Increasing household diet diversity and food security in rural Rwanda using small-scale nutrition-sensitive agriculture: A community-level proof of concept study

Abstract

Objectives In Rwanda, rates of malnutrition remain high in rural areas where residents consume a primarily starch-based, low variety diet. Nutrition-sensitive agricultural interventions using kitchen gardens have been effective in addressing low diet diversity in similar populations. This study’s objective was to develop a kitchen garden and nutrition education intervention aimed at sustainably increasing diet diversity and food security at the household-level. Design A mixed methods community-level study, with a sixteen-week nutrition-sensitive agricultural intervention including nutrition education was conducted. Household diet diversity scores and household hunger scores were calculated at baseline, post-intervention and one-year follow-up. Setting The intervention was conducted in a rural Rwandan community in the Northern Province. Participants Stratified purposeful sampling techniques were used to select women participants representing forty-two households. Results Household diet diversity scores increased over time from pre-intervention to six months post-intervention and one-year post-intervention. The magnitude of the change was similar in all stratified groups (2.3x at 6 months and 2.9x at 1 year). Households whose main source of income was working for other farmers, reported a significantly lower diet diversity score than those households receiving income from sources [t(40) = -2.108, p=0.041]. Among those households not consuming protein and vitamin-A rich food groups at baseline, all reported consuming foods from these food groups post-intervention. There were no significant changes in household hunger scores. Conclusions Collaborative community-based nutrition-sensitive agricultural interventions using kitchen gardens, can increase household diet diversity, which may encourage sustained change in dietary patterns for nutritional adequacy in low-income rural Rwandan populations.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

Funding for this study was provided by Village Makeover and Rotary International.

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This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving research study participants were approved by the Institutional Review Board at Colorado State University (ID: 19-9040H). Written informed consent was obtained from all subjects/patients.

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All shareable data is included in the submitted manuscript. Other data is associated with personal identifying information therefore protected under the Colorado State University Institutional Review Board.

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