An agriculture–nutrition intervention improved children's diet and growth in a randomized trial in Ghana

Abstract

Stunting in Ghana is associated with rural communities, poverty, and low education; integrated agricultural interventions can address the problem. This cluster randomized controlled trial tested the effect of a 12-month intervention (inputs and training for poultry farming and home gardening, and nutrition and health education) on child diet and nutritional status. Sixteen clusters were identified and randomly assigned to intervention or control; communities within clusters were randomly chosen, and all interested, eligible mother-child pairs were enrolled (intervention: 8 clusters, 19 communities, and 287 households; control: 8 clusters, 20 communities, and 213 households). Intention-to-treat analyses were used to estimate the effect of the intervention on endline minimum diet diversity (≥4 food groups), consumption of eggs, and length-for-age (LAZ)/height-for-age (HAZ), weight-for-age (WAZ), and weight-for-length (WLZ)/ weight-for-height (WHZ) z-scores; standard errors were corrected for clustering. Children were 10.5 ± 5.2 months (range: 0-32) at baseline and 29.8 ± 5.4 months (range: 13-48) at endline. Compared with children in the control group, children in the intervention group met minimum diet diversity (adjusted odds ratio = 1.65, 95% CI [1.02, 2.69]) and a higher LAZ/HAZ (β = 0.22, 95% CI [0.09, 0.34]) and WAZ (β = 0.15, 95% CI [0.00, 0.30]). Sensitivity analyses with random-effects and mixed-effects models and as-treated analysis were consistent with the findings. There was no group difference in WLZ/WHZ. Integrated interventions that increase access to high-quality foods and nutrition education improve child nutrition.

A Multi-Sectoral Approach Improves Early Child Development in a Disadvantaged Community in Peru: Role of Community Gardens, Nutrition Workshops and Enhanced Caregiver-Child Interaction: Project “Wawa Illari”

“…Food insecurity is a known determinant of inadequate child growth ( 45 , 46 ), and a reduction in food insecurity was an important achievement of the project, probably attributable to the creation of home gardens. There is growing evidence that home gardens have a positive impact on children's diet diversity, anthropometry ( 11 ), infectious diseases ( 47 ) and anemia ( 48 ). Although, home gardens were not associated with food security in a study from the Philippines ( 49 ), in the present study we showed a significant association of the combined intervention including gardens, on food security.…”

“…Interventions with home and community gardens constitute an important strategy to improve food security, and particularly in the Andean region, provide the opportunity to grow traditional products with high nutritional value (9). Interventions that include creating home gardens and the consumption of traditional regional foods have shown improved food diversity in infants undergoing complementary feeding (10) for growth and achieving adequate weight and height (11).…”

Eggs: A high potential food for improving maternal and child nutrition

“…The first paper provides an overview of the role of eggs in the diet of maternal and child nutrition and updated data on egg consumption (Lutter, Iannotti, & Stewart, ), while the second summarizes how social marketing was used in a randomized controlled trial of eggs early in the complementary feeding period to foster brand loyalty and high compliance, as well as empowerment of participants and policy change in Ecuador (Gallegos et al, ). The third and fourth papers examine how a controlled intervention to foster poultry production affected child dietary diversity and nutritional status in Ghana (Marquis et al, ) and Zambia (Dumas, Lewis, & Travis, ), while the fifth paper reviews successes and lessons learned from a project on small‐scale poultry production to increase egg production and household egg intake in four diverse African contexts (Nordhagen & Klemn, ). A novel approach to use chicken eggshells to improve dietary calcium intake in rural sub‐Saharan Africa is reported in the sixth paper (Bartter et al, ), while the seventh paper reports on business models for poultry production in East Africa and India (Beesabathuni, Lingala, & Kraemer, ).…”

Interactions between malnutrition, soil-transmitted helminthiasis and poverty among children living in periurban communities in Maranhao State, Northeastern Brazil

“…The micro regional differences in the nutritional status of children in different income groups have been demonstrated in Gambia and Bangladesh 32,33 . In Ghana and Nepal, increased dietary diversity has been able to increase the nutritional status of children in rural communities 34,35 .…”