Several studies have demonstrated that biofortified orange-fleshed sweetpotato (OFSP) consumption can reduce prevalence of vitamin A deficiency. Evidence from Mozambique indicated that improved micronutrient density in the diet depended heavily on intensity of participation in an agriculture-nutrition intervention. We assessed the drivers of participation in a three year agriculture-health intervention, the Mama SASHA project in Western Kenya, and its impacts on antenatal care service (ANC) utilization. The project integrated OFSP vine access and nutrition counseling into ANC services for pregnant women.
We divided 2,271 mother-child (under two years old) pairs participating in the projects endline survey in 2014, into three categories of participation: no participation in any project activities (none); participation in some activities only (partial) and participation in all components (full). Descriptive analysis and multinomial logit regression were employed.
Results showed that partial and full participation was reduced when the caregiver is under 25 years old (p-value=0.001), a non-biological-parent (p-value=0.001), when the nutrition promoters remuneration decreased midway through the intervention (p-value=0.000) and in some specific health facilities visited. Higher dependency ratio (p-value =0.000) and wealth index (p-value=0.008) increased full but not partial participation. Further, partial and full participants had more frequent ANC visits (4.51, p-value=0.002 and 4.61, p-value =0.001, respectively) than non-participants (3.87, p-value=0.005) while full participants began ANC attendance earlier in their pregnancy (3.37 months; p-value=0.001) than non-participants (3.67 months, p-value=1.07).
Participation in this agriculture-health project was affected by, among others, individual characteristics, wealth endowment and specific health facility used, while intensity of participation influenced health service utilization.