Ilse de Jager

Nutritional benefits of grain legume cultivation within the N2Africa project in

Northern Ghana

N2Africa project

• Ghana, Nigeria, DRC, Malawi, Kenya, Mozambique, Rwanda, ZimbabweNew: Uganda, Tanzania, Ethiopia

• Groundnut, soybean, cowpea, climbing bean, pigeon pea, common bean

• Demonstration plots for smallholder farmers (field day, farmer groups)

• Literature study and case studies

Agricultural productivity by BNF

Objectives

• Assessing impact (quantitative):– Nutrient adequacy of the diet– Nutritional status

By quasi-experimental, cross-sectional study

• Assessing pathways (qualitative):– Via food availability– Via income

By focus group discussions

Methodology –study area• Ghana– 238.537 km2, lowland country, on average 26 ºC– 28 % of children < 5 are stunted, 9 % are wasted

• Districts – Rainfall– Market accessibility

Methodology -subjects• Selection of N2Africa villages and farmers– Villages in N2Africa project from 2010– Farmers who received inputs in 2012

• Selection of non-N2Africa villages and household

– Villages supervised by same extension officer – Random walk method

Methodology -subjects• Households were included when present:– (N2Africa) farmer – Child of 6 – 59 month old (if >1, randomly selected)– Mother of child (if >1 wife, randomly selected)

N2Africa group: N = 129Non-N2Africa gourp: N = 202

Methodology - IDDS• Individual Dietary Diversity Score (IDDS)– Proxy measure of nutrient adequacy – 24 hour recalls– 14 Food groups

Food group Yes/NoCereals (1) Yes Vitamin A rich vegetables and tubers (>60 RAE) (2) NoWhite roots and tubers (3) NoDark green leafy vegetables (>60 RAE) (4) YesOther vegetables (5) YesVitamin A rich fruits (>60 RAE) (6) NoOther fruits (7) YesOrgan meat (8) NoFlesh meat (9) NoEggs (10) NoFish (11) YesLegumes, nuts and seeds (12) YesMilk and milk products (13) NoOil and fats (14) Yes

Methodology - IDDS • Role play

• Open questions• Not suggestive• ALL ingredients (mixed meals -> ask!) • Probe for snacks, fruits and fluids• Bought items (check ingredients on market) • Analysing: food composition table for

categorisation into food groups (vitamin A rich vegetables and fruits)

Methodology - anthropometry

• Measuring nutritional status

Height Weight-Children <2: recumbent length -remove shoes, jackets-Children >2: standing height -child <2: with mother-Analysis: 0.7 cm (length child>2) -child >2: stand still

Methodology -measurements

• Analysing nutritional status– Use WHO reference population 2006– SPSS syntax (anthro+), epi info (low key, free)

Stunted <-2 Z-scores height-for-age

Severe stunted <-3 Z-scores height-for-age

Wasted <-2 Z-scores weight-for-height

Severe wasted <-3 Z-scores weight-for-height

Underweight <-2 Z-scores weight-for-age

Severe Underweight <-3 Z-scores weight-for-age

Results

• Children > 2 years of N2Africa participants have a more nutrient adequate diet

• Children < 2 years do not differ

Individual dietary diversity N2Africa subjects and non-N2Africa subjects

N2Africa Non-N2Africa

Outcome Unit N = 129 N = 202

IDDS, out of 14 food groups Mean (SD) 5.5 (1.9) 5.1 (1.8)*

children <2 years Mean (SD) 4.2 4.1

children 2 – 5 years Mean (SD) 6.1 (1.2) 5.6 (1.3)*

Minimum dietary diversity(7 groups, IDDS>=4, child< 2)

% (N) 62.5 (25) 56.0 (14)

*P<0.05 (Mann-Whitney U test);

Results

• N2Africa subjects consumed more: ‘White roots and tubers’, ‘Other fruits’, ‘Legumes, nuts & seeds’ and ‘Oils & fats’

Consumption of food groups

Results

N2Africa subjects and non-N2Africa subjects

• Long-term effect• Other causes of malnutrition

Nutritional status indicators

Overall Children <2 years

Non-N2Africa

villages

(n=202)

N2Africa

villages

(n=129)

Non-N2Africa

villages

(n=76)

N2Africa

villages

(n=40)

Characteristic % (N) % (N) % (N) % (N)

Stunting (length/height-for-age) 29.2 (59) 35.7 (46) 25.0 (19) 27.5 (11)

Wasting (weight-for-age) 10.9 (22) 6.2 (8) 23.7 (18) 17.5 (7)

Underweight (weight-for-height) 23.3 (47) 24.0 (31) 31.6 (24) 27.5 (11)

Conclusions

• Legume intake higher in N2Africa subjects

• N2Africa seems to increase the nutrient adequacy of the diet of children > 2 years, but not < 2 years

• No impact on nutritional status

• Involving nutrition from the beginning...- Target households with children under 5, adolescent girls

- Varieties of legumes high in iron, low in phytate(measure) - Collaborate with other projects (health, WASH)

- Nutritional value addition within value chain

Questions?

n2africa.tv/video/77717212