Download Study

General

Study Overview

Title:

The Impact of School Gardens Linked to Complementary Interventions in Nutrition, Water, Sanitation and Hygiene in Bhutan, Burkina Faso, Indonesia and Nepal

Study is 3ie funded:

No

Study ID:

RIDIE-STUDY-ID-55d344c556559

Initial Registration Date:

08/18/2015

Last Update Date:

07/22/2019

Study Status:

Completed

Change History for Status

Changed On	Previous Value
05/07/2019	Ongoing

Location(s):

Bhutan
Burkina Faso
Indonesia
Nepal

Abstract:

This study evaluates the combined impact of school gardens linked to complementary interventions in nutrition, water, sanitation and hygiene on the nutritional awareness, knowledge, perceptions, eating behavior and nutritional status of 8-11 year old schoolchildren in Bhutan, Burkina Faso, Indonesia and Nepal. The study is conducted in the context of the project “Vegetables Go to School: Improving Nutrition through Agricultural Diversification” funded by the Swiss Agency for Development and Cooperation (SDC). Phase 1 of this project started in March 2012 and extends through June 2016. In each country, the ministries of agriculture, education and health work together to implement the project. For each country, the study uses a randomized controlled trial design with a stepwise introduction of 10 new school gardens per year over a 2-year period. Data are collected from a random sample of schoolchildren from the intervention and control groups at the start and at the end of each school year. The intervention will be scaled up to a larger number of schools in phase 2 of the project if there is sufficient evidence for impact.

Change History for Abstract

Changed On

Previous Value

07/22/2019

This study evaluates the combined impact of school gardens linked to complementary interventions in nutrition, water, sanitation and hygiene on the nutritional awareness, knowledge, perceptions, eating behavior and nutritional status of 8-11 year old schoolchildren in Bhutan, Burkina Faso, Indonesia and Nepal. The study is conducted in the context of the project “Vegetables Go to School: Improving Nutrition through Agricultural Diversification” funded by the Swiss Agency for Development and Cooperation (SDC). Phase 1 of this project started in March 2012 and extends through June 2016. In each country, the ministries of agriculture, education and health work together to implement the project. For each country, the study uses a randomized controlled trial design with a stepwise introduction of 10 new school gardens per year over a 2-year period. Data are collected from a random sample of schoolchildren from the intervention and control groups at the start and at the end of each school year. The intervention will be scaled up to a larger number of schools in phase 2 of the project if there is sufficient evidence for impact.

Registration Citation:

Schreinemachers, P., 2015. The Impact of School Gardens Linked to Complementary Interventions in Nutrition, Water, Sanitation and Hygiene in Bhutan, Burkina Faso, Indonesia and Nepal . Registry for International Development for Impact Evaluations (RIDIE). Available at: 10.23846/ridie069

Categories:

Agriculture and Rural Development
Health, Nutrition, and Population
Water and Sanitation

Additional Keywords:

School gardens, nutrition sensitive agriculture

Secondary ID Number(s):

Principal Investigator(s)

Name of First PI:

Pepijn Schreinemachers

Affiliation:

World Vegetable Center (http://avrdc.org/)

Change History for Affiliation

Changed On	Previous Value
07/22/2019	AVRDC - The World Vegetable Center (http://avrdc.org/)

Name of Second PI:

Affiliation:

Study Sponsor

Name:

Swiss Agency for Development and Cooperation (SDC)

Study Sponsor Location:

Switzerland

Research Partner

Name of Partner Institution:

Institute for Physical Geography, University of Freiburg, Germany and Swiss Tropical and Public Health Institute, Basel, Switzerland

Type of Organization:

Research institute/University

Location:

Nepal

Intervention

Intervention Overview

Intervention:

The study objective is to generate robust evidence for the combined impact of school gardens linked to complementary interventions in nutrition and water, sanitation and hygiene (WASH) on the eating behavior and nutritional status of schoolchildren (8-11 years old) in Bhutan, Burkina Faso, Indonesia and Nepal. The exact intervention design varies by country, but generally includes: (a) A school garden for the cultivation of nutrient-rich vegetables by the schoolchildren under the guidance of the teachers and with the support of parents and the local community. The land is leveled and raised beds are constructed for drainage and easy planting. The project provides quality seed and equipment as needed. (b) A WASH component: improvements are made in the supply of clean water and soap and to the lavatories, such as installing inside locks, separating lavatories for boys and girls. Promotional materials are distributed to raise awareness about the importance of WASH. (c) A Nutritional awareness component: promotional materials are provided to raise children's awareness about the importance of eating vegetables. All intervention schools received all three components.

Change History for Intervention

Changed On

Previous Value

07/22/2019

The study objective is to generate robust evidence for the combined impact of school gardens linked to complementary interventions in nutrition and water, sanitation and hygiene (WASH) on the eating behavior and nutritional status of schoolchildren (8-11 years old) in Bhutan, Burkina Faso, Indonesia and Nepal. The exact intervention design varies by country, but generally includes: (a) A school garden for the cultivation of nutrient-rich vegetables by the schoolchildren under the guidance of the teachers and with the support of parents and the local community. The land is leveled and raised beds are constructed for drainage and easy planting. The project provides quality seed and equipment as needed. (b) A WASH component: improvements are made in the supply of clean water and soap and to the lavatories, such as installing inside locks, separating lavatories for boys and girls. Promotional materials are distributed to raise awareness about the importance of WASH. (c) A Nutritional awareness component: promotional materials are provided to raise children's awareness about the importance of eating vegetables. All intervention schools received all three components.

Private Intervention Details:

Theory of Change:

The above-mentioned intervention components are jointly expected to raise children’s awareness about vegetables and increase their knowledge. This increased knowledge is then expected to stimulate their preferences for healthier food choices including vegetables, which should then lead to better food choices and improved nutritional status. However, nutritional status is a relatively complex outcome that is mediated by a host of other factors such as early childhood nutrition, children’s disease prevalence and parasitic infection that were not directly addressed by the intervention.

Multiple Treatment Arms Evaluated?

Yes

Implementing Agency

Name of Organization:

1. School Agr. Programme, Min of Ag & Forests, Bhutan; 2. Min. of Nat. Edu. and Lit., Burkina Faso 3. Food Sec. Agency, Min. of Ag., Indonesia; 4. Nepal Ag. Res. Council, Min. of Ag., Nepal

Type of Organization:

Public Sector, e.g. Government Agency or Ministry

Program Funder

Name of Organization:

Swiss Agency for Development and Cooperation (SDC)

Type of Organization:

Foreign or Multilateral Aid Agency

Intervention Timing

Intervention or Program Started at time of Registration?

Yes

Start Date:

01/01/2014

End Date:

06/30/2016

Evaluation Method

Evaluation Method Overview

Primary (or First) Evaluation Method:

Randomized control trial

Other (not Listed) Method:

Additional Evaluation Method (If Any):

Other (not Listed) Method:

Method Details

Details of Evaluation Approach:

The evaluation quantified the combined effect of all 3 intervention components. For each country we selected one or several districts and made a list of eligible schools. For Bhutan, Burkina Faso and Nepal we randomly selected 30 schools from the list and randomly assigned them to one of 3 categories: 10 schools to receive the intervention (all 3 components) in the 2014 school year; 10 schools to receive it in the 2015 school year; and 10 control schools. Data are collected 4 times at the start and at the end of each school year using a structured questionnaire that each child must complete individually. Baseline data have been collected. For Indonesia the study also tests if additional training and technical support increases the impact as the current government program does not include training and support. We randomly selected 30 schools from the total list of eligible schools and randomly allocated them to one of 3 categories: 10 schools to receive the regular intervention; 10 schools to receive the improved intervention including teacher training and technical support; and 10 control schools. Baseline data have been collected, follow-up data will be collected in Nov. 2015.

Change History for Details of Evaluation Approach

Changed On

Previous Value

07/22/2019

The evaluation quantified the combined effect of all 3 intervention components. For each country we selected one or several districts and made a list of eligible schools. For Bhutan, Burkina Faso and Nepal we randomly selected 30 schools from the list and randomly assigned them to one of 3 categories: 10 schools to receive the intervention (all 3 components) in the 2014 school year; 10 schools to receive it in the 2015 school year; and 10 control schools. Data are collected 4 times at the start and at the end of each school year using a structured questionnaire that each child must complete individually. Baseline data have been collected. For Indonesia the study also tests if additional training and technical support increases the impact as the current government program does not include training and support. We randomly selected 30 schools from the total list of eligible schools and randomly allocated them to one of 3 categories: 10 schools to receive the regular intervention; 10 schools to receive the improved intervention including teacher training and technical support; and 10 control schools. Baseline data have been collected, follow-up data will be collected in Nov. 2015.

Private Details of Evaluation Approach:

Outcomes (Endpoints):

Primary outcomes: 1. Nutritional status: body height and weight was measured for each schoolchild and confirmed with the mid-arm circumference. We did not employ blood sampling because of ethical and practical considerations. 2. Dietary behavior: all food items consumed in the previous day were recorded by the children and used to calculate the number of different vegetables consumed and dietary diversity. Intermediary outcomes: 1. Awareness: measured by children's ability to correctly name fruits and vegetables from photos. 2. Knowledge: measured in 5 ways: (a) children's ability to identify nutrient-rich foods; (b) children's knowledge about the importance of healthy eating; (c) children's knowledge about water, sanitation and hygiene; (d) children's ability to distinguish between insect pests and beneficial insects; and (e) children's ability to judge the suitability of certain crop rotations such as repeatedly growing cabbages on the same land. 3. Preferences/attitudes: measured in 2 ways: (a) children's liking for different vegetables; and (b) children's preferences for unprocessed vs. processed snack foods.

Change History for Outcomes (Endpoints)

Changed On

Previous Value

07/22/2019

Primary outcomes: 1. Nutritional status: body height and weight was measured for each schoolchild and confirmed with the mid-arm circumference. We did not employ blood sampling because of ethical and practical considerations. 2. Dietary behavior: all food items consumed in the previous day were recorded by the children and used to calculate the number of different vegetables consumed and dietary diversity. Intermediary outcomes: 1. Awareness: measured by children's ability to correctly name fruits and vegetables from photos. 2. Knowledge: measured in 5 ways: (a) children's ability to identify nutrient-rich foods; (b) children's knowledge about the importance of healthy eating; (c) children's knowledge about water, sanitation and hygiene; (d) children's ability to distinguish between insect pests and beneficial insects; and (e) children's ability to judge the suitability of certain crop rotations such as repeatedly growing cabbages on the same land. 3. Preferences/attitudes: measured in 2 ways: (a) children's liking for different vegetables; and (b) children's preferences for unprocessed vs. processed snack foods.

Unit of Analysis:

Data will be analyzed at the level of schoolchildren.

Hypotheses:

Primary hypothesis: School vegetable garden linked to complementary interventions in nutrition, water, sanitation and hygiene improve the dietary behavior and nutritional status of 8-11 year old schoolchildren in the target countries. Secondary hypotheses: School vegetable garden interventions linked to complementary interventions in nutrition, water, sanitation and hygiene raise the awareness about healthier food items such as vegetables; increase the knowledge about nutrition, sanitation and hygiene, and agriculture; and increase the preference for eating healthier foods among children aged 8-11 years in the target countries.

Change History for Hypotheses

Changed On

Previous Value

07/22/2019

Primary hypothesis: School vegetable garden linked to complementary interventions in nutrition, water, sanitation and hygiene improve the dietary behavior and nutritional status of 8-11 year old schoolchildren in the target countries. Secondary hypotheses: School vegetable garden interventions linked to complementary interventions in nutrition, water, sanitation and hygiene raise the awareness about healthier food items such as vegetables; increase the knowledge about nutrition, sanitation and hygiene, and agriculture; and increase the preference for eating healthier foods among children aged 8-11 years in the target countries.

Unit of Intervention or Assignment:

Schools

Number of Clusters in Sample:

30 clusters (schools) per country

Number of Individuals in Sample:

The number of schoolchildren sampled per country is: Bhutan 700, Burkina Faso 1000, Indonesia 1260, and Nepal 1370.

Size of Treatment, Control, or Comparison Subsamples:

Bhutan, Burkina Faso & Nepal: 10 intervention schools in 2014, 10 in 2015, and 10 control schools. Indonesia: 10 schools with standard intervention, 10 with new, and 10 control schools in 2014.

Supplementary Files

Analysis Plan:

Other Documents:

Data

Outcomes Data

Description:

A questionnaire is conducted among 8-11 year old schoolchildren. The questionnaire uses mostly photos with multiple choice answers.

Data Already Collected?

No

Data Previously Used?

Data Access:

Data Obtained by the Study Researchers?

Data Approval Process:

Approval Status:

Treatment Assignment Data

Participation or Assignment Information:

Yes

Description:

Data Obtained by the Study Researchers?

Data Previously Used?

Data Access:

Data Obtained by the Study Researchers?

Data Approval Process:

Approval Status:

Data Analysis

Data Analysis Status:

Study Materials

Upload Study Materials:

Registration Category

Registration Category:

Prospective, Category 1: Data for measuring impacts have not been collected

Completion

Completion Overview

Intervention Completion Date:

06/30/2017

Data Collection Completion Date:

04/30/2016

Unit of Analysis:

School child

Clusters in Final Sample:

Clustered at the school level with 18 schools in Bhutan, 40 schools in Nepal, and 30 schools in Burkina Faso.

Total Observations in Final Sample:

Complete observations for schoolchildren at baseline and endline: 468 for Bhutan, 2060 for Nepal, 1760 for Burkina Faso. Consort diagrams are available.

Size of Treatment, Control, or Comparison Subsamples:

The above sample sizes were equally split between treatment and control.

Findings

Preliminary Report:

Yes

Preliminary Report URL:

http://dx.doi.org/10.1080/19439342.2017.1311356 ; http://dx.doi.org/10.1007/s12571-017-0673-3; https://doi.org/10.1080/19439342.2019.1624595

Change History for Preliminary Report URL

Changed On	Previous Value
07/22/2019	http://dx.doi.org/10.1080/19439342.2017.1311356 ; http://dx.doi.org/10.1007/s12571-017-0673-3

Summary of Findings:

The results show that school garden interventions significantly improved children’s knowledge about food and agriculture in all three countries. For Bhutan and Nepal, the results showed improvements in children’s awareness of fruit and vegetables and their stated preferences for eating them. In none of the countries did these changes translate into clear increases in fruit and vegetable consumption.

Change History for Summary of Findings

Changed On

Previous Value

07/22/2019

The results show that school garden interventions significantly improved children’s knowledge about food and agriculture in all three countries. For Bhutan and Nepal, the results showed improvements in children’s awareness of fruit and vegetables and their stated preferences for eating them. In none of the countries did these changes translate into clear increases in fruit and vegetable consumption.

Paper:

Yes

Paper Summary:

Impact of School Gardens in Nepal: A Cluster Randomized Controlled Trial: There was a significant (p<0.01) increase in children's awareness about fruit and vegetables, their knowledge about sustainable agriculture, their knowledge about food, nutrition and health, and their stated preferences for eating fruit and vegetables. However, these improvements in intermediary outcomes did not translate into significant improvements in fruit and vegetable consumption. School gardening in Bhutan: evaluating outcomes and impact: The school gardening intervention significantly increased children's awareness about vegetables, their knowledge about sustainable agriculture, and their preferences for more healthy foods. We found an 11.7-percentage point increase in the probability that children included vegetables in their meals (p<0.05), but not in the number of different fruits or vegetables consumed. Impact of school gardens and complementary nutrition education in Burkina Faso: The results show a significant (p<0.05) increase in knowledge about sustainable agriculture (+5.0%) and about food and nutrition (+6.6%), but no significant (p>0.05) improvement in other outcome indicators.

Change History for Paper Summary

Changed On

Previous Value

07/22/2019

Impact of School Gardens in Nepal: A Cluster Randomized Controlled Trial: There was a significant (p<0.01) increase in children's awareness about fruit and vegetables, their knowledge about sustainable agriculture, their knowledge about food, nutrition and health, and their stated preferences for eating fruit and vegetables. However, these improvements in intermediary outcomes did not translate into significant improvements in fruit and vegetable consumption. School gardening in Bhutan: evaluating outcomes and impact: The school gardening intervention significantly increased children's awareness about vegetables, their knowledge about sustainable agriculture, and their preferences for more healthy foods. We found an 11.7-percentage point increase in the probability that children included vegetables in their meals (p<0.05), but not in the number of different fruits or vegetables consumed. Impact of school gardens and complementary nutrition education in Burkina Faso: The results show a significant (p<0.05) increase in knowledge about sustainable agriculture (+5.0%) and about food and nutrition (+6.6%), but no significant (p>0.05) improvement in other outcome indicators.

Paper Citation:

Schreinemachers, P. et al. 2017. Impact of School Gardens in Nepal: A Cluster Randomized Controlled Trial. Journal of Development Effectiveness 9(3): 329-343. Schreinemachers, P. et al. 2017. School gardening in Bhutan: evaluating outcomes and impact. Food Security 9, 635-648. Schreinemachers, P. et al. 2019. Impact of school gardens and complementary nutrition education in Burkina Faso. Journal of Development Effectiveness, 11(2), 132-145.

Change History for Paper Citation

Changed On

Previous Value

07/22/2019

Schreinemachers, P., D.R. Bhattarai, G.D. Subedi, et al. 2017. Impact of School Gardens in Nepal: A Cluster Randomized Controlled Trial. Journal of Development Effectiveness 9(3): 329-343 http://dx.doi.org/10.1080/19439342.2017.1311356 Schreinemachers, P., B.B. Rai, D. Dorji, et al. 2017. School gardening in Bhutan: evaluating outcomes and impact. Food Security 9, 635-648. http://dx.doi.org/10.1007/s12571-017-0673-3 The paper for Burkina Faso is still under review.

Data Availability

Data Availability (Primary Data):

Yes--Available now

Date of Data Availability:

Data URL or Contact:

Nepal data are available at: https://worldveg.tind.io//record/57654/files/ Bhutan data will be available at https://worldveg.tind.io/record/57666?ln=en shortly

Access procedure:

In case of problems accessing the data, please contact

Other Materials

Survey:

Yes

Survey Instrument Links or Contact:

Please contact

Program Files:

Yes

Program Files Links or Contact:

Please see weblink above or contact

Change History for Program Files Links or Contact

Changed On	Previous Value
07/22/2019	Currently only for Nepal. Please see weblink above or contact

External Link:

External Link Description:

Description of Changes:

1. The Indonesia component of the study was stopped because of problems with the data quality. 2. For the Bhutan component, data could only be collected for one year, while we collected data for two years for Nepal and Burkina Faso.

Change History for Description of Changes

Changed On	Previous Value
07/22/2019	1. The Indonesia component of the study was stopped because of problems with the data quality. 2. For the Bhutan component, data could only be collected for one year, while we collected data for two years for Nepal and Burkina Faso.

Study Stopped

Date:

Reason: