The effect of a combination of nutrition education, soy and vegetable gardening, and food preparation skill training interventions on dietary intake and diversity in women: a case study from Qwa-Qwa

A behavior change communication intervention, but not livelihood interventions, improves diet diversity and animal-source food consumption among Ghanaian women

Background

Women of reproductive age (WRA), especially in sub-Saharan Africa, are vulnerable to micronutrient deficiencies driven largely by poor quality diets. Intervening into food value chains, on which many households in low- and middle-income countries depend for their livelihood, may be a promising approach to improving diets in these contexts.

Objective

In this pilot-scale randomized trial, we evaluated whether a multisectoral, food value chain intervention improved the diet diversity and the consumption of animal-source foods (ASFs) among WRA in Ghana.

Design

Twelve fish-smoking communities in two regions of Ghana with 296 eligible women were randomly assigned to one of three 9-month treatment arms: 1) behavior change communication (BCC) to promote improved diet quality through twice-weekly audio messages and bi-weekly peer-to-peer learning sessions; 2) BCC with microcredit to increase women’s incomes; or 3) BCC with provision of new smoke-oven technology. We assessed baseline-endline and between-treatment arm differences using a 10-food group diet diversity score (DDS), the Minimum Dietary Diversity for Women (MDD-W) indicator, and 7-day frequency of ASF consumption.

Results

Among 118 participants (39 in both treatment arm 1 and treatment arm 3, and 40 in treatment arm 2, with no participant refusals), DDS increased from a mean (SD) of 4.0 (1.3) at baseline to 5.1 (0.9) at endline (P-value < 0.0001). The proportion of women achieving the MDD-W indicator nearly doubled from baseline (35.6%) to endline (69.5%) (P-value < 0.0001). Frequency of ASF consumption similarly increased for meat and poultry (2.7 (4.1) to 4.7 (5.3); P-value < 0.0001) and eggs (1.5 (3.1) to 2.3 (4.9); P-value = 0.02). Few differences in these outcomes were observed among treatment arms.

Conclusions

A BCC intervention improved diet diversity and consumption of ASFs among participants. However, neither a group-based microcredit nor improved smoke oven intervention, both of which increased women’s income, led to additional dietary improvements.

The Socio-Cultural Benefits of Urban Agriculture: A Review of the Literature

Despite extensive literature on the socio-cultural services of urban open spaces, the role of food-producing spaces has not received sufficient attention. This hampers advocacy for preserving and growing urban agricultural activities, often dismissed on justifications that their contributions to overall food supply are negligible. To understand how the social benefits of urban agriculture have been measured, we conducted a systematic review of 272 peer-reviewed publications, which drew on insights from urban agriculture sites in 57 different countries. Through content analysis, we investigated socio-cultural benefits in four spheres: engaged and cohesive communities, health and well-being, economic opportunities, and education. The analysis revealed growth in research on the social impacts of gardens and farms, with most studies measuring the effects on community cohesion and engagement, followed by increased availability and consumption of fruits and vegetables associated with reduced food insecurity and better health. Fewer studies assessed the impact of urban farming on educational and economic outcomes. Quantifying the multiple ways in which urban agriculture provides benefits to people will empower planners and the private sector to justify future investments. These findings are also informative for research theorizing cities as socio-ecological systems and broader efforts to measure the benefits of urban agriculture, in its many forms.

Comparative analysis of the factors contributing to sustainability of a food and nutrition intervention programme: Two case studies from South Africa

Sustainability of health interventions is a consistent and ongoing issue in Africa. Understanding key aspects of sustainable interventions provides the necessary methods for success. This research evaluates a nutrition intervention implemented in two peri-urban communities in the Free State and Gauteng province in South Africa (SA) respectively. A case study approach was employed using cross-case study analyses, including triangular data collection (empirical research through surveys of respondents; qualitative data collection through researcher journals, diaries, communications and photographs; and research team reflections). The information from these case studies is organized according to a framework from the United States (US) Office of Organizational Health (OAH) to evaluate the sustainability of intervention programmes. All eight of the OAH criteria were met in the Free State community and supported the importance of these key factors for sustainability compared to only three in the Gauteng community. The OAH framework provided a compelling rationale for the relative success of the intervention and clearly showed the Free State project was sustainable. The Gauteng project was not sustainable. Planned interventions should devote significant effort and time towards ensuring sustainability. The OAH guidelines provide key steps that the research shows is relevant to the South African context.