Impact of a Homestead Food Production program on poultry rearing and egg consumption: A cluster‐randomized controlled trial in Bangladesh

Women and children in Bangladesh face high levels of micronutrient deficiencies from inadequate diets. We evaluated the impact of a Homestead Food Production (HFP) intervention on poultry production, as a pathway outcome, and women's and children's egg consumption, as secondary outcomes, as part of the Food and Agricultural Approaches to Reducing Malnutrition cluster‐randomized trial in Sylhet division, Bangladesh. The 3‐year intervention (2015−2018) promoted home gardening, poultry rearing, and nutrition counseling. We randomly allocated 96 clusters to intervention (48 clusters; 1337 women) or control (48 clusters; 1368 women). Children < 3 years old born to participants were enrolled during the trial. We analyzed poultry production indicators, measured annually, and any egg consumption (24‐h recall), measured every 2−6 months for women and their children. We conducted intention‐to‐treat analyses using mixed‐effects logistic regression models with repeat measures, with minimal adjustment to increase precision. Poultry ownership increased by 16% points (pp) and egg production by 13 pp in the final intervention year. The intervention doubled women's odds of egg consumption in the final year (Odds Ratio [OR]: 2.31, 95% CI: 1.68−3.18), with positive effects sustained 1‐year post‐intervention (OR: 1.58, 95% CI: 1.16−2.15). Children's odds of egg consumption were increased in the final year (OR: 3.04, 95% CI: 1.87−4.95). Poultry ownership was associated with women's egg consumption, accounting for 12% of the total intervention effect, but not with children's egg consumption. Our findings demonstrate that an HFP program can have longer‐term positive effects on poultry production and women's and children's diets.