Strategic Layering to Improve Household Gender Dynamics for Optimal Nutrition in Niger
By: Jimi Hummer, Technical Advisor II — Gender, PIQA, Catholic Relief Services
Malnutrition is a pervasive problem throughout the West African nation of Niger. While the lack of availability, access to, and utilization of nutritious foods adversely affects many Nigeriens, these realities disproportionately impact Niger’s most vulnerable populations, including children under 5 years of age, pregnant and lactating women, and adolescent girls. According to the World Bank, in 2022, the prevalence of stunting in Niger was 47.7% while wasting was 10.9%. In the Zinder region of Niger, approximately two-thirds of children under 5 years of age are stunted, while roughly one in seven are wasted. According to the World Health Organization, stunting is defined as low height for his or her age. Similarly, wasting refers to a child who is too thin for his or her height. Both stunting and wasting prevent children from reaching their physical and cognitive potential. The underlying causes in the Zinder region include poor harvests, lack of viable economic alternatives to rainfed agriculture, poor nutrition knowledge among caregivers, gender inequity, and lack of women’s empowerment to make shared financial and nutrition decisions with their husbands, according to the findings from the gender analysis for the Girma project completed by CRS in 2020.
In response to this pressing issue, Catholic Relief Services (CRS) has been implementing the USAID/BHA-funded Resilience Food Security Activity (RFSA) Girma (meaning dignity, prestige, and growth in Hausa, the local language) in the Zinder region. The RFSA employs an innovative, multidimensional approach to improve food and nutrition security among households and communities. The activity has been implemented since 2018 and will continue through 2025, covering 622 administrative villages across 11 communes in two departments of the Zinder region, serving over 770,000 individuals.
The project is large in scale and scope with over 11 key areas of intervention. The project adopted a multifaceted approach, integrating economic strengthening and nutrition education while addressing gender dynamics to target the root causes of malnutrition. By layering interventions such as economic strengthening through Savings and Internal Lending Communities (SILC), nutrition education of mothers of children under the age of 5 using the Care Group model, and nutrition-integrated couples strengthening initiatives titled Maison Familiale Harmonieuse (MFH) or The Harmonious Family Home in English, the project aimed to foster a holistic environment conducive to nutritional and economic improvement
With support from an IDEAL Small Grants Program Applied Research Award (ARA), CRS and research partners Penn State and the University of Zinder embarked on an 18-month large-scale program evaluation to understand the effectiveness of the integration, sequencing, and layering of these three interventions on maternal and child nutrition outcomes.
About the Approaches
SILC Groups: SILC Groups are a key component of Girma’s household economic strengthening efforts, utilizing a savings-led microfinance approach to empower individuals from low-income households with essential financial management skills. Drawing on traditional community savings and credit models, SILC aims to enhance members’ ability to manage resources, set financial goals, budget, save, and handle debt. By facilitating increased savings, loan access, interest-free credit, and investment in ventures that enable nutritious food purchases, SILC supports economic growth among 15–25 member groups. Managed by a committee of seven elected members, each group autonomously handles financial activities, with transactions recorded during weekly meetings.
Care Groups: Care Groups aim to improve maternal and child health and nutrition by involving women in education and counseling. Care Groups are led by trained lead mothers who disseminate nutrition education messages to caregivers, generally mothers or female caregivers, of infants and young children under 5. Nutrition education messages span critical life stages for healthy growth and development, from infancy and childhood into adolescence and adulthood, focused on pregnancy and lactation. In Niger, Care Groups promote dietary diversity using a 4-Star Diet curriculum endorsed by the Niger Ministry of Health and partners. Each ‘star’ represents a different food group comprised of locally available foods. In Girma, the Care Groups deliver nutrition messages and conduct cooking demonstrations using materials that were developed through a collaborative process between Girma’s health team, local implementing partners, and the Niger Ministry of Health.
Strengthening Marriages and Relationships through Communication and Planning (SMART) Couples — Maison Familiale Harmonieuse (MFH): In addition to the SILC Groups and Care Groups, a couples strengthening approach was layered through the MFH activities. These activities are based on the CRS Strengthening Marriages and Relationships Through Communication and Planning Couples methodology (‘SMART Couples’). To do so, MFH programming engaged husbands and wives (as married couples) who had infants and young children under 5 years of age to improve communication, more equitable household decision-making, and better marital relationships. Adapted specifically for Girma, MFH was the first time CRS had incorporated a household finance and nutrition module into the SMART Couples curriculum to increase fathers’ awareness of nutrition and the importance of jointly deciding on budgeting, purchasing and consumption of nutritious foods, as well as to complement the nutrition education activities delivered through Care Groups that focus on women’s participation. While Care Groups deliver nutrition messages primarily to women, MFH activities were designed to also convey them to men.
Evaluating Effectiveness: Specific Aims and Methods
So, with this, the program evaluation aimed to assess the effectiveness of integrating Savings and Internal Lending Communities + the Care Group model + Maison Familiale Harmonieuse interventions on maternal and child dietary diversity. Utilizing a longitudinal, mixed methods ‘embedded’ research design between 2021 and 2023, the evaluation incorporated both impact and process evaluation components, guided by a Theory of Change framework (pictured below).
Key Findings: Impact and Challenges
Over 770,000 participants benefited from activities tailored to improve dietary diversity, financial literacy, and household dynamics. The project achieved modest improvements in women’s diet diversity, but no improvement in child dietary diversity. There were more substantial increases in knowledge on nutrition, suggesting some knowledge—behavior gap, in which the knowledge is there but there are multiple factors such as access to nutritional foods, poor agricultural yields, and financial inaccessibility, which do not allow that knowledge into practice. Greater encouragement for and provision of resources for homestead food production and animal husbandry may help those households wishing to access more diverse food items to do so in the face of far distances and costly travel to markets.
Additionally, the evaluation found greater couple’s marital satisfaction quality through clearer communication, better decision-making with fewer disputes, and improved understanding of one another. According to facilitators and couples participants, this was due to the methodology of the approach including the cultural and religious tailoring of the MFH approach, couples school approach, and the relevancy of the session content. Engaging community and religious leaders in the approach was also an enabling factor. Despite the gains in marital satisfaction, there was no substantial change in the ability of wives to have more equitable inputs when making household decisions around nutrition. Culturally, heads of household (husbands) have most, if not all, decision-making power around household finances, health care, and food purchasing decisions in this context. Gendered social norms are slow to change, especially in rural Niger where longstanding culturally-bound rules shape individual behaviors specific to health.
Despite the project’s successes, it encountered several challenges, including limited participation rates across all three-layered approaches, which limited participant’s exposure to key messages, likely limiting program impact on dietary outcomes. For those participants that did have regular attendance, they noted that the intensity and time needed were not an issue. It was also noted that the delayed roll-out and higher staple food prices due to COVID-19 likely also affected the impact. These obstacles highlighted the need for adaptive strategies and reinforced the importance of community engagement and support to overcome barriers to participation and implementation.
What Did We Learn?
Drawing from this large-scale program evaluation of a complex strategic layering of adapted and tested approaches, there was a lot to learn from this project for the continued implementation and future programming aimed at similar goals.
Enhancing the intensity of complementary livelihood activities delivered may help participants overcome food security-related barriers currently limiting nutrition-related behavior change.
- Economic empowerment, agricultural development, and livelihood development activities have complemented program activities, yet the lack of accessibility to nutritious food persisted during the evaluation period among program participants. A greater intensity of such activities may help improve participant access to diverse foods, even in the face of future shocks and hazards, moving forward.
Deliberate strategies to improve recruitment and enhance participation rates across layered activities may help ensure adequate programming is received for desired behavior change.
- Given the limited and inconsistent participation rates among husbands and wives both within and among the three interventions, improving the layering of activities through more precise planning of concurrently integrated activities, including carefully timed rollout of staggered program activities, improved messaging on how these programs work together (rather than being seen as standalone) and enhanced coordination efforts among implementers working across the interventions. Coupling such strategies with enhanced monitoring of participation rates across layered activities may also help with near, real-time course correction as needed.
Increased and strategic engagement of religious leaders may help to further engage men and husbands to further support nutrition activities which are currently limited by rigid gender norms and inequitable household decision-making.
- The engagement of religious leaders was seen to have a positive effect on the interventions to overcome embedded gender norms limiting engagement by husbands and fathers. Strategically engaging more religious leaders could help to reinforce the messages and help to build the enabling environment necessary for improved nutrition outcomes.
Where Do We Go From Here?
While the integrated approach of the Girma project showed promise in improving maternal dietary diversity, challenges in program participation and contextual factors hindered its full potential. The evaluation underscores the importance of tailored interventions, enhanced coordination, and continuous adaptation to address complex issues like malnutrition effectively.
By learning from the successes and challenges of programs like Girma, practitioners can better address the multifaceted nature of food insecurity and malnutrition in similar contexts. Through continuous learning and adaptation, we can strive towards a future where all communities have access to nutritious food and improved health outcomes.
This research was made possible by a grant from the Implementer-Led Design, Evidence, Analysis and Learning (IDEAL) Activity. The IDEAL Small Grants Program is made possible by the generous support and contribution of the American people through the United States Agency for International Development (USAID).
