"www.fao.org/about/meetings/sustainable-food-systems-nutrition-symposium The International Symposium on Sustainable Food Systems for Healthy Diets and Improved Nutrition was jointly held by FAO and WHO in December 2016 to explore policies and programme options for shaping the food systems in ways that deliver foods for a healthy diet, focusing on concrete country experiences and challenges. This Symposium waas the first large-scale contribution under the UN Decade of Action for Nutrition 2016-2025. This presentation was part of Parallel session 3.3: Empowering women as key drivers of food system change"

1. Empowering women to provide healthy diets for infants
and young children, the ENAM project in Ghana
Grace S. Marquis, PhD
McGill University
In collaboration with:
University of Ghana
EK Colecraft, O Sakyi-Dawson, A Lartey, BK Ahunu
Iowa State University
LM Butler, MB Reddy, HH Jensen, E Huff-Lonergan
With funding from:
Global Livestock-CRSP/US-AID
Iowa State University, University of Ghana, McGill University

2. Agro-business skills Nutrition knowledge
Economics
Animal husbandry,
food processing &
storage
Marketing
linkages
Child nutrition
knowledge
Cultural beliefs
about foods
Household food
allocation
Women’s access to income
Animal source
foods (ASF) in
children’s diets
Model developed from formative research on children’s diet in Ghana

3. Project design
16-month study in 3 ecological zones
6 intervention communities
n=179 households
6 comparison communities
n=287 households
Guinea Savannah
Forest Transitional
Coastal Savannah

4. Intervention
1. Microcredit for small businesses
1st 4-month loan = US$50
Groups self-defined & guaranteed
Conditional future loans
2. Weekly group meetings
Entrepreneurial education
Topics: marketing, customer care, financial literacy
Practice: skits on learned lessons
Nutrition education
Topics: benefits of ASF, balanced meal, hygiene
Practice: cooking competition
Repayment of loan & savings deposits
3. Additional training
Topics: poultry raising, fish smoking

5. Women’s perception of improvement in their
businesses
“I know I am doing well and
am more successful than other
members. I believe in the
project. I follow their lessons
well and practice most of the
things we are taught”.
0
20
40
60
80
100
Business expanded Business diversified
Percentage(%)
Intervention
Comparison
* p<0.01
*
*
Homiah et al. AJFAND 2012
Butler et al. AJFAND 2012

6. Women’s improved nutrition knowledge
“… I did not know that meat or
eggs were good for children and
would make them grow well. In
our culture, meat is usually not
given to children, so anytime I
prepared food with meat, I
would give the meat to the
adults… Now I know meat and
eggs will make a child grow well
and strong.” 0
20
40
60
80
100
Change in knowledge score
Percentage(%)
Intervention Comparison
p<0.05
Butler et al. AJFAND 2012
Christian et al. PAA conference 2013

7. Children’s improved quality of diet
Children in intervention
households consumed
53% more ASF than
those in comparison
households (p<0.001),
primarily reflecting
more ASF purchased
from the market
0
20
40
60
80
100
Percentofchildrenconsuming(%)
Intervention Comparison Intervention Comparison
*
*
*
* *
*
**
*
Marquis & Colecraft. Food Nutr Bull 2014
* p<0.05 group differences
Homiah et al. AJFAND 2012
Baseline Endline

8. Children’s improved nutritional status
Marquis et al. J Nutr 2015
-2
-1.5
-1
-0.5
0
0.5
1
Z-scoreatmaximumgroupdifference
Intervention Comparison
Weight-
for-age
BMI-
for-age
Height-
for-age
+0.32*
+0.36*
+0.19*
*p<0.05

9. KEY MESSAGE
Interventions must address inadequate knowledge and skills, and
economic barriers for women to become empowered and be able to
address the nutrition needs of their young children.