Spatial farming systems diversity and micronutrient intakes of rural children in Ethiopia

Seasonality and nutrition-sensitive farming in rural Northern Ghana

In rural sub-Saharan Africa, where malnutrition in all its forms is rife, the greatest gap between the availability of foods and the foods needed for a nutritious diet are faced during the ‘hunger season’. We investigated what rural households in Northern Ghana would need to grow to ensure year-round availability of a nutrient adequate diet or the income required to fulfil their dietary needs. We applied linear programming to model different scenarios and interventions. Our results provide three major insights. First, considering seasonality is crucial in nutrition-sensitive farming. Ensuring a nutritious diet year-round requires enhanced availability of vegetables and fruits throughout the year. Second, although staple crops do not provide the full range of essential nutrients, increasing their yields allows for a reduction of field size, freeing up space for the production of other foods belonging to a nutritious diet, such as vegetables. Third, small farms are unable to produce sufficient food to cover their needs. They depend on income both from agriculture and other sources, and the availability of types of foods on markets to meet their dietary needs. Our study shows the value of modelling the range of dietary effects from agricultural interventions in a specific context, using a local feasible nutritious diet as a starting point and taking seasonality into account.

Calculator for inadequate micronutrient intake for Ethiopia (CIMI‐Ethiopia): Validation of the software for lactating mothers and their children under 2 years

Early identification of inadequate intake of nutrients from a person's diet is usually crucial to prevent the development of micronutrient malnutrition. However, there is no single dietary assessment tool for Ethiopia that can assess the nutrient intake of a person from the type of food she or he consumed with a given amount. Therefore, the Calculator for Inadequate Micronutrient Intake (CIMI) application was adapted in consideration of food and nutrition contexts in Ethiopia and validated for its suitability to compute nutrient intake and identify nutrient intake inadequacy. For this, a 24‐h recall quantitative dietary data of children aged 12–23 months (n = 781) and lactating mothers (n = 1086) were collected between February 15 and 30, 2017, from rural Genta Afeshum district, Tigray region, Ethiopia. An individual nutrient intake was estimated by calculating using CIMI‐Ethiopia and also by NutriSurvey (NS) software for comparison. The average (mean and median) intake of energy and most nutrients and the prevalence of inadequacy calculated by the two software for the children aged 12–23 months and lactating mothers were comparable, except that of the vitamin A. The correlation coefficients for the intake results calculated by CIMI‐Ethiopia and NS were between 0.85 and 0.97 for the children and between 0.5 and 0.96 for the lactating mothers' group. Most of the mean intake differences calculated by the two methods were within the acceptable limits, except for the vitamins A, D, and B12 in the Bland–Altman plots. CIMI‐Ethiopia is very sensitive to identifying energy, protein, and selected micronutrients inadequacy included in this study, both for the lactating mothers (84.1%–100%) and 12–23‐month‐old children (77.6%–100%) group. Our results showed that CIMI‐Ethiopia estimates the energy and nutrient intake, and can be also used as a screening tool to identify energy, protein, and selected micronutrients inadequacy from an individual woman's and child's diet in rural Tigray, Ethiopia.

Folate Deficiency Is Spatially Dependent and Associated with Local Farming Systems among Women in Ethiopia

Background

Folate is essential for the synthesis and integrity of DNA, normal cell formation, and body growth. Folate deficiency among women of reproductive age (WRA) increases the risk of poor birth outcomes including neural tube defect (NTD)-affected pregnancies. Folate status is largely dependent on dietary intakes.

Objectives

We aimed to explore the spatial distribution of biomarkers of folate status and their association with farming systems among nonpregnant WRA in Ethiopia.

Methods

Serum and RBC folate concentration data were derived from the Ethiopia National Micronutrient Survey of 2015. The spatial dependencies of folate concentration of WRA were investigated and its relation with the dominant local farming system was explored.

Results

The median serum folate and RBC folate concentrations were 12.3 nmol/L and 567.3 nmol/L, respectively. The national prevalence of folate deficiency using homocysteine concentration as a metabolic indicator based on serum and RBC folate concentration was 11.6% and 5.7%, respectively. The majority of women (77.9%) had low RBC folate concentrations consistent with increased risk of NTD-affected pregnancies. Folate nutrition was spatially dependent at distances of ≤ 300 km. A marked variability in folate concentration was observed between farming systems: greater RBC folate concentration (median: 1036 nmol/L) was found among women from the Lake Tana fish-based system, whereas the lowest RBC folate concentration (median: 386.7 nmol/L) was observed in the highland sorghum chat mixed system.

Conclusions

The majority (78%) of WRA in Ethiopia had low folate status potentially increasing the risk of NTD-affected pregnancies. These findings may help national and subnational nutrition intervention strategies to target the most affected areas in the country.