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HKI presentation for GAAP final technical workshop

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HKI presentation for GAAP final technical workshop

  1. 1. ENHANCED HOMESTEADFOOD PRODUCTION FORIMPROVED FOODSECURITY ANDNUTRITION 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-HFPProgram in Burkina 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-HFPprogram in 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 Beneficiaries: n=120 Beneficiaries: n=145of beneficiaries Non-beneficiaries: n=60 Non-beneficiaries: n=75and non-beneficiariesPurposive sample VFL: n=60 VFL: n=60of key 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
  8. 8. Key Questions for GAAPKey Questions Impact Social Qualitativ Analysi evaluatio network e s n census research StatusHow do women and men view ownership of assets? x On- goingDid the EHFP program increase women’s ownership of x Completassets? eDid the EHFP program also influence men’s asset holdings? x Complet eWere women able to maintain control over the EHFP x x Completactivities and outputs? eDid the land agreements and/or project activities influence x Completcommunity norms related to women’s land ownership or land erights?What trade-offs were women required to make in order to x On-participate in the EHFP program? goingDid exposure to nutrition education diffused through village x Complethealth committee members (HC) increase knowledge and euptake of new practices as compared to that diffusedthrough older women leaders (OWL) or vice versa?
  9. 9. Did the EHFP program increase women’sand/or men’s ownership of assets?
  10. 10. Ownership of assets: Householddurables and agricultural assets35 9 8 ***30 7 625 5 420 3 *** 215 1 01050 Mens Mens Womens Womens durables durables durables durables 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 Womens small baseline endline livestock baseline livestock 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 overthe EHFP activities and outputs?
  13. 13. Control over EHFP activities andoutputs: Gardens, seeds, andvegetablesOperations research: Round Operations research: Round1 (2011) 2 (2012) 100% 100% 90% 90% 80% 70% 80% 60% 50% 70% 40% 60% 30% 20% 50% 10% 40% 0% 30% 20% 10% 0% Responsible Owns land Makes Manages for care of for garden decisions revenue garden on produce generated Beneficiary Husband Joint Beneficiary Husband Joint
  14. 14. Control over EHFP activities andoutputs: ChickensOperations research: Round Operations research: Round1 (2011) 2 (2012)60% 60%50% 50%40% 40%30% 30%20% 20%10% 10% 0% 0% Allowed to sell Keeps income from Responsible for Keeps income from chickens chickens decicions on chickens chickens Beneficiary Husband Beneficiary Husband
  15. 15. Control over EHFP activities andoutputs: GoatsOperations research: Round Operations research: Round1 (2011) 2 (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’sland ownership or land rights?
  17. 17. Community norms related to women’sland ownership and land rights: Landacquisition 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 landownership and land rights: Obstacles to owningland 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 ownand uselandChange 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 participationin the 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 healthcommittee members (HC) increase knowledge and uptake of newpractices as compared to 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 Begin Give breast months of age giving giving Give milk within should not liquids semi-solid colostru the first drink any other than foods at 6 m to hour after liquids other breast milk months of children birth than breast at 6 months age milk of age N=1,138 N=1,144 N=1,129 N=1,142 N=1,149OWL 0.16*** 0.092*** 0.23** 0.13** 0.13**villages (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. Estimatescontrolled for baseline age, 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 10% villages 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. Estimatescontrolled for baseline age, 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 ever breastfed Initiated breastfeeding < 1 hbreastfeeding, children < 6 mo children < Exclusively after birth Predominately breastfed, Control villages Older women leader villages Health committee villagesNote: Comparison is to a control group that did not receive any program services. Estimatescontrolled for baseline age, sex, clustering, and attrition. ** p < 0.05
  25. 25. Impact of the EHFP program on IYCF practices:Dietary diversity among children 3-12 months of ageat baseline25% * Met minimum dietary20% diversity requirement15% n=691 Older women 0.12*10% leaders (0.070) Health committee 0.098 5% (0.077) p-value 0.14 Note: Comparison is to a control group that did not receive any program services. All 0% estimates controlled for baseline age, sex, clustering, and attrition. All values Met minimum dietary Met minimum dietary are coefficient (SE). * p<0.10 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 0.023 committee10% (0.090) Note: Comparison is to a control group that did0% p-value 0.13 not receive any program services. All estimates controlled for baseline Had iron-rich foods at Had iron-rich foods at age, sex, clustering, and attrition. All 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 0.24 leaders 9.2 (0.31) Health committee 0.49* 9.0 (0.27) 8.8 p-value 0.19 Note: Comparison is to a control group that did not receive any program services. All estimates controlled for baseline 8.6 age, sex, clustering, and attrition. All 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 8.8 estimates controlled 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 statusof children: Wasting among children 3-12 monthsof age at 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 Yes, the E-HFP program had a positive impactwomen’s ownership of assets? on womens ownership of agricultural assets and small livestock.Did the EHFP program also influence Yes, the E-HFP program had a negativemen’s asset holdings? impact on 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 Yes, especially in regards to the gardenover the EHFP activities and outputs? activities. 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 wasactivities influence community norms noted in people’s opinions about who couldrelated to women’s land ownership or own and use land. In addition both men andland rights? 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 Only about 11% of respondents reported thatto make in order to participate in the taking care of their gardens affected their otherEHFP program? activities. 18% said that working at the VMF had costs (e.g. time and neglect of domestic work).Did exposure to nutrition education There do seem to be some differencesdiffused through village health although there is not yet a clear pattern ofcommittee members (HC) increase effects by method of dissemination. Analysis ofknowledge and uptake of new practices related data is on-going.as compared to that diffused througholder women leaders (OWL) or viceversa?

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