Pathways to Improving Nutrition among Upland Farmers through Nutrition-Sensitive Agriculture Interventions: A Case from Northern Laos

Indu K Sharma,Ranjan Shrestha,Victoria Fumado,Dirk Essink,Zefanya D Susanto,Jacqueline E W Broerse

doi:10.3390/su132313414

Abstract

While there is an increased awareness of the role of nutrition-sensitive agriculture (NSA) interventions on nutrition, the studies that investigate holistic pathways from interventions to nutrition outcomes are inadequate. We aimed to understand these pathways to improved nutrition from the Enhancing Nutrition of Upland Farming Families (ENUFF) Project implemented in northern Laos. We applied an embedded case study design by recruiting 101 participants representing implementers, school and private sector representatives, and beneficiaries, of which 34 participated in interviews and 68 participated in 11 FGDs. This was supplemented by a desk review of project documents. We analyzed the data using a directed content analysis across five pathways using a published framework on impact pathways from NSA interventions to nutrition outcomes. The project contributed to nutrition mainly through three core pathways-food production, nutrition and WASH-related knowledge, and agricultural income, supported by strengthening local institutions within the project’s scope. While it is evident that the project contributed to empowering women by saving their time and increasing income, further study is needed to investigate the translation of these aspects to nutrition-related practices. We also suggest the need to sustain the capacity of local institutions and their engagement beyond the project cycle. To enhance the effectiveness of NSA interventions on nutrition, there is a need to design and implement intervention package with multiple pathways and tailored strategies based on nutrition outcomes, the envisaged pathways, geographical context, and factors affecting these.

Highlights

The role of the agriculture sector in addressing poor diets and consequent malnutrition has been previously studied [1,2]
nutrition-sensitive agriculture (NSA) can appropriately fit in the context of low- and middle-income countries (LMICs), as most of the population depends on agriculture as the primary source for their livelihood [2,6]
This study aims to understand impact pathways from NSA interventions to improved nutrition outcomes in upland farming areas of northern Laos, using the Enhancing Nutrition of Upland Farming Families (ENUFF) Project as a case

Summary

Introduction

The role of the agriculture sector in addressing poor diets and consequent malnutrition has been previously studied [1,2]. Past studies have suggested that NSA can address malnutrition through multiple pathways [2,3,5]: improving food production [2,3,5], raising income level enabling the purchase of nutritious foods [2,3,5], empowering women to make nutrition-related decisions [2,3,5], increasing nutrition-related knowledge [3], strengthening local institutions [3], Sustainability 2021, 13, 13414. While there is abundant evidence on the impact of NSA interventions on nutrition and specific pathways to such effects, studies that investigate a holistic examination of impact pathways are limited. Fragmentation of the evidence-based intervention package across multiple studies has limited the understanding of the holistic pathways and the effects [3]. There is a need to map the comprehensive impact pathways that lead from NSA interventions to better nutrition outcomes by assessing the effects of the interventions on nutrition and detailing the pathways from the interventions to the effects

Objectives

Methods

Results

Discussion

Conclusion