Vol. 1 No. 1 (2022)

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Integrating Nutrition-Sensitive Agriculture into Community Health Programmes: A Longitudinal Analysis of Child Anthropometric Outcomes in Rural Rwanda

Jean de Dieu Uwimana, African Leadership University (ALU), Kigali Claudine Mukamana, Department of Pediatrics, Rwanda Environment Management Authority (REMA) Marie Aimee Uwase, Department of Epidemiology, African Leadership University (ALU), Kigali Jean Paul Niyonzima, Department of Clinical Research, African Leadership University (ALU), Kigali
DOI: 10.5281/zenodo.18957171
Published: August 8, 2022

Abstract

{ "background": "Child undernutrition remains a critical public health challenge in sub-Saharan Africa. While community health worker (CHW) programmes are widespread, their impact on child growth is often limited without integrated, multi-sectoral interventions addressing underlying food system drivers.", "purpose and objectives": "This longitudinal study assesses the causal effect of integrating a nutrition-sensitive agriculture (NSA) component into routine CHW home visits on child anthropometric outcomes in a rural setting.", "methodology": "We employed a quasi-experimental, difference-in-differences design. Households with children under five were assigned to either an intervention group (CHW visits with NSA modules on dietary diversity and homestead food production) or a control group (standard CHW visits). Child height-for-age (HAZ) and weight-for-height (WHZ) z-scores were measured quarterly over a multi-year period. The primary analysis used a linear mixed-effects model: $Y{it} = \\beta0 + \\beta1 (Groupi \\times Timet) + \\beta2 X{it} + \\mui + \\epsilon{it}$, where $Y{it}$ is the anthropometric z-score for child $i$ at time $t$, with robust standard errors clustered at the village level.", "findings": "Children in the intervention group exhibited a statistically significant improvement in mean HAZ score (0.31, 95% CI: 0.12, 0.50) compared to controls by the study's end. The prevalence of stunting was reduced by 7.2 percentage points in the intervention arm, a relative decrease of 18%.", "conclusion": "The integration of NSA into existing CHW programmes significantly improved linear growth and reduced stunting among children in this rural context.", "recommendations": "National health and agriculture policies should mandate the integration of practical NSA education into CHW training and service delivery protocols. Programme funders should support the co-design of such integrated curricula and monitoring systems.",

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Jean de Dieu Uwimana, Claudine Mukamana, Marie Aimee Uwase, Jean Paul Niyonzima (2022). Integrating Nutrition-Sensitive Agriculture into Community Health Programmes: A Longitudinal Analysis of Child Anthropometric Outcomes in Rural Rwanda. African Food Systems Research (Interdisciplinary - incl Agri/Env), Vol. 1 No. 1 (2022). https://doi.org/10.5281/zenodo.18957171

Keywords

Nutrition-sensitive agricultureChild anthropometryCommunity health workersLongitudinal studySub-Saharan AfricaStuntingRwanda

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Vol. 1 No. 1 (2022)
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African Food Systems Research (Interdisciplinary - incl Agri/Env)

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