Browsing by Author "Hoddinott, John"

Now showing 1 - 2 of 2

A Nutrition-Sensitive Agroecology Intervention in Rural Tanzania Increases Children's Dietary Diversity and Household Food Security But Does Not Change Child Anthropometry: Results from a Cluster-Randomized Trial.
(Oxford University Press, 2021-05-11) Santoso, Marianne V; Bezner Kerr, Rachel N; Kassim, Neema; Martin, Haikael; Mtinda, Elias; Njau, Peter; Mtei, Kelvin; Hoddinott, John; Young, Sera L
Background There are urgent calls for the transformation of agriculture and food systems to address human and planetary health issues. Nutrition-sensitive agriculture and agroecology promise interconnected solutions to these challenges, but evidence of their impact has been limited. Objectives In a cluster-randomized trial (NCT02761876), we examined whether a nutrition-sensitive agroecology intervention in rural Tanzania could improve children's dietary diversity. Secondary outcomes were food insecurity and child anthropometry. We also posited that such an intervention would improve sustainable agricultural practices (e.g., agrobiodiversity, intercropping), women's empowerment (e.g., participation in decision making, time use), and women's well-being (e.g., dietary diversity, depression). Methods Food-insecure smallholder farmers with children aged <1 y from 20 villages in Singida, Tanzania, were invited to participate. Villages were paired and publicly randomized; control villages received the intervention after 2 y. One man and 1 woman “mentor farmer” were elected from each intervention village to lead their peers in agroecological learning on topics including legume intensification, nutrition, and women's empowerment. Impact was estimated using longitudinal difference-in-differences fixed-effects regression analyses. Results A total of 591 households (intervention: n = 296; control: n = 295) were enrolled; 90.0% were retained to study end. After 2 growing seasons, the intervention improved children's dietary diversity score by 0.57 food groups (out of 7; P < 0.01), and the percentage of children achieving minimum dietary diversity (≥4 food groups) increased by 9.9 percentage points during the postharvest season. The intervention significantly reduced household food insecurity but had no significant impact on child anthropometry. The intervention also improved a range of sustainable agriculture, women's empowerment, and women's well-being outcomes. Conclusions The magnitude of the intervention's impacts was similar to or larger than that of other nutrition-sensitive interventions that provided more substantial inputs but were not agroecologically focused. These data suggest the untapped potential for nutrition-sensitive agroecological approaches to achieve human health while promoting sustainable agricultural practices.
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.