Dulal Bishnu, Mundy Gary, Sawal Rojee, Rana Pooja Pandey, Cunningham Kenda
1 Helen Keller International, Kathmandu, Nepal.
2 Helen Keller International, Asia Pacific Regional Office, Phnom Penh, Cambodia.
Food Nutr Bull. 2017 Sep;38(3):338-353. doi: 10.1177/0379572117703264. Epub 2017 Apr 21.
Suaahara, a large-scale integrated program, aimed to improve diets and nutritional status among women and children, in part by facilitating enhanced homestead food production (EHFP).
This study examines associations between EHFP and maternal and child dietary diversity and variations by season and agroecological zone (AEZ): mountains and terai.
We used data from household monitoring surveys (n = 2101 mothers; n = 994 children, 6-23 months), which included a 7-day dietary recall and maternal report on participation in 5 EHFP activities-received vegetable seeds, chicks, and technical support and participated in training and EHFP groups. We constructed binary variables for each activity and a scale (0-5) summing participation. For dietary diversity, we used the Women's Dietary Diversity Score using 10 food groups and 7 food groups for child diets. Multivariable linear regression analyses were used to assess associations between EHFP participation and dietary diversity by season and AEZ, controlling for potential confounders and clustering.
In adjusted models, we found positive associations between dietary diversity and chicks, technical support, and EHFP beneficiary groups; the magnitude of the associations varied by season and AEZ. The degree of participation in 5 EHFP activities was positively associated with maternal dietary diversity in the terai (β = .24, P < .001) and mountains (β = .12, P = .01) and child dietary diversity in the terai (β = .35, P < .001) during the winter. No associations were found in the rainy season.
Our findings highlight the potential for EHFP to address dietary diversity constraints among this population. Variation by subnational setting and seasonality suggest that policies and programs should be contextualized.
Suaahara是一个大规模综合项目，旨在改善妇女和儿童的饮食及营养状况，部分措施是促进家庭食物产量提高（EHFP）。
本研究探讨了EHFP与母婴饮食多样性之间的关联，以及按季节和农业生态区（AEZ）（山区和特莱地区）划分的差异。
我们使用了家庭监测调查的数据（2101名母亲；994名6 - 23个月大的儿童），其中包括7天饮食回顾以及母亲关于参与5项EHFP活动的报告——收到蔬菜种子、小鸡、技术支持，参与培训和EHFP小组。我们为每项活动构建了二元变量，并构建了一个汇总参与情况的量表（0 - 5）。对于饮食多样性，我们使用了针对女性的10种食物组别的饮食多样性得分以及针对儿童饮食的7种食物组别的得分。多变量线性回归分析用于评估按季节和AEZ划分的EHFP参与情况与饮食多样性之间的关联，同时控制潜在混杂因素并进行聚类分析。
在调整后的模型中，我们发现饮食多样性与小鸡、技术支持以及EHFP受益组之间存在正相关；相关程度因季节和AEZ而异。在冬季期间，参与5项EHFP活动的程度与特莱地区（β = 0.24，P < 0.001）和山区（β = 0.12，P = 0.01）的母亲饮食多样性以及特莱地区（β = 0.35，P < 0.001）的儿童饮食多样性呈正相关。在雨季未发现相关性。
我们的研究结果凸显了EHFP解决该人群饮食多样性限制的潜力。国家以下层面的环境和季节性差异表明，政策和项目应因地制宜。
