Effect of enhanced homestead food production on anaemia among Cambodian women and children: A cluster randomized controlled trial

Abstract

There is inconsistent evidence on the efficacy of agriculture programmes at improving women and children's anaemia and nutritional status. The primary aim of this study was to evaluate the impact of a nutrition‐sensitive enhanced homestead food production (EHFP) programme on anaemia in women (18–45 years) and children (6–59 months) in rural Cambodia. Secondary outcomes were women's micronutrient status and women and children's anthropometry. In this cluster‐randomized controlled trial, 900 households from 90 villages (clusters) were randomized to either (a) home gardens and behaviour change communication (BCC) on nutrition, hygiene, women's empowerment, and marketing (EHFP); (b) home gardens plus fishponds and BCC (EHFP + F); or (c) control (no intervention). Haemoglobin concentration and anthropometry were measured in women and children at baseline and at 22 months. Venous blood samples were collected in a subset of women (n = 450) at baseline and at 22 months. Generalized linear mixed effect models with repeated measures were used to evaluate the difference across groups and the change from baseline to end of study. Ninety clusters, 552 women, and 754 children completed the trial. Compared with control, we found a statistically significant impact on anaemia prevalence in children (−14.0 percentage points; P = 0.02) and retinol binding protein concentrations in women (difference in difference: 0.34; P = 0.02) randomized to EHFP and EHFP + F groups, respectively. No other statistically significant effects on anaemia, nutritional biomarker concentrations, or anthropometry were observed. Future research is needed to examine longer term impacts of EHFP on anthropometry in women and children and into the nutritional causes of anaemia among children in Cambodia.

Nutrition-Sensitive Agriculture: A Systematic Review of Impact Pathways to Nutrition Outcomes

“…An agriculture–gender intervention significantly improved the weight-for-height z score among children, whereas adding a BCC component did not result in the same effect ( 52 ). Likewise, an EHFP intervention alone largely reduced anemia among children, but adding a fish component did not bring the same effect ( 67 ).…”

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.…”

Linkages of agroecosystems producing farmed seafood on food security, nutritional status and adolescent health in Bangladesh

“…Evidence for improved access to fish and other sources of micronutrients on nutritional and health outcomes has been limited and contradictory. One recent randomised controlled trial in Cambodia did find positive impacts of enhanced homestead food production including a fish pond to improve iron, vitamin A and riboflavin among women, but not among children, for example (Michaux et al, 2019).…”