Effect of enhanced homestead food production on anaemia among Cambodian women and children: A cluster randomized controlled trial

Kristina D. Michaux, Kroeun Hou, Crystal D. Karakochuk, Kyly C. Whitfield, Sokhoing Ly, Vashti Verbowski, Ame Stormer, Keith Porter, Kathy H. Li, Lisa A. Houghton, Larry D. Lynd, Aminuzzaman Talukder, Judy McLean, Tim Green

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

There is inconsistent evidence on the efficacy of agriculture programmes at improving women and children's anaemia and nutritional status. The primary aim of this study was to evaluate the impact of a nutrition-sensitive enhanced homestead food production (EHFP) programme on anaemia in women (18–45 years) and children (6–59 months) in rural Cambodia. Secondary outcomes were women's micronutrient status and women and children's anthropometry. In this cluster-randomized controlled trial, 900 households from 90 villages (clusters) were randomized to either (a) home gardens and behaviour change communication (BCC) on nutrition, hygiene, women's empowerment, and marketing (EHFP); (b) home gardens plus fishponds and BCC (EHFP + F); or (c) control (no intervention). Haemoglobin concentration and anthropometry were measured in women and children at baseline and at 22 months. Venous blood samples were collected in a subset of women (n = 450) at baseline and at 22 months. Generalized linear mixed effect models with repeated measures were used to evaluate the difference across groups and the change from baseline to end of study. Ninety clusters, 552 women, and 754 children completed the trial. Compared with control, we found a statistically significant impact on anaemia prevalence in children (−14.0 percentage points; P = 0.02) and retinol binding protein concentrations in women (difference in difference: 0.34; P = 0.02) randomized to EHFP and EHFP + F groups, respectively. No other statistically significant effects on anaemia, nutritional biomarker concentrations, or anthropometry were observed. Future research is needed to examine longer term impacts of EHFP on anthropometry in women and children and into the nutritional causes of anaemia among children in Cambodia.

LanguageEnglish
Article numbere12757
JournalMaternal and Child Nutrition
Volume15
Issue numberS3
DOIs
Publication statusPublished - 1 May 2019

Keywords

  • Cambodia
  • anaemia
  • enhanced homestead food production
  • fishponds
  • nutrition sensitive
  • women of childbearing age

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynaecology
  • Nutrition and Dietetics
  • Public Health, Environmental and Occupational Health

Cite this

Michaux, Kristina D. ; Hou, Kroeun ; Karakochuk, Crystal D. ; Whitfield, Kyly C. ; Ly, Sokhoing ; Verbowski, Vashti ; Stormer, Ame ; Porter, Keith ; Li, Kathy H. ; Houghton, Lisa A. ; Lynd, Larry D. ; Talukder, Aminuzzaman ; McLean, Judy ; Green, Tim. / Effect of enhanced homestead food production on anaemia among Cambodian women and children : A cluster randomized controlled trial. In: Maternal and Child Nutrition. 2019 ; Vol. 15, No. S3.
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abstract = "There is inconsistent evidence on the efficacy of agriculture programmes at improving women and children's anaemia and nutritional status. The primary aim of this study was to evaluate the impact of a nutrition-sensitive enhanced homestead food production (EHFP) programme on anaemia in women (18–45 years) and children (6–59 months) in rural Cambodia. Secondary outcomes were women's micronutrient status and women and children's anthropometry. In this cluster-randomized controlled trial, 900 households from 90 villages (clusters) were randomized to either (a) home gardens and behaviour change communication (BCC) on nutrition, hygiene, women's empowerment, and marketing (EHFP); (b) home gardens plus fishponds and BCC (EHFP + F); or (c) control (no intervention). Haemoglobin concentration and anthropometry were measured in women and children at baseline and at 22 months. Venous blood samples were collected in a subset of women (n = 450) at baseline and at 22 months. Generalized linear mixed effect models with repeated measures were used to evaluate the difference across groups and the change from baseline to end of study. Ninety clusters, 552 women, and 754 children completed the trial. Compared with control, we found a statistically significant impact on anaemia prevalence in children (−14.0 percentage points; P = 0.02) and retinol binding protein concentrations in women (difference in difference: 0.34; P = 0.02) randomized to EHFP and EHFP + F groups, respectively. No other statistically significant effects on anaemia, nutritional biomarker concentrations, or anthropometry were observed. Future research is needed to examine longer term impacts of EHFP on anthropometry in women and children and into the nutritional causes of anaemia among children in Cambodia.",
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author = "Michaux, {Kristina D.} and Kroeun Hou and Karakochuk, {Crystal D.} and Whitfield, {Kyly C.} and Sokhoing Ly and Vashti Verbowski and Ame Stormer and Keith Porter and Li, {Kathy H.} and Houghton, {Lisa A.} and Lynd, {Larry D.} and Aminuzzaman Talukder and Judy McLean and Tim Green",
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Michaux, KD, Hou, K, Karakochuk, CD, Whitfield, KC, Ly, S, Verbowski, V, Stormer, A, Porter, K, Li, KH, Houghton, LA, Lynd, LD, Talukder, A, McLean, J & Green, T 2019, 'Effect of enhanced homestead food production on anaemia among Cambodian women and children: A cluster randomized controlled trial', Maternal and Child Nutrition, vol. 15, no. S3, e12757. https://doi.org/10.1111/mcn.12757

Effect of enhanced homestead food production on anaemia among Cambodian women and children : A cluster randomized controlled trial. / Michaux, Kristina D.; Hou, Kroeun; Karakochuk, Crystal D.; Whitfield, Kyly C.; Ly, Sokhoing; Verbowski, Vashti; Stormer, Ame; Porter, Keith; Li, Kathy H.; Houghton, Lisa A.; Lynd, Larry D.; Talukder, Aminuzzaman; McLean, Judy; Green, Tim.

In: Maternal and Child Nutrition, Vol. 15, No. S3, e12757, 01.05.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of enhanced homestead food production on anaemia among Cambodian women and children

T2 - Maternal and Child Nutrition

AU - Michaux, Kristina D.

AU - Hou, Kroeun

AU - Karakochuk, Crystal D.

AU - Whitfield, Kyly C.

AU - Ly, Sokhoing

AU - Verbowski, Vashti

AU - Stormer, Ame

AU - Porter, Keith

AU - Li, Kathy H.

AU - Houghton, Lisa A.

AU - Lynd, Larry D.

AU - Talukder, Aminuzzaman

AU - McLean, Judy

AU - Green, Tim

PY - 2019/5/1

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N2 - There is inconsistent evidence on the efficacy of agriculture programmes at improving women and children's anaemia and nutritional status. The primary aim of this study was to evaluate the impact of a nutrition-sensitive enhanced homestead food production (EHFP) programme on anaemia in women (18–45 years) and children (6–59 months) in rural Cambodia. Secondary outcomes were women's micronutrient status and women and children's anthropometry. In this cluster-randomized controlled trial, 900 households from 90 villages (clusters) were randomized to either (a) home gardens and behaviour change communication (BCC) on nutrition, hygiene, women's empowerment, and marketing (EHFP); (b) home gardens plus fishponds and BCC (EHFP + F); or (c) control (no intervention). Haemoglobin concentration and anthropometry were measured in women and children at baseline and at 22 months. Venous blood samples were collected in a subset of women (n = 450) at baseline and at 22 months. Generalized linear mixed effect models with repeated measures were used to evaluate the difference across groups and the change from baseline to end of study. Ninety clusters, 552 women, and 754 children completed the trial. Compared with control, we found a statistically significant impact on anaemia prevalence in children (−14.0 percentage points; P = 0.02) and retinol binding protein concentrations in women (difference in difference: 0.34; P = 0.02) randomized to EHFP and EHFP + F groups, respectively. No other statistically significant effects on anaemia, nutritional biomarker concentrations, or anthropometry were observed. Future research is needed to examine longer term impacts of EHFP on anthropometry in women and children and into the nutritional causes of anaemia among children in Cambodia.

AB - There is inconsistent evidence on the efficacy of agriculture programmes at improving women and children's anaemia and nutritional status. The primary aim of this study was to evaluate the impact of a nutrition-sensitive enhanced homestead food production (EHFP) programme on anaemia in women (18–45 years) and children (6–59 months) in rural Cambodia. Secondary outcomes were women's micronutrient status and women and children's anthropometry. In this cluster-randomized controlled trial, 900 households from 90 villages (clusters) were randomized to either (a) home gardens and behaviour change communication (BCC) on nutrition, hygiene, women's empowerment, and marketing (EHFP); (b) home gardens plus fishponds and BCC (EHFP + F); or (c) control (no intervention). Haemoglobin concentration and anthropometry were measured in women and children at baseline and at 22 months. Venous blood samples were collected in a subset of women (n = 450) at baseline and at 22 months. Generalized linear mixed effect models with repeated measures were used to evaluate the difference across groups and the change from baseline to end of study. Ninety clusters, 552 women, and 754 children completed the trial. Compared with control, we found a statistically significant impact on anaemia prevalence in children (−14.0 percentage points; P = 0.02) and retinol binding protein concentrations in women (difference in difference: 0.34; P = 0.02) randomized to EHFP and EHFP + F groups, respectively. No other statistically significant effects on anaemia, nutritional biomarker concentrations, or anthropometry were observed. Future research is needed to examine longer term impacts of EHFP on anthropometry in women and children and into the nutritional causes of anaemia among children in Cambodia.

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KW - anaemia

KW - enhanced homestead food production

KW - fishponds

KW - nutrition sensitive

KW - women of childbearing age

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U2 - 10.1111/mcn.12757

DO - 10.1111/mcn.12757

M3 - Article

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JO - Maternal and Child Nutrition

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