can ag/nutrition programs change gender norms_mara vandenbold_10.16.13
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Can Integrated Agriculture-Nutrition Programs Change Gender Norms on
Land and Asset Ownership?
Evidence from Burkina Faso
CORE group meeting – Washington DC, October 16 2013
Mara van den Bold | Research Analyst | Poverty, Health and Nutrition Division | IFPRIAbdoulaye Pedehombga | Monitoring and Evaluation Coordinator for E-HFP | HKI Burkina FasoMarcellin Ouedraogo | Program Coordinator for E-HFP | HKI Burkina FasoDeanna Olney | Research Fellow | IFPRIAgnes Quisumbing | Senior Research Fellow | IFPRI
Overview
• Background to Helen Keller International’s Enhanced Homestead Food Production (E-HFP) program in Burkina Faso
• Motivation for research on gender
• Study design
• Impact of E-HFP program on key gender-relevant research questions
Context
Burkina Faso• Eastern region, Gourma Province
Sahel• Water shortages, inhibits having a second cultivation season
High prevalence of acute and chronic malnutrition• Food insecurity• Suboptimal maternal and child nutrition and health practices• Limited availability of and access to health services
E-HFP program in Burkina Faso (1)
Overall objective: To improve women’s agricultural production of nutrient-rich foods, as well as their health- and nutrition-related knowledge and practices, to ultimately improve nutritional status of infants and young children
Targeted to women with children between 3 and 12 months of age
Improvements expected through three primary program impact pathways:
1. Increase women’s production of MN-rich foods -> increase availability and consumption of micronutrient-rich foods -> increase HH food security + child nutritional status
2. Income generation through the sale of surplus HH production -> improve HH food security and child nutritional status
3. Increased knowledge and adoption of optimal nutritional practices including consumption of micronutrient-rich foods -> improve child nutritional status
Two primary program components:
• Agricultural component• HKI provided agricultural inputs and training to establish ‘village model farms’
(VMF) (training site) to grow micronutrient-rich foods year-round and raise small animals. Led by 4 ‘village farm leaders’.
• HKI provided participating women with agricultural inputs and encouraged them to set up their own home gardens and raise small animals based on what they learned at the VMF
• Behavior Change Communication (BCC) strategy• Focused on improving health- and nutrition-related knowledge with specific
emphasis on encouraging consumption of micronutrient-rich foods by women and young children.
• Encourage participants to carry out optimal nutrition and health-related practices and help them overcome barriers to adoption
E-HFP program in Burkina Faso (2)
E-HFP program in Burkina Faso (3)
Program sought to directly increase women’s access to and control over physical assets:
• Community level: HKI worked with communities to identify land that could be used by beneficiary women for the ‘village model farm’ (VMF) and sensitized communities about the program and importance of targeting women
• Individual: HKI provided VMF and beneficiary women with gardening inputs (saplings, seeds, gardening tools) and chicks and encouraged them to set up of their own home gardens
Motivation for research on gender
Evidence shows:• Positive associations between women’s (dis)empowerment dimensions and
(adverse) nutrition outcomes (van den Bold et al. 2013)• Women and men within HH often do not have the same preferences for allocating
resources (Alderman et al. 1995; Hoddinott &Haddad 1995; Quisumbing &Maluccio 2003; Quisumbing 2003)
• Increasing women’s control over assets (esp. financial/physical) has been shown to positively impact food security, child nutrition, education, women’s own well-being (Quisumbing 2003; Smith et al. 2003; World Bank 2001); gender differences in bargaining power over household resources matter
Women often specifically targeted in agricultural programs, but to date there is limited evidence on the impacts of agricultural interventions on women’s control over and ownership of assets
E-HFP program expected to influence women’s asset holdings through direct (direct transfers of resources) and indirect (improved production techniques) mechanisms
Study design
Longitudinal impact evaluation (baseline 2010, endline 2012)
Operations research (2011)
Qualitative research to examine gender related topics including ownership and control over agricultural assets (2012)
Key gender-related questions
Key Questions Impact evaluation
Qualitative research
Analysis Status
Did the EHFP program increase women’s and men’s ownership of assets?
x Complete
Were women able to maintain control over the EHFP activities and outputs?
x x Complete
Did the land agreements and/or project activities influence community norms related to women’s land ownership or land rights?
x Complete
What trade-offs were women required to make in order to participate in the EHFP program?
x On-going
Impact evaluation
Cluster randomized design• 30 intervention villages (~1200 households and 120 village farm leaders (VFL))
o 15 “older women leader” villages (OWL)o 15 “health committee” villages (HC)
• 25 control villages (~800 households)
Longitudinal• Baseline Feb-Apr 2010 (target children 3-12 months of age)• Endline Feb-Apr 2012 (target children 21-40 months of age)
Household interview• Male HH head and female key respondent, including sex disaggregated modules on
asset ownership, agricultural production, income, household expenditures, knowledge on nutrition, household food security, dietary diversity, …
• Anthropometric measures and hemoglobin status of target children
Qualitative research
Operations Research (2011) GAAP* Qualitative Research (2012)
Random sample of beneficiaries and non-beneficiaries
Beneficiaries: n=120Non-beneficiaries: n=60
Beneficiaries: n=145Non-beneficiaries: n=75
Purposive sample of key informants
VFL: n=60 OWL: n=30HC: n=30Master agriculture trainers: n=18 Master nutrition trainers: n=24
VFL: n=60OWL: n=30HC: n=30Land owners: n=30Focus groups: n=24 (6m; 6f)
Data collection May-June 2011May-June 2012
May-June 2011May-June 2012
Methods Semi-structured interviews Semi-structured interviews and focus group discussions
*GAAP: Gender, Agriculture and Assets Project (www.gaap.ifpri.info) *HC: Health committee member*VFL: Village Farm Leader*OWL: Older Women Leader
ResultsDid the EHFP program increase women’s and/or
men’s ownership of assets?
Ownership of assets: Household durables and agricultural assets
***
***
Note: Comparison is to a control group that did not receive any program services. All estimates controlled for baseline age, sex, clustering, and attrition. All values are coefficient (SE). *** p <0.01
Ownership of assets: small animals
Note: Comparison is to a control group that did not receive any program services. All estimates controlled for baseline age, sex, clustering, and attrition. All values are coefficient (SE). * *p<0.05, *** p <0.01
Were women able to maintain control over the E-HFP activities and outputs?
Control over EHFP activities and outputs: Gardens, vegetables, revenue
Operations research: Round 1 (2011) Operations research: Round 2 (2012)
Control over EHFP activities and outputs: Chickens
Operations research: Round 1 (2011) Operations research: Round 2 (2012)
Control over EHFP activities and outputs: Goats
Operations research: Round 1 (2011) Operations research: Round 2 (2012)
Did the land agreements and/or project activities influence community norms related
to women’s land ownership or land rights?
Women MenIntervention villages Control
villagesIntervention villages Control
villages
HC OWL All Control HC OWL All Control n = 70 n = 75 n = 145 n = 75 n = 57 n = 58 n = 114 n = 60
Change in own opinion about who can own and/or use land for the production of fruits and vegetables
46 (66) 49 (68) 95 (67) 11 (16) 32 (56) 36 (62) 68 (60) 14 (23)
n = 56 n = 56 n = 112 n = 65 n = 46 n = 51 n = 97 n = 52Perceived changes in other people’s opinions about who can own and/or use land for the production of fruits and vegetables
24 (43) 31 (55) 55 (49) 8 (12) 21 (46) 24 (47) 45 (46) 5 (10)
n = 69 n = 67 n = 136 n = 73 n = 57 n = 59 n = 116 n = 60Perceived changes related to women’s ability to own land in the village
18 (26) 15 (22) 33 (24) 1 (1) 16 (28) 15 (25) 31 (27) 2 (3)
n = 68 n = 70 n = 138 n = 74 n = 55 n = 53 n = 108 n = 61Perceived changes related to women’s ability to use land for growing food in the village
29 (43) 32 (46) 61 (44) 3 (4) 27 (49) 21 (40) 48 (44) 1 (2)
Community norms related to women’s land ownership and land rights: Perceived changes by men and women on
women’s ability to own and use land
Trade-offs required for participation in the EHFP program
• Only 11% of beneficiaries (13/118) stated that taking care of the garden interferes with their other activities (e.g. outside work and domestic tasks).
• None of the beneficiary women interviewed thought that taking care of their chickens interfered with their other activities.
• 18% of women (16/89) stated that there were costs to working at the VMF including having to neglect their domestic work, taking care of their children, not being able to go to the market, and that it takes time to go and work at the VMF.
Summary
Key Question Summary
Did the EHFP program increase women’s ownership of assets?
Yes, the E-HFP program had a positive impact on women's ownership of agricultural assets and small livestock.
Did the EHFP program also influence men’s asset holdings?
Yes, the E-HFP program had a negative impact on men's ownership of agricultural assets which was about equal to the positive impact on women’s ownership of agricultural assets. The program had a positive impact on men’s ownership of small livestock which was larger than that for women.
Were women able to maintain control over the EHFP activities and outputs?
Yes, especially in regards to the garden activities. Vast majority of women were mainly responsible for decisions related to what to grow and were able to keep income generated from sale of produce.
Summary , cont’d
Key Question Summary
Did the land agreements and/or project activities influence community norms related to women’s land ownership or land rights?
Yes, in beneficiary villages some change was noted in people’s opinions about who could own and use land. Both men and women in beneficiary villages reported that women’s ability to own and use land had changed in the past two years. This was rarely reported in control villages.
What trade-offs were women required to make in order to participate in the EHFP program?
Only about 11% of respondents reported that taking care of their gardens affected their other activities. 18% said that working at the VMF had costs (e.g. time and neglect of domestic work).
References
EXTRA SLIDES
Why pay attention to gender in leveraging agriculture for nutrition?
• “Women are important in agriculture, and agriculture is important for women” (Doss 2009; Meinzen-Dick et al. 2011)
• Women are generally disadvantaged as agricultural producers: limited access to physical assets (ag inputs, technological resources, land), lack of capacity to use assets, disadvantaged in terms of non-tangible assets e.g. social/human capital, decisionmaking power
• Women and men within HH often do not have the same preferences for allocating resources (Alderman et al. 1995; Hoddinott and Haddad 1995; Quisumbing and Maluccio 2003; Quisumbing 2003)
• Increasing women’s control over assets (esp. financial/physical) has been shown to positively impact food security, child nutrition, education, women’s own well-being (Quisumbing 2003; Smith et al. 2003; World Bank 2001); gender differences in bargaining power over HH resources matter.
Agriculture—gender—nutrition pathways
Arimond et al. (2010) identified 5 pathways through which agriculture interventions can affect nutrition:
i) Increased food for own consumption through production*ii) Increased income through production for sale in markets*iii) Reductions in market prices (increased production)iv) Shifts in consumer preferencesv) Shifts in control of resources within households*
Limited evidence of the impact of agricultural interventions on nutrition outcomes (except for Vitamin A); hardly any evidence on impact pathways (Ruel and Alderman 2013).
Women’s empowerment interventions considered an important pathway through which agriculture can improve nutrition. But limited and mixed evidence (Ruel and Alderman 2013; van den Bold et al. 2013).
All mediated by gender roles, especially (*)
Linking gender and nutrition
Women are often primary caregivers: they influence their child’s nutrition indirectly through their own nutritional status and directly through child care practices
Various studies have looked at links between nutrition and dimensions of female empowerment (e.g. bargaining power, involvement in decisionmaking, mobility, access to information, control over assets)• Positive associations b/w female empowerment dimensions and nutrition
outcomes and b/w dimensions of female disempowerment (e.g. domestic violence) and adverse nutritional outcomes (van den Bold et al. 2013)
• Women’s relationships with men in the household (HH) and community can affect their bargaining power and ability to direct HH resources to nutrition
35
Undernutrition exists when insufficient food intake and repeated infections result in one or more of the following: underweight for age, short for age (stunted), thin for height (wasted), and functionally deficient in vitamins and/or minerals (micronutrient malnutrition).
Malnutrition is a broad term that refers to all forms of poor nutrition. Malnutrition is caused by a complex array of factors including dietary inadequacy (deficiencies, excesses or imbalances in energy, protein and micronutrients), infections and socio-cultural factors. Malnutrition includes undernutrition as well as overweight and obesity (Shakir, 2006a).
Food security exists when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life. Household food security is the application of this concept to the family level, with individuals within households as the focus of concern (FAO, 2009b).
Food insecurity exists when people do not have adequate physical, social or economic access to food as defined above (FAO, 2009b).
SCN 6th World Nutrition Situation Report. www.unscn.org/files/Publications/RWNS6/report/chapter4.pdf
Definitions of Key Terms
Did exposure to nutrition education diffused through village health committee members (HC) increase knowledge and uptake of new practices as compared
to that diffused through older women leaders (OWL) or vice versa?
Impact of the EHFP program on nutrition knowledge: IYCF practices
Give breast milk within the first hour after
birth
Give colostrum to
children
Children < 6 months of age
should not drink any liquids other than breast milk
Begin giving liquids other
than breast milk at 6 months of
age
Begin giving semi-solid foods at 6
months of age
N=1,138 N=1,144 N=1,129 N=1,142 N=1,149OWL villages 0.16*** 0.092*** 0.23** 0.13** 0.13**
(0.054) (0.029) (0.094) (0.063) (0.055)
HC villages 0.17*** 0.080*** 0.23*** 0.19*** 0.17***
(0.052) (0.029) (0.078) (0.059) (0.059)p-value 0.006 0.009 0.006 0.007 0.011
Impact of the EHFP program on IYCF practices: Dietary diversity among children 3-12 months of age at baseline
Met minimum
dietary diversity requirement
n=691
Older women leaders 0.12*
(0.070)Health committee 0.098
(0.077)p-value 0.14
Note: Comparison is to a control group that did not receive any program services. All estimates controlled for baseline age, sex, clustering, and attrition. All values are coefficient (SE). * p<0.10
Impact of the EHFP program on infant and young child feeding practices: Intake of iron-rich foods among children 3-12 months of age at baseline
Iron-rich foods
n=662
Older women leaders 0.15**
(0.072)Health committee 0.023
(0.090)p-value 0.13
Note: Comparison is to a control group that did not receive any program services. All estimates controlled for baseline age, sex, clustering, and attrition. All values are coefficient (SE). * *p<0.05
Impact of the EHFP program on nutritional status of children: Hemoglobin among children 3-12
months of age at baseline
Hemoglobin(g/dL)
n=1144Older women leaders 0.24
(0.31)Health committee 0.49*
(0.27)p-value 0.19
Note: Comparison is to a control group that did not receive any program services. All estimates controlled for baseline age, sex, clustering, and attrition. All values are coefficient (SE). * p<0.10
Change in hemoglobin from baseline to endline among children 3-5.9 months of age at baseline
Hemoglobin(g/dL)
n=449Older women leaders 0.044
(0.32)Health committee 0.76**
(0.30)p-value 0.043Note: Comparison is to a control group that did not receive any program services. All estimates controlled for baseline age, sex, clustering, and attrition. All values are coefficient (SE). * *p<0.05
Impact of the EHFP program on health-related knowledge: Hand-washing practices
**
Note: Comparison is to a control group that did not receive any program services. Estimates controlled for baseline age, sex, clustering, and attrition. * p < 0.1, ** p < 0.05, *** p<0.01
Impact of the EHFP program on IYCF practices: Breastfeeding practices among children 3-12 months of age at endline
**
Note: Comparison is to a control group that did not receive any program services. Estimates controlled for baseline age, sex, clustering, and attrition. * p < 0.1, ** p < 0.05, *** p<0.01
Impact of the EHFP program on nutritional status of children: HAZ among children 3-12 months of
age at baseline
Impact of the E-HFP program on nutritional status of children: Wasting among children 3-12 months of age at baseline
Program theory framework for HKI’s HFP program in Burkina Faso
HKI, APRG and governmental
structures (Ministries of
Health, Agriculture,
Animals, Environment, and the Promotion of
Women, local authorities and officials) work
together
Village Model Farms (VMF)
established
Improvements in small
ruminant and poultry
production
Improvements in fruit and vegetable
production
Training in plant and animal
production techniques for
master trainers
BCC training on ENA
practices for village health
workers (VHW)
Training in plant and animal
production techniques for beneficiaries
BCC training on ENA
practices for beneficiaries
Establishment of individual
farms (40 women per
village)
Improvements in household
consumption
Increased Income
Improved maternal and child health and nutrition
outcomes
Beneficiaries received and understood
BCC training on ENA practices
Improvements in nutrition and
feeding practices for children,
pregnant women and breastfeeding
mothers
Outcomes
Adoption of agriculture practices
Develop a training strategy in animal;
and plant production techniques
BCC training on ENA
practices for master trainers
Women’s empowerment
improved
Women’s assets increased
Increased availability of micronutrient
-rich fruits and
vegetables
Impact Inputs Process Outputs
Agriculture and zoological inputs
distributed
Develop a behavior change communication (BCC) strategy with regards to
Essential Nutrition Actions
(ENA)
Training in plant and animal
production techniques for Village Farm
Leaders (VFL)
Adoption of ENA
practices by beneficiaries
Improvements in care & hygiene
practices for children, pregnant
women and breastfeeding
mothers
Beneficiaries received and understood agriculture
training
Increased availability of
food from animal origin
Map of study area
Impact Evaluation Intervention villages HC villages OWL villages Control
villagesTotal
Number of villages 15a 15 25 55Number of households Baseline (2010) Household interview 511 512 734 1,757 Endline (2012) Household interview 436 444 590 1,470
Qualitative Research Intervention villages HC villages OWL villages Control
villagesTotal
Number of villages 14a 15 15 44Number of households First round (2011) Basic semistructured interviews 70 75 75 220 In-depth semistructured interviews 28 30 30 88 Second round (2012) Semistructured interviews 70 75 75 220
Table 3.1 Overview of methods and participants from health committee and older women leader intervention villages and control villages
Note: HC = health committee; OWL = older women leader.a One village from the HC intervention group dropped out of the program and study before the first round of qualitative research, resulting in a total of 14 villages for the first and second rounds of qualitative research and for the endline survey for the impact evaluation.