What works? Exploring the evidence base of rigorous homestead food production intervention studies conducted in South Asia: A systematic literature review of program component effectiveness to inform future intervention designs in this region. Open Access

Mucciardi, Gina (Spring 2023)

Permanent URL: https://etd.library.emory.edu/concern/etds/6d56zz18f?locale=en


Micronutrient malnutrition is a major global issue with nearly one third of the world’s population suffering from at least one essential micronutrient deficiency, with women and children under five in South Asia experiencing the highest rates of nutrient deficiencies and resulting health problems. Homestead food production interventions have been implemented to improve maternal and child nutrition in LMICs for the past 30 years. The purpose of this review is to synthesize the evidence base of rigorous homestead food production intervention studies to discern patterns of effectiveness within the interventions by component type utilized. Four publications were initially sent to this author by a partnering research team at Emory University, and additional publications were identified through forward and backward snowballing search strategy where references were carefully scanned and read for relevancy.

In total, ten publications representing eight intervention studies were included for review detailing homestead food production intervention trials in South Asia. Nutrition outcomes and intervention component types were qualitatively coded, and results analyzed. All intervention components included group- and one-on-one education components; asset distribution and/or animal, poultry, or fish promotion were employed in six out of eight studies, marketing training was included in three studies, and a mass media component was included in one. More studies presented nutrition outcomes for women (n=8) than for children (n=5). The most common outcome measured was dietary intake, for which the studies nearly all reported significant improvements for women (n=7 with 1 mixed result) and children (n=3 with 1 mixed result). No studies reported improvement children’s anthropometry (n=3). Mixed results were reported for women’s and children’s anemia and women’s anthropometry. Surprisingly, only one study examined women’s micronutrient status and no studies examined children’s micronutrients status.

While the intervention designs, nutrition outcomes measured, and methodology for measurement in these studies were largely heterogeneous, homestead food production interventions increase nutrient-rich food production and consumption at the household level, warranting continued research and support of programs in areas where micronutrient malnutrition is a public health problem.

Table of Contents

Introduction 1

Methods 4

Figure 1: Flow chart diagram and PRISMA checklist describing selection of publications for scoping review 7

Results 8

Table 1: Summary of findings from nutrition-sensitive agriculture intervention studies with nutrition outcomes conducted in South Asia 9

Table 2: Studies demonstrating effectiveness for improving selected nutrition outcomes in women by intervention component types 16

Table 3: Studies demonstrating effectiveness for improving selected nutrition outcomes in children by intervention component types 16

Results: Anemia 17

Results: Anthropometry 17

Results: Micronutrient Status 18

Results: Dietary Intake 19

Discussion 22

Implications/Recommendations 23

Strengths and Limitations 24

Conclusion 25

References 27

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