Better Together: Women-focused Agriculture Plus Nutrition Education Improve Growth in Young Children Compared to Nutrition Education Alone

Abstract

Objectives: Homestead food production (HFP) programs aim to provide families with access to micronutrient-rich foods and increase dietary diversity for improved functional outcomes, while also empowering women. However, evidence is lacking globally of the impact of HFP on child growth and nutrition. This research examines the relationship between HFP and child growth and nutrition. Methods: A large-scale program covering 406,866 households was implemented in southern Bangladesh from 2004-2010. Households were purposively assigned to two intervention arms: (a) HFP with maternal and child health and nutrition (HFP+MCHN) or (b) maternal and child health and nutrition only (MCHN-only). MCHN consisted of antenatal care, child growth monitoring and a minimal food ration. HFP included technical advice and inputs for production of micronutrient-rich vegetables and poultry rearing. Baseline and endline data were analysed to examine child stunting and underweight between intervention arms. Results: Severe stunting (P<0.037) and severe underweight (P<0.014) between intervention arms were significantly different at endline, with no significant difference at baseline. Dietary diversity in children (6-23 months) was significantly higher (P<0.012) at endline in HFP+MCHN compared to MCHN-only areas, with no significant difference at baseline. Conclusions: An agriculture-nutrition intervention was associated with increased dietary diversity and improved growth and nutritional status in children under 2 years of age. This provides new evidence of the effect of a women-focused HFP program with nutrition education on dietary quality and nutritional status. Promising areas for future research may include the impact of similar programs on additional functional outcomes such as cognition and school performance.