Farmers’ perceptions of orange-fleshed sweetpotato: Do common beliefs about sweetpotato production and consumption really matter?

Efforts to combat vitamin A deficiency in developing countries have focused on the promotion of growing and consuming orange-fleshed sweetpotato (OFSP), among other crops. Past studies have found increased intake and even incomes among households that have been reached with information about nutritional benefits of OFSP. Consequently, efforts to scale up the production and consumption of OFSP are on-going in several African countries where vitamin A deficiency is a major problem. However, to date, few studies have systematically examined farmers’ perceptions and attitudes towards some of the attributes of OFSP. This paper interrogates some of the beliefs about the production and consumption of sweetpotato in general, and OFSP, in particular. It uses data generated using multi-stage sampling technique and involving 732 households in the Lake zone of Tanzania. The households were stratified into project participants (the intervention group) and non-participants (the control group). Within each household, data were collected from a male or female adult member (usually spouses) through personal interviews. Overall, 455 project participants and 277 non-participants were interviewed. This study uses both descriptive and exploratory factor analysis to assess some common beliefs about sweetpotato production and consumption. Contrary to the common beliefs, the study finds that sweetpotato is an important food crop to producing households, and that the common negative beliefs about sweetpotato production and consumption are not widely held. This study, therefore, recommends the need to upscale and out-scale efforts to sensitize farmers about the nutritional benefits of growing and consuming OFSP to counter the common negative beliefs about sweetpotato. In particular, educating farmers on the health effects of inadequate intake of Vitamin A and the importance of OFSP as its source can greatly influence their perceptions about OFSP. Further, there is need to increase efforts at breeding aimed at supplying the multiple desirable table and postharvest attributes of orange-fleshed sweetpotato, in addition to focusing on agronomic traits. For sub-Saharan Africa, such attributes include taste, storability of the tubers, dry matter content, and sugar content.Keywords: Sweetpotato, attributes, nutritional benefits, common beliefs, farmer perceptions, Tanzani

A Study of Household Food security and Adoption of Biofortified Crop Varieties in Tanzania: The Case of Orange- Fleshed Sweetpotato

Food insecurity has become a key issue in the field of development in recent years with major inadequate intake of vitamin A-rich foods. Specifically, vitamin A deficiency (VAD) remains a major health problem among poor developing-country households, especially in Africa. Efforts to combat VAD currently focuses on food-based approach that entails breeding for crops that are rich in beta carotene, a precursor for Vitamin A. Success has been registered in sweetpotato, cassava and maize. Among these crops, the greatest effort has gone into promoting the production and consumption of orange-fleshed sweetpotato (OFSP). These efforts include sensitization of farmers on the nutritional benefits of OFSP and the provision of clean sweetpotato planting materials. This study used a rich dataset collected from 732 farm households in Tanzania to assess of effect of household food insecurity and benefit awareness on the adoption of OFSP varieties. The study found that the household food security and awareness of the benefit of OFSP affect the decision to adopt OFSP varieties. It also found evidence that agroecology and farmer endowment with financial and physical assets affect the decision to grow OFSP varieties. It discusses lessons and policy implications of the findings for other countries

Improving the use of crop models for risk assessment and climate change adaptation

Crop models are used for an increasingly broad range of applications, with a commensurate proliferation of methods. Careful framing of research questions and development of targeted and appropriate methods are therefore increasingly important. In conjunction with the other authors in this special issue, we have developed a set of criteria for use of crop models in assessments of impacts, adaptation and risk. Our analysis drew on the other papers in this special issue, and on our experience in the UK Climate Change Risk Assessment 2017 and the MACSUR, AgMIP and ISIMIP projects. The criteria were used to assess how improvements could be made to the framing of climate change risks, and to outline the good practice and new developments that are needed to improve risk assessment. Key areas of good practice include: i. the development, running and documentation of crop models, with attention given to issues of spatial scale and complexity; ii. the methods used to form crop-climate ensembles, which can be based on model skill and/or spread; iii. the methods used to assess adaptation, which need broadening to account for technological development and to reflect the full range options available. The analysis highlights the limitations of focussing only on projections of future impacts and adaptation options using pre-determined time slices. Whilst this long-standing approach may remain an essential component of risk assessments, we identify three further key components: 1. Working with stakeholders to identify the timing of risks. What are the key vulnerabilities of food systems and what does crop-climate modelling tell us about when those systems are at risk? 2. Use of multiple methods that critically assess the use of climate model output and avoid any presumption that analyses should begin and end with gridded output. 3. Increasing transparency and inter-comparability in risk assessments. Whilst studies frequently produce ranges that quantify uncertainty, the assumptions underlying these ranges are not always clear. We suggest that the contingency of results upon assumptions is made explicit via a common uncertainty reporting format; and/or that studies are assessed against a set of criteria, such as those presented in this paper

The cost‐effectiveness of prophylaxis strategies for individuals with advanced HIV starting treatment in Africa

Introduction Many HIV‐positive individuals in Africa have advanced disease when initiating antiretroviral therapy (ART) so have high risks of opportunistic infections and death. The REALITY trial found that an enhanced‐prophylaxis package including fluconazole reduced mortality by 27% in individuals starting ART with CD4 <100 cells/mm3. We investigated the cost‐effectiveness of this enhanced‐prophylaxis package versus other strategies, including using cryptococcal antigen (CrAg) testing, in individuals with CD4 <200 cells/mm3 or <100 cells/mm3 at ART initiation and all individuals regardless of CD4 count. Methods The REALITY trial enrolled from June 2013 to April 2015. A decision‐analytic model was developed to estimate the cost‐effectiveness of six management strategies in individuals initiating ART in the REALITY trial countries. Strategies included standard‐prophylaxis, enhanced‐prophylaxis, standard‐prophylaxis with fluconazole; and three CrAg testing strategies, the first stratifying individuals to enhanced‐prophylaxis (CrAg‐positive) or standard‐prophylaxis (CrAg‐negative), the second to enhanced‐prophylaxis (CrAg‐positive) or enhanced‐prophylaxis without fluconazole (CrAg‐negative) and the third to standard‐prophylaxis with fluconazole (CrAg‐positive) or without fluconazole (CrAg‐negative). The model estimated costs, life‐years and quality‐adjusted life‐years (QALY) over 48 weeks using three competing mortality risks: cryptococcal meningitis; tuberculosis, serious bacterial infection or other known cause; and unknown cause. Results Enhanced‐prophylaxis was cost‐effective at cost‐effectiveness thresholds of US$300 and US$500 per QALY with an incremental cost‐effectiveness ratio (ICER) of US$157 per QALY in the CD4 <200 cells/mm3 population providing enhanced‐prophylaxis components are sourced at lowest available prices. The ICER reduced in more severely immunosuppressed individuals (US$113 per QALY in the CD4 <100 cells/mm3 population) and increased in all individuals regardless of CD4 count (US$722 per QALY). Results were sensitive to prices of the enhanced‐prophylaxis components. Enhanced‐prophylaxis was more effective and less costly than all CrAg testing strategies as enhanced‐prophylaxis still conveyed health gains in CrAg‐negative patients and savings from targeting prophylaxis based on CrAg status did not compensate for costs of CrAg testing. CrAg testing strategies did not become cost‐effective unless the price of CrAg testing fell below US$2.30. Conclusions The REALITY enhanced‐prophylaxis package in individuals with advanced HIV starting ART reduces morbidity and mortality, is practical to administer and is cost‐effective. Efforts should continue to ensure that components are accessed at lowest available prices

Late Presentation With HIV in Africa: Phenotypes, Risk, and Risk Stratification in the REALITY Trial.

This article has been accepted for publication in Clinical Infectious Diseases Published by Oxford University PressBackground: Severely immunocompromised human immunodeficiency virus (HIV)-infected individuals have high mortality shortly after starting antiretroviral therapy (ART). We investigated predictors of early mortality and "late presenter" phenotypes. Methods: The Reduction of EArly MortaLITY (REALITY) trial enrolled ART-naive adults and children ≥5 years of age with CD4 counts .1). Results: Among 1711 included participants, 203 (12%) died. Mortality was independently higher with older age; lower CD4 count, albumin, hemoglobin, and grip strength; presence of World Health Organization stage 3/4 weight loss, fever, or vomiting; and problems with mobility or self-care at baseline (all P < .04). Receiving enhanced antimicrobial prophylaxis independently reduced mortality (P = .02). Of five late-presenter phenotypes, Group 1 (n = 355) had highest mortality (25%; median CD4 count, 28 cells/µL), with high symptom burden, weight loss, poor mobility, and low albumin and hemoglobin. Group 2 (n = 394; 11% mortality; 43 cells/µL) also had weight loss, with high white cell, platelet, and neutrophil counts suggesting underlying inflammation/infection. Group 3 (n = 218; 10% mortality) had low CD4 counts (27 cells/µL), but low symptom burden and maintained fat mass. The remaining groups had 4%-6% mortality. Conclusions: Clinical and laboratory features identified groups with highest mortality following ART initiation. A screening tool could identify patients with low CD4 counts for prioritizing same-day ART initiation, enhanced prophylaxis, and intensive follow-up. Clinical Trials Registration: ISRCTN43622374.REALITY was funded by the Joint Global Health Trials Scheme (JGHTS) of the UK Department for International Development, the Wellcome Trust, and Medical Research Council (MRC) (grant number G1100693). Additional funding support was provided by the PENTA Foundation and core support to the MRC Clinical Trials Unit at University College London (grant numbers MC_UU_12023/23 and MC_UU_12023/26). Cipla Ltd, Gilead Sciences, ViiV Healthcare/GlaxoSmithKline, and Merck Sharp & Dohme donated drugs for REALITY, and ready-to-use supplementary food was purchased from Valid International. A. J. P. is funded by the Wellcome Trust (grant number 108065/Z/15/Z). J. A. B. is funded by the JGHTS (grant number MR/M007367/1). The Malawi-Liverpool–Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine (grant number 101113/Z/13/Z) and the Kenya Medical Research Institute (KEMRI)/Wellcome Trust Research Programme, Kilifi (grant number 203077/Z/16/Z) are supported by strategic awards from the Wellcome Trust, United Kingdom. Permission to publish was granted by the Director of KEMRI. This supplement was supported by funds from the Bill & Melinda Gates Foundation

Farmer perception and attitude towards orange flesh sweetpotato attributes: an analysis of common beliefs about sweetpotato production and consumption

This paper interrogates some of the beliefs about production and consumption of sweetpotato in general, and orange fleshed sweetpotato (OFSP) in particular, using both descriptive and exploratory factor analysis and data collected from farmers in Tanzania. It finds that contrary to beliefs, sweetpotato production and consumption is significant to growers and farmers value some key attributes such as yield, taste, storability of the roots and nutritional benefits. It therefore concludes that the negative beliefs about sweetpotato are unfounded. The paper discusses the implications of the findings

Hidden hunger or knowledge hunger? Nutritional knowledge, diet diversity and micronutrient intake in Rwanda: The case of Vitamin A

The problem of hidden hunger has emerged as one of the major development issues alongside food security. This problem highlights the likelihood of households having access to inadequate amount of key micronutrients in a diet despite having access to adequate quantities of food. , This paper uses a recent detailed household consumption data to investigate households’ nutritional knowledge, the diversity of diets consumed, and the micronutrient uptake, focusing specifically on Vitamin A. The study finds high knowledge of Vitamin A but low understanding of the function of Vitamin A in human bodies. We find a disconnect between the knowledge of Vitamin A and diets consumed by the respondents. Further, the use of diet diversity scores (DDS) reveal a narrow range of foods consumed, with children age 6-23 months most affected. However, the predictions from DDS stand in stark contrast with actual consumption of Vitamin A rich foods. The study concludes that there is high awareness of Vitamin A and Vitamin A-rich foods among rural households although this knowledge does not directly translate into consumption Vitamin A rich foods. The study also concludes that care needs to be taken in using different measures of diet diversity to proxy micronutrient uptake. It discusses policy recommendations of these findings

Adoption of Nutritionally Enhanced Sweetpotato Varieties: The Role of Household Food Insecurity and Knowledge of Nutritional Benefits

Orange-fleshed sweetpotato, food insecurity, nutrition knowledge, adoption, Tanzani

Assessment of the influence of attitude and benefit-risk perceptions on yield variability among smallholder peri-urban commercial kale farmers in Wangige, Kenya

Declining soil fertility largely explains the gap between actual and potential yield among smallholder farmers in sub-Saharan Africa. This study investigates the relationship between yield variability in smallholder commercial kale (Brasica oleracea) production in Kenya and farmers’ attitudes for integrated soil fertility management (ISFM) as well as the relationship to a domain-specific risk-benefit preference scale. Data was collected from 125 peri-urban commercial kale farmers through personal interviews conducted by trained enumerators using a pre-tested questionnaire. Results of ordinary least squares regression indicate that farmers with strong attitudes in favour of ISFM experience decreased variability in yields. A significant negative relationship was observed between farmers expectation of benefits associated with soil fertility management technologies and yield variability. Farmers’ risk perception associated with the use of nonconventional soil fertility management practices, particularly the use of human faecal manure, increase variability in yields. However, risk perception associated with the use of conventional soil fertility management practices including application of animal manure, chemical fertilizers, crop rotation and use of crop residues significantly reduce yield variability. Individual farmers base their choice of ISFM practices on their assessment of both risks and benefits. It is argued, therefore, that in order to scale-up adoption of ISFM, policy should focus on increasing farmers’ access to information on the benefits associated with the practices while improving farmers’ perceptions of the risks associated with the use of non-conventional technologies such as human faecal manure by addressing farmers’ health concerns

Social incentives as nudges for agricultural knowledge diffusion and willingness to pay for certified seeds: Experimental evidence from Uganda

A transition from low-input subsistence farming in Sub-Saharan Africa will require the use of yield-increasing agricultural technologies. However, in developing countries, most farmers continue to rely heavily on pestinfested and disease-infected recycled seed from own or local sources leading to low yields. This study used a field experiment to examine the effect of a social incentive combined with goal setting on the diffusion of agricultural knowledge and uptake of quality certified seed by farmers. We relaxed the seed access and information/knowledge constraints by introducing improved varieties of sweetpotato in the study villages and providing training to carefully selected progressive farmers who were then linked to co-villagers. We find that social incentives combined with goal setting reduced the likelihood of the trained progressive farmers reaching out to co-villagers to share information and discuss farming. Further, social incentive combined with goal setting had no significant effect on knowledge and experimentation by progressive farmers, and on willingness to pay for improved seed – as elicited through auctions, our proxy for experimentation, by co-villagers. These findings suggest that the combination of goal setting and public recognition acted to crowd-out diffusion effort. We conclude that social incentive combined with goal setting by established progressive farmers already enjoying a certain degree of public recognition is not sufficient to induce effort in learning and experimentation with agricultural innovations. These results have implications for design of policy and extension services to promote adoption of agricultural technologies with proven food and nutrition security benefits in developing countries