Impact of gardening and nutrition support provided to women in refugee camps in Cox’s Bazar, Bangladesh

• First randomized controlled trial of a home garden and nutrition intervention in a refugee camp. • Trial included 1,050 pregnant/lactating women, equally split between control and treatment. • Garden adoption increased 17 percentage points (pp); share of households eating produce from own garden increased 57 pp. • Household food insecurity reduced by 66%; fruit intake increased, but vegetable intake did not. • The study shows the positive impact of garden interventions despite extreme space constraints in refugee camps. Nearly one million Rohingya refugees, displaced by the Myanmar civil war, live in densely populated camps in Cox’s Bazar, Bangladesh. While food aid addresses some of their immediate needs, additional solutions are necessary to foster self-reliance, as many have been living in camps for years with little hope of returning home. Gardening is one approach that could enhance diets, food security, and incomes, but evidence for the impact of home garden programs in refugee camps remains limited. The objective of this study is to evaluate the impact of a home garden and nutrition program on the diets and food security of pregnant and lactating women in refugee camps in Cox’s Bazar. A cluster-randomized controlled trial was conducted, with pre- and post-intervention data collected from 1050 women, evenly split into control and treatment groups. A difference-in-differences estimator was used to measure the intent-to-treat effects. Lack of space was the primary obstacle to gardening, but sack gardens and rooftop gardens offered solutions. Women reported many benefits from gardening beyond food consumption, such as personal joy and making the house look nice. The intervention led to a 17-percentage point increase in garden adoption (p = 0.018) and a 57-percentage point rise in households sourcing fruits and vegetables from their gardens (p < 0.001). It also improved nutrition knowledge by 23 percentage points (p < 0.001) and household food security by 66% (p < 0.05). The intervention led to a significant increase of 1 additional serving of fruit per week, but there was no significant increase in vegetable intake. These findings clearly show the benefits of providing gardening and nutrition training to nutritionally vulnerable women in densely populated refugee camps.