The production diversity of subsistence farms in the Bolivian Andes is associated with the quality of child feeding practices as measured by a validated summary feeding index

Abstract

Objective: To determine the validity of a summary infant and child feeding index (ICFI) and the association with the index of factors related to agricultural production. Design: A cross-sectional survey in eight health-post jurisdictions identified as priority nutrition regions. All households with children aged 6-23 months in eligible communities were administered an integrated survey on agricultural production and nutrition-related practices. Quantitative 24 h dietary recall, food frequency data and anthropometric measurements were collected for each child. Ninety-one per cent of eligible families participated. Setting: The northern region of the Potosí department in the Bolivian highlands. Subjects: Two hundred and fifty-one households with children aged 6-23 months. Results: In multiple regression models controlling for potential confounding variables, infant and young child feeding (IYCF) practices as measured by an ICFI showed positive associations with child length-for-age Z-score (mean difference of 0?47 in length-for-age Z-score between children in the high ICFI tertile compared with the low tertile), child energy intake (mean difference of 1500 kJ between tertiles) and the micronutrient adequacy of child diets (mean difference of 7?2 % in mean micronutrient density adequacy between tertiles; P , 0?05). Examining determinants of IYCF practices, mother's education, livestock ownership and the crop diversity of farms were positively associated with the ICFI, while amount of agricultural land cultivated was negatively associated with the ICFI. Crop diversity and IYCF practices were more strongly positively correlated among households at high elevations. Conclusions: Nutrition-sensitive investments in agriculture that aim to diversify subsistence agricultural production could plausibly benefit the adequacy of child diets. Keywords Infant and child feedingChild anthropometry Agriculture Crop diversity NutritionIn 2011, at least 165 million children under the age of 5 years suffered from linear growth faltering worldwide, a consequence of chronic undernutrition (1) . Chronic nutritional deficiencies in childhood can lead to an increased risk of morbidity and mortality (2,3) , as well as impaired growth and cognitive development, diminished reproductive and work capacity, poor school performance, lowered income-earning potential and an increased risk of several adult-onset chronic diseases (4,5) . The diets of children in their first years are predominantly determined by the decisions and behaviours of their mothers and other household members who feed and care for them. Caregivers' breast-feeding and complementary feeding practices then are essential to the healthy growth and development of children early in life.Providing education, counselling and complementary foods to caregivers has been shown to improve infant and young children feeding (IYCF) practices in many settings (6) . However, very little evidence is available to evaluate nutrition-sensitive approaches to improving these practices; that i...

Nutrition-sensitive agriculture: new term or new concept?

“…Also in a newer study, the total amount of agricultural land was negatively associated with child feeding practices. These findings underscore the fact that high agricultural labor burdens for women are a considerable barrier to improving child care and thus the nutrition of infants [59]. A study in Kenya analyzing the implications of dairy production intensification at household level on mothers' infant and young child feeding (IYCF) practices came to a similar conclusion: optimal IYCF practices were adversely affected by higher levels of dairy production.…”

“…The authors suspected that intensifying work loads of mothers and food insecurity may lead mothers to think they cannot adequately feed their infants through exclusively breastfeeding [60]. Furthermore, in subsistence regions, more diverse farms were associated with better feeding practices [59]. Farmers' crop choices, management practices, and the harsh highland environment decreased agricultural production efficiency and diversity.…”

“…Besides the potential for agriculture to improve household food security, it is critically important that care aspects be analyzed and that the manner in which agriculture and food systems might enhance or diminish caregiving environments, resources, and capacities be taken into consideration [58,59]. However, literature showing the negative impacts on nutrition was limited, and empirical studies on the links need to be updated [63].…”

Urbanization, market development and malnutrition in farm households: evidence from the Demographic and Health Surveys, 1986–2011

“…Turning to dietary outcomes, access costs and infrastructure were another key factor determining dietary diversity in urban and rural China (Liu et al 2013). Production diversity by rural farm households in Bolivia is positively associated with an index of child feeding quality, and the strength of this association increases with the altitude of farm household location, again suggesting the importance of access to markets, as higher elevations are likely to be more isolated (Jones 2014).…”

The challenge of achieving basal energy, iron and zinc provision for home consumption through family farming in the Andes: a comparison of coverage through contemporary production systems and selected agricultural interventions

“…Diversity in agricultural production has been associated with nutritional diversity and improved dietary quality, especially in the context of smallholder farming systems [98][99][100][101][102]. While overall crop and livestock production diversity is high in the study area, many households would not be able to cover the basal micronutrient (iron and zinc) demand through self-production.…”