Comparing delivery channels to promote nutrition-sensitive agriculture: A cluster-randomized controlled trial in Bangladesh

We use a randomized controlled trial in rural Bangladesh to compare two models of delivering nutrition content jointly to husbands and wives: deploying female nutrition workers versus mostly male agriculture extension workers. Both approaches increased nutrition knowledge of men and women, household and individual diet quality, and women's empowerment. Intervention effects on agriculture and nutrition knowledge, agricultural production diversity, dietary diversity, women's empowerment, and gender parity do not significantly differ between models where nutrition workers versus agriculture extension workers provide the training. The exception is in an attitudes score, where results indicate same-sex agents may affect scores differently than opposite-sex agents. Our results suggest opposite-sex agents may not necessarily be less effective in providing training. In South Asia, where agricultural extension systems and the pipeline to those systems are male -dominated, training men to deliver nutrition messages may offer a temporary solution to the shortage of fe-male extension workers and offer opportunities to scale and promote nutrition-sensitive agriculture. However, in both models, we find evidence that the presence of mothers-in-law within households modifies the programs' effectiveness on some nutrition, empowerment, and attitude measures, suggesting that accounting for other influential household members is a potential area for future programming.

Automated summary

We conducted a randomized controlled trial in rural Bangladesh comparing the effectiveness of female nutrition workers and mostly male agriculture extension workers in delivering nutrition content. Both approaches increased nutrition knowledge, diet quality, and women's empowerment. The presence of same-sex or opposite-sex agents did not significantly affect intervention effects, except for attitudes scores where same-sex agents had a different impact. Our findings suggest that training men to deliver nutrition messages may help address the shortage of female extension workers in South Asia, but accounting for other influential household members, such as mothers-in-law, should be considered in future programs.