Agricultural Interventions for Improved Nutrition: A Review of Livelihood Dimensions

A diverse group of agricultural interventions aim to improve the quality, quantity, and diversity of smallholder production and thereby improve nutritional status of women and children in participating households. Previous reviews of the effects of agricultural interventions on nutritional status have demonstrated methodological limitations in generalizing from the current evidence on the effects on nutritional status (Webb Girard et al. 2012; Masset et al. 2012). Our work builds on these results and aims to characterize the livelihoods dimensions of agricultural interventions and summarize the pathways through which this diverse set of interventions may improve nutritional status. We reviewed 41 evaluations of agricultural interventions for improved maternal and child nutrition. We developed intervention typologies that reflect the differential impact of interventions on household livelihoods and patterns of food consumption and applied them to existing evaluations of agricultural interventions. Our typologies of agricultural interventions to improve nutrition include Enhancement, Diversification, and Substitution ( Table 1). Enhancement adjusts a household's current production strategy to improve yield or increase micronutrients in crops produced. Diversification interventions introduce a new food production method, activity, or strategy to complement a household's on‐going livelihood activities. Substitution reflects the introduction of a new and substantially changed food production strategy or alternative livelihood. In applying our typologies to existing interventions we found Diversification interventions are most commonly evaluated ( Table 2). Enhancement and Substitution interventions each comprised 20% of evaluated interventions. Sixty percent of evaluations engaged Diversification, with 23% of these also including Enhancement strategies and 11% also including Substitution. Diversification interventions particularly emphasized home gardening with or without a focus on vitamin A rich crops and small animal husbandry. Few and more varied Substitution interventions have been evaluated for their nutrition outcomes. Further, Enhancement interventions primarily focused on vitamin A. Variable intervention quality prevents making conclusion about the effectiveness of each type of intervention in affecting nutrition outcomes, however. Agricultural interventions represent a promising set of strategies to improve maternal and child nutrition. The diversity of these food‐based strategies, though a strength in tailoring them to local contexts, provides for challenges in generalizing evaluations and impacts. The typologies we propose above and apply to existing evaluations of agricultural interventions provide a nuanced view of the impacts of such interventions on household livelihood and food consumption behavior. Importantly these typologies have implications for the intervention intensity, potential for displacement effects, and pathways of impact. In addition, they reflect the extent to which household consumption may be reshaped by the intervention. Though the evidence base for agricultural interventions to improve nutrition is quickly expanding, generalizing the effects of specific interventions as well as understanding and anticipating pathways of impact for these programs requires an appreciation of the distinct ways they aim to shift household livelihoods, incomes, and food consumption. Support or Funding Information This work was supported with partial funding from NSF‐GEO grant CNH115057 and an NSF DDRI to KJF. 1 Intervention Typologies: Enhancement, Diversification, and Substitution.Description Livelihood Effect Nutritional Pathway Sample Nutritional Outcome Aims ExamplesEnhancement Adjust an element of a household's current food production strategy to provide for nutrient‐focused dietary improvements Relatively minor adjustment Food type or nutrient availabilityIncreased self consumption Micronutrient statusIntake of vitamin A rich foods Biofortification of cultivated crops; Vitamin A rich food production; Agricultural training, inputs, irrigation to existing farmsDiversification Introduce a new food production method or strategy to complement household's on‐going activities Additional activity, part of a suite of activities Access to nutritious foodsDiversification of self consumed foodsWomen's empowerment (often)Supplementary income (possibly) Animal source food intakeDietary diversityWomen and child's utilization of nutritious foods Home gardens; Dairy goats; Poultry productionSubstitution Introduce a new food production strategy that provides for a substantial change in household activities Substantial activity change or adjustment to livelihood activities Increased incomeIncreased self consumption (possibly) Energy intake, high‐quality food intake Intensive livestock or fish production; Cash crop production; Irrigation expansion2 Types of interventions within each typology.Types ReferencesEnhancement (8) Orange Fleshed Sweet Potato (5) de Brauw et al. (2015); Hagenimana et al. (1999); Hagenimana et al. (2001); Jones and de Brauw (2015); Low et al. (2007) Ivy Gourd (1) Attig et al. (1993) Papaya and Guava (1) Kidala et al. (2000) Protein Biofortificd Maize (1) Gunaratna et al. (2010)Diversification/Enhancement (6) Home Gardens: Focus on vitamin A rich crops (6) Balcha (2001); Faber et al. (2002b)/(Fabcr et al. 2002a); (Laurie and Faber 2008); (Smitasiri et al. 1999); (Vijayaraghavan et al. 1997)Diversification (17) Home Production (11) Bezner Kerr et al. (2011); Bushamuka et al. (2005); English et al. (1997) / English and Badcock (1998); Greiner and Mitra (1995); (Kaufer et al. 2010); Langworthy and Caldwell (2009); Schmidt and Vorster 1995; Marsh (1997) / Talukder et al. (2000); Taher et al. (2002) Home Garden + Small Animal Husbandry (5) HKI Nepal (2004); HKI Cambodia (2004)/Olney et al. (2009); Olney et al. (2015); A. Talukder (2010) Fish Farming + Small Animal Husbandry (1) Schipani et al. (2002)Diversification/Substitution (3) Fish Farming or Home Gardens (1) Kumar and Quisumbing (2010) Fish Farming (1) Roos et al. (2003) High Value Crop Production (1) Jones et al. (2005)Substitution (8) Dairy Livestock / Large Animal Production (6) Ayalew et al. (1999) / Kassa et al. (2003); Hoorweg et al. (2000); Miller et al. (2014); Rawlins et al. (2014); Walingo (2009) Fish Farming (1) Murshed‐e‐Jahan et al. (2010) Poultry Production (1) Nielsen et al. (2003)