Economic evaluation of a novel homestead food production program in rural Cambodia

Background: For over 20 years Helen Keller International has implemented homestead food production (HFP) programs in developing countries to improve the nutritional status of women and children, household food security and income. The HFP model encourages year-round food production through home gardens and animal husbandry. Although, HFP has been successful in increasing household food production, economic assessment of this program has been limited. In order for program implementers to allocate limited resources efficiently, there is a need for a rigorous economic assessment of HFP programs. Objective: To (1) identify factors associated with household income in rural, Cambodia, (2) to systematically measure and monetize food production from gardens and fishponds, and explore the cost-effectiveness of HFP in Cambodia in a cost-benefit analysis (CBA), using data from a randomized control trial (RCT), (3) explore the sensitivity of the CBA results and alternative scenarios for program implementation. Methods: Factors associated with household income, were examined using a generalized linear mixed model at a univariate and multivariate level. Food production was estimated from multiple longitudinal data sources. The program benefits (food production) were monetized using local village market values, while costs were determined through a micro-costing analysis. A CBA was carried out from the project perspective and the net monetary benefit in each study arm was estimated and compared to control households. Lastly, the sensitivity of the CBA results was tested in a one-way sensitivity and scenario analysis. Results: Assessment of baseline household income revealed that in rural Cambodia fishponds and pigs were associated with income. Households in the HFP program produced more food, relative to the control. The results from CBA show that home gardens are a cost-effective HFP intervention. The results from the scenario analysis suggest that the addition of fishponds to gardens may also be cost-effective if implemented outside a RCT. Conclusion: This study has developed tools to systematically measure and monetize food production from HFP, while finding that establishment of home gardens is a cost-effective use of resources.Medicine, Faculty ofPopulation and Public Health (SPPH), School ofGraduat