Using Program Impact Pathways to Understand and Improve Program Delivery, Utilization, and Potential for Impact of Helen Keller International's Homestead Food Production Program in Cambodia

Olney, Deanna K.; Vicheka, Sao; Kro, Meng; Chakriya, Chhom; Kroeun, Hou; Hoing, Ly Sok; Talukder, Aminzzaman; Quinn, Victoria J.; Iannotti, Lora; Becker, Elisabeth; Roopnaraine, Terry

doi:10.1177/156482651303400206

Cited by 45 publications

(64 citation statements)

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“…Our study contributes to a growing body of implementation research using varied and rigorous methods to assess how well nutrition programmes are delivered and utilized compared to plans (Avula et al, ; Kim et al, ; M. N. N. Mbuya et al, ; Menon, Rawat, & Ruel, ; Rajaraman et al, ), how to optimize programme implementation (Olney, Vicheka, et al, ; Winch et al, ) and to provide confirmatory evidence of the posited causal pathways (Loechl et al, ; Robert et al, ). Like ours, other studies have identified breakdowns in the pathway between training and effective application of its contents, including the volume of content to be absorbed, the skills and attributes of trainers, logistical and human challenges to adequate supervision, and the considerable and perhaps unrealistic demands placed on community agents (Kim et al, ; Mbuya, Menon, Habicht, Pelto, & Ruel, ).…”

Section: Discussionmentioning

confidence: 86%

“…The objectives were fourfold: (a) investigate if implementation and utilization were proceeding as designed; (b) evaluate the quality of programme activities; (c) invite feedback for improvements from beneficiaries and implementers; and (d) identify ways to strengthen delivery and/or utilization of the programme components to increase ultimate impact. The design and analysis of the PE were guided by the PIP model adapted from a version jointly designed by IFPRI, HKI, and local stakeholders for HKI's programme in Cambodia (Olney, Richter, et al, ; Figure ). The model distinguishes aspects of programme delivery and utilization and highlights three pathways to impact, each of which required contributions from the government as well as APRG and HKI: Improved production: VFL are trained and equipped to apply more productive cultivation techniques and to transfer these skills to beneficiary women producing at the household level.…”

Section: Methodsmentioning

confidence: 99%

“…Components with positive/correct responses of >75% were coded as working well; 25–75% as needs improvement; and <25% as not working. This classification has been used in other process evaluations to estimate programme performance and identify components most in need of improvement (Olney, Parker, Iruhiriye, Leroy, & Ruel, ; Olney, Richter, et al, ; Olney, Vicheka, et al, ).Qualitative data were transcribed and analyzed manually and coded for key themes guided by the PIP (Olney, Behrman, et al, ).…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Process evaluation improves delivery of a nutrition‐sensitive agriculture programme in Burkina Faso

Nielsen

Olney

Ouedraogo

et al. 2017

Maternal & Child Nutrition

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Evidence is emerging from rigorous evaluations about the effectiveness of nutrition-sensitive agriculture programmes in improving nutritional outcomes. Additional evidence can elucidate how different programme components and pathways contribute and can be optimized for impact. The International Food Policy Research Institute, with Helen Keller International, designed a comprehensive framework to evaluate the delivery, utilization, and impact of Helen Keller International's enhanced homestead food production programme in Burkina Faso. After 18 months of implementation, a process evaluation was conducted to examine programme impact pathways, using key informant and semistructured interviews with implementing agents and beneficiaries, and with residents of control communities. Data were analyzed by International Food Policy Research Institute and reviewed with project managers and partners through multiple workshops to identify opportunities to strengthen implementation. Findings illuminated gaps between intended and actual delivery schemes, including input constraints, knowledge gaps among community agents in agriculture and young child nutrition practices, and lower than expected activity by community volunteers. In response, staff developed measures to overcome water constraints and expand vegetable and poultry production, retrained volunteers in certain techniques of food production and counselling for nutrition behaviour change, added small incentives to motivate volunteers, and shaped both immediate and long-term changes to the programme model. Working closely with International Food Policy Research Institute on the evaluation activities also expanded the repertoire of research methods and skills of Helen Keller International staff. Process evaluation can strengthen programme delivery, utilization, and design. Collaboration between researchers and implementers can improve programme effectiveness, project staff capacity, and advance delivery science.

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Section: Discussionmentioning

confidence: 86%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Process evaluation improves delivery of a nutrition‐sensitive agriculture programme in Burkina Faso

Nielsen

Olney

Ouedraogo

et al. 2017

Maternal & Child Nutrition

Self Cite

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“…Over the past few years, randomized controlled trials (RCTs) have investigated the evidence for a range of nutrition‐sensitive agricultural interventions, such as biofortification and improved and diversified household food production. These studies have demonstrated improvements in diet quality, micronutrient intake, and women's knowledge and empowerment by combining agricultural interventions, gender empowerment, and nutrition education …”

Section: Links Between Agriculture Food and Health In The Food Systemmentioning

confidence: 99%

The role of pulses in sustainable and healthy food systems

McDermott

Wyatt

2017

Annals of the New York Academy of Sciences

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Improving nutrition is a development priority, particularly in low-and middle-income countries (LMICs) in Africa and South Asia, in which there is a persistent burden of undernutrition and increasing obesity. Healthy food systems can play a necessary role, aligned with other multisectoral actions, in addressing this challenge. Contributing to improved nutrition and health outcomes through food-based solutions is complex. In considering the role that pulses can play in addressing this challenge, there are useful conceptual frameworks and emerging lessons. National food systems in LMICs provide limited diet quality. Foods for a healthy diet may be produced locally, but they increasingly rely on improved markets and trade. What might be done to transform food systems for healthier diets, and what role can pulses play? Food systems innovations will require a convergence of technical innovation with smarter institutional arrangements and more effective policies and regulations. In many countries in Africa and South Asia, pulses can make important contributions to healthier diets. Options for supporting pulses to make a greater contribution to healthier diets include increasing the efficiency of pulse supply chains, creating more effective public-private institutional arrangements for innovation, and establishing policies, regulations, and investments that are nutrition sensitive.

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“…2,3 It is theorized that by equipping women farmers with inputs and educational resources, technical assistance, and behaviour change communication (BCC), families will enjoy year round access to nutritious food thereby improving indicators of nutrition and food security of women and their young children. 3 To test this hypothesis in Cambodia and assess the impact of EHFP model at improving food security, nutrition outcomes, and women's empowerment, we conducted a cluster randomized controlled trial (RCT) from 2011 to 2014 known as Fish on Farms (FOF). In FOF, 900 households were randomly assigned to one of three arms: 1) EHFP (gardens only); 2) EHFP+F (gardens plus small pond aquaculture); or 3) control.…”

mentioning

confidence: 99%

Impact of an enhanced homestead food production program on household food production and dietary intake of women aged 15-49 years and children aged 6-59 months: a pragmatic delayed cluster randomized control trial protocol

et al. 2017

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Background: Undernutrition remains a public health problem in Cambodia. To address this, Helen Keller International has implemented an enhanced homestead food production (EHFP) program that provides agricultural inputs and, nutrition, hygiene, and gender empowerment training. This research evaluates the impact of EHFP on dietary intake of women and children and, household food production.Methods: This two-year pragmatic delayed cluster randomized controlled trial will be conducted in 600 households in Kampot, Cambodia. Half the households will be randomly assigned to the intervention group and administered the EHFP program immediately. The remaining households (control) will be delayed for one year after which they will receive EHFP. In year one in the control group and year two in the intervention group, household data on food production and income generation will be collected using monthly surveys and, dietary data will be collected using 24-hour recalls from women 15-49 years and children 6-59 months twice during the year. Primary outcomes are differences between the treatment groups in mean intake of zinc and vitamin A among women and children. Secondary outcomes are differences between the treatment groups for other key nutrients and the incremental net monetary benefit of EHFP. Additional outcomes including household food security, women’s empowerment, and hygiene practices from larger project data will also be assessed.Conclusions: The results of this trial will assess the impact of EHFP on household food production and the dietary intake of women and children.

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Using Program Impact Pathways to Understand and Improve Program Delivery, Utilization, and Potential for Impact of Helen Keller International's Homestead Food Production Program in Cambodia

Abstract: Background. Evidence of the impact of homestead food production programs on nutrition outcomes such as anemia and growth is scant. In the absence of information on program impact pathways, it is difficult to under

Cited by 45 publications

References 8 publications

Process evaluation improves delivery of a nutrition‐sensitive agriculture programme in Burkina Faso

Process evaluation improves delivery of a nutrition‐sensitive agriculture programme in Burkina Faso

The role of pulses in sustainable and healthy food systems

Impact of an enhanced homestead food production program on household food production and dietary intake of women aged 15-49 years and children aged 6-59 months: a pragmatic delayed cluster randomized control trial protocol

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