"Men Are in Front at Eating Time, but Not When It Comes to Rearing the Chicken": Unpacking the Gendered Benefits and Costs of Livestock Ownership in Kenya

Women's input and decision-making in agriculture are associated with diet quality in rural Tanzania

Background

Women's empowerment is one critical pathway through which agriculture can impact women's nutrition; however, empirical evidence is still limited. We evaluated the associations of women's participation, input, and decision-making in key agricultural and household activities with women's diet quality.

Methods

We analyzed data from a cross-sectional study of 870 women engaged in homestead agriculture. We used food frequency questionnaires to assess women's diets and computed women's diet quality using the Prime Diet Quality Score (PDQS) (range 0-42), which captures healthy and unhealthy foods. We evaluated women's decision-making in 8 activities, food crop farming, cash crop farming, livestock raising, non-farm economic activities, wage/salary employment, fishing, major household expenditures, and minor household expenditures. Generalized estimating equations (GEE) linear models were used to evaluate associations between (a) women's participation, (b) decision-making, (c) adequate input, (d) adequate extent of independence in decision-making in agriculture, and (e) adequate input in use of agricultural income with their PDQS. Adequate input was defined as input into some, most or all decisions compared to input into few decisions or none. Adequate extent of independence was defined as input to a medium or high extent compared to input to a small extent or none.

Findings

Median PDQS was 19 (IQR: 16-21). Women's adequate input in decision-making on wage and salary employment (estimate: 4.19, 95% CI: 2.80, 5.57) and minor expenditures were associated with higher PDQS vs. inadequate input. Women with independence in decision-making on livestock production (estimate: 0.97, 95% CI: 0.05, 1.90) and minor household expenditures, and women with adequate decision-making in the use of income from wages/salaries (estimate: 3.16, 95% CI: 2.44, 3.87) had higher PDQS. Participation in agricultural activities was positively associated with PDQS.

Conclusions

Women's participation and input in decision-making in wage and salary employment, livestock production, and minor household expenditures were strongly associated with the consumption of better-quality diets. Women participating in multiple farm activities were also likely to have better diet quality. This study adds to the growing evidence on the pathways through which women's empowerment may influence women's nutrition in rural Tanzania.

Contribution of Village Chickens in Sustainable and Healthy Food Systems for Children along a Rural-Urban Gradient: A Systematic Review

Achieving sustainable and healthy food systems in support of human and planetary health is a global challenge. We systematically reviewed papers (n = 2322) showing how village chicken products (meat, eggs, and offal) contribute to sustainable and healthy food systems for children along a rural-urban gradient. A total of 72 articles, representing all different sections covered in this review, were finally included. Production of village chickens contributed positively on livestock-derived food consumption by children. Households who owned chickens were likely to move from medium to high dietary diversity. Children from households that owned chickens had lower odds of anemia (1.07) and higher height-for-age (HAZ) and weight-for-age (WAZ) scores. Egg intervention increased HAZ and WAZ for children by 0.63 [95% confidence interval (CI), 0.38-0.88] and 0.61 [95% CI, 0.45-0.77], respectively. Village chicken ownership had positive effect on children's poultry meat and egg consumption. Per capita consumption of chicken by girls and boys combined was 38.2 g/day, where girls had 36.9 g/day and boys had 39.4 g/day. Children from households that owned chickens consumed eggs 2.8 more times per week compared to children from households without chickens. Moving along a rural-urban gradient, village chicken production was less common. Improved production and quality of village chicken products, and policies supporting optimal maternal and child intake these products are required.

The impact of livestock interventions on nutritional outcomes of children younger than 5 years old and women in Africa: a systematic review and meta-analysis

Background

Nutrition-sensitive livestock interventions have the potential to improve the nutrition of communities that are dependent on livestock for their livelihoods by increasing the availability and access to animal-source foods. These interventions can also boost household income, improving purchasing power for other foods, as well as enhance determinants of health. However, there is a lack of synthesized empirical evidence of the impact and effect of livestock interventions on diets and human nutritional status in Africa.

Objective

To review evidence of the effectiveness of nutrition-sensitive livestock interventions in improving diets and nutritional status in children younger than 5 years old and in pregnant and lactating women.

Methods

Following PRISMA guidelines, we conducted a systematic review and meta-analysis of published studies reporting on the effect of livestock interventions on maternal and child nutrition in Africa. Data were extracted, synthesized, and summarized qualitatively. Key outcomes were presented in summary tables alongside a narrative summary. Estimation of pooled effects was undertaken for experimental studies with nutritional outcomes of consumption of animal-source foods (ASFs) and minimum dietary diversity (MDD). Fixed effects regression models and pooled effect sizes were computed and reported as odds ratios (ORs) together with their 95% confidence intervals (CI).

Results

After the screening, 29 research papers were included in the review, and of these, only 4 were included in the meta-analysis. We found that nutrition-sensitive livestock interventions have a significant positive impact on the consumption of ASFs for children < 5 years (OR = 5.39; 95% CI: 4.43-6.56) and on the likelihood of meeting minimum dietary diversity (OR = 1.89; 95% CI: 1.51-2.37). Additionally, the impact of livestock interventions on stunting, wasting, and being underweight varied depending on the type of intervention and duration of the program/intervention implementation. Therefore, because of this heterogeneity in reporting metrics, the pooled estimates could not be computed.

Conclusion

Nutrition-sensitive livestock interventions showed a positive effect in increasing the consumption of ASFs, leading to improved dietary diversity. However, the quality of the evidence is low, and therefore, more randomized controlled studies with consistent and similar reporting metrics are needed to increase the evidence base on how nutrition-sensitive livestock interventions affect child growth outcomes.

Gender-Responsive Design of Bacteriophage Products to Enhance Adoption by Chicken Keepers in Kenya

Women and men keeping chickens in Kenya aspire to have a source of income, feed their families healthy food, and grow their businesses. Managing animal diseases and minimizing input costs enable their success. This study uses qualitative methods to recommend design opportunities for a veterinary product under development in Kenya that contains bacteriophages (phages) that target pathogenic Salmonella strains responsible for fowl typhoid, salmonellosis, and pullorum in chickens and foodborne illness in people. Our findings revealed the interplay between gender and two production systems: free-range and semi-intensive. Chicken keepers in both systems could benefit from phages combined with the orally administered Newcastle disease vaccine, one of the most commonly used preventive veterinary interventions, or phages as a treatment for fowl typhoid. Oral administration is less labor intensive, with greater benefits for women who have less control over family labor and reported doing more care tasks themselves. Men in free-range systems usually pay for veterinary inputs. In semi-intensive production systems, a phage-based product used prophylactically could be an alternative to expensive, intramuscular fowl typhoid vaccines. Keeping layers was common for women in semi-intensive systems, as they are more economically impacted by reduced laying caused by bacterial diseases. Awareness of zoonoses was low, but men and women were concerned about the negative health effects of drug residues in meat and eggs. Therefore, highlighting the lack of a withdrawal period for a phage product may appeal to customers. Antibiotics are used to both treat and prevent diseases, and phage products will need to do both to compete in the Kenyan market. These findings guide the ongoing design of a phage-based product with the goal of introducing a new veterinary product that meets the diverse needs of chicken keepers in Africa and serves as an alternative or complement to antibiotics.

The value of donkeys to livelihood provision in northern Ghana

Increased demand for the supply of donkey hides for use in the Traditional Chinese Medicine e'jiao, is leading to a re-appraisal of donkeys' contributions to livelihoods across the world. This research aimed to understand the utilitarian value donkeys provide to poor small holder farmers, especially women, in their efforts to make a living in two rural communities in northern Ghana. Uniquely, children and donkey butchers were interviewed for the first time about their donkeys. A qualitative thematic analysis was undertaken of data disaggregated by sex, age and donkey-ownership. The majority of protocols were repeated during a second visit, ensuring comparative data between one wet, and one dry season. Donkeys are more important in people's lives than had previously been recognised and are highly valued by their owners for their help in reducing drudgery and the multi-functional services they offer. Hiring out donkeys to generate income is a secondary role for people who own donkeys, especially women. However, for financial and cultural reasons the way donkeys are kept results in the loss of a certain percentage of the animals to the donkey meat market, as well as the global hides trade. Increasing demand for donkey meat, coupled with increasing demand for donkeys for farming, is leading to donkey price inflation and theft of donkeys. This is putting pressure on the donkey population of neighbouring Burkina Faso and pricing resource-poor non-donkey owners out of the market. E'jiao has put the spotlight on the value of dead donkeys for the first time, especially to governments and middlemen. This study shows that the value of live donkeys to poor farming households is substantial. It attempts to understand and document this value thoroughly, should the majority of donkeys in West Africa be rounded up and slaughtered for the value of their meat and skin instead.

Female-friendly toilets in schools in Burkina Faso: A mixed-methods study using photo-elicitation

Background

An absence of gender-sensitive sanitation facilities in schools and the negative effects this has on girls has been widely discussed among advocacy groups, though less examined in academic spheres. Drawing on triangulated data, we outline current challenges and respondent-driven solutions to enhance the female-friendly nature of toilets in a context of extreme poverty.

Methods

This mixed-methods study was informed by the tenets of human-centred design. We first quantitatively assessed facilities in 14 secondary schools in the Kossi Province of Burkina Faso. We then collected qualitative data, including 15 focus group discussions and 53 in-depth interviews among schoolgirls, mothers, teachers and key informants. We applied photo-elicitation, a novel method, to explore perceptions of facilities and the desirability and feasibility of interventions to improve gender-friendly sanitation facilities.

Results

No school met international water, sanitation and hygiene (WASH) standards for schools. Roughly one third of schools did not have water and, when present, there was no reliable way to use it within the toilet complex. Schoolgirls shared feelings of shame and stress when menstruating at school, and said that they would avoid using school toilets, if possible. Schoolgirls described water access as the most urgent need to address, followed by fostering privacy and facilitating cleanliness within facilities. Mothers and teachers mostly aligned with these priorities, while key informants additionally emphasised the need to raise awareness on both general and menstrual hygiene and to develop maintenance systems. Photo-elicitation engaged and empowered participants to pinpoint priorities and concrete solutions, namely a need for doors and locks, water containers and cleaning materials.

Conclusions

WASH needs in many schools remain unmet. Women and girls should be involved in decision-making across stages of intervention design and implementation. Young women's voices merit greater inclusion in academic literature. Future interventions should enhance access to water and privacy. Future research could explore maintenance and monitoring strategies to develop guidance on sustainable solutions.

Understanding how food safety risk perception influences dietary decision making among women in Phenom Phnom Penh, Cambodia: a qualitative study

OBJECTIVES

To determine women's perception of the risk of food safety and how it relates to diet, health and decision making as part of formative research for a market-based intervention that aims to improve the safety of animal-source foods sold in informal markets.

DESIGN

Qualitative study including in-depth personal interviews with 24 caregivers were conducted and complemented with a second follow-up PhotoVoice interview, which allowed the women to photograph their meals and perceptions of food safety and nutrition. Interview data were analysed using thematic analysis in MAXQDA. Participants were purposively sampled from a larger Safe Food, Fair Food for Cambodia study, conducted from May to August 2018.

SETTING

Urban and periurban neighborhoods of Phnom Penh, Cambodia.

PARTICIPANTS

24 female caregivers (mothers and grandmothers) of children under age 5, each interviewed twice.

FINDINGS

A primary food safety concern expressed was that chemicals (pesticides and other agricultural additives) in animal-source foods, fruits and vegetables may impact the health of their families by causing diarrhoea and problems during pregnancy. This fear created a lack of trust in markets, which influenced their food purchasing behaviours and strategies for making the food safer for their families. These mitigation strategies, including food selection and cleaning, vary among the women but are perceived as important to be able to provide their families with what they define as safe meals.

CONCLUSIONS

Interventions that wish to decrease rates of foodborne illness and increase animal source food consumption should also address the belief that the food system has been compromised by the addition of pesticides and agricultural additives.

Livestock Innovations, Social Norms, and Women’s Empowerment in the Global South

Livestock have strong empowerment potential, particularly for women. They offer millions of women in the Global South the opportunity to provide protein-rich foods for home consumption and sale. Livestock provide women with income and opportunities to expand their livelihood portfolios and can strengthen women’s decision-making power. Fully realizing livestock’s empowerment potential for women is necessary for sustainable livestock development. It requires, though, that gender-equitable dynamics and norms are supported in rural communities. We draw on 73 village cases from 13 countries to explore women’s experiences with livestock-based livelihoods and technological innovations. Our analysis follows a gender empowerment framework comprised of four interdependent domains—recognition of women as livestock keepers, access to resources, access to opportunities, and decision making as a cross-cutting domain—which must come together if women are to become empowered through livestock. We find improved livestock breeds and associated innovations, such as fodder choppers or training, to provide significant benefits to women who can access these. This, nonetheless, has accentuated women’s double burdens. Another challenge is that even as women may be recognized in their community as livestock keepers, this recognition is much less common among external institutions. We present a case where this institutional recognition is forthcoming and illuminate the synergetic and empowering pathways unleashed by this as well as the barriers that remain.

Donkey Ownership Provides a Range of Income Benefits to the Livelihoods of Rural Households in Northern Ghana

Simple Summary

Until recently, the important contributions donkeys make to the daily lives of millions of people around the world have been overlooked. Global donkey populations are under threat from increasing demand for their skins, a key ingredient in a traditional Chinese medicine called e’jiao. The aim of this research was to study the role of donkeys in rural households in northern Ghana. We wanted to know how donkeys support families in making a living, especially their use by women and children. We found that donkeys are highly valued by their owners. Donkeys help reduce the hard physical work of many farming and domestic activities and can also be rented out to generate income. There are actually more methods available to earn money from the family donkey than previously known. Females from donkey-owning households advised us that their donkey can provide between 30–60% of their total income. Children can also play a key role accompanying their donkey when it is hired out for cash. Donkeys are certainly important to their owners, who describe them as priceless. This research adds to our understanding of the impact of the e’jiao industry, by detailing the considerable value of live donkeys to poor farming households.

Abstract

Donkeys provide important resources and benefits for millions of people worldwide. However, global donkey populations are under increasing pressure from the growing demand for a traditional Chinese medicine, e’jiao, made from donkey-skin. The objective of this reflexive, qualitative thematic analysis was to examine the role of donkeys with 262 participants in northern Ghana and how donkeys contribute to livelihood outcomes, especially their use by women and children. Data were collected from four surveys, 12 in-depth interviews and 84 daily time budgets with the same participants, plus 16 focus groups, during one wet and one dry season across 2018-19. Uniquely, boys and girls between the ages of 10–16-years old were interviewed. Donkeys are highly valued by their owners as they play a valuable role in providing a pathway out of ultra-poverty. Donkeys’ contributions to livelihoods are significant and more complex than previously understood and documented in the literature. Donkey ownership confers up to six different income benefits in comparison to non-donkey owners. Female owners of donkeys reported that donkeys can contribute between 30–60% of their income. Children of both sexes can play an important role in the efficient deployment of one of these income generating activities.

Benefits and Risks of Smallholder Livestock Production on Child Nutrition in Low- and Middle-Income Countries

Livestock production may improve nutritional outcomes of pregnant women and children by increasing household income, availability of nutrient-dense foods, and women's empowerment. Nevertheless, the relationship is complex, and the nutritional status of children may be impaired by presence of or proximity to livestock and their pathogens. In this paper, we review the benefits and risks of livestock production on child nutrition. Evidence supports the nutritional benefits of livestock farming through income, production, and women's empowerment. Increasing animal source food consumption requires a combination of efforts, including improved animal management so that herd size is adequate to meet household income needs and consumption and addressing sociocultural and gendered norms. Evidence supports the inclusion of behavior change communication strategies into livestock production interventions to facilitate the sustainability of nutritional benefits over time, particularly interventions that engage women and foster dimensions of women's empowerment. In evaluating the risks of livestock production, evidence indicates that a broad range of enteric pathogens may chronically infect the intestines of children and, in combination with dietary deficits, may cause environmental enteric dysfunction (EED), a chronic inflammation of the gut. Some of the most important pathogens associated with EED are zoonotic in nature with livestock as their main reservoir. Very few studies have aimed to understand which livestock species contribute most to colonization with these pathogens, or how to reduce transmission. Control at the point of exposure has been investigated in a few studies, but much less effort has been spent on improving animal husbandry practices, which may have additional benefits. There is an urgent need for dedicated and long-term research to understand which livestock species contribute most to exposure of young children to zoonotic enteric pathogens, to test the potential of a wide range of intervention methods, to assess their effectiveness in randomized trials, and to assure their broad adaptation and sustainability. This review highlights the benefits and risks of livestock production on child nutrition. In addition to identifying research gaps, findings support inclusion of poor gut health as an immediate determinant of child undernutrition, expanding the established UNICEF framework which includes only inadequate diet and disease.

Biosecurity and Antimicrobial Use Practices in Live Bird Markets within Abeokuta Metropolis, Southwest, Nigeria: A Preliminary Survey

The development of an antimicrobial stewardship plan (AMSP) for live bird sellers (LBS) requires an understanding of the current biosecurity status, antimicrobial use (AMU) and the practices involved in live bird selling (e.g., drivers, sellers, etc.) which is a direct source of poultry meat for human consumption. Seven Live Bird Markets (LBMs) within Abeokuta, Ogun State were surveyed using a semi-structured questionnaire. Data on LBMs characteristics, LBS demographics, biosecurity, and AMU practices, awareness on Antimicrobial Resistance (AMR), as well as preferred channels of information on antimicrobial stewardship were gathered. A total of 40 consenting LBS with 82.5% female and 17.5% male participants were included in the study. The participants’ mean age was 45.3 years (SD±11.9, range: 23-70 years). Laying hens, broilers, and cockerels were the main poultry types sold by LBS. Antimicrobials (AMs) were used for growth promotion (57.5%), therapeutic (40.0%), and prophylactic (2.5%) purposes. Tetracycline, metronidazole, and chloramphenicol were the most frequently used AMs. The majority of the participants (90.0%) have treated birds based on their empirical experience, with little or no inputs from veterinarians. Biosecurity and AMU practices were generally low (54.0% and 34.0%, respectively). The contact with veterinarians was associated with satisfactory biosecurity practices (p=0.049). No significant factors were found to be linked with AMU. This study has provided recent evidence-based data on practices in poultry management among LBS in Abeokuta, Ogun state. The findings would be useful for policy decisions and the development of AMSP on prudent AMU among LBS.

A Systematic Scoping Review of the Impacts of Community Food Production Initiatives in Kenya, Cameroon, and South Africa

BACKGROUND

Even before the COVID-19 pandemic, one in two people in Africa were food insecure. The burden of malnutrition remains high (e.g. childhood stunting, anaemia in women of reproductive age) or are increasing (e.g. overweight and obesity). A range of coordinated actions are required to improve this situation, including increasing local food production and consumption. The aim of this review was to provide a systematic and comprehensive overview of recently published research into the health, social, economic, and environmental impacts of community food production initiatives (CFPIs) in Kenya, Cameroon and South Africa.

METHODS

We searched eight electronic databases covering health, social, environmental, economic and agricultural sciences. Primary research studies published from 1 January 2014 to 31 December 2018 were considered. Data on geographic location, study design, type of CFPI and the impacts assessed were abstracted from eligible articles.

FINDINGS

We identified 4828 articles, 260 of which required full-text review and 118 met our eligibility criteria. Most research was conducted in Kenya (53.4%) and South Africa (38.1%). The categories of CFPIs studied were (in order of decreasing frequency): crop farming, livestock farming, unspecified farming, fisheries, home / school gardens, urban agriculture, and agroforestry. The largest number of studies were on the economic and environmental impacts of CFPIs, followed by their health and social impacts. The health impacts investigated included food security, nutrition status and dietary intake. One study investigated the potential impact of CFPIs on non-communicable diseases. Over 60% of studies investigated a single category of impact. Not one of the studies explicitly used a theoretical framework to guide its design or interpretation.

CONCLUSIONS

Our findings on research studies of CFPIs suggest the need for a greater focus on interdisciplinary research in order to improve understanding of the relationships between their health, environmental, economic, and social impacts. Greater use of explicit theoretical frameworks could assist in research design and interpretation, helping to ensure its relevance to informing coordinated intersectoral interventions and policy initiatives.

Exploring the Influence of Social Norms on Complementary Feeding: A Scoping Review of Observational, Intervention, and Effectiveness Studies

The influence of social norms on child feeding is recognized, but guidance is lacking on how to address norms and related perceptions that hinder or support positive nutrition practices. We reviewed recent peer-reviewed and grey literature to summarize social norms relevant to complementary feeding (CF), intervention approaches that address norms, and their impacts on social norms and CF outcomes. Many reports described various norms, customs, and perceptions related to appropriate foods for young children, parenting practices, gender, and family roles, but rarely explored how they motivated behavior. Community engagement and media interventions addressed norms through facilitated discussions, challenging negative norms, portraying positive norms, engaging emotions, and correcting misperceptions. Evaluations of norms-focused interventions reported improved CF practices, but few assessed impacts on social norms. Although multiple contextual factors influence CF practices, evidence suggests the feasibility and effectiveness of addressing social norms as one component of programs to improve CF practices.

A Chicken Production Intervention and Additional Nutrition Behavior Change Component Increased Child Growth in Ethiopia: A Cluster-Randomized Trial

BACKGROUND

Chicken production in the context of nutrition-sensitive agriculture may benefit child nutrition in low-income settings.

OBJECTIVES

This study evaluated effects of 1) a chicken production intervention [African Chicken Genetic Gains (ACGG)], and 2) the ACGG intervention with nutrition-sensitive behavior change communication (BCC) [ACGG + Agriculture to Nutrition (ATONU)], on child nutrition and health outcomes and hypothesized intermediaries.

METHODS

Forty ACGG villages received 25 genetically improved chickens and basic husbandry guidance; of these, 20 ACGG + ATONU villages in addition received a nutrition-sensitive behavior change and homegardening intervention; 20 control clusters received no intervention. We assessed effects of the interventions on height-for-age z scores (HAZ), weight-for-age z scores (WAZ), and weight-for-height z scores (WHZ) at 9 (midline) and 18 mo (endline) through unadjusted and adjusted ordinary least squares (OLS) regressions. We examined the interventions' effects on hypothesized intermediaries including egg production and consumption, dietary diversity, women's empowerment, income, child morbidities, anemia, and chicken management practices through OLS and log binomial models.

RESULTS

Data included 829 children aged 0-36 mo at baseline. ACGG + ATONU children had higher midline HAZ [mean difference (MD): 0.28; 95% CI: 0.02, 0.54] than controls. The ACGG group had higher HAZ (MD: 0.28; 95% CI: 0.05, 0.50) and higher WAZ (MD: 0.18; 95% CI: 0.01, 0.36) at endline than controls; after adjusting for potential baseline imbalance, effects were similar but not statistically significant. At endline, differences in ACGG + ATONU children's HAZ and WAZ compared with controls were similar in magnitude to those of ACGG, but not statistically significant. There were no differences in anthropometry between the intervention groups. ACGG + ATONU children had higher dietary diversity and egg consumption than ACGG children at endline. Both interventions showed improvements in chicken management practices. The interventions did not increase anemia, diarrhea, fever, or vomiting, and the ACGG + ATONU group at midline showed reduced risk of fever.

CONCLUSIONS

A chicken production intervention with or without nutrition-sensitive BCC may have benefited child nutrition and did not increase morbidity.This trial was registered at clinicaltrials.gov as NCT03152227.

Household water insecurity is strongly associated with food insecurity: Evidence from 27 sites in low- and middle-income countries

OBJECTIVES

Food and water insecurity have both been demonstrated as acute and chronic stressors and undermine human health and development. A basic untested proposition is that they chronically coexist, and that household water insecurity is a fundamental driver of household food insecurity.

METHODS

We provide a preliminary assessment of their association using cross-sectional data from 27 sites with highly diverse forms of water insecurity in 21 low- and middle-income countries across Africa, Asia, the Middle East, and the Americas (N = 6691 households). Household food insecurity and its subdomains (food quantity, food quality, and anxiety around food) were estimated using the Household Food Insecurity Access Scale; water insecurity and subdomains (quantity, quality, and opportunity costs) were estimated based on similar self-reported data.

RESULTS

In multilevel generalized linear mixed-effect modeling (GLMM), composite water insecurity scores were associated with higher scores for all subdomains of food insecurity. Rural households were better buffered against water insecurity effects on food quantity and urban ones for food quality. Similarly, higher scores for all subdomains of water insecurity were associated with greater household food insecurity.

CONCLUSIONS

Considering the diversity of sites included in the modeling, the patterning supports a basic theory: household water insecurity chronically coexists with household food insecurity. Water insecurity is a more plausible driver of food insecurity than the converse. These findings directly challenge development practices in which household food security interventions are often enacted discretely from water security ones.

Small-scale egg production centres increase children's egg consumption in rural Zambia

Animal source foods can efficiently enhance dietary quality, but they remain inaccessible and unaffordable for many women and young children in remote, low-income communities. We piloted an intervention in which 20 groups established egg production centres (EPCs) in their rural Zambian communities to increase the availability of eggs in the local food system. In a repeated cross-sectional design over 1 year (midline [4 months after the start of egg production] and endline [11 months]), we evaluated programme impact on household egg acquisition within those communities and on egg consumption and height-for-age z score (HAZ) among young children (6-36 months) using multilevel linear, logistic, and truncated negative binomial regression techniques. At midline, households in project areas were significantly more likely to consume eggs than those in control areas (OR 2.08, 95% CI [1.56, 2.78]), particularly those located within 250 m of the EPC. Similarly, children living in project communities were significantly more likely to consume eggs at midline than those in control areas (OR 5.53, 95% CI [2.90, 10.58]). Although increased over baseline, egg acquisition and consumption decreased by endline because of depressed egg production over time. There was no impact on children's HAZ, likely because of the short follow-up time and relatively modest "dose" of egg consumption. Although productivity can be improved, the EPC programme offers a novel approach to improving access to eggs in rural communities, and optimization of the production practices and marketing is needed to ensure that egg consumption translates to improved dietary quality, growth, and health.

Family poultry: Multiple roles, systems, challenges, and options for sustainable contributions to household nutrition security through a planetary health lens

Achieving sustainable production of eggs by family poultry production systems that meet both environmental health and welfare standards is a complex endeavour. Humans have been raising different species of poultry for thousands of years across many different agroecological zones. The Food and Agriculture Organization of the United Nations has identified four different family poultry production systems: small extensive, extensive, semi‐intensive, and intensive. Each of these systems varies in terms of inputs, outputs, gender dimensions, poultry health and welfare, and environmental impacts. This paper addresses key issues associated with the production of family poultry eggs in support of both improved maternal and child nutrition and sustainable, nutrition‐sensitive agricultural practices. It provides an overview of the history of poultry raising; characteristics of the different family poultry production systems; challenges and solutions to poultry production in low‐ and middle‐income countries; poultry husbandry (including breeds, nutrition, and shelter); infectious disease prevention and control in line with national and international animal health regulations; and food safety (microbial pathogens, toxins, and egg storage). To ensure that bird, human, and environmental health can flourish, it is essential for interdisciplinary research and development teams to work in collaboration with communities to ensure the long‐term environmental and economic sustainability of family poultry production enterprises that are a good fit with local circumstances.

Assessing the Impact of Animal Husbandry and Capture on Anemia among Women and Children in Low- and Middle-Income Countries: A Systematic Review

Animal husbandry and capture (AHC) may mitigate anemia among women and children by supplying a source of micronutrient-rich animal source foods (ASF), yet may concurrently increase exposure to anemia-inducing pathogens such as Plasmodium spp., helminths, and enteropathogens. We conducted a systematic literature review to assess the relation between AHC and anemia among women of reproductive age, school-aged children, and children aged <5 y in low- and middle-income countries (LMICs). We used a 2-stage screening process, in which 1 reviewer searched 4 databases (PubMed, Web of Science, EMBASE, and Global Health) with predetermined search terms for relevant articles. Two reviewers then independently screened studies using a priori exclusion criteria, yielding a total of 23 articles included in the final review. We evaluated evidence from observational studies assessing animal-dependent livelihoods and livestock ownership, and interventions that promoted livestock and fish production. We found little consistency in anemia outcomes across the several AHC exposures and population groups. Poultry production interventions had modest benefits on anemia among women and children, although whether these improvements were a result of increased ASF consumption, or a result of the combined treatment study design could not be determined. Observational studies identified chicken ownership, and no other livestock species, as a risk factor for anemia among young children. However, there was limited evidence to evaluate pathways underlying these associations. Studies tended to rely on self-reported fever and diarrhea to assess illness, and no study directly assessed linkages between AHC, pathogen burden, and anemia. Thus, there is insufficient evidence to conclude whether AHC improves or worsens anemia among women and children in LMICs. Given the current interest in promoting animal production among low-income households, future studies with robust measures of livestock ownership, ASF consumption, pathogen burden, and anemia status are needed to understand the nuances of this complex and potentially contradictory relation.

Implementing small-scale poultry-for-nutrition projects: Successes and lessons learned

This paper examines Helen Keller International's model for nutrition-sensitive poultry production using a programme implemented in four diverse African contexts-three rural and one urban. Consecutive cross-sectional surveys conducted every 5 months among ~15% of participating households show that despite project-provided training and inputs, there was only limited uptake of many "best practices." Few households constructed improved henhouses; vaccination rates varied and were highest when support was provided. Poultry mortality was high. Egg productivity remained average for village poultry systems, and egg consumption remained low (two to six eggs consumed per household per fortnight). However, children whose mothers were exposed to project messages on nutrition were more likely to eat eggs, and consumption was consistently higher among households with chickens. Women's involvement in chicken rearing was widespread, but their control over revenues from the sale of poultry products was limited. Key lessons learned from implementation were as follows: (a) strong behaviour change communication is needed to encourage egg consumption, (b) nutrition-sensitive village poultry programmes should often focus more on improved practices than improved breeds, (c) supporting women's chicken production is not a route to empowerment without complementary activities that directly support women's ownership and decision making. There is also a need for rigorous research on the role of village poultry in livelihoods, food systems, and consumption as well as the structure of poultry and egg markets in low-resource areas.