Food security mediates the decrease in depressive symptoms among smallholder women farmers in a participatory nutrition-sensitive agroecology intervention in rural Tanzania

Abstract

Objective: To investigate if food security mediated the impact of a nutrition-sensitive agroecology intervention on womens depressive symptoms. Design: We used annual longitudinal data (4 time points) from a cluster-randomized effectiveness trial of a nutrition-sensitive agroecology intervention, the Singida Nutrition and Agroecology Project. Structural equation modeling estimation of total, natural direct, and natural indirect effects was used to investigate food securitys role in the interventions impact on womens probable depression (CES-D > 17) over three years. Setting: Rural Singida, Tanzania. Participants: 548 food insecure, married, smallholder women farmers with children < 1-year-old at baseline. Results: At baseline, one third of the women in each group had probable depression (Control: 32.0%, Intervention: 31.9%, p-difference=0.97). The intervention lowered odds of probable depression by 43% (OR=0.57, 95% CI: 0.43-0.70). The effect of the intervention on probable depression that was due to differences in food security was approximately 10% (OR = 0.90, 95% CI: 0.83-0.95). Conclusions: Nutrition-sensitive agricultural interventions can have broader impacts than previously demonstrated, i.e., on mental health, and food security plays an important causal role in this pathway. These data suggest nutrition-sensitive agriculture interventions have the potential to reduce the loss of quality life years for women in farming communities. Future agricultural and nutrition projects should include mental health evaluations to determine generalizability.

Files

Additional details