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NURTURING CONNECTIONS©: ADVANCING
GENDER EQUALITY FOR IMPROVED
NUTRITION AND LIVELIHOODS
Ramona Ridolfi – Regional Gender Advisor, HKI - Asia-Pacific Regional Office
OVERVIEW
Section 1: Background: HKI’s EHFP Model
Section 2: The Nurturing Connections© Approach: Key Elements
Section 3: Implementing Nurturing Connections© - Adaptations and Results
Our Work in Asia-Pacific
We bring expertise in helping households –
especially women – increase food security,
access income, improve nutrition and
prevent blindness.
Homestead Food Production (HFP)
• Works through groups of approximately
20 women, centered around “Village
Model Farms”.
• Increases production of nutritious
foods, including vegetables, eggs,
poultry and fish, for household
consumption and sale.
BACKGROUND – OUR EHFP MODEL
HKI’s Mission
HKI’s Mission is to save and improve the sight and lives of the world’s
vulnerable by combatting the causes and consequences of blindness, poor
health and malnutrition.
Photo©: HKI Cambodia
BACKGROUND – OUR EHFP MODEL
INTRODUCTION TO NURTURING CONNECTIONS©
 Gender Transformative curriculum
developed and piloted by HKI in 2012
 Integrated into seven projects
worldwide in four countries (in four
languages)
 Adapted for homestead food
production (agri- and aquaculture)
and nutrition.
THE NURTURING CONNECTIONS©
APPROACH
Building
Communication
Trust
Respect
Identifying
Perceptions
Negotiating
Power
Empowering
women and
men to Act
for Change
 Joint decision-making power;
 Support to domestic tasks run by women;
 Improved trust, spousal communication, ability to
solve conflict and shift harmful practices.
THE NURTURING CONNECTIONS©
APPROACH
EQUITABLE INTRA-HOUSEHOLD RELATIONS
IMPLEMENTING NURTURING CONNECTIONS© -
ADAPTATIONS AND RESULTS
Key Features
 Standalone component.
 10-12 sessions, of peer and mixed
sub-groups.
Fortnightly frequency.
 Integrated version drops entirely
activities from Block 1 and
includes only activities more
easily linked to technical trainings.
IMPLEMENTING NURTURING CONNECTIONS©
IN BANGLADESH
NC implemented in multiple projects (6) adopting a multi-sectorial
approach to improving nutrition.
NURTURING CONNECTIONS© RESULTS
BANGLADESH
Agriculture, Nutrition, and Gender
Linkages (ANGeL) Project
5 arms - interventions delivered to
both men and women and 1
control:
• T1: Nutrition BCC (DAE)
• T2: Nutrition BCC (trained
community women)
• T3: Agriculture Production (DAE)
• T4: Agriculture+Nutrition (DAE)
• T5:
Agriculture+Nutrition+Gender*
(DAE and project facilitators
hired by Helen Keller
International)
• C: Control
A-WEAI to assess
empowerment
In arm 5 where NC was
implemented:
- women became more
empowered in asset ownership
and income decisions.
- Significant “improvements” in
women’s and men’s total
gender attitude scores.
- Most consistent improvement:
women recognize they make
important contributions to the
community.
Source: IFPRI – Endline Survey 2018
Agriculture
NutritionGender
IMPLEMENTING NURTURING CONNECTIONS©
IN CAMBODIA
Key Features
 Standalone component in 2
hour sessions (1 is NC and 1 is
ENA counselling)
 7 sessions of mixed groups
only (W, M, elders).
 Dropped “repetitive”
activities, added domestic
violence and more on intra-hh
management of income.
 Bi-monthly frequency.
FF4F (2015 – 2018): adapted and implemented in 2800 households.
Women-Centred HFP / Gates (2016 ongoing): implemented in 480
households.
NURTURING CONNECTIONS© RESULTS
CAMBODIA
BL and EL surveys assessed 2
dimensions from WEAI:
agricultural production and
income generation:
 Increased women’s
decision-making
autonomy over food and
cash crop farming by 10%.
 Stable results on income
generation.
Qualitative interviews with
female & male participants:
- Increased men’s
participation in domestic
chores
- Improved spousal
communication.
Source: FF4F endline report (2018)
 PRO-WEAI in baseline of
Gates-funded WGCD project
 Results available in May 2019
0
20
40
60
80
100
%ofWRA
Baseline End-line
IMPLEMENTING NURTURING CONNECTIONS©
IN WEST AFRICA
Key Features
 Standalone component.
 16 sessions.
 Issue of polygamy: other
“sister-wives” invited to
observe. Power Block more
extensive due to numerous
family compositions.
 Peer and mixed. Mixed include
all participants.
 Weekly frequency.
CHANGE (2013-2016) adapted and tested in two countries of the
project (Senegal and Cote d’Ivoire – respectively 5 and 8 villages).
NURTURING CONNECTIONS© RESULTS
WEST AFRICA
BASELINE AND ENDLINE SURVEYS WITH MEN AND WOMEN WITHIN THE SAME
HOUSEHOLDS ON OUTCOME PROJECT INDICATORS
0
2
4
6
8
10
Baseline Endline
Non NC village NC village Non NC village NC village
Self Esteem Spousal Communication
Spousal Comm. (Health/Nutrition) Social Support
Communication w/ Women Purchasing
Gender Equity Views Women's Decision-Making
Joint Decision Making
HKI-IFPRI and ICRW survey tools
Positive & significant Impacts:
 Women’s sole decision making
in 4 areas (Senegal): childcare
& health , use of agricultural
plots and livestock rearing. Self-
esteem increased.
 Joint decision making (CI):
livestock rearing, agri plots,
childcare & health. Self-esteem
increased.
 Intra-household
communications: larger shares
of women reported discussing 9
selected topics.
Source: CHANGE endline report 2016
FUTURE OPPORTUNITIES
Nurturing Connections© is a proven example of GTA,
demonstrating that integrated programming has better impact
on women’s decision-making and ownership, spousal
communication and husband’s support to domestic tasks.
AREAS OF INTEREST FOR FUTURE RESEARCH AND
IMPLEMENTATION:
 Sustainability of empowerment results;
 Nutrition and agriculture outcomes where NC is
implemented;
 Differences in impact between ‘full’ vs ‘light’ NC approach
and its frequency.
THANK YOU.
“Although the world is full of suffering, it is also full of overcoming it.”
-Helen Keller

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Nurturing connections: advancing gender equality for improved nutrition and livelihoods

  • 1. NURTURING CONNECTIONS©: ADVANCING GENDER EQUALITY FOR IMPROVED NUTRITION AND LIVELIHOODS Ramona Ridolfi – Regional Gender Advisor, HKI - Asia-Pacific Regional Office
  • 2. OVERVIEW Section 1: Background: HKI’s EHFP Model Section 2: The Nurturing Connections© Approach: Key Elements Section 3: Implementing Nurturing Connections© - Adaptations and Results
  • 3. Our Work in Asia-Pacific We bring expertise in helping households – especially women – increase food security, access income, improve nutrition and prevent blindness. Homestead Food Production (HFP) • Works through groups of approximately 20 women, centered around “Village Model Farms”. • Increases production of nutritious foods, including vegetables, eggs, poultry and fish, for household consumption and sale. BACKGROUND – OUR EHFP MODEL HKI’s Mission HKI’s Mission is to save and improve the sight and lives of the world’s vulnerable by combatting the causes and consequences of blindness, poor health and malnutrition. Photo©: HKI Cambodia
  • 4. BACKGROUND – OUR EHFP MODEL
  • 6.  Gender Transformative curriculum developed and piloted by HKI in 2012  Integrated into seven projects worldwide in four countries (in four languages)  Adapted for homestead food production (agri- and aquaculture) and nutrition. THE NURTURING CONNECTIONS© APPROACH
  • 7. Building Communication Trust Respect Identifying Perceptions Negotiating Power Empowering women and men to Act for Change  Joint decision-making power;  Support to domestic tasks run by women;  Improved trust, spousal communication, ability to solve conflict and shift harmful practices. THE NURTURING CONNECTIONS© APPROACH EQUITABLE INTRA-HOUSEHOLD RELATIONS
  • 8. IMPLEMENTING NURTURING CONNECTIONS© - ADAPTATIONS AND RESULTS
  • 9. Key Features  Standalone component.  10-12 sessions, of peer and mixed sub-groups. Fortnightly frequency.  Integrated version drops entirely activities from Block 1 and includes only activities more easily linked to technical trainings. IMPLEMENTING NURTURING CONNECTIONS© IN BANGLADESH NC implemented in multiple projects (6) adopting a multi-sectorial approach to improving nutrition.
  • 10. NURTURING CONNECTIONS© RESULTS BANGLADESH Agriculture, Nutrition, and Gender Linkages (ANGeL) Project 5 arms - interventions delivered to both men and women and 1 control: • T1: Nutrition BCC (DAE) • T2: Nutrition BCC (trained community women) • T3: Agriculture Production (DAE) • T4: Agriculture+Nutrition (DAE) • T5: Agriculture+Nutrition+Gender* (DAE and project facilitators hired by Helen Keller International) • C: Control A-WEAI to assess empowerment In arm 5 where NC was implemented: - women became more empowered in asset ownership and income decisions. - Significant “improvements” in women’s and men’s total gender attitude scores. - Most consistent improvement: women recognize they make important contributions to the community. Source: IFPRI – Endline Survey 2018 Agriculture NutritionGender
  • 11. IMPLEMENTING NURTURING CONNECTIONS© IN CAMBODIA Key Features  Standalone component in 2 hour sessions (1 is NC and 1 is ENA counselling)  7 sessions of mixed groups only (W, M, elders).  Dropped “repetitive” activities, added domestic violence and more on intra-hh management of income.  Bi-monthly frequency. FF4F (2015 – 2018): adapted and implemented in 2800 households. Women-Centred HFP / Gates (2016 ongoing): implemented in 480 households.
  • 12. NURTURING CONNECTIONS© RESULTS CAMBODIA BL and EL surveys assessed 2 dimensions from WEAI: agricultural production and income generation:  Increased women’s decision-making autonomy over food and cash crop farming by 10%.  Stable results on income generation. Qualitative interviews with female & male participants: - Increased men’s participation in domestic chores - Improved spousal communication. Source: FF4F endline report (2018)  PRO-WEAI in baseline of Gates-funded WGCD project  Results available in May 2019 0 20 40 60 80 100 %ofWRA Baseline End-line
  • 13. IMPLEMENTING NURTURING CONNECTIONS© IN WEST AFRICA Key Features  Standalone component.  16 sessions.  Issue of polygamy: other “sister-wives” invited to observe. Power Block more extensive due to numerous family compositions.  Peer and mixed. Mixed include all participants.  Weekly frequency. CHANGE (2013-2016) adapted and tested in two countries of the project (Senegal and Cote d’Ivoire – respectively 5 and 8 villages).
  • 14. NURTURING CONNECTIONS© RESULTS WEST AFRICA BASELINE AND ENDLINE SURVEYS WITH MEN AND WOMEN WITHIN THE SAME HOUSEHOLDS ON OUTCOME PROJECT INDICATORS 0 2 4 6 8 10 Baseline Endline Non NC village NC village Non NC village NC village Self Esteem Spousal Communication Spousal Comm. (Health/Nutrition) Social Support Communication w/ Women Purchasing Gender Equity Views Women's Decision-Making Joint Decision Making HKI-IFPRI and ICRW survey tools Positive & significant Impacts:  Women’s sole decision making in 4 areas (Senegal): childcare & health , use of agricultural plots and livestock rearing. Self- esteem increased.  Joint decision making (CI): livestock rearing, agri plots, childcare & health. Self-esteem increased.  Intra-household communications: larger shares of women reported discussing 9 selected topics. Source: CHANGE endline report 2016
  • 15. FUTURE OPPORTUNITIES Nurturing Connections© is a proven example of GTA, demonstrating that integrated programming has better impact on women’s decision-making and ownership, spousal communication and husband’s support to domestic tasks. AREAS OF INTEREST FOR FUTURE RESEARCH AND IMPLEMENTATION:  Sustainability of empowerment results;  Nutrition and agriculture outcomes where NC is implemented;  Differences in impact between ‘full’ vs ‘light’ NC approach and its frequency.
  • 16. THANK YOU. “Although the world is full of suffering, it is also full of overcoming it.” -Helen Keller

Editor's Notes

  1. the VMFs become local agriculture extension agents – a community resource – marketing and basic processing- as well as targeted components for vulnerable groups- such as selection, planning, management.
  2. HKI’s EHFP model works primarily with women to produce micronutrient rich food, including organic fruit, vegetables and poultry for improved maternal and child nutrition (1000 days window). We also support the marketing of surplus production, so help the household gain income. Technical trainings on production go hand in hand with behavior change on ENA and EHA and women’s empowerment – the NC approach – all contributing to the goal of shifting harmful gendered practices around health and nutrition and to the uptake of optimal nutrition practices.
  3. ANGEL aimed to strengthen the nexus between ag, nutrition and gender. Scattered impacts from other treatment arms on gender attitudes and empowerment. The greatest improvement in empowerment indicators is in Nutrition + Ag Production + Gender (T5), as expected Examined respondents agreement with statements based on NC Eg: Even when I disagree with my spouse, I usually think he/she has valid things to say. This suggests that integrated programming that includes gender sensitization is effective in empowering women
  4. Survey objective: Examine changes in women’s empowerment including decision-making in HFP and utilization of income Although we didn’t calculate an empowerment index, we can infer that women in this sample were close to achieving empowerment on the two dimensions of interest even at baseline. Autonomy over food-crop farming, crops grown primarily for household consumption, and cash crop farming, crops grown for sale, however, did increase by10% by end-line. With respect to income use, the vast majority of women indicated control over household expenditures as well as non-farm economic activities. Questions in this section were adapted from the Women’s Empowerment in Agriculture Index tool. The two dimensions of interest in this project, agricultural production and income generation were assessed. Changes in these indicators from baseline to end-line were assessed to determine the impact of nurturing connections on gender dynamics in the household. Additionally, in Cambodia, HKI is testing through a randomized control trial the benefits of a transformative EHFP model (with NC) as compared to a gender blind approach. Results available in late 2019
  5. Just over 200 households
  6. A longitudinal pre-post set-up was used, with NC randomized at the village level • Baseline (Dec. 2014) and endline (Nov/Dec. 2015) surveys collected information from men and women within the same household on outcome indicators and other characteristics Questionnaire items were adapted from previously validated surveys, such as the ICRW International Men and Gender Equality (IMAGES) and GLAS Surveys and IFPRI-HKI work on the CHANGE project in Burkina Faso 9 questions about the frequency of communications with one’s spouse on various topics (professional activities, domestic activities, expenses, community events, child health and nutrition, own health, personal problems, and the spouse’s problems).
  7. Endline surveys must happen by the end of the project – in our experience this is 3-5 months on avg from the end of implementation. We don’t know if results are long lasting.