The impact of household food gardens on food security in South Africa, Lesotho and Zimbabwe

English: Food insecurity is a challenge faced by many in the developing world, where more and more individuals are finding healthy food inaccessible due to poverty. The triple burden of malnutrition includes undernutrition (underweight, stunting and wasting); overnutrition (overweight and obesity); and micronutrient deficiencies. These may coexist in the same household. Although it is well accepted that household food gardens have the potential to address the various forms of malnutrition, studies to confirm their impact are lacking. In the present study, a pre- and post- test study design was applied to determine the impact of household vegetable gardening interventions in South Africa, Lesotho and Zimbabwe. In each country the household food gardening intervention was implemented by a different organisation, including The Department of Agriculture in South Africa, the Society of Women against AIDS in Africa (SWAALES) in Lesotho and Batani HIV/AIDS Service organisation (BHASO) in Zimbabwe). Programme beneficiaries of these intervention partners were eligible to be included in the study. These intervention partners worked in the study population that included households from Rampepe Village in Lesotho, Kayelisha Informal Settlement in Bloemfontein and Mashvingu in Zimbabwe. In each of these areas, 50 households were purposively selected for the study in each country (for logistic reasons). From each list of 50 households, 25 households were randomly included in an intervention group and 25 were included in a control group. A standardised questionnaire was completed by fieldworkers in a structured interview with a member of the household (preferably the household head). This was done before and after the household food garden interventions. The questionnaire was used to determine socio-demographic conditions as well as indirect measures of food security in each household, using the Living Poverty Index (LPI); Months of Adequate household Food Provisioning (MAHFP); Household Dietary Diversity (HDD) and frequency of vegetables eaten. The LPI assesses the frequency that households go without basic necessities of life (namely food, water, medicine, electricity, and fuel and cash income). Responses to questions are combined to calculate a LPI score for the household, with 0 indicating no poverty to 4 (complete poverty). The MAHFP determines the total number of months out of the previous 12 months that the household was unable to meet their food needs, ranging from 0 to 12. A score of 12 indicates that the household had year-round adequate food provisioning, while 8-11 indicates moderate food security, 4-7 low food security and zero to 3 severe food insecurity. HDD is determined using the previous 24-hour period as a reference. The number of different food groups consumed during this period from a possible 12 food groups is noted. The HDD scores are interpreted in the following way: 0- 3 = low dietary diversity; 4-5 = medium dietary diversity and 6-12 = high dietary diversity. Frequency of vegetables eaten by adults and children in the households is measured using a set of 6 responses to the question ‘How frequently do ADULTS/CHILDREN in the household eat vegetables? The responses include several times a day, once a day, a times per week, once a week, rarely and Never. The sample included in the study in South Africa consisted of more female than male participants. Most participants were unmarried and more than 40% had completed high school or had a tertiary qualification. As evidenced by the LPI of 2.8, the sample was characterised by high levels of poverty. Measures of food security showed that about a third of participants had a low level of food security. At baseline, the median HDDS was 7 in the control group and 6 in the intervention group, indicating high dietary diversity. As far as frequency of vegetables consumed was concerned, less than half of participants reported that both adults and children ate vegetables relatively frequently. In terms of the impact of the intervention, the MAHFP increased to a score of 11 in the control group at follow-up and improved by 2 points in the intervention group that was exposed to the household food garden intervention. Median HDDS did not change in the control group but showed a 2 point improvement in the intervention group at follow-up. The main outcome of the intervention was obviously related to vegetable consumption, but households showed little improvement. More adults consumed vegetables a few times a day, but children’s’ vegetable consumption remained the same. Overall, the household food garden intervention had a moderately positive effect on the indicators of food security in the intervention group. An improvement in the median MAHFP from 8 to 10 occurred (95% CI for the change [-2; 0]). The sample included in the current study in Lesotho consisted of more male than female participants. About half were married and less than 20% had completed high school or had a tertiary qualification. As evidenced by the LPI of 2.5, the sample was characterised by high levels of poverty. Despite this, some measures of food security showed that participants were not as badly off as one would have expected. Even before intervention, the median MAHFP was 11 in the control group and 10 in the intervention group, indicating relatively good levels of food provisioning. At baseline, the median HDDS was 5 in the control group and 6 in the intervention group, indicating medium to high dietary diversity. As far as frequency of vegetables consumed was concerned, a relatively high percentage of participants reported that both adults and children ate vegetables relatively frequently. The habit of sharing that has been described in the Lesotho population, probably contributed to these findings. No improvements were noted in the frequency of vegetables consumed in the intervention group or in the control group. In terms of the impact of the intervention, the MAHFP remained at 11 in the control group at follow-up and improved by one point in the intervention group that was exposed to the household food garden intervention. Median HDDS did not change in either group at followup. The main outcome of the success of the intervention was obviously related to vegetable consumption. Significant improvements were noted in the frequency of vegetables consumed in the intervention group that were not noted in the control group. These can thus most probably be attributed to the intervention. The sample included in the current study in Zimbabwe consisted of more female than male participants. Most of the population was married and had a fairly high level of education with more than 50% of individuals having completed high school and in possession of a tertiary qualification. As evidenced by the LPI of 2.3, the sample was characterised by high levels of poverty. Despite this, some measures of food security showed that participants were not as badly off as one would have expected. Even before intervention, the median MAHFP was 11 at baseline in the control group and 10 in the intervention group, indicating relatively good levels of food provisioning. At baseline, the median HDDS was 6 in the control group and 7 in the intervention group, indicating medium to high dietary diversity. As far as frequency of vegetables consumed was concerned, a relatively high percentage of participants reported that adults ate vegetables frequently, though less frequent than in adults children still had a relatively high level of vegetable consumption. In terms of the impact of the intervention, the MAHFP improved by one point in in the control group at follow-up and remained at 11 the intervention group that was exposed to the household food garden intervention. Median HDDS did not change in either group at follow-up. The main outcome of the intervention was obviously related to vegetable consumption, but due to an already high level of consumption at baseline no significant improvement could be seen. In conclusion, the impact of the household food garden intervention varied in each of the countries. This could be attributable to different levels of education, cultures and environmental factors. The improvements that were noted do however show that food gardens have the potential to improve availability of food, level of diversity in the diet and frequency of vegetables eaten.