ISDC-International Security and Development Center, Berlin, Germany.
Leibniz Institute of Vegetable and Ornamental Crops, Großbeeren, Germany.
Food Nutr Bull. 2023 Sep;44(3):195-206. doi: 10.1177/03795721231194124.
Integrated school and home garden interventions can improve health outcomes in low-income countries, but rigorous evidence remains scarce, particularly for school-aged children and to reduce anemia.
We test if an integrated school and home garden intervention, implemented at pilot stage, improves hemoglobin levels among school children (aged 9-13 years) in a rural district in the mid-hills of Nepal.
We use a cluster randomized controlled trial with 15 schools each in the control and treatment groups (n = 680 school children). To test if nutritional improvements translate into a reduction of anemia prevalence, hemoglobin data were collected 6 months after intervention support had ended. Using structural equation modeling, we estimate the direct and indirect effects of the treatment through several pathways, including nutritional knowledge, good food and hygiene practices, and dietary diversity.
The integrated school and home garden intervention did not lead to a direct significant reduction in anemia. Causal positive changes of the treatment on nutritional outcomes, although significant, are not strong enough to impact hemoglobin levels. The program improved hemoglobin levels indirectly for children below 12 by increasing the use of good food and hygiene practices at home. These practices are associated with higher hemoglobin levels, particularly for girls, young children, and in households where caregivers are literate.
Even integrated school and home garden interventions are not sufficient to reduce anemia among school children. Incorporating behavioral change components around food and hygiene practices into integrated garden interventions is important to unlocking their health impacts.
综合学校和家庭花园干预措施可以改善低收入国家的健康结果，但严格的证据仍然很少，特别是对于学龄儿童和减少贫血。
我们测试综合学校和家庭花园干预措施是否可以提高尼泊尔中山区农村地区学龄儿童（9-13 岁）的血红蛋白水平，该干预措施处于试点阶段。
我们使用了一项在对照组和治疗组中各有 15 所学校的集群随机对照试验（n=680 名学龄儿童）。为了测试营养改善是否转化为贫血患病率的降低，血红蛋白数据在干预支持结束后 6 个月收集。我们使用结构方程模型，通过多种途径，包括营养知识、良好的食物和卫生习惯以及饮食多样性，估计治疗的直接和间接影响。
综合学校和家庭花园干预措施并没有直接显著降低贫血患病率。尽管治疗的因果积极变化是显著的，但不足以影响血红蛋白水平。该计划通过增加家庭中良好食物和卫生习惯的使用，间接地为 12 岁以下的儿童提高了血红蛋白水平。这些做法与较高的血红蛋白水平相关，特别是对于女孩、幼儿以及有文化的照顾者的家庭。
即使是综合学校和家庭花园干预措施也不足以降低学龄儿童的贫血患病率。将围绕食物和卫生习惯的行为改变成分纳入综合花园干预措施对于释放其健康影响很重要。
