Nutrition-sensitive agriculture programs hold substantial promise for improving access to nutritious food in contexts like rural Nepal. Yet, implementing such programs in geographically and culturally diverse settings can be challenging. To better understand the contextual factors that influence the ability of program participants to benefit from agriculture-nutrition interventions, we qualitatively examined the implementation of Helen Keller International’s Homestead Food Production program (HFP) in far-western Nepal. Data collection consisted of shadowing program staff for three months, interviewing program participants ( n = 31) and staff ( n = 10), and conducting three focus-group discussions with female community health volunteers ( n = 28). An integrated food and nutrition system framework guided thematic analysis. Participants demonstrated high levels of knowledge about the program’s nutrition messages and expressed interest in and motivation to engage in the HFP program. However, access to water, land, and time determined the extent to which their full participation in the program was feasible. Factors within the biophysical and sociocultural environments interacted to influence access to these crucial resources. Some program participants and staff provided examples of ways in which they overcame these contextual constraints. These included investing in micro-irrigation equipment, arranging land-sharing agreements, and demonstrating more equitable gender norms. Successfully implementing nutrition-sensitive agriculture requires addressing context-specific structural barriers, particularly when aiming to benefit the most vulnerable. Long-term solutions to the barriers faced by the most marginalized households will require broad structural changes. However, problem-solving strategies used by program participants and staff also point towards immediate actions that programs can take to expand the potential for marginalized households to fully participate.

中文翻译：

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克服尼泊尔实施农业营养计划的结构性障碍

营养敏感型农业计划在改善尼泊尔农村等环境中获得营养食品的机会方面具有重大前景。然而，在地理和文化多样化的环境中实施此类计划可能具有挑战性。为了更好地了解影响计划参与者从农业营养干预中受益的能力的背景因素，我们定性地检查了海伦凯勒国际的宅基地食品生产计划 (HFP) 在尼泊尔西部的实施情况。数据收集包括跟踪项目工作人员三个月、采访项目参与者 (n = 31) 和工作人员 (n = 10)，以及与女性社区健康志愿者 (n = 28) 进行三个焦点小组讨论。综合粮食和营养系统框架指导专题分析。参与者展示了对该计划营养信息的高度了解，并表达了参与 HFP 计划的兴趣和动力。然而，获得水、土地和时间决定了他们充分参与该计划的可行性。生物物理和社会文化环境中的因素相互作用以影响对这些关键资源的获取。一些计划参与者和工作人员提供了他们克服这些背景限制的方法的例子。其中包括投资微型灌溉设备、安排土地共享协议以及展示更公平的性别规范。成功实施营养敏感型农业需要解决具体情况的结构性障碍，特别是在旨在使最弱势群体受益的情况下。解决最边缘化家庭面临的障碍的长期解决方案将需要广泛的结构性变革。然而，计划参与者和工作人员使用的解决问题的策略也指向计划可以采取的立即行动，以扩大边缘化家庭充分参与的潜力。