Can a Combined Agriculture and Nutrition Behaviour Change Intervention Improve Women’s Empowerment? A Mixed Methods Feasibility Study in Rural Bangladesh

Authors

• Elizabeth K. Kirkwood, The University of SydneyFollow
• Michael J. Dibley, University of Sydney
• Wajiha Khatun, Food and Agriculture Organisation, Bangladesh and University of Sydney
• Gulshan Ara, International Centre for Diarrhoeal Disease Research, Bangladesh
• Mansura Khanam, International Centre for Diarrhoeal Disease Research, Bangladesh
• Anowarul Bokshi, University of Sydney
• Mu Li, University of Sydney
• Neeloy Ashraful Alam, University of SydneyFollow

Abstract

Many agricultural and home gardening interventions aim to improve the nutritional status of women and children in low- and middle-income countries by focusing on women as the recipients of the intervention and make assumptions that women will be empowered as a result. This paper examines the potential impact of an intervention study that combined home garden training and support, and nutrition behaviour change communication, with a social safety net payment, on women’s empowerment in rural Bangladesh. We assessed the implementation of this study in terms of feasibility, acceptability, and practical application. Twenty in-depth interviews were conducted with randomly selected women that took part in the study. Qualitative data was coded using thematic analysis (Braun & Clarke 2006) and the results presented using the following five indicators: control over use of income, input into productive decisions, respect among household members, self-efficacy, and input into nutrition and health care decisions. Our study showed that a combined nutrition-specific (nutrition counselling) and nutrition-sensitive (agricultural training and unconditional cash transfer) intervention, delivered on a mobile platform, to women from low-income families in rural Bangladesh was feasible and acceptable. The study further revealed evidence on behaviour change across five key indicators related to women’s empowerment. The study highlights the potential for such an intervention to impact women’s empowerment and provides insight for the aid in the design of larger-scale trials implemented in similar settings.

Keywords

women’s empowerment, feasibility, nutrition-sensitive agriculture, behaviour change communication, mHealth, social safety net, qualitative methods, in-depth interviews

Author Bio(s)

Elizabeth Kirkwood (ORCID 0000-0001-8603-4903) is a Research Fellow at the Sydney School of Public Health at the University of Sydney. Her research aims to improve the health status of women and children in low- and middle-income countries, with a focus on understanding the intersection of gender and maternal and child health interventions. Her area of expertise lies in using a gender lens to assess interventions, from designing context and project specific tools to measuring programmatic impact of health interventions on women's empowerment. Please direct correspondence to elizabeth.kirkwood@sydney.edu.au.

Michael J Dibley (ORCID 0000-0002-1554-5180) is a Professor in Global Public Health Nutrition and an internationally renowned nutritional epidemiologist with major research outputs and translation over the past 30 years. Professor Dibley's contributions have illuminated the double burden of under and over-nutrition prevalent in many countries across the Asia-Pacific. He has also directed research assessing the magnitude of childhood and adolescent obesity, micronutrient deficiencies in women and children, infant and young child feeding practices, and a wide range of associated environmental, social, and behavioural risks factors and their effects on health in South and Southeast Asia and Africa.

Dr. Wajiha Khatun (ORCID 0000-0003-3650-561X) research interests include exploring the challenges and strategies to improve maternal nutrition among the poor in Bangladesh. Dr Khatun was a PhD student at the Sydney School of Public Health at the time of this study.

Gulshan Ara (ORCID 0000-0002-3745-5952) is an Associate Scientist in the Nutrition and Clinical Services Division at the International Centre for Diarrhoeal Disease Research, Bangladesh. Her research focuses on exploring the mechanisms underpinning maternal and childhood malnutrition, developing innovative interventions to prevent and treat these conditions, and evaluating the efficacy, feasibility, and scalability of new interventions.

Mansura Khanam (ORCID 0000-0001-7813-4242) is an Assistant Scientist in the Nutrition and Clinical Services Division at the International Centre for Diarrhoeal Disease Research, Bangladesh. Her research also focuses on exploring the mechanisms underpinning maternal and childhood malnutrition, developing innovative interventions to prevent and treat these conditions, and evaluating the efficacy, feasibility, and scalability of new interventions.

Dr. Anowarul Bokshi (ORCID 0000-0001-5248-8616) is a research associate at the University of Sydney with extensive experiences in the field of horticultural science while working on various projects funded by different horticultural and grain crop industries. His specialisation is postharvest management of horticultural produce for minimising their physical and nutritional losses, and supply chain management. Dr Bokshi is also playing an academic role in the higher degree research support activities mainly on plant physiology and biology, postharvest management of fruits and vegetables, and ornamental crops.

Mu Li (ORCID 0000-0002-2371-8950) is a Professor at the Sydney School of Public Health, the University of Sydney. Professor Li's main research contributions are in public health nutrition, particularly iodine deficiency and excess that are highly cited, and public health program evaluation. She has a strong track record in developing cross cultural and cross discipline research collaborations.

Associate Professor Neeloy Ashraful Alam (ORCID 0000-0001-7034-1095) is a health social scientist with expertise in integrating qualitative studies within randomized trials to improve their design, conduct and interpretation. His current projects include implementation research in maternal, child and adolescent nutrition in South/Southeast Asia and Africa. A/Prof Alam has expertise in nutrition-sensitive agriculture and social safety net interventions.

Acknowledgements

Acknowledgments: This research is part of the research generated by the Leveraging Agriculture for Nutrition in South Asia Research (LANSA) research consortium under a Responsive Window Grant and is funded by UK aid from the UK government. The views expressed do not necessarily reflect the UK Government’s official policies. We are grateful to our research partners—icddr,b and BARI—for their support. We acknowledge the valuable contribution of Solidarity Kurigram, our local implementation partner. Robyn McConchie at the University of Sydney School of Life and Environmental Sciences contributed to development of the grant. Above all, we are grateful to all study participants for their valuable time. Conflicts of Interest: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Publication Date

12-21-2022

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 International License.

Recommended APA Citation

Kirkwood, E. K., Dibley, M. J., Khatun, W., Ara, G., Khanam, M., Bokshi, A., Li, M., & Ashraful Alam, N. (2022). Can a Combined Agriculture and Nutrition Behaviour Change Intervention Improve Women’s Empowerment? A Mixed Methods Feasibility Study in Rural Bangladesh. The Qualitative Report, 27(12), 2905-2922. DOI: https://doi.org/10.46743/2160-3715/2022.5716

ORCID ID

0000-0001-8603-4903