Scale up of Enhanced Homestead Food Production in Cambodia
Scale up of Enhanced Homestead Food Production in Cambodia
This project is a delayed pragmatic delayed-intervention cluster randomized control study in
 a subset of households (n=600) enrolled in a larger scale up program of enhanced homestead
 food production (EHFP) in Cambodia. The trial is designed to evaluate the impact of EHFP
 (home gardens only; home garden and fishponds; home gardens and poultry) versus control group
 on dietary intake of women and youngest child, household food security, income, and
 production throughout the agricultural cycle. Following administration of the baseline survey
 300 households will be randomized to the EHFP package of their choosing (Intervention Group)
 for two years. The other 300 households will not receive any intervention during the first
 year and will act as the control group; data will be collected monthly on production and
 income generated from gardening (and other homestead food production activities) and at two
 points throughout the year 24-hour dietary recall data will be collected from the women head
 of the household (aged 15-49y) and the youngest child between the ages of 6 - 59 months.
 After one year, the control group will be offered the intervention (EHFP package of their
 choice) fully subsidized and the project team will collect identical data on intervention
 group for one year as described for the control group.
Cambodia's economy has improved remarkably in the last decade, yet 80% of households
 experience some form of poverty, and 20% are severely impoverished. Food insecurity and its
 sequelae remain a problem, especially among rural farmers. As a solution Helen Keller
 International (HKI) implements a Enhanced Homestead Food Production (EHFP) model in Cambodia.
 EHFP, focusing on women farmers, fosters year-round environmentally sustainable production of
 nutrient-rich fruits, vegetables and animal-source foods. The program provides initial
 farming inputs coupled with technical assistance, nutrition education, and training on
 marketing and gender equity.

 In 2012, HKI together with the University of British Columbia (UBC), conducted a 22-month
 randomized control trial of EHFP, known as 'Fish on Farms'. Using HKI's approach, 900 women
 farmers were randomized to three groups: 1) plant-based EHFP; 2) EHFP plus fishponds; or 3) a
 control. Remarkably, in less than two years working with women farmers, Fish on Farms
 established 300 fishponds and 600 gardens. In the fishponds, small nutrient-rich fish were
 raised for household consumption and larger fish were raised for consumption or sale. After
 two years, households in both EHFP arms saw improvements in food production, income
 generation, food security, dietary diversity, and dietary intake of certain micronutrients
 relative to the control. However, the randomized-control trial (RCT) approach did have a
 number of issues, and gaps that need to be addressed were identified. Attrition was high,
 perhaps in part because of better opportunities for women, but also because women were not
 given a choice in the type of HFP activity to participate in. Further, the project provided
 many inputs for free so the women were not as invested as they might have otherwise been.
 Other issues identified were a lack of market access for sale of produce and fish, gender
 inequities, and a need to better capture the seasonality of food production and consumption
 at the household level.

 Building on lessons learned from the pilot study (Fish on Farms), this pragmatic
 delayed-intervention cluster randomized control study includes rigorous monitoring of
 production throughout the agricultural cycle as well as multiple 24-hour dietary recalls with
 improved methodology and frequency to better capture dietary intake. Women are self-selecting
 to participate, and are provided access to micro-credit institutions or other cost-sharing
 options so that women have a greater financial stake in EHFP leading to more successful
 farmers. Participants will also able to select from more EHFP options that include home
 gardens, poultry and fish.

 The ultimate goal of the program is to provide evidence of an integrated model of EHFP that
 has scalability and sustainability to improve the livelihoods of Cambodians and possibly the
 larger region.
Inclusion Criteria:

 -  Women of reproductive age (15-49 y)

 -  Child aged 6 - 59 months

 -  Demonstrate a willingness to cost-share on EHFP inputs

 -  Have suitable land for Enhanced Homestead Food Production activities

 Exclusion Criteria:

 -  Not meeting the above inclusion criteria