A pre- post- evaluation of a nutrition and agriculture intervention in Meru Kenya: impact on food security, diet diversity, food production, frequency of recommended nutrition practices, and women's empowerment

Introduction: There is a lack of data on the effectiveness of multi-year combined nutrition and agriculture interventions on diet diversity (DD), food insecurity (FI), and nutrition practices. Objective: to compare DD, FI, frequency of implementation of recommended nutrition practices, food production and consumption between preintervention (2019) and post-intervention (2023) periods. Methods: A pre-post design was utilized, with women in the post intervention (PI) group (n=51) (2023) receiving agriculture resources and food-based nutrition education; women in the pre-intervention group (PRI) (n=67) (2019) had not yet received the intervention. Results: The proportion of women experiencing severe FI increased PI (p=0.0001) as did FI associated limitations in food quality (p<0.007). The proportion of women with adequate DD was higher PRI (80.6%) compared to PI (51.0%) ( p=0.0006). Mean diet diversity scores were lower PI (5.51 ± 1.4) compared to PRI (p<0.0001). More women who produced orange fleshed sweet potato and spinach PRI reported that they consumed these vegetables compared to those who didn't produce them (p< 0.003, p<0.0008, respectively). There was a significant association between the production and consumption of orange fleshed sweet potato (p<0.002) and eggs (p<0.007) PI. The proportion of women implementing recommended nutrition practices was higher PI (p<0.0001). Women post-intervention reported feeling more involved in their community and having more input on household farming decisions. Conclusion: Findings suggest that neither FI nor DD improved between PRI and PI, likely reflecting the prolonged drought associated with climate change. Although this limited the potential benefits of the intervention, the positive association between food production and consumption suggests positive effects.