Dietary Surveys and Nutritional Epidemiology

A large-scale intervention to introduce orange sweet potato in rural Mozambique increases vitamin A intakes among children and women

Christine Hotz^a1a2 c1, Cornelia Loechl^a3, Alan de Brauw^a4, Patrick Eozenou^a1, Daniel Gilligan^a4, Mourad Moursi^a1, Bernardino Munhaua^a3, Paul van Jaarsveld^a5, Alicia Carriquiry^a6 and J. V. Meenakshi^a1

^a1 HarvestPlus, International Food Policy Research Institute, 2033 K Street NW, Washington DC 20006, USA

^a2 Nutridemics, 231 Fort York Boulevard, Unit #1711, Toronto, ON, Canada M5V 1B2

^a3 International Potato Center (CIP), Avenida La Molina 1895, La Molina, Apartado Postal 1558, Lima, Peru

^a4 Poverty, Health and Nutrition Division, International Food Policy Research Institute, 2033 K Street NW, WashingtonDC 20006, USA

^a5 Nutritional Intervention Research Unit, Medical Research Council, Cape Town, South Africa

^a6 Department of Statistics, Iowa State University, Ames, IA, USA

Abstract

β-Carotene-rich orange sweet potato (OSP) has been shown to improve vitamin A status of infants and young children in controlled efficacy trials and in a small-scale effectiveness study with intensive exposure to project inputs. However, the potential of this important food crop to reduce the risk of vitamin A deficiency in deficient populations will depend on the ability to distribute OSP vines and promote its household production and consumption on a large scale. In rural Mozambique, we conducted a randomised, controlled effectiveness study of a large-scale intervention to promote household-level OSP production and consumption using integrated agricultural, demand creation/behaviour change and marketing components. The following two intervention models were compared: a low-intensity (1 year) and a high-intensity (nearly 3 years) training model. The primary nutrition outcomes were OSP and vitamin A intakes by children 6–35 months and 3–5·5 years of age, and women. The intervention resulted in significant net increases in OSP intakes (model 1: 46, 48 and 97 g/d) and vitamin A intakes (model 1: 263, 254 and 492 μg retinol activity equivalents/d) among the younger children, older children and women, respectively. OSP accounted for 47–60 % of all sweet potato consumed and, among reference children, provided 80 % of total vitamin A intakes. A similar magnitude of impact was observed for both models, suggesting that group-level trainings in nutrition and agriculture could be limited to the first project year without compromising impact. Introduction of OSP to rural, sweet potato-producing communities in Mozambique is an effective way to improve vitamin A intakes.

(Received February 08 2011)

(Revised August 22 2011)

(Accepted August 22 2011)

(Online publication October 10 2011)

Key Words:

• Orange sweet potato;
• Randomised effectiveness studies;
• Mozambique;
• Vitamin A

Correspondence:

^c1 Corresponding author: C. Hotz, email christinehotz.to@gmail.com

Footnotes

Abbreviations: EAR, estimated average requirement; HAZ, Z-scores for height-for-age; LAZ, Z-scores for length-for-age; OSP, orange sweet potato; RAE, retinol activity equivalents; USDA, United States Department of Agriculture; WAZ, Z-scores for weight-for-age