 years.ResultsOverall, less than 6 % of women met the minimum dietary diversity (≥5 food groups) and the most commonly consumed food groups were staples and legumes. Median MFD was 4 food groups (interquartile range: 2–8). Multivariate models indicated that women’s dietary diversity differed by livestock diversity, food crop diversity and agroecology, with significant interaction effects between agroecology and MFD.ConclusionsWomen’s dietary diversity is poor in Ethiopia. Local markets are variable in food availability across seasons and agroecological zones. The MFD indicator captures this variability, and women who have access to higher MFD in the highland agroecological zone have better dietary diversity. Thus, MFD has the potential to mitigate the effects of environment on women’s dietary diversity.

scholarly journals La Niña weather impacts dietary patterns and dietary diversity among children in the Peruvian Amazon

2020 ◽  
pp. 1-11
Author(s):  
Ramya Ambikapathi ◽  
Margaret N Kosek ◽  
Gwenyth O Lee ◽  
Maribel Paredes Olortegui ◽  
Benjamin Zaitchik ◽  
...  
Keyword(s):  
Dietary Patterns ◽  
Dietary Diversity ◽  
Southern Oscillation ◽  
La Niña ◽  
Birth Cohort Study ◽  
Peruvian Amazon ◽  
Food Groups ◽  
Social Strategies ◽  
La Nina ◽  
The Impact

Abstract Objective: In 2011–2012, severe El Niño Southern Oscillation (ENSO) conditions (La Niña) led to massive flooding and temporarily displacement in the Peruvian Amazon. Our aims were to examine the impact of this ENSO exposure on child diets, in particular: (1) frequency of food consumption patterns, (2) the amount of food consumed (g/d), (3) dietary diversity (DD), (4) consumption of donated foods, among children aged 9–36 months living in the outskirts of City of Iquitos in the Amazonian Peru. Design: This was a longitudinal study that used quantitative 24-h recall dietary data collection from children aged 9–36 months from 2010 to 2014 as part of the MAL-ED birth cohort study. Setting: Iquitos, Loreto, Peru. Participants: Two hundred and fifty-two mother–child dyads. Results: The frequency of grains, rice, dairy and sugar in meals reduced by 5–7 %, while the frequency of plantain in meals increased by 24 % after adjusting for covariates. ENSO exposure reduced girl’s intake of plantains and sugar. Despite seasonal fluctuations in the availability of fruits, vegetables and fish, DD remained constant across seasons and as children aged. However, DD was significantly reduced under moderate La Niña conditions by 0·32 (P < 0·05) food groups. Adaptive social strategies such as consumption of donated foods were significantly higher among households with girls. Conclusions: This is the first empirical study to show differential effect of the ENSO on the dietary patterns of children, highlighting differences by gender. Public health nutrition programmes should be climate- and gender-sensitive in their efforts to safeguard the diets of vulnerable populations.

scholarly journals Production Diversity, Men's Help with Household Tasks, & Lower Women's Depression Mediate Impact of an Agriculture Intervention on Child's Dietary Diversity in Tanzania (FS01-06-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Marianne Santoso ◽  
Rachel Bezner Kerr ◽  
Neema Kassim ◽  
Haikael Martin ◽  
Elias Mtinda ◽  
...  
Keyword(s):  
Mental Health ◽  
Dietary Diversity ◽  
Women's Empowerment ◽  
Women’S Empowerment ◽  
Household Tasks ◽  
Household Chores ◽  
Women's Mental Health ◽  
Nutrition Sensitive ◽  
Production Diversity ◽  
The Impact

Abstract Objectives Production diversity and women's empowerment are two ways by which nutrition-sensitive agriculture interventions are thought to improve children's diet, but, few empirical studies have tested these pathways. We therefore investigated the impact of the Singida Nutrition and Agroecology Project (SNAP-Tz; NCT02761876) on child's dietary diversity, as well as the mediating role of production diversity and women's empowerment on that relationship. Methods SNAP-Tz is a randomized trial of a participatory agroecology and nutrition intervention on which mentor farmers lead their fellow farmers with children < 1 y.o. at baseline (n = 587) in learning and experimentation on agroecology, nutrition, and gender equity. We estimated the intention-to-treat impact of SNAP-Tz on Child's Dietary Diversity Score (CDDS) [0–7] using difference-in-difference analysis between 2016 and 2018. Average Causal Mediation Effect (ACME5) were estimated for production diversity (Crop Nutritional Functional Richness; 0–7) and 4 measures of women's empowerment: Abbreviated Women's Empowerment in Agriculture Index (AWEAI, 0–1), women's ability to allocate income (WEAI questions; 0–1), men's help with household chores (with 7 activities; 0–7), and women's depression (Center for Epidemiologic Studies Depression Scale; 0–60). All analyses were done on Stata14 and controlled for geographic clustering and social desirability bias. Results SNAP-Tz significantly improved child's dietary diversity (β = 0.53, P < 0.01). Increased production diversity, greater male involvement in household chores, and lower women's depression mediated 11% (ACME: .06; 95%CI: .01-.11), 6% (ACME: .04; 95CI: .00-.08), and 7% (ACME: .03; 95%CI: .00-.07) of SNAP-Tz's impact on child's dietary diversity, respectively. Mediation of AWEAI and income allocation decision making, on the other hand, were not significant. Conclusions SNAP-Tz improved child's dietary diversity through increasing agricultural production diversity, men's involvement in household chores, and women's mental health. By engaging men in household tasks and prioritizing women's mental health, we can optimize the impact of nutrition-sensitive agriculture projects. Funding Sources SNAP-Tz is funded by the McKnight Foundation. SLY was supported by the NIH (K01MH098902).

scholarly journals Participation in a Nutrition Education and Demonstration Program in Rural Senegal Is Associated with Higher Household Dietary Diversity

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 900-900
Author(s):  
Hannah Sanders ◽  
Scott Ickes
Keyword(s):  
Food Insecurity ◽  
Nutrition Education ◽  
Dietary Diversity ◽  
Low Cost ◽  
Program Participation ◽  
Food Groups ◽  
Linear Regression Models ◽  
Demonstration Program ◽  
The Impact ◽  
Household Dietary Diversity

Abstract Objectives We conducted a non-randomized evaluation of a nutrition education program delivered by Soins de Santé Primaire in rural Senegal to identify the impact of participation on household dietary diversity scores (HDDS). We also sought to understand participant's perceptions of program strengths and weaknesses. Women participated in a single education session that emphasized hygiene, selecting from a variety of food groups, risk awareness of diet-related non-communicable diseases, and a recipe demonstration of a locally-sourced, balanced meal. We hypothesized that program participation would be associated with increased HDDS. Methods We surveyed 20 female program participants sampled from two communities and compared their responses with 20 women sampled from two non-intervention communities (n = 40). Surveys collected 24-hour dietary recall to calculate a dietary diversity score using the 12-point HDDS scale. The mean difference in HDDS was evaluated between post-program and comparison groups using linear regression. Models controlled for household size, employment, education, marital status, and the Food Insecurity Experience Scale. We conducted key informant interviews with post-program participants (n = 19) to understand message recall, reported behavior change, and feedback for future sessions. Results Women in intervention households reported higher HDDS than comparison households [Mean (SE) = 9.0 (0.39) vs. 7.65 (0.24), P = .003]. In the adjusted model, program participation was positively associated with HDDS (β = 1.16, P = .041). Household food insecurity was associated with lower HDDS (β = −0.52, P = .024). Program participants recalled the importance of reducing bouillon cube usage and eating from each food group. Participants reported changes in food preparation and hygiene routines, such as adding more beans or vegetables and changing dirty dishwater often. The key improvement suggestion was to increase session frequency and expand education on hygiene and sanitation. Conclusions Low intensity nutrition education programs that include meal demonstrations may be a low-cost, effective method for improving dietary diversity among a population with moderate food insecurity in rural Senegal. Funding Sources World Renew, Services Luthériens pour le Developpement au Sénégal, and the Wheaton Human Needs and Global Resources Program.

scholarly journals Evaluating the impact of agricultural extension programmes in sub-Saharan Africa: Challenges and prospects

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Hailemichael Taye
Keyword(s):  
Impact Evaluation ◽  
Agricultural Development ◽  
Agricultural Research ◽  
Evaluation Studies ◽  
Monitoring And Evaluation ◽  
Agricultural Extension ◽  
Sub Saharan Africa ◽  
Validity And Reliability ◽  
Sub Saharan ◽  
The Impact

Background: In sub-Saharan Africa (SSA), impact evaluation has been used to assess whether agricultural extension interventions have brought the intended result or to establish causal linkages between interventions and outcomes. However, there is some scepticism about the validity and reliability of the results of the impact evaluation reports due to some contradictory and exaggerated results.Objectives: This article analyses some impact evaluation studies conducted in SSA as to why contradictions and exaggerations are manifested in some reports and what would be the future prospects of impact evaluation of agricultural extension programmes in the region.Methods: Impact evaluation reports and results of agricultural extension programmes from 10 SSA countries were reviewed and analysed based on impact evaluation principles and theories.Results: The results show that most of the evaluations reported positive impacts. There are also conflicting reports on extension performance. The fact that the overwhelming majority of impact evaluation reports claim positive extension impacts is not in line with the reports on agricultural productivity growth in the region. There are various reasons for over estimated impacts and contradictory results, which include use of poor impact evaluation methodologies, lack of reliable data and insufficient capacity to conduct rigorous impact evaluations.Conclusion: Due to these challenges and the shift in agricultural research and extension approaches, it is recommended that rather than investing effort in trying to prove impact, greater attention should be given to improving impact as well as using other innovative monitoring and evaluation (M&E) and learning tools that consider the dynamic nature of agricultural development.

Health Effects of Pesticides on Pregnant Women and Children

2020 ◽  
pp. 272-295
Author(s):  
Mudasir Youssouf ◽  
Arun Kalia ◽  
Zahid Nabi ◽  
Zubair A. Malik
Keyword(s):  
Pregnant Women ◽  
Green Revolution ◽  
Assessment Tools ◽  
Disease Vectors ◽  
Risk Assessment Tools ◽  
Hybrid Seeds ◽  
Women And Children ◽  
The Impact ◽  
Different Levels ◽  
Impact Of Pesticides

Pesticides, along with hybrid seeds and fertilizers, are an integral part of the green revolution and are used to control and eradicate disease vectors for the improvement of agricultural production. Pesticides is an umbrella term for insecticides, nematocides, fungicides, herbicides, fumigants, repellents, and attractants. Pesticides are used against unwanted plants and animals to control diseases and losses. Efforts at different levels may help to reduce the impact of pesticides on newborn babies and on pregnant women. Different efforts can be considered at clinical, educational, and policymaking institutes. Use of risk assessment tools, encouragement of organic diets, educating parents working in agricultural fields from hazards of pesticides particularly in pregnancy and breast feeding, implementation of integrated pest management (IPM) programs, and encouraging policies supporting IPM can help in tackling the menace of pesticide hazards.

scholarly journals The Impact of Wealth Status on Food Intake Patterns in Filipino School-Aged Children and Adolescents

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2910
Author(s):  
Imelda Angeles-Agdeppa ◽  
Yvonne M. Lenighan ◽  
Emma F. Jacquier ◽  
Marvin B. Toledo ◽  
Mario V. Capanzana
Keyword(s):  
Dietary Diversity ◽  
Age Groups ◽  
Daily Intake ◽  
Primary Source ◽  
Food Groups ◽  
Nutrition Survey ◽  
Wealth Status ◽  
School Aged Children ◽  
Filipino Children ◽  
The Impact

Socio-economic status (SES) has an impact on food consumption in developing countries. However, the impact of SES on dietary patterns in Filipino school-aged children is currently unknown. The aim of this study was to fill this knowledge gap, using data from the 2013 National Nutrition Survey. Dietary intake of 11,691 children (6–18 years) were assessed using a 24-h recall. All food and beverages were assigned to one of 85 food groups. Mean daily intake, percent consuming (prevalence), and contribution to energy intake were determined, and stratified by SES, in 6–9 years old, 10–12 years old, and 13–18 years old. Rice was the most consumed food and the primary source of energy across all three age groups, independent of SES. Children of poor SES presented greater consumption of fish, vegetables, fruit, and table sugar (p < 0.05). In comparison, children of rich and middle SES presented greater consumption of milk, chicken, pork, sausages, and soft-drinks (p < 0.05). In conclusion, SES impacts the type of foods consumed by Filipino children, with children in the poorest households being most at risk of consuming low-variety diets. This analysis could be used to support public health strategies to improve dietary diversity, and potentially nutrient intake, in Filipino children.

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