94752 A g r i c u lt u r e G l o b a l P r a c t i c e N o t e 03 Digital Green Agriculture- Nutrition Convergence: Final Report The World Bank’s South Asia Food and Nutrition Security Initiative Rikin Gandhi, Ritika Pandey,1 Terhi Havimo, and Eija Pehu Background The South Asian region has the highest rates of hunger in the world. According to one estimate, 336 million people (nearly 23 percent of its population) are routinely hungry and new threats are emerging to intensify the situation.2 The challenge of hunger and undernutrition in South Asia is complex and has many causes; it must therefore be met by a variety of cross-sectoral interventions. The South Asia Food and Nutrition Security Initiative (SAFANSI), supported by the World Bank and the UK’s Department for International Development (DFID), aims to foster cross-cutting actions that will lead to measurable improvements in food and nutrition security. Recognizing that an effective way to ensure food and working with the Bihar Rural Livelihood JEEViKA, which nutrition security is to explore the interconnections is run by the Government of Bihar, to use its approach between agriculture and nutrition, the SAFANSI Trust Fund to share agricultural knowledge among self-help groups supported the promotion of nutritional practices as part of of women that it had mobilized across more than 2,000 an existing agricultural extension program among farming villages in the state. Through SAFANSI, Digital Green communities in Bihar, India. This pilot was conducted in conducted a pilot in 42 of these villages in three Bihar partnership with the Bihar Rural Livelihood Promotion districts to evaluate the feasibility of integrating nutrition Society (also known as “JEEViKA”). The World Bank’s Food information into this existing agricultural program. and Agriculture Global Practice, under the supervision of Digital Green’s pilot focused on investigating how locally Eija Pehu (Science Adviser) and supported by Terhi Havimo produced videos could increase community knowledge (Junior Professional Officer, Innovation), partnered with and adoption of improved agricultural and nutrition Digital Green, an international organization that special- practices. These videos have the potential to strengthen izes in using videos produced by communities, to help agricultural university curricula by their context-specific communities improve the efficacy of communications practical nature. intended to change behaviors. Digital Green was already AGRICULTURE GLOBAL PRACTICE NOTE — JUNE 2015 Simone D. McCourtie / World Bank Approach and public sector agencies collaborate with Digital Green to train community intermediaries to produce and screen The Digital Green approach is an innovative, technology- locally tailored video content to social organizations, enabled means of behavior change communication primarily women’s self-help groups. In a controlled evalu- that is cost-effective and scalable and brings together ation, Digital Green’s approach was shown to be at least researchers, development practitioners, and community 10 times more effective, on a cost per adoption basis, than members to produce and share locally relevant informa- a conventional approach to agricultural extension, with a tion. Digital Green uses video as a basis for disseminating sevenfold increase in the rate of behavior change.3 best practices. The medium is optimally designed for communication aimed at changing interpersonal behavior Digital Green’s participatory video production and among smallholder farmers because it overcomes mediated dissemination approach can be layered onto challenges related to illiteracy and is an intuitively acces- any sector and location, using existing extension services sible technology, especially when local farmers convey the to educate and trigger behavior change. Widely applied in advice and information in the video. the context of agriculture and livelihood, the Digital Green approach is also being piloted in the health and nutrition Although video provides a point of focus, it is people and domains. social dynamics that ultimately make Digital Green work. Local social networks are tapped to connect farmers with experts; the thrill of appearing on video motivates farmers; Objectives and social cohesion is leveraged to minimize the distance The objectives of Digital Green’s involvement in the between teacher and learner. project were as follows: The Digital Green approach operates through a hub-and- • To develop community-based instructional videos spoke model in which nongovernmental organizations on a nutrition topic (including food preparation, 2 | AGRICULTURE GLOBAL PRACTICE NOTE — JUNE 2015 dietary diversity, crops rich in vitamin A, and kitchen • Importance of the first 1,000 days gardens) to enable access to and adoption of best • Importance of iron and folic acid tablets practices by the community members • Maternal diet during pregnancy • To enhance and promote knowledge management • Maternal workload during pregnancy platforms that enable a wider audience, including agricultural universities and other organizations, to • Importance of exclusive breast-feeding use these instructional videos • Managing exclusive breast-feeding by working mothers Outcomes • Introduction of complementary feeding for the Objective 1: To develop community-based instructional baby after 6 months videos on a nutrition topic (including food preparation, • Age-appropriate complementary feeding for babies dietary diversity, crops rich in vitamin A, and kitchen gardens) 6 to 24 months to enable access to and adoption of best practices by the • Importance of eating a diverse diet community members SPRING’s feasibility study4 revealed that Digital Green’s Digital Green identified and developed instructional approach was effective in disseminating information on community videos around agriculture and nutrition and maternal, infant, and young child nutrition practices and tested these in collaboration with JEEViKA to help pro- showed the potential to trigger behavior change. Though mote nutrition best practices through the government of it was conducted in a different location, the SAFANSI pilot Bihar’s existing extension advisory services in target rural conducted in Bihar was informed by the key messages areas. This intervention complemented JEEViKA’s existing and learning from the SPRING/Digital Green project. Community Health and Nutrition Care Centers (CHNCCs) for pregnant and lactating women during their first 1,000 The topics for the videos were selected by their relevance days after childbirth. Digital Green was already working to the local agriculture and nutrition landscape, and the with JEEViKA in more than 2,000 villages to exchange content of the videos was created specifically on themes agricultural knowledge among the self-help groups that it related to agriculture and nutrition. For example, topics had mobilized. Through the SAFANSI project, Digital Green chosen included cultivating kitchen gardens to increase conducted a pilot in 42 of these villages in three Bihar access to nutrient-rich vegetables and reduce chemical districts—Gaya, Khagaria, and Muzaffarpur—to evaluate runoff into water supplies; better balancing maternal the feasibility of integrating nutrition information with this workload related to agriculture during pregnancy; improv- existing agricultural program. ing dietary quality and diversity for women and children; and increasing the consumption of animal proteins, Defining topics and producing videos Digital Green had previously partnered with the Strength- ening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) project, funded by the U.S. Agency for International Development October 2012–October 2013, on a pilot intervention in 30 villages in Keonjhar District, Odisha. The goal of the pilot was to test the feasibility of leveraging the Digital Green approach for agriculture to promote behaviors and care practices related to maternal, infant, and young child nutrition, including child feeding, Curt Carnemark / World Bank care during pregnancy, and hand washing. Under the pilot project, videos were made on the following topics: • Benefits of washing hands with soap AGRICULTURE GLOBAL PRACTICE NOTE — JUNE 2015 | 3 Curt Carnemark / World Bank primarily milk and eggs. The following topics were identi- health and nutrition program manager verified the techni- fied that relate to both agriculture and nutrition: cal accuracy of the storyboards, approving them for video production. The technical messages to be delivered to the • Nutritional garden community through participatory videos were validated • Cultivation of vegetables in sacks in both the projects by SPRING and JEEViKA’s nutrition • Recipe for a nutritional sweet called “laddu” experts. In addition, Digital Green’s technical advisory com- mittee at the national level looked at the technical aspects • Nutritional value of moringa trees of the videos. The validation of the technical messages • Linking with Community Health and Nutrition Care is critical in these health and nutrition videos, which Centers also emphasizes the importance of the nutrition experts • Diet during pregnancy having up-to-date knowledge and how higher education plays a vital role in providing that knowledge. This was also Though not directly related to agriculture, other topics, the impetus for the pilot on education curriculum that was such as the importance of personal hygiene and breast- conducted under SAFANSI. feeding, were also considered from a more general public health and nutrition perspective given JEEViKA’s interest in Building the capacity of communities to improving the nutrition status of the communities that it produce and disseminate videos works with through a combination of means. Digital Green had already trained JEEViKA resource persons from the communities to produce videos related After these topics were identified, JEEViKA’s district- and to JEEViKA’s agriculture and livelihood-related programs. block-level staff produced storyboards in which characters VRP teams in Bihar’s Gaya, Khagaria, and Muzaffarpur were finalized and key messages were outlined. JEEViKA’s Districts produced the nutrition-related videos under this health and nutrition manager worked on the storyboards project. The VRPs shot videos at locations such as CHNCCs, along with the video resource persons (VRPs). JEEViKA’s 4 | AGRICULTURE GLOBAL PRACTICE NOTE — JUNE 2015 Testing the videos through mediated video screenings at community forums After producing the videos, feedback was collected from the community on each of the 15 videos produced under the pilot. In each village, the community resource person screened the videos among women self-help groups (SHGs). These SHGs were mobilized by JEEViKA and are engaged in microcredit and savings activities. The SHGs were familiar with Digital Green’s approach because they were already watching videos on a bimonthly basis pertaining to improved agricultural practices. As part of the screening process, the community resource person would pause the video at strategic points and engage the group in purposive and productive discussion on their understanding of the featured practice. The typical size of a group attending these screenings was 15 to 20. Small groups created an informal and intimate environment, enabling all members to interact, ask questions, and clarify their doubts. The cross-sectional nature of SHGs, which include pregnant and lactating mothers, mothers-in-law, Curt Carnemark / World Bank sisters-in-law, and other peers, can be influential, especially for women, in being receptive to change their behavior on a particular practice. Though women SHG members were the primary target audience for the video screenings, men, including fathers, husbands, and brothers, joined at times Anganwadi centers,5 and primary health centers.6 The as well, but less regularly. videos featured individuals (who provided formal consent The community resource person facilitating the video for the filming) such as the CHNCC cook, JEEViKA Saheli dissemination captured structured feedback from the (contact person), auxiliary nurse midwives,7 accredited viewers on each video. The videos were screened to a total social health activists,8 Anganwadi workers,9 and women of 104 self-help groups across the three districts (Muzaf- and their children from the community. farpur, Khagaria, and Gaya). Feedback received from the The VRPs reflected that producing the nutrition-related community is summarized below: videos took longer than producing the agricultural videos Strong message recall and comprehension because at times it was difficult to shoot videos at public health facilities (for example, CHNCCs, primary health • Community members remembered key messages centers) that tend to be crowded and because some top- in the videos. ics (for example, immunization) required filming on site. • The local dialect used in the videos was familiar to viewers. After shooting the raw footage, the VRPs edited the videos on JEEViKA’s district-level office computers. JEEViKA’s • Community members said that the messages were district-level nutrition experts then made a final check to clear. Some videos were screened more than once ensure the integrity of the message from the previously on demand from the viewers, for better reiteration approved storyboard was maintained. Links to the videos of the messages. produced under the project are listed in the table on “These videos give us valuable knowledge. We can do page 8. everything that is being said in these videos. Earlier, we didn’t have this information. Our knowledge has increased AGRICULTURE GLOBAL PRACTICE NOTE — JUNE 2015 | 5 after watching these videos.” —Babita Kumari, community stakeholders involved in this project are keen to see how member, 37 years of age, Khagaria District, Bihar. the links between agriculture and nutrition, especially for women, can be strengthened and to rigorously evaluate Increased knowledge on health and nutri- the extent to which messaging, related to agriculture and tion practices nutrition, improves the nutrition security and health of the • Community members said that they learned about rural communities that we engage with. new maternal and child nutrition and health prac- Objective 2: To enhance and promote knowledge manage- tices from the videos. ment platforms that enable a wider audience, including “These videos will increase the knowledge of the women agricultural universities and other organizations, to use these in the community, which will improve their health and instructional videos well-being.” —Reena Kumari, nutrition specialist, 32 years of age, Gaya District, Bihar. On November 10, 2014, Digital Green organized a one-day consultative workshop in partnership with the World Bank “[The] videos increased our knowledge about nutrition and and IFPRI to share the findings from this collaborative pilot health issues. These videos should be shown to men also.” as well as to showcase the final set of instructional videos. —S. Devi, JEEViKA Saheli, 30 years of age, Khagaria District, Leading experts, policy makers, and program implement- Bihar. ers with rich and extensive experience in agriculture, livelihood, nutrition, and maternal and child health Sociocultural myths addressed came together to (1) synthesize findings from the pilot • Prevalent myths related to pregnancy and childbirth projects funded under SAFANSI and develop appropriate (for example, not eating pumpkin during preg- tools and media for wider dissemination and adoption nancy) were dispelled, and communities felt more of agriculture-nutrition practices, and (2) review and informed about health and nutrition practices. make recommendations for the content and curricula of “[The] videos have dispelled our myths and misconcep- agricultural universities, other higher learning institutions, tions. Earlier, we used to think that food must be cooked and farmers’ organizations. on high flame, but after watching the video on cooking The workshop sought experiences and suggestions on method we got to know that cooking on high flame ways to enhance the quantity and quality of nutrition- adversely affects the nutrition content.” —Chandrani related curricula in the state agricultural university system. Bharti, JEEViKA Saheli, 27 years of age, Khagaria District, The key findings of the two pilot projects funded under Bihar. SAFANSI were discussed and reflected upon during The feedback from individuals interviewed expressed that the workshop with the intention that these knowledge they had adopted many of the promoted behiavors, but products be adopted by state agricultural universities as given the limited scope and duration of the pilot project, part of their agricultural curricula. it was unable to conclusively assess whether they had The key recommendations that emerged from the done so and would continue doing so over the long term. workshop included the following: The pilot successfully demonstrated the feasibility of a technology-enabled platform for locally producing and • The agricultural and nutrition education system distributing improved food and nutrition practices as part needs to be redesigned to be able to produce of an existing public extension system. So far, these videos solution designers who can make linkages between have been disseminated to more than 2,000 community agricultural production and choice of crops and members that JEEViKA works with, and there is an interest livestock products to improve family nutrition and in sharing the videos more broadly to the 1 million self- health. help groups that it works with across Bihar. The subjects of • To reach rural communities, we need to think along the videos were varied, including those primarily related to the lines of developing “massive open courses,” both public health and nutrition behaviors and those in which on- and offline, for training frontline workers as well agricultural messages were made nutrition-sensitive. The 6 | AGRICULTURE GLOBAL PRACTICE NOTE — JUNE 2015 as communities on improved agricultural and nutri- Further Information tion practices. The outputs of this project, including videos produced and • There is a need to understand dietary patterns and community usage data, are available on Digital Green’s food and nonfood expenditures of rural households knowledge management platform at http://digitalgreen in order to educate communities about spending .org/discover. A video summarizing the processes involved on nutrition. in this pilot is available at http://www.digitalgreen.org/ • We need to review links between the capacity- blog/safansi-pilot-in-bihar/. The report, presentations, and building efforts of organizations implementing videos that were shared during the project’s consultative nutrition programs at a grassroots level and the workshop can be accessed at http://www.digitalgreen educational curricula of agricultural universities to .org/events/#workshop_agnu. identify and develop synergies. • Popular opinion and political will must be mobilized Endnotes to mandate the government’s responsibility for 1. Rikin Gandhi and Ritika Pandey are from Digital Green ensuring nutritional security to all. (http://www.digitalgreen.org). • Agricultural education, research, and extension 2. http://www.fao.org/3/a-i4030e.pdf strategies should promote the goal of affordable, diversified, nutritious diets for all. 3. Gandhi, R., R. Veeraraghavan, K. Toyama, and V. • The Government of India’s recent policy to mandate Ramprasad. 2009. “Digital Green: Participatory Video corporate social responsibility should include a for Agricultural Extension.” Information Technologies focus on nutritional security. for International Development 5(1): 1–15. Available at • Platforms such as Krishi Vigyan Kendras10 and Agri- http://itidjournal.org/itid/article/view/322/145. cultural Produce Market Committee markets should 4. http://www.spring-nutrition.org/sites/default/files/ be used as hubs for the dissemination of nutrition- publications/reports/spring_community_led_video_ related messages. miycn_india.pdf • Every village must have a nutrition ambassador who can advocate for agricultural production and plan- 5. Anganwadi—meaning “countryside shelter” in ning with a nutrition lens based on local needs. Hindi—centers were set up under the Integrated Ray Witlin / World Bank AGRICULTURE GLOBAL PRACTICE NOTE — JUNE 2015 | 7 Child Development scheme of the Ministry of Women 8. Accredited social health activists are community and Child Development in each village to provide health volunteers who have been engaged under the six services: supplementary nutrition, immunization, mission for establishing a link between the communi- health checkups, referral services, preschool educa- ty and the health system. An accredited social health tion, and nutrition and health education for adult activist is the first port of call for any health-related women. For more information, see http://wcd.nic.in/ demands of deprived sections of the population, icds.htm. especially women and children, who find it difficult to access health services in rural areas. 6. Primary health centers are the cornerstone of rural health care and are supposed to meet the health care 9. Anganwadi workers work out of the Anganwadi needs of the rural population. Each primary health centers allotted to a population of 1,000, to bridge the center covers a population of 1 million and is spread gap between the person and organized health care, over about 100 villages. A medical officer, block exten- and to focus on the health and educational needs of sion educator, female health assistant, compounder, children aged 0–6 years. driver, and laboratory technician look after the pri- mary health center. 10. Krishi Vigyan Kendras (farm science centers) are in- novative science-based institutions established to 7. Auxiliary nurse midwives are associated with primary impart vocational training to the farmers and field- health centers and are supposed to cover a popula- level extension workers. tion of 5,000. In most cases, the accredited social health activists work under them. Videos Produced through the SAFANSI-Supported Project Video Topics Video Links Nutritional garden http://www.digitalgreen.org/discover/video/7285/ Cultivation of vegetables in sacks http://www.digitalgreen.org/discover/video/7283/ Recipe for a nutritional sweet called “laddu” http://www.digitalgreen.org/discover/video/7284/ Nutritional value of the moringa tree http://www.digitalgreen.org/discover/video/7473/ Purpose of Community Health and Nutrition Care Centers http://www.digitalgreen.org/discover/video/7269/ Diet during pregnancy http://www.digitalgreen.org/discover/video/7279/ Documentation of the entire process of cooking at CHNCCs http://www.digitalgreen.org/discover/video/7281/ Training a group of community members on http://www.digitalgreen.org/discover/video/7282/ hygienic cooking Antenatal care http://www.digitalgreen.org/discover/video/7265/ Postnatal care http://www.digitalgreen.org/discover/video/7268/ Child immunization process http://www.digitalgreen.org/discover/video/7266/ Family planning http://www.digitalgreen.org/discover/video/7277/ Menstrual hygiene http://www.digitalgreen.org/discover/video/7278/ Personal hygiene http://www.digitalgreen.org/discover/video/7264/ Importance of breast-feeding http://www.digitalgreen.org/discover/video/7267/ This material has been funded by UK aid from the UK government through the South Asia Food and Nutrition Security Initiative (SAFANSI), which is administered by the World Bank. The views expressed do not necessarily reflect the UK gov- ernment’s official policies or the policies of the World Bank and its Board of Executive Directors. Internet: www.worldbank.org/agriculture Twitter: wb_agriculture 8 | AGRICULTURE GLOBAL PRACTICE NOTE — JUNE 2015