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      Men's nutrition knowledge is important for women's and children's nutrition in Ethiopia

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          Abstract

          In an effort to address undernutrition among women and children in rural areas of low‐income countries, nutrition‐sensitive agriculture (NSA) and behaviour change communication (BCC) projects heavily focus on women as an entry point to effect nutritional outcomes. There is limited evidence on the role of men's contribution in improving household diets. In this Agriculture to Nutrition trial (Clinicaltrials.gov identifier: NCT03152227), we explored associations between men's and women's nutritional knowledge on households', children's and women's dietary diversity. At the midline evaluation conducted in July 2017, FAO's nutrition knowledge questionnaire was administered to male and female partners in 1396 households. There was a high degree of agreement (88%) on knowledge about exclusive breastfeeding between parents; however, only 56–66% of the households had agreement when comparing knowledge of dietary sources of vitamin A or iron. Factor analysis of knowledge dimensions resulted in identifying two domains, namely, ‘dietary’ and ‘vitamin’ knowledge. Dietary knowledge had a larger effect on women's and children's dietary diversities than vitamin knowledge. Men's dietary knowledge had strong positive associations with households' dietary diversity scores (0.24, P value = 0.001), children's dietary diversity (0.19, P value = 0.008) and women's dietary diversity (0.18, P value < 0.001). Distance to markets and men's education levels modified the effects of nutrition knowledge on dietary diversity. While previous NSA and BCC interventions predominantly focused on uptake among women, there is a large gap and strong potential for men’s engagement in improving household nutrition. Interventions that expand the role of men in NSA may synergistically improve household nutrition outcomes.

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          Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition?

          Acceleration of progress in nutrition will require effective, large-scale nutrition-sensitive programmes that address key underlying determinants of nutrition and enhance the coverage and effectiveness of nutrition-specific interventions. We reviewed evidence of nutritional effects of programmes in four sectors--agriculture, social safety nets, early child development, and schooling. The need for investments to boost agricultural production, keep prices low, and increase incomes is undisputable; targeted agricultural programmes can complement these investments by supporting livelihoods, enhancing access to diverse diets in poor populations, and fostering women's empowerment. However, evidence of the nutritional effect of agricultural programmes is inconclusive--except for vitamin A from biofortification of orange sweet potatoes--largely because of poor quality evaluations. Social safety nets currently provide cash or food transfers to a billion poor people and victims of shocks (eg, natural disasters). Individual studies show some effects on younger children exposed for longer durations, but weaknesses in nutrition goals and actions, and poor service quality probably explain the scarcity of overall nutritional benefits. Combined early child development and nutrition interventions show promising additive or synergistic effects on child development--and in some cases nutrition--and could lead to substantial gains in cost, efficiency, and effectiveness, but these programmes have yet to be tested at scale. Parental schooling is strongly associated with child nutrition, and the effectiveness of emerging school nutrition education programmes needs to be tested. Many of the programmes reviewed were not originally designed to improve nutrition yet have great potential to do so. Ways to enhance programme nutrition-sensitivity include: improve targeting; use conditions to stimulate participation; strengthen nutrition goals and actions; and optimise women's nutrition, time, physical and mental health, and empowerment. Nutrition-sensitive programmes can help scale up nutrition-specific interventions and create a stimulating environment in which young children can grow and develop to their full potential. Copyright © 2013 Elsevier Ltd. All rights reserved.
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            Nutrition-sensitive agriculture: What have we learned so far?

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              The Nuances of Health Literacy, Nutrition Literacy, and Food Literacy.

              Health literacy, defined as the ability to access, understand, and use health information, has been identified as an international public health goal. The term nutrition literacy has emerged as a distinct form of health literacy, yet scholars continue to reflect on constituent skills and capabilities in light of discussions regarding what it means to be food literate and health literate. This viewpoint argues that a comprehensive conceptualization of nutrition literacy should reflect key elements of health literacy and food literacy constructs. Nutbeam's tripartite model of health literacy is employed to explore competencies that are likely to facilitate healthy food relationships.
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                Author and article information

                Contributors
                rambikap@purdue.edu
                Journal
                Matern Child Nutr
                Matern Child Nutr
                10.1111/(ISSN)1740-8709
                MCN
                Maternal & Child Nutrition
                John Wiley and Sons Inc. (Hoboken )
                1740-8695
                1740-8709
                04 August 2020
                January 2021
                : 17
                : 1 ( doiID: 10.1111/mcn.v17.1 )
                Affiliations
                [ 1 ] Department of Nutrition Science Purdue University West Lafayette Indiana USA
                [ 2 ] Departments of Nutrition Harvard T.H. Chan School of Public Health Boston Massachusetts USA
                [ 3 ] Departments of Global Health and Population Harvard T.H. Chan School of Public Health Boston Massachusetts USA
                [ 4 ] Addis Continental Institute of Public Health Addis Ababa Ethiopia
                [ 5 ] Food, Agriculture and Natural Resources Policy Analysis Network Pretoria South Africa
                [ 6 ] Departments of Epidemiology Harvard T.H. Chan School of Public Health Boston Massachusetts USA
                [ 7 ] Department of Public Health Purdue University West Lafayette Indiana USA
                Author notes
                [*] [* ] Correspondence

                Ramya Ambikapathi, Department of Public Health, Purdue University, Matthews Hall, Room 223, 812 W. State St. West Lafayette, IN 47907.

                Email: rambikap@ 123456purdue.edu

                Article
                MCN13062 MCN-10-19-OA-4155.R2
                10.1111/mcn.13062
                7729551
                32755057
                7d6ab8f2-8cdf-40b4-a03f-854ea99fd123
                © 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons, Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 3, Tables: 4, Pages: 13, Words: 9494
                Product
                Funding
                Funded by: Bill & Melinda Gates Foundation , open-funder-registry 10.13039/100000865;
                Award ID: OPP1032718
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                January 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.5 mode:remove_FC converted:11.12.2020

                dietary diversity,ethiopia,men's nutrition knowledge,nutrition‐sensitive agriculture,women's nutrition knowledge

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