Browsing by Author "Merchant, E.V."
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Item An Evaluation of Nutrition, Culinary, and Production Interventions Using African Indigenous Vegetables on Nutrition Security Among Smallholder Farmers in Western Kenya(Frontiers, 2023-05-15) Merchant, E.V.; Odendo, M.; Maiyo, N.; Govindasamy, R.; Morin, X.K.; Simon, J.E.; Hoffman, D.J.Introduction. Nutrition security continues to worsen in sub-Saharan Africa. Current research is limited on how seasonality may influence the impact of nutrition, culinary, and production interventions on food security, diet quality, and consumption of African Indigenous Vegetables (AIV); a culturally accepted source of micro-and-macronutrients that are easily produced due to their adaptation to the local environment. The objective of this study was to evaluate the programmatic impact of AIV interventions on nutrition security among smallholder farmers. Methods. In a randomized control trial, five target counties in Western Kenya were randomly assigned to one of four treatments: (1) control; (2) production intervention (PI); (3) nutrition and culinary intervention (NCI); and (4) NCI and PI (NCI/PI). After the counties were randomly assigned to a treatment, 503 smallholder farmers (18–65 years) were selected from participatory farmer groups. The PI consisted of five agricultural production modules delivered between 2016 and 2019. The NCI was delivered twice: (1) household nutrition education (2017) and (2) community culinary training (2019). The NCI/PI included communities receiving both interventions at these time periods. Baseline and endline surveys were administered to all participants once in October 2016 (harvest season) and to all available participants (n = 250) once in June to July 2019 (dry season), respectively. The impact evaluation was analyzed by Household Hunger Scale (HHS), Women’s Dietary Diversity Score (WDDS), AIV consumption frequency, and AIV market availability. Statistical tests included descriptive statistics (means and frequencies), paired t-test, McNemar’s test, Wilcoxon Signed-Rank test, ANOVA test with Tukey post hoc, and χ2 test. Open-ended questions were aggregated, and responses were selected based on relevancy and thoroughness of the response to provide context to the quantitative data. A value of p < 0.05 was used to denote statistical significance. Results. There was an overall decrease in WDDS, HHS, and consumption frequency between baseline and endline attributed to seasonal differences. Despite this, post-intervention, households that received NCI/PI had a higher WDDS relative to the control: WDDS 5.1 ± 1.8 vs. 4.2 ± 1.5, p = 0.035. In addition, between baseline and endline, there was an overall increase in the percentage of respondents that reported an adequate supply of key AIVs, particularly for households that received PI. Furthermore, seasonal effects caused a reported shift in the primary location for purchasing AIVs from the village to the town market. There was no reported difference in HHS. While “diet awareness” significantly influenced diet quality among the NCI treatment group, “production” was reported to have the greatest influence on diet quality among all intervention groups. Discussion. The findings revealed that coupled nutrition, culinary, and production interventions could create a protective effect against seasonal fluctuations in the availability and affordability of AIV as evidenced by a higher WDDs. Conclusion and Recommendations: These findings suggest that future programming and policy should focus on promoting the availability, accessibility, acceptability, and affordability of improved agronomic practices and germplasm for both smallholder farmers with particular emphasis on AIV varieties that contain high levels of micro-and macronutrients, improved agronomic characteristics (e.g., delayed flowering, multiple harvests, higher yields, and disease resistance), and are aligned with the communities’ cultural preferences. In addition, agricultural training and extension services should incorporate nutrition and culinary interventions that emphasize the importance of farmers prioritizing harvests for their household consumption.Item Barriers and Facilitators in Preparation and Consumption of African Indigenous Vegetables: A Qualitative Exploration from Kenya(Frontiers, 2022-03-21) Merchant, E.V.; Odendo, M.; Ndinya, C.; Nyabinda, N.; Maiyo, N.; Downs, S.; Hoffman, D.J.; Simon, J.E.; Rutgers University ; Kenya Agricultural and Livestock Research Organization - Kakamega ; Academic Model Providing Access to HealthCare ; Rutgers School of Public HealthMalnutrition and food security continue to be major concerns in sub-Saharan Africa (SSA). In Western Kenya, it is estimated that the double burden of malnutrition impacts 19% of adults and 13–17% of households. One potential solution to help address the concern is increased consumption of nutrient-dense African Indigenous Vegetables (AIVs). The objectives of this study were to: (i) document current methods used for preparation and consumption of AIVs; (ii) identify barriers and facilitators of AIVs consumption and preparation; and (iii) identify a package of interventions to increase the consumption of AIVs to promote healthy diets. This study used qualitative data collected from 145 individual farmers (78 female and 67 male) in 14 focus group discussions (FGDs) using a semi-structured survey instrument. Most farmers reported that they prepared AIVs using the traditional method of boiling and/or pan-cooking with oil, tomato, and onion. However, there were large discrepancies between reported cooking times, with some as little as 1–5 min and others as long as 2 h. This is of importance as longer cooking times may decrease the overall nutritional quality of the final dish. In addition, there were seasonal differences in the reported barriers and facilitators relative to the preparation and consumption of AIVs implying that the barriers are situational and could be modified through context-specific interventions delivered seasonally to help mitigate such barriers. Key barriers were lack of availability and limited affordability, due to an increase cost, of AIVs during the dry season, poor taste and monotonous diets, and perceived negative health outcomes (e.g., ulcers, skin rashes). Key facilitators included availability and affordability during peak-season and particularly when self-produced, ease of preparation, and beneficial health attributes (e.g., build blood, contains vitamins and minerals). To promote healthy diets within at risk-populations in Western Kenya, the findings suggest several interventions to promote the preparation and consumption of AIVs. These include improved household production to subsequently improve affordability and availability of AIVs, improved cooking methods and recipes that excite the family members to consume these dishes with AIVs, and the promotion of the beneficial heath attributes of AIVs while actively dispelling any perceived negative health consequences of their consumption.
