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Table 4 Overview of facilitators and barriers per pathway

From: Qualitative evidence for improved caring, feeding and food production practices after nutrition-sensitive agriculture interventions in rural Vietnam

  Production–consumption Caring and feeding HGSF
Facilitators Role models and increased confidence
Households with successful experiences acquired a role model status within their communities;
Exposure to such positive experiences and their visible benefits gave other beneficiaries the confidence and motivation to implement improved agricultural systems;
Increased confidence and pride in their achievements were important elements in the successful program implementation.
Micro-entrepreneur (R17): “Since my father started this model [chicken and pig raising] many people have learnt to apply the model like him.”
MCNV office chief (R30): “People are confident and proud that they achieved what they did. Two years ago, they only focussed on cassava, rice and acacia, and now they can do many things. They feel that they can control it and are proud of it. It is an important aspect.”
Commune agriculture (R5): “The second most important change is that the community now believes in their capacity to implement the agricultural models; in the past they never raised quails, crickets or earthworms, but now they can. Confidence is very important for them to maintain and develop these models.”
Role models and increased confidence
Household group leaders became role models for other parents especially for mothers. They transferred the new knowledge and skills acquired by training, infusing confidence on the results of the improved practices.
VHW (R11): “ I saw mothers join household group meetings regularly […]. The group heads who received training shared with group members.The mothers have made changes because they now understand. For those with children under 5, they learned how to take care of their children, how to improve child hygiene and how to cook the right food for their children. These changes make it better than in the past.”
District health (R1): “For ethnic minority people it should be quite easy; when they see someone in the community who has success, they are eager to learn. […]. These positive role models are very active in supporting other households to learn from them. […]. So we should focus on role models for others to learn and change their behaviour.”
District education (R2): “I think the local people see the benefits and their responsibility when they are involved in the project, so they feel confident and responsible when they join the project.”
Role models and increased confidence
Parents whose children had visible improvement in nutritional status, became role models, sharing their successful experience with others at school and HGMs;
Exposure to positive examples and their results enhanced confidence and motivated other beneficiaries to replicate good practices.
Commune nursery school principal (R4): “At school, when a child looks healthy, other parents asked teachers about the parents of that child, because they wanted to meet them.”
Change agents
Both nursery school children and micro-entrepreneurs were perceived as agents of change;
Children’s appreciation of the school meals and their request to eat the same food at home induced changes in parents’ cooking and feeding practices;
Micro-entrepreneurs engaged with the community not only by supplying school meals but also by selling food and demonstrating recipes to community members;
Multiple interviewees confirmed that the micro-enterprises also provided benefits to children not registered at nursery schools.
VHW (R9): “For mothers of children not yet attending preschool, for both well- and malnourished children, mothers buy nutritional porridge for breakfast.”
Barriers Socio-economic conditions of vulnerable households
Poor households lacked time to implement the agricultural models. Their need for waged labour far from home was noted as a main constraint;
Furthermore, economic conditions affected the extent and quality of implementation.
Commune agriculture (R5): “Most households that do not change their behaviour, it’s because they have a very difficult economic situation. To earn money they have to go to work far away; they may work away from the community for 10 or even 20 days.”
District agriculture (R3): “Some households implemented the model not very well; they could not expand the number of their chickens, or had fewer chickens. I think that this is all related to the economic situation of the household.”
Land and water scarcity
Despite having acquired sufficient skills, a large number of beneficiaries were unable to sustain their vegetable production during the dry season due to lack of water;
The change of agricultural practices was also constrained by the lack of land, which limited the scale of production;
Farmers recognised a lack of drought-resistant crops, such as pumpkin, bitter gourd and papaya.
Phu Giang Village FGD (G3): “We lack water in the dry season. We have to fetch water from places away from home, but not enough for watering vegetables.”
Animal diseases and limited feed
Beneficiaries received chickens to produce eggs but faced several challenges, including animal diseases;
Building on the lessons learnt from implementation, the NSA program trained beneficiaries on techniques, such as corralling and vaccinations, to minimize the spread of diseases. The applied strategies were not successful enough;
Early on, shortages of animal feed were perceived as a barrier. After the introduction of alternative feeding systems with crickets and earthworms, that barrier was overcome.
District agriculture (R3): “Chicken diseases are still happening, even though we provided vaccinations.”
Socio-economic conditions of vulnerable households
Barriers to change were found among the most disadvantaged households, which tend to have more children but less time for their care;
Management of their limited financial resources constrained their ability to change;
Some families find caretakers for their children but inadequate caring and feeding practices may not change if those caretakers are not involved in the learning activities.
VHW (R11): “Households who earn money and spend it within a day have a very difficult situation. It is a challenge to convince these households because their economic situation is too hard.”
Household priorities and lack of time
In spite of the positive attributes of HGMs, participants’ priorities and/or lack of time proved to be a constraint;
Lower engagement was partly attributed to communication materials being insufficiently tailored to the illiterate participants, hampering uptake of complex messages, such as vaccination and seasonal diseases.
VHW (R28): “If I or other group leaders ask, they come, but I must talk strictly; if I suggest gently to have a meeting about their children, they said they don't have time, they are tired, they work every day and don't have time for group meetings.”
Socio-economic conditions of vulnerable households
The school meal subsidy provided by the NSA program was crucial at the beginning, as it encouraged community buy-in. However, as the program progressed, the costs raised issues regarding sustainability;
Limited financial capacity to contribute became a significant constraining factor especially for the poorest households, in spite of their willingness to continue.
Village teacher (R8): “Actually, parents having better economic status will support this model. However, with parents having low income, it's a challenge for them.”
Micro-entrepreneur (R14): “I think most parents like the school meal, they are happy when their children are fed with good and tasty food, but for some families it is not easy to pay for 100% of the school meal.”
Parent/farmer (R12): “For my group, two other members have chickens and have children at pre-school. They are willing to pay for the school meal but for other households in the group, maybe 50% are willing to do that.”