Farmer Nutrition Schools

The following good practice is conducted by George Collett . The case study was selected and presented in Mekong Knowledge and Learning Fair (IFAD) by representative from Vietnam.

Background

SSFSNP is a six-year project (2016 to 2022) to address chronic malnutrition and food insecurity in Lao PDR upland areas. It supports the Government’s National Nutrition Strategy and Plan of Action. It aims to address extreme poverty and malnutrition through supporting diversified, climate resilient agricultural production and improved household nutrition in 400 poor villages in Northern Laos. It supports over 20,000 households to increase their incomes above the poverty level and over 20,000 households to improve their food security. Reduction in stunting is a key impact indicator. The key interventions include participatory village planning and supporting development of village nutrition-sensitive agricultural infrastructure; Farmer Nutrition Schools (FNS) for women (focusing on the 1,000 day window) to promote understanding of healthy diets, improved food access and utilization, and improved infant and young child feeding (IYCF) practices; small grants to address seasonal household food and nutrition gaps; mobilizing and training farmer organizations and providing them investment grants; promoting a broader agricultural extension through farmer-to-farmer approaches and private sector service delivery; and strategic market analyses and value chain development.

Innovations / Good Practices

The Farmer Nutrition Schools (FNS) for pregnant women and women with children under two years of age address the critical 1,000-day window. It is not sufficient for households only to know how to increase and diversify their food production to address chronic under-nutrition, households also must utilize food effectively for adequate, nutritious diets particularly for pregnant women, nursing mothers and young children. Although stunting is a complex condition influenced by many factors, interventions that promote adequate complementary feeding are the cornerstone of prevention and management. FNS extends this approach to encompass understanding of what constitutes an adequate and nutritious diet (especially for IYCF); analysis of seasonal access to each food group though farm production, collection/hunting from the wild, and food purchases; planning to address seasonal food and nutrition gaps; receiving advice on production of diverse fruits and vegetable, production of animal protein, and safe food storage/preservation; and practical, participatory cooking demonstrations focusing on nutritious complementary feeding. Women who attend the majority of the ten fortnightly FNS sessions are eligible for a grant to improve household production, processing, storage or preservation of nutritious foods for consumption.

The FNS sessions are run in the village by FNS facilitators who are paid a small incentive (USD $8/mth). These facilitators are trained by multi-sector teams of government staff in each of project’s 12 districts. Staff are from district agriculture and health offices and the Lao Women’s Union. This is the first time such a multi-sector approach supporting village nutrition behavior change has been successfully applied using government staff at the district level.

Impact

It is expected that women from up to 40 households in each of the 400 target villages will participate in the FNS (a total of 16,000 women plus their family members will benefit). Already over 1,500 pregnant women and mothers of children under two, from the initial 61 villages, have learnt about the problem of under-nutrition (particularly stunting). They have been provided nutrition, health and WASH knowledge, they have analyzed their household diets, and assessed their seasonal food and nutrition gaps. These FNS members have practiced the preparation of nutritious meals and complementary feeding, using a diversity of ingredients, that should help address the problem of stunting. At the same time, district government officials have improved their understanding of nutrition and the behavioral changes necessary to address stunting.

Facilitating Factors / Challenges

FNS is an ambitious program reliant on collaboration across ministries and projects; a level of collaboration that has not been common in the past. Departments of agriculture and health and the Lao Women’s Union in each district must feel ownership and responsibility for delivering the FNS program, particularly for training FNS village facilitators and providing technical support, monitoring and supervision in each village. However, the Government of Laos is a strong proponent of both a convergence approach across sectors in its national nutrition strategy, and decentralized development implementation at the district level (under its Sam sang policy). FNS provided opportunity for collaboration as the approach incorporates the nutrition, health and WASH messages traditionally promoted by the health sector, with information on food production and nutrition-sensitive agriculture, along with women’s empowerment and capacity development promoted by the Lao Women’s Union.

An ongoing challenge will be the provision of technical advisory services and training to FNS participants who receive grants for food production, processing, preservation/storage to ensure their small investment plans are successful in supporting household food consumption. The FNS will also require effective M&E (using quantitative and qualitative methods) to learn how to improve its implementation and to provide evidence of its success to stakeholders at all levels (from district implementers, to project funders, to government policy makers).

Lessons Learned

• FNS has shown that multi-sector collaboration for nutrition is possible and has been demonstrated at the district and village levels.  FNS is resource intensive, requires continued collaboration across sectors, and sometimes faces criticism from government officers who prefer to continue their traditional sector roles rather than try something new.
• Village women can be trained as effective facilitators to promote the delivery and exchange of information among pregnant women and mothers of young children. Village women are interested in learning about practices to improve their household diets and address under-nutrition and stunting.
• Small grants for FNS participants are an important incentive to encourage continued high levels of participation among eligible pregnant women and mothers of children under two in the village.
• Participatory cooking demonstrations, which provide meals for participants, particularly young children, are an added incentive and provide opportunity to discuss foods, nutritious diets and IYCF more informally.

Recommendations

The FNS approach shows great potential to address stunting in remote, poor villages and should be documented, scaled up and adapted for other projects and programs. All FNS modules and materials should be made widely available (even in draft forms). FNS should be carefully documented for the benefit of other projects in Laos and the region. Production of FNS videos illustrating various aspects of the FNS approach is recommended,

Work is required to develop simple extension and training materials around nutrition-sensitive agriculture for use by district extension staff, village facilitators and village women and men, FNS approach needs to be complemented with interventions specifically targeting men, village leaders and elder women in the community who also influence nutrition, health and WASH behaviors.  More in-depth training may be required and FNS exchanges should be conducted for the village facilitators. These will assist in developing facilitator skills and in sharing experiences and will support FNS groups where facilitation is weakest.