Kirimi Sindi

Health and nutrition knowledge, attitudes and practices of pregnant women attending and not-attending ANC clinics in Western Kenya: a cross-sectional analysis

BackgroundAntenatal care (ANC) is a key strategy to decreasing maternal mortality in low-resource settings. ANC clinics provide resources to improve nutrition and health knowledge and promote preventive health practices. We sought to compare the knowledge, attitude and practices (KAP) among women seeking and not-seeking ANC in rural Kenya.MethodsData from a community-based cross-sectional survey conducted in Western Province, Kenya were used. Nutrition knowledge (NKS), health knowledge (HKS), attitude score (AS), and dietary diversity score (DDS) were constructed indices. χ2 test and Student’s t-test were used to compare proportions and means, respectively, to assess the difference in KAP among pregnant women attending and not-attending ANC clinics. Multiple regression analyses were used to assess the impact of the number of ANC visits (none, <4, ≥4) on knowledge and practice scores, adjusting for maternal socio-demographic confounders, such as age, gestational age, education level and household wealth index.ResultsAmong the 979 pregnant women in the survey, 59% had attended ANC clinics while 39% had not. The mean (±SD) NKS was 4.6 (1.9) out of 11, HKS was 6.2 (1.7) out of 12, DDS was 4.9 (1.4) out of 12, and AS was 7.4 (2.2) out of 10. Nutrition knowledge, attitudes, and DDS were not significantly different between ANC clinic attending and non-attending women. Among women who attended ANC clinics, 82.6% received malaria and/or antihelmintic treatment, compared to 29.6% of ANC clinic non-attendees. Higher number of ANC clinic visits and higher maternal education level were significantly positively associated with maternal health knowledge.ConclusionsSubstantial opportunities exist for antenatal KAP improvement among women in Western Kenya, some of which could occur with greater ANC attendance. Further research is needed to understand multi-level factors that may affect maternal knowledge and practices.

Sweetpotato Seed Systems in Uganda, Tanzania, and Rwanda

Surveys were made of the seed systems used in Uganda, Tanzania, and Rwanda and to investigate the reasons underlying them. Along the equator in Uganda, where rainy seasons are evenly spaced and occur twice a year, vine cuttings from mature plants only are used as planting material. Where there is a long dry season, the seed system includes a diversity of means of conservation: the passive production of volunteer plants from groundkeeper roots sprouting when the rains come; small-scale propagation of plants in the shade or backyard production using waste domestic water; and relatively large-scale propagation in wetlands or irrigated land. The last is the only means of obtaining sufficient quantity for sales, but is also the most expensive. Volunteers only produce planting material one or two months after the start of the rains and tend to be regarded as common property; nevertheless, they are an important source of planting material for poorer farmers. Although farmers perceive multiple benefits from planting early, planting material is in short supply at the beginning of the rains and mainly larger scale farmers gain these benefits. Farmers select carefully to avoid using plants with symptoms of virus disease as planting material and may also remove any diseased plants from crops.

Planning an integrated agriculture and health program and designing its evaluation: Experience from Western Kenya

Highlights • Complex, integrated development programs present planning and evaluation challenges and opportunities.• Multiple evaluation components are needed to respond to different disciplinary cultures of evidence in cross-sectoral programs.• Delineating impact pathways helps visualize cross-sectoral outcomes and guides implementation monitoring.• Feedback meetings are critical to build understanding across sectors and problem-solve in real time.

Effect of technology awareness and access on the conservation of clean planting materials of vegetatively produced crops: The case of sweetpotato.

Efforts to combat vitamin A deficiency in children and pregnant mothers have focused on promotion of nutritionally enhanced food security crops. Such efforts have recently targeted the production and consumption of these crops. The orange-fleshed sweetpotato (OFSP) is one of the most known nutritionally enhanced crops. However, access to quality planting materials of OFSP and most vegetatively propagated crops by farmers remains a major constraint. This study used discrete and count data regression models and data collected from 732 farm households in Tanzania to test the effect of participation on a project designed to break this quality “seed” bottleneck (via technology awareness and targeted access to clean planting materials) on a) the decision to conserve planting materials during dry periods for future planting and b) the number of conservation strategies used by farmers. The study found that participation in such a project increases both the likelihood of conserving quality planting materials and also the number of conservation strategies employed by the farmers. It also found that varietal attributes and the agroecology of the area affect conservation of OFSP planting materials. It concludes that awareness and access to clean sweetpotato planting materials of nutritionally enhanced crops promote farmers’ conservation of own planting materials. The study discusses the policy implications of the findings.

Specialised sweetpotato vine multiplication in Lake Zone, Tanzania: What “sticks” and what changes?.

Abstract In Lake Zone, Tanzania, farmers were trained to multiply and distribute quality sweetpotato planting material. The objectives of this study were to assess changes in skills and practices among the trained farmers as vine multiplication became a specialized task. Nine months after the project ended, all 88 decentralized vine multipliers (DVMs) operating as groups (72%) or individuals (28%) were visited and qualitative data on their current multiplication practices collected through a questionnaire, checklists and observations. Results showed that 69% of DVMs were still multiplying vines, but less than half were using the seed production technologies promoted by the project. 34% used rapid multiplication beds; 61% used conventional plant spacing on ridges for roots and vines and 5% used both. As the vine multiplication cycle became a specialised activity, the multiplication and root production cycles were separated. Vines were treated differently in terms of site selection, length of cutting and spacing, depending on whether the objective of their use was for high root or high vine production. Capacity building of specialised vine multipliers and scaling-up seed interventions should consider the implications of skilling and task segregation in a broader context based on society’s choice of technologies and agrarian change.

The dynamics of smallholder farmers’ acquisition and distribution of sweetpotato vines in the Lake Victoria Zone Region, Tanzania

This paper offers new insights into smallholder farmer’s practices regarding acquisition and distribution of sweetpotato planting material in the Mwanza and Mara regions of Tanzania by examining three specific issues: (i) farmers’ sources of planting material; (ii) factors that influence farmers’ sourcing of planting materials outside their own farms and (iii) the types of transactions and social relations involved in farmers’ acquisition and distribution of sweetpotato planting material. Data were collected using mixed methods, including a survey of 621 households across nine districts, semi-structured key informant interviews with 28 women sweetpotato farmers, and six focus group discussions. Findings show that farmers in the study area rely almost exclusively on informal seed systems, and that the majority (> 56%) produce their own planting material. Individual, household and community level factors influence farmers’ acquisition of planting materials outside their own farms. The sources and mode of transaction related to acquisition/distribution of planting material are strongly influenced by the type of social relationship between the parties involved. Strong social ties facilitate the majority of local planting material acquisitions/distributions, and favor provision of locally available planting material as a gift/without payment. Weak social ties are primarily associated with the transaction modality of purchase/sale, and frequently help facilitate acquisition of new or exotic planting material. The findings provide entry points both for entities that seek to enhance small-scale farmers’ access to improved, high quality sweetpotato germplasm, as well as broader efforts to strengthen research and development strategies for integrating formal and informal seed systems.

A Study of Household Food security and Adoption of Biofortified Crop Varieties in Tanzania: The Case of Orange- Fleshed Sweetpotato

Food insecurity has become a key issue in the field of development in recent years with major inadequate intake of vitamin A-rich foods. Specifically, vitamin A deficiency (VAD) remains a major health problem among poor developing-country households, especially in Africa. Efforts to combat VAD currently focuses on food-based approach that entails breeding for crops that are rich in beta carotene, a precursor for Vitamin A. Success has been registered in sweetpotato, cassava and maize. Among these crops, the greatest effort has gone into promoting the production and consumption of orange-fleshed sweetpotato (OFSP). These efforts include sensitization of farmers on the nutritional benefits of OFSP and the provision of clean sweetpotato planting materials. This study used a rich dataset collected from 732 farm households in Tanzania to assess of effect of household food insecurity and benefit awareness on the adoption of OFSP varieties. The study found that the household food security and awareness of the benefit of OFSP affect the decision to adopt OFSP varieties. It also found evidence that agroecology and farmer endowment with financial and physical assets affect the decision to grow OFSP varieties. It discusses lessons and policy implications of the findings for other countries.

Effect of Farmers’ Multidimensional Beliefs on Adoption of Biofortified Crops: Evidence from Sweetpotato Farmers in Tanzania

Abstract We examined the effect of multidimensional farmers’ beliefs on the likelihood of cultivating planting materials of biofortified orange-fleshed sweetpotato (OFSP) varieties. Using a panel dataset and combining difference-in-differences regression with propensity score matching, results showed positive effects of beliefs related to health benefits, yielding ability, sweetness, disease-resistance, storability, early maturity, colour, and that children enjoy eating OFSP roots, on cultivation of OFSP varieties. The proportion of OFSP roots out of total sweetpotato production for a household increased among farmers’ who held these beliefs. Efforts to promote biofortified crops can, therefore, benefit from taking farmers’ multidimensional beliefs into consideration.