Targeting and re-aligning agriculture to improve nutrition (TRAIN) in Bangladesh: Exploring the impacts of female targeting and male sensitization to accelerate agriculture’s potential for nutrition change
International Food Policy Research Institute
Primary research question: TRAIN’s objective is to address evidence gaps related to the effects of agricultural interventions on maternal and child nutrition. Specifically, the project will use a randomized control trial (RCT) to assess the impact of incorporating a maternal and child health and nutrition behaviour change communication (BCC) strategy into a well-established credit program targeted to women.
Targeting and Realigning Agriculture for Improved Nutrition (TRAIN) project addresses the issue of undernutrition among women and children in rural Bangladesh using a three-pronged approach that will: (1) increase the availability of, and access to a more diverse diet, either directly via increasing production diversity of poor rural producers or indirectly via increased incomes; (2) improve child feeding, health and sanitation practices through a strong behavior change communications (BCC) component; and (3) focus on empowering women (directly, by facilitating greater control over agricultural income and its allocation toward health and nutrition; and indirectly by sensitizing their husbands and other household members to support them in their productive and reproductive tasks). This three-pronged approach is embedded in the intervention design which will examine which program component or combination of program components are most effective for improving maternal and child nutrition. The proposed study will design an randomized controlled trial to address the following questions:
- Does the inclusion of a BCC platform aimed at improving maternal and child nutrition and women’s empowerment to an existing credit program (targeted to women) enhance the impacts on maternal and child nutrition? (What is the value added of a BCC platform to a credit program?)
- Are the impacts on maternal and child nutrition and on women’s empowerment of the combined credit and BCC program larger if agricultural extension services focused around nutrition sensitive agriculture targeted to men and women are provided in addition? (What is the value added of nutrition sensitive agriculture extension services to an existing credit program focused on boosting incomes and BCC intervention?)
- Does the inclusion of a BCC platform aimed at improving maternal and child nutrition and women’s empowerment and nutrition sensitive agriculture extensions services to an existing credit program (targeted to women) enhance the impacts on maternal and child nutrition? (What is the value added of a BCC intervention and nutrition sensitive agriculture extension services to an agriculture credit program?)
- Are the impacts on maternal and child nutrition and women’s empowerment of this combined credit and BCC program with nutrition sensitive agriculture extension services targeted to men and women also includes a gender sensitization/social mobilization component (this will include community-level discussions aimed at community and religious leaders as well as men-only sessions) focused on supporting women in their productive and reproductive roles, protecting their time, nutrition and health, and preventing intimate partner violence). (What is the value added of a male sensitization intervention to a credit and BCC intervention with nutrition sensitive agriculture extension services targeted to men and women?)
We will assess the impact of the intervention on the following primary outcomes:
- Women’s dietary diversity
- Women’s BMI
In addition, we will measure several secondary outcomes to ensure a comprehensive knowledge base on the diverse pathways through which the intervention affects different welfare outcomes. These include:
Woman’s nutrition, empowerment and welfare:
- Women’s hemoglobin and anemia prevalence
- Women’s empowerment as measured over the five domains of the Women’s Empowerment in Agriculture Index
- Women’s time allocation and time burden
- Women’s knowledge, attitudes and practices regarding IYCF and sanitation and hygiene
- Women’s dietary intake
Child level outcomes
- Child dietary diversity and other IYCF practices
Male perspectives and support for nutrition:
- Men’s knowledge, attitudes and practices regarding IYCF and sanitation and hygiene
- Men’s knowledge and attitudes regarding the nutrition of women and children around the first 1000 days, women’s time and status and their productive and reproductive roles, fathers’ role in ensuring adequate health and nutrition of their family, domestic violence, etc.
- Agricultural production and assets (gender-disaggregated);
- Consumption/expenditure and income (gender-disaggregated);
- Household dietary diversity
The impact evaluation will be based on a two-round panel survey of women, children and households and supported by a process evaluation to explicitly map and study the pathways to impact.
The project is in its fourth year. Over the first year of the project, the research team, in collaboration with the implementing partner, finalized the design of the intervention and the evaluation. The baseline survey and analysis of the baseline survey data took place in the second year. The project produced a slide-deck summarizing the findings from the baseline survey. The intervention activities also started in the second year soon after the data collection for the baseline survey was completed. Intervention activities continued in year three and monitoring data were collected and analyzed. Multiple field visits by the researchers as well as the implementors were also made. In year three of the project, the research team, based on available data and information, prepared an implementation assessment report to guide the process evaluation planned for year four. Currently, a mixed-methods process evaluation is being designed. The endline survey and analysis of impact of the project will be done in the fifth, and final, year of the project.