Blakstad Mia M, Mosha Dominic, Bliznashka Lilia, Bellows Alexandra L, Canavan Chelsey R, Yussuf Mashavu H, Mlalama Killian, Madzorera Isabel, Chen Jarvis T, Noor Ramadhani A, Kinabo Joyce, Masanja Honorati, Fawzi Wafaie W
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA.
Ifakara Health Institute, Dar es Salaam, Tanzania.
Food Policy. 2022 May;109. doi: 10.1016/j.foodpol.2022.102248. Epub 2022 Mar 21.
Homestead food production (HFP) programs may improve diet and nutrition outcomes by increasing availability of nutrient dense foods such as vegetables and supporting livelihoods. We conducted a pair-matched cluster-randomized controlled trial to investigate whether vegetable home gardens could improve women's dietary diversity, household food security, maternal and child iron status, and the probability of women consuming nutrient-rich food groups. We enrolled 1,006 women of reproductive age (18-49 years) in ten villages in Pwani Region, Eastern Tanzania, matched the villages into pairs according to village characteristics, and randomly allocated villages to intervention or control. Households in the intervention villages received agricultural training, inputs to promote home production of nutritious crops, and nutrition and health education. Data were collected in 2016, 2017, and 2019 and analyzed using linear regression models with propensity score weighting adjusting for individual-level confounders, differential loss to follow-up, and fixed effects for village pairs to accommodate the pair-matched design. Results after one year of the intervention (previously published) found significant improvements in dietary diversity. However, three years after the start of the intervention the difference in dietary diversity disappeared, even though the number of women who grew at least one crop was significantly higher (75 percentage points, 95% CI: 72, 81) in treatment households compared to controls. Barriers to maintaining a home garden, including lack of irrigation opportunities and fencing materials, and social disruption may have precluded sustained impacts from home gardening in this context. Future home garden programs should carefully consider mechanisms and investments needed for sustained impact over time.
宅基地食物生产（HFP）项目可以通过增加蔬菜等营养丰富食物的供应以及支持生计来改善饮食和营养状况。我们进行了一项配对集群随机对照试验，以调查家庭菜园是否能够改善妇女的饮食多样性、家庭粮食安全、母婴铁营养状况以及妇女食用营养丰富食物组的概率。我们在坦桑尼亚东部滨海地区的10个村庄招募了1006名育龄妇女（18 - 49岁），根据村庄特征将这些村庄配对，并随机将村庄分配到干预组或对照组。干预组村庄的家庭接受了农业培训、促进营养作物家庭生产的投入以及营养和健康教育。数据于2016年、2017年和2019年收集，并使用线性回归模型进行分析，该模型采用倾向得分加权法，对个体层面的混杂因素、随访中的差异失访以及村庄对的固定效应进行调整，以适应配对设计。干预一年后的结果（此前已发表）发现饮食多样性有显著改善。然而，干预开始三年后，饮食多样性的差异消失了，尽管与对照组相比，种植至少一种作物的妇女数量在处理组家庭中显著更高（75个百分点，95%置信区间：72, 81）。在这种情况下，维持家庭菜园存在障碍，包括缺乏灌溉机会和围栏材料，以及社会干扰，这可能排除了家庭园艺产生持续影响的可能性。未来的家庭菜园项目应仔细考虑实现长期持续影响所需的机制和投资。
