ORIGINAL PAPER
Improving household food security in eastern Democratic Republic
of the Congo: a comparative analysis of four interventions
Shannon Doocy
1
&
Jillian Emerson
1
&
Elizabeth Colantouni
1
&
Johnathan Strong
1
&
Kimberly Amundson Mansen
1
&
the Jenga Jamaa II Study Team
&
Laura E. Caulfield
&
Rolf Klemm
&
Laura Brye
&
Sonya Funna
&
Jean-Pierre Nzanzu
&
Espoir Musa
&
Jozimo Santos Rocha
&
Joseph Menakuntuala
2
Received: 9 June 2017 / Accepted: 30 April 2018 / Published online: 14 May 2018
#
Springer Science+Business Media B.V., part of Springer Nature and International Society for Plant Pathology 2018
Abstract
Food insecurity contributes to poor nutritional status of many populations, but long-term approaches to improving household
food insecurity have not been widely evaluated. This study evaluates the effectiveness of four interventions, Women’s
Empowerment Groups (WEG), Prevention of Malnutrition in Children under 2 Approach (PM2A), Farmer Field Schools
(FFS), and the Farmer to Farmer approach (F2F), implemented in the context of a five-year Development Food Assistance
Program in South Kivu, Democratic Republic of the Congo. A community-matched quasi-experimental design was used.
Primary outcome measures included Household Dietary Diversity Score (HDDS) and the Household Food Insecurity Access
Scale (HFIAS). Mean HDDS was significantly greater than the control group for three interventions (FFS, WEG, PM2A; ß:
0.69–0.88, p < 0.001 for all) as was the difference in proportion of households achieving target HDDS compared to the control
group (12.3–21.7%, p < 0.001 for all). HFIAS score was significantly lower for all interventions compared to the control group,
but smaller gains were seen in F2F (ß: -2.06 - -4.59, p < 0.001 for all). The adjusted difference in proportion of households
improving in HFIAS category compared to controls was significant for all groups, but smallest among F2F (15.0–26.7%, p <
0.05 for all). WEG, PM2A, and FFS interventions had significant effects on improving household dietary diversity and food
security; the F2F approach was less effective. Food insecurity remained prevalent despite the interventions, suggesting more
research is needed to understand the pathways through which they were effective and how interventions could be strengthened to
improve food insecurity in post-conflict settings.
Keywords Food security
.
Dietary diversity
.
Farmer field schools
.
Women’s empowerment
.
Prevention of malnutrition in
children under two
.
Democratic Republic of the Congo
1 Introduction
People are considered food secure when they have access, at
all times, to sufficient, safe, nutritious food to maintain a
healthy and active life—the absence of these conditions is
known as food insecurity (FAO 2008). The latest global esti-
mates indicate that 795 million, around one of every nine
people, are hungry and that of undernutrition prevalence,
which measures the proportion of people unable to consume
enough food for an active and healthy life, is 12.9% in devel-
oping regions (FAO 2015). Household food insecurity is an
underlying cause of undernutrition, which is associated with
increased risk of child morbidity and mortality and longer-
term outcomes of growth stunting and poor cognitive devel-
opment (Black et al. 2013; Maluccio et al. 2009; Hoddinott
et al. 2008). Programs aimed at improving food security are
increasingly recognized as a sustainable approach to address-
ing undernutrition (Ruel et al. 2013). Improved household
food security has been shown to reduce risk of poor maternal
and child anthropometric outcomes (McDonald et al. 2015;
Sreeramareddy et al. 2015).
Five U.S. Agency for International Development (USAID)
Title II Development Food Assistance Programs (DFAP) seek
to reduce food insecurity and undernutrition and target both
* Shannon Doocy
doocy1@jhu.edu
1
Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St,
Baltimore, MD 21205, USA
2
The Adventist Development and Relief Agency, Silver Spring, MD,
USA
Food Security (2018) 10:649–660
https://doi.org/10.1007/s12571-018-0808-1
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