Adapting Agriculture Platforms for Nutrition: A Case Study of a Participatory, Video-Based Agricultural Extension Platform in India

Abstract

Successful integration of nutrition interventions into large-scale development programmes from nutrition-relevant sectors, such as agriculture, can address critical underlying determinants of undernutrition and enhance the coverage and effectiveness of on-going nutrition-specific activities. However, evidence on how this can be done is limited. This study examines the feasibility of delivering maternal, infant, and young child nutrition behaviour change communication through an innovative agricultural extension programme serving nutritionally vulnerable groups in rural India. The existing agriculture programme involves participatory production of low-cost videos promoting best practices and broad dissemination through village-level women’s self-help groups. For the nutrition intervention, 10 videos promoting specific maternal, infant, and young child nutrition practices were produced and disseminated in 30 villages. A range of methods was used to collect data, including in-depth interviews with project staff, frontline health workers, and self-help group members and their families; structured observations of mediated video dissemination sessions; nutrition knowledge tests with project staff and self-help group members; and a social network questionnaire to assess diffusion of promoted nutrition messages. We found the nutrition intervention to be well-received by rural communities and viewed as complementary to existing frontline health services. However, compared to agriculture, nutrition content required more time, creativity, and technical support to develop and deliver. Experimentation with promoted nutrition behaviours was high, but sharing of information from the videos with non-viewers was limited. Key lessons learned include the benefits of and need for collaboration with existing health services; continued technical support for implementing partners; engagement with local cultural norms and beliefs; empowerment of women’s group members to champion nutrition; and enhancement of message diffusion mechanisms to reach pregnant women and mothers of young children at scale. Understanding the experience of developing and delivering this intervention will benefit the design of new nutrition interventions which seek to leverage agriculture platforms.

A scoping review of social‐behaviour change techniques applied in complementary feeding interventions

“…Twenty‐two interventions occurred in sub‐Saharan Africa (Aidam et al, n.d.; Aubel, Touré, & Diagne, ; Alive and Thrive Ethiopia, ; Berti, Mildon, Siekmans, Main, & Macdonald, ; Bruyeron, Denizeau, Berger, & Trèche, ; Chiutsi‐Phiri et al, ; Crossman et al, ; Fernald et al, ; Gelli et al, ; Gelli et al, ; Guyon et al, ; Harris et al, ; Kim et al, ; Kimani‐Murage et al, ; Kulwa et al, ; Leroy, Olney, & Ruel, ; Mukuria, Martin, Egondi, Bingham, & Thuita, ; Mulualem, Henry, Berhanu, & Whiting, ; Nikiema et al, ; Olney, Pedehombga, Ruel, & Dillon, ; Parvanta, Thomas, & Zaman, ; Sarrassat et al, ; Save the Children, ; Webb Girard et al, ; Alive and Thrive, 2016) and 11 in Bangladesh (Aboud & Akhter, ; Aboud, Moore, & Akhter, ; Aboud, Shafique, & Akhter, ; Frongillo et al, ; Hoddinott, Ahmed, Ahmed, & Roy, ; Kimmons et al, ; Owais et al, ; Parvanta et al, ; Roy et al, ; Roy et al, ; TANGO International, ). Of the remaining, nine occurred in India (Alive & Thrive India, n.d.; Bhandari et al, ; Bhandari et al, ; Dongre, Deshmukh, & Garg, ; Kadiyala, Morgan, Cyriac, Margolies, & Roopnaraine, ; Kilaru, Griffiths, Ganapathy, & Ghosh, ; Palwala et al, ; Singh et al, ; Vazir et al, ) and eight Central/South American or Mexico (Bonvecchio, Pelto, Escalante, & Monterrubio, ; de Oliveira, Giugliani, Santo, & Nunes, ; Iannotti et al, ; Jensen, Frongillo, Leroy, & Blake, ; Leroy et al, ; Monterrosa et al, ; Penny et al, ; Santos et al, ). Five were implemented in China (Guldan et al, ; Li et al, ; Sun et al, ; J. Zhang, Shi, Chen, Wang, & Wang,…”

“…We next sought to assess whether patterns emerged between the type and/or quantity of BCT used and intervention effectiveness. Of the 64 unique interventions identified, six (Alive & Thrive India, n.d.; Fernald et al, ; Gelli, Becquey, et al, ; Gelli, Margolies, et al, ; Kadiyala et al, ; Kulwa et al, ) were in progress and had not reported evaluation data as of August 2018. Forty‐two were randomized controlled or quasi‐experimental studies, and one was a propensity score matched impact evaluation; the remaining interventions applied evaluation strategies that consisted of pre/post designs with no control group ( n = 15), cross‐sectional surveys ( n = 1), or were missing baseline data ( n = 1) and were excluded from these analyses.…”

Factors influencing delivery of intersectoral actions to address infant stunting in Bogotá, Colombia – a mixed methods case study.

“…A further conceptual point for discussion regarding differences between intersectoral and multisectoral interventions for stunting arises from the analysis of factors that condition ISA. Nutrition-speci c interventions rely on the health sector (7) but there is ample recognition that many additional sectors have roles to play in nutrition-sensitive interventions (11,(30)(31)(32). During planning and implementation of the intervention against stunting in Bogotá, a lack of engagement of the health sector was frequently seen as a barrier for ISA.…”

Establishing integrated agriculture-nutrition programmes to diversify household food and diets in rural India

“…Evidence is found in the literature of the different pathways linking agriculture and nutrition (World Bank 2007;FAO 2013;Kadiyala et al 2014;Kadiyala et al 2016;Gillespie and van den Bold 2017). Taking into account the spatial influence of farming practices, cultural settings, resource availability at a household level, and soil and agro-ecological environment, what may be considered a fitting strategy at one place, while providing the framework, is unlikely to be directly applicable in a different setting.…”