Browsing by Author "Bezner-Kerr, Rachel"

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A Participatory Agroecological Intervention Reduces Women’s Risk of Probable Depression Through Improvements in Food Security in Singida, Tanzania
(Elsevier, 2020-06) Cetrone, Hollyn; Santoso, Marianne; Petito, Lucia; Bezner-Kerr, Rachel; Blacker, Lauren; Kassim, Neema; Mtinda, Elias; Martin, Haikael; Young, Sera
In 2015, depressive disorders led to over 50 million disability-adjusted life years lost globally, with more than 80% occurring in low- and middle-income countries. Depressive disorders are also risk factors of a number of adverse maternal and child health outcomes. To our knowledge, the Singida Nutrition and Agroecology Project (SNAP-Tz), is the first nutrition-sensitive agriculture (NSA) intervention identified to improve women’s probable depression (2020). Food security has been posited to play an important role in the relationship between NSA interventions and depression, yet causal factors have not yet been analyzed quantitatively. Therefore, we investigated food security’s mediating role on this impact.
Predictors of Program Participation in a Nutrition-Sensitive Agroecological Intervention in Singida, Tanzania
(Oxford University Press, 2020-06) Santoso, Marianne; Bezner-Kerr, Rachel; Kassim, Neema; Mtinda, Elias; Martin, Haikael; Hoddinott, John; Young, Sera
Objectives Nutrition-sensitive agricultural interventions are theorized to improve child’s diet through asset provision and program participation. Although some programs measure participation, predictors of participation are understudied. We therefore investigated predictors of men’s and women’s program participation in Singida Nutrition and Agroecology Project (SNAP-Tz; NCT02761876). Methods In SNAP-Tz, ‘mentor farmers’ led their peers (smallholder farmers with children < 1 year at baseline) in learning about agroecology, nutrition, and gender equity through meetings and household visits. At baseline, we collected data on demographics, Household Food Insecurity Access Scale (0–27), men’s involvement in 7 household tasks (0–7), and Abbreviated Women’s Empowerment in Agriculture Index (AWEAI). Participating men (n = 262) and women (n = 283) were asked to recall their program participation biannually. Predictors of high participation, defined as attendance in ≥60% participant meetings and household visits, were identified using multiple logistic regressions, controlling for clustering at the village level. Results Only 59% and 37% of women and men, respectively, had high participation. Women’s high participation was associated with their spouse’s participation (OR = 4.23, P < 0.01), greater food insecurity (OR = 1.03, P = 0.03), years of education (OR = 1.13, P = 0.02), and being empowered (OR = 5.88, P < 0.01). Men’s high participation was associated with their spouse’s participation (OR = 4.22, P < 0.01), greater food insecurity (OR = 2.23, P = 0.01), involvement in household tasks (OR = 1.25, P = 0.04), and age (OR = 1.03, P < 0.01). Conclusions Associations between an individual’s and their spouse’s participation indicate the importance of spousal dynamics. The association between participation and baseline gender equity (i.e., women’s empowerment, men’s involvement in household tasks) highlights the challenges of gender programming in nutrition-sensitive interventions. Analysis of program participation was simple and revealed valuable lessons for program implementation and design; more programs should therefore analyze participation.
Production Diversity Is Not Associated with Women’s Dietary Diversity After Controlling for Wealth and Participation in an Agriculture Intervention in Tanzania
(Oxford University Press, 2019-06) Guo, Mianzhao; Santoso, Marianne; Bezner-Kerr, Rachel; Kassim, Neema; Martin, Haikael; Mtinda, Elias
Objectives Farm production diversity has long thought to be a primary driver of dietary diversity. Few studies have explored the drivers of dietary diversity among women, who are often vulnerable to sub-optimal diets. We therefore investigated how production diversity affects women’s dietary diversity in smallholder farming communities in rural Tanzania. Specifically, we hypothesized that women in households with greater farm production diversity would have higher dietary diversity. Methods Female farmers (n = 462) were surveyed on agricultural practices in 2018 and their diet in the subsequent harvest season as a part of the Singida Nutrition and Agroecology Project (SNAP-Tz). SNAP-Tz is a cluster randomized effectiveness trial of a participatory agroecology and nutrition intervention. We estimated the impact of production diversity (crop species richness, range: 1–10) on women’s dietary diversity (Minimum Dietary Diversity for Women, range: 1–10) using linear regression analysis with Stata15, controlling for geographic clustering and other known covariates of women’s dietary diversity. Results Farm production diversity was positively associated with women’s dietary diversity after controlling for household size, age, and women’s occupation (b = 0.15, P < 0.01). However, this association was not significant (b = 0.068, P = 0.18) after additionally controlling for household wealth and participation in the intervention. Conclusions Contrary to our hypothesis, women living in households with higher production diversity did not have more diverse diets when controlling for other covariates of dietary diversity, i.e., household wealth and participation in the participatory agroecology intervention. Modifiable determinants of women’s dietary diversity are an important area for future exploration. Comparing and contrasting the role of production diversity here to that in other settings will be fruitful.