Nutrition Knowledge, Attitudes, and Practices Among Employees of Organizations that Provide Agricultural Extension Services and their Beneficiaries in Rural Honduras
Authors: Lotton Jennifer L. , Scherer Andie L. , Sloffer Elizabeth M. , McNamara Katharine R. , Andrade Jeanette M. , Andrade Juan E 
Published: June 2021

Background

In Honduras, undernutrition disproportionately affects women, children and rural inhabitants living from subsistence agriculture. Organizations that provide agriculture extension services (AES) are often well positioned to bring the most up to date information to farming communities at the different information transfer points associated with the agricultural food supply chain (e.g., production, marketing, processing, and finance). Nonetheless, AES has traditionally focused on productivity aspects for basic staples (e.g., corn and beans), rather than the well‐being of farmers beyond improved incomes. Therefore, there is strong interest in developing or strengthening the capacity of AES organizations to improve nutrition. The purpose of this study was to characterize the nutrition‐related knowledge, attitudes, and practices (KAP) and household dietary diversity (HDD) amongst employees of AES organizations (EAES) and their beneficiaries (BAES) in the Dry Corridor of Honduras.

Methods

A convenience sample of BAES households (n=51) located in Copan and Ocotepeque was interviewed. Male and female heads of household were interviewed whenever possible (n=86 total; 56% female). In‐home, in‐person interviews were conducted to complete surveys: nutrition KAP (constructs include: dietary guidelines, iron deficiency anemia, vitamin A, overweight/obesity, water safety/sanitation), HDD, coping strategies index (CSI), and demographics. Housing quality (HQ) was evaluated by informal interviewer observation. A convenience sample of EAES (n=52 total; 75% male) self‐selected to complete KAP, HDD, and demographic questionnaires via online Qualtrics platform.

Results

A large proportion of BAES (71%) reported primary school as their highest level of education. More than 90% of EAES earned at least a high school diploma. Average composite nutrition knowledge scores between BAES and EAES differed (46.3% vs. 59.6%; P<0.01). Average composite healthy nutrition attitudes scores were similar between BAES and EAES (70% and 75%; P>0.05). Overall, knowledge and healthy attitudes toward nutrition were associated across groups (r=0.62; P<0.01). Knowledge scores varied by construct and differed between groups. On average, BAES and EAES knowledge scores were 22% vs. 74% in dietary guidelines (P<0.01), 51% vs. 41% in anemia (P<0.01), 29% vs. 31% in vitamin A (P>0.05), 68% vs. 68% in overweight/obesity (P>0.05), and 76% vs. 83% in water safety/sanitation (P<0.05). BAES total nutrition knowledge scores were correlated to HDD scores (r=0.288; P<0.01); EAES (P>0.05). BAES education level, but not that of EAES, correlated with HDD scores (r=0.305; P<0.01). Dietary diversity scores were higher in EAES than in BAES (10.5 ± 0.9 vs. 8.7± 1.8; P<0.01). On average, foods from animal sources contributed more to the dietary diversity of EAES than BAES (P<0.01). BAES CSI scores were indicative of food insecurity (45.6±36.0; range=0–154), however CSI was not associated with HHD (r=−0.2; P=0.07). Most BAES coped with food insecurity by reducing portion sizes or buying food on credit.

Conclusion

Considering BAES relationship to EAES and that increased knowledge results in healthy nutrition attitudes, there is an urgent need for nutrition education interventions sensitive to both BAES and EAES demands, particularly pertaining to dietary guidelines for Honduras, anemia, and vitamin A.

Support or Funding Information

USAID/Integrating Nutrition and Gender within Agricultural Extension Services (INGENAES)