Adressing food and nutrition insecurity through the development and implementation of an agricultural and nutrition education programme on legumes for older farmers living in Mariannhill, KwaZulu-Natal, South Africa

Abstract

Introduction Food and nutrition security can be influenced by various external and internal factors that contribute to a compromised wellbeing status amongst older farmers who are considered as a vulnerable group. This group faces diverse socio-economic and health challenges within an evolving food system. The complexity of this challenge persistently requires multisectoral intervention programmes, as reflected in the nature of this study. Aim and Objectives The aim of the study was to determine the levels of and address the food intake and nutrition insecurity status of elderly farmers. The main objective was to address the challenges that compromised the health of selected previously non-legume producing farmers by encouraging legume production and consumption amongst them. The findings of the study informed the proposal of appropriate strategies to develop an intervention programme intended to educate the identified elderly farmers and to promote their dietary diversification by means of legume production and consumption. Methodology The study employed a cross-sectional design. A baseline study was conducted that aimed at examining variable relationships using a mixed methods approach involving both qualitative and quantitative data collection techniques. A sample of 112 elderly farmers participated in the baseline study, followed by a case-controlled intervention programme that included preand post-intervention surveys. The measuring instruments included socio-demographic as well as health and medical surveys to elicit data such as blood pressure, blood indices for glucose and cholesterol due to dietary intake, household food security, legume knowledge, legume acceptability and agricultural practices. The data informed the findings of both the baseline and the intervention phases of the study. The baseline study involved a sample of 112 elderly farmers, whereas the intervention study involved two case controls (n=103) that comprised an experimental group (EG: n=53) and a control group (CG: n=50). Data were obtained for both groups by analysing blood indices, dietary intake, yields of legume production (EG only) and legume acceptability levels using statistical analyses of variance, significance and trends of pre- and post-intervention surveys over two years. A follow-up survey (FU) was conducted six months after the conclusion of the intervention phase and involved only the EG (n=32), to assess the impact of the intervention programme on their dietary intake and farming practices. The follow-up study thus compared the intervention data of the farmers’ consumption and production patterns with data obtained postintervention. During this latter study, only dietary intake and production levels were measured. All the data were analysed using IBM Statistical Package for Social Sciences (SPSS), Food Finder software, the Mann-Whitney U test, Analysis of Variance (ANOVA) and T-tests for statistical frequencies, variances and correlations. Results In the baseline study, 79.5% of the participants were women. The mean age of the participants was 63.3 ± 8.2 years. A diverse legume consumption was not observed as indicated by a low legume food group diversity score (FGDS) for 0-9 varieties with a mean of 3.5 (SD ± 1.70). Legumes were the least (19.0%) preferred crop planted by the farmers prior to the study. In the intervention study, the majority of participants were also women (73.6% in the EG and 66.0% in the CG). Of the six varieties of legumes under study, red kidney beans was the most preferred (141.60 kg/ha-1 SD ± 162.11). There was a high significance (p=0.001) amongst the six legume varieties produced, which implies that some legumes had a higher yield than others. A comparison between the genders indicated that the women produced 81.70 kg/ha-1 (SD ± 77.95), while the men produced 33.63 kg/ha-1 (SD ± 166.40). The higher yields produced by the women were significant (p=0.011). Legume consumption improved for the EG because the intervention programme resulted in a significantly (p=0.000) increased dietary diversity score (DDS) of legume intake with a mean (±SD) FGDS from 2.4 (SD ± 1.35) to 5.7 (SD ± 2.56) and a mean (±SD) Dietary Diversity Score (DDS) from 8.59 ± 0.74 to 8.23 ± 1.11, while that of the CG was 3.0 (SD ± 1.82). According to the post-intervention survey, the blood results of the EG indicated nutrient improvement at the 5.0% significance level for blood glucose (p=0.038) and cholesterol (p=0.008). The blood glucose levels of the EG were statistically significant (p=0.037) when this group was compared with the CG in both the pre-intervention and post-intervention surveys. Trend analyses were conducted and compared between those men and women who participated throughout the study (i.e. participation from the baseline to the post-intervention surveys). It was found that cholesterol (p=0.033) and Systolic Blood Pressure (SBP) (p=0.013) were statistically significant when the genders were compared across all phases of the study. Data obtained for the EG in the Follow Up (FU) study six months after the intervention study indicated that the production of legumes had declined (71.8%). This was because the legume intake with a mean (±SD) FGDS of 3.0 ± 2.2 indicated a significant (p=0.000) drop from 5.7 (SD ± 2.56) with DDS from 8.23 (± 1.11) to 8.81 (± 0.47) at p=0.005 significance as determined by the FU survey. It was also found that limited marketing of legumes had occurred, which suggests that the sustainability of legume production and consumption post-intervention by the elderly farmers was a challenge. However, 100.0% of the farmers indicated that they intended to continue their production and consumption of legumes, provided that the constant supply of legumes did not cease. Conclusions Evidence was obtained that the intervention project positively impacted the production and consumption of legumes and that the elderly farmers thus diversified their dietary intake for the better during this phase of the study. However, further investigations need to be conducted to explain the decline in consumption and production in the post-intervention period if support for a healthier lifestyle amongst elderly farmers is to be sustained. The technology to produce legumes with high yields to address food insecurity through more appropriate consumption patterns also needs to be explored in greater depth. Because the two streams of knowledge transfer that involved hands-on training of elderly farmers improved legume production and consumption patterns, this study established a sound foundation on which future studies and intervention strategies for food security amongst vulnerable groups may be built.