Nutrition-sensitive Agriculture Research Articles

Agroecosystem-based analysis of household dietary diversity and its linkage with agricultural production diversification in the Upper Blue Nile Basin, Ethiopia: Multilevel analysis approach

Even though the UN's Sustainable Development Goals emphasize improving dietary diversity and overall nutritional status globally by promoting sustainable agriculture, inadequately diversified dietary intake remains a public health problem in many low-income countries, including in Sub-Saharan Africa. The main objective of this study was to gather relevant information to gain an improved understanding of household dietary diversity and explore the role that production diversification could play within household diets and nutrition so that appropriate interventions could be implemented with the goal of enhancing nutrition-sensitive agriculture while also considering the varied features across the agroecosystems. Agroecosystem-based cross-sectional study design was employed. Data were collected predominantly through semi-structured questionnaires and analyzed by descriptive and inferential statistics, and a multilevel mixed-effect model. Results showed that the usual dietary intake of households has a monotonous pattern dominated by starchy staple foods, and consumption of fruits, vegetables, and animal-sourced foods was very limited. One out of five households had inadequate dietary diversity but varied significantly across agroecosystems. About 26% of the heterogeneity in dietary diversity was attributed due to agroecosystem level factors. In the fixed-effect part of the model, production diversification, wealth status, number of meals per day, market access, and annual mean rainfall were significantly associated with household dietary diversity status. The findings of our research contribute to give insights on the linkage between dietary diversity and production diversification among subsistence rural farmers across contrasting agroecosystem zones. Therefore, understanding agroecosystem variations and local context in the rural subsistence farming setup is a key point in designing nutrition-sensitive agriculture.

Integrating nutrition in the Sasakawa Africa Association extension services: Knowledge, attitude and practices among smallholder farmers

This survey aimed to establish nutrition-related knowledge, attitudes and practices, and to observe how gender influences household food-related decision-making processes in the Sasakawa Africa Association (SAA) intervention areas in the Oromia and Southern Nation Nationalities and People regions of Ethiopia. The findings would inform implementation of communication for nutrition social and behaviour change among small-holder farmers as part of the SAA corporate strategy on nutrition-sensitive agriculture. The study population was smallholder farmers supported by SAA from which 311 respondents were selected through multistage sampling. Data were collected via a mixed methods approach consisting of a household survey, focus group discussions (FGDs) and key informant interviews (KIIs). Quantitative data were analysed using descriptive statistics while qualitative data was analysed using a narrative and content approach. The study focused on knowledge, attitudes and practices related to production and consumption of micronutrient-rich foods. Majority (59.5%) of the respondents were male. Men were the main decision makers on staple or commercial food crop production and proportion of produced crops to be consumed at home or sold in the market. Women mainly made decisions regarding production and consumption of fruits and vegetables, intra-household food distribution, preservation and storage. There was a lack of knowledge on iron and vitamin A fortified or biofortified sources of food. Nearly three quarters (72%) of women did not meet the minimum dietary diversity for women, a proxy indicator of adequacy of micronutrient intake and diet quality. The mean dietary diversity score was 3.8 with animal source foods being the least consumed. Not having sufficient money to buy food, unavailability of different food groups and poor intra-household food distribution were among the key reasons for lack of diverse diets. Majority of the respondents were aware of the importance of production and consumption of micronutrient-rich foods. However, there was a gap in practice and awareness about biofortified and fortified foods. While most of the respondents had produced fruits and vegetables in home gardens in the three months prior to this survey, more than half (54%) of the respondents thought it was not likely that they would produce fruits and vegetables for home consumption. More targeted nutrition campaigns are required to increase the ability of small-holder farmers to adopt best practices while reducing the barriers associated with access and consumption. Promotion of fruit and vegetable production in home gardens could be considered as option for improving household dietary quality as well as empowering women to make more decisions. Key words: Sasakawa Africa Association, Small-holder farmers, Nutrition, Knowledge, Practices

Perceptions and experiences of an intervention to improve diets of women and young children in Ghana

BackgroundEfficacious integrated intervention strategies to address the drivers of malnutrition at multiple levels are hardly implemented at scale, although opportunities for cross-sectoral action exist. In 2020, the Improved Feeding Practices (IFP) Project was implemented in Ghana to improve the dietary diversity and well-being of women of reproductive age (15-49 years) and children >2 years.ObjectiveThis paper reports the perceptions and experiences of project beneficiaries and the lessons learned from the IFP project.MethodsUsing a socio-ecological framework, data from the IFP project documents (n=8) and in-depth interviews with key stakeholders, including local government officers, and direct and indirect beneficiaries (n=61), were triangulated to construct an evidence-based overview of the implementation of the complementary strategies of the IFP project. The interviews explored respondents' knowledge, experiences of the project activities, and perceptions of how the project affected their lives. The data were analysed and synthesized thematically using ATLAS.ti.ResultsThe IFP project envisaged an impact pathway through promoting community- or home-based nutrient-rich crop production and poultry to enhance diet quality, child care and feeding practices. Multi-sectoral partners facilitated training and service delivery at community, farm, facility, and household levels. Beneficiaries reported an overall positive experience of participating in the project, including enhanced dietary knowledge, capacity to produce and use eggs and orange fleshed sweet potatoes (OFSP), earned revenues, and access to nutritious foods. Caregivers reported that the IFP project contributed to enhancing children’s diet quality, reduced disease incidence, and improved child growth. Community-level program implementers experienced capacity strengthening. The dry season, increased poultry feed input prices, diseases (such as fowl pox, Newcastle and smallpox), and poultry deaths, limited the scale of benefits. Key implementation lessons include leveraging local resources to produce poultry feed at home, crossbreeding local and commercial poultry, and enhancing disease management, leading to improved potential for project sustainability.ConclusionsOverall, the communities reported a positive experience of an integrated nutrition-sensitive agriculture (NSA) intervention, leading to improved diets of households, women of reproductive age, and young children >2 years. These strategies can be adapted for use in other to improve women's and children's dietary diversity in similar settings, giving due consideration to lessons learned.

Home-Garden Production and Women Dietary Diversity: An Experience from Success of Micro-Intervention in Boru Meda Kebele, Ethiopia

Background: In order to combat malnutrition and micronutrient deficiencies, Nutrition Sensitive Agriculture (NSA) gives nutrient-dense foods, dietary diversity, and food fortification the highest priority. This micro-intervention project's goal is to increase home-gardening system's contribution to raising women's dietary diversity score (WDDS) by diversifying family farming practices. Methods: In Ethiopia's Boru-Meda Kebele, The authors applied the intervention to 40 specifically chosen female beneficiaries between the ages of 15 and 49. FAO's standardized questionnaire was used as a tool to conduct an initial and end-line dietary diversity survey by giving careful consideration to cultural and religious elements. The qualitative information was also gathered using case studies, key informant interviews, and focus group discussions. Results: The local population's diet was dominated by staple cereal crops, and women were less knowledgeable about home gardening and diverse diets. Before intervention, the average number of food groups produced and consumed was 2.63±1.00 and 3.68±1.16 respectively. The intervention enhanced the WDDS to 6.13±0.76, and the production diversity to 5.63±0.90. The intervention changed the community's consumption and production patterns, especially among women. Conclusion: Home-garden agriculture helps to increase WDDS. As a result, development partners must concentrate on farming system diversification by increasing the accessibility of vegetable seeds and educating local farmers about the contribution of diversified vegetable production and consumption. Strengthening the cooperation among stakeholders and maintaining monitoring of activities should also be given due emphasis.

The role of nutrition-sensitive climate-smart agriculture in ensuring global food security

Climate-Smart Agriculture (CSA) is a sustainable farming approach that attempts to maximize resource utilization, improve long-term agricultural sustainability, and prevent environmental degradation while improving agricultural income and production. Nutrition-Sensitive Agriculture (NSA) revolves around the connections between agriculture, food systems, and health, with the goal of ensuring that agricultural practices contribute to better nutrition and well-being. This research focuses on the deployment of a Nutrition-Sensitive Climate Smart Agriculture (NSCSA) method in order to better understand its potential benefits for global food security and nutrition. The research methodology comprises a thorough analysis and review of existing literature on CSA, NSA, and NSCSA policies and practices. To address the complex concerns of food security and nutrition in the context of climate change, the article emphasizes the significance of incorporating nutrition considerations into CSA policies and initiatives. The findings further highlight the importance of multi-stakeholder collaboration and knowledge sharing in implementing and scaling up nutrition-sensitive CSA initiatives. In conclusion, the study reveals that nutrition-sensitive CSA has the potential to help achieve sustainable development goals such as food security, nutrition, and climate change mitigation and adaptation.

Feasibility, acceptability and equity of a mobile intervention for Upscaling Participatory Action and Videos for Agriculture and Nutrition (m-UPAVAN) in rural Odisha, India.

Addressing undernutrition requires strategies that remove barriers to health for all. We adapted an intervention from the 'UPAVAN' trial to a mobile intervention (m-UPAVAN) during the COVID-19 pandemic in rural Odisha, India. In UPAVAN, women's groups viewed and discussed participatory videos on nutrition-specific and nutrition-sensitive agricultural (NSA) topics. In m-UPAVAN, weekly videos and audios on the same topics were disseminated via WhatsApp and an interactive voice response system. We assessed feasibility, acceptability, and equity of m-UPAVAN using a convergent parallel mixed-methods design. m-UPAVAN ran from Mar-Sept 2021 in 133 UPAVAN villages. In Feb-Mar 2021, we invited 1000 mothers of children aged 0-23 months to participate in a sociodemographic phone survey. Of those, we randomly sampled 200 mothers each month for five months for phone surveys to monitor progress against targets. Feasibility targets were met if >70% received videos/audios and >50% watched/listened at least once. Acceptability targets were met if >75% of those watching/listening liked the videos/audios and <20% opted out of the intervention. We investigated mothers' experiences of the intervention, including preferences for m-UPAVAN versus UPAVAN, using in-person, semi-structured interviews (n = 38). Of the 810 mothers we reached, 666 provided monitoring data at least once. Among these mothers, feasibility and acceptability targets were achieved. m-UPAVAN engaged whole families, which facilitated family-level discussions around promoted practices. Women valued the ability to access m-UPAVAN content on demand. This advantage did not apply to many mothers with limited phone access. Mothers highlighted that the UPAVAN interventions' in-person participatory approaches and longer videos were more conducive to learning and inclusive, and that mobile approaches provide important complementarity. We conclude that mobile NSA interventions are feasible and acceptable, can engage families, and reinforce learning. However, in-person participatory approaches remain essential for improving equity of NSA interventions. Investments are needed in developing and testing hybrid NSA interventions.

Dairy trade liberalization and child stunting: Evidence from low- and middle-income countries

Despite the well-studied nutritional benefits of dairy for child linear growth, dairy is less consumed in low- and middle-income countries (LMICs) where the prevalence of child stunting is high. Previous studies have suggested the cost of dairy as a potential barrier to increased dairy consumption in these countries. Surprisingly, little research on the association between dairy consumption and child stunting in LMICs focuses on the role of trade policies, particularly the liberalization of dairy trade. To explore this, we use representative cross-country individual data on child stunting from 2006 to 2020 and link it with country-level dairy trade data. We find that a 10% decline in dairy tariff rates reduces the risk of stunting by 7.78%. Our results are robust to a subsample analysis excluding countries which joined the WTO after 2000 and to an alternative clustering method. As a falsification test, our results show child stunting is not linked with tariffs for coffee and tea. Heterogeneity analysis indicates the associations are more pronounced for boys, children aged 3–5, and children from households with lower socioeconomic status. Although we did not find significant rural–urban differences, the associations are indeed stronger for households without cattle and for countries in Western Africa, South East Asia and Europe and Central Asia. Mechanism analysis suggests that dairy tariffs are positively correlated with milk prices, while they are negatively associated with dairy import values. Lower dairy tariffs are also found to be linked with higher probability of child dairy consumption. Our findings highlight the importance of removing tariff barriers in reducing the cost of dairy and promoting dairy consumption in LMICs. This study has implications for repurposing dairy trade policies in creating nutrition-sensitive agriculture.

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

BackgroundRice-predominant diets are common in Bangladesh, leading to widespread nutritional deficiencies. The Food and Agricultural Approaches to Reducing Malnutrition (FAARM) cluster-randomized controlled trial in rural Sylhet, Bangladesh evaluated a homestead food production intervention implemented 2015–2018 through Helen Keller International, aiming to improve child growth. ObjectivesWe estimated the intervention’s impact on women’s and children’s dietary diversity, a secondary trial objective. MethodsWe collected dietary diversity throughout the trial (March 2015 to June 2020) at multiple times each year using standard, United Nations-endorsed, self-reported measures for women (10-food group scale) and children (7-food group scale). We included 28,282 observations of 2701 women (out of 2705 enrolled) and 17,445 observations of their 3257 children (aged 6–37 mo) in 96 settlements, 48 of which received the intervention. We estimated the intervention’s impact on dietary diversity by year of intervention, overall periods following the start of the intervention, and seasonally, using multilevel regression with the control group as the counterfactual, controlling for seasonality, baseline dietary diversity, and clustering by settlement and repeated measures. ResultsAt baseline, approximately one-third of women and children consumed a minimally diverse diet. Over the entire intervention and postintervention period, women’s and children’s odds of consuming a minimally diverse diet nearly doubled (odds ratio [OR] 1.8, P < 0.001, for both). This benefit was barely present in the first year, increased in the second, and peaked in the last intervention year (OR 2.4 for women, OR 2.5 for children, both P < 0.001) before settling at around double the odds in postintervention years (P < 0.001). Dietary improvement was observed throughout the year for both women and children with incremental increases in nearly all food groups. ConclusionsThe nutrition-sensitive agriculture intervention successfully increased dietary diversity in women and children, and these impacts persisted after the project closed, including during the early COVID 19 lockdown period.This trial was registered at clinicaltrials.gov as NCT02505711.

Integrated aquatic and terrestrial food production enhances micronutrient and economic productivity for nutrition-sensitive food systems

Integrated aquaculture–agriculture (IAA) is a form of crop diversification where aquatic and terrestrial foods are grown together on a single parcel of land. We compare economic and nutrient productivity per hectare for 12 distinct IAA combinations, identified from a representative survey of 721 farms in southern Bangladesh. Just under half of households integrate agriculture into their aquaculture production. Regression analyses show positive associations between the integration of terrestrial foods into aquatic farming systems and nutrient productivity, but that nutrient productivity is partly disconnected from economic productivity. However, we find that production of specific combinations of aquatic foods and vegetables can simultaneously improve nutrient productivity and economic productivity, thereby promoting nutrition-sensitive agriculture (NSA). The approach demonstrated here can be applied to the design of NSA programmes that are important for realizing nutrition-sensitive food systems.

Influence of Capacity Building on Nutrition Sensitivity of the Municipal Agriculture Development Plan in Calabarzon, Philippines

To improve the nutrition sensitivity of the Municipal Agriculture Development Plan (MADP) of Calabarzon, a one-group pre-test post-test design quasi-experimental study was conducted involving the Local Agriculture Planners (LAP) of 57 municipalities in the region from March to December 2021. Wilcoxon Paired Signed Rank was used to determine significant differences in the nutrition sensitivity of the MADP and level of knowledge, attitude, and self-efficacy of the LAP before and after the intervention. Binary logistic regression analysis was also performed to model the change in the level of the nutrition sensitivity of the MADP. The LAP's level of knowledge, attitude, and self-efficacy as well as the nutrition sensitivity of the MADP significantly improved after the capacity building. The study also found that the change in knowledge of municipal agriculturists may increase the nutrition sensitivity of the MADP by 28%. Therefore, capacitating LAP on nutrition-sensitive agriculture can significantly improve their capability to create local agriculture plans that are also nutrition-focused.

Increasing Household Diet Diversity and Food Security in Rural Rwanda Using Small-Scale Nutrition-Sensitive Agriculture: A Community-Engaged Proof-of-Concept Study.

Malnutrition and food insecurity remain high in rural Rwanda, where residents consume a low-diversity diet provided through subsistence farming. Agricultural interventions using kitchen gardens may improve diet diversity in some populations. However, little is known about their efficacy when developed using community-based participatory research in combination with nutrition education focused on the empowerment of women. The objective of this study was to develop and implement a kitchen garden and nutrition education intervention using a community-engaged model and examine its impact on household diet diversity and food security. Using a mixed methods community-level design, we assessed a 16-week intervention implemented in Cyanika, Rwanda. Stratified purposeful sampling was used to select women participants representing 42 households. Household diet diversity scores (HHDS) and hunger scores were calculated at the baseline, post-intervention and one-year follow-up. HDDS increased after intervention from a pre-intervention intake of 2.59 [1.3] food groups/day, to 4.85 [1.6] at four months post-intervention and at one year post-intervention, reaching 5.55 [1.3]. There were no significant changes in household hunger scores. Our results indicate that collaborative community-engaged nutrition-sensitive agricultural interventions can increase household diet diversity; however, future work should explore whether this type of intervention strategy can lead to sustained changes and impact nutritional adequacy in this population.

Nutritional Assessment of Farm Women under Nutri-Smart Village Programme

The objectives of the programme were to promoting nutritional awareness, education and behavioural change in rural area involving farm women and school children, harnessing traditional knowledge through local recipe to overcome malnutrition and implementing nutrition sensitive agriculture through homestead agriculture and nutri-garden. For this study, All India Coordinated Research Project on Women in Agriculture, MPUAT, Udaipur adopted five villages of Badgaon Panchayat Samiti to make Nutri Smart Villages i.e. Madar, Thoor, Brahmano ki hunder, Feniyon ka guda and Loyra. Regarding nutritional, health and hygiene practices, 57.07 per cent of the respondents followed poor practices. Majority of the rural women were vegetarian. Regarding BMI of respondents, 40.53 per cent women were pre-obese and18.12 per cent were obese. Awareness generation is required regarding importance of good nutrition.

Government Budget for Nutrition-Sensitive Agriculture in Nigeria Increased Following Development of Related Strategy.

Financial resources that are commensurate with the magnitude of malnutrition problem are requisite for effective interventions to reduce malnutrition. Understanding the amount and nature of sectoral investments in nutrition is important for advocating and mobilizing increased government budgetary allocations and release. This study assessed trends in Nigeria's agriculture sector nutrition allocations and whether launch of nutrition-sensitive agriculture strategy and/or the COVID-19 pandemic may have affected these nutrition allocations. Agricultural budgets from 2009 to 2022 of Nigeria's federal government were analyzed. Nutrition-related budget lines were identified using a keyword search and were then classified as nutrition-specific, nutrition-sensitive, or potentially nutrition-sensitive, based on defined criteria. Potentially nutrition-sensitive items were further screened. Budget lines finally included as nutrition allocations directly targeted improvements in nutrition or intermediate outcomes in pathways between agriculture and nutrition. Budget lines were summed, and these nominal values were adjusted for inflation (using the consumer price index for each year) to obtain real values. Nutrition allocations in the agriculture budget increased considerably even after adjusting for inflation and went from 0.13% of agriculture capital budget in 2009 to 2.97% in 2022; while the real value of total government agricultural budget declined. Large budgetary increases coincided with the development/launch of costed strategies with nutrition-sensitive agriculture components. Still, there were some missed opportunities to increase nutrition allocations. Existence of nutrition-sensitive agriculture strategies has facilitated increased nutrition funding and improved the enabling environment. There is need to optimize existing nutrition allocations while advocating for additional funds.

Advancing a Multisectoral Platform for Nutrition-Sensitive Agriculture in Nigeria: Reflections on Effectiveness and Lessons Learnt.

Inadequate coordination mechanisms and capacity to coordinate are limiting factors for maximizing the ability of agriculture to improve nutrition in Sub-Saharan Africa. Effective coordination requires the availability of a platform for stakeholder convening, planning, operationalization of ideas, communication, and accountability. Nigeria's Federal Ministry of Agriculture and Rural Development established one such platform to support the institutionalization of nutrition-sensitive agriculture. Platform members include several departments within the Ministry, other ministries, and development partners. While the platform achieved key milestones and fostered collaboration, some gaps remained. This study reports an assessment to understand the perspectives of members of the coordination platform and identify ways of increasing effectiveness. Desk reviews of relevant documents and 18 key informant interviews were conducted. Documents and interview notes were coded and analysed to identify recurring themes. Themes were appraised using a nutrition coordination framework. Sufficiently understanding the nutrition role of representatives' own organization/department and the purpose of the coordination platform and its activities was important for success. The profile and seniority of representing officers also mattered. While the leadership of the Ministry was committed to advancing nutrition through agriculture, the coordination platform could improve its functionality through consistent leadership, increased seniority of member representatives, and appropriate communication. Multisectoral coordination platforms are necessary but do not alone achieve nutrition coordination. Effective leadership and investments in time, strategic orientation, and training are critical to achieving a shared purpose, individual sector fulfilment of nutrition roles, and additional coordination success factors.

Comparing delivery channels to promote nutrition-sensitive agriculture: A cluster-randomized controlled trial in Bangladesh

We use a randomized controlled trial in rural Bangladesh to compare two models of delivering nutrition content jointly to husbands and wives: deploying female nutrition workers versus mostly male agriculture extension workers. Both approaches increased nutrition knowledge of men and women, household and individual diet quality, and women’s empowerment. Intervention effects on agriculture and nutrition knowledge, agricultural production diversity, dietary diversity, women’s empowerment, and gender parity do not significantly differ between models where nutrition workers versus agriculture extension workers provide the training. The exception is in an attitudes score, where results indicate same-sex agents may affect scores differently than opposite-sex agents. Our results suggest opposite-sex agents may not necessarily be less effective in providing training. In South Asia, where agricultural extension systems and the pipeline to those systems are male-dominated, training men to deliver nutrition messages may offer a temporary solution to the shortage of female extension workers and offer opportunities to scale and promote nutrition-sensitive agriculture. However, in both models, we find evidence that the presence of mothers-in-law within households modifies the programs’ effectiveness on some nutrition, empowerment, and attitude measures, suggesting that accounting for other influential household members is a potential area for future programming.

Nutrition Sensitive Agriculture Practices in Rural Communities of Nalgonda District, India

Nutrition-Sensitive Agriculture (NSA) is important for rural communities as it promotes the production of diverse, nutrient-rich crops and helps to improve food security, reduce malnutrition, and promote better health outcomes. It also helps to increase the incomes of smallholder farmers and enhance their resilience to climate change and other external shocks.&#x0D; The study indicated that the majority of respondents are between the ages of 20 to 40 (59.50%), have a low level of education (51.70% are illiterate), come from joint families (56.10%), and have an annual income between Rs.50,000-1,50,000 (72.78%).&#x0D; The study provides information on the nutrition and agricultural practices of the respondents. It shows that a high proportion of respondents practice kitchen/nutrition gardening (85.56%) and grow vegetables in their garden (85.56%). Leafy vegetables (51.67%) and fruits (57.22%) are the most commonly grown crops. However, practices such as integrated farming systems (4.44%), the Nutri thali concept (0.00%), and organic farming (7.22%) are not widely adopted.&#x0D; The aim of the study was to know the nutrition sensitive agriculture practices followed by small and marginal women in Nalgonda district of Telangana state. In this study a total number of 180 respondents were selected for the study.&#x0D; This study was an attempt to as there is a need to put attention on the educational aspects by stimulating the small and marginal women farmers and the families of rural communities by adopting farming practices that promote the production and consumption of diverse and nutrient-rich crops, rural farmers can also improve their own nutrition as well as that of their communities.

Fostering an Enabling Environment for Nutrition-Sensitive Agriculture and Food Systems in Nigeria.

Although recommendations exist for making agriculture and food systems nutrition sensitive, guidance about how to successfully operationalize these recommendations within national institutions is limited. Over the 13 years from 2010 to 2023, there were several undertakings to strengthen the enabling environment for sustainable nutrition-sensitive agriculture (NSA) and food systems in Nigeria. Some studies were also conducted over the period to foster better understanding of the national enabling environment and facilitate effective actions. This article documents successes and failures from Nigeria's experiences by reflecting on critical developments, events, policies, and programmes on Nigeria's journey toward advancing nutrition through agriculture and food systems; as well as findings from conducted studies. Successes include the existence of a Nutrition and Food Safety Division in the Ministry of Agriculture and an approval for a Nutrition Department, existence of an agriculture sector nutrition strategy, increased private sector engagement and commitment to nutrition-sensitive food systems, and increased funding for nutrition in the agriculture sector. Challenges especially remain for scaling up strategic, operational, and delivery capacity of both organizations and individuals involved in advancing NSA and food systems. Lessons learned include-institutionalizing NSA and food systems takes time; knowledge brokering is indispensable and requires several collaborating entities and stakeholders; and approaches used should be suited to available government capacity. More than a decade of efforts targeting different enabling environment factors has resulted in greater political commitment for nutrition within the agriculture sector and an improved enabling environment for NSA and food systems.

Effects of an integrated poultry value chain, nutrition, gender and WASH intervention (SELEVER) on hygiene and child morbidity and anthropometry in Burkina Faso: A secondary outcome analysis of a cluster randomised trial.

Nutrition-sensitive agriculture programmes have the potential to improve child nutrition outcomes, but livestock intensification may pose risks related to water, sanitation and hygiene (WASH) conditions. We assessed the impact of SELEVER, a nutrition- and gender-sensitive poultry intervention, with and without added WASH focus, on hygiene practices, morbidity and anthropometric indices of nutrition in children aged 2-4 years in Burkina Faso. A 3-year cluster randomised controlled trial was implemented in 120 villages in 60 communes (districts) supported by the SELEVER project. Communes were randomly assigned using restricted randomisation to one of three groups: (1) SELEVER intervention (n = 446 households); (2) SELEVER plus WASH intervention (n = 432 households); and (3) control without intervention (n = 899 households). The study population included women aged 15-49 years with an index child aged 2-4 years. We assessed the effects 1.5-years (WASH substudy) and 3-years (endline) post-intervention on child morbidity and child anthropometry secondary trial outcomes using mixed effects regression models. Participation in intervention activities was low in the SELEVER groups, ranging from 25% at 1.5 years and 10% at endline. At endline, households in the SELEVER groups had higher caregiverknowledge ofWASH-livestock risks (∆ = 0.10, 95% confidence interval [CI] [0.04-0.16]) and were more likely to keep children separated from poultry (∆ = 0.09, 95% CI [0.03-0.15]) than in the control group. No differences were found for other hygiene practices, child morbidity symptoms or anthropometry indicators. Integrating livestock WASH interventions alongside poultry and nutrition interventions can increase knowledge of livestock-related risks and improve livestock-hygiene-related practices, yet may not be sufficient to improve the morbidity and nutritional status of young children.

Policies for optimal nutrition-sensitive options: a study of food and nutrition security policies, strategies and programs in Ghana, Kenya and South Africa

Sub-Saharan Africa is experiencing the coexistence of overnutrition, undernutrition and micronutrient deficiencies. Comprehensive programs and coherent public policies are required to address this problem. A study of food and nutrition security policies, strategies and programs in Ghana, Kenya and South Africa was conducted between February and July 2022 through desk reviews and key informant interviews. The aim was to generate evidence on the extent to which the policies, strategies and programs were nutrition-sensitive and add value to the scaling up of nutrition and food security. The assessment of the documents was based on the four dimensions of food security, and the Food and the Food and Agriculture Organization of the United Nations guidelines on nutrition-sensitive agriculture. A total of 48 policies, strategies and programs were reviewed. To ensure food availability, most reviewed documents tend to focus on food production and income generation, with limited attention on production and supply of diverse and nutrient-dense foods. Access to inputs, credit and land is targeted at smallholder farmers, without little sensitivity to women and youth engagement. Food access is promoted through improved market access by upgrading infrastructure and promoting social safety nets for vulnerable populations. However, information systems for agricultural marketing as well as labor- and time-saving technologies are lacking. Although nutrition education is widely promoted, especially for mothers and children, there is a gap in addressing the nutrition needs of adolescent girls. Regarding food stability, inadequate funding, poor leadership and governance and inadequate monitoring and evaluation systems are the main barriers to successful implementation of policies, strategies and programs. While efforts have been made to promote nutrition-sensitive options in the agriculture and food system value chains, the study identified several gaps that need to be addressed to ensure adequate food and nutrition security.

Inclusive diets within planetary boundaries

Inclusive diets within planetary boundaries