Homestead Food Production PG
Homestead Food Production PG
Homestead Food Production PG
PRODUCTION: A MULTI-
SECTORAL INTERVENTION TO
ADDRESS MALNUTRITION
11 March, 2016
Overview of the content for this presentation.
4
Progress Toward the Global WHA Targets*
*2014 Global Nutrition Report
Framework for actions to achieve optimum fetal and
child nutrition and development*
*2014 Black Maternal and child undernutrition and overweight in low‐income and middle‐income countries
NUTRITION‐SENSITIVE INTERVENTIONS TO ADDRESS
MALNUTRITION
9
Nutrition‐sensitive Interventions and Programs*
•The overall outcome for food
security is the nutritional status of
the population; and
•All four key elements (availability,
access, stability, and utilization of
food) are important for achieving a
good nutritional status.
HOMESTEAD FOOD PRODUCTION
15
HKI’s HFP Program Model
Objective of HKI’s HFP model: Improve the nutritional status
of vulnerable members in low income households through
home production of micronutrient (MN) rich foods including
vegetable and fruit crops, small animals, and poultry.
First generation programs focused on micronutrient outcomes
(esp. vitamin A and iron) via dietary diversity
Second generation programs (e.g. HFP’s current programs) now
also include improvement in child growth as an objective in
addition to micronutrient status
Program impact pathways to achieve objectives
• Increased year‐round production & consumption of home
produced micronutrient‐rich vegetables and fruits and animal
source foods (increased dietary diversity);
• Increased household income from the sale of produce that can
be used to purchase nutritious foods & other necessities,
especially that under control of participating women;
• Improved child nutrition and health practices through nutrition
behavior change (e.g. enhanced nutrition actions) and links to
local health services; and
• Improved child care and family welfare through the
empowerment of participating women.
Conceptual framework of the relationship between household
food production strategies and health and nutrition outcomes
Increased Increased
household spending
income on health
Improved
Improved
utilization maternal
of vitamins and child
Nutrient Increased and
Gender‐ health
spending minerals
sensitive ‐rich outcomes
agriculture
on
foods nutritious
training
sold foods
Improved
Participation Increased Nutrient‐ Increased
intake of Improved
production rich foods consumption
in household macro‐ and maternal
Agricultural of nutrient‐
food of consumed rich foods by
micro‐ and child
production inputs nutrients by
nutrient‐ by women and nutritional
interventions women and status
rich foods household children
children
Nutrition
education
2012 Webb‐Girard: The effects of household food production strategies on the health and nutrition outcomes of women and young children.
Characteristics of HKI’s HFP program model
Utilizes existing community structures and systems to
establish Demonstration Farms (DFs) who received
agriculture support and nutrition education;
Integrates home gardening with small animal
husbandry, poultry/fowl production and fish farming;
Promotes year round access of indigenous
micronutrient‐rich crops and animal source foods, many
of which are already being produced by households; and
Improves on local farming practices to extent possible.
Program Model Cascade
HKI
Demonstration Farm
Local Members
Gov’t
NGOs
Head
Comm
Others
Leaders
Targeted household and beneficiaries
• Resource poor households: land holding, not salaried, no
sanitary latrine, no motor cycles, TV, electricity, no
irrigation/power tiller;
• Female‐headed household when possible;
• Interested to participate in the program;
• One young child: A majority of the total households have
one child < 5 or pregnant women; and
• Important: Households in the demonstration farm should
not be far apart.
Intervention inputs:
• Input support: seeds, seedlings and saplings, poultry (local
breeds) or/and support for poultry sheds, poultry vaccines,
fish cultivars, horticultural inputs, animal fodder, and
gardening tools like water cane and pipes
• Training in Essential Agriculture Techniques including animal
husbandry at different levels – extension agents from NGOs,
community health volunteers, village and subdistrict
government
• Training in Essential Nutrition Actions and behavior change at
different levels – health staff from NGOs and government
offices, health volunteers, and targeted women
• Establish of links for marketing & resource access
• Important: Input support shouldn’t be 100% free of cost
Agriculture Training
Agriculture
• Year‐round vegetable and fruit
production;
• Seed, seedling and sapling
production;
• Integrated pest management;
• Organic fertilizer and pesticides; and
• Small scale irrigation
Nutrition Training
Nutrition
• The Importance of Dietary Diversity;
• Undernutrition and its Causes;
• The Importance of Micronutrients;
• Hygiene Practices; and
• Infant and Young Child Feeding Practices.
Nutrition Education
• Chicken Rearing;
• Chicken Coop Construction;
• Chicken feeding;
• Chicken vaccination; and
• Catfish rearing.
Suaahara: Integrated Nutrition Project in Nepal
(2012‐2016)
Suaahara: Overview
Goal: Improve the nutritional status of women
and children < 2 years
Result 4:
Result 1: Result 2: Result 3:
Coordination on
Household Use of quality Consumption of
nutrition
nutrition, health nutrition and diverse and
between
and hygiene health services by nutritious food by
government and
behaviors women and women and their
other actors
improved children increased families increased
strengthened
Suaahara’s intervention districts
Suaahara
A 5-year (2011-2016) multi-sector
nutrition project operating at scale in
25 districts and recently expanded to
additional 16 districts to reach over
625,000 households
Suaahara components
Nutrition‐specific Nutrition‐sensitive
• Essential Nutrition Actions • Homestead Food Production
• Essential Hygiene Actions • Maternal Newborn and Child
Health Services
• Family Planning
• Water Sanitation and Hygiene
Cross‐cutting themes
• Social behavior change communication
• Nutrition Governance
• Gender and Social Inclusion
• Capacity Building
• Monitoring, Evaluation and Learning
Suaahara: Implementation modality
Food Production, Household Income, and Food Security
Outcome Treatment Control
Had both home garden and
poultry, % +18.3%* +6.0%*
Eggs produced from HFP, last 2
months, count +21.8%* +10.0%*
Cash income ≥ Rs. 4,000, last
month, % +26.4%* +13.8%*
Perception of food insecurity
(HFIAS), last 30 days, % ‐26.1%* ‐9.1%*
Source: 2014 USAID Operations *Differences between baseline and endline within the study group
Research Brief were statistically significant at P<0.05
Results from a Cluster Randomized Trial for HFP in
Nepal
Health Knowledge and Practices
Outcome Treatment Control
Nutrition knowledge, %
Eggs good for children 6–12 months old* +51.5%* +1.3%
Meat good for children 6–12 months old* +38.5%* +13.6%*
Women should eat more during pregnancy* +31.4%* +7.4%*
Complementary feeding for children 6–23 months
old, %
Received minimum dietary diversity* +45.0%* +4.7%
Received minimum meal frequency* +12.6%* +4.2%*
Antenatal care, %
Received any antenatal care* +23.0%* +15.0%*
Attended ≥ 4 antenatal care visits* +34.9%* +18.6%*
Source: 2014 USAID Operations *Differences between baseline and endline within the study group
Research Brief were statistically significant at P<0.05
Results from a Cluster Randomized Trial for HFP in
Nepal
Nutritional Status
Outcome Treatment Control
Underweight, women (BMI <18.5
kg/m2), %* ‐1.6% +5.5%*
Anemia, women (Hgb <12 g/dL non‐
pregnant; Hgb <11 g/dLpregnant), %* +5.0%* +14.7%*
Stunting, children (ht‐for‐age z‐score
<‐2 SD), % ‐2.6% ‐2.3%
Wasting, children (wt‐for‐height z‐
score <‐2 SD, % ‐0.1% ‐0.4%
Underweight, children (wt‐for‐age z‐
score <‐2 SD), %* ‐2.4% ‐7.4%*
Anemia, children (Hgb <11 g/dL), %* +2.6% +10.9%*
Source: 2014 USAID Operations *Differences between baseline and endline within the study group
Research Brief were statistically significant at P<0.05
An independent evaluation showed that the
HFP is sustainable*:
*Source: Bushamuka, V. N. et. al. FNB 2005
HOMESTEAD FOOD PRODUCTION IN INDONESIA
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Nutritional Status in Indonesia
*2013 Riskesdas; **2012 IDHS
HKI’s Project Goals
• Improve the food security and nutrition conditions
among vulnerable households in Timor Tengah
Selatan (TTS) district, East Tenggara Timur (NTT)
Province in eastern Indonesia.
• Promote and facilitate improved household food
security and nutrition through Homestead Food
Production (HFP).
• Improve the capacity of households to produce
year‐round micronutrient rich foods (fruits,
vegetables, small animals (e.g. chickens, eggs) for
their own consumption.
• Improve the nutritional practices and behaviours of
those households.
“Before I mainly sold the vegetables I grew. Now I feed my children more
of the vegetables that I grow and they are gaining weight and getting
healthier.”
Fin learned that children need to
consume various nutritious foods
every day so they can be healthy.
Fin received seeds for 12
vegetables at the training that she
could plant in her home garden.
Fin grew these vegetables, but
instead of selling all of her produce,
she used the new vegetables to
feed her children. Fin did sell the
surplus to her neighbors. Her
children now enjoy eating
vegetables every day because they
get a variety.
Where is NTT?
NTT Has the Highest Prevalence of Stunting in Indonesia
Access to Health Services can be an Issue in the TTS
district (Project Area) of NTT Province
35%
30%
Distance to Health Facility in Time*
25%
20%
NTT
15%
TTS
10%
5%
0%
31'‐60' >60'
*2007 Riskesdas Data
Target Phase 1 (2012) Phase 2 (2013‐ Total
2015)
Households (HH) 1,601 2,400 4,001
Sub‐districts 17
Before participating in the
Homestead Food
Production project,
Sancerina used to buy
vegetables for consumption,
but now she sells her
surplus produce to the
market. As she said, “Before
I doubted (I could do this)
since my homestead is full
of trees, but HKI taught me
how to cultivate vegetables
using polybags”.
Results from Baseline (2012) in NTT
Food Production and Household Income
Outcome Baseline Endline
Planted orange/yellow fruits or
vegetables in garden 48.9% ?
Planted green leafy vegetables in
garden 35.5% ?
Percentage of farmers profiting
from their garden 32.8% ?
Source: 2012 Baseline survey
Results from Baseline (2012) in NTT
Health Knowledge and Practices
Outcome Baseline Endline
Complementary feeding
for children 6–23 months
old, %
Received minimum
dietary diversity 11.8% ?
Received minimum meal
frequency 87.9% ?
Source: 2012 Baseline survey
Results from Baseline (2012) in NTT
Nutritional Status
Outcome Baseline Endline
Stunting, children (ht‐for‐age z‐score
<‐2 SD), % 60.1% ?
Wasting, children (wt‐for‐height z‐
score <‐2 SD, % 11.8% ?
Underweight, children (wt‐for‐age z‐
score <‐2 SD), %* 44.3% ?
Anemia, children (Hgb <11 g/dL), %* 48.3% ?
Source: 2012 Baseline survey
Change in Food Consumption Scores from
baseline after 24 months of implementation
100%
80%
60%
Baseline
Sep‐13
Jan/Feb 14
Jul‐14
40%
Jan‐15
20%
0%
Poor Borderline Acceptable
Source: 2012 Baseline survey, 4 rounds of LQAS survey
Availability of expertise and land in Indonesia*
• In Indonesia, approximately 28% of men are agriculture
workers;
• Ranges from 1% (Jakarta) to 53% (West Sulawesi)
• Approximately 13% of women are agriculture workers;
• Ranges from <1% (Jakarta) to 40% (Papua); and
• Approximately 39% of households in Indonesia own
land usable for agriculture;
• Ranges from 9% (Jakarta) to 64% (Papua).
*Source: 2012 Indonesian DHS
Strategy on Acceleration of Nutrition Improvement in technocratic
draft of RPJMN Sub‐fields Health and Community Nutrition
1. Improvement nutrition surveillance, including monitoring of growth;
2. Improvement of access and quality of health care and nutrition package with a primary
focus on first 1,000 days of life.
3. Increase promotion of community behavioral health, nutrition, sanitation, hygiene, and
parenting;
4. Increase community involvement to improve nutrition, including through community‐
based health / UKBM (integrated service post / Posyandu and Early Childhood Education
and Development / PAUD);
5. Strengthening the implementation and supervision of regulation and nutrition
standards;
6. Development of food fortification;
7. Strengthening the cross‐sector role within the framework of specific interventions
(health sector) and sensitive interventions (education, religion affair, agriculture,
fisheries, livestock, family planning, social, industry, trade, communication and
information, and infrastructure).
63
Comparison between the Ministry of Agriculture’s Sustainable Food Reserve
Garden Model (Kawasan Rumah Pangan Lestari/KRPL) and HKI’s Homestead
Food Production Model
• Vulnerable households can:
• diversify their diet by increasing production
and consumption of micronutrient‐rich foods,
including poultry and fish
• generate income, also to be spent on foods
• HFP has the potential to reduce micronutrient
deficiencies;
• Considering its multiple benefits, HFP is an option
to improve household food security, nutrition
and livelihoods and contribute to achieving the
MDGs.
THANK YOU.
“Alone we can do so little; together
we can do so much.” ‐Helen Keller pgupta@hki.org