Does household participation in food markets increase dietary diversity? Evidence from rural Malawi

How Livelihood Change Affects Food Choice Behaviors in Low- and Middle-Income Countries: A Scoping Review

Livelihoods have changed dramatically over the past decade in low- and middle-income countries (LMIC). These shifts are happening in tandem with shifts in individual and household food choice behaviors. This scoping review aimed to identify and characterize mechanisms through which livelihood changes could affect food choice behaviors in LMIC, including behaviors relating to food production, acquisition, preparation, distribution, and consumption. A literature search was conducted using 4 databases: PubMed, PsycInfo, AGRICOLA, and Embase. The search was further enhanced by expert solicitations. Studies were included if they measured or focused on a livelihood change, described or assessed a change in ≥1 food choice behavior, and focused on LMIC. Studies were excluded if they focused on migration from LMIC to a high-income country. Of the 433 articles that were identified, 53 met the inclusion criteria. Five mechanisms of how livelihood change can affect food choice were identified: occupation, locality, time, income, and social relations. Changes in occupation altered the balance of the availability and affordability of foods in local food environments compared with individual food production. Changes in location, time use, and income influenced where food was purchased, what types of foods were acquired, and how or where foods were prepared. Additionally, changes in social relationships and norms led to expanded food preferences, particularly among urban populations. Time limitations and higher discretionary income were associated with consumption of ultraprocessed foods. Understanding the relationships between the changes in livelihood occuring in LMIC and food choices of households in these countries can inform the development of policies, programs, and other actions to promote sustainable healthy diets and planetary health.

Factors influencing household and women's dietary diversity in migrant households in central Nepal

Food security and dietary diversity, defined as providing either physical (availability) or economic (accessibility) access to food, are linked with access to and control over productive resources and is a highly-gendered phenomenon. In Nepal, labor out-migration has increased household income and may have increased people's ability to access diverse food either by increasing investment in agriculture or purchasing various food items from the market. However, the relationship between household dietary improvement and labor out-migration is complex. Drawing on a survey of 1,053 migrant households in three agroecological regions of Nepal, this paper disentangles this complex phenomenon by showing how household dietary diversity and women's dietary diversity are influenced by biophysical, social, economic, and cultural factors. The influence of the amount of remittances, land abandonment, and women confined to the house by household chores are some factors that policy makers should consider seriously in designing gender-sensitive nutrition policies. The expansion of women's agency contributes to enhancing dietary diversity and specifically women's dietary diversity at the household level; however, how these factors determine an individual's dietary diversity depends on intrahousehold dynamics and relations.

The politics of agricultural policy and nutrition: A case study of Malawi's Farm Input Subsidy Programme (FISP)

The concept of food and nutrition policy has broadened from simply being an aspect of health policy, to policy interventions from across a wide range of sectors, but still with potentially important impact on nutritional outcomes. This wider and more complex conceptualisation involves policy with multiple objectives and stakeholder influences. Thus, it becomes particularly important to understand the dynamics of these policy processes, including policy design and implementation. To add to this literature, we apply the Kaleidoscope Model for understanding policy change in developing country contexts to the case-study of an agricultural input subsidy (AIS) programme in Malawi, the Farm Input Subsidy Programme (FISP), exploring the dynamics of the FISP policy process including nutritional impact. Over a three-month period between 2017 and 2019 we conducted in-depth interviews with key stakeholders at national and district levels, and focus groups with people from rural districts in Malawi. We also undertook a review of literature relating to the political economy of the FISP. We analysed the data thematically, as per the domains of the Kaleidoscope Model. The analysis across the FISP policy process including policy design and implementation highlights how stakeholders' ideas, interests and influence have shaped the evolution of FISP policy including constraints to policy improvement-and the nutritional impacts of this. This approach extends the literature on the tensions, contradictions and challenges in food and nutrition policy by examining the reasons that these occur in Malawi with the FISP. We also add to the political science and policy analysis literature on policy implementation, extending the concept of veto players to include those targeted by the policy. The findings are important for consideration by policymakers and other stakeholders seeking to address malnutrition in rural, food-insecure populations in Malawi and other low-income settings.

Assessing rural household's food groups-and-sources and dietary diversity pattern in Malaita Province

Access to and availability of various food sources is not an issue in rural communities. However, there is no guarantee that households are not affected by nutritional inadequacy, which is still a problem in most underdeveloped nations. A mixed-methods study was conducted to determine the HDDS through the snowballing method for the last 12 months' food groups-and-sources and the 48-h diet recall. Ninety-eight households in two rural communities surrounding Sikwafta (zone one) and Malu'u (zone two) participated in the interview between April and May 2019. The results were then analyzed through SPSS and QDA MINER. The aim is to analyze the household dietary patterns of the communities between the two zones. The study also hypothesizes that the dietary pattern of households has not changed. Results showed that a total of nine food groups were consumed: grain, white roots, tubers, plantains, oils/fats (95.90%), condiments (83.70%), and meat/poultry/sea foods (77.60%). The majority of the food consumed comes from the gardens, followed by other food sources, which make up the average HDDS of five. A correlation analysis found a statistically significant relationship between HDDS and total meal (0.504*), with no relationships between demographics. When comparing 48-h food sources-and-groups to the previous year, there was little to no difference in accessibility and availability. This implies that the majority of households are likely to achieve their nutritional needs within the parameters of their dietary trend. Even though households have adequate access to food, there is a significant need to improve their nutritional needs, even if they consume the average amount of the required food groups.

Measuring the intensity of rural livelihood diversification strategies, and Its impacts on rural households' welfare: Evidence from South Gondar zone, Amahara Regional State, Ethiopia

In Ethiopia, rural households are under risk in the sustainability of sources of income and forced to involve in diversified livelihoods because of the uncertain nature of the agricultural sector. Therefore, the aim of the study is to measure the livelihood diversification strategies and its impacts on rural households' welfare. The study used cross-sectional data, which is quantitative and qualitative in nature. Through the multistage sampling technique, the study selected 398 samples from the south Gondar zone. The data was analyzed through descriptive statistics, and Tobit and multiple linear regression models. The descriptive statistics analysis showed that income from crop and livestock productions are the most important contributors (97.74%) to livelihood diversification in the study area. The Simpsons Index of Diversity is (0.4) showing that there is a lower livelihood diversification in the study area. The Tobit model regression results showed that education, family size, irrigation, soil conservation, extension service, livestock, and infrastructure facility affect the intensity of livelihood diversification. Furthermore, the multiple regression result revealed that livelihood diversification has a positive impact on the welfare of rural households. The study concludes that to improve the livelihood and welfare of rural households, diversified livelihood strategies should be enhanced by facilitating farm activities through access to inputs, irrigation schemes, and infrastructure and off-farm activities. This article applied the Simpsons Index of Diversity (SID) to estimate the intensity of income diversification.• The method helps to measure the amount of diversified income and its effect on the welfare of rural dwellers. • The study helps to identify the common livelihood strategies and their relevance to improving rural living style.

Improving wasting among children under-5 years in Malawi: The role of farm input subsidies

Wasting among children under-5 years remains a public health problem in Malawi, despite the quest to improve food availability through Farm Input Subsidy Program (FISP). As such, the study examined the link between FISP and child wasting. Using Malawi Integrated Household Panel Surveys for 2013, 2016, and 2019, two-stage least squares approach was employed to run a Cobb Douglas production function and a correlated Random Effects (CRE) Model to account for endogeneity challenges and an unbalanced panel dataset. The study hypothesized the role of FISP to dietary diversity at the household level on child wasting [weight-for-height (WHZ)]. Based on the analysis, the study found that household access to FISP coupons was not a stand-alone predictor for low wasting among children under-5 years. However, increased maize production due to FISP coupon access significantly correlated with lower wasting likelihood incidences at the household level. Worth to note, that in 2015/16, households that had accessed FISP coupons and were in the central region had higher wasting probabilities among the children under-5 years in Malawi compared to other counterparts panels. This implies challenges to addressing wasting among children under-5 years- which can be attributed to higher redemption costs of the FISP coupon. Therefore, the current study suggests that input subsidies can improve the reduction of wasting among children under-5 years through specific pathways, among them, increased maize production and considering appropriate targeted approaches to ensure households access the inputs for sustained food availability, which in turn enhances improved the children under-5 years health dividends in Malawi.

Plant different, eat different? Insights from participatory agricultural research

We examine the association between on-farm production diversity on household dietary diversity in Malawi using microdata collected as part of an environmentally sustainable agricultural intensification program. The program primarily focuses on the integration of legumes into the cropping system through maize-legume intercropping and legume-legume intercropping. Relative to staple cereals such as maize, legumes are rich in micronutrients, contain better-quality protein, and lead to nitrogen fixation. Given the systematic difference we document between program beneficiaries and randomly sampled non-beneficiary (control) households, we employ causal instrumental variables mediation analysis to account for non-random selection and possible simultaneity between production and consumption decisions. We find a significant positive treatment effect on dietary diversity, led by an increase in production diversity. Analysis of potential pathways show that effects on dietary diversity stem mostly from consumption of diverse food items purchased from the market made possible through higher agricultural income. These findings highlight that, while increasing production for markets can enhance dietary diversity through higher income that would make affordable an expanded set of food items, the production of more nutritious crops such as pulses may not necessarily translate into greater own consumption. This may be due to the persistence of dietary habits, tastes, or other local factors that favor consumption of staples such as maize and encourage sales of more profitable and nutritious food items such as pulses. Pulses are a more affordable and environmentally sustainable source of protein than animal source food, and efforts should be made to enhance their nutritional awareness and contribution to sustainable food systems and healthier diets.

Dietary Quality of Women of Reproductive Age in Low-Income Settings: A Cross-Sectional Study in Kyrgyzstan

Dietary diversity and adequate nutrient intake are essential for conducting a healthy life. However, women in low-income settings often face difficulties in ensuring dietary quality. This research assessed relationships between the dietary diversity, nutrient adequacy, and socio-economic factors among women of reproductive age (WRA) in Kyrgyzstan. A cross-sectional study was undertaken in four locations, including two rural and two urban areas in the north and south of Kyrgyzstan. A survey with pre-coded and open-ended questions was employed during the interviews of 423 WRAs aged 18-49. Data collection was conducted in March-May 2021. The average value body mass index (BMI) of WRA was 24.2 ± 4.6 kg/m2. The dietary diversity score (DDS) was higher among rural women (common language effect size) cles = 0.67, adjusted p < 0.001) in the northern region (cles = 0.61, p < 0.05) who have cropland (cles = 0.60, p < 0.001) and a farm animal (cles = 0.60, p < 0.05). Mean nutrient adequacy ratio (NAR) was below 1 in most micronutrients, whereas thiamine, riboflavin, vitamins B6 and C, folic acid, calcium, and magnesium were even lower than 0.5. Women with a kitchen garden or a cropland had better NAR energy (cles = 0.57), NAR carbohydrate (cles = 0.60), NAR fiber (cles = 0.60), NAR vitamin B1 (cles = 0.53), and NAR folic acid (cles = 0.54). Respondents who receive remittances and a farm animal have better NARs for energy, carbohydrates, fiber, vitamin B1, folic acid, iron, zinc, and mean adequacy ratio for 16 nutrients (MAR 16) than those who do not. Education and income have a negative correlation with dietary quality. This study contributes to the limited literature on the quality of diets in Kyrgyzstan. Hidden hunger and undernutrition are a severe problem among WRA in low-income settings. Recommendations are including study programs in nutrition, teaching households farming practices, and raising awareness on adequate nutrition.