Increasing household diet diversity and food security in rural Rwanda using small-scale nutrition-sensitive agriculture: A community-level proof of concept study

ObjectivesIn Rwanda, rates of malnutrition remain high in rural areas where residents consume a primarily starch-based, low variety diet. Nutrition-sensitive agricultural interventions using kitchen gardens have been effective in addressing low diet diversity in similar populations. This studys objective was to develop a kitchen garden and nutrition education intervention aimed at sustainably increasing diet diversity and food security at the household-level. DesignA mixed methods community-level study, with a sixteen-week nutrition-sensitive agricultural intervention including nutrition education was conducted. Household diet diversity scores and household hunger scores were calculated at baseline, post-intervention and one-year follow-up. SettingThe intervention was conducted in a rural Rwandan community in the Northern Province. ParticipantsStratified purposeful sampling techniques were used to select women participants representing forty-two households. ResultsHousehold diet diversity scores increased over time from pre-intervention to six months post-intervention and one-year post-intervention. The magnitude of the change was similar in all stratified groups (2.3x at 6 months and 2.9x at 1 year). Households whose main source of income was working for other farmers, reported a significantly lower diet diversity score than those households receiving income from sources [t(40) = -2.108, p=0.041]. Among those households not consuming protein and vitamin-A rich food groups at baseline, all reported consuming foods from these food groups post-intervention. There were no significant changes in household hunger scores. ConclusionsCollaborative community-based nutrition-sensitive agricultural interventions using kitchen gardens, can increase household diet diversity, which may encourage sustained change in dietary patterns for nutritional adequacy in low-income rural Rwandan populations.