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Impact of a nutrition-sensitive agroecological intervention on anemia and diet diversity: Insights from the midline assessment of the Homestead Food Production (HSFP) in rural Andhra Pradesh, India

environmental-sciences
evidence-based-medicine
nutrition
public-health
healthcare-services

Abstract

Introduction

Homestead Food Production (HSFP) program, embedded within the Andhra Pradesh Community Managed Natural Farming (APCNF), aims to address the challenges of anemia and malnutrition through home-based cultivation of crops, nutrition counseling, and behavior change interventions. This study compares anemia prevalence and dietary diversity among different population groups in intervention (HSFP) and model mandal villages based on midline assessment data.

Methods

A cross-sectional midline assessment was conducted in 2024 across intervention and model mandal villages in Andhra Pradesh. A total of 23,749 individuals were included, with a focus on pregnant and lactating women, children under five, and adolescents. Hemoglobin levels were measured, and dietary diversity was assessed using the Dietary Quality Questionnaire, Non-Communicable Disease (NCD) Protect and Risk scores, and Infant and Young Child Feeding (IYCF) indicators.

Results

A sample of 23,749 participants (11,619 in intervention and 12,130 in model mandal/new villages) was included in the midline assessment. Among lactating women, anemia prevalence was 39% in the intervention group versus 61% in the model mandal group (p < 0.001). Similarly, among the poorest of the poor, anemia was lower in the intervention group (48% vs. 52%, p < 0.001). Pregnant women, children under five, and adolescents had similar reductions, with mean hemoglobin levels higher in the intervention group across all groups (p < 0.001). Similarly, severe and moderate anemia were lower in the intervention group than model group among all groups. The model mandal group had a higher Dietary Diversity Score (5.70 vs. 4.94) than the intervention group.

Conclusion

The midline assessment suggests that the Homestead Food Production led to significant reductions in anemia prevalence and severity, improved diet diversity, and IYCF practices.

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