Gender accommodative versus transformative approaches: a comparative assessment within a post-harvest fish loss reduction intervention

Technical and social constraints limit value chain actors from equitably engaging in and benefiting from capture fisheries in low-income settings. Extension and development programs often focus on the former, which reflects a technocratic orientation of the fisheries sector and uncertainty about effective ways for development programs to engage with gender and other social constraints. This study presents empirical insights that address these challenges to fisheries development. The study took place in fishing camps in the Barotse Floodplain, Zambia to compare two approaches addressing gender constraints within a broader post-harvest fish loss reduction intervention: an accommodative and a transformative approach. The former embodied a more common ‘practical needs’ set of strategies to ensure female participation, while the latter comprised a communication tool embedded in an action research process to build critical consciousness. Results indicate that the use of a transformative approach led to significant changes in gender equal attitudes and women’s empowerment outcomes compared to only using an accommodative approach. Development programs working in fisheries can apply the findings to engage effectively with gender constraints, especially using transformative approaches to help enable women and men to overcome the social and technical barriers that constrain their lives and livelihoods

On the relationship between aquaculture and food security: why does aquaculture contribute more in some developing countries than it does in others?

As much as 78% of fish production is subject to international trade competition. While this may be positive for economic growth, it may be at odds with achieving food security. The purpose of this paper is to review the relationship between aquaculture and food security, focussing on trade and markets in some developing countries that account for more than 90% of aquaculture output. The international trade in fish products largely involves the movement of high value species from developing to developed countries and the opposite in reverse, which can contribute to food security. Countries where food security is not improving tend to rely on small-scale aquaculture production of species that are not desired in the main markets, themselves relying on imported fish to meet domestic demand. This suggests that an aquacultural revolution in these countries may contribute to food security, as well as economic growth.This paper has received funding from the EU 7th Framework Programme Project under grant agreement number 289760

Minimum dietary diversity for women of reproductive age (MDD-W) data collection : validity of the list-based and open recall methods as compared to weighed food record

Minimum dietary diversity for women of reproductive age (MDD-W) was validated as a population-level proxy of micronutrient adequacy, with indicator data collection proposed as either list-based or open recall. No study has assessed the validity of these two non-quantitative proxy methods against weighed food records (WFR). We assessed the measurement agreement of list-based and open recall methods as compared to WFR (i.e., reference method of individual quantitative dietary assessment) for achieving MDD-W and an ordinal food group diversity score. Applying a non-inferiority design, data were collected from non-pregnant women of reproductive age in Cambodia (n = 430), Ethiopia (n = 431), and Zambia (n = 476). For the pooled sample (n = 1337), proportions achieving MDD-W from both proxy methods were compared to WFR proportion by McNemar’s chi-square tests, Cohen’s kappa, and receiver operating characteristic (ROC) analysis. Ordinal food group diversity (0–10) was compared by Wilcoxon matched-pairs signed-rank tests, intraclass correlation coefficients (ICC), and weighted kappa. MDD-W food groups that were most frequently misreported (i.e., type I and II errors) by the proxy methods were determined. Our findings indicate statistically significant differences in proportions achieving MDD-W, ordinal food group diversity scores, and ROC curves between both proxy methods and WFR (p < 0.001). List-based and open recall methods overreported women achieving MDD-W by 16 and 10 percentage points, respectively, as compared to WFR (proportion achieving MDD-W: 30%). ICC values between list-based or open recall and WFR were 0.50 and 0.55, respectively. Simple and weighted kappa values both indicated moderate agreement between list-based or open recall against WFR. Food groups most likely to be misreported using proxy methods were beans and peas, dark green leafy vegetables, vitamin A-rich fruit and vegetables, and other fruits. Our study provides statistical evidence for overreporting of both list-based and open recall methods for assessing prevalence of MDD-W or ordinal food group diversity score in women of reproductive age in low- and middle-income countries. Operationalizing MDD-W through qualitative recall methods should consider potential trade-offs between accuracy and simplicity

Association between dietary diversity, health and nutritional status of older persons in rural Zambia

Objective: The purpose of the study was to assess the association between dietary diversity, health and nutritional status of older persons aged 50 years and above in Milenge district of Luapula province, Zambia. Design: A cross-sectional, descriptive study was conducted. Subjects and setting: The study was conducted among 135 older persons (≥ 50 years) comprising 67 men and 68 women who were randomly selected from three communities in Milenge district, Luapula province. Outcome measures: Anthropometric measurements (weight and height) were used to determine the prevalence of malnutrition among the respondents by calculating the body mass index (BMI). Food consumption was assessed using a non-quantified food frequency questionnaire and dietary diversity scores were used to determine the adequacy of food intake, while a health questionnaire was used to determine self-perceived health status of the respondents. Results: Based on the WHO BMI classification, 30.4% of older persons were underweight, whilst 8.1% were overweight. There was a significant difference in mean BMI between male and female older persons (p < 0.01). More men had severe underweight, whilst more women were found to be overweight and obese. The mean dietary diversity score (DDS) was 3.6 ± 1.1. Dietary assessment showed that 64.4% of the respondents had dietary diversity scores that were below the mean value, while 35.6% had scores above the mean value. The Spearman rho correlation test revealed a positive correlation (r = 0.184, p = 0.028) between BMI categories and dietary diversity scores. The majority (74%) of respondents reported having at least one health condition including high blood pressure (42.6%), coronary heart disease (8.9%), malaria (24.4%), tuberculosis (35.6%) and pneumonia (24.4%), while only 26% perceived themselves to be healthy. Conclusion: The study revealed a high prevalence of undernutrition and low dietary diversity among older persons. A positive association was found between nutritional status and dietary diversity. Although the majority of the respondents reported having health conditions, there was no relationship between nutrition-related health conditions and dietary diversity

Determinants of inequality in health care seeking for childhood illnesses : Insights from Nairobi informal settlements

An in-depth understanding of patterns of inequities in healthcare seeking among the urban residents is critical in identifying appropriate interventions strategies. The study evaluates determinants of inequality in health care seeking for childhood illnesses among informal settlement residents in Nairobi, Kenya. Methods: Data from the second Nairobi Cross-Sectional Slum Survey (NCSS 2012) was examined. The inequality in seeking health care for childhood diarrhea as the prototype illness was assessed using concentration index (CI). The wealth index based on the household possessions and amenities was used as a measure for socioeconomic status. Results: A total of 2 027 qualified women were included in this study. About 16.6% of children born of younger mothers aged < 20 years had diarrhea and a similar proportion of children (16.3%) was observed among mothers who were unemployed. The CI of −0.026 on health care seeking for diarrhea among children points to significant inequality among the urban poor (95% confidence interval: −0.028 to −0.023). Conclusion: Occupation of parents, age of mothers, ethnicity, marital status and children's age were major determinants with regard to disease outcome and to a broader extent inequality in health care seeking for childhood illnesses. Enhanced bottom top community health invigoration strategies in health information awareness and services access would be instrumental

Dietary diversity and nutritional status of children aged 6–59 months from rural fishing and non-fishing communities in Zambia

Low-quality complementary foods combined with inappropriate feeding practices put children under the age of five in developing countries at high risk for undernutrition. This study explored dietary diversity, fish consumption patterns and nutritional status of children in Luapula, a rural province in Zambia, where households rely on capture fisheries for their livelihoods. In the cross-sectional study, households with children aged 6–59 months were enrolled in the study. A semi-structured questionnaire was utilised to collect socioeconomic characteristics, dietary intake and anthropometric data. Descriptive statistics and bivariate associations were conducted. 23% of children aged 6–23 months met the minimum dietary diversity. About 49% and 41% of the children were fed on fresh small pelagic fish and large dried fish once to twice a week, respectively. Imbilya (Serranochromis mellandi), Chisense (Poecilothrissa moeruensis), and amatuku (Tilapia sparrmanii) were the most preferred fish species due to their availability and affordability. Only 3.5% of children consumed porridge to which fish powder had been added. There was a significant difference in the height for age z scores of children in the two communities (χ2= 12.404; p = 0.002, d.f = 2). Low dietary diversity was observed across the fishing and non-fishing communities and less than half of the children consumed fish despite proximity of the study sites to one of the largest water bodies in Zambia. Better nutrition outcomes were observed among children in capture fisheries dependent households. Nutrition education in growth monitoring and promotion centres should address the issue of adequacy of diets with regard to frequency and diversity

Adequate Dietary Intake and Consumption of Indigenous Fermented Products Are Associated with Improved Nutrition Status among Children Aged 6–23 Months in Zambia

Agroecological food systems and socioeconomic characteristics are known to influence household food security and food consumption patterns and consequently have an impact on child nutritional status. The present study examined food consumption patterns among children aged 6–23 months in two geographic regions of Zambia, with special focus on consumption of fermented products, and its association with illnesses and nutritional status. The cross-sectional survey enrolled a total of 213 children from Namwala and Mkushi districts of Zambia. A 24 h recall and food frequency questionnaire (FFQ) were used to determine the number of food groups consumed and consequently dietary diversity scores and food consumption patterns, respectively. Determinants of child’s linear growth as measured by Height-for-Age Z-scores (HAZ) were assessed via multiple linear regression analysis. In total, 54% of the children met the minimum dietary diversity by consuming food from at least 5+ food groups. Maize meal porridge, Mabisi (fermented milk), Chibwantu and Munkoyo (fermented beverages based on cereals) and groundnuts were among the frequently consumed foods. A higher consumption of fermented beverages was observed in Namwala compared to Mkushi district. A significant association was observed between HAZ score (rho = 0.198, p = 0.004), Weight-for-Age Z-score (WAZ) (rho = 0.142, p = 0.039) and consumption of mabisi. Dietary intake had a positive association with child nutritional status. The frequent consumption of traditional non-alcoholic cereal and milk-based fermented foods underpinned their contribution to the children’s dietary intake. Moreover, the trend would be viewed as an indicator to nutrition and policy actors on possible unoptimized potential of indigenous fermented foods’ influence in nutritional and health status among children at regional and national levels. Although Zambia has a wide range of traditional non-alcoholic fermented food products, their prospects in provision of macro- and micronutrients along with microbiota benefits remain scanty despite global efforts increasingly advocating for the inclusion of such traditional foods in food-based recommendations

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes