Abstract
Background: Research on nutrition-sensitive agriculture (NSA) has mostly been aimed at demonstrating its impact on nutrition and explicating underlying pathways, and more rarely at understanding processes and lessons learnt from them. This study aimed to gain insights into the processes that influence behaviour change, contributing to improved caring, feeding and food production practices, using a program theory perspective. It also investigated perceived challenges to the sustainability of interventions and potential solutions, in the context of an NSA program in rural Vietnam. Using a participatory approach, data were gathered on impact pathways and perceived outcomes, on elements of program theory that led to behavioural change, as well as barriers and facilitators. Respondents in semi-structured interviews (n = 30) and seven focus group discussions (total n = 76) were selected purposively among program participants. Data was collected and triangulated across several stakeholder groups. Results: The impact pathways (production-consumption, caring and feeding, and home-grown school feeding) envisaged in the NSA program functioned as intended; synergies were revealed. The increased supply of locally produced nutrient-rich foods not only contributed to the emergence of a promising income sub-pathway but also reinforced synergy with the home-grown school feeding pathway. Improved diets, feeding and caring practices, and school attendance were key outcomes of the program. Successful elements were pathway-specific, such as flexibility in implementing context-appropriate agricultural models. Others, such as benefit-driven motivation and improved knowledge, triggered changes in multiple pathways. Role models, increased self-confidence, and change agents were the main process facilitators. The biggest barrier to both implementation and sustainability was the poor socio-economic conditions of the most disadvantaged households. Conclusions: This study showed the relevance of NSA programs in addressing undernutrition in remote areas by enhancing self-reliance in local communities. The integration of behaviour change activities proved to be a key strategy in the process to enhance the impact of agriculture on nutrition outcomes. Though outcomes and influencing factors are very context-dependent, lessons on what worked and what did not work could inform the design and implementation of effective behaviour change strategies in future NSA programs in Vietnam and elsewhere.
| Original language | English |
|---|---|
| Article number | 29 |
| Pages (from-to) | 1-23 |
| Number of pages | 23 |
| Journal | Agriculture and Food Security |
| Volume | 11 |
| DOIs | |
| Publication status | Published - 11 Apr 2022 |
Bibliographical note
Funding Information:The authors would like to thank all the stakeholders—informants and program implementers—that contributed to this study. Our sincere gratitude and appreciation go to the people of Phu Mo commune (parents, children, farmers, micro-entrepreneurs, village health workers, health station and agriculture extension staff, nursery school teachers and principal, village authorities and the communities). We would also like to acknowledge the important contribution of Dong Xuan district staff from agriculture, health and education departments and Phu Yen provincial authorities. Special thanks goes to the Medical Committee Netherlands-Vietnam and the academic partners involved in the NSA program, specifically Hue University of Agriculture and Forestry and Hue University of Medicine and Pharmacy. Finally, we would like to thank the Netherlands Organisation for Scientific Research (NWO)—Food and Business Global Challenges Programme for the financial contribution to the NSA program.
Funding Information:
This study is part of the joint first authors’ PhD research funded by the Netherlands Organisation for Scientific Research (NWO)—Food and Business Global Challenges Programme (Grant Number: W80.25.302). The funding agency did not play any role in the research design, execution of the study and the compilation of the article.
Funding Information:
The authors would like to thank all the stakeholders?informants and program implementers?that contributed to this study. Our sincere gratitude and appreciation go to the people of Phu Mo commune (parents, children, farmers, micro-entrepreneurs, village health workers, health station and agriculture extension staff, nursery school teachers and principal, village authorities and the communities). We would also like to acknowledge the important contribution of Dong Xuan district staff from agriculture, health and education departments and Phu Yen provincial authorities. Special thanks goes to the Medical Committee Netherlands-Vietnam and the academic partners involved in the NSA program, specifically Hue University of Agriculture and Forestry and Hue University of Medicine and Pharmacy. Finally, we would like to thank the Netherlands Organisation for Scientific Research (NWO)?Food and Business Global Challenges Programme for the financial contribution to the NSA program.
Publisher Copyright:
© 2022, The Author(s).
Keywords
- Behaviour change
- Ethnic minority groups
- Impact pathways
- Nutrition-sensitive agriculture
- Process assessment
- Remote areas
