Successful reintroduction of landrace orange maize in rural Malawi is not related to the nutritional knowledge of women in farming families

Vitamin A deficiency is a global health challenge, particularly in the developing world. Diet based approaches, using locally available foods, are recommended for providing long term, sustainable solutions. The ProFarmer project, initiated in Malawi, encouraged local farmers to re-adopt landrace crop varieties. Orange maize was used as a case study. Over time, reintroducing this carotenoid-rich crop is predicted to increase provitamin A content in the Malawian diet. Furthermore, it is considered a relatively simple, cost-effective approach that has the potential to reduce dependence on food fortification. This study was aimed at evaluating the impact of the reintroduction of landrace orange maize on nutrition knowledge, attitudes and behaviours (KAB) in women of farming families that currently cultivate the crop. Women were selected, as they are largely responsible for food preparation and providing healthy foods for their families. Additionally, the overall diet adequacy in women living in rural Malawi was assessed. A total of 336 females took part in the cross-sectional study. Before the study, the participating farming families underwent a training program run by local Agriculture Extension workers prior to receiving seeds for cultivation. The training included an explanation of the rationale behind reintroducing landrace maize and nutrition education regarding the health aspects of providing provitamin A through locally grown foods. Families that had recently joined the project and families that had already harvested the crop in previous years were included in the study sample. A semi-structured questionnaire was used to determine KAB regarding orange maize. Diet quality was also assessed using the FAO Minimum Dietary Diversity questionnaire (MDD-W) designed for women. Independent t-tests and Chi-square tests were performed where appropriate. Positive attitudes towards growing and consuming landrace orange maize were recorded. However, only 32% of the women understood the nutritional benefits. Dietary Diversity scores, a proxy for nutrient adequacy, were low with only 34% of women consuming a sufficiently diverse diet. Despite low levels of nutritional knowledge, landrace orange maize was well accepted by families in rural Malawi and presents an affordable, sustainable option for increasing dietary sources of provitamin A. Nutrition education emphasizing the advantages of eating orange maize and expanding diet diversity is recommended in Malawi.