Food security mediates the decrease in women's depressive symptoms in a participatory nutrition-sensitive agroecology intervention in rural Tanzania

Hollyn M. Cetrone, Marianne V. Santoso, Rachel Bezner Kerr, Lucia Petito, Lauren Blacker, Theresia Nonga, Haikael D. Martin, Neema Kassim, Elias Mtinda, Sera L. Young*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To investigate if food security mediated the impact of a nutrition-sensitive agroecology intervention on women's depressive symptoms. Design: We used annual longitudinal data (four time points) from a cluster-randomised effectiveness trial of a participatory nutrition-sensitive agroecology intervention, the Singida Nutrition and Agroecology Project. Structural equation modelling estimation of total, natural direct and natural indirect effects was used to investigate food security's role in the intervention's impact on women's risk of probable depression (Center for Epidemiologic Studies Depression Scale > 17) across 3 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 the odds of probable depression by 43 % (OR = 0·57, 95 % CI: 0·43, 0·70). Differences in food insecurity explained approximately 10 percentage points of the effects of the intervention on odds of probable depression (OR = 0·90, 95 % CI: 0·83, 0·95). Conclusions: This is the first evidence of the strong, positive effect that lowering food insecurity has on reducing women's depressive symptoms. Nutrition-sensitive agricultural interventions can have broader impacts than previously demonstrated, i.e. improvements in mental health; changes in food security play an important causal role in this pathway. As such, these data suggest participatory nutrition-sensitive agroecology interventions have the potential to be an accessible method of improving women's well-being in farming communities.

Original languageEnglish (US)
Pages (from-to)4682-4692
Number of pages11
JournalPublic Health Nutrition
Volume24
Issue number14
DOIs
StatePublished - Oct 12 2021

Keywords

  • Agroecology
  • Depression
  • Food security
  • Mental health
  • Nutrition-sensitive agriculture

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Public Health, Environmental and Occupational Health

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