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While there is an increased awareness of the role of nutrition-sensitive agriculture (NSA) interventions on nutrition, the studies that investigate holistic pathways from interventions to nutrition outcomes are inadequate. We aimed to understand these pathways to improved nutrition from the Enhancing Nutrition of Upland Farming Families (ENUFF) Project implemented in northern Laos. We applied an embedded case study design by recruiting 101 participants representing implementers, school and private sector representatives, and beneficiaries, of which 34 participated in interviews and 68 participated in 11 FGDs. This was supplemented by a desk review of project documents. We analyzed the data using a directed content analysis across five pathways using a published framework on impact pathways from NSA interventions to nutrition outcomes. The project contributed to nutrition mainly through three core pathways-food production, nutrition and WASH-related knowledge, and agricultural income, supported by strengthening local institutions within the project’s scope. While it is evident that the project contributed to empowering women by saving their time and increasing income, further study is needed to investigate the translation of these aspects to nutrition-related practices. We also suggest the need to sustain the capacity of local institutions and their engagement beyond the project cycle. To enhance the effectiveness of NSA interventions on nutrition, there is a need to design and implement intervention package with multiple pathways and tailored strategies based on nutrition outcomes, the envisaged pathways, geographical context, and factors affecting these.

Pathways to Improving Nutrition among Upland Farmers through Nutrition-Sensitive Agriculture Interventions: A Case from Northern Laos