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Title:
Small plots, big hopes : factors associated with participation in an urban garden project in lesotho
Physical Description:
Book
Language:
English
Creator:
Noble, Charlotte
Publisher:
University of South Florida
Place of Publication:
Tampa, Fla
Publication Date:

Subjects

Subjects / Keywords:
Household gardens
HIV/AIDS
Southern africa
Applied anthropology
Dissertations, Academic -- Anthropology -- Masters -- USF   ( lcsh )
Genre:
non-fiction   ( marcgt )

Notes

Abstract:
ABSTRACT: Studies of food insecurity have frequently focused on rural dwellers as vulnerable populations. However, during the 'global food crisis' of 2007-2008, riots in more than 50 countries visibly demonstrated the vulnerability of urban populations to food insecurity due to rapidly rising food prices. This study examines factors associated with participation in an urban garden project (UGP), utilizing surveys (n=61) and in-depth household interviews (n=37) to examine food security and dietary diversity of households in urban Lesotho. Households that participated in the garden project were more food insecure and had lower dietary diversity than those that did not participate. However, it cannot be determined if participation in the project caused this difference, or if households already experiencing these issues self-selected to participate. Factory workers households, which make up a large part of the target population, did not appear to be much difference between factory worker and non-factory worker households. More female-headed households than male-headed households were categorized as severely food insecure and experienced lower levels of dietary diversity, though this difference is not statistically significant. Because the study did not utilize random sampling, the findings cannot be generalized. Nonetheless, they provide important direction for future studies. Lack of awareness was the primary barrier to participation in the project. Another barrier was not having enough time to attend demonstrations, to plant, or to tend a garden. Time constraints were often work-related but sometimes included to other obligations such as attending funerals. Participants in the urban garden project were very knowledgeable about the costs and benefit of participating, reported having taught others how to replicate the gardens, and had even shared seeds with friends and neighbors. Despite the project having started a mere six weeks before the time of this study, and the fact that the garden demonstrations were being held during the winter season in Lesotho, UGP participants reported having already eaten and sold leafy greens from their gardens. Key areas for follow up study include a randomized, longitudinal examination of participation in the garden program, as well as an evaluation of the effectiveness of the project. Further, an examination of coping strategies such as the use of funerals as a source of food also deserves systematic study. Finally, there should be consideration of how information is disseminated to communities, with careful examination of what defines "community" and how social networks strongly influence the distribution of knowledge about such projects.
Thesis:
Thesis (MA)--University of South Florida, 2010.
Bibliography:
Includes bibliographical references.
System Details:
Mode of access: World Wide Web.
System Details:
System requirements: World Wide Web browser and PDF reader.
Statement of Responsibility:
by Charlotte Noble.
General Note:
Title from PDF of title page.
General Note:
Document formatted into pages; contains X pages.

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usfldc handle - e14.4756
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ABSTRACT: Studies of food insecurity have frequently focused on rural dwellers as vulnerable populations. However, during the 'global food crisis' of 2007-2008, riots in more than 50 countries visibly demonstrated the vulnerability of urban populations to food insecurity due to rapidly rising food prices. This study examines factors associated with participation in an urban garden project (UGP), utilizing surveys (n=61) and in-depth household interviews (n=37) to examine food security and dietary diversity of households in urban Lesotho. Households that participated in the garden project were more food insecure and had lower dietary diversity than those that did not participate. However, it cannot be determined if participation in the project caused this difference, or if households already experiencing these issues self-selected to participate. Factory workers households, which make up a large part of the target population, did not appear to be much difference between factory worker and non-factory worker households. More female-headed households than male-headed households were categorized as severely food insecure and experienced lower levels of dietary diversity, though this difference is not statistically significant. Because the study did not utilize random sampling, the findings cannot be generalized. Nonetheless, they provide important direction for future studies. Lack of awareness was the primary barrier to participation in the project. Another barrier was not having enough time to attend demonstrations, to plant, or to tend a garden. Time constraints were often work-related but sometimes included to other obligations such as attending funerals. Participants in the urban garden project were very knowledgeable about the costs and benefit of participating, reported having taught others how to replicate the gardens, and had even shared seeds with friends and neighbors. Despite the project having started a mere six weeks before the time of this study, and the fact that the garden demonstrations were being held during the winter season in Lesotho, UGP participants reported having already eaten and sold leafy greens from their gardens. Key areas for follow up study include a randomized, longitudinal examination of participation in the garden program, as well as an evaluation of the effectiveness of the project. Further, an examination of coping strategies such as the use of funerals as a source of food also deserves systematic study. Finally, there should be consideration of how information is disseminated to communities, with careful examination of what defines "community" and how social networks strongly influence the distribution of knowledge about such projects.
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PAGE 1

Small Plots, Big Hopes: Factors Associated with Participation in an Urban Garden Project in Lesotho by Charlotte Ann Noble A thesis submitted in partial fulfillment of the requirements for the degree of Master of Arts Department of Anthropology College of Arts and Sciences University of South Florida Major Professor: David A. Himmelgreen, Ph.D. Nancy Romero-Daza, Ph.D. Daniel Lende, Ph.D. Date of Approval: November 5, 2010 Keywords: household gardens, HIV/AIDS, southern africa, applied anthropology Copyright 2010, Charlotte Ann Noble

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ACKNOWLEDGEMENTS I would like to acknowledge the valuable support of my advisor, Dr. David Himmelgreen, who truly inspires me. I cannot thank you enough for guiding me through this experience. I appreciate your constant s upport, as well as your eternal optimism! To Dr. Nancy Romero-Daza, your passion is contag ious and your advice is always on point. Thanks you so much for everything you do. To Dr. Daniel Lende, thank you for joining my committee at such a late stage; I ve ry much appreciated your insightful recommendations. Dr. Jeannine Coreil, my first years as a graduate student were challenging and rewarding because I worked with you. Thank you for taking the time to provide comments on my MPH project, wh ich grew into this thesis. To the wonderful staff from the organi zation in Lesotho carrying out the urban garden projectmy sincerest thanks for everything. I would also like to offer my appreciation to National Un iversity of Lesotho student Mphu Selai, who provided important linguistic and other research support. For their infinite patience and unconditio nal support, I would like to thank my husband John and my daughter Caryn. I truly co uld not have done this without their love and support Lastly, I would like to thank the ma ny Basotho women and men who took time from their busy lives to talk with me about food and gardens. Thei r hope and strength are a constant source of inspiration.

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i TABLE OF CONTENTS LIST OF TABLES iv LIST OF FIGURES v ABSTRACT vi CHAPTER 1: INTRODUCTION 1 Statement of the Problem 1 Background: An Urban Garden Project in Lesotho 3 Research Project Overview 6 CHAPTER 2: LITERATURE REVIEW 9 Lesotho in Context: Issues to Consider 9 History of Migration a nd Wage Labor in Lesotho 10 HIV/AIDS in Lesotho: Im plications of the Crisis 13 Food Insecurity in Lesotho 16 Defining Food Insecurity 17 Global Food Crisis 18 Current State of Food Insecurity in Lesotho 22 Use of Home Gardens to Address Food Insecurity 23 Theoretical Approaches 25 CHAPTER 3: METHODS 32 Introduction 32 Research Site 34 Preliminary Research and Research Problem 36 Study Objectives 37 Methods of Data Collection 38 Study Participant Sel ection and Recruitment 38 Household Surveys 39 Household Food Insecurity (Access) Survey 39

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ii Household Dietary Diversity Survey 43 Semi-Structured Interviews 46 Data Analysis 47 Survey Data Entry in Excel, PASW/SPSS 18 47 Semi-structured Interview Data Entry into MaxQDA 10 47 Ethical Conduct 49 CHAPTER 4: RESULTS 50 Introduction 50 Study Participant Ch aracteristics 51 Survey Results 55 Household Food Insecurity Access Survey 55 Event Occurrence Questions 55 HFIAS as a Continuous Score 57 HFIAS as a Food Security Category 58 Household Dietary Diversity Survey 61 Semi-Structured Interview Results 68 How Households Obtain Food 68 Experience with Vegetable Production 69 Food Insecurity: Perceived Su sceptibility and Severity 70 Perceived Benefits of Participating in Garden Project 74 Perceived Costs of Partic ipating in Garden Project 76 Material requirements 78 Time requirements 78 Perceptions of the Urban Garden Project 79 Participation 80 Reasons Households Did Participate 81 Reasons Households Did Not Participate 81 Emergent Interview Themes 83 HIV/AIDS 84 Funerals as Coping Strategy 86 Recruiting Community Members 87 Summary of Results 89 CHAPTER 5: DISCUSSION, CONCLUSION AND RECOMMENDATIONS 91 Discussion of Results 91 Most Significant Barrier is Awareness 91 Participants Know Be nefits of the Project 93 Recommendations 94

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iii Study Limitations and Future Research Directions 97 Conclusion 99 Contributions to Applied Anthropology 100 LITERATURE CITED 102 APPENDIX A: HOUSEHOLD FOOD INSECURITY ACCESS SCALE 116 APPENDIX B: HOUSEHOLD DIETARY DIVERSITY EXPANDED QUESTIONNAIRE 120 APPENDIX C: HOUSEHOLD INTERVIEW GUIDE NON-UGP HOUSEHOLDS 123 APPENDIX D: HOUSEHOLD INTERVIEW GUIDE UGP HOUSEHOLDS 127 APPENDIX E: HOUSEHOLD DEMOGRAPHICS SHEET 131

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iv LIST OF TABLES Table 2.1 Life Expectancy (years) for Males and Females, 1996 and 2006 14 Table 2.2 Theories and Levels in So cial Ecology of Health Framework 27 Table 3.1 HFIAS Questions 40 Table 3.2 Household Dietary Diversity Score Food Groups 45 Table 4.1 Selected Characteristics of Study Households 52 Table 4.2 Age Distribution of Household Heads and Household Composition 53 Table 4.3 Selected Characteristics of Study Households by Participation 54 Table 4.4 Affirmative Responses to HFIAS Occurrence Questions 56 Table 4.5 Benefits of Participation in Garden Project 75 Table 4.6 Costs or Barriers to Part icipation in the Garden Project 77

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v LIST OF FIGURES Figure 1.1 Keyhole Garden 5 Figure 1.2 Anatomy of a Keyhole Garden 5 Figure 1.3 Trench Garden in Maseru 6 Figure 2.1 Map of Lesotho 10 Figure 3.1 Line of Textile Factories near Maputsoe, Lesotho 33 Figure 3.2 Map of Lesotho 34 Figure 4.1 HFIAS Category by Participation 59 Figure 4.2 HFIAS Category by Sex of Household Head 60 Figure 4.3 HFIAS Category by Factory Work 60 Figure 4.4 Percentage of All Households Consuming HDDS Food Groups 62 Figure 4.5 Food Groups Consumed by All Households 63 Figure 4.6 Consumption of Food Group by Pa rticipation in the Garden Project 65 Figure 4.7 Consumption of Food Gr oup by Sex of Household Head 66 Figure 4.8 Consumption of Food Group by Factory Work 67 Figure 4.9 Reasons for Participation in Garden Project 82 Figure 4.10 Reasons for Non-Partic ipation in Garden Project 83

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vi ABSTRACT Studies of food insecurity have frequently focused on rural dwellers as vulnerable populations. However, during the global f ood crisis of 2007-2008, ri ots in more than 50 countries visibly demonstrated the vul nerability of urban populations to food insecurity due to rapidly rising food prices. This study examines fact ors associated with participation in an urban garden project ( UGP), utilizing surveys (n=61) and in-depth household interviews (n=37) to examine food s ecurity and dietary diversity of households in urban Lesotho. Households that participated in the ga rden project were more food insecure and had lower dietary diversity than those that did not particip ate. However, it cannot be determined if participation in the project cau sed this difference, or if households already experiencing these issues self-selected to pa rticipate. Factory workers households, which make up a large part of the target populat ion, did not appear to be much difference between factory worker and non-factory wo rker households. More female-headed households than male-headed households were categorized as severely food insecure and experienced lower levels of di etary diversity, though this di fference is not statistically significant. Because the study did not uti lize random sampling, the findings cannot be generalized. Nonetheless, they provide important dire ction for future studies. Lack of awareness was the primary barrier to participation in the project. Another barrier was not having enough time to attend de monstrations, to plant, or to tend a

PAGE 9

vii garden. Time constraints were often work -related but sometimes included to other obligations such as attending funerals. Partic ipants in the urban gard en project were very knowledgeable about the costs a nd benefit of participating, reported having taught others how to replicate the gardens, and had even shared seeds with friends and neighbors. Despite the project having star ted a mere six weeks before the time of this study, and the fact that the garden demonstrations were be ing held during the winter season in Lesotho, UGP participants reported having already eate n and sold leafy greens from their gardens. Key areas for follow up study include a randomized, longitudinal examination of participation in the garden program, as well as an evaluation of the effectiveness of the project. Further, an examination of coping st rategies such as the use of funerals as a source of food also deserves systematic study. Finally, there should be consideration of how information is disseminated to communities, with careful examination of what defines community and how social networks strongly influence the distribution of knowledge about such projects.

PAGE 10

1 CHAPTER 1: INTRODUCTION STATEMENT OF THE PROBLEM The global food crisis of 2007-2008, during wh ich world market prices for staples such as rice and wheat rose more than 60% resulted in significant food emergencies around the world (Ruel et al. 2010; Romero-D aza et al. 2009; Stanford 2008). It was determined that the number of undernouris hed people in the world increased by 75 million in 2007 and 40 million in 2008, and this increase was largely due to higher food prices (FAO 2008b; FAO 2008c). In a recent ar ticle, Ruel and colleagues have noted the disproportionate vulnerability of the ur ban poor (2010:170S) to the impacts of these crises, because of their tendency to rely on a cash economy which makes them susceptible to price fluctuations. Considering this rise in food prices, and the fact that urban populations in developing countries spend a significant portion of their incomes on food (von Braun et al. 1993), the food security of urban populations has increas ingly dominated the agendas of international aid agencies working in developing c ountries. Several international organizations have argued for the use of ag ricultural nutrition interventions such as homegardens as a means to address food ins ecurity. There is good evidence to suggest that such interventions work well in rural areas of developi ng countries (Nember et al. 2001; Faber et al. 2002; Low et al. 2006; Faber et al. 2007), resulting in increases in

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2micronutrient intake. There is also evidence of the benefits of homegardens in urban areas of developed countries, which includes increased access to fruits and vegetables as well as improved physical, mental, and even so cial well-being (Wakefield et al. 2007; Alaimo et al. 2008). However, there is still a gap in research examining home garden interventions in urban areas of developing countri es. In particular, th ere is little research that seeks to understand why individuals engage in such projects; often the assumption is that need should equal particip ation. This research seeks to fill this gap in knowledge about factors associated with participation in an urban ga rden project in Lesotho. Home garden interventions typically aim to increase dietary diversity, which is conceptualized as the number of different foods or food groups consumed over a given reference period (Ruel 2003:3). Home gardens are associated with increased intakes of micronutrients such as calcium, iron, riboflavin, and vitamin A (Romero-Daza et al. 2009; Faber et al. 2002; Low et al. 2006; Faber et al. 2007). In rural Mozambique, Low and colleagues found that the ch ildren in participa ting households that produced orangefleshed sweet potatoes (OFSP), we re not only more likely to consume OFSP than control children; their vitamin A intakes were also higher (Romero-Daza et al. 2009; Low et al 2006). Interestingly, these projects have been found to increase micronutrient levels of children within a community, regardless of their pa rticipation (Faber et al. 2002). However, participation is associated with higher micronutrient levels while nonparticipation is associated with lower mi cronutrient levels (Faber et al. 2002). Home gardens are also viewed as a sustainable way to address micronutrient deficiencies (Romero-Daza et al. 2009; Friis et al. 2002). It is important to note that the improvement of dietary diversity has the pot ential to increase the intake of several

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3micronutrients simultaneously (Romero-Daza et al. 2009; Allen 2003). An agricultural nutrition intervention is one that emphasizes th e use of agriculture to increase access to foodeither though small gardens or through larger agricultural plots or fields. For the purposes of this study, agricultural nutrition interventions (or garden interventions) refer to the promotion and in struction in the us e of small homestead gardens, including keyhole, trench and container gardens, to increase access to food. BACKGROUND: AN URBAN GARDEN PROJECT IN LESOTHO A one-year urban garden project was implemented in Lesotho by a number of international partner agencies; these agencies had worked successfully in rural areas of the country and sought to expand their food s ecurity programming into urban areas of Lesotho. The project was a multi-phased intervention consisting of several components including home gardening demonstrations, basi c marketing skills training, distribution of seeds and tools, establishment of community fund raising mechanisms to leverage collective purchases such as seeds or other inputs, and monitoring and technical support with reference to home garden implementation. The UGP targeted poor households with the goal of increasin g access to food and mitigating the impact of rising food prices. Project staff assumed that this could help households in two ways. First, they would gain direct access to the fresh vegetables from their gardens. By growing rather than pur chasing vegetables, house holds could use those funds to meet other needs. Second, sale of surplus vegetables could provide a secondary source of income for partic ipating households. The pr oject intended to reach 5,000

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4households, with approximately 20,000 individu als benefiting from the training and services provided, based on their success with a similar project in ru ral areas of Lesotho (Romero-Daza et al. 2009; Turkon et al. 2009). To avoid confusion, when describing th e study population as a whole, I will refer to the group as respondents or the study population. Households enrolled in the urban garden project will be referred to as UGP households. Households not participating in the urban garden project wi ll be referred to as non-UGP households. Keyhole gardens (Figure 1.1) are a type of raised bed garden that, when viewed from above, appear to have a wedge removed from a circular garden. They consist of a raised circular bed of soil about six feet in diameter and roughly th ree feet or waist high, held together by a wall of stones. The garden is comprised of mainly organic materials in several layers (See Figure 1.2). The wedge provides a narrow passage that joins the outside walls to a central area where a gra ss or straw basket is located. The passage allows easy access to the basket, where water, kitchen scraps or compost can be added1. These features make it easy to tend for people who are sick, have disabilities, or even people living with HIV. However, these ga rdens are often difficult for those populations to construct. A trench garden is similar in that it is also a ra ised bed garden, with multiple layers of primarily organic materials2. The garden is only about 6-10 inches high, and does not contain a central bask et for watering or adding compost. 1 For more information about these garden ty pes, refer to materials published by FAO (http://wwwfao.org/ag/agn/nutrition/docs/FSNL%20Fact%20sheetKeyhole%20gardens.pdf ) and Send a Cow (http://www.cowfiles.com/african-gardens/keyhole-gardens ). 2 For information about trench gardens, see Catho lic Relief Services (2008). Homestead Gardening: A Manual for Program Managers, Implementers, and Practitioners (http://crsprogramquality.org/pubs/agenv/Lesotho_homestead_gardening_manual_low.pdf

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5 Figure 1.1: Keyhole garden Photo Credit: Charlotte Noble Figure 1.2: Anatomy of Keyhole garden Photo Credit: Charlotte Noble Rocks for walls LAYERS IN GARDEN Soil and manure Manure Soil Ash Soil Ale, tins, bones Central basket for compost and gray water Passage to allow ease of tending, and caring for garden

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6While the walls of a keyhole ga rden can allow a person to lean against them to tend the garden, the trench garden requires one to bend at the waist to tend them. As can be seen from Figure 1.3, trench gardens can be constructed with scavenged or inexpensive materials such as broken bricks or rocks. Container gardens can be planted in discarded containers such as tires or cr acked wash bins, and can use or ganic materials to fortify soil quality and for retention of moisture. Figure 1.3: Trench Garden Photo Credit: Charlotte Noble RESEARCH PROJECT OVERVIEW The Food and Agriculture Organizati on of the United Nations (FAO) has indicated that homegardens have the potenti al to supply most of the daily non-staple foods that a family needs, including roots and tubers, vegetables and fruits, legumes,

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7herbs and spices, animals and fish3 (FAO 2008a). In light of this potential, why might households choose not to enroll in an ur ban garden intervention? During the UGP baseline assessment, UGP staff learned that early recruitment efforts had proven to be sluggish. They were pressed to learn why th e garden program, which offered free seeds, a small hand tool and instruction in garden tec hniques, should garner so little interest in their target communities. This exploratory study was proposed to better understand reasons related to participati on, and particularly aims to a ddress the following questions: 1. What factors are associated with pa rticipation, or non-pa rticipation, in a homegarden project? 2. Are households that are food insecure mo re or less likely to participate? 3. Are households that have less diverse diet s more or less likely to participate? 4. What barriers are perceived by both UGP and non-UGP households that might interfere with willingness or ability to participate? 5. What benefits are perceived by both UGP and non-UGP households? 6. Many residents in the target communities migrated for work in textile factories; does this affect their willingness or ability to participate? A cross-sectional study was carried out to examine the factors associated with participation in a garden project in the urba n areas of Maseru and Maputsoe, Lesotho. 3 For example, FAO supports animal husbandry projects that include poultry in Nepal and Cambodia; projects in Bangladesh also encourage the fish farming to provide a source of protein. In their report on smallholder gardens, FAO reports that it is not unusual that homegardens in West Java contain fishponds (Mitchell and Tim Hanstad 2004).

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8Using qualitative and quantitative methods, th is study aims to examine the factors that determine whether residents of urban areas choose to participate in a home garden intervention aimed at mitigating the detrimental impact of food-cost increases in Lesotho. The study examines associations between part icipation in the urban garden program and household food insecurity and dietary diversit y. Additionally, domain s related to healthbehavior outlined in the Health Belief and the Theory of Planned Behaviors models will be considered; these include perceived suscepti bility to a disease or issue (in this case, food insecurity), perceived severity of such an issue, and the perceived barriers and benefits to engaging in home gardens to al leviate food insecurity. Finally, a political economic lens will be focused on the question of participation; such issues as unequal access to resources or engagement in wage labor will be considered as potential barriers to participation. One important note is that while food s ecurity and dietary diversity measures are examined, this study is not intended to ch aracterize the nutriti onal status of the participants. Instead, food security and di etary diversity measures are used only to describe important categories of househol ds: UGP and non-UGP households, factory and non-factory worker households, as well as fema leand male-headed households. This is done in order to determine if differences be tween these categories are associated with participation.

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9 CHAPTER 2: LITERATURE REVIEW LESOTHO IN CONTEXT: ISSUES TO CONSIDER The Kingdom of Lesotho (Figure 2.1) is a small, landlocked country roughly the size of Belgium that is completely surrounde d by the Republic of South Africa (RSA). Lesotho has a long and tumultuous history, mark ed by British colonial rule as well as aggression and economic dominance by RSA (Himmelgreen et al. 2009; Rosenberg 2007; Gill 1997; Murray 1981). There are few natural resources in Lesotho, and reliance on wage work coupled with high unemployment and increasing world food prices put the Basotho (the people of Lesotho) at risk for high levels of food insecurity and infectious disease, particularly HIV/AIDS. To provide the needed context for an examination of participation in an urban garden project in Lesotho, this chapter begins with a brief history of migration and wage labor, as textile factory work ers were a key part of the target population for this program. This will be followed by an overview of the HIV/AIDS crisis in Lesotho and a review of the implications of such a crisis. This part of the literature review is important because even though th e urban garden project does not target people living with HIV/AIDS (PLWHA) explicitly, it ha s been noted that the HIV prevalence rate in Lesotho is one of the highest in the world at 23.6%; among textile workers, the prevalence is estimated to be 40.1% (UNGASS 2009).

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10Figure 2.1: Map of Lesotho This chapter will also provide an overvie w of the global food crisis, which has had a significant impact on both the rural and ur ban population of Lesotho (DMA, LVAC, WFP 2008). Food security, food insecurity and related concepts will be defined and the current state of food insecurity in Lesotho pr esented, as well as a re view of the use of home gardens as a means to address food ins ecurity, to better understand in what context decisions to participate are made. Finall y, this chapter will discuss the theoretical approaches that will be used in this study. History of Migration and Wage Labor in Lesotho I am working five, six, and sometimes seven days in a weekeach day, sometimes 10 hours or more. On my free days, I stand with many others out side the gates of the factory, hoping to get more work. In this way, it is sometimes difficult for me to work in the gardenI am still hoping to receive more paid work. Non-UGP household, 31 year old female, Maputsoe District MASERU Maputsoe LERIBE DISTRIC T MASERU DISTRICT MAP OF LESOTHO South Africa

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11 Historically, the people of Lesotho have served as a source of cheap labor for South African industry, partic ularly mining. From the 1930s, the economy of Lesotho relied primarily on migrant labor with a pproximately 19,000 workers employed in South African gold mines in 1929; by the 1950s over 110,000 Basotho men (nearly 30% of working age men) were employed in mines (Rosenberg 2007). Lesothos dependence on migration and work in the mines peaked in 1977 with between 60 a nd 75% of adult males working in South Africa at any given tim e (Himmelgreen 1994; Murray 1981). During the early 1980s, it was estimated that as many as 200,000 Basotho were employed as migrant laborers (Ferguson 1990; GOL 1983; World Bank 1981). By the mid-1990s, following the dismantling of apartheid in South Africa, Lesotho began to experience a significant ec onomic crisis, which originated in South Africa. Because Lesotho is inextricably linked to South Africa (Van Buren 2004), changes in its larger and more powerful nei ghbor reverberate in th e small, land-locked nation. South Africas economy was built on a foundation of stable gold prices, represented by the gold standard. Until th e gold standard was dismantled in 1971, the only variable affecting the rate of profit wa s the cost of inputsth at is, labor (Hirsch 2005). The price of gold varied widely in the 1970s and then began to drop in the 1980s (Hirsch 2005). As a result, South Africa bega n to repatriate many mi nors to the front-line countries including Lesotho. Because Lesot ho had few natural resources and a limited infrastructure, there were few employment opportunities for these returning miners (Rosenberg 2007). Though employment opportunities in South Af rican mines have been significantly reduced, Lesotho still serves as a labor rese rve for industry. However, with the passing

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12of the Africa Growth and Opportunity Act (AGOA) in 1998, textiles and shoe manufacturing industries were drawn to Lesoth o. Instead of migrating to South Africa, the Basotho move internally from rural to urban areas to supply cheap manufacturing labor for foreign investors (Rosenberg 2007). These industries have flourished and are now the largest employer in Le sotho, with women representi ng the majority of workers (Himmelgreen et al. 2009; Department for International Development 2008; Turkon 2008). In 2005, textile employment reached its peak at around 50,000, though the numbers are slipping as textile factories close. Six factories alone closed in 2005, leaving 6,650 workers without jobs (BBC News 2005). Fluctuations in the number of jobs and migration are not the only problems faced by Basotho workers. Rosenberg notes that though textile mills seemed to be a savior (2007:467), the differences in salaries between what Basotho men earn in South African mines (about $5,000 a year in 2007) and what Ba sotho women earn working in the textile industry (about $1,500 a year in 2006) are st riking. In 2010, those salaries have not changed much; the minimum wage for textile wo rkers in Lesotho is set at 881 Maloti or just over $126 per month4 and about $1515 per year (Mol omo 2010). Rosenberg notes that the salaries women earn are so low, they can barely afford to feed their families, and that Basotho women face the same dilemma that their fathers and grandfathers faced decades ago: starve, or be subjected to low wages and verbal and physical abuse (2007:468). Baylies and Wright (1993) not e that Lesotho appears to have an extraordinarily high level of female involveme nt in textile industries; of those firms reporting, 92% of their workers were female. These figures are high when compared to 4 Rate of exchange on October 31, 2010: 1 Maloti = 0.1433 US dollars.

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13other African countries such as Botswana (44%), Zimbabwe (41%), Kenya (21%), and Malawi (11%) (Baylies and Wright 1993). According to a more recent source, approximately 88% of employees working in textile factors in urban areas are female (UNGASS 2009). Additionally, 60% of worker s have migrated from other parts of Lesotho to work in the factor ies, and the HIV prevalence rate among textile workers is 40.1% (UNGASS 2009). According to the United Nations Gene ral Assembly Special Session (UNGASS) 2009 report, there is also a si gnificant amount of cross-bo rder informal employment, particularly in the large bor der towns of Maseru and Maput soe. Lesotho still relies heavily on the out-migration of workers to Sout h Africa. This situation is problematic, as ethnographic evidence that suggests that this contributes to high HI V infection rates and high-risk sexual behaviors not only in the Leso tho-South Africa corridor but also in other African countries (IRIN 2003, Lurie et al. 2003, IRIN 2002, Hope 2000, Lurie et al. 1997; Himmelgreen and Romero-D aza 1994; Jochelson 1991). HIV/AIDS in Lesotho: Im plications of the Crisis There are two types of people in Lesotho; those infected and those affected by HIV/AIDS.5 The HIV/AIDS prevalence rate for adults 15-59 years is currently 23.6%, which is the third highest rate in the world (UNGASS 2009). For urban populations, the prevalence is higher: approximately 29% (W HO Mortality Country Fact Sheets 2006). 5 Bowsky, Sara. (2004). CARE Lesotho and Family Health International.

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14According to the 2006 Lesotho Population Census, life expectancy had dramatically changed between 1996 and 2006 (Table 2.1). Females have lost more than 17 years of life, and males almost 19 years; much of th at loss has been attributed to HIV/AIDS (Himmelgreen et al. 2009; Hassan 2002) Additionally, healthy life expectancy6, which takes into account healthy year s of life lived, is even more dire years of healthy life are expected for males, 33 years for female s (UNDP Human Developm ent Reports 2008). Among the adult population (aged 15-60), the proba bility of not surviv ing past the age of 40 is an alarming 47.8% (UNDP Hu man Development Reports 2008). Table 2.1: Life Expectancy (years ) for Males and Females, 1996 and 2006 Females Males Total 1996 60.2 58.6 59.0 2006 42.9 39.7 41.2 change 17.3 years 18.9 years 17.8 years figures from Lesotho Bureau of Statistics 2006 In Lesotho, an estimated 90% of the years of life lost are due to communicable diseases including HIV/AIDS and tuberculos is (WHO Mortality Country Fact Sheets 2006). Sixty-three percent of all deaths and 56.2% of deaths in children under five years can be attributed to HIV. Antiretrovira l therapy coverage, assessed in December 2005 was only 14% (WHO Mortality Country Fact Sheets 2006) but is now estimated to reach 51% of the adults and chil d population with advanced HIV infection (UNGASS 2009). 6 Healthy life expectancy is the aver age number of years a person can ex pect to live in "full health" by taking into account years lived in less than full health due to disease and/or injury (http://www.who.int/whosis/whostat2006H ealthyLifeExpectancyAtBirthHALE.pdf).

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15It is also important to note than in the context of high rates of infectious disease, malnutrition not only contributes to lower health status; it also cont ributes to suppression of immune function, which is often compounde d by the high prevalence of bacterial and parasitic diseases (Mller and Krawinke l 2005; FAO 2004; Brabin 2003; DeOnis 1993). This in turn feeds the cycle of malnutri tion through the nutriti on-infection complex (Semba and Tang 1999; Semba 1998; Scrimshaw and SanGiovanni 1997)7. Infectious diseases also decreases appetite and in tur n, food consumption, while diarrheal diseases can exacerbate nutrient loss (Lanata and Black 2001). In addition, malnutrition affects the severity of infecti ons, leading to a greate r likelihood of illness a nd death from disease, (Himmelgreen et al. 2009; Mller and Krawinkel 2005; FAO 2004; Brabin 2003; Black et al. 2003; Piwoz and Preble 2000 ; Rice 2000; Murray et al. 1997). There is a distinct synergis tic relationship be tween malnutrition and infection, in which diseases (e.g., tuberculos is, HIV/AIDS, and malaria) adversely affect nutritional status (Scrimshaw and SanGiovanni 1997). In fectious disease also impairs the health status of individuals by affec ting their ability to produce an adequate and appropriate diet for themselves and their families. It accomplishes this by weakening bodies and decreasing the ability of people to work to their full physical and mental or cognitive potential (Gillespie and Kadi yala 2005; see also discussi ons of new variant famine theory: De Waal and Whiteside 2003; Naysm ith et al. 2009). As proposed in the New Variant Famine theory, as individuals experi ence the impacts of infectious disease and food insecurity, households experience labo r shortages and a reduction of household 7 For a more complete review of studies explicating the relationship between malnutrition and infectious disease, see Himmelg reen et al. 2009.

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16assets. These assets are used for health care funeral costs, or possibly not earned at all because individuals were ill. Further, family members not infected may not be able to work because of time spent caring for the ill. This situation may further reduce the households ability to provide food. Eventual ly, households must d eal with death of a family member, which means not only the lo ss of loved one, but also of labor, and possibly the skills which are not passed on to surviving ch ildren (Himmelgreen et al. 2009; De Waal and Whiteside 2003; Naysmith et al. 2009). In light of such biological and ecological synergies, it becomes of param ount importance to address issues related to food insecurity in the context of high rates of HIV (Himmelg reen et al. 2009; Turkon et al. 2009). FOOD INSECURITY IN LESOTHO It [food insecurity] happens, particularly toward th e month end because you will find that the food that was bought at the be ginning of the month will have finished along the way, and you will find toward the end of the month you are only left with mealie (maize) meal. And at that tim e of the month, there is no money at all in the house because all the money that was there was used for other expenses in the house other than food. Non-UGP Household, 21-y ear old female, Maseru Yes I am living that kind of life because it is not easy for me to change the food, I eat the same food from time to time such t hat it becomes horrible in the sense that I am now eating for the sa ke of eating because I do not like this food anymore. UGP Household, 62-year old female, Maseru

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17Defining Household Food Insecurity Food security has been conceptualized in various ways. Gillespie and Kadiyala define food security as the physical and economic access to food of sufficient quality and quantity (2005:3). Another definition stresses social aspects, stating that "food insecurity exists whenever the availability of nutritionally adequate and safe foods or the ability to acquire acceptable foods in socia lly acceptable ways is limited or uncertain (Anderson 1990:1560). A more recent and widely used definition of food security is that Food security is a situation that exists wh en all people, at all times, have physical, social, and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life (FAO 2002). In defining food insecurity there are four key elements that seem to be consistent cross-culturally: 1) worry or uncertainty about food resources; 2) lack of access to food resources of adequate quality; 3) lack of access to food resources in adequate quantities; or 4) acquisition of food through socially unacceptable means (Coates et al. 2006). Humans of course must eat to live, as there are biological re quirements that must be met for us to function. But what humans choose to eat is highly struct ured by the physical, social, and cultural environments. It is b ecause of this that this definition of food insecurity identifies more than the physical implications of insufficient quantities of food, such as hunger or malnutrition. Instead, this definition recognizes that mere quantity of food is not enoughfood must be of a certain quality or vari ety to satisfy biological as well as social, cultural, or even psychologica l needs. It also highlights the mental or psychological impact of a lack of access to food, and the worry that frequently accompanies such experiences, while also acknowledging the stigma that might arise

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18from acquiring foods in non-socially accepta ble ways. These might include begging, stealing, or engaging in sexual transactio ns to gain access to food, but will vary depending on context. When measuring household food insecurity, it is also important to be clear about what is meant by the household. Based on interviews with key informants during the survey development stage, household was translated to the Sesotho (i.e. the language of Lesotho) word lelapa or family. To clarify what is meant by household, key informants also indicated that the phrase ba jang pitseng e le ngoe could be used, which translates as people who eat from the sa me pot. This definition fits well with the intended purpose of measuring househol d food insecurity in this study. Global Food Crisis Around the world, food prices rose mo re than 60% between late 2006 and 2008, resulting in a global food cris is (Stanford 2008). Von Braun ha s noted that the prices of agricultural commodities sharply increased in 2007 and 2008; world prices of wheat and maize trebled between 2003 and 2008, while th e price of rice was five times higher (2008:3). As a result, food secu rity and livelihoods of the mo st vulnerable were severely eroded (Von Braun 2008). The volatility in food prices exacerbated already tenuous food security situations in many areas of the wo rld; the World Food Pr ogramme (2008) called the increase in food prices a silent tsunami that revers ed food security gains and plunged as many as 75 million people into hunger (FAO 2008b). WFP (2009) estimated

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19that the higher food prices from 2007 -2008 could set progress on Millennium Development Goals8 back approximately seven years. The rapid and sharp rises of food pr ices around the world, and their attending social, economic and political responses are collectively referred to as the Global Food Crisis (Clapp and Cohen 2009b). Related to this, or perhaps an extension of the concept, is the F Crisis or the Food, Fuel, and Financial Crisis (s ee Ruel et al. 2010) which includes the rise in fuel prices as well as financial market instability around the globe. While a singular review of the causes of the global fo od crisis (or 3F crisis) is beyond the scope of this chapter, some potenti al shortand long-term factors have been suggested by Mittal (2009). These include: declines in growth of agricultural pro duction (affected by issues such as climate change and water depletion) declines in global stocks of grains (due in part to the high costs associated with holding grain stocks and movement to more on demand inventory management) increasing energy costs (fuels) which in tu rn increase producti on costs of grains financial markets speculation (deregulati on of commodities futures in 2000 led to a surge in speculative investment commodities markets (Mittal 2009: 17) 8 The Millennium Development Goals (MDGs) are a set of eight international development goals that include the eradication of extreme poverty and hunger, achievement of universal primary education, promotion of gender equality, reduction of child mortality, improvements in maternal health, combating HIV/AIDS, malaria and other diseases, as well as othe r goals. All UN member states as well as other international organizations goals have agreed to reach these by the year 2015. For more information, see http://www.undp.org/mdg/basics.shtml

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20 impact of biofuel production on availability of grain use for food, and a shifting of production from soybeans, wheat or oilsee ds to corn for the use in biofuels long term declines in agricultural productivity (farm spending halved in developing countries between 1980 and 2004) reduced regulation of agricultural pr oduction and trade, including tariffs shifts to production of crops for export While it is important to understand how su ch crises arise, more importantly for the purposes of this study ar e the implications of unstabl e food prices and the attending responses. Clapp and Cohen (2009) offer recommendations for responding to the crisis on a policy level, offering insights about lesso ns we should learn from the international aid enterprise which often responds to such crises with food ai d (Clapp 2009; Hopkins 2009). In addition, authors offer potential solutions such as reorienting local and global food systems (Ishii-Eiteman 2009) as well as promoting urban ag riculture (Redwood 2009). Another notable contri bution providing insights into the global food crisis is a recent issue of the NAPA Bulletin (Himmelg reen 2009), which argues for the use of anthropological approaches for understanding an d responding to the global food crisis. It includes articles that identity groups vulnerable to food insecu rity in the context of the global food crisis, such as popul ations embedded in violence and conflict (Messer 2009), adolescents and young adults (Hadley et al. 2009), and women (Githinji 2009). Moreover, articles in this collection also a ddress the vulnerability of nations weakened by global restructuring and trade policies such as Haiti (Mazzeo 2009) and the Dominican Republic (Rosing 2009). Finally, there are r ecommended strategies for addressing food

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21insecurity, such as through the creation of community-based food monitoring systems (Chaiken et al. 2009) as well as through th e support of agricu ltural interventions including home gardens (Romero-Daza et al. 2009). These volumes highlight the need to link the global and th e local when determining the best strategies for addressing the crisis. While the majority of th e ultra-poor population in Leso tho resides in the rural areas, households in urban areas have been f ound to have the highest level of aggregate food insecurity (Lesotho Disaster Management Authority [DMA], Lesotho Vulnerability Assessment Committee [LVAC] and the UN Worl d Food Programme [WFP] 2008). It is estimated that poor households spend between 75 percent and 80 per cent of their income merely to purchase food (IRIN 2009). In a recent assessment (DMA, LVAC, WFP, 2008), the majority of households interviewe d reported being affect ed by escalating food costs, and in urban areas 15,000 people were sa id to be facing a critical food deficit, defined as the inability to meet their food needs either through production, purchases or other means of acquisition. More than ha lf of urban households admitted that they borrowed food to get by, and more than 40 percent reduced th e number of meals consumed per day (DMA, LVAC, and WFP 2008). Some reasons cited for this food defi cit were declining maize production and increasing prices that affected access to f ood; maize prices have increased 300% since 2004/05, and the price of cooking oil ro se 100% between May 2007 and May 2008 (LVAC 2008). Additionally, the prices of commodities in urban areas increase at a higher rate than prices in rural areas (DMA, LVAC, and WFP 2008). Because of the increase in food prices, it was anticipated th at there would be a 41% expenditure deficit

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22for urban households over the next year. This deficit took into account the costs of staple and minimum non-staple items, such as soap, paraffin for heating, matches, cooking oil, beans, salt and other household necessities (L VAC 2008). It did not account for expenses such as education, medical costs, farm inputs, or other expenses such as rent, water, or electricity (LVAC 2008). Current State of Food Security in Lesotho According to the Global Hunger Index (a measure of hunger and malnutrition that takes into account the proportion of the population that is undernourished, the prevalence of underweight children zero to fi ve years, and the mortality rates of those children), Lesothos Global Hunger Index is considered severe (Wiesmann 2006). Consider the following statistics for these categories of malnut rition in Lesotho: 46.1% of children under five are low he ight-for-age (or stunted, indicative of chronic malnutrition) 20.0% of children under five are low wei ght-for-age (or wasted, indicative of acute malnutrition) 14% of all newborns are low birth weight (a risk factor for early morbidity and mortality in children under 5 (WHO Mortality Country Fact Sheets 2006) Prior to the global food crisis (GFC), Lesotho seemed to have been making headway in terms of the mitigation of food insecurity. Calorie counts put consumption at or near established benchmarks, showing an approxi mate 200-calorie defi cit (FAOSTAT 2006). However, caloric intake alone is not an adequate measure of food security or nutritional

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23status, and a closer examinati on of intake reveals an overreliance on grains. In fact, on average, nearly 80% of daily energy cons umption in Lesotho is made up of cereals (primarily maize), which contributes over 1500 calories to the average daily consumption of about 2500 calories. Non-cereal foods contri bute no more than 18% of total caloric intake (FAOSTAT 2006). As previously di scussed, when considering the synergy between malnutrition and infectious disease, it is important to note that diets heavily reliant on cereals have been shown to lead to nutritional deficiencies (particularly micronutrient), which put people at risk for a number of health conditions, not the least of which is suppressed immune function (Yeudall et al. 2005). Unfortunately, current data on the food secu rity situation in Lesotho is not readily available, though an FAO Price Monitoring Brief (2010) indicates that while cereal prices have stabilized they are stil l higher than 2005 levels. High f ood prices still continue to affect much of the population, and of Lesot hos population of two million--almost half a million were in need of some form of food assistance in 2009/2010 (FAO 2010). USE OF HOME GARDENS TO ADD RESS FOOD INSECURITY Considering global food price increases, and the fact that urban populations in developing countries are spe nding a significant portion of their incomes on food (Clapp and Cohen 2009a; von Braun et al. 1993), food security of urban populations has increasingly dominated the ag endas of international aid ag encies working in developing countries. In response, organizations such as World Health Or ganization (WHO), CARE, CARITAS Internationalis, and Catholic Relief Services increasingly argue for the use of

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24agricultural food-based nutrition interventions (such as home gardens) as a means to address food insecurity. One goal of home garden interventions is to increase dietary diversity, conceptualized here as the number of di fferent foods or food groups consumed over a given reference period (Ruel 2003:3). Dietary diversity is a potential proxy indicator of micronutrient intake (Ruel 2002). There are several types of nut rition interventions, including supplementary feeding, fortifica tion, nutritional inform ation, and food-based interventions. While supplem entary feeding tends to target vulnerable groups such as infants and children, fortification focuses on particular nutritiona l deficiencies. Foodbased interventions are interv entions that focus on the pr ovision of food to address nutritional deficiencies, and these interventions can include the provision of food aid. Food-based nutrition interventions such as home gardens are often viewed as sustainable ways to reduce or eliminate micr onutrient deficiencies (Friis et al. 2002). Other micronutrient interventions, such as food fortification or the provision of supplementary foods are often implausibl e or unsustainable. For example, food fortification requires the coope ration of several actors. Th ese include producers of a highly consumed food that would serve as vehicle for fortification, packaging and fortification sites responsible for fortification and agencies responsible for the oversight of such activities (MOST USAID Micronutrien t Program 2004). Lesotho is a net food importer, obtaining approximately 70% of its maize and other food requirements (LVAC 2008; IRIN 2009). Thus, food fortification woul d rely heavily on infrastructure in other countries, to accomplish a far-reaching food fortification program. The provision of supplementary foods, such as ready-to-use th erapeutic foods (RUTF) or foods distributed

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25by aid organizations, is not typically viewed as sustainable because these foods are overwhelmingly imported. Additionally, food supplementation (like RUTF) targets certain members of the household like ch ildren, or persons living with HIV/AIDS, leaving others without assi stance. However, improving dietary diversity through foodbased strategies has the poten tial to benefit all members of a household, not just those targeted for supplementation (Allen 2003). Additionally, as previously discussed, improving dietary diversity has the potent ial to increase the intake of several micronutrients simultaneously (Allen 2003). THEORETICAL APPROACHES This study utilizes a bioc ultural perspective, whic h Himmelgreen and Crooks (2005) described as incorporating theory and methods from both biological and cultural anthropology. Himmelgreen and Crooks (2005) noted that nutriti onal anthropologists could use different heuristic models when examining the relationship between biology and culture as they relate to food and nut rition (see also Pelto et al. 2000 and their discussion of an ecological model for examin ing food and nutrition). Thus, I will utilize the socioecological, or social ecology of health framework to organize theoretical approaches such as Health Belief Model, Theory of Planned Behavior Model, and a political economic model, which were applied to the research probl em. I will outline the contribution that each of these models make to the study, then discuss how the use of these models together help us to underst and, from a biocultural perspective, why households choose to participate (or not) in an urban garden project.

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26I used the socioecological model to organize both public health and anthropological theories for a number of reasons. First, this study was conceived to fulfill requirements for masters degrees in Public Health and Applied Anthropology. As a dual-degree student, it was important that I utilize theories from each field. Second, this integration of theories offers the poten tial to inform both fi elds of inquiry. By designing a study that straddles both fields, important findings can be delivered in language and frameworks that make sense to each. Finally, to my knowledge, there few if any studies that focus on the etic reasons for participation in urban garden projects. Thus, the public health theories I use, whic h relate to how people make decisions about health-related behaviors, were my best gue sses to guide this e xplorative study. As I began to collect data from participants th rough surveys and intervie ws, I relied less and less on these theories. However, because they framed data collection, they are included here. Emerging from various fields, a socioecol ogical paradigm views individual health as shaped by complex interacting systems of biological, social, and environmental factors (Coreil 2010b: 10). As such, it allows for the examination of the human condition within the context of different phys ical environments al ong with their attending stressors, pathogens, or diseas es. Any number of factors that influence the health of humans can be examined including the depleti on of resources (natural social, financial), food insecurity, socioeconomic disparit y, poverty, illiteracy, population growth, increasing urbanization and moderniza tion, migration, and globalization. The socioecological framework, like the bi ocultural framework, recognizes that an interwoven relationship exis ts between individuals and their environment. This

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27interwoven relationship has been developed into a social eco logy of health model, which provides a means of conceptualizing multiple le vels of influence and interactions linking the individual to the environment (Corei l 2010a). Though many permutations of the model exist, most tend to divide the levels of influence into four to five broad categories: individual or intrapersonal relationships or interpersonal organizational community and society For the purpose of this study, I con centrate on the individual/intrapersonal and societal level. Coreil (2010a:86.) demonstrates how soci al science theories might be mapped to the social ecology of health model, as shown in Table 2.2. Table 2.2: Theories and Levels in Social Ecology of Health Framework Level Theory or Model How theory or model applies to research question Individual/ Intrapersonal Health Belief Model Theory of Planned Behavior Understand determinants of participation in a health intervention. Posits that decision to act is determined by four factors: 1) Perceived susceptibility to issue 2) Pe rceived severity of issue 3) Perceived benefits and 4) Perceived barriers of participation Understand cognitive factor s that influence ones intention to act. It considers an individuals attitude toward the ac tion, that individuals perception of how others will view their actions (subjective norms) as well as their perceived ability to take action (self-efficacy) Societal Political Economy of Health Focuses on relationship between class and health; used to study the impact of societal factors on health. In this study, it will be used to examine if socioeconomic factors are associated with participation in the garden intervention Adapted from Coreil, 2010a

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28 One model for understanding what factors influence participat ion in the urban garden program in Lesotho is the Health Beli ef Model. Health Belief Model (HBM) is a psychological model first developed in the 1950s by social scientists to attempt to understand why people did not participate in a free tuberculosis screening program offered by the U.S. Public Health Service (Rimer and Glanz 2005; Coreil 2010b). This model attempts to explain and even pred ict health-related behaviors based on four constructs: Perceived susceptibility or vulne rability to disease or problem Perceived severity of the disease Perceived benefits related to adopting the health behavior Perceived barriers to adop ting the health behavior The health belief model was initially used as a disease-focused model to explain why some people chose to enga ge in a health-related ac tivity or not; however, more recently it is being used to explain a wider variety of health behaviors and even being used to design interventions (Pierce and Na lle 2002). The HBM has been revised to include a variety of cues to action such as bodily responses that le ad to recognition of a problem, or even public announcements to promote illness awareness or announce programs to address issues (P ierce and Nalle 2002). Using the framework of the Health Belief Model, participation in garden interventions can be understood through an examination of perceptions of susceptibility to food insecurity or the perceived severity of such a condition. Moreover, the percepti on of potential benefits and barriers for adopting household gardens might also be influencing participation. Further, considering the Theory of Planned Behavior (TPB) Model, ones attitude toward participating in a garden interventi on, their perception of how others will view

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29their actions, as well as their perceived ability to control th eir actions can influence their intention to act. According to the TPB, a pers ons intention to act is determined by his or her attitude toward that behaviordo target households see participation as positive, negative, or even a neutral act? Clearly, some aspects of Health Belief Model apply here, as people weigh potential benefits and barrier s before deciding if participation can be positive or negative. TPB also considers whether the people important to an individual will approve or disapprove of their actions (Rimer and Glanz 2005). Thus, ones intention to act is not solely dependent on their own beliefs, but also hinges upon the opinions of friends, family and even fellow community members. Thus, even if someone considered that the garden program were a worthwhile project to engage in, if they thought others might think poorly of them fo r doing so, they might not participate. Finally, a persons intention to ac t is influenced by their belief that they can indeed act or their perceived control over a particular behavi or. This means that their perceived ability to participate in a garden pr oject could be a significant factor; for example, they might feel they lack the skills to produce their ow n food, or a lack of ab ility to change their circumstances. This model places an emphasi s on cognitive as well as social aspects that might be influencing the likelihood that someone will engage in certain behaviors, such as garden interventions. It is important to recognize that the value of using a biocultural perspective while conducting anthropological research rests in the view that huma ns are biological, social, and cultural beings (McElroy 1990: 244). A bi ocultural perspective is an integrated approach that seeks to situate human biology within the environment because ultimately biological factors cannot be separated fr om cultural ones (Himmelgreen and Crooks,

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302005). This study uses a biocultural lens as Goodman and Letterman (1998) would have framed the term; that is, that biocultural st udies should take a polit ical economic focus, which is one that emphasizes the impact of an unequal distribution of resources on health as well as related responses or adaptations to those conditions (see also Leatherman and Goodman 1997). Applying a political economic focus to this studys hypotheses, such factors as engagement in wa ge labor, owning (or renting) land, and other socioeconomic variables were examined in order to determine if they would be associated with participation in the project. Thus, this research can be described as ha ving a biocultural focu s, in that it tries to determine if there are biol ogical and cultural/social reas ons for participation and nonparticipation in an urban garden program. By using this theoretical framework, this study does not assume that decisions about partic ipation are made purely on a biological need to supplement dietwhether it is the quantity, quality or variety of food one has access to or consumes. Nor does it assume that such decisions are purely cultural or social, which often times leads to assumptions about cultural barriers when and if these projects fail. Instead, this study not only measures food s ecurity and dietary diversity as potential corollaries to participation; it inquires about experiences with other agricultural pursuits, engagement in wage labor, and even ones perceptions about the project or how others might think or feel about the project. It delves into the live d experiences of food insecurity and low dietary di versity, to demonstrate how st udy participants view these experiences and how those experiences influen ce participation in development projects. Through this study, respondents themselves id entify reasons for pa rticipation (or nonparticipation) outside that of pre-constructe d hypotheses; they report participating simply

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31for the purposes of increasing their own le vels of knowledge, or for supporting friends and family with the products of their gard ens, which come at little to no cost to themselves. In one case, a respondent reports participation in the project simply to support development projects in her village, sa ying she knew that if th is project went well that other projects might follow. These reasons seemingly have little direct correlation to a biological or even pheno menological, or lived experien ce, of food insecurity.

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32 CHAPTER 3: METHODS INTRODUCTION This chapter outlines the research setting, provides a brief overview of preliminary research conducted in the study area, and presents the methods employed in this exploratory, cross sec tional study that compares urban garden project (UGP) households and non-UGP households to determine factors associated with participation. Here, I attempt to provide a rationale for the decisions made before and during the process of conducting this study. The research took place in urban ar eas of Maseru and Maputsoe during the months of June and July of 2009. Maseru is the capital city of Lesotho with a population of 197,907; it is the la rgest, most urbanized city in the country (Lesotho Bureau of Statistics [Lesotho BOS] 2006). The district of Maseru has a population of almost half a million or roughly a quarter of the total population (Lesotho Ministry of Health and Welfare 2010). Maputsoe, which houses 30,800 people (Lesotho BOS 2006), is in the Leribe district, whic h has a population of 362,339 (Lesotho Ministry of Health and Welfare 2010). Both of these cities contain indu strial areas with textile and other manufacturing plants; some operational, others empty and abandoned (Figure 3.1).

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33Figure 3.1: Line of Textile Fact ories near Maputsoe, Lesotho Photo Credit: Charlotte Noble This study employed mixed methods, in that it incorporated quantitative measures of food insecurity and dietary diversity w ith ethnographic explor ations of factors associated with participation. I initially conducted Household Food Insecurity (Access) Surveys and Household Dietary Diversity Su rveys with 61 households. From these 61 households, I conducted semi-structured in terviews with 37 respondents, 21 UGP households and 16 non-UGP households to co ntextualize factors associated with engagement in the urban garden project. By combining survey methods assessing food security and dietary diversity with qualitative in terview methods, a more nuanced picture of reasons for particip ation is presented.

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34RESEARCH SITE The project examined in this study is a multi-phased intervention carried out in two urban districts, Maseru and Maputsoe, in Lesotho (Figure 3.2). The project consisted of several components, including homegarden demonstrations, basic marketing skills training, distribution of seeds and tools, establishment of community fund raising mechanisms to leverage collective purcha ses such as seeds or other inputs, and monitoring and technical support for the implemen tation of homegardens. At the core of the project are learning modules presented in villages, usuall y at the home of the chief, during which community members are taught vari ous techniques such as the construction of trench, keyhole, and container gardens, comp ost heaps, as well as pest management. Figure 3.2: Map of Lesotho MASERU Maputsoe LERIBE DISTRIC T MASERU DISTRICT MAP OF LESOTHO South Africa

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35 Because most urban households have limited access to land, households were trained in several intensive gardening tec hniques. One such technique is companion planting, which is a method of planting of cer tain crops in close proximity, with the assumption that they will assist each other. This synergistic relation can be in terms of nutrients, pest control, pollin ation, and other factors necessa ry to increase productivity. One example is the Three Sisters or the Na tive American system of growing maize, beans, and squash in the same mound. Maize draws large amount of nitrogen from the soil, and legumes are a nitrog en-fixing crop. Beans can use the stalk of the maize as a vertical support for growth. Squash grow s close to the ground, which helps retain moisture and control weeds (Beyfuss and Pr itts 1994). For this project, companion planting consisted of alternating leaf and root crops. This is done because leaf and root crops have different needs in terms of soil nutrients, air and water. By planting this way, crops are less likely to compete with each other for these resources. Households were also taught to use space-conserving methods such as container, trench and keyhole gardens9. Ideally, all techniques utilize materi als that are easily obtainable within communities at little to no charge, such as dried grasses, cow manure, aloe, sticks, stones, cardboard and cans. The demonstrations we re open to the public and typically announced through the village chief one to two weeks in advance. At demonstrations, community members could choose to register fo r the project and rece ive 5-6 varieties of seed (beetroot, carrot, onion, spinach, rapa and sepaile-two green leafy vegetables consumed in Lesotho) as well as a garden fork. 9 See chapter 1 for images of these garden types.

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36 Through the construction of small house hold gardens, the project hoped to increase food security in two ways. First, households gain direct access to the fresh vegetables their garden produces, which in turn may ease the burden of food costs in proportion to income. Second, the production an d sale of any surplus vegetables could provide a secondary source of income for program households. PRELIMINARY RESEARCH AND RESEARCH PROBLEM In the early spring of 2009, I had the oppor tunity (along with Drs. Himmelgreen and Romero-Daza from the University of S outh Florida, and Dr. Turkon from Ithaca College) to consult with an international ai d organization on the development a baseline survey for an urban garden project that was just being implemented. Though this initial collaboration on the design of the baseline wa s conducted while we were in the United States, I was given the opportunity in March 2009 to travel to Lesotho for just under three weeks and assist with the baseline survey, and to lead focus group discussions with UGP participants. It was during this visit that it became apparent to organization staff, myself and my advisor, Dr. Himmelgreen that the organization was having problems recruiting and registering participants for the program; even after a month and a half of efforts, there were less than 200 households register ed, nowhere near the 5,000 households they hoped to reach in this year-long project. The yearlong intervention needed to register participants quickly so that they might st art attending garden de monstrations, building gardens and begin to produce, to consume, a nd possibly to sell vegeta bles. Therefore, it was imperative to quickly assess why recruitmen t was stalled. Based on discussions with the development organization and my advi sor, a study was proposed that sought to

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37compare UGP and non-UGP households to de termine what factors, if any, were associated with participation in the urban gard en project. I returned in June and carried out this study over an eight-week period. STUDY OBJECTIVES If home gardens provide the opportunity to increase access to pr oduce, increasing the quantity and variety of vegetables members of a household might consume, the question remained: Why do people choose to participate, or not, in home garden interventions? This exploratory study proposed to better unders tand and answer the following questions: 1. What factors are associated with pa rticipation, or non-pa rticipation, in a homegarden project? 2. Are households that are food insecure mo re or less likely to participate? 3. Are households that have less diverse diet s more or less likely to participate? 4. What barriers are perceived by both UGP and non-UGP households that might interfere with willingness or ability to participate? 5. What benefits are perceived by both UGP and non-UGP households? 6. Many residents in the target communities mi grated to the study area for work in textile factories; does this affect their willingness or ability to participate?

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38METHODS OF DATA COLLECTION Study Participant Selec tion and Recruitment As suggested by Bernard (2002) for this type of exploratory research, targeted sampling was used to select households for this study. These sampling methods were utilized because there are differences in household composition besides enrollment or not in the UGP project. Within the target popul ation, we also find factory worker and nonfactory worker households, as well as femaleand male-hea ded households; thus, it was important to recognize and account for such hous ehold differences. In each community, I recruited households during community garden demonstrations, as well as approached households based on the presence or absence of certain types of gardens (keyhole or trench) in the yards, or the absence of gard ens altogether. Partic ipation in the urban garden project was confirmed during the intervie w. I attempted to obtain a sample with a relatively equal distribution of UGP and non-UGP households10, which also equally represented both femaleand male-headed hous eholds, households with members that did or did not work in textile or other factories to allow for a robust exploration of possible factors that are associated with participation and nonparticipation in the garden project. I conducted surveys with 61 households in Maseru (n=30) and Maputsoe (n=31). Of the study respondents, 67.74% were UGP households and 31.16% were non-UGP 10 An equal distribution between participants (n=42) and non-participants (n=19) was not obtained. Frequently, households that did not appear to be participating or reported by neighbors not to be participating were unable to be reached because no one was home. In some cases, minors were alone in the household as the person in charge of food preparation (usually a woman) was working. Repeated attempts were made to reach non-participant households, which frequently failed, lending some credence to the idea that time to plant and care for a garden are barriers to participation.

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39households. The Household Food Insecurity Access Scale (HFIAS) and Household Dietary Diversity Survey (HDDS) were used to determine food security status and household dietary diversity, respectively (s ee appendices A and B). Surveys were conducted with the person responsible for f ood preparation in the household. From this group, I conducted semi-structured interviews with 37 households (21 UGP and 16 nonUGP households), to explore issu es related to the experience of food insecurity as well as discuss reasons for participat ion in the garden project. Household Surveys The HFIAS and HDDS have been utilized by numerous agencies in various cultural contexts to obtain information about household food access and the quality of diets consumed by households a nd individuals. The benefits of these two tools are that they are both simple to administer, answer, and analyze; there are a limited number of questions for each, and they can take as litt le as 10 minutes to administer (Coates, Swindale, and Bilinsky 2007). Household Food Insecurity (Access) Survey The HFIAS survey consists of nine qu estions that address domains of food security such as worry or anxiety over f oods, as well as issues with food quality and quantity. The Household Food Insecurity (A ccess) Scale (HFIAS) provides information about whether or not a household has experi enced food insecurity in the previous 30 days. The HFIAS poses questions of increasi ng severity on food security domains, which considers anxiety over food, insufficient di etary quality, and the quantity of food.

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40Households were asked to cons ider if any of the following events had occurred in the 30 days prior to the survey, and then provid e the frequency with which these events occurred. Each of the questions (see Tabl e 3.1) has a potential sc ore of three depending on how often the experience occurs (0 for never to 3 for often). Table 3.1: HFIAS Questions 1. Did you have worry or anxiety th at your household would not have enough food? 2. Were you or any household member not able to eat the kinds of foods you preferred because of a lack of resources? 3. Did you or any household member ha ve to eat a limited variety of foods (less kinds of food on the plat e) due to a lack of resources? 4. Did you or any household member ha ve to eat some foods that you really did not want to eat because of a lack of resources to obtain other types of food? 5. Did you or any household member have to eat a smaller meal than you felt you needed because th ere was not enough food? 6. Did you or any other household me mber have to eat fewer meals in a day? 7. Was there ever no food to eat of any kind in your household? 8. Did you or any household member go to sleep at night hungry? 9. Did you or any household member go a whole day and night without having eaten anything? The Household Food Insecurity Access S cale (HFIAS) has been subjected to a number of validation studies. Knueppel et al. (2009) tested the construct validity, internal consistency and convergent validity of the (HFIAS) in measuring household food

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41insecurity in rural Tanzania and determin ed that instrument showed validity and reliability in measuring household food in security among poor households in rural Tanzania. Maes et al. (2009) tested the content and face valid ity of the HFIAS in Ethiopia based on four criteria established a priori: Cronbach to test internal validity should approach 0.85 and the HFIAS item re sponse curves should be parallel across income strata. In addition, there should be clear dose-response relationships between income strata and level of food insecurity (FI) as well as between the consumption of fruits, vegetables, meat, and dairy and level of FI. Based on these criteria, the authors determined that the HFIAS performed well in Ethiopia, though some potential issues arose such as observer bias and response shif t (Maes et al. 2009). A recent examination of the HFIAS for use as a universally applic able tool for cross-cultural comparative studies has found that only three questions (Q7, Q8, and Q9) are valid for such purposes (Deitchler et al. 2010). Howeve r, it is important to note that the validity of the HFIAS in individual country studies, wh ere it measures food insecurity in particular contexts or settings, was not called into quest ion (Deitchler et al. 2010). Data from the HFIAS can result in a con tinuous score that ranges from zero as the lowest score, indicating the lo west levels of food insecurity (that is, households are more food secure), and 27 as the highest possible score, indicating the highest level of food insecurity (Coates et al. 2007). Using a ma trix provided by Coates and colleagues (2007) data from the HFIAS can also be converted into categorical data depending on answers provided to each of the nine questions. Th e four categories are food secure, mildly food insecure, moderately food insecure, and severely food insecure. For example, any responses other than never to questions 7, 8 and 9 results in a classification of

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42severely food insecure while households ar e categorized as f ood secure if they answer never for all questions except the fi rst one, to which they might answer never or rarely. The HFIAS requires modification to adapt the survey to local contexts, and the adaptation of the survey needs to address more than mere translati on of the instrument from English to Sesotho (for detailed informa tion about this process, see Coates et al. 2007). Five key staff members from the ga rden project organization and a supporting agency participated in the modification of the HFIAS. The process of adapting the instrument included individual interviews with key personnel to determine locally relevant ways to express such concepts as household, preferred foods, lack of resources, limited variety of foods, and foods one does not want to eat. In a setting similar to a focus group, the key personnel were gathered, to discuss these concepts and to come up with examples of each; it was es pecially important to develop a sense of consensus with regard to the concepts and examples from the group of key personnel. While in the field, it is important that should a respondent not understand the way a question is worded, previously agreed upon clarifications could be provided. The survey was then pilot tested in the field (n=10) to verify comprehension of the nine survey questions. Respondents were given the survey, which was followed by a cognitive interview, during which they were asked if any concepts, words or phrases were unclear. Based on feedback from the pilot survey, only minor grammatical adjustments were made and the survey was accepted for use in this study.

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43Household Dietary Diversity Survey The Household Dietary Divers ity Score (HDDS) is a survey tool used to gather data about the frequency of consumption of a specified number of food groups during a specified recall period (for th is study, 24 hours). The HDDS is a rapid, user-friendly and cost-effective tool to assess changes in diet ary diversity over time (Food and Agricultural Organization of the United Nations Nutrition and Consumer Protection Division [FAO NCPD] 2007). However, the household dietary diversity score (HDDS) can also be used as a snapshot of a households ability to access food (FAO NCPD 2007). When carried out this way, the HDDS cannot be used to target individual househol ds; instead, the score must be aggregated to a population (s uch as UGP and non-UGP households) and differences between those two populations can be assessed (FAO NCPD 2007). It is important to note that a low dietary di versity score can suggest micronutrient deficiencies, particul arly when coupled with a consideration of the types of foods consumed. An ideal or target HHDS level is not typically available for adults, though there are standards for children depending on the format of the HDDS used (FAO NCPD 2007). The number of food groups consumed in the previous 24 hours are summed to obtain the household dietary diversity score (HDDS). The use of one 24hour recall period does not provide an i ndication of an individuals habitual diet. However, it provides an assessment of the diet at a populat ion level. The FAO uses a reference period of 24 hours because it is less subject to recall error, less cumbersome for the respondent and also conforms to the recall time period us ed in many other dietar y diversity studies (FAO NCPD 2007: 13).

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44 According to Swindale and Bilinsky (2006), the number of different food groups consumed is calculated to better reflect a qua lity diet, rather than the number of different foods consumed. It is more important to know how many different food groups are consumed, because households may consume seve ral different cereals or several different food groups. Capturing that distinction is crucial, as differences may exist in the diversity of both macroand micronutrients. For the purposes of this survey, and based on recommendations found in Swindale and Bilinsky (2006) as well as from discussions with garden project staff, I decided to collect data on fifteen food groups to help capture th e diversity of foods consumed at the household level. There were several reasons for colle cting data in this way. First, because it was important to gard en project UGP staff to know what varieties of vegetables were being consumed, it was necessary to disaggregate the vegetable group into multiple categories that allowed for a more nuanced picture of vegetable consumption. Therefore, I decided to divide ve getables into 1) yell ow or orange-fleshed vegetables (which could provide some informat ion into potential vitamin A deficiencies); 2) green, leafy vegetables; 3) white, starchy tubers; and 4) other vegetables. In addition, fresh and processed meats were separated, as were other sources of protein like eggs, fish, and even dairy products. Examples of the items within food groups included in this survey are presented in Table 3.2 Respondents were first asked if the prev ious 24 hours represented a typical day of food consumption. If the previous day was not a typical day of consumption (that is, there was a funeral, feast or some other even t that altered their normal diet), no household surveys were conducted. If it was a typical day, respondents were as ked to report if any

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45household member had consumed items in the listed food group, of which examples were provided. Table 3.2: Household Dietary Di versity Score Food Groups Food Groups Examples of food items in group A. Cereals papa (stiff maize meal porridge), motoho (sour sorghum porridge), bread, biscuits, cookies, breakfast cereal, or any other foods made from maize, rice, wheat, or sorghum B. Yellow or orange-fleshed vegetables pumpkin, carrots, squash, or sweet potatoes that are yellow or orange inside C. White, starchy tubers white potatoes, white yams, manioc, cassava or any other foods made from roots or tubers D. Green, leafy vegetables moroho (a particular wild gr een that is cooked, but also any cooked green leafy vegetable), spinach, sepaile (or wild mustard leaves), rape (radish leaves), kale E. Other vegetables onions, toma toes, green beans (not legumes) F. Fruits peaches, apples, oranges G. Fresh meats beef, pork, lamb, goat, chicken or other birds, organ meats H. Processed meats polony (a processed meat product similar to bologna), sausages I. Eggs eggs or items made with eggs J. Fish pilchards, tuna, hake; canned, fresh, frozen J. Pulses/legumes/nuts groundnuts (peanuts), other legumes K. Milk, milk products, cheese milk, feta, yogurt L. Oil/fats, butter oil, fats, butter M. Sugar/honey Sugar/honey N. Other: condiments, coffee, teacondiments, coffee, tea

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46Semi-Structured Interviews The ethnographic component of this study included observation of urban garden program (UGP) demonstrations and nutrition ed ucation activities and 37 semi-structured household interviews. Semi-structured inte rview included household demographics such as sex of the household head, household compos ition, employment status of adults in the household, and experience in agri cultural activities. Semi-s tructured questions guided the interview on such topics as knowledge of and participati on in the UGP, and sought to elicit information related to d ecisions about participating in the UGP. This instrument was semi-structured to allow the study particip ants to discuss topics they felt were most pertinent to their decision to participate or not, while providing data to address the specific questions of th is research study. Qualitative interviews were audio-record ed with permission from the respondent for later translation and tran scription. Interviews we re conducted by the principal investigator and an experienced fieldworker from Lesotho; th e latter was fluent in both the local language (Sesotho) and English. The interviews were transcribed and translated by the fieldworker and principal investigator into English, then reviewed by a second fieldworker also fluent in Sesotho and English, to ve rify the translation.

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47DATA ANALYSIS Survey Data Entry in Excel, PASW/SPSS 18 Results from the household survey, HFIAS and HDDS were entered into SPSS/PASW Statistics 18.0 for sta tistical analysis. The inde pendent variable for this study was participation in the urban garden project, and dependent variables included the continuous food security score from the HFIAS as well as the continuous dietary diversity score from the HDDS. For data that are normally distributed (such as the HFIAS continuous score, and the HDDS), indepe ndent t-tests were used to determine if differences between the means of groups we re significant at the p<0.05 level (Madrigal 1998). To check the validity of these test s and because dietary data are often not normally distributed, non-parametric tests we re performed using the same comparison groups. Semi-Structured Interview Data Entry into MaxQDA 10 The semi-structured interview guide included questions about how households typically obtain food and their experiences w ith vegetable production (either at the time of the study or in the past). In addition, ther e were questions about factors that might be influencing participation, incl uding knowledge and perceptions of the project, as well as respondents experience with food insecurity or low dietary di versity. Participants were asked why they decided to take part in th e garden project; non-participants were first asked what (if anything) they knew of th e project, and later asked reasons for nonparticipation.

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48 Interviews lasted between 20 minutes and one hour and were conducted in Sesotho by a native speaker, who was also fluent in English. Most interviews allowed for the instantaneous translation of interview responses into English so that follow up questions could be asked; however in some cases it was discovered11 that only partial translations were provided during interviews, and there were missed opportunities to follow up on issues. The audio recordings of interviews were simultaneously transcribed and translated by a team of two researchers, one native English sp eaker (Noble) and one native Sesotho speaker also fluent in Englis h. After this transcribed translation was obtained, the same team later translated and transcribed th e interviews again, comparing the two versions and making minor adjustments to transcripts. Once a final English version was agreed upon, the interview texts were entered into MaxQDA 10, qualitative data analysis soft ware that allows te xt to be searched, coded and organized into themes. A grounded th eory method of text analysis allows key domains to be identified; this facilitates a better understand ing of how decisions are made concerning participation in the urban garden project. I coded the data based on themes from the interview guide (such as experi ence with gardening, pe rceptions about the project), but also identified topics that emerged during interviews, such as experiences with HIV. 11 These issues were discovered during transcription an d translation of interviews Fortunately, we were translating and transcribing interviews within two da ys of starting the study, so feedback was quickly provided to my Basotho research assistant and the ability to follow up improved. That being said, as noted in the section on research challenges, there alwa ys seems to be something lost in translation.

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49ETHICAL CONDUCT In accordance with ethical guidelines set by the American Anthropological Association (1998) as well as the federal po licy for the protection of human subjects (DHHS 2005), I endeavored to pr otect the rights and well-being of the participants of this study. This study does not involve vulnerable populations, defined as children, prisoners, pregnant women, or handicappe d or otherwise mentally di sabled persons (DHHS, 2001) though some participants might have found the discussion of food insecurity embarrassing or uncomfortable. With this in mind, I protected the confid entiality of participants in this study by using a numeric code in place of their names in all notes, records, and audio recordings. These items (notes, records, audio record ings) were stored on password-protected computers or in otherwise secured conditions. Because of issues of low literacy levels in the urban areas of Lesotho, as well as to mi nimize the potential for identification, oral informed consent was obtained from each pa rticipant prior to engaging in any data collection. Because none of the notes, survey or interview data could be linked to participants, this study was granted IRB exempt status by the University of South Florida Institutional Review Board on May 27, 2009 (P rotocol 107933). In addition, this study was also subjected to an internal review by the urban garden project organization, which oversaw the ethical conduct of the research. No compensation was offered to study participants. However, it is important to note that no costs were incurred by study participants as a result of thei r involvement in the study.

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50 CHAPTER 4: RESULTS INTRODUCTION While causal relationships cannot be determined in a cross-sectional study such as this one, this study does present useful findi ngs about how households make decisions to participate or not in urban garden progra ms. This information cannot only guide the evaluation of such programs but also inform the design of similar projects. Reasons for engaging in urban garden proj ects are widespread and go well beyond a lack of sufficient quantity or variety of foods, as project particip ants report. As well, some reasons for not participating in such projects are surprisi ngly obviousfor example, many households reported never having heard of the project. However, other barriers exist: for factory workers, having the time to work in a garden is a signi ficant issue. What is clear is that decisions to participate in such projects are complex, and the use of mixed methodologies essential for understanding the process. This chapter presents an analysis of the HFIAS and HDDS survey data, and provides some comparisons based on category of participation (that is, participant or nonparticipant). Differences between maleand female-headed households, as well as factory worker and non-factory worker househ olds are also presented. However, it is important to note that since targeted sa mpling was used these findings cannot be generalized to the population.

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51 Following analysis of these data, themes from the semi-structured interviews are presented. Themes specifically addressed in the semi-structured interview guide, such as experience with gardening, know ledge of and participation in the garden program, are presented. In particular, benefits and costs as reported by respondent s are discussed here. A discussion of the experience of food insecuri ty and low dietary diversity is included, as a means to contextualize decisions about par ticipation. Also, because the instrument was semi-structured to allow the st udy participants to discuss t opics they felt were most pertinent to their decision to participate or not, other themes that participants discussed are also summarized, such as the impact of HIV and funerals. STUDY PARTICIPANT CHARACTERISTICS For this study, sixty-one households were surveyed; 50.8% of whom live in Maputsoe and 49.2% in Maseru. There was a de liberate attempt to ba lance the number of households from both districts as well as ba lance male and female household heads, in order to provide as much information about pos sible factors associated with participation in the urban garden project. Thus, 48% of households were headed by males, and 52% were headed by females. In Maputsoe, 15 of the household surveyed were headed by males and 16 households were headed by females. In Maseru, 14 households were headed by males and 16 households were head ed by females. Household size ranges from 1 to 12 people, with a mean of 4.74 me mbers per household and a median of 5.0. Around half of the households (n=30) had at least one child under 5 years of age; 66% of households had children aged 5 to 18 y ears, 93% of households had an adult aged

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5219 and 49 years, while only 26% of households contained adults over 66. Selected characteristics of the study house holds are presented in Table 4.1. Table 4.1: Selected Characteristic s of Study Households (n=61) Average SD Min Max Household Size (n) 4.7 2.32 1 12 Age of Head of Household 45.7 15.4 19 76 Household Composition Children under 5 years (n) 0.8 0.9 0 3 5 18 years (n) 1.3 1.4 0 5 19-60 years (n) 2.3 1.5 0 8 > 60 years (n) 0.3 0.5 0 2 The distribution of the age of the household head and the composition of their households are presented in Table 4.2. The majority of households were headed by persons between 19 and 49 years (mean 45.7, median 48). These age categories were chosen to maintain consistency with the urban garden project s own baseline reporting of household demographics. There were no households headed by persons less than 19 years of age. It is also important to note that approximately 48% of household heads are married, 34.4% widowed12, 13.1% single, and 4.9% divorced or separated. 12 This category includes widows and widowers. Considering the high prevalence of HIV and low life expectancy in Lesotho, it is not surprising that such a high percentage of households contain members who have lost their spouses.

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53Table 4.2: Age Distribution of Househ old Heads and Household Composition 19-60 yrs 60 yrs + # of Households 49 12 Average household members 7 3.9 Household Composition Children under 5 years (n) 1.2 1 5 18 years (n) 2.5 0.5 19-60 years (n) 3.5 1.3 > 60 years (n) .1 1.2 Approximately half of the respondents had at least one household member who worked in the nearby textil e factories; maleand female-headed households having textile workers are represented relatively equally (that is, 15/29 MHH and 16/32 FHH have household members who work in factories). Of the 61 households surveyed, 39 (62.9%) own their homes, while 22 (37.1%) re nt; this proportion did vary between districts. In Maputsoe, 83.9% own their homes and 16.1% rent. In Maseru, 56.7% of those surveyed owned their homes, while 43.3% rent. Select study characteristics parsed by participation or non-participation are su mmarized in Table 4.3. Although there are differences in household size, home ownershi p, households with textile workers and female-headed households between UGP and non-UGP households, none of these differences were statistically significant (Table 4.3).

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541 Mann-Whitney test Respondents were asked to report the main s ource of cereals and vegetables for their households. The main source of cereals for households was though purchases from the market, though some produced their own a nd one respondent reported being unable to obtain cereals except through the charity of ot hers. The main source of cereal differed slightly by category of participation. As for the main source of vegetables, most of the sample as a whole reported producing their ow n, while roughly a third obtained most of their vegetables from the market. However, these differences varied widely by category Table 4.3: Selected Characteristics of Study Households by Participation All HH (n=61) UGP HH (n=42) Non-UGP HH (n=19) Household Size (average n) 4.7 5.1 3.9 p=.1191 Own home (%) 63% 71.4% 47.4% 2 =3.284 p=.70 Households with factory workers (%)50.8% 54.8% 42.1% 2 =.838 p=.36 Female Head of Household (%) 52.5% 52.4% 52.6% 2 =0.00 p=.99 Main source of cereals own production purchase borrow, barter, exchange for labor, or gift 11% 88% 1% 17% 81% 2% --100% --Main source of vegetables own production purchase 67% 33% 83% 17% 32% 68%

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55of participation; UGP participants were more th an twice as likely to report that their main source of vegetables was from their ow n production when compared to nonUGP participants. SURVEY RESULTS Household Food Insecurity (Access) Survey (HFIAS) As discussed in chapter 3, the Househol d Food Insecurity (Access) Scale (HFIAS) provides information about whether or not a household has experienced food insecurity in the previous 30 days. Using the HFIAS, th e researcher poses questions of increasing severity on food security domains, which considers anxiety over food, as well as insufficient quality and quantity of food. House holds were first asked to consider if any of those events had occurred in the 30 days pr ior to the survey, and then asked to provide the frequency with which thes e events occurred over the sa me period. For the purposes of this study, rarely (code 1) means once or twice; sometimes (code 2) means three to ten times; and often (code 3) means more th an ten times in the 30 day period. Event Occurrence Questions One way to understand the experience of food insecurity of households in this study is to examine the frequency with which households responds affirmatively to the questions of the HFIAS (Table 4.4). A lthough this summary does not consider the severity of problems (that is, if something ha ppens rarely, sometimes, or often), it does

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56provide important information about actions th at households may be taking to cope with food insecurity. The questions are ordered in a way that reflects an increasing severity with regard to the food insecurity experi ence (Coates et al. 2007). Based on the theoretical underpinning s of the tool, we would expect th at the frequency of affirmative responses would decrease; that is, more hous eholds might experience worry (Q1) than have to reduce variety of food (Q3) or eat sma ller meals (Q5). Overall, results from this study follow this expected pattern, with only tw o small increases from Q1 to Q2 and from Q7 to Q8 (both 1.7%). Table 4.4: Affirmative Responses to HFIAS Occurrence Questions Because of a lack of food or resources to obtain food, in the past month: Affirmative responses (% yes) 1. Did you have worry or anxiety that your household would not have enough food? 93.4% 2. Were you or any household member not able to eat the kinds of foods you preferred because of a lack of resources? 95.1% 3. Did you or any household member have to eat a limited variety of foods (less kinds of food on the plate) due to a lack of resources? 91.8% 4. Did you or any household member have to eat some foods that you really did not want to eat because of a lack of resources to obtain other types of food? 90.2% 5. Did you or any household member have to eat a smaller meal than you felt you needed because there was not enough food? 73.8% 6. Did you or any other household member have to eat fewer meals in a day? 68.9% 7. Was there ever no food to eat of any kind in your household? 47.5% 8. Did you or any household member go to sleep at night hungry? 49.2% 9. Did you or any household member go a whole day and night without having eaten anything? 47.5%

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57 It is significant to note that most of the study respondents report not only having worried about having enough food; over 90% if study households also report having adjusted their eating patterns. These house holds respond by not eating foods they would prefer, eating a limited variety of food (that is, a more monot onous diet), or even eating foods they did not want to eat. Alarmingly, almost 50% of households experienced more severe food insecurity events such as havi ng no food of any kind in the house, having household members go to bed hungry, or go an entire day without having eaten. HFIAS as a Continuous Score Data from the HFIAS resulted in cont inuous scores ranging from zero to 2613. The mean of the entire sample was 14.28 with a standard deviation of 6.7; the median was 14.0, and the scores are normally distributed. HFIAS data from this study shows high internal validity, with a Cronbach alpha = 0.926. With regards to another measure of validity, there is an in verse correlation between HFIA S data and household dietary diversity scores (HDDS) (r = -.628, p <0.001). This indicates that as food insecurity increases, dietary diversity is reduced. An examination of household food insecurity access scores (HFIAS) by the dichotomous category of participation (UGP or non-UGP) indicates that UGP households have higher levels of food insecurity than households that do not participate in the urban garden program. The UGP households have a mean HFIAS of 15.48 (median 16; SD=6.68) while the mean HFIAS for non-UGP households was 11.63 (median 12; 13 Recall that zero represents the lowest levels of food insecurity and 27 indicated the highest level of food insecurity (Coates et al. 2007).

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58SD=6.18); this difference is statistically significant ( p=0.04). Textile worker households have a mean HFIAS of 14.48 (median 14.0; SD=6.45) while the mean HFIAS for nontextile worker households was 14.07 (median 12.5; SD 7.1); not only was this difference in means small, it was not statistically significant ( p=0.53). Female-headed households have a mean HFIAS of 15.22 (median 15.5; SD 6.74) while the mean HFIAS for maleheaded households was 13.24 (median 12.0; SD= 6.66); however, this difference was also not statistically significant (p=0.56). HFIAS as a Food Security Category Based on data analysis instructions found in Coates et al. (2007), households were categorized based on each households response to survey questions then grouped for comparison. When grouped into HFIAS f ood security categories (Figure 4.1), households involved in the UGP are more fr equently categorized as severely food insecure (66.67%) than non-UGP households (42.11%), though these differences are not statistically significant ( p=.067). The proportion of respondents that are either food secure or mildly food insecure is low relative to categories of moderately and severely food insecure. Among non-UGP households, re latively equal numbers are moderately and severely food insecure; however, among UG P households, there is considerable bias toward severe food insecurity. This differe nce could suggest that households that are more food insecure are more likely to partic ipate in the garden project; however because the study is cross-sectional, th ere is no way to know the tempor ality of these events. To determine effectiveness of th e urban garden program at re ducing food insecurity, this

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59measure should be assessed longitudinally w ith the participating households, to detect change over time (Coates et al. 2007). Figure 4.1: HFIAS Category by Participation Similarly, when comparing malea nd female-headed households (Figure 4.2), more female-headed households are more categ orized as severely food insecure (68.75% FHH versus 48.28% MHH), though these differe nces are not statis tically significant ( p=.139). Because the study did not use ra ndom sampling, it would be difficult to assume these differences characterize the population. However, these differences between groups could affect reasons for participation, so they deserve cautious consideration. A comparison of households by engagement in factory work (Figure 4.3) demonstrated that factory households are more frequently categorized as severely food insecure (63.33%) than non-factory househol ds (54.84%); though these differences were also not statistically significant (p=.533). 2.38% 10.53% 2.38% 0.00% 28.57% 47.37% 66.67% 42.11%UGP HouseholdsNon UGP Households Food Secure Mildly Food Insecure Moderately food insecure Severely food insecure

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60 3.33% 6.45% 3.33% 0.00% 30.00% 38.71% 63.33% 54.84%Factory Worker HH NonFactory Worker HH Food Secure Mildly Food Insecure Moderately food insecure Severely food insecure Figure 4.2: HFIAS Category by Sex of Household Head Figure 4.3: HFIAS Category by Factory Work 3.45% 6.25%3.45% 0.00% 44.83% 25.00% 48.28% 68.75% Male Headed HouseholdsFemale Headed Households Food secure Mildly food insecure Moderately food insecure Severely food insecure

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61Household Dietary Diversity Survey (HDDS) The number of food groups consumed in the previous 24 hours were summed to obtain the household dietary di versity score (HDDS). As previously noted, whether or not the previous 24 hours represented a typica l days consumption was determined prior to the delivery of the survey. The 15 dichotomous items (that is, consumed or not) yielded a continuous variable that ranged from 0 to 14, w ith higher scores indicating levels of increasing dietary di versity. The mean household di etary diversity score of the entire sample (n=61) was 6.65 food groups (m edian=7.0; SD=2.56). The most frequently consumed foods were grains, such as mai ze meal, sorghum, or bread made from wheat flour or a combination of wheat flour and ma ize meal (100% of the sample). The second most frequently consumed group of foods was oils, which were typically used in small amounts to prepare maize meal and leafy green s. Roughly three-quar ters of households reported consuming green leafy vegetables, s ugar (mainly for use in tea or coffee), and coffee or tea (from the misce llaneous/other category). Le ss than half of households consumed fruits such as oranges, which were in season and imported from South Africa. The percentage of households that consumed each food group in the previous 24 hours is shown in Figure 4.4.

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62Figure 4.4: Percentage of All Households Consuming HDDS Food Groups (n=61) The number of food groups consumed by all households is presented in Figure 4.5. Although these numbers may seem high, it is important to note that the number of food groups translated into approximately 70% of households consuming a grain (typically maize), oil, green leafy vegetables, along with sugar in coffee or tea. Only 47% of households were able to add a fruit to their daily intake, a nd 41% were able to add a yellow or orange-fleshed vegetable such as pumpkin or butternut squash. 100.0% 86.9% 75.4% 75.4% 73.8% 47.5% 41.0% 34.4% 24.6% 23.0% 23.0% 23.0% 14.8% 14.8% 8.2% Grains Oils, fats, and butter Dark green leafy vegetables Sugar, Soft Drinks, Candies Misc: Coffee, Tea, Condiments Fruits Orange-fleshed vegetables Other vegetables Beans, peas, lentils Starchy tubers Milk, yogurt, cheese Fresh meat Processed meat Eggs Fish, fresh or canned Grains Oils, fats, and butter Dk Green LeafyVegetables Sugar, Soft Drinks, CandiesMisc: Coffee, Tea, CondimentsFruitsOrange vegetable

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63 Figure 4.5: Food Groups Consumed by All Households (n=61) UGP households have lower dietary diversity than non-UGP households do. Households that participated in the UGP had a mean HDDS of 6.19 food groups (median 8.0, SD=2.75), while non-UGP households averaged 7.68 food groups (median= 6.0, SD=2.36); further, this difference is statistically significant ( p =.034)14. To confirm this finding, I also analyzed the data using a Krus kal-Wallis test for ranked data. This test confirmed that UGP households (mean rank 27. 82) have lower dietary diversity than nonUGP households do (mean rank 38.03); this di fference is statistically significant ( 2 =4.396; p=.036). In Figure 4.6, the food group consumpti on is compared by participation or nonparticipation in the UGP. UGP households were less like to consume almost all food groups except orange-fleshed vegetables, pulses, and eggs. When examining this information, it is important to note several thi ngs. Because this study is cross-sectional, 14 Based on the Shapiro-Wilk test for normality, the HDDS is normally distributed; an independent t-test was used to compare participants and non-participants. 0 2 4 6 8 10 12 2345678910121314Number of householdsNumber of Food Groups Consumed

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64this finding cannot be offered as support for or evidence against the effectiveness of the urban garden program. Though no data were co llected on length of time in the program, garden demonstrations were begun roughly si x weeks before the study began; in many cases, gardens were not planted immediately after demonstrati ons. Thus, it is likely that this research occurred too early in the projec t to determine its effectiveness for increasing dietary diversity; therefore, this is not one of the goals of this study. The difference in means of household di etary diversity score (HDDS) by the sex of the head of household was also exam ined. The mean HDDS of male-headed households was 7.1 food groups (median=7.0 ; SD=2.74), while the mean of femaleheaded households was 6.25 food groups (median=6.0; SD=2.36). Female-headed households had lower dietary diversity (m ean rank 28.14) than male-headed households did (mean rank 34.16), though these differences were not statistically significant ( p=0.1815). The number of food groups consumed by sex of the household head is summarized in Figure 4.7. Finally, HDDS by engagement in factory work was also examined. The mean HDDS of factory households was 6.48 food groups (media n=7.0; SD=2.51), while the mean of non-factory -headed households was 6.8 food groups (median=6.5; SD=2.60), though this difference was not statistically significant ( p =.60). Factory households had higher dietary diversity (mean rank 31.57) than non-factory households did (mean rank 30.45); these differences were small, and not statistically significant ( p=0.80516). 15 Kruskal-Wallis test for ranked data 16 Kruskal-Wallis test for ranked data

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65Figure 4.6: Consumption of Food Group by Participation in the Garden Project 16.70% 2.40% 26.20% 21.40% 14.30% 33.30% 16.70% 42.90% 11.90% 38.10% 71.40% 71.40% 71.40% 81% 100% 10.50% 21.10% 15.80% 31.60% 15.80% 36.80% 36.80% 36.80% 47.40% 68.40% 84.20% 84.20% 78.90% 100% 100%Eggs Fish Pulses/legumes/nuts White, starchy tubers Processed meats Other vegetables Fresh meats Yellow/orange fleshed vegetables Milk, milk products Fruits Sugar, soda, candy Green, leafy vegetables Other: condiments, coffee, tea Oil/fats, butter Grains Non UGP Households (N=19)UGP Households (N=42)

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66Figure 4.7: Consumption of Food Group by Sex of Household Head 10.34% 13.79% 31.03% 27.59% 20.69% 31.03% 10.34% 48.28% 34.48% 51.72% 86.21% 75.86% 86.21% 82.76% 100.00% 18.75% 3.13% 18.75% 18.75% 9.38% 37.50% 34.38% 34.38% 12.50% 43.75% 65.63% 75.00% 62.50% 90.63% 100.00%Eggs Fish Pulses/legumes/nuts White, starchy tubers Processed meats Other vegetables Fresh meats Yellow/orange fleshed vegetables Milk, milk products Fruits Sugar, soda, candy Green, leafy vegetables Other: condiments, coffee, tea Oil/fats, butter Grains Female Headed HH Male Headed HH (N=32) (N=29)

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67Figure 4.8: Consumption of Food Group by Factory Work 13.3% 10.0% 26.7% 26.7% 20.0% 33.3% 30.0% 53.3% 20.0% 40.0% 76.7% 80.0% 73.3% 80.0% 100.0% 9.7% 3.2% 22.6% 19.4% 19.4% 35.5% 25.8% 41.9% 16.1% 41.9% 71.0% 77.4% 71.0% 93.5% 100.0%Eggs Fish Pulses, legumes, nuts White starchy tubers Processed meat Other vegetables Fresh meats Yellow or Orange fleshed vegetables Milk, Milk products Fruits Sugar, soda, candy Green leafy vegetables Other: condiments, coffee, tea Oil, fat, butter Grains Factory HH (N=31) Non factory HH (N=30)

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68SEMI-STRUCTURED INTERVIEW RESULTS In addition to asking participants to disc uss their experiences with food insecurity and low-dietary diversity, they were asked about their decision-mak ing processes related to participation in the urban garden pr oject. These intervie ws provided unique information not assessed in the surveys, a nd allowed for the validation and triangulation of information from surveys. The semi-str uctured interview format allowed respondents to identify reasons for enga gement with the project. How Households Obtain Food Interestingly, when asked about how they obtain foods consumed at home, all of the non-UGP households reported purchasing most if not all of their food from markets. In contrast, almost all UGP households indicat ed that they not only grew vegetables, but also maize or sorghum if they were able to access seeds and other required inputs such as fertilizers and pesticides. One pattern of purchase that emerged during interviews was end-of-the-month bulk purchasin g; households that received wages are paid one time monthly, near the last day of the month. On those weekends, shopping markets are filled with people making purchases that they hope w ill last the month. Staples such as maize meal and oil can be purchased in bulk more cheaply than buying smaller amounts throughout the month. Several respondents indi cated that the middle of the month could be a difficult time, as the variety of food begins to decline. When asked about the experience of food insecurity, one woman reported that:

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69It is something that we are also facing [food insecurity] because the problem is that in order for us to ea t, we have to go to the market to buy food. So you will find that we will not be able to buy a variety of food and you will find that we will be eating th e same kinds of food all of time, especially in the middle of the month. That is when we are suffering a lot. We are only able to change the foods when it is the month end [pay day] because that is when we have money as my husband is getting paid at the month end, and so then we are able to buy a variety of food. Non-UGP Participant, 28year old female, Maseru This quote illustrates a situ ation that many respondents identified. Every month households experience both shortage and va riety in available foods, depending on the proximity of the pay cycle. Often, just befo re the end of the month, households reported that if they were able to purchase enough in bulk, they would have just enough maize meal and oil to make it to the end of th e month. By month-end, variety suffers but households that can afford to purchase in bul k can still eat at least maize meal and oil every day. Experience with Vegetable Production Seventy-eight percent of all respondent s reported having grown vegetables or cereals at some time in the past, and 70 percent of all respond ents reported being currently engaged in food pr oduction. Of non-UGP households, more than half (56%) indicated that they had experience growing food in the past; in contrast, almost all UGP households (95%) had grown food in the past. This difference is interesting because familiarity with agricultural practices may be one factor influencing household participation in the garden project. Anothe r point that came up during interviews was that several households (21%) indicated that th ey used to grow grains such as maize or

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70sorghum, but that issues such as a lack of acce ss to fertilizers, pesticides, or even animal labor to till fields were barri ers to continuing production. Food Insecurity: Perceived Susceptibility and Severity As discussed in chapter 2, this study draw s on levels of public health theory to explore factors associated with participation in an urban garden project. The Health Belief Model (HBM) states that participati on might be influenced by four domains of belief) perceived susceptibility to a problem; 2) perceived severity of the problem, 3) perceived benefits of particip ation and 4) perceived costs of participation. The Health Belief Model also considers cues to action as motivation to engage in health-related activities; thus, having k nowledge of the project, as well as recognizing ones susceptibility to food insecurity can be considered cues to action (Pierce and Nalle 2002). Among non-UGP households, 81% reported having experience with food insecurity, which they characterizes as in cluding worry or anxi ety about having enough food, eating the same foods all the time, or running out of food. Similarly, 71% of participants in the UGP also reported experience with food insecurity. These percentages are actually the opposite of HFIAS results, wh ich showed that UGP households were less food secure. However, one possible reason for this discrepancy is that no time frame is specified for the interview. Households could speak to their experience with food insecurity at any point in time. When asked to elaborate about their e xperiences, interviewees frequently framed their answers in the form of responses or coping strategies for dealing with food insecurity. Providing enough for children was an important theme mentioned in many of

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71the household interviews. Women often expre ssed distress that they could not provide adequate quantity or variety of foods fo r their children. A common method of coping was for adults to change thei r patterns of consumption: sometimes we have to sacrifice by eating very small [amount of] food for the sake of letting the children have enough to eat. Non-UGP Household, 34-year old female, Maseru As this woman indicated, she and sister with whom she shares a small flat will at times have to reduce the amount of food they consum e so that the children can have enough to eat. This coping response tends to buffer child ren from the effects of insufficient access to food. However, some women must take a dditional steps to protec t their children from hunger: It is something that is so painful but half a bread is better than no bread. It is better to have something than to be without anything. Sometimes I sacrifice for the sake of children in the sense that I will not eat so the children can have something to eat. Non-UGP Household, 24-year old female, Maseru What is interesting about this womans quote is that while she says that having a small amount of food is better than having no food at all, she indicates th at she chooses not to eat so that her children will be able to do so. Thus, it seems that the food security situation in this household has worsened to th e point that this woma n is not just reducing her intake; she is skipping meals al together to buffer her children.

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72Having enough was not the only theme to emer ge from these discussions; respondents also discussed the impact of monotonous diets. Among non-UGP households, 94% reported that low variet y and/or low quantities of food were significan t issues that affect the physical and mental health of adults a nd children in their co mmunities. Eighty-one percent of UGP households reported the same issues. While household dietary diversity survey data can be informative, open-ende d interviews provide additional information such as the impact of low dietary diversit y on peoples perceptions about eating. For example, these respondents discussed the expe rience of eating the same foods every day, for days at a time: Yes I am living that kind of life [eating the same foods every day] because it is not easy for me to change the foo d. I eat the same food so frequently, such that it becomes horrible, in th e sense that I am now eating only for the sake of eating because I do not like this food anymore. -UGP Participant, 62-year old female, Maputsoe When we consider the emotional and psychol ogical distress caused by such situations, it is clear that monotonous diet s have greater implications than simply a loss of micronutrients. In another striking example of the impact of little dietary variety, another woman reported that: Eating the same foods all the time is not something that feels good because to eat something even though you feel like you dont like it anymore is something that is terrible. For example, eating papa and cabbage all the time is so terrible. That is why sometimes when I think of eating papa and moroho, instead I decide to go to bed without having

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73eaten just to avoid it, rather than to eat that again because I know I will see it again in the morning UGP Household, 37-year old female, Maputsoe In a food insecure environment, one charac terized by low access to sufficient quantity and variety of foods, what level of distress might cause people to skip meals voluntarily? Faced with the prospect of consuming the same two or three foods on a daily basis, this woman chose to go to bed without eating just to avoid such monotony. However, adults are not the only ones affected by this issue. One woman discussed the impact of a lowvariety diet on her children, i ndicating her distress that they seemed to have become inured to their situation. For the fact that there is nowhere that I can obtain money to buy a variety of food, we are bound to eat the same f ood all the time. And what I do not like is that my children seemed to have accepted that situation, they are no longer complaining. UGP household, 49-year old female, Maseru From these quotes, it is clear that progr ams hoping to address food insecurity and low dietary diversity should c onsider more than physiological implications of such situations, such as hunger or wasting; they should also ma de attempts to understand the lived experiences of people experiencing these issues.

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74Perceived Benefits of Participating in Garden Project The benefit that I could see was that I would be able to have my own vegetables and I would not have to go the market to buy them. And if I produce well, I will end up selling some and so I will be able to respond to some of the other needs inside the house. UGP participant, 46-year old female, Maseru Another domain of the Health Belief Model is the consideration of perceived benefits when making decisions about health-r elated behaviors. For this study, UGP and non-UGP households were asked to identity benef its of the urban garden project, with the expectation that UGP households would be able to list more benefits than barriers to participation. In turn, non-UGP households might list more barriers than benefits, or might be unaware of project benefits. This information provided a ri ch understanding of what respondents consider b enefits of the project. While some reasons might be expected such as free seedsthere was a wi de range of benefits reported including no costs to construct gardens, no difficulties ob taining materials, and not having to purchase pest control chemicals. One benefit identifi ed by participants was the realization that vegetables could be grown year-round: Summer always seems to be a very good tim e to grow the vegetables, even though I am now realizing that wint er is also a good time. This is my first time to produce the vegetables that I am growi ng now from UGP, in the way that UGP teaches us. UGP household, 41-year old male, Maseru

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75 Among non-participants, 88% reported that based on information they had about the project, participation could benefit their households due to di rect production of vegetables as well as the potential for in crease in cash through the sale of surplus vegetables. Among participants, about 90% repo rted that they were already experiencing benefits, such as harvesting and consumi ng early greens from their gardens. The remaining 10% of participants indicated that while they were not currently eating or selling from their gardens, they believed they would be soon. Benefits reported by respondents are summarized in Table 4.5. Table 4.5: Benefits of Participation in Garden Project (n=37) Benefit Respondents % (n) No costs to construct gardens 49% (18) Making your own production 38% (14) No difficulties in obtaining materials 35% (13) Being able to eat/consum e your produce 35% (13) Knowledge (garden, pest control techniques) 19% (7) Being able to sell surplus 19% (7) Teaching others or being taught 19% (7) Realized crops could be grown in winter 16% (6) Save money 14% (5) Help others 14% (5) Increase vegetable variety 5% (2) Already sold from gardens 5% (2) Free seeds 5% (2) Small size of garden is manageable 3% (1) Not buying pest control chemicals 3% (1) Healthy life, healthy diet 3% (1)

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76 While tangible benefits were important to responde nts, some benefits they mentioned included the ability to help others with vegetables from their gardens and being able to teach others. These factors dem onstrate that social benefits that could be gained from such projects. Similarly, ma ny participants reporte d helping each other construct gardens or compost heaps, as well as engaging with neighbor s in ways they had not previously done. Also considering social benefits, one theme that emerged from a group of women at a garden demonstration was the issue of hope. One woman had this to say about the impact of the project on their mindset: So, it has been encouraging to see this pr oject here because it is like the people here have been abandoned and neglected by everybody who has been in power. And again, when the first time [UGP] arrived here, it was like a dream. And now we are so happy that it has changed our mi ndset. We were not happy at first to see that we were not receivi ng food aid, as we all know t hat we need such things. Instead you gave us seeds. Our minds ha ve changed in that we see now we have the power within our hands to change th e way we are living. And also, with [UGP], at least we have something be tter to talk about. So that is great. UGP Household, 50-year old female, Maseru Perceived Costs of Partic ipating in Garden Project As with perceived benefits of participation in the proj ect, the potential costs or barriers to participation in the project were explored. Domains included time, materials required, costs associated with project, and av ailability of land. In addition, respondents were asked about issues that co uld interfere with pa rticipation. As expected, few barriers to participation were identified by UGP households. Eighteen out of 21 households

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77participating in the urban garden program repor ted that there was little to no cost in terms of time, land, or monetary expenditures for materials. The remaining two UGPhouseholds17 reported having had to pay for manure. When asked if there were other possible barriers to participation in the project, UGP and non-UGP households reported that some costs might include giving up yard space for a garden, or shifting childcare responsibilities to tend the garden. Among pa rticipants, 81% reporte d little to no costs (time, land, or monetary expenditures), with the remaining 19% re porting the need to acquire tools (mainly through borrowing) a nd the need to spe nd weekend time tending the garden. Reported costs or barriers to participation are shown in Table 4.6. Table 4.6: Costs or Barriers to Participation in the Ga rden Project (n=37) Costs or Barriers Respondents % (n) Not having much land to plant 22% (8) Difficulty obtaining manure, water, grasses or aloe; stones 16% (6) Work looks demanding 11% (4) Cattle, rats eat gardens 8% (3) Water is far away 8% (3) Cost of/need to pay for manure 5% (2) Too ill (self or family member) 5% (2) Funerals 5% (2) Frost 3% (1) Landlords negative reaction to use of space 3% (1) 17 Inadvertently, one household was not asked this question.

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78Material requirements Most UGP households reported that ther e was little to no cost to them to participate in the garden proj ect. Seeds and a small tool were provided at no charge, and ideally the gardens could be constructed us ing easily obtained items such as manure, stones dried grasses, bones and metal cans. However, a small number of UGP households (2 of 21) reported that they ha d to pay for the manure for their gardens, something most respondents indicated that they typically received free. This is interesting in light of an experience I had at one of the garden demonstrations. While watching a workshop on building a trench garden, I noticed a man with a very large hat who paced at the back of the crowd, speaki ng loudly to other men when most of the crowd was silent and still. I asked one of the demonstrators translating the proceedings for me to tell me about his very loud c onversation, as he seemed to be making announcements of some sort. She relayed that he was telling the men at the back of the group that if this organization was going to tell people to put two or three wheelbarrows of manure into their trench gardens, he surely was not going to give it away free anymore. Thus, it seems that a potential unint ended consequence of the garden project is thatby creating demand for a product that is usually freepa rticipants and nonparticipants alike could now incur a cost fo r fertilizing their gardens with manure. Time Requirements When study participants were asked about th e sorts of things th at might interfere with their ability to participate in the urba n garden project, the answers tended to differ

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79by category of participation. Those already in the urban ga rden project discussed that though there is a large investment of time (typically three hours) to construct their gardens, tending them took minutes a day for watering and perhaps as much as 30 minutes on the weekend for weeding and other maintenance. Participants believed that time should not really be a factor, even for factory workers, because so little time was required daily. However, non-participants were somewhat sp lit. About half believed that if given seeds and instructions on the construction of gardens, they could easily fit these activities into their days off. These respondents i ndicated that the benefits of the garden outweighed the requirement of additional work on the weekends. The remaining half of non-participants, however, cited work or other time constrai nts as a barrier to joining the project. These respondents talked about spending the morning of their days off at the factory, hoping to be hired for overtime work, th en walking home for hours so that they do not have to spend money on public transp ortation. On these days, one respondent spoke of returning home tired, dirty, and hungry: she said that this was worse because I had no pay. In some cases, respondents indicated that because they spent their weekdays at work, many household activities had to be done on weekends, leaving little time for other pursuits. Perceptions of the Urban Garden Project According to the Theory of Planned Beha vior (TPB) Model, ones attitude toward participating in a garden intervention, thei r perception of how others will view their actions and their perceived ability to control their actions can influence their intention to

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80act. Do target households see participation as positive, negative, or even a neutral act? Study participants were asked if they had s poken to any friends, family or community members about participation in this project. If they had spoken with others about the project, they were asked to share what th ey could about the perceptions of others regarding their part icipation or the project itself. On one hand, non-UGP households did not typically respond to this question, other than to indicate that th ey could not speculate about what others would think if they joined the project. On the other hand, 94% of UGP households di d discuss the project with other people and more than half of participants reported having taught friends, family or neighbors the garden ing techniques they had learne d. In addition, 87% of UGP participants reported a positive response from others to the project, with many people indicating a desire to join. It is important to note that ther e were some negative responses to the project; about 12% of participants reported that neighbo rs thought the project seemed very time consuming and might requir e significant labor. Unfortunately, due to the lack of responses from non-UGP households it was impossible to assess the utility of this model in understanding study findings. Participation The framework for this study involves the use of public health and anthropological theory to unders tand reasons for participating or not in an urban garden project. While such theoretical frameworks are useful, it was also important to ask study respondents directly about reasons fo r participation in the project.

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81Reasons Households Did Participate Twenty-one UGP households were asked to discuss their reasons for deciding to participate in the project. Their responses are presented in Figure 4.7. It is apparent that the motivations for participation included more than the recognition of vulnerability to or experience with food insecurity. While motivati ons included the desire to increase access to resources (such as seeds or their own vege table production); they also included a desire to increase knowledge, and to teach and help others. In one case, a respondent reported participation in the project simply to s upport development projects in her village. Reasons Households Did Not Participate Similarly, non-participants were asked to discuss the reasons that they chose not to participate in the urban garden project. A summary of responses are presented in Figure 4.8. While the phrasing of this quest ion assumed that a conscious decision was made to not participate, respondents were quick to point out that they had either not heard of the project, heard about it t oo late (i.e., after a demonstrat ion had been held), or were unable to attend due to work, disability, or absence from village. Further, two respondents believed they were ineligible, due to having a tap in their yard or because they rented their flat.

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82Figure 4.9: Reasons for Participation in Garden Project Free Seeds 24% (6) To make own production 24% (6) Knowledge, to learn new techniques 16% (4) To produce a variety of vegetables 8% (2) To teach, help others 8% (2) Drought protection 4% (1) Technical assistance 4% (1) To save money 4% (1) Small size of gardens 4% (1) To back development projects in village 4% (1)(n=21*) *Totals dont add to 21 as respondents could provide multiplereasons for participating

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83Figure 4.10: Reasons for Non-Participation in Garden Project Emergent Interview Themes Beyond discussions of food insecurity, m onotonous diets, and excited discussions about lush green leafy vegetables and inch-hi gh carrot tops sprouting in neat rows in the middle of winter, respondents ta lked about other issues important in their lives. Some women talked in passing about being ab andoned by their husbands; others discussed losing their jobs, bragged about their children, or spoke about the struggle to send their children to school. However, two related themes were especially prominent when interviews drifted off the topic of urban gardens: HIV/ AIDS and funerals. Had not heard of project 58% (11) Heard of project after distribution 16% (3) Believed ineligible due to tap in yard 6% (1) Believed ineligible as renters 5% (1) Could not attend (out of village) 5% (1) Could not attend (disabled) 5% (1) Could not attend (work) 5% (1)(n=16*) *Totals dont add to 16 as respondents could provide multiplereasons for not participating

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84HIV/AIDS As previously discussed, the synergis tic relationship between malnutrition and infectious disease can adversely affect on nut ritional status (Scrimshaw and SanGiovanni 1997). Infectious disease, such as HIV, impairs the health status of individuals, weakening bodies and decreasi ng the ability to work and provide food for themselves or their families (Gillespie and Kadiyala 2005). Micronutrient deficiencies (either preor post-HIV infection) have been shown to be important factors in the transmission and progression of HIV (Friis 2002). HIV-infected individuals have higher nut ritional requirements than normal, with protein increasing by up to 50 percent, and ca loric needs rising up to 15 percent (Haddad and Gillespie 2001). Micronutrients such as vitamin A play significant roles in delaying the onset of active AIDS disease as well as delaying morbidity (Haddad and Gillespie 2001). Moreover, HIV-positive individuals with ad equate diets are better able to resist opportunistic infections (ACC/SCN 1998). Haddad and Gill espie also note that individuals with good nutritional, particularly micronutrient, status might have a reduced chance of infection with the HIV virus; thus, proper nutrition can be viewed as a preventative measure (Hadda d and Gillespie 2001). Although this project did not addres s HIV specifically, several respondents revealed their status and discussed how thei r experiences with food insecurity and low dietary diversity influenced their health. Several households reporte d that clinic visits yielded advice to consume a minimum of three types of vegetables in a day (to increase likelihood of consuming a variety of micronutri ents) but provided no way to ensure this could happen. Many households could barely a fford the minimum staple diet of maize

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85meal and greens cooked in oil, and some hous eholds only ate maize meal with sugar or bread with tea. Although not specifically measured, it is clear that such a monotonous diet does not contribute adequate micronutri ent to support immune function, and may not even be meeting protein and caloric needs for people with HIV. This situation, in conjunction with the receipt of antiretroviral therapy, result ed in one woman calling her treatment for HIV a parasite that consumed everything she put in to her mouth, leaving nothing for her. It is not a good thing to have the sa me food all the time, every day. And that is also not healthy because I am not the way I look now, I was not as thin as I look now but because I take the ARVs without having eaten anything that makes my body more weaker every day because sometimes it happens that I eat only once a day yet having to take the ARVs three times a day. It is almost as if there is some sort of parasite or a living thing that is in my body that is taking everything t hat I put into it. I cannot give this drug what it needs and I am getting thi nner with each day. This is my everyday life and it does not change UGP Household, 52-year old woman, Maputsoe In this case, the respondent reported that prior to registering with the UGP; she had strongly considered leaving treatment. She and another woman with HIV saw the gardens as a source of hope because through th e variety of vegetables they could grow, they might be able to heed their doctors ad vice and begin to feel better. Another UGP participant who was HIV+ (57-year-old fema le, Maseru) remarked that she planned to

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86teach all of the people she knew with HIV/AIDS how to garden, and that program should be discussed at the clinic where she received monthly check-ups. Funerals as Coping Strategy In HIV/AIDS literature, funerals tend to be discussed as a shock to the household (see for example Gillespi e and Kadiyala 2005; Freire 2003 ; and Desmond et al. 2000). Household resources need to be expe nded in order to conduc t the services for a family member, and household assets may have been reduced during a long illness to pay for care. Funerals, however, are also demonstrations of comm unity support (Baylies 2002) that frequently include religious services and funeral feasts. Considering the high prevalence of HIV in Lesotho (24%; higher in urban areas) and th e frequent occurrence of funerals (at the organiza tion that carried out the urba n garden program in Lesotho, staff are said to attend funerals nearly every weekend), the complex role these events play in peoples lives must be considered. In addition to the coping strategies al ready mentioned (such as eating less or skipping meals), it was also revealed that so me respondents thought of funerals as their only chance to eat different foods, or the type of foods they would like to eat. They saw funerals as an opportunity to consume foods not normally available to them because they did not have the resources. However, funerals were also seen as a barrier to working in the garden as there is a taboo against touching soil when there is a f uneral in the village or in your own family. The dilemma that funerals present is apparent. For the community member, funerals provide imme diate access to a variety of food, while gardens will take about a month to produce edib le greens, longer for other vegetables.

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87For the researcher or development agency, not considering the impact of funerals is problematic. On one hand, dietary diversity was assessed using a recall of the previous days consumption (if it was a t ypical day) but if people attend funerals to gain access to a greater variety of food, not obtaining inform ation about their intake on these days can skew consumption data. On the other hand, if people wish to c onstruct homegardens, either they must hope there is no funeral or violate taboos to work soil. It is important to note that this issue wa s not examined systematically here, and so it cannot be assumed that house holds explicitly consider f unerals as a means of coping with food insecurity or not. In fact, I am not sure how feasible it would be to research this area; it would seem that the stigma alone for admitting such strategizing might inhibit honest reporting of these activities. It is an important consideration not only for the urban garden project in Lesotho, but also for a ny development project carried out in such contexts. Recruiting Community Members Issues related to recruitment were also prevalent during interviews with participants and non-participants. Consider that from the pr oject organizations point of view, garden demonstrations are carried ou t in communities usually on the chiefs land, and all members of that community are invited to attend. Both proj ect participants and non-participants can come to these gatherings, where methods of garden and compost pit construction, pest management, or basic marketing skills are taught18. How are these demonstrations advertised? How do community members find out about these 18 Though only registered participan ts receive seeds and a small tool.

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88workshops? While conducting in itial surveys in the villages it seemed apparent that there were inconsistencies in the way the UGP was advertised. Households that were literally right next door to the chiefs compound indicated that they were not aware of the project, while households on the far edges of some villages had several attendees. Though no systematic measure of distance from the demonstration site was taken, of the 11 people who reported never having heard of the project, more than half (6) lived within eyesight of the chiefs compound. A number of possible reasons could account for this. I was told that chiefs could disseminate inform ation as they pleased; some put a flyer on the door of their office, some sent runners through the village, wh ile others relied on word of mouth. People not visiting the chief might not see the flyer, and households with working adult could potentially miss a runner coming to their home if they are at work. In a related issue, there seemed to be a dichotomy between those who are community members and those who are not, an d it is not clear where this delineation originates. As an example of this, I would like to sh are the following conversation between myself (and my research assistant who translated the conversation) (CN/MS) and a 21-year old female in a non-UGP household in Maseru (R): CN/MS: So you said that you are not a pa rticipant in the garden project. Can you tell me why you decided not to participate in this project? R: I dont really know a nything about the project. MS: Did you hear about the pitso (gathering) at the chiefs place, where they distributed seeds and such?

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89R: I did hear about the pitso but I didnt know what kinds of people were being called to the chiefs place and so I did not know who was supposed to go. CN/MS: I am not sure I understand R: Yes, see as a renter, I didnt feel like the call for the pitso was for me. Pitsos are typically for people of the community. CN/MS: Are renters not pa rt of the community? R: No, they are not typically seen in this way. In fact if there is a pitso it is typically for the chiefs people CN/MS: Chiefs people? I am sorryI dont understand R: His people. People who own pr operty in these areas. As such, pitsos are not typically rele vant for renters. MS: Maam, these demonstrations are for all people in this area, even renters R: I didnt realize I was eligible. I would participate now if I could. Here we can see the importance of understanding how community is defined, particularly if our framework for recruitmen t relies on one definition of community (that is, anyone living in a certain geographic area) and those distributing or receiving information are using another definition of community. Summary of Results The Health Belief Model seems to fit well with study findings. Households in the garden program reported a number of benefits while at the sa me time identifying little to

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90no costs or barriers associated with particip ation. Non-UGP househol ds tended to report that they were unaware of th e project as a whole. When told about the project, however, several indicated a willingness to participate and identified the value of producing their own food. Both UGP and non-UGP households perceive a susceptibility to food insecurity as well as recognition of varying levels of severity to the problem. However, a lack of awareness about the pr ogram would seem to be a ba rrier in itself. If households do not know there is a program available to address food insecurity, they cannot make a decision to participate or not in such a program. As disc ussed, the Theory of Planned Behavior was not applied to the results, as non-UGP households could not speculate about the perceptions of others. Though overwhelmingly non-participants reported having no knowledge of the project, it cannot simply be assumed that not engaging in a project is solely due to awareness; it is certainly more nuanced th an that, as evidenced by the dilemma that funerals present. While UGP households had higher levels of food insecurity and lower dietary diversity than non-UGP households did, unfortunately it cannot be assumed that the right target groups are self-selecting to join the project, nor can we assume this means the project is not working. Need does not nece ssarily translate into participation, because peoples reasons for engaging in garden projects are varied and complex, and not limited to assumed domains in theoretical models. Further, it is interesting to note that both participants and non-participan ts recognize the bene fits of engaging in the urban garden project, and that the ove rall perception of the pr oject is positive.

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91 CHAPTER 5: DISCUSSION AND RECOMMENDATIONS DISCUSSION OF RESULTS Most Significant Barrier is Awareness In terms of the Health Belief Model, most participant and non-participant households recognize their susceptibility to and the severity of food insecurity, thus, it cannot be said that there is not awarene ss of this problem in the community. The perceived benefits of the UGP are also fa irly well recognized among participants and nonparticipants, though cl early participants draw from experience while nonparticipants draw from comm unity perceptions or the description of the program by the researchers. In terms of the perceived co sts of participation, ma ny non-participants do not have adequate project knowledge to an swer this question; though for those who responded, half believed there would be little cost to participate. Of respondents who have experience building and maintaining gardens, a large majority report little to no cost for participation. All of this suggests that if community members are not participating in the UGP, there may be barriers at othe r levels of influence (such as the household or community levels) that impinge on their ability to act. However, lack of knowledge about the project on the part of non-participants suggests that respondents are not making conscious

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92decisions not to participate; instead, one major barri er appears to be awareness of the project. Respondents were first asked if they had any knowledge of the UGP, then probed to describe what they knew about this pr oject. If respondents did not recognize the project, a short description of the project wa s given to aid recall. Considering general discussion in interviews, as well as responses to the direct question of why households chose to participate or not, it was apparent that those interviewe d did not participate because of a lack of awareness of, or misinf ormation about, the project. One example of this includes the idea that households with a water tap in their front yards were not eligible for the project. Another misconcep tion was that renters were not eligible to participate in the urban garden project. One household reported having heard about the project but believed that only la ndowners were eligible to part icipate. In a related area, another household did not attend demonstratio ns because they thought the project was only for the chiefs people. These examples suggest that more n eeds to be done to disseminate project information to the target population, which includes both factory and non-factory workers. It was also suggested that reliance on village-level officials as the sole means to disseminate project informati on might be problematic for a number of reasons. First, though not systematically examined, some res pondents noted that they did not perceive themselves as being part of a community if they migrated to the area to work nearby. Therefore, when the chief called a gathering of his people, they did not feel the need or right to attend. In a ddition, in two of the vi llages, there were patterns of awareness that seemed to indicate an uneven dissemination of information. While it cannot be assumed

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93that some households in the community were deliberately excluded, some houses within eyesight of chiefs place reported not havi ng heard about demonstrations, while other households farther from the chief knew about the project. This issue is possibly related to whether or not people were available when the information was disseminated. Future studies should consider these issues as potential barriers to the recruitment. Participants Know Be nefits of the Project While there are some misconceptions as to the construction of gardens, overall, participants cite benefits of constructing home gardens as ta ught during demonstrations in ways that reflect retention and understanding of the projects principles. This knowledge is not simply the recognition of lessons that were taught; but ra ther, the ability to describe and discuss their gardens with phrasing re markably similar to that provided in demonstrations. This suggests that the mode of information delivery is appropriate for the target population. In addition, there seem s to be a positive general attitude toward gardening and farming activities, both as a way to save money on vegetables and potentially earn an income by selling any su rplus. In fact, one woman commented that: It is like my garden pays me twice; when I grow my own vegetables, it is like I am paying myself instead of the marketthen, if I sell vegetables to my neighbor or my landlord, I am paid again! UGP household, 51-year old female, Maseru In addition to having a solid knowledge base concerning the c onstruction of home gardens, participants report talking to friends and neighbors about the project and receiving positive feedback about their gardens. All respondents reported that other

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94community members were interested in partic ipating in the project Further, several respondents report that they were either taught by a community member, or taught someone else how to construct gardens. Two additional respondents reported that upon return to the village of their birth, they planne d to teach others about garden techniques. RECOMMENDATIONS Several recommendations are put forth to a ddress issues related to participation. Project Staff might consider alternativ es avenues to disseminating project information. One solution discussed with project staff incl uded the use of posters or flyers in local businesses such as small shops or restaurant s. Another suggestion was to continue to build upon radio advertisement of the garden project. These suggestions might help to circumvent potential biases in the advertisement of the project. Flyers and radio advertisements should indicat e that all people living in a certain geographic area are eligible to participate. Project Staff should consider drawing community members into the process of disseminating the project. Community members frequently reported not only hope in the project, but early successes such as eating and se lling from the garden. Several respondents have also already taught neighbors a nd friends to construct trench gardens. In addition,

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95participants describe the project in ways that correlate with what is taught at demonstrations; for example, they report th at benefits of home gardens include yearround production, an increase in vegetable va riety, increase in capacity to produce own vegetables and the potential to se ll surplus product. In addition, some nonparticipants thought that trench gardens we re labor intensive; however, participants know (and report) that while several hours of labor is required during the construction of gardens, regular tending and watering of the garden typically takes only minutes a day or 30 minutes on the weekend. Because of their willingne ss to tell and teach others about the project, community memb ers are good ambassadors for the project. Project Staff should consider additional strategies to support the production, availability, and consumption of a variety of vegetables Because growing vegetables does not necessarily mean that households will consume that produce, some complementary programs for home garden projects might include nutrition education or social marketing to emphasize the health benefits of producing and consuming a variety of vegetables (F aber and Benade 2001). Some ways to accomplish this would be to add a nutriti on module to the demonstrations already offered as part of the urban garden program. It might also be useful to disseminate flyers or small booklets that highlight im portant nutritional messages. These items could be distributed at the sa me venues as project flyers.

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96 Renewed efforts should be made to reach the factory worker population Though the differences between factory and non-factory worker households were not significant in terms of food ins ecurity, textile factory worker s represent a large part of the target population. Seve ral textile workers households reported not having heard about the project; as a result, they were not participati ng. Efforts to reach workers could be accomplish need not necessarily targ et the factories themselves, as flyers or radio advertisements in strategic areas of the villages should be seen by factory and non-factory workers alike. However, the UGP organization might consider dissemination of printed materials in fact ories within the project areas. Monitoring and evaluation efforts should be broadened Monitoring and evaluation efforts should incl ude variables beyond the presence of the garden, the presence of multiple vegetable types, or the sale of surplus vegetables. Another way to assess the impact of the ur ban garden project is to evaluate household or individual food security. This evalua tion could include the food security and dietary diversity surveys used here, or others that are validat ed to assess food security. It might also include anthropometric asse ssments to demonstrate whether or not participation might be associated with im proved growth indicators. Implementation of a community-based growth-monitoring pr ogram could be used to follow the longterm effects of such interventions (Faber and Benade 2001).

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97STUDY LIMITATIONS AND FUTU RE RESEARCH DIRECTIONS A major limitation of this study is a sma ll sample size (n=61) in relation to the size of the target population ( 5000 participants in Maseru and Maputsoe). Because the reasons for non-participation were not know n, an exploratory study was conducted to allow for a more in-depth exploration of issues related to participation though semistructured household interviews. This type of methodology tends to yi eld a great deal of information from a smaller number of cases rather than a more restricted amount of information from a greater number of cases. Based on results of the two surveys, household dietary diversity and household food insecurity may be influencing the part icipation of households. UGP households have lower mean dietary diversity scores th an those who do not pa rticipate, suggesting that low dietary diversity may influence participation. Though the HFIAS provides information about the experience of food insecurity in the 30 days prior to the survey, it is important to note that seasonality of f ood environments cannot be captured in such a cross-sectional sample. In a study in Mozambique, Garrett and Ruel (1999) note that despite hypothesizing that rural and urban e nvironments might experience determinants of food insecurity such as seasonality differently, surprisingly, seasonality does not have a differential effect between urban and rural areas (1999: 1963). Thus, I cannot dismiss seasonality, not addressed in this study, as a potential influence on food insecurity. However, there may be confounding factors such as the sex of head of household and engagement in wage labor. A st udy by Moreno-Black and Homchampa (2007) on Thai industrial workers describes the way that the food habits and nutritional status can be affected by work. The authors found that factors such as de manding schedules, long

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98working hours, and traveling long distances be tween work and home led to skipped meals or the consumption of ready-made foods sold by local canteens or street vendors. It would be useful to conduct a follow-up st udy with randomization and a larger sample size to allow for statistical modeling of factors associated with participation. Despite this limitation, this study contributes to the understa nding of this project as well as other urban garden programs in low-resource settings by offering an analysis of the project from the point of view of participants. It is also important to note that how I framed th e question of what factors influence decisions to participate or not in the urban garden project shifted significantly during the course of data coll ection. As previously disc ussed, the inclusion of public health and anthropological th eory was significantly influenced by my enrollment in a dual degree program. Also, because to my knowledge there is no literature discussing participation in urban garden projects in de veloping world settings, I relied upon my best guesses to frame my research questions. I posited that decisions to participate in an urban garden program were much lik e a decisions to seek health screenings or make other health related decisions. Thus, they could be modeled on public hea lth theories such as the Health Belief Model (HBM) or the Theory of Planned Behavior (TPB). Though the findings of this study seem to fit the framewor k of HBM, problems with awareness of the project as well as issues with data collection from non-UGP households led to the inability to apply TPB. Even if these issu es could be addressed, I am not sure I would take the same tact if this problem were examined again. Nevertheless, I found the constructs of HBM such as perceived costs and benefits very useful for understanding the

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99decision to participate or not in the urban ga rden project, and I w ould support the use of these domains in future studies. CONCLUSION In general, households who participate in the urban garden program tend to have lower dietary diversity and higher food insecu rity scores; thus, it seems possible that households having difficulties acquiring food with sufficient variety and quantity selfselect to participate in the UGP. This de termination cannot be made, however, because the study is cross sectional and cannot capture the temporality of these events. It cannot be determined if food insecurity or low dietary diversity preceded the decision to participate, or came as a result of pa rticipation, though interview responses do not support the latter conclusion. Both participant and non-participan t households recognized the value of producing their own vegetables, for either cons umption or sale. Participants are willing to share knowledge about their gardens with others, and overall speak positively about the project. Participants are able to identify many benefits of constructing and maintaining gardens and some have reported having already eaten or sold from their plots. Social benefits to pa rticipation were also reported-people said they spoke more with their neighbors, gathered to work colle ctively to help each other build gardens, taught others how to construct gardens, or even provided food for others from their produce. There is indication that ot her factors influence participation, such as village sociopolitical issues. Examples of this include misunderstand ings or potentially

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100discriminatory practices concerning differen ces in how community is defined and who qualifies to participate in the project. So me households report not attending community gatherings because they do not perceive them selves to be part of the community. In addition, access to materials may present a ba rrier, as some participants indicate having troubles obtaining some of the mate rials to construct gardens. Non-participants recognized the benefits of constructing gardens; however, motivation to participate was hindered by a lack of awareness of the project. Households that were unaware of the project prior to being appr oached to take part in this study were given a brief description of the project; all non-participants expressed an interest in participating should the opportunity arise. Finally, projects proposed in the context of high rates of HIV/AIDS and food insecurity should strongly cons ider the impact of these synergistic issues. Physiological interactions between infectio us disease and malnutrition have detrimental effects on the body and a persons ability to cope with diseas e. Social and cultural interactions may provide impetus or barriers to participation in interventions like the urban garden project. Attention should be paid to thes e contexts if indeed such inte rventions will be successful. CONTRIBUTIONS TO APPLIED ANTHROPOLOGY Applied anthropology can be described as the application of anthropological theory and methods to real-world probl ems, with the purpose of broadening the understanding of those problems and creating or facilitating solutions or positive changes. This study contributes to app lied anthropology in a number of ways. Rather than relying solely on an etic examination of reasons for pa rticipation in an urban garden project, this

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101study uses anthropological methods to reach members of the target population to understand how they view the project. Their voices and understanding, or even their lack of awareness of the project, informs the recomm endations in this study. Ultimately, it is their thoughts about the costs a nd benefits related to the proj ect that are transmitted to the organization carrying out the urban garden program. A summary report, including the recommendations presented here, has been given to that organization. Even more rewarding, the organization has already acted upon these findings, such as broadening dissemination efforts.

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102 LITERATURE CITED Administrative Committee on Coordination/Subcommittee on Nutrition of the United Nations (ACC/ SCN) 1998 Overview to the Feature: Nutriti on and HIV/AIDS. SC N News 17: 3-4. Alaimo, K., Packnett, E., Miles, R. A. and Kruger, D. J. 2008 Fruit and Vegetable Intake among Ur ban Community Gardeners. Journal of Nutrition Education and Behavior 40(2):94-101. Allen, L. H. 2003 Interventions for Micronutrient Deficiency Control in Developing Countries: Past, Present and Future. Journal of Nutrition 133(11):3875S3878. American Anthropological Association 1998 Code of Ethics of the American Anthropological Association. Retrieved April 13, 2009 from http://www.aaanet.org/comm ittees/ethics/ethicscode.pdf Anderson, S. E. 1990 Core Indicators of Nutritional St atus for Difficult-to-Sample Populations. Journal of Nutrition 120:1559-1599. Baylies, C. 2002 The Impact of AIDS on Rural Hous eholds in Africa: A Shock Like Any Other? Development and Change 33(4):611-632. Baylies, C. and Wright, C. 1993 Female Labour in the Textile and Clothing Industry of Lesotho. African Affairs 92(369): 577-591. BBC News 2005 Lesotho Textile Workers Lose J obs. January 12. Retrieved from http://news.bbc.co.uk/2/ hi/business/4169587.stm Bernard, H. R. 2002 Research Methods in Anthropology: Qualitative and Quantitative Approaches. Walnut Cree k, CA: AltaMira Press.

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103Beyfuss, R. and Pritts, M. 1994 Companion Planting. Ecogardenin g Factsheet #10, Winter. Cornell University, Department of Ho rticulture. Retrieved from http://www.gardening.cornell.edu/fact sheets/ecogardening/complant.html Black, R., Morris, S., and Bryce, J. 2003 Where and Why Are 10 Million Chil dren Dying Every Year? The Lancet 361:2226-2234. Brabin, B. J. and Coulter, J. B. S. 2003 Nutrition-associated Disease. In Manson's Tropical Diseases. Pp. 561580. G. C. Cook and A. I. Zu mla (eds.). London: Saunders: Bowsky, S., CARE Lesotho and Fa mily Health International 2004 Matla ea Lesotho ke Sechaba: Hlahlobo ea Kokelo ea Bakuli ma Haeng Lesothos Strength is its People: A Rapid Appraisal of Home and Community Based Care, Summary Re port. CARE Lesotho, Family Health International, and the USAI D Regional HIV/AIDS Program, April 2004. Retrieved September 15, 2010 from http://www.fhi.org/NR/rdonlyres/e7v534mhmhyfi2mrdpzecnesr3ckcz7xn 2stllfwopf5ctec7ckhcknnuzwwz3skfpyehkzuexczqe/FinalCARELesothoH BC1.pdf Catholic Relief Services 2008 Homestead Gardening: A Manual fo r Program Managers, Implementers, and Practitioners. Baltimore, MD:Catholic Relief Services. Retrieved from http://crsprogramquality.org/pubs/agenv/Lesotho_homestead_gardening_ manual_low.pdf Chaiken, M.S., Dixon, J. R., Powers, C., and Wetzler, E. 2009 Asking the Right Questions: Commun ity-Based Strategies to Combat Hunger. NAPA Bulletin 32(1): 92-114. Clapp, J. 2009 Responding to Food Price Volatility and Vulnerability. In The Global Food Crisis: Governance Challenges a nd Opportunities. Pp. 43-57. J. Clapp, and M. C. Cohen (eds.). Wa terloo, ON: Centre for International Governance Innovation (CIGI) and Wilf rid Laurier University Press Clapp, J. and Cohen, M. C. 2009a Introduction: The Food Crisis and Global Governance. In The Global Food Crisis: Governance Challenges and Opportunities. Pp. 1-10. J. Clapp and M. C. Cohen (eds.). Wa terloo, ON: Centre for International Governance Innovation (CIGI) and Wilf rid Laurier University Press

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104Clapp, J. and Cohen, M. C. 2009b (eds.). The Global Food Crisis: Gove rnance Challenges and Opportunities. Waterloo, ON: Centre for Internatio nal Governance I nnovation (CIGI) and Wilfrid Laurier University Press Coates, J., Frongillo, E. A., Rogers, B. L ., Webb, P., Wilde, P. E., Houser, R. 2006 Commonalities in the Experience of Household Food Insecurity across Cultures: What Are Measures Missing? Journal of Nutrition 136(5): 1438S-1448S. Coates, J., Swindale, A. and Bilinsky, P. 2007 Household Food Insecurity Access Scale (HFIAS) for Measurement of Household Food Access: Indicator Guid e (v. 3). Washington, D.C.: Food and Nutrition Technical Assistance Project, Academy for Educational Development, August 2007. Coreil, J. 2010a Behavioral and Social Science Theory. In Social and Behavioral Foundations of Public Health. Pp. 69 -90. J. Coreil (ed.). Los Angeles: Sage. 2010b Why Study Social and Behavioral Factors in Public Health? In Social and Behavioral Foundations of Public Hea lth. Pp. 3-21. J. Coreil (ed.). Los Angeles: Sage. Deitchler, M., Ballard, T., Sw indale, A., and Coates, J. 2010 Validation of a Measure of Household Hunger for Cross-Cultural Use. Washington, DC: Food and Nutrition Technical Assistance II Project (FANTA-2), AED. DeOnis, M., Monteiro, C. A., Akr, J., and Clugston, G. 1993 The Worldwide Magnitude of Protei nenergy Malnutriti on: An Overview from the WHO Global Database on Ch ild Growth. Bulletin of the World Health Organization 71:703-712. Department of Health and Human Services (DHHS) 2005 Code of Federal Regulations Titl e 46: Protection of Human Subjects. Retrieved April 15, 2009 from http://www.hhs.gov/ohrp%20/humans ubjects/guidance/45cfr46.htm

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108Himmelgreen, D. A., Romero-Daza, N., Tu rkon, D., Watson, S., Okello-Uma, I., and Sellen, D. 2009 Addressing the HIV/AIDSFood Insecurity Syndemic in Sub-Saharan Africa. African Journal of AIDS Research 8(4): 401-412 Hirsch, A. 2005 Season of Hope: Economic Refo rm under Mandela and Mbeki. Pietermaritzberg, South Africa:Universi ty of KwaZulu-Natal Press/IDRC. Retrieved from http://www.idrc .ca/en/ev-91102-201-1-DO_TOPIC.html Hope, K. R., Sr. 2000 Mobile Workers and HIV/AIDS in Botswana. AIDS Analysis Africa 10: 6. Hopkins, R. F. 2009 Responding to the 2008 Food Crisis: Lessons from the Evolution of the Food Aid Regime. In The Global Food Crisis: Governance Challenges and Opportunities. J. Clapp, and M. C. Cohen (eds.). Pp. 79-94. Waterloo, ON: Centre for International Governance Innovation (CIG I) and Wilfrid Laurier University Press IRIN: Humanitarian News and Analysis 2009 Lesotho: Feeling the Pinch of Soar ing Food Prices. Accessed October 15, 2010 from http://www.irinnews.or g/Report.aspx?ReportId=82227 2003 Lesotho: Growth of Garment I ndustry fuels AIDS concerns. Accessed January 15, 2010 from http://www.irinnews.org/Report.aspx?ReportId=44344 2002 Lesotho: Focus on Exploitation in Textile Factories. Accessed January 15, 2010 from http://www.irinnews.or g/Report.aspx?ReportId=32011 Ishii-Eiteman, M. 2009 Reorienting Local and Global Food Systems: Institutional Challenges and Policy Options from the UN Agricultural Assessment. In The Global Food Crisis: Governance Challenges and Oppor tunities. J. Clapp, and M. C. Cohen (eds.). Pp. 217-236. Waterlo o, ON: Centre for International Governance Innovation (CIGI) and Wilf rid Laurier University Press Jochelson, K., Mothibeli, M., and Leger, J. P. 1991 Human Immunodeficiency Virus an d Migrant Labor in South Africa. International Journal of H ealth Services 21(1): 157.

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110Lurie, M., Harrison, A., Wilkinson, D. & Abdool Karim, S. 1997 Circular Migration and Sexual Networking in Rural South Africa: Implications for the Spread of HIV and other Sexually Transmitted Diseases. Health Transition Review 7(supplement 3), pp. 15. Madrigal, L. 1998 Statistics for Anthropology. New York: Cambridge University Press. Maes, K. C., Hadley, C., Tesfaye, F., Shifferaw, S., and Tesfaye, Y. A. 2009 Food Insecurity among Volunteer AI DS Caregivers in Addis Ababa, Ethiopia Was Highly Prevalent but Buffered from the 2008 Food Crisis. Journal of Nutrition 139(9):1758-1764. Mazzeo, J. 2009 Lavich: Haiti's Vulnerability to the Global Food Crisis. NAPA Bulletin, 32(1):115-129. McElroy, A. 1990 Bio-cultural Models in Studies of Human Health and Adaptation. Medical Anthropology Quarterly 4: 243-265. Messer, E. 2009 Rising Food Prices, Social Mobilizations, and Violence: Conceptual Issues in Understanding and Responding to the Connections Linking Hunger and Conflict. NAPA Bulletin 32(1):12-22. Mitchell, R. and Hanstad, T. 2004 Small Homegarden Plots and Sustainable Livelihoods for the Poor. LSP Working Paper 11 Access to Natura l Resources Sub-Programme. Food and Agriculture Organization of th e United Nations (FAO). Retrieved from ftp://ftp.fao.org/docrep/fao/007/j2545e/j2545e00.pdf Mittal, A. 2009 The Blame Game: Understanding Struct ural Causes of the Food Crisis. In The Global Food Crisis: Governance Challenges and Opportunities. J. Clapp, and M. C. Cohen (eds.). Pp. 13-28. Waterloo, ON: Centre for International Governance Innova tion (CIGI) and Wilfrid Laurier University Press. Molomo, N. 2010 Billy Pledges to Fight Wage Board. Lesotho Times 8 Sep 2010. Retrieved from http://www.lestimes.com/?p=4426

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111Moreno-Black, G. and Homchampa, P. 2007 At the Factory, At the Table: Dietary Beliefs and Practices of Thai Industrial Workers. Ecology of F ood and Nutrition 46(3-4):313-337. MOST USAID Micronu trient Program 2004 Elements of a National Food-Fo rtification Program for Bangladesh. Arlington, Virginia, USA Mller, O. and Krawinkel, M. 2005 Malnutrition and Health in Deve loping Countries. Canadian Medical Association Journal 173(3):279-286. Murray, C. 1981 Families Divided: The Impact of Migrant Labor in Lesotho. Cambridge, UK, Cambridge University Press. Murray, C. C. J. L. and Lopez, A. D. 1997 Global Mortality, Disability, and the C ontribution of Risk Factors: Global Burden of Disease Study. Lancet 34:1436-1442. Naysmith, S., De Waal, A. and Whiteside, A. 2009 Revisiting New Variant Famine: th e Case of Swaziland. Food Security 1(3):251. Nemer, L., Gelband, H. and Jha, P. 2001 The Evidence Base for Interventi ons to Reduce Malnutrition in Children under five and School-age Childre n in Lowand Middle-income Countries. Commission on Macroecono mics and Health. CMH working paper no WG5:11. Geneva: World Health Organization. Pelto, G. H., Goodman, A. H. and Dufour, D. L. 2000 Preface. In Nutritional Anthropology: Biocultural Perspectives on Food and Nutrition. A. H. Goodman, D. L. Dufour, and G. H. Pelto (eds.) p. 1. Mountain View, CA: Mayfield Publishing Company. Pierce, J. U. and Nalle, M. 2002 Theoretical Foundations for Population-Based Practice. In Comprehensive Community Health Nursing: Family, Aggregate & Community Practice. S. Clemen-Stone, S. L. McGuire, D. Gerber Eigsti (eds.). Pp. 379-399. St. Louis: Mosby.

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113Ruel, M. T. 2002 Is Dietary Diversity an Indicator of Food Security or Dietary Quality? A Review of Measurement Issues and Research Needs. FCND Discussion Paper 140. Washington DC: Internationa l Food Policy Rese arch Institute Ruel, M. T., Garrett, J. L., Hawkes, C., Cohen, M. J. 2010 The Food, Fuel, and Financial Crises Affect the Urban and Rural Poor Disproportionately: A Review of th e Evidence. Journal of Nutrition 140(1): 170S-176S. Scrimshaw, N. S. and Giovanni, J. P. 1997 Synergism of Nutrition, Infection, and Immunity: An Overview. American Journal of Clin ical Nutrition 66:464S-477S. Semba, R.D. 1998 The Role of Vitamin A and Rela ted Retinoids in Immune Function. Nutrition Review 56(1-2):S38S48. Semba, R.D. and Tang, A.M. 1999 Micronutrients and th e Pathogenesis of Human Immunodeficiency Virus Infection. British Journal of Nutrition 81(3):181. Stanford, L. 2008 Globalized Food Systems: The View from Below. Anthropology News 49(7):7-10. Swindale, A., and Bilinsky, P. 2006 Household Dietary Diversity Score (HDDS) for Measurement of Household Food Access: Indicator Guid e, Version 2. Food and Nutrition Technical Assistance Project, Academy for Educational Development, Washington D.C. Turkon, D. 2008 Commoners and Kings and Suba ltern: Political Factionalism and Structured Inequality in Lesot ho. Political and Legal Anthropology Review 31(2), pp. 203. Turkon, D., D. Himmelgreen, N. Romero-Daza and C. Noble 2009 Anthropological Perspectives on the Challenges to Monitoring and Evaluating HIV and AIDS Programming in Lesotho African Journal of AIDS Research 8(4): 473 UNAIDS The Joint United Nations Programme on HIV/AIDS 2004 Report on the Global AIDS Epidemic, July 2004.

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114United Nations Development Program (UNDP) Human Development Reports 2008 Human Development Indices: A Stat istical Update 2008 HDI rankings. Retrieved February 6, 2010 from http://hdr.undp.org/en/statistics/ UN General Assembly Special Session (UNGASS) 2009 Lesotho UNGASS Country Report: Status of the National Response to the 2001 Declaration of Commitment on HIV and AIDS. Maseru: National AIDS Commission (NAC) and Ministry of Health and Social Welfare (MOHSW). Van Buren, Linda 2004 Lesotho: Economy. In Africa South of the Sahara 2004. Katharine Murison (ed.). Pp. 588-592. London: Europa Publications. von Braun, J. 2008 Food and Financial Crises: Implica tions for Agriculture and the Poor. Food Policy Report No. 20. Washington, DC: International Food Policy Research Institute. von Braun, J.; McComb, J.; Fred-Mensah, B.; Pandya-Lorch, R. 1993 Urban Food Insecurity and Malnutr ition in Developing Countries: Trends, Policies, and Research Implications International Food Policy Research Institute, Washington, DC, USA. Wakefield, S. Yeudall, F., Taron, C ., Reynolds, J., and Skinner, A. 2007 Growing Urban Health: Community Gardening in South-East Toronto. Health Promotion International 22(2):92-101. Wiesmann, D. 2006 Global Hunger Index: A Basis for Cross-Country Comparisons. Washington, D.C. International F ood Policy Research Institute. Wiesmann, D., Bassett, L., Benson, T., and Hoddinott, J. 2008 Validation of Food Frequency and Di etary Diversity as Proxy Indicators of Household Food Security. Rome: International United Nations World Food Programme. World Bank 1981 Accelerated Development in Sub-Sa haran Africa: An Agenda for Action. Washington, D.C.: World Bank. World Food Programme (WFP) 2009 WFP Crisis Page: High F ood Prices. Retrieved from http://one.wfp.org/english/?ModuleID=137&Key=2853

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115World Food Programme (WFP) 2008 WFP says High Food Prices a Silent Tsunami, Affecting Every Continent. Retrieved from http://www.wfp.org/node/195 World Health Organization 2004 Lesotho: Epidemiological Country Profile on HIV and AIDS. Accessed October 12, 2009 from http://apps.who.int/globalatlas /predefinedReports/EFS2008 /short/ EFSCountry Profiles2008LS.pdf World Health Organization (WHO) Mortality Country Fact Sheets. 2006 Country Health System Fact Sheet 2006: Lesotho. Retrieved February 7, 2009 http://www.afro.who.int/home/ countries/fact_sheets/lesotho.pdf Yeudall, F., Gibson, R. S., Cullinan, T. R., and Mtimuni, B. 2005 Efficacy of a community-based dietary intervention to enhance micronutrient adequacy of high-phyt ate maize-based diets of rural Malawian children. Public Health Nutrition 8:826-836

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116 APPENDIX A: HOUSEHOLD FOOD INSECURITY ACCESS SCALE (HFIAS)

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117 Household Food Insecurity Access Scale (HFIAS) For each of the following questions, consider what has happened in your household [LELAPA] for the past 4 weeks. By household we mean all of those who eat from the same pot [BA JANG PITSENG E LE NGOE]. Please answer whether or not this has ever happened, then let us know about how many times this has happened in the last four weeks. Participant # |__|__|__| Question Response Options Code 1. Kheoling e fetileng na okile oa khathatseha hore lelapa la hao lekeke laba le lijo tse lekaneng? In the past 4 weeks, did you have anxiety that your household would not have enough food? How many times? 0 = Never 1 = Rarely (once or twice) 2 = Sometimes (3 to 10 times) 3 = Often (more than 10 times) |___| 2. Kheoling e fetileng na uena kapa emong oa lelapa ha ka khona ho ja mofuta oa lijo tseo aneng a lakalitse ho lija ka lebaka la bohloki? In the past 4 weeks, were you or any household member not able to eat the kinds of foods you preferred (a lakalitse=the kinds of foods that you would like to eat) because of a lack of resources (bohloki=having a status characterized by a lack of resources)? How many times? 0 = Never 1 = Rarely (once or twice) 2 = Sometimes (3 to 10 times) 3 = Often (more than 10 times) |___| 3. Kheoling e fetileng na uena kapa e mong oa lelapa o ile a ja mefuta e fokolang ka baka la bohloki? In the past 4 weeks, did you or any household member have to eat a limited variety of foods (less kinds of food on the plate) due to a lack of resources (bohloki=having a status characterized by a lack of resources)? How many times? 0 = Never 1 = Rarely (once or twice) 2 = Sometimes (3 to 10 times) 3 = Often (more than 10 times) |___|

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118Household Food Insecurity Access Scale (HFIAS) Question Response Options Code 4. Kheoling e fetileng, na uena kapa emong oa lelapa oile a tlameha hoja lijo tseo asa lirateng hobane hone ho sena bokhoni ba ho fumana tse ling? In the past 4 weeks, did you or any household member have to eat some foods that you really did not want to eat because of a lack of resources to obtain other types of food? How many times? 0 = Never 1 = Rarely (once or twice) 2 = Sometimes (3 to 10 times) 3 = Often (more than 10 times) |___| 5. Kheoling e fetileng na uena kapa emong oa lelapa oile a tlameha hoja lijo tse nyane ho feta tseo aneng a lihloka hobane hone ho sena lijo tse lekaneng? In the past 4 weeks, did you or any household member have to eat a smaller meal than you felt you needed because there was not enough food? How many times? 0 = Never 1 = Rarely (once or twice) 2 = Sometimes (3 to 10 times) 3 = Often (more than 10 times) |___| 6. Kheoling e fetileng na uena kapa emong oa lelapa oile a tlameha hoja makhetlo a fokolang ka letsatsi hobane hone ho sena lijo tse lekaneng? In the past 4 weeks, did you or any other household member have to eat fewer meals (fewer times) in a day because there was not enough food? How many times? 0 = Never 1 = Rarely (once or twice) 2 = Sometimes (3 to 10 times) 3 = Often (more than 10 times) |___| Participant # |__|__|__|

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119Household Food Insecurity Access Scale (HFIAS) Question Response Options Code 7. Kheoling e fetileng na hone ho sena lijo tsa mofuta ofe kapa ofe tse neng lika jeoa ka tlung ka lebaka la bohloki ba ho fumana lijo? In the past 4 weeks, was there ever no food to eat of any kind in your household because of lack of resources to get food? (Availability of foods in HH, not consumption of food.) How many times? 0 = Never 1 = Rarely (once or twice) 2 = Sometimes (3 to 10 times) 3 = Often (more than 10 times) |___| 8. Kheoling e fetileng na uena kapa emong oa lelapa oile a ea tlung bosiu a lapile hobane ho sena lijo tse lekaneng? In the past 4 weeks, did you or any household member go to sleep at night hungry because there was not enough food? How many times? 0 = Never 1 = Rarely (once or twice) 2 = Sometimes (3 to 10 times) 3 = Often (more than 10 times) |___| 9. Kheoling e fetileng na uena kapa emong oa lelapa oile a qeta leteare a sa ja letho hobane hone ho sena lijo? In the past 4 weeks, did you or any household member go a whole day (and night) without eating anything because there was not enough food? How many times? 0 = Never 1 = Rarely (once or twice) 2 = Sometimes (3 to 10 times) 3 = Often (more than 10 times) |___| Participant # |__|__|__|

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120 APPENDIX B: HOUSEHOLD DIETARY DIVERSITY SURVEY (HDDS) [EXPANDED]

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121 Household Dietary Diversit y Survey (HDDS) [Expanded] Participant # |__||__|__| Now I would like to ask you about the ty pes of foods that you or anyone else in your HOUSEHOLD ate YESTERDAY during the day and at night. PLEASE THINK ABOUT FOODS THAT WERE EATEN INSIDE YOUR HOUSE, AS WELL AS FOODS PREPARED INSIDE YOUR HOUSE FOR CONSUMPTION OUTSIDE OF YOUR HOUSE. In considering your food consumption for the day, was yesterday a typical or usual day for your household? Typical Day Not a Typical Day Q READ THE LIST OF FOODS. PLACE A 1(ONE) IN THE BOX IF ANYONE IN THE HOUSEHOLD ATE THE FOOD IN QUESTION, PLACE A 0 (ZERO) IN THE BOX IF NO ONE IN THE HOUSEHOLD ATE THE FOOD. QUESTIONS AND FILTERS CODING CATEGORIES A Any papa, samp bread, biscuits, cookies, breakfast cereal, or any other foods made from maize, rice, wheat, millet, or sorghum? A .......... |___| B Any pumpkin, butternut, carrots, squash, or sweet potatoes that are yello w or orange inside? B .......... |___| C Any potatoes, yams, beetroot, or any other starchy vegetables, or foods that are made from roots or tubers? C .......... |___| D Any dark, green, leafy vegetables such as spinach, cabbage, sepaile, rapa, lihaba, or moroho Sesotho? D .......... |___| E Any other vegetables, such as green pepper, eggplant, tomato, onion, green beans? E .......... |___| F Any fruits, such as apples, oranges, or peaches? F .......... |___| G Any FRESH meat such as beef, pork, mutton, chicken or other birds, rabbit, live r, kidney, heart, other organ meats, or the heads and feet of animals? (Please do not include items such as polony sausage, vienna bacon) G .......... |___| H Any PROCESSED meat, such as polony sausage, vienna bacon, or canned meat? H .......... |___| I Any fish, such as hake or canned fish such as pilchards, sardines, or tuna? I .......... |___|

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122 Household Dietary Diversity Survey (HDDS) [Expanded] Participant # |__||__|__| J Any eggs? J .......... |___| K Any foods made from beans, peas, or lentils (dried or canned)? K .......... |___| L Any cheese, yogurt, milk or other milk products? L .......... |___| M Any foods made with oil, fat, or butter? M .......... |___| N Any sugar, candy, or soda? N .......... |___| O Any other foods, such as condiments, coffee, tea? O .......... |___| P Could you please tell me the main source for obtaining cereals (LIJO THOLLO) for your household? 1= Own production 4= Food aid 2= Purchased 5= Other 3= Borrowed, bartered, exchanged for labor, gift from friends or relatives P .......... |___| Q Could you please tell me the main source for obtaining vegetables for your household? 1= Own production 4= Food aid 2= Purchased 5= Other 3= Borrowed, bartered, exchanged for labor, gift from friends or relatives Q .......... |___|

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123 APPENDIX C: HOUSEHOLD INTERVIEW GUIDE NON-UGP HOUSEHOLDS

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124Household Interview Guid e NON-UGP HOUSEHOLDS District Name: _ _ _ _ _ _ _ _ _ Participant # |__||__|__| Village Name: _ _ _ _ _ _ _ _ _ ENUMERATOR Date: _____/_____/_____ RECORDING FILE# day month year DATA ENTRY CLERK We would like to make an audio recordi ng of this interview so that we can be sure to capture everything that you say correctly. Can you please let us know if that is alright with you? HOW OBTAIN FOOD Can you tell me ALL OF THE PLACES that your household gets the food for your home? [If not mentioned]: Do you purchase foods from a market? How often do you typically purchase foods from the market? What foods do you purchase from the market? VEGETABLE PRODUCTION Have you or anyone else in your househol ds ever grown crops or vegetables in the PAST? If so, can you tell us what ha s that experience been like? What types of crops or vegetabl es have you produced in the PAST? Introduction: Thank you for taking the time to meet with me today and talk about how households get food and make deci sions about how to get food. I have developed some questions to help you talk about your experience, but please feel free to add other information that you think is important. Please feel free to give as long an answer as you need. Also, please know that there are no right or wrong answers; we are interested in what you think, and your experiences. To confirm, we would like to make an audi o recording of this interview so that we can be sure to capture everything that you say correctly. Can you please let us know if that is alright with you? If so, we will start the recording, then ask you this question again just so that we can be sure to record your permission. Shall we begin?

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125 Do you CURRENTLY grow any of th e food your household consumes? (IF NO Move to Factors) [IF YES]: What types of crops or vege tables do you produce? For what part of the year do you grow food? Can you produce enough food for your household? How much time and effort do you spend tending your garden? Who is responsible for the production of crops or vegetables? (Probe for gender, age) Are there other vegetables you would like to produce? (IF YES) What are they? --PROBE: What stops you from producing them? (tools, ownership/use of land, time, other inputs) FACTORS INFLUENCING PARTICIPATION -(PERCEIVED SUSCEPTIBILITY TO FOOD INSECURITY) I have heard that there a re some people in this commu nity who eat the same foods all the time but would like to eat differen t foods, or better foods (VARIETY). Is this a problem for your household? PERCEIVED SEVERITY {IF they dont say why its a problem:} Can you tell me why or why not? I have been told that there are some people in this community who sometimes do not have enough to eat (QUANTITY). Is this a concern for your household? PERCEIVED SEVERITY {IF they dont say why its a problem:} Can you tell me why or why not? -(KNOWLEDGE OF PROJECT) You mentioned before that you are NOT participating in the Garden Program Had you heard about this proj ect before I mentioned it?

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126 If NO: ASK AGE End Interview, Thank them for their time If YES: CONTINUE Can you tell me what you know about this project? Did you attend any of the garden demonstrations that were held in this community? -(PERCEIVED BENEFITS TO PARTICIPATING IN GARDEN PROGRAM) From what you know about the Urban Garden Program what benefits can people expect if they participate? -(PERCEIVED COSTS OF PARTICIPATION) What do you think participants will h ave to do or will have to possess, to participate in the project? --PROBE: Do you think the project w ill require a lot of time? Do you think the project will require a lot of land? If someone had a job, do you think it would interfere with his or her ability to participate in this project? Is there anything else th at might interfere with someon es ability to participate? -PERCEPTIONS OF URBAN GARDEN PROGRAM Do you think participation in Urban Garden Program would help your household? Why or why not? Can you tell me why you decided NOT to participate in this project, if this was your decision? Can you tell me more about that? If you believed you were not eligible to participate, can you tell me more about that? Is there anything else that you is impo rtant for others to know, either about the Garden Program or anything you would like to talk about? Can you please give me your age?

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127 APPENDIX D: HOUSEHOLD INTERVI EW GUIDE UGP HOUSEHOLDS

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128Household Interview Gu ide UGP HOUSEHOLDS District Name: _ _ _ _ _ _ _ _ _ Participant # |__||__|__| Village Name: _ _ _ _ _ _ _ _ _ ENUMERATOR Date: _____/_____/_____ RECORDING FILE# day month year DATA ENTRY CLERK We would like to make an audio recordi ng of this interview so that we can be sure to capture everything that you say correctly. Can you please let us know if that is alright with you? HOW OBTAIN FOOD Can you tell me ALL OF THE PLACES that your household gets the food for your home? [If not mentioned]: Do you purchase foods from a market? How often do you typically purchase foods from the market? What foods do you purchase from the market? VEGETABLE PRODUCTION Have you or anyone else in your househol ds ever grown crops or vegetables in the PAST? If so, can you tell us what ha s that experience been like? What types of crops or vegetabl es have you produced in the PAST? Introduction: Thank you for taking the time to meet with me today and talk about how households get food and make deci sions about how to get food. I have developed some questions to help you talk about your experience, but please feel free to add other information that you think is important. Please feel free to give as long an answer as you need. Also, please know that there are no right or wrong answers; we are interested in what you think, and your experiences. To confirm, we would like to make an audi o recording of this interview so that we can be sure to capture everything that you say correctly. Can you please let us know if that is alright with you? If so, we will start the recording, then ask you this question again just so that we can be sure to record your permission. Shall we begin?

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129 Do you CURRENTLY grow any of th e food your household consumes? (IF NO Move to Factors) [IF YES]: What types of crops or vege tables do you produce? For what part of the year do you grow food? Can you produce enough food for your household? How much time and effort do you spend tending your garden? Who is responsible for the production of crops or vegetables? (Probe for gender, age) Are there other vegetables you would like to produce? (IF YES) What are they? --PROBE: What stops you from producing them? (tools, ownership/use of land, time, other inputs) FACTORS INFLUENCING PARTICIPATION -(PERCEIVED SUSCEPTIBILITY TO FOOD INSECURITY) I have heard that there a re some people in this commu nity who eat the same foods all the time but would like to eat differen t foods, or better foods (VARIETY). Is this a problem for your household? PERCEIVED SEVERITY {IF they dont say why its a problem:} Can you tell me why or why not? I have been told that there are some people in this community who sometimes do not have enough to eat (QUANTITY). Is this a concern for your household? PERCEIVED SEVERITY {IF they dont say why its a problem:} Can you tell me why or why not? -(PERCEIVED BENEFITS TO PARTICIPATING IN UGP) You mentioned before that you are participating in the Garden Program Can you tell me WHY you decided to participate in this project? Have you attended Garden Program demonstrations that were held in your community? Which ones? (Trench garden, keyhole gardens, compost, pest control) Were these demonstrations useful to you?

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130 WHEN YOU FIRST JOINED THE PROGRM: What benefits did you hope to gain from participating? NOW HAVING BEEN IN THE PROGRAM: What benefits (if any) have you already gained from participating in this program? (Such as, are they harvesting plants already, sold plants already) -(PERCEIVED COSTS OF PARTICIPATION) To participate in this project, what will you have to do? Will you have to have certain things to participate in this project? What are they, do you have them? Will this project require much of you r time? Does it require much land? Has it cost you anything to participat e in this program (such as purchasing manure)? Have you had any difficulty in obtaining th e things you need to make or maintain your garden, like water, manure, leaves or pl ants for compost, stones, or anything else you can think of? If you work, can you tell me how your work might interfere with your ability to participate in this project? Is there anything else that might interfere with your ability to participate? -(SOCIAL COSTS, PERCEIVED REACTIONS OF OTHERS) Have you discussed your participation in this project with your friends, family, or neighbors? Can you tell me what they think about your participation in this project? -PERCEPTIONS OF UGP PROGRAM Do you think participation in the Garden Program will help your household? Why or why not? Is there anything else that you is important for others to know, either about the Garden Program, or anything you would like to talk about? Can you please give me your age?

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131 APPENDIX E: HOUSEHOLD DEMOGRAPHICS SHEET

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132Household Demographics Sheet Participant # |__ | |__ | __| ENUMERATOR RECORDING FILE# DATA ENTRY CLERK 1 Hlooho ea lelapa ke me kapa ntate? What is the sex of the household head 1 = Male 2 = Female |__| 2 O lilemo li kae? What is the age of the household head [Record age] |__||__| 3 What is your relationship to the household head? 1 = Self 2 = Spouse 3 = Sibling 4 = Parent 5 = Other ______________________ (if , record answer) |__| 4 Maemo a lenyalo a hlooho ea lelapa ke afe? What is the marital status of the HH head 1 = married 2 = divorced 3 = widowed 4 = single 5 = separated |__| 5 Likhoeling tse tharo tse fetileng le ne le phela le le bakae katlung u kenyelelitse bohle le bao seng litho tsa lelapa? What is the total number of people who have been living in your household for the past three months (including nonfamily). # of HH members <5 years _________ 5-18 years _________ 19-60 years _________ > 60 years _________ Total _________ Check Total District Name: _ _ _ _ _ _ Village Name: _ _ _ _ _ _ Date: _____/_____/_____ day month year

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133Household Demographics SheetParticipant # |__||__|__| 6 Do you own your home, or do you rent? 1 = Own 0 = Rent |__| 7 Are you or a household member a REGISTERED participant of the UGP project? 1 = Yes 0 = No |__| 8 Have you received seeds and a gardening tool from the UGP project? 1 = Yes 0 = No |__| 9 Na ho na le motho ea sebetsang lifemeng lapeng moon ? Does the household have any members working at the textile factories? 1 = Yes (If YES, Q10) 0 = No (If No, skip to Q11) |__| 10 O sebetsa lifemeng life ? [If yes] At which textile factory do they work? name of factory: _________________ 1= Maseru 2= Maputsoe |__||__| 11 Do you RECEIVE remittances or goods [limpo, or regular support] from other people? 1 = Yes IF YES Q12 0 = No IF NO Q14 |__| 12 For a usual month, can you tell me the approximate amount of CASH for those remittances that you RECEIVE? |______________ | Rand/Miloti Record amount 99=N/A 88=Dont Know 13 Can you tell me what type of GOODS you RECEIVE ? List GOODS : Record GOODS 99=N/A 88=Dont Know 14 Do you GIVE remittances or goods [limpo, or regular support] from other people? 1 = Yes IF YES Q15 0 = No IF NO Q17 |__|

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134 Household Demographics SheetParticipant # |__||__|__| 15 For a usual month, can you tell me the approximate amount of CASH for those remittances you GIVE? |______________| Rand/Miloti Record amount 99=N/A 88=Dont Know 16 Can you tell me what type of GOODS you GIVE ? List GOODS : Record GOODS 99=N/A 88=Dont Know 17 Record sex of respondent [DO NOT ASK UNLESS UNSURE] 1 = Male 2 = Female |__| 18 Willing to participate in a Household Interview? 1 = Yes 0 = No |__|