Browsing by Author "Blacker, Lauren"

Now showing 1 - 3 of 3

Food security mediates the decrease in women's depressive symptoms in a participatory nutrition-sensitive agroecology intervention in rural Tanzania.
(Cambridge University Press 2021, 2021-03-12) Cetrone, Hollyn; Santoso, Marianne; Bezner Kerr, Rachel; Petito, Lucia; Blacker, Lauren; Nonga, Theresia; Martin, Haikael; Kassim, Neema; Mtinda, Elias; Young, Sera
Objective: To investigate if food security mediated the impact of a nutrition-sensitive agroecology intervention on women’s depressive symptoms. Design: We used annual longitudinal data (4 time points) from a cluster-randomized effectiveness trial of a participatory nutrition-sensitive agroecology intervention, the Singida Nutrition and Agroecology Project (SNAP-Tz). Structural equation modelling estimation of total, natural direct, and natural indirect effects was used to investigate food security’s role in the intervention’s impact on women’s risk of probable depression (CES-D > 17) across three years. Setting: Rural Singida, Tanzania. Participants: 548 food insecure, married, smallholder women farmers with children < 1-year-old at baseline. Results: At baseline, one third of the women in each group had probable depression (Control: 32.0%, Intervention: 31.9%, p difference=0.97). The intervention lowered odds of probable depression by 43% (OR=0.57, 95% CI: 0.43-0.70). Differences in food insecurity explained approximately 10 percentage points of the effects of the intervention on odds of probable depression (OR = 0.90, 95% CI: 0.83-0.95). Conclusions: This is the first evidence of the strong, positive effect that lowering food insecurity has on reducing women’s depressive symptoms. Nutrition-sensitive agricultural interventions can have broader impacts than previously demonstrated, i.e., improvements in mental health, and changes in food security play an important causal role in this pathway. As such, these data suggest participatory nutrition-sensitive agroecology interventions have the potential to be an accessible method of improving women’s wellbeing in farming communities.
Household food insecurity and gender inequity is associated with high prevalence of maternal depression amongst female farmers with young children in rural Tanzania
(The Federation of American Societies for Experimental Biology, 2018-10-03) Blacker, Lauren; Santoso, Marianne; Harnett, Laura; Kassim, Neema; Mollay, Clara; Martin, Haikael; Mtinda, Elias; Kalonga, Esther; Mtei, Kelvin; Kalonga, Joseph; Bezner, Rachel; Young, Sera
There is growing recognition of the importance of maternal mental health for the well-being of both mothers and children. In addition to being of importance to public health concern on its own right, maternal depression could impede women's capacity to provide quality care to their children. However, the covariates of maternal depression, especially in low-resource settings, are not well-understood. In particular, the role of gender equity in maternal depression needs further investigation. Therefore, we sought to understand covariates associated with maternal depression in a rural farming community in Tanzania. We hypothesized that greater food insecurity and gender inequity in a household would be positively correlated with maternal depression. The Singida Nutrition and Agroecology Project (SNAP-Tz) is a participatory agroecology and nutrition intervention with rural farmers with children <1 y in Singida, Tanzania. As part of the baseline assessment in February 2016, women from the 587 participating households were asked about a range of socio-demographic, agricultural, health, and nutrition topics. The Center for Epidemiologic Studies Depression Scale (CES-D, range: 0–65) was used to measure maternal depression. The Household Food Insecurity Access Scale (HFIAS, range: 0–27) was used to measure household food insecurity. Gender equity was indicated by a summed score of husband's help with household chores (range: 0–7), women's (dis)satisfaction with leisure time, and women's experience with domestic violence. Social support was measured using the Perceived Social Support scale (PSS, range:0–40). Multivariate linear regression models of depression were then built using backwards stepwise elimination and include village fixed effects. Standard error estimates considered clustering at the village level. CESD scores indicated probable depression (CES-D≥17) among 69.2% of women. Probable major depression (CES-D≥26) was indicated for 42.5% women. The mean HFIAS of 14.0 (sd: 7.9) suggested that food insecurity was also very common. In multivariate models of depression, food insecurity score was positively and strongly correlated with maternal depression score (β=0.62, p=0.000). Having experienced domestic violence was positively associated with increased maternal depression score (β=4.29, p=0.004). Greater help from husband and satisfaction with amount of leisure time were negatively correlated with maternal depression score (β=−0.65, p=0.011 and β=−3.00, p=0.000, respectively). In sum, the prevalence of maternal depression is very high in Singida, Tanzania. While some covariates were not modifiable, several important ones were, including food insecurity, unbalanced household division of task, and domestic violence. Causality should be further explored, but these data suggest important and novel domains in which to intervene to improve maternal mental health.
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.