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Review
. 2016 May;12 Suppl 1(Suppl 1):155-68.
doi: 10.1111/mcn.12260.

Evidence-based evolution of an integrated nutrition-focused agriculture approach to address the underlying determinants of stunting

Nancy J Haselow  1 , Ame Stormer  1 , Alissa Pries  1
Affiliations
Review

Evidence-based evolution of an integrated nutrition-focused agriculture approach to address the underlying determinants of stunting

Nancy J Haselow et al. Matern Child Nutr. 2016 May.

Abstract

Despite progress in reducing hunger and malnutrition since the 1990s, many still suffer from undernutrition and food insecurity, particularly women and young children, resulting in preterm birth, low birthweight and stunting, among other conditions. Helen Keller International (HKI) has addressed malnutrition and household food insecurity through implementation of an Enhanced Homestead Food Production (EHFP) programme that increases year-round availability and intake of diverse micronutrient-rich foods and promotes optimal nutrition and hygiene practices among poor households. This paper reviews the evolution and impact of HKI's EHFP programme and identifies core components of the model that address the underlying determinants of stunting. To date, evaluations of EHFP have shown impact on food production, consumption by women and children and household food security. Sale of surplus produce has increased household income, and the use of a transformative gender approach has empowered women. EHFP has also realized nutrition improvements in many project sites. Results from a randomized control trial (RCT) in Baitadi district, Nepal showed a significant improvement in a range of practices known to impact child growth, although no impact on stunting. Additional non-RCT evaluations in Kailali district of Nepal, demonstrated a 10.5% reduction in stunting and in the Chittagong Hill Tracts in Bangladesh, revealed an 18% decrease in stunting. Based on evidence, the EHFP has evolved into an integrated package that includes agriculture, nutrition, water/hygiene/sanitation, linkages to health care, women's empowerment, income generation and advocacy. Closing the stunting gap requires long-term exposure to targeted multi-sectoral solutions and rigorous evaluation to optimize impact.

Keywords: homestead food production; nutrition-sensitive agriculture; stunting.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Suaahara Programme Implementation Pathway Helen Keller International, 2012.
Figure 2
Figure 2
Type of garden related to production and consumption of vegetables in Bangladesh (2003–2005) and Cambodia (2005–2007) at endline (consolidated).
Figure 3
Figure 3
Women's Empowerment Making Markets Work for Women Final Report. 2012.
Figure 4
Figure 4
Percentage of stunted children at baseline and endline, Making Markets Work For Women, HKI Bangladesh.
See this image and copyright information in PMC

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MeSH terms