title: Adapting Agriculture Platforms for Nutrition: A Case Study of a Participatory, Video-Based Agricultural Extension Platform in India.
abstract: Successful integration of nutrition interventions into large-scale development programmes from nutrition-relevant sectors, such as agriculture, can address critical underlying determinants of undernutrition and enhance the coverage and effectiveness of on-going nutrition-specific activities. However, evidence on how this can be done is limited. This study examines the feasibility of delivering maternal, infant, and young child nutrition behaviour change communication through an innovative agricultural extension programme serving nutritionally vulnerable groups in rural India. The existing agriculture programme involves participatory production of low-cost videos promoting best practices and broad dissemination through village-level women's self-help groups. For the nutrition intervention, 10 videos promoting specific maternal, infant, and young child nutrition practices were produced and disseminated in 30 villages. A range of methods was used to collect data, including in-depth interviews with project staff, frontline health workers, and self-help group members and their families; structured observations of mediated video dissemination sessions; nutrition knowledge tests with project staff and self-help group members; and a social network questionnaire to assess diffusion of promoted nutrition messages. We found the nutrition intervention to be well-received by rural communities and viewed as complementary to existing frontline health services. However, compared to agriculture, nutrition content required more time, creativity, and technical support to develop and deliver. Experimentation with promoted nutrition behaviours was high, but sharing of information from the videos with non-viewers was limited. Key lessons learned include the benefits of and need for collaboration with existing health services; continued technical support for implementing partners; engagement with local cultural norms and beliefs; empowerment of women's group members to champion nutrition; and enhancement of message diffusion mechanisms to reach pregnant women and mothers of young children at scale. Understanding the experience of developing and delivering this intervention will benefit the design of new nutrition interventions which seek to leverage agriculture platforms.
authors.affiliation: Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.|Leverhulme Centre for Integrative Research on Agriculture and Health (LCIRAH), London, United Kingdom.
authors.forename: Suneetha
authors.initials: S
authors.lastname: Kadiyala
authors.affiliation: Leverhulme Centre for Integrative Research on Agriculture and Health (LCIRAH), London, United Kingdom.|Division of Nutritional Sciences, Cornell University, Ithaca, New York, United States of America.
authors.forename: Emily H
authors.initials: EH
authors.lastname: Morgan
authors.affiliation: St. Johns Research Institute, Bengaluru, Karnataka, India.
authors.forename: Shruthi
authors.initials: S
authors.lastname: Cyriac
authors.affiliation: Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Amy
authors.initials: A
authors.lastname: Margolies
authors.affiliation: Independent consultant, Brasilia, DF, Brazil.
authors.forename: Terry
authors.initials: T
authors.lastname: Roopnaraine
mesh_terms: D000383:Agriculture / Q000379:methods*; D001942:Breast Feeding; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D004032:Diet; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D007194:India; D007223:Infant; D009035:Mothers; D018673:Nutrition Policy; D009752:Nutritional Status; D011247:Pregnancy; D039401:Prenatal Nutritional Physiological Phenomena; D012424:Rural Population; D012657:Self-Help Groups; D014743:Videotape Recording