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Al Daccache M, Abi Zeid B, Hojeij L, Baliki G, Brück T, Ghattas H. Systematic review on the impacts of agricultural interventions on food security and nutrition in complex humanitarian emergency settings. BMC Nutr 2024; 10:60. [PMID: 38641632 PMCID: PMC11027246 DOI: 10.1186/s40795-024-00864-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/18/2024] [Indexed: 04/21/2024] Open
Abstract
Complex humanitarian emergencies are a main driver of food and nutritional insecurity. Agricultural interventions are key to improving nutrition and food security, and their positive impacts are well-documented in stable developing countries. However, it is unclear if their positive effects on food security hold in complex emergency settings, too. In this paper, we systematically review empirical articles that apply rigorous designs to assess the causal impacts of agricultural interventions on food security, nutrition, or health outcomes in complex humanitarian emergencies. We only find six articles matching these criteria, which have mixed results on dietary diversity and food security, and little evidence on child nutrition. Our review underscores the need for more rigorous research on the impacts of agricultural interventions in complex humanitarian emergency settings.
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Affiliation(s)
- Melodie Al Daccache
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- ISDC - International Security and Development Center, Berlin, Germany
- Zero Hunger Lab, Thaer-Institute, Humboldt-University of Berlin, Berlin, Germany
| | - Berthe Abi Zeid
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Leila Hojeij
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Ghassan Baliki
- ISDC - International Security and Development Center, Berlin, Germany
| | - Tilman Brück
- ISDC - International Security and Development Center, Berlin, Germany
- Zero Hunger Lab, Thaer-Institute, Humboldt-University of Berlin, Berlin, Germany
- Leibniz Institute of Vegetable and Ornamental Crops (IGZ), Großbeeren, Germany
| | - Hala Ghattas
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA.
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Baliki G, Weiffen D, Schreinemachers P, Shrestha A, Shrestha RM, Schreiner M, Brück T. Effect of an Integrated School Garden and Home Garden Intervention on Anemia Among School-Aged Children in Nepal: Evidence From a Cluster Randomised Controlled Trial. Food Nutr Bull 2023; 44:195-206. [PMID: 37728126 DOI: 10.1177/03795721231194124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
BACKGROUND Integrated school and home garden interventions can improve health outcomes in low-income countries, but rigorous evidence remains scarce, particularly for school-aged children and to reduce anemia. OBJECTIVE We test if an integrated school and home garden intervention, implemented at pilot stage, improves hemoglobin levels among school children (aged 9-13 years) in a rural district in the mid-hills of Nepal. METHODS We use a cluster randomized controlled trial with 15 schools each in the control and treatment groups (n = 680 school children). To test if nutritional improvements translate into a reduction of anemia prevalence, hemoglobin data were collected 6 months after intervention support had ended. Using structural equation modeling, we estimate the direct and indirect effects of the treatment through several pathways, including nutritional knowledge, good food and hygiene practices, and dietary diversity. RESULTS The integrated school and home garden intervention did not lead to a direct significant reduction in anemia. Causal positive changes of the treatment on nutritional outcomes, although significant, are not strong enough to impact hemoglobin levels. The program improved hemoglobin levels indirectly for children below 12 by increasing the use of good food and hygiene practices at home. These practices are associated with higher hemoglobin levels, particularly for girls, young children, and in households where caregivers are literate. CONCLUSIONS Even integrated school and home garden interventions are not sufficient to reduce anemia among school children. Incorporating behavioral change components around food and hygiene practices into integrated garden interventions is important to unlocking their health impacts.
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Affiliation(s)
- Ghassan Baliki
- ISDC-International Security and Development Center, Berlin, Germany
- Leibniz Institute of Vegetable and Ornamental Crops, Großbeeren, Germany
| | - Dorothee Weiffen
- ISDC-International Security and Development Center, Berlin, Germany
| | | | - Akina Shrestha
- Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | | | - Monika Schreiner
- Leibniz Institute of Vegetable and Ornamental Crops, Großbeeren, Germany
| | - Tilman Brück
- ISDC-International Security and Development Center, Berlin, Germany
- Leibniz Institute of Vegetable and Ornamental Crops, Großbeeren, Germany
- Thaer-Institute, Humboldt University of Berlin, Germany
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Stojetz W, Ferguson NTN, Baliki G, Díaz O, Elfes J, Esenaliev D, Freudenreich H, Koebach A, Abreu L, Peitz L, Todua A, Schreiner M, Hoeffler A, Justino P, Brück T. The Life with Corona survey. Soc Sci Med 2022; 306:115109. [PMID: 35724582 PMCID: PMC9167047 DOI: 10.1016/j.socscimed.2022.115109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic is a global crisis affecting everyone. Yet, its challenges and countermeasures vary significantly over time and space. Individual experiences of the pandemic are highly heterogeneous and its impacts span and interlink multiple dimensions, such as health, economic, social and political impacts. Therefore, there is a need to disaggregate “the pandemic”: analysing experiences, behaviours and impacts at the micro level and from multiple disciplinary perspectives. Such analyses require multi-topic pan-national survey data that are collected continuously and can be matched with other datasets, such as disease statistics or information on countermeasures. To this end, we introduce a new dataset that matches these desirable properties - the Life with Corona (LwC) survey - and perform illustrative analyses to show the importance of such micro data to understand how the pandemic and its countermeasures shape lives and societies over time.
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Affiliation(s)
- Wolfgang Stojetz
- ISDC - International Security and Development Center, Auguststr. 89, 10117 Berlin, Germany; Department of Economics, Humboldt University of Berlin, Spandauer Str. 1, 10178 Berlin, Germany.
| | - Neil T N Ferguson
- ISDC - International Security and Development Center, Auguststr. 89, 10117 Berlin, Germany
| | - Ghassan Baliki
- Leibniz Institute of Vegetable and Ornamental Crops, Theodor-Echtermeyer-Weg 1, 14979 Großbeeren, Germany
| | - Oscar Díaz
- ISDC - International Security and Development Center, Auguststr. 89, 10117 Berlin, Germany
| | - Jan Elfes
- ISDC - International Security and Development Center, Auguststr. 89, 10117 Berlin, Germany
| | - Damir Esenaliev
- ISDC - International Security and Development Center, Auguststr. 89, 10117 Berlin, Germany; Leibniz Institute of Vegetable and Ornamental Crops, Theodor-Echtermeyer-Weg 1, 14979 Großbeeren, Germany
| | - Hanna Freudenreich
- Leibniz Institute of Vegetable and Ornamental Crops, Theodor-Echtermeyer-Weg 1, 14979 Großbeeren, Germany
| | - Anke Koebach
- Department of Politics and Public Administration, University of Konstanz, Universitätsstr. 10, 78464 Konstanz, Germany; Department of Psychology, University of Konstanz, Universitätsstr.10, 78464 Konstanz, Germany
| | - Liliana Abreu
- Department of Politics and Public Administration, University of Konstanz, Universitätsstr. 10, 78464 Konstanz, Germany
| | - Laura Peitz
- ISDC - International Security and Development Center, Auguststr. 89, 10117 Berlin, Germany
| | - Ani Todua
- ISDC - International Security and Development Center, Auguststr. 89, 10117 Berlin, Germany; Leibniz Institute of Vegetable and Ornamental Crops, Theodor-Echtermeyer-Weg 1, 14979 Großbeeren, Germany
| | - Monika Schreiner
- Leibniz Institute of Vegetable and Ornamental Crops, Theodor-Echtermeyer-Weg 1, 14979 Großbeeren, Germany
| | - Anke Hoeffler
- Department of Politics and Public Administration, University of Konstanz, Universitätsstr. 10, 78464 Konstanz, Germany
| | - Patrícia Justino
- World Institute for Development Economic Research, United Nations University, Katajanokanlaituri 6 B, FI-00160 Helsinki, Finland
| | - Tilman Brück
- ISDC - International Security and Development Center, Auguststr. 89, 10117 Berlin, Germany; Leibniz Institute of Vegetable and Ornamental Crops, Theodor-Echtermeyer-Weg 1, 14979 Großbeeren, Germany; Natural Resources Institute, University of Greenwich, Medway Campus, Central Avenue Chatham Maritime, Kent ME4 4TB, UK
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Schreinemachers P, Shrestha RM, Gole B, Bhattarai DR, Ghimire PL, Subedi BP, Brück T, Baliki G, Gautam IP, Blake CE. Drivers of Food Choice among Children and Caregivers in Post-earthquake Nepal. Ecol Food Nutr 2021; 60:826-846. [PMID: 34420456 DOI: 10.1080/03670244.2021.1969925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Food systems in many countries are experiencing a shift from traditional foods toward processed foods high in sugar, fat and salt, but low in dietary fiber and micronutrients. There is an urgent need to better understand drivers of changing food behavior, particularly for lower-income countries. This study analyzes drivers of food choice among children and parents in rural Nepal. It uses qualitative data collected through key informant interviews and focus group discussions with school children, parents and teachers. The study reveals substantial changes in food behavior during the past decade with increased consumption of rice, meat, and highly processed snack foods while an increased consumption of fruit and vegetables is not evident. It identifies cash availability is the main driver of increased rice, meat and snack food consumption. The second driver is the 2015 Nepal earthquake, which accelerated the transition from homegrown food to purchased food as people got habituated to eating more meat and snack foods while reconstruction tripled local wages and changed the food environment. This shows how humanitarian assistance in the wake of extreme shocks can unintentionally contribute to unhealthy eating habits. An integrated school and home garden intervention appears to contribute to healthier diets.
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Affiliation(s)
| | - Rachana Manandhar Shrestha
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Dhruba Raj Bhattarai
- Outreach Research Division, Nepal Agricultural Research Council, Lalitpur, Nepal
| | - Puspa Lal Ghimire
- Asia Network for Sustainable Agriculture and Bioresources (ANSAB), Kathmandu, Nepal
| | - Bhishma P Subedi
- Asia Network for Sustainable Agriculture and Bioresources (ANSAB), Kathmandu, Nepal
| | - Tilman Brück
- Leibniz Institute of Vegetable and Ornamental Crops (IGZ), Großbeeren, Germany.,Natural Resources Institute, University of Greenwich, Kent, UK.,ISDC - International Security and Development Center, Berlin, Germany
| | - Ghassan Baliki
- Leibniz Institute of Vegetable and Ornamental Crops (IGZ), Großbeeren, Germany.,ISDC - International Security and Development Center, Berlin, Germany
| | - Ishwori P Gautam
- Horticulture Research Division, Nepal Agricultural Research Council, Lalitpur, Nepal
| | - Christine E Blake
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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Schreinemachers P, Baliki G, Shrestha RM, Bhattarai DR, Gautam IP, Ghimire PL, Subedi BP, Brück T. Nudging children toward healthier food choices: An experiment combining school and home gardens. Glob Food Sec 2020; 26:100454. [PMID: 33324538 PMCID: PMC7726313 DOI: 10.1016/j.gfs.2020.100454] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 10/17/2020] [Accepted: 10/19/2020] [Indexed: 01/22/2023]
Abstract
School gardens have become a widely used approach to influence children's food knowledge, preferences and choices in low- and high-income countries alike. However, evidence indicates that such programs are more effective at influencing food knowledge and preferences than actual food choices. Such finding may occur because school gardens insufficiently influence the food behavior of parents and because healthy food items are not always available in children's homes. We tested this hypothesis using a one-year cluster randomized controlled trial in Nepal with 15 treatment and 15 control schools and a matched sample of 779 schoolchildren (aged 8-12) and their caregivers. Data were collected before and after the intervention during the 2018-2019 school year. In addition, children's food consumption was monitored using a monthly food logbook. Average treatment effects were quantified with a double-difference estimator. For caregivers, the intervention led to a 26% increase in their food and nutrition knowledge (p < 0.001), a 5% increase in their agricultural knowledge (p = 0.022), a 10% increase in their liking for vegetables (p < 0.001), and a 15% increase in home garden productivity (p = 0.073). For children, the intervention had no discernible effect on food and nutrition knowledge (p = 0.666) but led to a 6% increase in their liking for vegetables (p = 0.070), healthy food practices (p < 0.001), and vegetable consumption (October-December +15%; p = 0.084; January-March +26%; p = 0.017; April-June +26%; p = 0.088). The results therefore indicate both schools and parents matter for nudging children toward healthier food choices.
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Affiliation(s)
| | - Ghassan Baliki
- Leibniz Institute of Vegetable and Ornamental Crops (IGZ), Großbeeren, Germany
| | | | - Dhruba Raj Bhattarai
- Outreach Research Division, Nepal Agricultural Research Council, Khumaltar, Lalitpur, Nepal
| | - Ishwori P. Gautam
- National Horticulture Research Centre, Nepal Agricultural Research Council, Khumaltar, Lalitpur, Nepal
| | - Puspa Lal Ghimire
- Asia Network for Sustainable Agriculture and Bioresources (ANSAB), Baneshwor, Kathmandu, Nepal
| | - Bhishma P. Subedi
- Asia Network for Sustainable Agriculture and Bioresources (ANSAB), Baneshwor, Kathmandu, Nepal
| | - Tilman Brück
- Leibniz Institute of Vegetable and Ornamental Crops (IGZ), Großbeeren, Germany
- Natural Resources Institute (NRI), University of Greenwich, Chatham Maritime, UK
- ISDC – International Security and Development Center, Berlin, Germany
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Baliki G, Brück T, Schreinemachers P, Uddin MN. Long-term behavioural impact of an integrated home garden intervention: evidence from Bangladesh. Food Secur 2019. [DOI: 10.1007/s12571-019-00969-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Badra M, Mehio-Sibai A, Zeki Al-Hazzouri A, Abou Naja H, Baliki G, Salamoun M, Afeiche N, Baddoura O, Bulos S, Haidar R, Lakkis S, Musharrafieh R, Nsouli A, Taha A, Tayim A, El-Hajj Fuleihan G. Risk estimates for hip fracture from clinical and densitometric variables and impact of database selection in Lebanese subjects. J Clin Densitom 2009; 12:272-8. [PMID: 19246223 DOI: 10.1016/j.jocd.2009.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2008] [Revised: 01/13/2009] [Accepted: 01/13/2009] [Indexed: 01/23/2023]
Abstract
Bone mineral density (BMD) and fracture incidence vary greatly worldwide. The data, if any, on clinical and densitometric characteristics of patients with hip fractures from the Middle East are scarce. The objective of the study was to define risk estimates from clinical and densitometric variables and the impact of database selection on such estimates. Clinical and densitometric information were obtained in 60 hip fracture patients and 90 controls. Hip fracture subjects were 74 yr (9.4) old, were significantly taller, lighter, and more likely to be taking anxiolytics and sleeping pills than controls. National Health and Nutrition Examination Survey (NHANES) database selection resulted in a higher sensitivity and almost equal specificity in identifying patients with a hip fracture compared with the Lebanese database. The odds ratio (OR) and its confidence interval (CI) for hip fracture per standard deviation (SD) decrease in total hip BMD was 2.1 (1.45-3.05) with the NHANES database, and 2.11 (1.36-2.37) when adjusted for age and body mass index (BMI). Risk estimates were higher in male compared with female subjects. In Lebanese subjects, BMD- and BMI-derived hip fracture risk estimates are comparable to western standards. The study validates the universal use of the NHANES database, and the applicability of BMD- and BMI-derived risk fracture estimates in the World Health Organization (WHO) global fracture risk model, to the Lebanese.
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Affiliation(s)
- Mohammad Badra
- Orthopedics Department, School of Medicine, American University of Beirut, Beirut, Lebanon
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