Using Formative Research to Inform a BCC Strategy to Increase Food Security and Dietary Diversity in Low-Income Rural Communities

2021 ◽  
Vol 6 (3) ◽  
Author(s):  
Turk T ◽  
◽  
Safdar NF ◽  
Hashmi S ◽  
Shah N ◽  
...  
Keyword(s):  
Literature Review ◽  
Nutrition Education ◽  
Low Income ◽  
Rural Areas ◽  
Dietary Diversity ◽  
Current Knowledge ◽  
Formative Research ◽  
Lessons Learned ◽  
Attitudes And Practices ◽  
Kitchen Gardens

Background: Adequate nutrition is a public health priority, particularly in low-income rural areas where there is a high prevalence of malnutrition and stunting. Baluchistan is an arid desert and mountainous province with the worst health indicators in Pakistan. The objective of this research study was to identify current knowledge, attitudes and practices of vulnerable women with young children residing in remote areas of Baluchistan and assess their information needs to guide the development of a BCC nutrition strategy materials and activities. Methods: This study design incorporated formative research via eight focus group discussions with demand and supply-side program beneficiaries (n=124) to assess current nutrition knowledge, attitudes and beliefs toward kitchen gardens and proposed nutrition resources. Semi-structured interviews (n=16) were also conducted to provide program intelligence from key informants. A literature review supported the development of discussion agenda based on predominant behavioral theories. Data analysis was conducted with in vivo qualitative software coupled with grounded theory with qualitative findings triangulated. Results: The study identified important factors for the development of BCC resources and activities. Opportunities included effective nutrition education, improved income and livelihoods from kitchen gardens, women’s empowerment and gender equality. Challenges included traditional cultural practices, entrenched food preparation behaviour, environmental and infrastructural constraints. Conclusions: Lessons learned highlight the benefits of integrating formative research methods with a comprehensive literature review and behavioural theories for the development of BCC resources for nutrition programs in insecure and resource-constrained settings.

scholarly journals Using Formative Research to Inform a BCC Strategy to Increase Food Security and Dietary Diversity Through a Kitchen Gardens Project in Low-Income Rural Communities

2021 ◽  
Author(s):  
Tahir Turk ◽  
Nilofer Safdar ◽  
Shahkamal Hashmi ◽  
Nadia Shah ◽  
Sidra Zaheer
Keyword(s):  
Rural Communities ◽  
Literature Review ◽  
Low Income ◽  
Dietary Diversity ◽  
Current Knowledge ◽  
Formative Research ◽  
Lessons Learned ◽  
Attitudes And Practices ◽  
Kitchen Gardens ◽  
Behavioural Theories

Abstract Background Adequate nutrition is a public health priority, particularly in low-income rural communities where there is a high prevalence of malnutrition and stunting. Baluchistan is an arid desert and mountainous Province with the worst health indicators in Pakistan. The objective of this study was to identify current knowledge, attitudes and practices of vulnerable women with young children residing in remote areas of Balochistan and assess their information needs to guide the development of a BCC nutrition strategy materials and activities to support a Kitchen Gardens Project. Methods The needs assessment incorporated formative research via eight focus group discussions with demand and supply-side program beneficiaries (n = 124) to assess current nutrition knowledge, attitudes and beliefs toward kitchen gardens and proposed nutrition resources. Semi-structured interviews (n = 16) were also conducted with key stakeholders. A literature review supported the development of discussion agenda based on predominant behavioural theories. Data analysis was conducted with NVivo qualitative software coupled with grounded theory with triangulation of findings Results Opportunities categories for BCC identified more effective nutrition education, incentives of improved income and livelihoods from kitchen gardens, women’s empowerment and gender equality. Challenges included traditional cultural practices, entrenched food preparation behaviours, environmental and infrastructural constraints. Conclusions Lessons learned highlight the benefits of integrating a rapid assessment formative research method with a literature review including behavioural theories for BCC resource development for nutrition programs in culturally conservative, insecure and resource constrained settings.

scholarly journals Community-Based Stunting Intervention Strategies: Literature Review

2020 ◽  
Vol 8 (2) ◽  
pp. 259
Author(s):  
Lita Heni Kusumawardani ◽  
Rasdiyanah Rasdiyanah ◽  
Utami Rachmawati ◽  
Muhamad Jauhar ◽  
I Gusti Ayu Putu Desy Rohana
Keyword(s):  
Literature Review ◽  
Rural Areas ◽  
Health Workers ◽  
Management Strategies ◽  
Intervention Strategies ◽  
Personal Hygiene ◽  
Community Based ◽  
Normal Children ◽  
Nutritional Interventions ◽  
Attitudes And Practices

Stunting is a growth disorder in children caused by malnutrition for a long time. The child's condition becomes shorter than normal children his age and has a delay in thinking. The incidence of stunting in Indonesia is quite high sostunting is becoming a priority health problem now. An effective strategy is needed to control stunting in Indonesia. The aim of this review was to explore the stunting management strategies to potentially implement in Indonesia.A literature review design was used to explore the stunting management strategies. Literature study of 15 articles retrieved from the journal database of Science Direct, Proquest, Scopus, and EBSCO in the last 5 years using keywords stunting, management, rural areas, and community based. Data were analyzed in tables consist of title, author, year, sample, methodology, and result. Control and preventionstunting could done through integrated nutrition interventions.Strategy Specific nutritional interventions such as providing supplementation and supplementary food plus nutritional interventions including non-health interventions, improving the family's economy, access and utilization of clean water, sanitation (especially latrines and safe septic tanks), which are urgently needed to support personal hygiene behavior and the environment . Interventions can use mother's counseling and support methods regularly by health workers by involving health cadres.Specific and sensitive intervention strategies are effective strategies within stunting control and prevention. Monitoring and evaluation of nutritional knowledge, attitudes and practices coupled with an assessment of the nutritional status and morbidity of mothers and children is also very necessary in controlling and preventing stunting in Indonesia

scholarly journals A Garden-Based Intervention to Improve Dietary Diversity in Kenyan School Children: Results from a Natural Experiment

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 810-810 ◽  
Author(s):  
Sara Benjamin-Neelon ◽  
Tiange Liu ◽  
Eve S Puffer ◽  
Liz Turner ◽  
Daniel Zaltz ◽  
...  
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Primary Schools ◽  
Dietary Diversity ◽  
Food Group ◽  
Low Income Countries ◽  
Severe Drought ◽  
School Gardens ◽  
Post Intervention

Abstract Objectives School gardens may improve child diet, but little is known about their effectiveness in rural areas in low-income countries. We evaluated the ability of school gardens to improve child diet in rural Kenya. We hypothesized that children in intervention schools would improve their dietary diversity and specifically their produce intake. Methods An non-government organization installed gardens in 2 primary schools. We selected 2 geographically proximal additional schools as comparisons. We conducted baseline assessments in 2013, prior to garden installation, and follow-up assessments a year later in 2014 in all 4 schools. We measured child dietary intake via a single 24-hour recall. We calculated dietary diversity using the women's dietary diversity score (WDDS) (continuous) and also examined each of the 10 food group components defined as adequate ≥15 g (binary). We conducted marginal linear or logistic regression models using a generalized estimating equation and included an exposure x time interaction to assess differences in outcomes between intervention and comparison schools from baseline to follow up. We controlled for child age, gender, and orphan status. Results We assessed 855 children (n = 438 intervention; n = 417 comparison) at baseline and 688 children (n = 383 intervention; n = 305 comparison) at follow up. Children in intervention schools were 51.8% male, compared to 56.5% in comparison schools. Mean (standard deviation) age was 11.6 (2.1) years in intervention and 11.8 (2.3) years in comparison schools. All children's WDDS worsened post-intervention. In adjusted difference in difference analyses, WDDS did not differ in intervention vs. comparison schools pre- to post-intervention (β 0.04, CI −0.19, 0.27). However, we observed less of a decrease in meeting adequate intake for pulses (OR 2.18, CI 1.18, 4.01) and other fruits (OR 1.55, CI 1.00, 2.40) in intervention versus comparison schools. Conversely, children in comparison schools had less of a decrease in meat, poultry, and fish compared to children in intervention schools (OR 0.67, CI 0.45, 0.99). Conclusions Children's WDDS worsened in all 4 schools, likely due to a severe drought that affected the region in 2014. We observed some differences in intervention vs. comparison children, but cannot attribute these improvements to school gardens. Funding Sources Duke Global Health Institute.

scholarly journals Nutrition Knowledge and Dietary Intake in Pregnancy in Rural Malawi: Comparing Supplementary Nutrition Education and -Counseling With Routine Antenatal Care

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 145-145
Author(s):  
Lillian Katenga-Kaunda ◽  
Penjani Rhoda Kamudoni ◽  
Gerd Holmboe-Ottesen ◽  
Heidi Fjeld ◽  
Ibrahimu Mdala ◽  
...  
Keyword(s):  
Nutrition Education ◽  
Low Income ◽  
Dietary Habits ◽  
Dietary Diversity ◽  
Intervention Group ◽  
Study Groups ◽  
Nutrition Knowledge ◽  
Randomised Control Trial ◽  
Control Group ◽  
End Point

Abstract Objectives To describe and compare changes in nutrition knowledge, perception and dietary habits between the intervention and control group and to evaluate the effects of nutrition knowledge on dietary diversification among the two study groups. Methods This study was a two armed randomised control trial. We recruited 257 women (gestational week 9–12) of which 195 (76%) were available for analyses: intervention 92; Control 103) the women were assessed at inclusion (baseine) and two weeks before the expected date of delivery (study end-point) for differences in nutrition knowledge, perception (using a structured questionnaire) and dietary habits (assessing dietary diversity score). We performed descriptive analyses to assess these differences between the two study groups. Three-level linear multilevel regression models with random intercept and random effect of time on participant at level 1 and village level 2 were used to expore the association between nutrition knowledge and dietary habits Results Our results show that both nutrition knowledge and dietary diversity improved in both study groups, but the improvement were significantly higher in the intervention group at study-end point. Increase in nutrition knowledge was associated with improved dietary diversity only among women in the intervention group. Moreover, women in the intervention group improved their nutrition perception and behaviour. Conclusions Our results provide evidence that poor nutrition knowledge is a barrier to consumption of healthy diet during pregnancy, thus supporting the relevance for augmenting nutrition education offered at ANC with supplementary and community-based nutrition interventions. We thus suggest that efforts should be made to strengthen the education component of ANC services as these are decentralized and locally accessible in Malawi and other low-income countries Funding Sources This project was funded by the University of Oslo, The Global Health and Vaccination Program (GLOBVAC) of the research council of Norway and by the Throne Holst foundation.

scholarly journals Community-Level Impacts of Climate-Smart Agriculture Interventions on Food Security and Dietary Diversity in Climate-SMART VILLAGES in Myanmar

Climate ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 166
Author(s):  
Andrew Hanley ◽  
Galina Brychkova ◽  
Wilson John Barbon ◽  
Su Myat Noe ◽  
Chan Myae ◽  
...  
Keyword(s):  
Food Security ◽  
Rural Communities ◽  
Nutrition Education ◽  
Dietary Diversity ◽  
Household Food Security ◽  
Attitudes And Practices ◽  
Trade Offs ◽  
Smart Agriculture ◽  
The Impact ◽  
Knowledge Attitudes And Practices

Diversification of production to strengthen resilience is a key tenet of climate-smart agriculture (CSA), which can help to address the complex vulnerabilities of agriculture-dependent rural communities. In this study, we investigated the relationship between the promotion of different CSA practices across four climate-smart villages (CSVs) in Myanmar. To determine the impact of the CSA practices on livelihoods and health, survey data were collected from agricultural households (n = 527) over three years. Within the time period studied, the results indicate that some the CSA practices and technologies adopted were significantly associated with changes in household dietary diversity scores (HDDS), but, in the short-term, these were not associated with improvements in the households’ food insecurity scores (HFIAS). Based on the survey responses, we examined how pathways of CSA practice adoption tailored to different contexts of Myanmar’s four agroecologies could contribute to the observed changes, including possible resulting trade-offs. We highlight that understanding the impacts of CSA adoption on household food security in CSVs will require longer-term monitoring, as most CSA options are medium- to long-cycle interventions. Our further analysis of knowledge, attitudes and practices (KAPs) amongst the households indicated a poor understanding of the household knowledge, attitudes and practices in relation to nutrition, food choices, food preparation, sanitation and hygiene. Our KAP findings indicate that current nutrition education interventions in the Myanmar CSVs are inadequate and will need further improvement for health and nutrition outcomes from the portfolio of CSA interventions.

scholarly journals Community-based educational intervention improved the diversity of complementary diets in western Kenya: results from a randomized controlled trial

2015 ◽  
Vol 18 (18) ◽  
pp. 3406-3419 ◽  
Author(s):  
Lydiah M Waswa ◽  
Irmgard Jordan ◽  
Johannes Herrmann ◽  
Michael B Krawinkel ◽  
Gudrun B Keding
Keyword(s):  
Nutrition Education ◽  
Educational Intervention ◽  
Treatment Effect ◽  
Rural Areas ◽  
Dietary Diversity ◽  
Intervention Group ◽  
Nutrition Knowledge ◽  
Control Group ◽  
Education Intervention ◽  
Western Kenya

AbstractObjectiveLack of diversity is a major factor contributing to inadequate nutrient intakes among children during the complementary feeding period in many rural areas in developing countries. This has been attributed to inadequate feeding practices and nutrition knowledge among their caregivers. The aim of the present study was to assess the effect of an educational intervention on children’s dietary diversity and nutrition knowledge of caregivers.DesignCluster randomization was applied and twenty matched village pairs were randomly assigned to the intervention or control group. The nutrition education intervention consisted of four sessions comprising of group trainings and cooking demonstrations that were conducted over a period of 5 months.SettingHouseholds in rural communities in Bondo and Teso South sub-counties, western Kenya.SubjectsCaregivers with children aged 6–17 months receiving nutrition education.ResultsThe children’s dietary diversity scores (CDDS) and nutrition knowledge scores of the caregivers improved significantly in the intervention group at endline. The treatment effect on CDDS was positive and significant (P=0·001). The CDDS rate of the children in the intervention group was 27 % larger than it would have been without the treatment effect. The intervention also had a significant effect on the caregivers’ nutrition knowledge scores (incidence rate ratio=2·05; P<0·001). However, the nutrition knowledge of the caregivers did not have a significant effect on CDDS (P=0·731).ConclusionsThe nutrition education intervention led to improvements in children’s dietary diversity and nutrition knowledge of the caregivers.

Determinants of nutritional knowledge, attitude, and practice among southwestern Iranian households: A community-based study

2020 ◽  
Vol 26 (2) ◽  
pp. 93-102
Author(s):  
Mahshid Naghashpour ◽  
Samaneh Mansouri ◽  
Ali Vadizadeh ◽  
Bahman Cheraghian ◽  
Reza Fallahi ◽  
...  
Keyword(s):  
Nutrition Education ◽  
Rural Areas ◽  
Current Knowledge ◽  
Household Head ◽  
Population Based ◽  
Cluster Sampling ◽  
Nutritional Knowledge ◽  
Cross Sectional ◽  
Nutritional Interventions ◽  
Household Heads

Background: Malnutrition is generally due to a lack of nutritional information rather than food deficiency. Therefore, the current knowledge, attitudes, and practice (KAP) of the target audience should be evaluated to eliminate malnutrition. However, KAP varies across demographic status and socioeconomic status (SES). Aim: The associations of nutritional KAP with demographic and socioeconomic variables were evaluated among households living in urban and rural areas of southwestern Iran. Methods: A cross-sectional, population-based study was conducted on 842 household heads (492 urban and 350 rural) using a standardized NUTRIKAP Household Questionnaire. The data evaluating nutritional KAP as well as demographic and socioeconomic information were obtained using a multi-stage cluster sampling method. SES score was also computed. Results: Urban households had a higher level of nutritional knowledge ( p < 0.05) but a lower level of nutritional attitude ( p < 0.001) and practice ( p < 0.001) compared with the rural ones. Rural households with the poorest quintiles of SES were 0.4 times less likely to have good nutritional knowledge (adjusted odds ratio = 0.4, confidence interval: 0.2, 0.9; p < 0.05), compared with higher quintiles. Households with an over-60-years-old household head had significantly higher nutritional attitude ( p < 0.05) and practice ( p <0.01) scores than households with younger ones. Households with male household heads had a higher nutritional practice score compared with households with female ones. Conclusions: These results can indicate the role of demographic and socioeconomic determinants in KAP of Iranian households towards the principle of nutrition and can be effective in prioritizing the implementation of nutritional interventions including nutrition education for them.

scholarly journals Assessing food security using household consumption expenditure surveys (HCES): a scoping literature review

2018 ◽  
Vol 21 (12) ◽  
pp. 2200-2210 ◽  
Author(s):  
Joanna Russell ◽  
Anne Lechner ◽  
Quentin Hanich ◽  
Aurélie Delisle ◽  
Brooke Campbell ◽  
...  
Keyword(s):  
Food Security ◽  
Literature Review ◽  
Food Insecurity ◽  
Low Income ◽  
Dietary Diversity ◽  
Household Consumption ◽  
Household Food Security ◽  
Data Sets ◽  
Household Food ◽  
Scoping Literature Review

AbstractObjectiveTo meet some of the UN’s seventeen Sustainable Development Goals by 2030, there is a need for more effective policy to reduce food insecurity in low-income and lower-middle-income countries (LMIC). Measuring progress towards these goals requires reliable indicators of food security in these countries. Routinely conducted household consumption and expenditure surveys (HCES) provide potentially valuable and nationally representative data sets for this purpose. The present study aimed to assess methods used to determine national food security status using proxy measures from HCES data in LMIC globally.DesignA scoping literature review was conducted using electronic databases. Of the 929 abstracts identified, a total of twenty articles were reviewed against strict inclusion and exclusion criteria and included for further analysis.ResultsFourteen LMIC globally were represented in the twenty articles. The simplest metric used to indicate food insecurity compared household food expenditure against a level of expenditure considered to be below the poverty line. Data on acquisition of food was commonly converted to available energy for the household using local food composition tables and expressed as a proportion of household total energy requirements. Dietary diversity was also assessed in some studies as well as experience of food insecurity.ConclusionsThe review demonstrated that routinely collected HCES data sets provide a useful resource for the measurement of household food security in often resource-limited LMIC. Standardisation of methods used to assess food security is needed to allow for more useful comparisons between countries, as well as to assess temporal trends.

scholarly journals Trends and determinants of minimum dietary diversity among children aged 6-23 months: a pooled analysis of Indonesia Demographic and Health Surveys from 2007 to 2017

2021 ◽  
pp. 1-28
Author(s):  
Bunga A Paramashanti ◽  
Tanvir M Huda ◽  
Ashraful Alam ◽  
Michael J Dibley
Keyword(s):  
Nutrition Education ◽  
Rural Areas ◽  
Health Surveys ◽  
Maternal Education ◽  
Dietary Diversity ◽  
Multiple Logistic Regression Analysis ◽  
Demographic And Health Surveys ◽  
Food Groups ◽  
Community Factors ◽  
Minimum Dietary Diversity

Abstract Objective: To examine minimum dietary diversity trends and determinants among children aged 6-23 months. Design: Secondary analysis of the Indonesia Demographic and Health Surveys (IDHS) between 2007 and 2017. The primary outcome was minimum dietary diversity, the consumption of at least five out of eight food groups (MDD-8). We included a total of 5015 (IDHS 2007), 5050 (IDHS 2007), and 4925 (IDHS 2017) children aged 6 to 23 months to estimate trends of MDD-8 and to identify factors associated with MDD-8. We used multiple logistic regression analysis adjusted for the complex sampling design to investigate the association between the study factors and MDD-8. Setting: Indonesia. Participant: A total of 14990 children aged 6-23 months. Results: Over the ten years, the percentage of children who consumed a diversified diet was 53.1% in 2007, 51.7% in 2012, and 53.7% in 2017. Multivariate analyses showed that older age children, higher maternal education, maternal weekly access to media, paternal non-agricultural occupation, history of at least four ANC visits, and wealthier households were associated with the increased odds of MDD-8. Children living in rural areas, Sulawesi and Eastern Indonesia, were less likely to eat a diversified diet. Conclusions: The proportion of children meeting MDD-8 has stagnated in the last decade. Child, parental, health care, household, and community factors are associated with MDD-8. Therefore, nutrition-education programmes and behaviour change communication activities should target mothers and families from socio-economically and geographically disadvantaged populations.

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