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. 2020 Aug 5;2020(8):CD011504. doi: 10.1002/14651858.CD011504.pub3

5. Income‐generation interventions – overview of included studies.

Study (country of conduct) Study design Overall risk of biasa Other key details of intervention Population (sample size at baseline: Intervention/ Control) Outcome domains and measures with available data Time point of measurement
Darrouzet Nardi 2016 (Nepal) cRCT Unclear Programme name: Heifer training curriculum
Programme description and frequency: participation in programme that focused on training regarding poverty alleviation, citizen empowerment, community development and optimisation of livestock management as means to generate income.
Provider: NGO (Heifer International)
Delivery: women's self‐help groups which met with a trained facilitator, supplemented by specific interactive instruction, workshops, guidance, and training. Biweekly meetings
Co‐interventions: none reported
Rural farming communities; HHs: 201/214; children (aged 6–60 months): 283/324 Dietary diversity:
  • Household dietary diversity index

  • Child minimum dietary diversity


Anthropometry
  • HAZ;

  • WAZ

1 and 2 years
Doocy 2017 (Democratic Republic of the Congo) Prospective controlled study High Programme name: Intervention implemented as part of the Jenga Jamaa II project
Programme description and frequency: WEGs met weekly and meetings served as a delivery mechanism for a variety of interventions including literacy and numeracy, business and marketing training, and income‐generation activities. Savings and credit groups were started in each WEG. Beneficiaries were provided with a starter kit of basic materials for their income‐generation activity. Many WEG participants also received goats and energy‐efficient stoves. The FFS intervention provided farmers with experience‐based education on farming practices and postharvest handling as well as business and natural resource management skills. Each FFS group received semi‐monthly training sessions for 2 years. Each FFS group had a community demonstration plot, and group members also received starter packages of seeds and tools for use on individual farms. The FFS programmes focused on a variety of common crops in the region. The first year of training focused on knowledge of production systems and technologies; adoption of techniques and technologies and behaviour change were the focus in the second year
Provider: ADRA
Delivery: FFS – training sessions on agriculture techniques and other content by ADRA field agents.
Co‐interventions: after they finished the FFS intervention (2 years) some transitioned to farmer business associations, which were intended to improve access to credit and marketing opportunities.
Farming villages; HHs (WEG: 390/324; FFS: 338/324) Food security:
  • HFIAS

  • Proportion of HHs improving a HFIAS category


Dietary diversity:
  • HDDS

  • Achieving target dietary diversity (based on HDDS)

3.5 years
Weinhardt 2017 (Malawi) Prospective controlled study (non‐equivalent control group) Unclear Programme name: support to able‐bodied vulnerable groups to achieve food security (SAFE) programme
Programme description and frequency: programme comprised 4 components
  • Improving farming practices and sustainable agriculture through Farmer Field Schools

  • Increasing access to savings and investment through Village Savings and Loans Groups

  • Building capacity of local governance structures

  • Integrating HIV education and gender empowerment into programmes through training and education


Provider: NGO (CARE Malawi)
Delivery: community‐based programme
Co‐interventions: agricultural education programme for a few intervention and control participants
Rural HHs (598/301) Food security:
  • Mean number of months with less food than necessary to meet needs


Anthropometry:
  • WAZ

  • HAZ

  • Moderate and severe underweight (< –2SD WAZ)

  • Child BMI

18 and 36 months
Jodlowski 2016 (Zambia) Prospective controlled study Low Programme name: Copperbelt Rural Livelihoods Enhancement Support Project (CRLESP)
Programme description and frequency: ongoing training and one‐off transfer of livestock contingent on training participation. 1 female livestock offspring per transferred female had to be donated to a Pass‐on‐the‐Gift HH.
Provider: NGO (Heifer International)
Delivery: NR
Co‐interventions: none reported
Rural households (105/178) Dietary diversity:
  • Household Dietary Diversity Index

  • Probability weighted dietary diversity score

6, 12 and 18 months
Asadullah 2015 (Bangladesh) Prospective controlled study High Programme name: challenging the frontiers of poverty reduction – targeting the ultra‐poor (CFPR‐TUP)
Programme description and frequency: multicomponent intervention including orientation training, selection of income‐generation microenterprise by female participants with one‐off transfer of productive assets worth BDT 10,000 to support it (90% of households chose livestock combination), community savings, monthly health worker visits, weekly follow‐up for technical advice, building social capital (village support networks and sponsorship of community leaders), and weekly stipends (BDT 70).
Provider: NGO (Bangladesh Rural Advancement Committee (BRAC))
Delivery: NGO staff deliver training and assets
Co‐interventions: none reported
Ultra‐poor households (2633/2993) Food security
  • Proportion experiencing food deficit always


Morbidity:
  • Perceived health status

  • Perceived health improvement

3, 6 and 9 years
Marquis 2018 (Ghana) cRCT Low Programme name: Nutrition Links (NL)
Programme description and frequency: 12‐month intervention was an integrated package of agricultural inputs and training as well as education in nutrition, health care and child stimulation for participants. The intervention had 4 main components
  • Poultry for egg production

  • Home gardens

  • Weekly group education sessions throughout the year

  • Community‐wide education


Provider: "Heifer's Passing on the Gift (POG) community development programme, project staff, district agricultural extension officers, district government staff, University of Ghana's Nutrition Research and Training Centre
Delivery:
  • 4‐day training received chickens and initial feed for 1 month and vaccinations, and weekly technical assistance by the project staff

  • Training, received planting materials, and weekly technical assistance

  • Weekly group education sessions

  • Training that was accessible to all residents


Co‐interventions: none reported
Mother–infant pairs in rural communities (287/213). Dietary diversity
  • Minimal diet diversity


Anthropometry:
  • WAZ;

  • LAZ/HAZ;

  • WLZ/WHZ

1 year
Olney 2016 (Burkina Faso) cRCT Unclear Programme name: enhanced‐homestead food production (EHFP)
Programme description and frequency: integrated agriculture and nutrition programme. Agriculture interventions included provision of land with inputs (crops, animals and implements) and training. Nutrition intervention included behaviour change communication strategy for health and nutrition behaviours, delivered through visits by community volunteers twice per month.
Provider: NGO (Helen Keller International – HKI)
Delivery: agriculture interventions rolled out first to female village farm leaders, who then trained other mothers. Nutrition education carried out by older women leaders or health committee members.
Co‐interventions: none reported
Villages with agricultural homesteads (30/25). HHs: 514 (health committee); 512 (older women leaders); 741 (control) Dietary diversity:
  • Household Dietary Diversity Index

  • Proportion of mothers consuming individual food groups in past 7 days


Anthropometry:
  • BMI (adult)

  • Underweight (adults) (BMI < 18.5 kg/m2)

2 years
Osei 2017 (Nepal) cRCT Unclear Programme name: Enhanced Homestead Food Production (EHFP) programme
Programme description and frequency: training in improved gardening and poultry‐rearing practices; hosting of a village model farm, which served as a site for purchasing inputs and ongoing training for all the beneficiary women. For every season (rainy and winter) of the first year, each woman was given a one‐off free supply of seeds, saplings and locally bred chicks to establish their home gardens and poultry production. Throughout the period of the intervention, the women met monthly at the farm to refresh lessons on agriculture techniques and nutrition through social and behaviour change communications. During monthly home visits, the project staff and the female community health volunteers also reinforced the educational messages on breastfeeding and complementary feeding to all mothers.
Provider: NGO (Helen Keller International – HKI)
Delivery: 1 woman per group of intervention villages (5 or 6) was selected and trained by HKI and this woman then trained 20 other beneficiary women; meetings at farm; home visits by trained project staff, female community health volunteers and agriculture extension officers.
Co‐interventions: none reported.
Homesteads: mothers (1055/1051), children (1055/1051) Food security
  • Prevalence of HH food insecurity


Anthropometry:
  • HAZ

  • Stunting (HAZ < –2SD)WAZ

  • Underweight (child) (WAZ < –2SD) and mother (BMI < 18.5 kg/m2)

  • WHZ

  • Wasting (WHZ < –2SD)

  • BMI (mother)


Biochemical indicators:
  • Mean haemoglobin concentration (child and mother)


Morbidity:
  • Prevalence of anaemia (child and mother)

2.5 years
Verbowski 2018 (Cambodia) cRCT Unclear Programme name: Fish on Farms (FoF) project using the Enhanced Homestead Food Production (EHFP) programme
Programme description and frequency: basic agricultural inputs and training, and nutrition and hygiene education. The education focused on optimal nutrition for women and infants and young child practices, and the use of nutrient‐dense produce grown by farmers were demonstrated. The purpose of EHFP was to increase production and intakes of various types of vegetables, herbs and tree fruit. The aquaculture intervention was designed to increase the production of 3 types of small fish, which typically were consumed whole, as well as 3 types of large fish (typically sold for income or fillets consumed).
Provider: NGO (Helen Keller International – HKI, local)
Delivery: trained village health volunteers provided education sessions, through small group and 1‐to‐1 counselling. Cooking demonstrations were also conducted. Support was provided through village model farms (1 in each village).
Co‐interventions: none reported.
Rural HHs: EHFP + aquaculture (100), EHFP (100) and control (100) Anthropometry:
  • Underweight (women) (BMI <18.5 kg/m2) and children (WAZ < –2SD);

  • Stunting (HAZ < –2SD);

  • Wasting (WHZ < –2SD)


Biochemical indicators:
  • Haemoglobin (non‐pregnant women)

  • Haemoglobin (children)


Morbidity:
  • Anaemia (non‐pregnant women)

  • Anaemia (children)

22 months
Murshed E Jahan 2011 (Bangladesh) Prospective controlled study Unclear Programme name: Development of Sustainable Aquaculture Project (DSAP)
Programme description and frequency: farmers received support to efficiently implement integrated aquaculture‐agriculture (IAA) approaches under 2 models – 1 with a one‐off provision of a small grant for purchasing inputs (value not reported) and 1 without, with training provided (3 sessions in the first year, 2 in the second year and 1 in the third year).
Provider: NGO; WorldFish Center
Delivery: farmers trained in recording required information which was collected bi‐monthly by research assistants.
Co‐interventions: none reported
Small‐scale farmers (260/126).
Within intervention farmers: 127 grant farmers, 133 non‐grant farmers
Proportion of HH expenditure on food 3 years
Kennedy 1989 (Kenya) Prospective controlled study Unclear Programme name: South Nyanza Sugar Factory (Sony) smallholder sugarcane outgrowers' scheme
Programme description and frequency: farmers were enrolled into the scheme to provide sugarcane to a new factory, with payments to farmers after every harvest (24 months after planting)
Provider: Kenyan government
Delivery: contract agreement between farmers and factory.
Co‐interventions: none reported
Smallholder farm HHs (181/231).
Within intervention: 139 sugar farmers and 42 new entrant
  • Proportion of HH expenditure on food


Adequacy of dietary intake
  • Percentage of HHs with caloric deficiency

  • Caloric adequacy of preschool children


Anthropometry
  • WAZ

  • Underweight (< 80% of standard for WAZ)

  • HAZ

  • Stunted (< 90% of standard for HAZ)

  • WHZ

  • Wasting (< 90% of standard for WHZ)

  • BMI (adult)


Morbidity:
  • Illness of women and children (all‐cause and diarrhoea)

2 years
Alaofe 2016 (Benin) Prospective controlled study Unclear Programme name: Solar Market Gardens (SMG)
Programme description and frequency: drip irrigation powered by solar water pump, using a perennial stream or borehole, with continued maintenance and training to farmers provided.
Provider: NGO (Solar Electric Light Fund – SELF)
Delivery: installation of system and training of local technicians carried.
Co‐interventions: women's agriculture group activities.
Rural HHs (116/98)
In both intervention and control groups, HHs included women who participated in women's agriculture groups (59/38) or not (60/60)
Proportion of HH expenditure on food 1 year
Alaofe 2019 (Benin) Prospective controlled study Unclear Programme name: Solar Market Garden (SMG)
Programme description and frequency: Installation of a low‐pressure drip irrigation system, combined with a solar‐powered water pump in each intervention village. Each SMG was used jointly by 30–35 women belonging to the local women's agriculture group (each woman farmed her own land of 120 m2).
Provider: NGO (Solar Electric Light Fund – SELF)
Delivery: expanded installation of SMG systems (from programme reported in Alaofe 2016).
Co‐interventions: women's agriculture group activities.
Women in rural HHs (415/359).
In both intervention and control groups, HHs included women who participated in women's agriculture groups (184/126) or not (228/233)
Dietary diversity:
  • HDDS

  • Women's Dietary Diversity Score


Anthropometry
  • BMI (adult);

  • Underweight (adult) (BMI <18.5 kg/m2)


Biochemical indictors:
  • Iron deficiency

  • Vitamin A deficiency


Morbidity:
  • Anaemia

  • Iron‐deficiency anaemia

1 year
Kangmennaang 2017 (Malawi) Prospective controlled study High Programme name: the Malawi Farmer to Farmer Agroecology project (MAFFA).
Programme description and frequency: farmers do their own experimentation with agroecological methods. Farmers are also encouraged to share knowledge gained with other farmers. MAFFA encourages farmers to adopt a suit of innovations rather than just a single innovation and to encourage farmer‐led learning. In addition to crop diversification, many farmers increased or began to apply compost and manure to their rain‐fed fields. Some farmers also experimented with botanical pesticides. Also, MAFFA goes beyond agroecological training to focus on knowledge sharing, leadership support, nutrition and attention to social inequalities.
Provider: Soils, Food and Healthy Communities organisation of Ekwendeni Hospital, Chancellor College, University of Malawi as well as Malawian and Canadian scientists.
Delivery: training, educational activities, campaigns, provision of seeds. Farmers shared knowledge with other farmers.
Co‐interventions: none reported.
Smallholder farm HHs (793/408) Food security:
  • HFIAS score

About 2 years
Beegle 2017 (Malawi) cRCT High Programme name: Malawi Social Action Fund's Public Works Programme (MASAF PWP).
Programme description and frequency: the MASAF PWP aims to provide short‐term labour‐intensive activities. The programme was designed to be interlinked with Malawi's large‐scale fertiliser input subsidy programme through the implementation of the PWP in the planting months of the main agricultural season when the fertiliser distribution also occurs. Projects were mostly road rehabilitation or construction, with some afforestation and irrigation projects. The wage rate was USD 0.92/day for a total payment of USD 11.01 for a 12‐day wave, total of 4 waves.
Provider: Malawi government
Delivery: payments in the study districts were facilitated by the research team for the purposes of the evaluation, with physical delivery of the cash in conjunction with the district officials.
Co‐interventions: the national fertiliser subsidy programme provided fertiliser coupons that allow two bags of fertiliser to be purchased for MK 500 each. These coupons are more likely to be available to treated HHs.
10 poor and able‐bodied HHs per community were offered the programme; communities (144/38) Food security:
  • Food Security Score


Dietary diversity:
  • Food Consumption Score

  • Number of food groups consumed

  • Food Security Score

3/4 months
Porter 2016 (Ethiopia) Prospective controlled study High Programme name: Productive Safety Net Program (PSNP)
Programme description and frequency: 80% public works programme (food/cash‐for‐work; USD 0.56/day in 2008) and 20% unconditional transfers to those unable to work (value NR). Programme operated seasonally but predictably, i.e. not emergency.
Provider: Ethiopian government, with donor funding
Delivery: centrally co‐ordinated by Government
Co‐interventions: none reported
Poor and food insecure rural HHs (682/924) Anthropometry (results presented for all programme participants; not disaggregated according to type of intervention received)
  • HAZ

  • WAZ

5 and 7 years
Katz 2001 (Nepal) Prospective controlled study High Programme name: N/A
Programme description and frequency: part‐time (5 hours/week) employment for women; distributing weekly supplements to and recording data on married women of child‐bearing age in own or neighbouring communities. Monthly income valued at USD 15
Provider: Joint undertaking by USAID, academic institutions (Johns Hopkins University), NGOs (National Society for the Prevention of Blindness, Kedia Seva Mandir) and the Nepalese government
Delivery: NR
Co‐interventions: approximately 31% of women employed by the project reported having additional cash employment, but amounts are unknown
Women living in rural areas (350/520) Anthropometry:
  • MUAC

2 years

aOverall risk of bias based on risk for selection and attrition bias

ADRA: Adventist Development and Relief Agency; BDT: Bangladeshi taka; BMI: body mass index; FFS: Farmer Field School; HAZ: height‐for‐age z‐score; HDDS: Household Dietary Diversity Score; HFIAS: Household Food Insecurity Access Scale; HH: household; LAZ: length‐for‐age z‐score; MUAC: mid‐upper arm circumference; NGO: non‐governmental organisation; NR: not reported; RCT: randomised controlled trial; SD: standard deviation; WLZ: weight‐for‐length z‐score; WAZ: weight‐for‐age z‐score; WEG: Women Empowerment Group.