A Mixed Methods Exploration of the Role of Participation in a Nutrition-Sensitive Agroecology Intervention in Rural Tanzania.

Background: Participation is key to the successful implementation of nutrition-related interventions, but it has been relatively overlooked. Objective: We sought to describe participation intensity among smallholder farmers in a randomized nutrition-sensitive agroecology study in rural Tanzania. We explored the association between baseline characteristics and overall participation intensity (quantitatively at the individual level and qualitatively at the group level), the association of participation intensity with 2 process indicators, and the association between participation intensity and key study outcomes. Methods: Data came from 7 rounds of surveys with 295 women and 267 men across 29 months and 2 rounds of semi-structured interviews with the 20 "mentor farmers" who delivered the intervention. Participation intensity was based on the number of months of attendance at village-level project meetings or household visits (range: 0-29). Multivariable models of participation were built. Results: Women and men participated for 17.5 ± 7.2 and 13.6 ± 8.3 months, respectively. Participation intensity followed 1 latent trajectory: initially low, with a sharp increase after month 7, and plateaued after the first year. At baseline, higher participation intensity was associated with older age, higher education, level of women's empowerment, being in the middle quintile of wealth, and qualitatively, village residence. Higher participation intensity was associated with 2 process indicators - better recall of topics discussed during meetings and greater knowledge about key agroecological methods. High participation intensity was positively associated with increased use of sustainable agricultural practices among all participants, and among women, with husband's involvement in household tasks and child's dietary diversity score. Conclusions: Participation intensity covaried with key study outcomes, suggesting the value of increased attention to implementation in nutrition-related programs for providing insights into drivers of impact. We hope that investigations of participation, including participation intensity, will become more widespread so that intervention impacts, or lack thereof, can be better understood.

Does Crop Diversity Influence Household Food Security and Women's Individual Dietary Diversity? A Cross-Sectional Study of Malawian Farmers in a Participatory Agroecology and Nutrition Project.

BACKGROUND: Agroecological methods have the potential to impact nutrition and food security, however, to date there is limited research evaluating this approach. OBJECTIVE: A 5-year participatory research project with farming households in north and central Malawi was designed to train farmers on agroecological practices, alongside raising awareness on nutrition and gender equity. This cross-sectional study aimed to explore the relationships between crop diversity, food security at the household level, and individual diversity for women, within the context of an agroecology, nutrition education, and farmer mentoring program. METHODS: Participating farmers were trained in and experimented with different farming methods. These farmers subsequently trained other farmers on these short-term agroecological practices and provided mentorship using community-based educational methods designed to address both household food security and nutrition. In year 4 of the intervention, a cross-sectional survey assessed farm practices, food security, and individual dietary diversity of 851 participating households. RESULTS: Households with lower crop diversity were significantly less likely to be food secure (odds ratios [OR] = 0.829, P < .001). Women in households with higher crop diversity were more likely to have higher individual dietary diversity (OR = 1.120, P < .01), eat vitamin A rich foods (OR = 1.176, P < .01), and legumes, nuts, and seeds (OR = 1.141, P < .01). CONCLUSIONS: These findings suggest that within a participatory agroecological training combined with community-based nutrition education with a focus on social equity, crop diversity is associated with less household food insecurity and poorer diet quality for rural farming households. Crop diversity may improve dietary diversity by making nutritious foods more available.

Agroecology and household production diversity and dietary diversity: Evidence from a five-year agroecological intervention in rural Malawi.

Following a decade of declining food insecurity, the global undernourished population has increased successively in the last three years. This increasing trend highlights the challenge of meeting the zero hunger and nutrition targets of Sustainable Development Goal (SDG) 2. Malawi is one of the most food insecure countries in Africa, with a significant proportion of its population being undernourished. Amid evidence of the counter-productive effects of input-intensive agriculture in this context, including the narrowing of the food basket and unequal access to subsidized inputs, some scholars have argued that alternative diversified agricultural approaches, combined with attention to underlying inequalities, maybe more promising in addressing undernutrition. Agroecology is one such approach which promotes biodiversity and pays attention to socio-political inequalities. That notwithstanding, there is limited research on the potential role of agroecology in improving household food outcomes. Drawing theoretical insights from political ecology and using Difference-in-Difference and mediation techniques, we examine the impact of agroecology on household production diversity and dietary diversity using data from a five-year agroecological intervention in Malawi (n = 514 agroecology-practicing farming households and 400 non-agroecology households). Findings from the Difference-in-Difference analysis show a positive treatment effect of agroecology on both production diversity (ß = 0.289, p < 0.01) and dietary diversity (ß = 0.390, p < 0.01). Results from the mediation analysis indicate that generally, production diversity is directly associated with dietary diversity (ß = 0.18, p < 0.01), although the relationship is stronger for households practicing agroecology (ß = 0.19, p < 0.01) compared to non-agroecology households (ß = 0.14, p < 0.01). These findings provide evidence of the potential for agroecology to improve nutrition in smallholder farming contexts and contribute to achieving SDGs 2. Malawi is currently grappling with widespread micronutrient deficiencies. Given that smallholder farmers typically draw a significant proportion of their diet from what they produce, farming approaches like agroecology, which emphasizes the cultivation of diverse crops, may be promising for improving household nutrition.

Agroecology and healthy food systems in semi-humid tropical Africa: Participatory research with vulnerable farming households in Malawi.

This paper assesses the relationship between agroecology, food security, and human health. Specifically, we ask if agroecology can lead to improved food security and human health among vulnerable smallholder farmers in semi-humid tropical Africa. The empirical evidence comes from a cross-sectional household survey (n=1000) in two districts in Malawi, a small country in semi-humid, tropical Africa. The survey consisted of 571 agroecology-adoption and 429 non-agroecology-adoption households. Ordered logistics regression and average treatment effects models were used to determine the effect of agroecology adoption on self-reported health. Our results show that agroecology-adoption households (OR=1.37, p=0.05) were more likely to report optimal health status, and the average treatment effect shows that adopters were 12% more likely to be in optimal health. Furthermore, being moderately food insecure (OR=0.59, p=0.05) and severely food insecure (OR=0.89, p=0.10) were associated with less likelihood of reporting optimal health status. The paper concludes that with the adoption of agroecology in the semi-humid tropics, it is possible for households to diversify their crops and diets, a condition that has strong implications for improved food security, good nutrition and human health.

Integrated agriculture programs to address malnutrition in northern Malawi.

BACKGROUND: In countries where the majority of undernourished people are smallholder farmers, there has been interest in agricultural interventions to improve nutritional outcomes. Addressing gender inequality, however, is a key mechanism by which agriculture can improve nutrition, since women often play a crucial role in farming, food processing and child care, but have limited decision-making and control over agricultural resources. This study examines the approaches by which gender equity in agrarian, resource-poor settings can be improved using a case study in Malawi. METHODS: A quasi-experimental design with qualitative methods was used to examine the effects of a participatory intervention on gender relations. Thirty married couple households in 19 villages with children under the age of 5 years were interviewed before and then after the intervention. An additional 7 interviews were conducted with key informants, and participant observation was carried out before, during the intervention and afterwards in the communities. The interviews were recorded and transcribed, and analysed qualitatively for key themes, concepts and contradictions. RESULTS: Several barriers were identified that undermine the quality of child care practices, many linked to gender constructions and norms. The dominant concepts of masculinity created shame and embarrassment if men deviated from these norms, by cooking or caring for their children. The study provided evidence that participatory education supported new masculinities through public performances that encouraged men to take on these new roles. Invoking men's family responsibilities, encouraging new social norms alongside providing new information about different healthy recipes were all pathways by which men developed new 'emergent' masculinities in which they were more involved in cooking and child care. The transformational approach, intergenerational and intra-gendered events, a focus on agriculture and food security, alongside involving male leaders were some of the reasons that respondents named for changed gender norms. CONCLUSIONS: Participatory education that explicitly addresses hegemonic masculinities related to child nutrition, such as women's roles in child care, can begin to change dominant gender norms. Involving male leaders, participatory methods and integrating agriculture and food security concerns with nutrition appear to be key components in the context of agrarian communities.

Agroecology and sustainable food systems: Participatory research to improve food security among HIV-affected households in northern Malawi.

This article shares results from a long-term participatory agroecological research project in northern Malawi. Drawing upon a political ecology of health conceptual framework, the paper explores whether and how participatory agroecological farming can improve food security and nutrition among HIV-affected households. In-depth interviews were conducted with 27 farmers in HIV-affected households in the area near Ekwendeni Trading Centre in northern Malawi. The results show that participatory agroecological farming has a strong potential to meet the food, dietary, labour and income needs of HIV-affected households, whilst helping them to manage natural resources sustainably. As well, the findings reveal that place-based politics, especially gendered power imbalances, are imperative for understanding the human impacts of the HIV/AIDS epidemic. Overall, the study adds valuable insights into the literature on the human-environment dimensions of health. It demonstrates that the onset of disease can radically transform the social relations governing access to and control over resources (e.g., land, labour, and capital), and that these altered social relations in turn affect sustainable disease management. The conclusion highlights how the promotion of sustainable agroecology could help to partly address the socio-ecological challenges associated with HIV/AIDS.