Background. Homestead food production programs have
the potential to improve maternal and child health and
nutrition through multiple pathways.
Objective. To evaluate the impact of a homestead food
production program in Cambodia on household production
and consumption of micronutrient-rich foods and
on maternal and child health and nutrition (intake of
micronutrient-rich foods, anthropometry, hemoglobin,
and anemia prevalence); and to assess pathways of
impact on maternal and child health and nutrition.
Methods. Two cross-sectional surveys (baseline and
endline) were used to assess differences between intervention
(n = 300) and control (n = 200) households
using t-tests and chi-square tests. Using endline data
and multivariate analyses, we examined the pathways
of impact of the program on maternal and child health
and nutrition.
Results. Intervention and control households were
similar at baseline in sociodemographic characteristics,
but more intervention households owned animals,
earned income from homestead food production, and
produced and consumed micronutrient-rich foods. At
endline, some of these differences had widened; more
intervention households produced and consumed more
vegetables, had higher dietary diversity, and had a lower
prevalence of fever among children under 5 years of age.
In the intervention group, more children consumed more
eggs and more mothers consumed micronutrient-rich
food more frequently than in the control group. There
were no other differences between the groups in maternal
and child health and nutrition. Greater household
production of fruits and vegetables was associated with
greater household dietary diversity, which was associated
with dietary diversity among mothers and children.
Dietary diversity was not associated with other maternal
and child health and nutrition outcomes.
Conclusions. Cambodia’s homestead food production
program increased household production and consumption
of micronutrient-rich foods and maternal and child
intake (or frequency of intake) of some of these foods.
Weaknesses in the evaluation design (e.g., lack of comparability
between groups at baseline, failure to control
for self-selection of households into the intervention,
and collection of baseline and endline data during different
seasons) prevent drawing firm conclusions about
the program impacts. Analysis of impact pathways also
shows that household-level benefits from the program did
not translate into significant improvements in maternal
and child health and nutrition. A careful redesign and
rigorous assessment of the program using a program
theory framework would help unleash its true potential
to improve maternal and child health and nutrition
outcomes