Effectiveness of agricultural interventions that aim to improve nutritional status of children: systematic review

This systematic review focuses on the impact of agricultural interventions that aim to improve children’s nutritional status by improving the incomes and the diet of the rural poor. Covering the period 1990-2010, mixed results were found, with limited demonstrable impact of agricultural interventions on nutritional status. This was attributed to methodological weaknesses of the studies reviewed rather than to specific characteristics of interventions. As many as 7,000 studies were identified in the search, but only 23 qualified for final inclusion based on the exclusion criteria set. Most of the 23 studies selected were evaluating home garden interventions. The studies reviewed did not report participation rates or the characteristics of participants in programmes.

The results report that no data is available on participation rates or characteristics of participants in agricultural interventions. As a result, little is known about the impact of these interventions on specific vulnerable groups; the targeting efficiency of the interventions; and the characteristic of programme participants. Agricultural interventions appear to have a positive impact on the production of the food item promoted by the intervention. However, it is less clear whether these interventions have a positive impact on total household income. The evidence available is very weak. Given the generally low response of food consumption and particularly of calories consumption to income changes, it is unlikely that the interventions considered had an impact on nutritional status via a simple income effect.

There is considerable evidence that the interventions analysed are successful in promoting the consumption of specific food items such as vegetables, fish or milk. However, consumers can, for example, compensate for an increase in the consumption of fish with a reduction in the consumption of other protein rich food such as meat. The overall impact of the interventions on the diet of the poor remains unexplored. The impact of agricultural interventions on micronutrients is unclear. There is no evidence of an impact of the interventions on iron intake. There is some evidence of a positive impact on vitamin A intake, but the number of studies available is too small to generate robust results as the summary results are very sensitive to the inclusion of one or two studies. Evaluations of biofortification interventions are positive, but the number of these evaluations is too small to provide conclusive answers. The studies reviewed report little or no impact of agricultural interventions on the nutritional status of children. This result confirms the results of previous systematic reviews on the same topic. However, unlike previous reviews, the authors attribute this result to the lack of statistical power of the studies reviewed rather than to the lack of efficacy of these interventions. The studies reviewed found a greater impact of the intervention on the prevalence of short term indicators of hunger (wasting and underweight) versus long-term indicators (stunting). However, this result could be a consequence of the short time frame adopted by the evaluations, which is not well suited to detect long term effects.

To conclude this review found the effectiveness of agricultural interventions in improving the nutritional status of children in developing countries to not be clear from the available evidence.

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