Food and agricultural approaches to reducing malnutrition: a cluster-randomised trial in rural Bangladesh

Network Project

To reduce undernutrition, nutrition-sensitive agricultural interventions that aim to increase dietary diversity, empower women and include an educational behavior change component focused on nutrition and hygiene are a promising and sustainable approach.

Food and Agricultural Approaches to Reducing Malnutrition (FAARM) trial tests the hypothesis that such an integrated agriculture, nutrition and hygiene intervention can reduce undernutrition when children benefit in their crucial first 1000 days. FAARM is a cluster-randomized controlled field trial in Habiganj District, Sylhet Division, Bangladesh, including 2700 young women and their children under 3 years of age in 48 intervention and 48 control settlements. Women in the intervention settlements received training and support in Homestead Food Production over three years (2015-2018).

The intervention was implemented by the NGO Helen Keller International and included training women’s groups in vegetable and fruit gardening, poultry rearing, hygiene, child care and nutrition. Outcomes of interest include stunting (primary outcome: length-for-age), wasting, anemia, micronutrient deficiencies, dietary intake, infection prevalence as well as early child development. We also collected data on different pathway indicators including food production, income, food security, health service use, women’s empowerment, feeding and hygiene practices.


Several add-on studies to FAARM are conducted on the following topics:

Women’s empowerment: Evaluation of the Homestead Food Production program’s impact on women’s empowerment through quantitative and qualitative tools

Food hygiene: Evaluation of the food hygiene component’s impact on maternal food hygiene practice, food contamination and diarrheal disease in children

Mycotoxins and pregnancy: Assessment of the exposure level of pregnant women to various mycotoxins and their impact on pregnancy outcomes

Biochar-based fertilizer: Feasibility study and scale-up of biochar-based fertilizer in home gardens, assessing acceptability and measuring yield benefits

Drinking water quality: Assessment of mineral content and arsenic contamination of tube well water and potential interactions with domestic wastewater

Causes of anemia: Examination of the causes of anemia among women and children in rural Bangladesh, considering nutritional and non-nutritional factors

Flooding effects: Assessment of specific flood events in Bangladesh and Chile, including impacts on food security and health as well as adaptation strategies

The FAARM project is funded by the German Federal Ministry of Education and Research.


Sabine Gabrysch presented FAARM at the Berlin Epidemiological Methods Colloquium (BEMC) on 2 June 2021 (45 min.): watch here.

FAARM featured on BBC in December 2019: Can kitchen gardens combat climate change?

FAARM featured in BMBF Newsletter in June 2019:

HKI’s Press Room featured an article on FAARM in June 2016: “Gardening: A Sustainable Solution for Malnutrition?“.

“Gesund & Krank” (Healthy & Sick) of Heidelberg University’s research magazine in June 2015 Ruperto Carola: “Der stille Hunger. Nachhaltig gegen Mangelernährung” (Hidden hunger. Sustainable action against malnutrition).

“Preis für mutige Wissenschaft” (Award for bold research) of the State of Baden-Württemberg awarded for FAARM in 2018:  Press release (in German)

Wendt AS, Sparling TM, Waid JL, Mueller AA, Gabrysch S. (2019): Food and Agricultural Approaches to Reducing Malnutrition (FAARM): protocol for a cluster-randomised controlled trial to evaluate the impact of a Homestead Food Production programme on undernutrition in rural Bangladesh. BMJ Open, 9(7):e031037. doi: 10.1136/bmjopen-2019-031037.

For a current publication list of FAARM studies, please visit the project homepage.

Header image credit: Dr. Thalia Sparling