Perceptions and experiences of an intervention to improve diets of women and young children in Ghana

Sandra B Kushitor; Claudia V Ewa; Ewurabena Q Dadzie; Veronica Quartey; Maxwell Amedi; Richard Okai; Michael Tia-Adjei; Richmond Nii Okai Aryeetey

doi:10.26596/wn.202415118-31

Sandra B Kushitor Ensign Global College https://orcid.org/0000-0002-0638-6261
Claudia V Ewa
Ewurabena Q Dadzie World Vision Ghana
Veronica Quartey Ghana Health Service
Maxwell Amedi World Vision Ghana https://orcid.org/0000-0001-7189-0774
Richard Okai World Vision Ghana
Michael Tia-Adjei World Vision Ghana
Richmond Nii Okai Aryeetey University of Ghana School of Public Health https://orcid.org/0000-0003-4667-592X

DOI: https://doi.org/10.26596/wn.202415118-31

Keywords: Nutrition-Sensitive Agriclture, OFSP, Micronutrient Powder, Ghana, Dietary Diversity, Caregivers, orange-fleshed sweet potato

Abstract

Background
Efficacious integrated intervention strategies to address the drivers of malnutrition at multiple levels are hardly implemented at scale, although opportunities for cross-sectoral action exist. In 2020, the Improved Feeding Practices (IFP) Project was implemented in Ghana to improve the dietary diversity and well-being of women of reproductive age (15-49 years) and children >2 years.
Objective
This paper reports the perceptions and experiences of project beneficiaries and the lessons learned from the IFP project.
Methods
Using a socio-ecological framework, data from the IFP project documents (n=8) and in-depth interviews with key stakeholders, including local government officers, and direct and indirect beneficiaries (n=61), were triangulated to construct an evidence-based overview of the implementation of the complementary strategies of the IFP project. The interviews explored respondents' knowledge, experiences of the project activities, and perceptions of how the project affected their lives. The data were analysed and synthesized thematically using ATLAS.ti.
Results
The IFP project envisaged an impact pathway through promoting community- or home-based nutrient-rich crop production and poultry to enhance diet quality, child care and feeding practices. Multi-sectoral partners facilitated training and service delivery at community, farm, facility, and household levels. Beneficiaries reported an overall positive experience of participating in the project, including enhanced dietary knowledge, capacity to produce and use eggs and orange fleshed sweet potatoes (OFSP), earned revenues, and access to nutritious foods. Caregivers reported that the IFP project contributed to enhancing children’s diet quality, reduced disease incidence, and improved child growth. Community-level program implementers experienced capacity strengthening. The dry season, increased poultry feed input prices, diseases (such as fowl pox, Newcastle and smallpox), and poultry deaths, limited the scale of benefits. Key implementation lessons include leveraging local resources to produce poultry feed at home, crossbreeding local and commercial poultry, and enhancing disease management, leading to improved potential for project sustainability.
Conclusions
Overall, the communities reported a positive experience of an integrated nutrition-sensitive agriculture (NSA) intervention, leading to improved diets of households, women of reproductive age, and young children >2 years. These strategies can be adapted for use in other to improve women's and children's dietary diversity in similar settings, giving due consideration to lessons learned.

Author Biographies

Sandra B Kushitor, Ensign Global College

Currently, Dr. Sandra Boatemaa Kushitor’s research focuses on three distinct, yet related areas of population health: population shifts (disease patterns and mortality, urbanization, dynamics of family change,); public health nutrition (nutrition-related non-communicable diseases (NCD), foodways, the nexus between food environment and health), and governance (food system governance, health system governance).

Dr. Kushitor is skillful in both qualitative and quantitative research methodology. Her recent work has transcended boundaries through the use of transdisciplinary research methods. Her publications have focused on NCD risk factors, hypertension prevalence, treatment and control, health system response to NCDs, and food system governance in Ghana, Eswatini, and South Africa. Her work has influenced food system innovations in the Oforikrom Municipality in Ghana and the Western Cape Province in South Africa through Transformation-labs and policy dialogues with public officials and market women.

Dr. Kushitor has worked as a project manager at the Department of Nutrition and Food Science, University of Ghana, and a postdoctoral fellow at the Food Security Initiative, Stellenbosch University, Stellenbosch, South Africa. Dr. Kushitor is currently a full-time lecturer at the Ensign College of Public Health. As a lecturer at Ensign, Sandra teaches, supervises, and mentors students enrolled in the Master of Public Health program.
Sandra contributes to community engagement through the projects she oversees. Findings from these community activities inform her teaching and vice versa.

Richmond Nii Okai Aryeetey, University of Ghana School of Public Health

Professor Richmond Aryeetey is a Public Health Nutrition Specialist and Head of the Population, Family, and Reproductive Health Department at the University of Ghana. He has been with the School of Public Health since 2007. He has a PhD in Human Nutrition from Iowa State University (Ames, USA) and both Master of Public Health and Bachelor of Public Health from the University of Ghana. His research focuses on Food systems and Nutrition policy, with emphasis on the diet and nutrition on infants and young children. He has extensive experience in conducting policy and field research related to optimizing infant and young feeding in various contexts in and outside Ghana. He teaches courses in Public Health Nutrition, Food Security and Malnutrition, Nutrition Rehabilitation and Nutrition Interventions. Professor Aryeetey is a Fellow of the Ghana Academy of Arts and Sciences. He is a Co-Chair of the Task Team for Ghana’s first Food-Based Dietary Guidelines. He is author of over 140 peer-reviewed journal articles and book chapters.