Pathways to diverse diets – a retrospective analysis of a participatory nutrition-sensitive project in Kenya

This study is based on a community-based participatory project, running in Kenya since 2015 and aiming to diversify diets of women and children by making use of local food biodiversity. An impact study indicated that dietary diversity of women and children increased through the project. Using a theoretical agriculture-nutrition framework, we assessed the pathways that have led to the dietary changes and identified possible secondary effects beyond nutrition. Data was gathered through ten semi-structured focus group discussions with community members engaging in the project and 5 key informant interviews with local authorities that worked with these communities during the project. Data analysis was supported by the approach of summative content analysis. Defined pathways were compared to existing and widely-used theoretical pathways from the literature. Out of the agriculture-nutrition pathways that are presented in literature, three were found in the responses: 1) food from own-production; 2) income from sale of foods produced; 3) women's empowerment through access to and control over resources. In addition, we identified a first pathway based on the spreading and implementation of agricultural knowledge and a second pathway that was based on saved time and money due to decreased doctor’s visits through improved health. Beyond nutritional benefits, male and female respondents reported aspects of increased empowerment and harmony in the household. Our pathway analysis provides qualitative evidence on the impact of the community-led agriculture-nutrition project on increased dietary diversity for women and young children. If done more systematically, pathway analysis in nutrition-sensitive agricultural projects could increase our understanding on how interventions improve nutrition. MethodologyWe collected qualitative data because it has the potential to assess individual behavior and allows keeping a broader scientific scope to also investigate unintended effects of an intervention. Data was gathered through ten semi-structured focus group discussions with community members engaging in the project and 5 key informant interviews with local authorities that worked with these communities during the project. Gender disaggregation during data collection and analysis has enabled interpretation regarding gender equality and women empowerment aspects. Transcripts were analyzed by two researchers. They applied the approach of summative content analysis. Defined pathways were compared to existing and widely-used theoretical pathways from the literature. Also, unintended secondary effects of the intervention were investigated.

本研究基于一项自2015年起在肯尼亚实施的社区参与式项目（community-based participatory project），旨在通过利用当地食物生物多样性，丰富妇女与儿童的膳食结构。一项影响评估显示，该项目有效提升了妇女与儿童的膳食多样性。本研究依托农业-营养（agriculture-nutrition）理论框架，剖析了推动膳食结构改善的作用路径，并识别了营养领域之外的潜在次生效应。
研究数据来源于两类调研：一是与参与该项目的社区成员开展的10场半结构化焦点小组讨论（semi-structured focus group discussions），二是与项目期间为上述社区提供支持的地方主管开展的5场关键知情人访谈（key informant interviews）。数据分析采用总结式内容分析（summative content analysis）方法完成。
将本研究界定的作用路径与现有文献中广泛应用的理论路径进行比对。在现有文献提及的农业-营养作用路径中，本次研究共识别出3条经典路径：1）自有种植的食物供给；2）售卖自产食品获得的收入；3）通过获取与支配资源实现的妇女赋权。此外，本研究还识别出两条全新路径：其一为基于农业知识传播与落地的作用路径，其二为因健康状况改善减少就医次数，进而节省时间与资金的作用路径。
除营养增益外，男女受访者均提及项目带来了家庭内部赋权水平提升与家庭关系更和谐的积极变化。本研究的路径分析为社区主导型农业-营养项目提升妇女与幼儿膳食多样性的影响提供了质性证据。若能以更系统化的方式开展营养敏感型农业项目（nutrition-sensitive agricultural projects）的路径分析，将有助于深化我们对干预措施如何改善营养状况的认知。
方法论
本研究采用质性数据开展分析，因其可有效评估个体行为，且能维持更广阔的科学研究边界，同时可探究干预措施的非预期效应。研究数据来源于两类调研：一是与参与该项目的社区成员开展的10场半结构化焦点小组讨论，二是与项目期间为上述社区提供支持的地方主管开展的5场关键知情人访谈。在数据收集与分析阶段开展性别细分（gender disaggregation），使得本研究可针对性别平等与妇女赋权相关议题展开解读。转录文本由两名研究人员共同分析，二者采用总结式内容分析方法完成编码与解读。研究团队将本研究界定的作用路径与现有文献中广泛应用的理论路径进行比对，同时也对干预措施的非预期次生效应展开了探究。