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HKI GAAP Presentation January 2013

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Presentation given by HKI at GAAP final technical workshop in Addis Ababa, January 2013

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HKI GAAP Presentation January 2013

  1. 1. ENHANCED HOMESTEADFOOD PRODUCTION FORIMPROVED FOOD SECURITYAND NUTRITION IN BURKINAFASOHelen Keller International (HKI) andthe International Food Policy Research Institute (IFPRI)
  2. 2. E-HFP program in Burkina Faso Burkina Faso  Eastern region, Gourma Province, Fada district Sahel  Water shortages inhibit having a second cultivation season High prevalence of acute and chronic malnutrition  Food insecurity  Suboptimal maternal and child nutrition and health practices  Limited availability of and access to health services
  3. 3. Overall objective of the E-HFP Program inBurkina Faso To improve the nutritional status of infants and young children through a set of production and nutrition interventions targeted to women with children 3-12 months of age through three primary program impact pathways 1. Increased availability of micronutrient-rich foods through household production during the secondary agriculture season. 2. Income generation through the sale of surplus household production. 3. Increased knowledge and adoption of optimal nutritional practices including consumption of micronutrient-rich foods
  4. 4. Program theory framework for HKI’s E-HFP programin Burkina Faso Inputs Process Outputs Outcomes Impact Agriculture and Village Model Establishment Improvements Increased Increased Income Women’s zoological inputs Farms (VMF) of individual in fruit and availability of empowerment distributed established farms (40 vegetable micronutrient improved women per production -rich fruits village) and HKI, APRG and Training in vegetables governmental plant and Women’s assets structures animal Improvements increased in small Increased (Ministries of production techniques for ruminant and availability of Health, Improved poultry food from Agriculture, master trainers maternal and production animal origin Animals, child health Improvements in Environment, and and nutrition Training in Training in household the Promotion of outcomes plant and plant and Adoption of consumption Women, local authorities and animal animal agriculture officials) work production production practices together techniques for techniques for Village Farm beneficiaries Leaders (VFL) Improvements in Beneficiaries nutrition and Develop a training received and feeding practices strategy in animal; understood BCC training for children, and plant agriculture on ENA pregnant women production training practices for and breastfeeding techniques mothers master trainers Develop a behavior change Improvements in communication BCC training BCC training Beneficiaries Adoption of care & hygiene (BCC) strategy on ENA on ENA received and ENA practices for with regards to practices for practices for understood practices by children, pregnant Essential village health beneficiaries BCC training beneficiaries women and Nutrition Actions workers on ENA breastfeeding (ENA) (VHW) practices mothers
  5. 5. Study Design Longitudinal impact evaluation Social network census Operations research Qualitative research on gender related topics including ownership and control over agricultural assets
  6. 6. Impact Evaluation Cluster randomized design  30 intervention villages (~1200 households and 120 village farm leaders (VFL))  15 “older women leader” villages (OWL)  15 “health committee” villages (HC)  15 control villages (~800 households) Longitudinal  Baseline Feb-Apr 2010 (target children 3-12 months of age)  Endline Feb-Apr 2012 (target children 21-40 months of age) Household interview  Male household head and female key respondent including gender disaggregated modules on asset ownership, agricultural production, income, household expenditures, knowledge on nutrition, household food security, dietary diversity, etc.  Anthropometric measures and hemoglobin status of target children
  7. 7. Operations Research and GAAP Qualitative Research Operations Research GAAP Qualitative ResearchRandom sample of Beneficiaries: n=120 Beneficiaries: n=145beneficiaries and Non-beneficiaries: n=60 Non-beneficiaries: n=75non-beneficiariesPurposive sample of VFL: n=60 VFL: n=60key informants OWL: n=30 OWL: n=30 HC: n=30 HC: n=30 Master agriculture trainers: n=18 Land owners: n=30 Master nutrition trainers: n=24 Focus groups: n=24 (12m; 12f)Data collection May-June 2011 May-June 2011 May-June 2012 May-June 2012Methods Semi-structured interviews Semi-structured interviews and focus group discussions
  8. 8. Key Questions for GAAPKey Questions Impact Social Qualitative Analysis evaluation network research Status censusHow do women and men view ownership of assets? x On-goingDid the EHFP program increase women’s ownership of assets? x CompleteDid the EHFP program also influence men’s asset holdings? x CompleteWere women able to maintain control over the EHFP activities and x x Completeoutputs?Did the land agreements and/or project activities influence x Completecommunity norms related to women’s land ownership or land rights?What trade-offs were women required to make in order to x On-goingparticipate in the EHFP program?Did exposure to nutrition education diffused through village health x Completecommittee members (HC) increase knowledge and uptake of newpractices as compared to that diffused through older womenleaders (OWL) or vice versa?What are the characteristics of social networks that increase or x On-goingdecrease of nutritional human capital within villages?
  9. 9. Did the EHFP program increase women’s and/ormen’s ownership of assets?
  10. 10. Ownership of assets: Household durablesand agricultural assets35 9 8 ***30 725 620 5 *** 415 310 25 1 00 Mens Mens Womens Womens Mens Mens Womens Womens agricultural agricultural agricultural agricultural durables durables durables durables assets assets assets assets baseline endline baseline endline baseline endline baseline endline Treatment Control Treatment Control Note: Comparison is to a control group that did not receive any program services. All estimates controlled for baseline age, sex, clustering, and attrition. All values are coefficient (SE). *** p <0.01
  11. 11. Ownership of assets: livestock25 **201510 ***50 Mens small livestock Mens small livestock Womens small livestock Womens small livestock baseline endline baseline endline Treatment Control Note: Comparison is to a control group that did not receive any program services. All estimates controlled for baseline age, sex, clustering, and attrition. All values are coefficient (SE). * *p<0.05, *** p <0.01
  12. 12. Were women able to maintain control over theEHFP activities and outputs?
  13. 13. Control over EHFP activities and outputs:Gardens, seeds, and vegetablesOperations research: Round 1 Operations research: Round 2(2011) (2012)100% 100% 90% 90% 80% 80% 70% 70% 60% 60% 50% 50% 40% 40% 30% 30% 20% 20% 10% 10% 0% 0% Responsible Owns land Makes Manages Responsible Owns land Makes Manages for care of for garden decisions on revenue for care of for garden decisions on revenue garden produce generated garden produce generated Beneficiary Husband Joint Beneficiary Husband Joint
  14. 14. Control over EHFP activities and outputs:ChickensOperations research: Round 1 Operations research: Round 2(2011) (2012)60% 60%50% 50%40% 40%30% 30%20% 20%10% 10% 0% 0% Allowed to sell chickens Keeps income from Responsible for decicions Keeps income from chickens on chickens chickens Beneficiary Husband Beneficiary Husband
  15. 15. Control over EHFP activities and outputs:GoatsOperations research: Round 1 Operations research: Round 2(2011) (2012)80% 80%70% 70%60% 60%50% 50%40% 40%30% 30%20% 20%10% 10% 0% 0% Who makes decisions Who makes decisions Who keeps income Beneficiary Husband Joint Beneficiary Husband Joint
  16. 16. Did the land agreements and/or project activitiesinfluence community norms related to women’s landownership or land rights?
  17. 17. Community norms related to women’s landownership and land rights: Land acquisition Land for agricultural purposes is primarily obtained through inheritance and gifts. In general, men obtain land through inheritance. Women generally obtain land through marriage/widowhood or through gifts.
  18. 18. Community norms related to women’s land ownershipand land rights: Obstacles to owning land Respondents in both beneficiary villages (56%m-63%f) and non- beneficiary villages (46%m-51%f) reported obstacles to women’s ability to own land, mainly due to traditional / social barriers The most commonly cited ways to improve women’s ability to own land were to:  Discontinue traditional customs and practices  Sensitize stakeholder’s about women’s ability to own land  Grant pieces of land to women Respondents in both beneficiary villages (36%m-40%f) and non- beneficiary villages (24%m-36%f) reported obstacles to women’s ability to use land, mainly due to lack of inputs such as seeds, fertilizers or tools and lack of rainfall as well as traditional practices. The most commonly cited ways to improve women’s ability to use land were to:  Provision of inputs  Sensitize stakeholder’s about women’s ability to own land  Grant pieces of land to women
  19. 19. Community norms related to women’s land ownership and land rights: Perceived changes in women’s ability to own and use land by both women and men Women Men HC OWL All Control HC OWL All Control (n=70) (n=75) (n=145) (n=75) (n=58) (n=60) (n=118) (n=63)Change in 46 (66) 49 (65) 95 (62) 11 (15) 32 (55) 36 (60) 68 (57) 14 (22)opinionabout whocan own anduse landChange in 18 (26) 15 (20) 33 (23) 1 (1) 16 (28) 15 (25) 31 (26) 2 (3)ability toown landChange in 29 (41) 32 (43) 61 (42) 3 (4) 27 (47) 21 (35) 48 (41) 1 (2)ability touse land
  20. 20. Trade-offs required for participation inthe EHFP program Only 11% of beneficiaries (13/118) stated that taking care of the garden interferes with their other activities (e.g. outside work and domestic tasks). None of the beneficiary women interviewed thought that taking care of their chickens interfered with their other activities. 18% of women (16/89) stated that there were costs to working at the VMF including having to neglect their domestic work, taking care of their children, not being able to go to the market, and that it takes time to go and work at the VMF.
  21. 21. Did exposure to nutrition education diffused through village health committeemembers (HC) increase knowledge and uptake of new practices as comparedto that diffused through older women leaders (OWL) or vice versa?
  22. 22. Impact of the EHFP program on nutrition knowledge: IYCF practices Children < 6 Begin giving Begin giving Give breast months of age liquids other semi-solid Give milk within should not drink than breast foods at 6 colostrum the first hour any liquids milk at 6 months of to children after birth other than months of age breast milk age N=1,138 N=1,144 N=1,129 N=1,142 N=1,149OWL villages 0.16*** 0.092*** 0.23** 0.13** 0.13** (0.054) (0.029) (0.094) (0.063) (0.055)HC villages 0.17*** 0.080*** 0.23*** 0.19*** 0.17*** (0.052) (0.029) (0.078) (0.059) (0.059)p-value 0.006 0.009 0.006 0.007 0.011Note: Comparison is to a control group that did not receive any program services. Estimates controlled for baselineage, sex, clustering, and attrition. ** p < 0.05, *** p<0.01
  23. 23. Impact of the EHFP program on health-related knowledge: Hand-washing practices 50% 45% ** 40% 35% 30% Control villages 25% Older women leader 20% villages 15% Health committee villages 10% 5% 0% Before feeding a Before feeding a child, baseline child, endlineNote: Comparison is to a control group that did not receive any program services. Estimates controlled for baselineage, sex, clustering, and attrition. ** p < 0.05
  24. 24. Impact of the EHFP program on IYCF practices: Breastfeeding practices among children 3-12 months of age at endline 100% 90% 80% 70% ** 60% 50% 40% 30% 20% 10% 0% Child everInitiated breastfeeding < 1 h breastfeeding, children breastfed, children < 6 breastfed Exclusively after birth Predominately < 6 mo Control villages Older women leader villages Health committee villagesNote: Comparison is to a control group that did not receive any program services. Estimates controlled for baselineage, sex, clustering, and attrition. ** p < 0.05
  25. 25. Impact of the EHFP program on IYCF practices: Dietarydiversity among children 3-12 months of age at baseline25% * Met minimum dietary diversity20% requirement n=69115% Older women 0.12* leaders10% (0.070) Health committee 0.098 (0.077) 5% p-value 0.14 Note: Comparison is to a control group that did not receive any program services. All estimates controlled 0% for baseline age, sex, clustering, and attrition. All values are coefficient (SE). * p<0.10 Met minimum dietary Met minimum dietary diversity requirement at diversity requirement at baseline endline Control villages Older women leader villages Health committee villages
  26. 26. Impact of the EHFP program on infant and young child feeding practices: Intake of iron-rich foods among children 3-12 months of age at baseline70%60% ** Iron-rich foods50% n=66240% Older women 0.15** leaders30% (0.072)20% Health committee 0.023 (0.090)10% p-value 0.13 Note: Comparison is to a control group that did not0% receive any program services. All estimates controlled for baseline age, sex, clustering, and attrition. All Had iron-rich foods at Had iron-rich foods at values are coefficient (SE). * *p<0.05 baseline endline Control villages Older women leader villages Health committee villages
  27. 27. Impact of the EHFP program on nutritional status of children: Hemoglobin among children 3-12 months of age at baseline10.0 9.8 * Hemoglobin 9.6 (g/dL) n=1144 9.4 Older women leaders 0.24 (0.31) 9.2 Health committee 0.49* (0.27) 9.0 p-value 0.19 8.8 Note: Comparison is to a control group that did not receive any program services. All estimates controlled for baseline age, sex, clustering, and attrition. All 8.6 values are coefficient (SE). * p<0.10 Baseline hemoglobin (g/dL) Endline hemoglobin (g/dL) Control villages Older women leader villages Health committee villages
  28. 28. Change in hemoglobin from baseline to endline among children 3-5.9 months of age at baseline10.0 9.8 ** Hemoglobin (g/dL) 9.6 n=449 Older women 0.044 9.4 leaders (0.32) 9.2 Health committee 0.76** (0.30) 9.0 p-value 0.043 Note: Comparison is to a control group that did not receive any program services. All estimates controlled 8.8 for baseline age, sex, clustering, and attrition. All values are coefficient (SE). * *p<0.05 8.6 Baseline hemoglobin (g/dL) Endline hemoglobin (g/dL) Control villages Older women leader villages Health committee villages
  29. 29. Impact of the EHFP program on nutritional status of children: HAZ among children 3-12 months of age at baseline0.0-0.2 Baseline HAZ Endline HAZ-0.4-0.6-0.8-1.0-1.2-1.4-1.6-1.8-2.0 Control villages Older women leader villages Health committee villages
  30. 30. Impact of the E-HFP program on nutritional status ofchildren: Wasting among children 3-12 months of ageat baseline35%30%25%20% Control villages15% Older women leader villages Health committee villages10%5%0% Baseline prevalence of Endline prevalence of wasting wasting
  31. 31. SummaryKey Question SummaryDid the EHFP program increase women’s Yes, the E-HFP program had a positive impact onownership of assets? womens ownership of agricultural assets and small livestock.Did the EHFP program also influence men’s Yes, the E-HFP program had a negative impact onasset holdings? mens ownership of agricultural assets which was about equal to the positive impact on women’s ownership of agricultural assets. The program had a positive impact on men’s ownership of small livestock which was larger than that for women.Were women able to maintain control over Yes, especially in regards to the garden activities.the EHFP activities and outputs? The vast majority of women were primarily responsible for decisions related to what to grow in the garden and were able to keep the income generated from the sale of the produce.
  32. 32. SummaryKey Question SummaryDid the land agreements and/or project Yes, in beneficiary villages some change was notedactivities influence community norms related in people’s opinions about who could own and useto women’s land ownership or land rights? land. In addition both men and women in beneficiary villages reported that women’s ability to own and use land had actually changed in the past two years whereas this was rarely reported in control villages.What trade-offs were women required to Only about 11% of respondents reported thatmake in order to participate in the EHFP taking care of their gardens affected their otherprogram? activities. 18% said that working at the VMF had costs (e.g. time and neglect of domestic work).Did exposure to nutrition education diffused There do seem to be some differences althoughthrough village health committee members there is not yet a clear pattern of effects by method(HC) increase knowledge and uptake of of dissemination. Analysis of related data is on-new practices as compared to that diffused going.through older women leaders (OWL) or viceversa?

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