Objective: Lack of diversity is a major factor contributing to inadequate nutrient intakes among children during the complementary feeding period in many rural areas in developing countries. This has been attributed to inadequate feeding practices and nutrition knowledge among their caregivers. The aim of the present study was to assess the effect of an educational intervention on children’s dietary diversity and nutrition knowledge of caregivers.Design: Cluster randomization was applied and twenty matched village pairs were randomly assigned to the intervention or control group. The nutrition education intervention consisted of four sessions comprising of group trainings and cooking demonstrations that were conducted over a period of 5 months.Setting: Households in rural communities in Bondo and Teso South sub-counties, western Kenya.Subjects: Caregivers with children aged 6–17 months receiving nutrition education.Results: The children’s dietary diversity scores (CDDS) and nutrition knowledge scores of the caregivers improved significantly in the intervention group at endline. The treatment effect on CDDS was positive and significant (P=0·001). The CDDS rate of the children in the intervention group was 27 % larger than it would have been without the treatment effect. The intervention also had a significant effect on the caregivers’ nutrition knowledge scores (incidence rate ratio=2·05;P<0·001). However, the nutrition knowledge of the caregivers did not have a significant effect on CDDS (P=0·731).Conclusions: The nutrition education intervention led to improvements in children’s dietary diversity and nutrition knowledge of the caregivers.

Small-holder farm households in developing countries mainly depend on rain-fed agriculture activities, thus seasonality affects eating habits and contributes to micronutrient deficiencies. This study assessed women’s dietary diversity score (WDDS) across three agricultural seasons in the Kapchorwa District, Uganda. In each season, 445 women with under five-year-old children from small-holder farm households were interviewed on socio-demographic characteristics as well as dietary practices between May 2016 and January 2017. Linear regression models estimated differences in WDDS across seasons. The mean WDDS at the lean, harvest and post-harvest seasons was 4.33 ± 1.21, 4.63 ± 1.30 and 4.36 ± 1.21, respectively. Mean WDDS was higher in urban regions across all seasons. Women in urban regions generated more income through off-farm activities, had better access to markets and consumed significantly more ‘meat, poultry and fish’ (p < 0.001), dairy products (p < 0.05), ‘vitamin A-rich fruits and vegetables’ (p < 0.001) and ‘other vegetables’ (p < 0.001) during the lean season, whilst rural women ate more dark green leafy vegetables (p < 0.001) during the same period. Poorer households in the rural setting were more likely to be affected by seasonally limited food availability and accessibility. Hence, strengthening the linkages between market participation, agricultural activities, improved food storage and preservation techniques and dietary intake is recommended.

Countries which imposed strict containment measures in response to the COVID-19 pandemic are thought to have faced particular socio-economic challenges. This study assesses the implications of COVID-19 disruptions on local agri-food value chain actors in Kenya and Uganda, as both countries enacted strict lockdowns to limit the spread of the virus. Using survey data from 527 smallholder farmers and 107 small-scale market actors, the study analyses these actors’ vulnerability and resilience. This is operationalised as (1) the exposure of respondents to COVID-19 containment measures, (2) effects of these measures as observed by respondents (e.g. on production or trade and income), and (3) (short-term) coping strategies used by respondents to deal with such impacts. Our results show how containment measures have restricted personal movement and transport options and have limited access to agricultural inputs and markets. This led to a decrease in agricultural production and local trading activities. While both farmers and market actors experienced massive negative income effects, market actors were being hit particularly hard as their livelihoods depend on free movement which was severely curtailed during the pandemic. Actors from both categories often tried to cope by selling livestock, using savings and lowering both food intake and food diversity. Coping strategies were thus short-term and further reduced actors’ resilience by exhausting their buffering capacity and exposing them to the risk of food insecurity.

We studied innovation processes in agriculture and nutrition to discuss a scaling approach that encompasses the technical, institutional, and behavioral dimensions of change.To understand dynamics ...

Fruits are micronutrient-rich sources which are often underrepresented in children’s diets. More insights into the determinants of children’s fruit consumption are needed to improve nutrition education in Teso South Sub-County, Kenya. A multiphase mixed method study was applied among 48 farm households with children 0–8 years of age. A market survey together with focus group discussions were used to design a formative research approach including qualitative and quantitative data collection methods. The unavailability of fruits and the inability to plant fruit trees in the homesteads were the main challenges to improve fruit consumption behaviour, although a number of different fruit species were available on the market or in households. Perceived shortage of fruits, financial constraints to purchase fruits and taste were important barriers. Fruits as snacks given between meals was perceived as helpful to satisfy children. The mean number of fruit trees in the homesteads was positively associated with fruit consumption. Field trials are needed to test how best fruit trees within home gardens and on farms can be included, acknowledging limited space and constraints of households with young children. This should be combined with nutrition education programs addressing perceptions about the social and nutrient value of fruits for children.

Responsive infant and young child feeding as a reciprocal relationship between the child and his or her caregiver is recommended by the WHO but has received less attention than dietary diversity or meal frequency up to now. The current study assessed common (non)responsive child feeding practices and factors that facilitate or hinder caregivers to improve feeding practices in rural Teso South Sub-County, Western Kenya. The qualitative study used focus group discussion (n = 93) and Trials of Improved Practices (TIPs) (n = 48) to identify challenges and opportunities in household food distribution and feeding practices. Overall, the implementation of responsive feeding practices was feasible for the caregivers. Parents reported mainly positive experiences in terms of the child’s feeding behavior and effects on child health. Traditional beliefs, practices, and cultural norms hindered some households to change intrahousehold food distribution. Households who manage to implement responsive feeding even in food insecure regions should be consulted to (a) improve existing nutrition education messages that acknowledge these cultural norms, (b) to include more responsive feeding information in nutrition education material, and (c) to address gender norms to create awareness of the importance of responsive feeding practices and the need for adequate time allocation for infant and young child feeding.