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. 2012 Jan 17:344:d8222.
doi: 10.1136/bmj.d8222.

Effectiveness of agricultural interventions that aim to improve nutritional status of children: systematic review

Edoardo Masset  1 , Lawrence Haddad, Alexander Cornelius, Jairo Isaza-Castro
Affiliations

Effectiveness of agricultural interventions that aim to improve nutritional status of children: systematic review

Edoardo Masset et al. BMJ. .

Abstract

Objective: To assess the effectiveness of agricultural interventions in improving the nutritional status of children in developing countries.

Design: Systematic review.

Data sources: Published and unpublished reports (after 1990) in English identified by searching 10 databases (Agris, Econlit, Eldis, IBSS, IDEAS, IFPRI, Jolis, PubMed, Web of Science, and World Bank), websites, previous systematic reviews, and reference lists and by contacting experts.

Study selection: Included studies assessed effects of agricultural interventions aiming at improving the nutritional status of children (bio-fortification, home gardens, small scale fisheries and aquaculture, dairy development, and animal husbandry and poultry development). Only studies that used a valid counterfactual analysis were included. Before/after studies and participants/non-participants comparisons affected by selection bias were excluded. Data analysis Results were analysed for four intermediate outcomes (programme participation, income, dietary diversity, and micronutrient intake) and one final outcome (prevalence of under-nutrition). Analysis was by summary tables of mean effects and by meta-analysis (for vitamin A absorption).

Results: The review included 23 studies, mostly evaluating home garden interventions. The studies reviewed did not report participation rates or the characteristics of participants in programmes. The interventions had a positive effect on the production of the agricultural goods promoted, but not on households' total income. The interventions were successful in promoting the consumption of food rich in protein and micronutrients, but the effect on the overall diet of poor people remains unclear. No evidence was found of an effect on the absorption of iron, but some evidence exists of a positive effect on absorption of vitamin A. Very little evidence was found of a positive effect on the prevalence of stunting, wasting, and underweight among children aged under 5.

Conclusions: The question posed by the review cannot be answered with any level of confidence. The data available show a poor effect of these interventions on nutritional status, but methodological weaknesses of the studies cast serious doubts on the validity of these results. More rigorous and better designed studies are needed, as well as the establishment of agreed quality standards to guide researchers in this important area.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: all authors had financial support from the UK Department for International Development (DFID) for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Figures

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Fig 1 Pathways of effect of agricultural interventions on nutrition
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Fig 2 Effect of intervention on serum retinol concentrations in children aged under 5
See this image and copyright information in PMC

Comment in

  • Agriculture and health.
    Dorward A, Dangour AD. Dorward A, et al. BMJ. 2012 Jan 17;344:d7834. doi: 10.1136/bmj.d7834. BMJ. 2012. PMID: 22251862 No abstract available.

References

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    1. Ruel MT. Can food-based strategies help reduce vitamin A and iron deficiencies? A review of recent evidence. International Food Policy Research Institute, 2001.

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