DOI: 10.1002/cl2.1353 P RO TOCO L S I n t e r n a t i o n a l d e v e l o pm e n t PROTOCOL: The impact of infrastructure on low‐income consumers' nutritious diet, women's economic empowerment, and gender equality in low‐ and middle‐income countries: An evidence and gap map Gloria Adobea Odei Obeng‐Amoako1 | Clarice Panyin Nyan1 | Joseph Clottey1 | Sheila Agyemang Oppong1 | Edward Kusi Asafo‐Agyei1 | Pacem Kotchofa1 | Charles Yaw Okyere1,2 | Solomon Zena Walelign1,3 | Takyiwaa Manuh1 | David Sarfo Ameyaw1 1International Centre for Evaluation and Development, Tema, Accra, Ghana Abstract 2Department of Agricultural Economics and This is the protocol for an evidence and gap map. The objectives are as follows: this Agribusiness, University of Ghana, Legon, evidence and gap map (EGM) aims to identify, map, and provide an overview of the Ghana 3School of Economics, University of Gondar, existing evidence and gaps on the impact of different types of physical infrastructure Gondar, Ethiopia on various outcomes of low‐income consumers' nutritious diet, women's economic empowerment, and gender equality in low‐ and middle‐income countries. The Correspondence Solomon Zena Walelign, International Centre specific objectives of the EGM are: (1) identify clusters of evidence that offer for Evaluation and Development, Tema, opportunities for evidence synthesis and (2) identify gaps in evidence where new Ghana. Email: swalelign@iced-eval.org studies, research, and evaluations are needed. 1 | BACKGROUND (United, 2020b). Vulnerable social groups such as women, infants, children, and adolescents are at higher risk of malnutrition. Also, poor 1.1 | Introduction people are more likely to experience different forms of malnutrition, that is, undernutrition, micronutrient deficiencies, and obesity 1.1.1 | The problem, condition, or issue (United, 2020a) Malnutrition also raises healthcare costs while reducing productivity and slowing economic growth, which can Malnutrition remains a major global health challenge, especially perpetuate a cycle of poverty and ill‐health. However, according to among young children, despite the continued efforts of the (Marshak, 2021), malnutrition is mainly seasonal, particularly in international community to address it (Ahmed, 2012). Malnutrition African drylands. Seasonality in malnutrition involves variability in refers to deficiencies or excesses in nutrient intake, imbalance of nutritional outcomes correlated with changes in climatical conditions essential nutrients, or impaired nutrient utilization (WHO, 2022). In such as temperature, rainfall, and vegetation affecting food produc- 2020, about 150 million children worldwide under the age of five tion systems. Seasonal changes in these variables, mediated through were reported stunted, with almost 45 million wasted and 40 million livelihoods and institutions, can reinforce issues surrounding consist- overweight or obese (United, 2020a). Similarly, about 1.9 billion were ent intakes of healthy and nutritious food, food security, health, and overweight while 462 million of them were underweight driving malnutrition (Marshak, 2021; Young, 2020). Seasonality can This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2023 The Authors. Campbell Systematic Reviews published by John Wiley & Sons Ltd on behalf of The Campbell Collaboration. Campbell Systematic Reviews. 2023;19:e1353. wileyonlinelibrary.com/journal/cl2 | 1 of 15 https://doi.org/10.1002/cl2.1353 2 of 15 | ODEI OBENG‐AMOAKO ET AL. be measured through year‐round fluctuations in prices and food infrastructure and nutritious diet, women's economic empowerment availability affecting producers and consumers, particularly in South (WEE), and gender equality for LICs in LMICs in sub‐Saharan Africa Asia (SA) and Africa. (SSA) and SA. Poor people's seasonal food accessibility, that is, year‐round food availability and affordability, is a multifaceted problem with few concrete solutions being deployed at scale. Hence, under- 1.1.2 | Why it is important to develop the EGM standing factors influencing the agri‐food systems to enhance nutritious food supply and shape people's nutrition and social To our knowledge, there is no existing EGM on the impact of physical development is critical for geographically targeted policy inter- infrastructure on nutritious diets, WEE, and gender equality. There ventions and trade‐offs associated with them. According to the are some general maps for instance on transport in LMICs WHO 2020, the nutrition needs of low‐income consumers (LICs), (Malhotra, 2021), but the EGM has a broader focus in terms of especially women and children, in low‐and middle‐income countr- outcomes, narrowly focused on one type of infrastructure (i.e., ies (LMICs) are often compromised due to poor infrastructure distribution infrastructure—roads, rail, trams, and monorail, ports, underpinning the agri‐food systems (WHO, 2020). Also, even shipping, and inland waterways, and air transport) and restricted where different types of infrastructure exist, their designs are not focus quantitative studies. Hence the study doesn't have a specific, always gender‐inclusive, hampering women's and girls' access to detailed focus to be used in this map. food (Morgan, 2020). While gender equality implies equal rights, Previous systematic reviews (see e.g., Nandi, 2021), in addition to responsibilities, and opportunities for women, men, boys, and impact evaluations (see e.g., Kihiu, 2021), have analyzed the effect of girls; women and girls are disproportionately affected by persist- specific infrastructure on the outcome variables of interest (see also ent gender inequalities when accessing infrastructure (United Bryan, 2022; Dinkelman, 2011; Mahmud, 2018; Passarelli, 2018; Nations Secretariat and United Nations Entity for Gender Equality Stifel, 2017). This study is the first to provide comprehensive evidence and the Empowerment of Women, 2020). Women and girls are and gap on the impact of a wider typology of infrastructure on unable to access the basic services to support their upward social nutrition, women empowerment, and gender equality in LMICs to mobility and reduce the gender gap because most infrastructure in inform research and evidence on the impact of infrastructure on developing countries is underdeveloped and gender‐blind. Conse- nutritious diet, WEE, and gender equality. By doing so, it will inform the quently, “gender‐blind infrastructure fails to consider the different design and evidence‐informed decision‐making on infrastructure to roles, responsibilities, and particular needs of women, men, girls, achieve broader goals enunciated in the SDGs (2, 3, 5, and 10). and boys in a specific context and how this affects their ability to Additionally, this study would provide evidence and gaps on the level of use or access infrastructure” (Morgan, 2020). Gender inclusivity advancement of gender equality as set out in the Beijing Declaration must guide the design and uptake of future infrastructure, and Platform for Action (UN Women, 1995). especially those related to agri‐food systems (Mohun, 2016; Morgan, 2020). Shively (2017a) argues that well‐functioning infrastructure such 1.2 | Conceptual framework (the theory of change) as market centers and roads could foster gender‐inclusive socio- economic development and mitigate the adverse effects of The lack of well‐functioning infrastructure poses a substantial risk to seasonality on the availability and price of nutritious food. Shively rural livelihoods and threatens food and nutrition security; depriving (2017b) found that investments in health, market infrastructure, millions of LICs of safe, nutritious, and affordable food (WHO, 2020), agricultural innovations, and transport infrastructure positively particularly women and girls. The conceptual framework of this EGM correlate with child nutritional status in developing countries. explains how the interventions mentioned above are hypothesized to Additionally, infrastructure is a game‐changer for development affect the three outcomes of interest ‐ nutritious diets, WEE, and and enhances women's economic opportunities; because when gender equality (Figure 1). The framework demonstrates how more women get the chance to work, it makes their families, infrastructure typologies lead to either short or intermediate‐term communities and countries wealthier (Mohun, 2016). Hence, well‐ outcomes, which eventually result in long‐term outcomes. Four designed and gender‐inclusive investment in infrastructure can infrastructure typologies are explained in this framework. They support meeting various SDGs, among which are SDGs 1, 2, 3, 5, 6, include; production infrastructure where interventions such as 7, and 8 (World, 2020). Nonetheless, to the best of our knowledge, irrigation, greenhouse, and on‐farm energy are considered. The no study has explored the extent of existing evidence and gap on second infrastructure is post‐production infrastructure where inter- the impact of infrastructure on Nutritious Diets, while also ventions such as market facilities, processing facilities, storage empowering women and promoting gender equality in LMICs. To facilities, and off‐farm energy were considered. The third infra- address this gap, the International Centre for Evaluation and structure is distribution infrastructure where interventions such as Development (ICED) is designing an evidence and gap map (EGM) roads, railways, and bridges were considered and finally, the fourth to review all relevant evidence on links connecting some pertinent infrastructure is information infrastructure where interventions such 18911803, 2023, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/cl2.1353 by University of Ghana - Accra, Wiley Online Library on [02/10/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License ODEI OBENG‐AMOAKO ET AL. | 3 of 15 F IGURE 1 Conceptual framework for the theory of change. as telecommunication masts, radio stations, and information centers as employment to these women and creates both social and were considered. economic opportunities for these women which eventually Production infrastructure which comprises interventions like results in their empowerment as well as equality. irrigation systems, greenhouse and energy systems used for on‐ Post‐production infrastructure comprises of market, proces- farm activities impact all three outcomes through various sing, storage facilities as well as energy systems used for off‐farm channels. For instance, by using irrigation facilities, farmers can activities. An intervention like market facility leads to reduction in produce crops throughout the year reducing the effect of post‐harvest losses which enhances the income of the individual seasonality. Production infrastructure does not only enhance and the household as well as improves the availability of food at multiple crop cycles and reduce seasonality but also improves the market level. As a result of improvement in income, households access to the market. These improve food productivity at the can afford food which in the long‐term leads to nutritious diet. farm level. As a result of the improvement in food productivity at Similarly, with food being available as a result of reduction in post‐ the farm level, the income of farmers is improved, and food harvest loss, individuals or households enhance their consumption becomes available at the farm gate as well as the market level. of food which also leads to nutritious diet in the long‐term. In SSA The availability of food enhances both individual and household and SA most of the processing and storage facilities are operated food consumption eventually leading to nutritious diet. Income of or owned by women (Negash, 2015). Operation of these facilities farmers also enhances food affordability which also leads to leads to both social and economic opportunities for these women nutritious diet. Production infrastructure also results in WEE and as well as employment. This in the long‐term leads to empower- gender equality. The production infrastructure enhances the ment of these women as well as bridging the equality gap. Another emergency of markets. Women take advantage of these markets channel where this post‐production infrastructure can lead to WEE to open retail stores where they can sell commodities. This serves and gender equality is through ownership and operating of retail 18911803, 2023, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/cl2.1353 by University of Ghana - Accra, Wiley Online Library on [02/10/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 4 of 15 | ODEI OBENG‐AMOAKO ET AL. markets or stores. As shown in the overall theory of change, due to for use by relevant stakeholders such as researchers, research the presence of storage facilities, food can be stored for future commissioners, policymakers, and practitioners (Saran, 2018). We use. They can also be processed into another state other than will not synthesize the results as done in systematic reviews the raw state from the farm. With this, women who are largely the (Potter, 2010). The proposed EGM will serve as a platform for a operators or owners of small retail stores or outlets gain body of evidence on the relationship between infrastructure, employment. nutritious diets, WEE, and gender equality. The EGM will be made Distribution infrastructure enhances access to transportation accessible to its potential users. networks which lead to reduction in transportation cost for producers in both the input and product market. Reduction in transportation cost of produce leads to a reduction in input prices 3.2 | Scope of EGM which enhances food productivity. Food productivity will lead to food availability at the farm level as well as improvement of We will apply the stipulated procedures and standards described in income of both the farmer and the household. This eventually led the Campbell Collaboration checklist and guidance for EGMs to nutritious diet in the long‐term. Also, with the reduction of (White, 2018; White, 2020). The scope of this proposed EGM will transport cost, women are encouraged to establish market outlets be guided by the population, intervention, comparison, outcomes, and retails stores. This creates employment for these women, and study designs (PICOS framework). It will cover studies that improve their income levels as well as enable them to take up demonstrate the effect/impact of physical infrastructure—as a social roles in the community. In the long‐term, the establishment result of establishing or upgrading ‐ on nutritious diets, WEE, and of the road which is a distribution infrastructure intervention gender equality (see Table 2 for the indicators for the outcomes). ensures that the women are empowered and bridged the gender We do not look at the intersection between the three outcomes of equality gap. Investment in information infrastructure, like radio interest. Evaluation and studies examining the effects of infra- stations and information centers, improves information dissemi- structural interventions on the outcomes of interest using quantita- nation about nutrition. With enhanced knowledge of nutrition, tive (i.e., experimental, quasi‐experimental, and non‐experimental), households or individuals make informed decisions about that systematic reviews, and meta‐analyses, will be covered in this EGM. diet which eventually leads to nutritious diet. Unlike most other previous EGMs, we will also include studies with qualitative study designs. Similar to previous EGMs (e.g., CGIAR, 2021; Moore, 2021), this EGM will include studies published 2 | OBJECTIVES in the year 2000 and beyond for two main reasons. First, based on a preliminary search, we find out that most of the relevant studies are This EGM aims to identify, map, and provide an overview of the from 2000, and hence doing an unrestricted search would result in existing evidence and gaps on the impact of different types of more studies that are not relevant, which increases the screening physical infrastructure on various outcomes of LICs' nutritious diet, task to the team. Second, we are interested in the evidence and gap WEE, and gender equality in LMICs. The specific objectives of the in the recent literature. EGM are: • Identify clusters of evidence that offer opportunities for evidence 3.2.1 | Population synthesis. • Identify gaps in evidence where new studies, research, and The population of interest for this EGM is LICs living in LMICs evaluations are needed. across SSA and SA regions. We define LICs as “individuals whose financial resources or income results in them being unable to obtain the goods and services needed for an “adequate” and “socially 3 | METHODS acceptable” standard of living” (Darley, 1985). We will exclude a study from the EGM if it was conducted in countries other than 3.1 | Defining an EGM LMICs as classified by the World Bank in 2022. We define LMICs listed under SSA and SA with per capita Gross National Income Several definitions of an EGM exist in the literature (e.g., Lum, 2011; (GNI) below USD12,695. This definition encompasses lower‐income Saran, 2018; Snilstveit, 2013). Following Saran (2018), we define an countries (GNI less than USD1, 046), LMICs (GNI ranging from US EGM as “a systematic visual presentation of the availability of $1046 to 4095), and upper‐middle‐income countries (GNI per capita relevant evidence of effects for a particular policy domain.” The between US$4096 and US$12,695) (World Bank, 2022). However, evidence is identified by a search following a pre‐specified, if a study conducted in the LMIC does not specifically focus on LICs published search protocol. Along with the map, the study will but presents a general population that paper will be eligible for our present a descriptive report that summarizes the evidence and gap study. Unless the authors state that the study population was urban 18911803, 2023, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/cl2.1353 by University of Ghana - Accra, Wiley Online Library on [02/10/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License ODEI OBENG‐AMOAKO ET AL. | 5 of 15 rich then that paper will be illegible for the EGM. LMIC classification physical infrastructure have been implemented by government was not based on the year of intervention or previous country and development organizations in improving welfare in develop- status to avoid complications. We used the LMIC classification by ing countries to meet the needs of LIC as well as women and girls. the World Bank as of 2022. We will use the World Bank's income classification in 2022 as the basis for deciding which countries are considered LMICs. 3.2.3 | Comparison This EGM does not specify a comparison group. However, studies 3.2.2 | Intervention with comparison groups or designs that estimate impact using data from treated and untreated observations (such as difference‐in‐ The intervention for this EGM is establishing new or upgrading differences) will be included. existing physical infrastructure, which refers to establishing new or upgrading existing physical infrastructures that are relevant for agriculture, food production, marketing, and thus 3.2.4 | Outcomes local development. While infrastructure can be broadly defined as the basic physical and organizational structures and facilities (e.g., The EGM focuses on three outcomes: nutritious diets, WEE, and markets, roads, power supplies, etc.) needed for a society or gender equality. The categories and sub‐categories are presented in enterprise (Oxford, 2018; World, 2022), this EGM is limited in Table 2. scope to the impact of the physical presence of infrastructures, not services provided by them. This EGM will focus on four types of infrastructure (see Table 1 for description): These are: (i.) 3.2.5 | Study designs production (such as irrigation systems and water wells); (ii.) post‐ production (such as market centers and storage facilities); (iii.) This EGM targets both published and unpublished studies, reports, distribution (such as transportation‐ roads, bridges); and (iv.) and reviews that had applied mixed methods, quantitative and/or Information infrastructure (such as masts and radio stations). The qualitative methods with the following study designs: choice of the categories is based on two considerations. First, the focus of the study is on the physical infrastructure mostly used by • Effectiveness studies (impact evaluations studies that used LICs whose welfare impacts could be quantified in developing Randomized Controlled Trials (RCTs) and quasi‐experimental countries, particularly in SSA. Second, these broad categories of studies). TABLE 1 Categories, sub‐categories, and intervention examples (infrastructure). Categories of infrastructures Definition Sub‐categorya Production Facilities that are used in agricultural Irrigation systems, water wells, greenhouse, on‐farm power infrastructure production or any other facilities that are in supply (energy) place to enhance agricultural productivity. Post‐production Facilities that are used for storing, processing, – Storage (warehouses and sheds, cold rooms, pack houses) infrastructure and marketing products as well as facilities – Processing (grain mills) that are used to ensure the supply of – Market place (spaces, stalls, and lockups, provided with healthy foods in safe environments. sanitary facilities (toilets) and childcare centers) – Off‐farm power supply (energy) – Others (Slaughterhouses, landing sites, livestock vaccination parks) Distribution Facilities that are used for transporting inputs – Roads, infrastructure and products to ensure that LICs, including – Railways, farmers, have access to markets and – Bridges increased access to nutritious and diversified foods. Information Facilities used to support the dissemination of Information centers, radio stations, provision of infrastructure information on good agricultural practices, telecommunication masts to facilitate and enhance nutritional knowledge, child feeding communication practices, weather information, markets, and credit, etc. aSee Supporting Information: Appendix 1 for definitions of some of sub‐categories of infrastructure considered in the evidence and gap map. 18911803, 2023, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/cl2.1353 by University of Ghana - Accra, Wiley Online Library on [02/10/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 6 of 15 | ODEI OBENG‐AMOAKO ET AL. • Non‐experimental quantitative studies. Geographical location • Process evaluations. Eligible studies for the EGM must have targeted LICs living in LMICs • Summative evaluations. across SSA and SA regions. We will also include studies that • Qualitative studies. considered both eligible and ineligible participants (population) • Systematic reviews and meta‐analysis of eligible studies. irrespective of whether they reported their data and results separately. These studies will be coded for the eligible population during the data extraction. Nevertheless, we will enrich the rationale 3.2.6 | How we plan to handle adverse outcomes of the EGM when necessary, with relevant studies conducted in other geographic areas as in CGIAR (2021). Adverse effects of infrastructural intervention reported in the eligible papers will be captured in the EGM to avoid one‐sided summaries of Timeframe evidence (White, 2020). To accommodate this, we labeled our This EGM will include studies published/reported in the years outcome as neutral so that studies that report either of the outcomes 2000 and onwards. are coded in the relevant subdomains. Thus, if a paper reports desirable outcomes as well as undesirable outcomes for the specific Language subdomain, we will code the paper in the subdomain under Studies written in English will be included in the EGM. This is consideration. If the paper reports a desirable outcome in one because most of the researchers of the current study are only subdomain and an undesirable outcome in another subdomain, the English‐speaking meaning that considering studies that are not paper will be coded in both subdomains. written in English will require additional resources for translation (Neimann, 2018). 3.3 | Criteria for including and excluding studies 3.3.2 | Exclusion criteria We will assess the eligibility of the included studies (i.e., published, and unpublished) based on the population, interven- Studies published in languages other than English and conducted in tion, outcome, and study design (PICOS) defined for this EGM locations other than LMICs in SSA and SA will be excluded from this (White et al., 2018). EGM. Furthermore, this EGM will not include studies in areas other than LICs. Studies conducted in the period before the year 2000 will be excluded. Also, studies on infrastructure that are relatively less 3.3.1 | Inclusion criteria prevalent in LMIC and less accessible to the LICs in the LMIC, such as airports and harbors will be excluded from the EGM. Studies that do Type of studies not assess the causal linkage of one or more of the infrastructural This EGM will include all kinds of studies that applied all kinds of interventions on a nutritious diet, WEE, and gender equality as study study designs, such as quantitative, qualitative, or mixed methods. outcomes will not be included in the EGM. Eligible study designs will consist of studies that assess infrastruc- ture's impact on nutritious diets, WEE, and gender equality and will include, but not be limited to the following: effectiveness studies 3.4 | Search strategy, screening, and coding (impact evaluations/experimental studies); modeling studies (only if the model was based on primary data and not hypothetical values) 3.4.1 | Search strategy process evaluations; summative evaluations; qualitative assess- ments; and analytical frameworks. Having a wide range of study With the support of an information specialist, we will adopt a search designs in this EGM will provide the opportunity (i) to include all strategy that will identify all potential published and unpublished potential studies given the paucity of literature on the topic of studies for this EGM. This will help minimize publication bias. We will interest and (ii) to assess the extent of evidence across a spectrum search for potential studies from three relevant scientific and of study designs. Eligible qualitative studies should have a clear academic databases: CAB Abstract, Greenfile Ebsco, and Medline description of research methods (such as e.g., exploratory, narrative, Pubmed. Also, we will search for additional potential papers using deductive, inductive, ethnographic, and grounded theory ap- OpenAlex in Eppi‐reviewer software (Thomas, 2010). OpenAlex is an proaches) and a detailed description of data collection techniques index of hundreds of millions of interconnected entities across the (focus group discussion, in‐depth interviews, key informants, sample global research system (Priem, 2022). We will also do a search on size). Systematic reviews and meta‐analyses of the eligible primary databases such as Agriculture, Nutrition and Health (ANH) Academy studies will be included in the EGM. We will consider peer‐reviewed for proceedings of conferences and abstracts. papers, pre‐prints, reports, and other documents (e.g., discussion We will also search for studies and papers/reports from websites papers, working papers). of relevant organizations, such as theWorld Bank, International Fund 18911803, 2023, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/cl2.1353 by University of Ghana - Accra, Wiley Online Library on [02/10/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License ODEI OBENG‐AMOAKO ET AL. | 7 of 15 TABLE 2 Definition of outcomes. Outcome domains Sub‐outcomes Examples of indicators Nutritious diets Food availability: Farm level Quantity of food produced per area (kg/hectare) Food Availability: Market Availability of nutritious foods (fruits, vegetables, dairy, eggs, level food meat, fish, legumes, nuts) (e.g., specific metrics could be market volumes sold or transported or aggregated, number of market stands selling these items, etc.), Market Level Dietary Score (MLDS): Number of foods or food groups available in local markets at a given point in time Food accessibility: Affordability – The volatility of food prices – Income variation in food access – Market Level Dietary Score (MLDS): Number of foods or food groups available in local markets at a given point in time. – Weather seasonality indexes in agriculture – Women empowerment in nutrition index (WENI) Food accessibility: Consumption Per capita dietary energy supply (DES)kcal/per capita/day, and experiences Food Consumption Score (FCS), Food Groups Consumed, food variety score, Food Insecurity Experience Scale (FIES), HOusehold Food Insecurity Access Scale (HFIAS), Household Hunger Scale (HHS) Diet qualitya (nutrient adequacy) Individual dietary diversity scores (DDS), Minimum Acceptable individual dietary diversity Diet (MAD) for infant/child (6–23 months), Minimum Dietary Diversity (MDD) for infant/child (6–23 months), Minimum Dietary Diversity for Women between 15–49 years (MDD‐W), Mean adequacy ratio (MAR): measures an individual's intake of the nutrient Diet qualitya (nutrient adequacy) Household dietary diversity scores (HDDS) household dietary diversity Socioeconomic and cultural Women empowerment in nutrition index (WENI), food dimensions of foods preferences Women's Economic Agricultural production Input in production decisions, autonomy in production Empowerment Access and control over Ownership of assets; purchase, sale, or transfer of assets: access productive resources to, and decisions on credit Income Control over the use of income Time allocation – Workload, Leisure Leadership Group Member, Speaking in Public Women Empowerment in Women Empowerment in Agriculture Index (WEAI)b Agriculture Gender Parity Index (GPI)c Women's achievements in the 5 domains (5DE),d relative to the men in their householdse Gender Equality Economic Opportunities and Women and men have equal opportunities in agricultural Outcomes production systems, value chains, markets, resources (GAGP),f and entrepreneurship Social outcomes Discriminatory and unequal social, cultural and gender norms change to enable women and men to participate equally in household and community institutions Leadership, Agency, and – Women's agency, leadership, and decision‐making are Collective Action recognized and affirmed in the household and community – Women can engage in collective action to protect their interests (Continues) 18911803, 2023, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/cl2.1353 by University of Ghana - Accra, Wiley Online Library on [02/10/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 8 of 15 | ODEI OBENG‐AMOAKO ET AL. TABLE 2 (Continued) Outcome domains Sub‐outcomes Examples of indicators Reduced Exposure to Risk – Gender‐based violence (Cf. Pro‐WEAI +MI)‐ legislation and institutions exist to protect against GBV, and women are empowered to take action, leading to low and reduced rates of GBVg aDietary diversity represents qualitative measures of individual or household food consumption that reflect access to a variety of food groups and is used as a proxy for nutrient adequacy of the diet of individuals (INDDEX, 2015; INDDEX, 2018). We usually count 9 food groups listed as follows: (1) cereals, (2) starchy roots, (3) legumes, (4) vegetables and fruits, (5) sugars, preserves, and syrups, (6) meat, fish, and eggs, (7) milk and milk products, (8) fats and oils, and (9) beverages. bThis is measured using theWomen's Empowerment in Agriculture Index (WEAI) (Alkire, 2013). WEAI is an aggregate index and is composed of two sub‐ indexes‐ the five domains of empowerment (5DE), and the gender parity index (GPI). 5 Domains of empowerment (5DE), specified in the sub‐outcomes (Alkire, 2013). The overall WEAI is a weighted average of 5DE and GPI, with weights of 0.9 and 0.1, respectively (Malapit, 2015). cThe GPI measures women's achievements in the five domains compared with the men in their households. All these indexes have values ranging from 0 to 1, where higher values reflect greater empowerment. Households are classified as having gender parity if either the woman is empowered (her empowerment score is 80% or higher), or her score is greater than or equal to the empowerment score of the male decision‐maker in her household. It is only calculated for dual‐headed households. dThe 5DE is constructed from individual level empowerment scores which reflect each person's achievements in the five sub‐outcomes (see Table 2) and measured by the 10 indicators with their corresponding weights. Each indicator measures whether an individual has surpassed a given threshold, or has adequate achievement, with respect to each indicator. eAs in Malapit (2015) (op cit.), note, gender parity is not equal to gender equality. fGender Assets Gap Project. Cf. (Deere, 2013). gAccording to Nationen (2015), unsafe market spaces, transport, and public spaces expose women workers and traders to violence and limit their economic opportunities. for Agricultural Development (IFAD), United Nations Women, United All the eligible papers will be converted into Research Information Nations Food and Agriculture Organization (FAO), International Food System (RIS) and uploaded into EPPI‐Reviewer software Policy Research Institute (IFPRI) and the Alliance for a Green (Thomas, 2010). We will keep a log of literature search activities Revolution in Africa (AGRA) and IMMANA grant database (Support- for reporting purposes. ing Information: Appendix 2). We will also search the organizational websites and repositories of CGIAR group, IFAD, IIED, AgriProFocus, Bill and Melinda Gate Foundation, Donor Committee for Enterprise 3.4.2 | Search terms Development, Swiss Agency for Development and Cooperation, Department for International Development (DFID), Innovation Based on the PICOS framework, we will generate search terms for Poverty Action (IPA) and The Abdul Latif Jameel Poverty Action retrieving published studies or reports from electronic databases. As Lab (J‐PAL), USAID Development Experience Clearinghouse and indicated earlier, we intend to include studies with any study designs, United Nations Office for Project Services (UNOPS). including qualitative studies and process evaluation. Hence, the We will use the backward‐track citations approach to check for search terms for this EGM will not be restricted to any study design. additional primary studies, reviews, and meta‐analyses that may not Rather, we will use study designs as filters in displaying the EGM. be identified in our search but are eligible for our EGM. We will Supporting Information: Appendix 2 shows the list of organizational particularly look out for authors who are most cited in papers in the websites for gray literature search. While Supporting Information: subject matter field for additional information on completed or Appendix 3 shows examples of the search terms we will use to search ongoing studies to ensure that we capture all important evidence in for the studies/papers. the EGM. We will also look for ongoing and completed studies in trials, as well as reviews, and EGMs in registries or repositories. Including ongoing studies will provide information on emerging 3.4.3 | Screening and coding future studies and hence inform future plans for updating the EGM. However, we will restrict a timeframe of not more than 5 years within Before screening the potential studies or papers, all duplicates which a new study was registered as a decision rule to avoid including will be identified and removed using the EPPI‐Reviewer software. uncompleted studies which are long overdue. To make screening of the papers faster, we will adopt a machine We will glean additional studies in gray literature, evaluation learning model to aid the ordering of the identified papers by reports, and academic theses. Existing relevant EGMs conducted by relevance/priority based on the eligibility criteria for the organizations such as Campbell Collaboration and 3ie will be a proposed EGM review. Eligibility screening of published and valuable resource for potential studies we could include in our EGM. unpublished studies or papers for the EGM will involve two 18911803, 2023, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/cl2.1353 by University of Ghana - Accra, Wiley Online Library on [02/10/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License ODEI OBENG‐AMOAKO ET AL. | 9 of 15 stages. First, the studies will be screened for title and abstract 3.4.4 | Data cleaning based on the eligibility criteria (inclusion and exclusion criteria) as shown in Figure 2. Second, a full‐text screening will be under- The coded data set in the EPPI‐Reviewer will be cleaned before taken for the studies to be included based on title and abstract analysis. We will use univariate analysis to examine any out‐of‐range screening. All studies will be screened by two reviewers codes. We will investigate the reasons for the outliers and address independently. In cases of discrepancies in the decision to them. The team will thoroughly review random samples of the data. include or exclude a paper for the EGM, the reviewers will All missing papers will be identified, and if possible, corresponding discuss and if they disagree, a third reviewer will conduct the authors will be contacted them to ensure that all relevant literature is screening independently to resolve the differences. Then studies included in the EGM (White, 2020). that are included in the EGM will be coded and extracted. We will use EPPI‐Reviewer for coding, data management, and analysis (Thomas, 2010). Each study or paper will be coded in EPPI‐ 3.4.5 | Data analysis plan Reviewer based on a predefined form and duplicate data extracted for comparison (refer to Supporting Information: The unit of analysis of the EGM will be a study, meaning that each Appendix 4: Coding form). item entered in the EPPI‐Reviewer will represent a study. A study is F IGURE 2 Screening tool showing inclusion and exclusion criteria. 18911803, 2023, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/cl2.1353 by University of Ghana - Accra, Wiley Online Library on [02/10/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 10 of 15 | ODEI OBENG‐AMOAKO ET AL. defined as an analysis of a unique sample, which may include multiple employed by the eligible studies as filters for displaying the EGM time points for the same sample (White, 2018). As in other EGMs, (White, 2020). when multiple publications are identified on a single study, for instance, a working paper and a published paper, we will consider including the most recent open‐access publication in the EGM 3.5 | Pilot study of EGM (Malhotra, 2021). Suppose a study reports on multiple interventions or outcomes or study designs, the study will be considered as one Before creating our EGM, we pilot our search strategy, screening, and entry in the EGM but will be assigned codes for the interventions or coding tools for the proposed EGM. In a pilot study, we will test and outcomes, or study designs. Similarly, if a single study has multiple develop our search strategy in an iterative process. We will assess the interventions with some being ineligible for our EGM, we will only suitability of the coding form with a small number (20–30) of the consider the interventions relevant to our EGM. eligible studies for the EGM (Albers, 2019; White, 2020). The EGM However, primary studies appearing in a systematic review that framework, that is, the row and column headings for the interventins qualify for our EGM will be considered as a unit of analysis and will be and outcomes with their sub‐categories, search strategy, and the counted once. coding form will be revised, refined, and re‐defined based on Summary statistics such as percentages will be used to describe the findings of the pilot study after each round of the pilot exercise the distribution and characteristics of the studies in the EGM. The (White, 2020). While we will consider refining the labels of findings will be presented in graphs, tabulations, and cross‐ the categories of interventions, outcomes as well as filters, which tabulations of intervention versus outcomes categories, regions, we have not previously thought of in the iterative pilot exercises, we and study design in a narrative report for the EGM. We will then will be cautious not to make our map cumbersome and not summarize and synthesize the results to identify clusters of evidence user‐friendly (White, 2020). We will conduct a trial of the EGM to and gaps. The utility of the EGM and any potential limitations assess the practicality of EGM presentation and features as part of identified will be discussed. EPPI‐Reviewer software will be used to the pilot exercise. The trial EGM will be shared with our stakeholders generate descriptive statistics for the technical report and to create (development practitioners, academicians, policymakers, Campbell the EGM based on the data uploaded into the EPPI‐Reviewer Collaboration, and Bill and Melinda Gates Foundation) to seek their (Thomas, 2010). feedback on the EGM features such as the searchable filters, and labels for the row and column headers. We will include the final search strategy and coding forms in our EGM protocol. The principal 3.4.6 | Presentation of EGM investigator (PI) and the same team of researchers dedicated to EGM development will conduct both the pilot exercise as well as the actual Like the EGM on transport by Malhotra (2021), our EGM will consist EGM (White, 2020). of a matrix with searchable filters. The interventions and outcomes are the two main dimensions of an EGM matrix. Through a consultative engagement with critical stakeholders (Campbell Collab- 3.6 | Stakeholder engagement oration and Bill and Melinda Gates Foundation), we will define the map framework: the row and heading titles and filters. We anticipate We will consult development practitioners, academicians, and that the matrix will have intervention categories and subcategories as policymakers familiar with the subject matter of the scope, design, row headings against outcomes domains and subdomains as column and production of the EGM. We will work closely with the Campbell headings. The matrix cells will contain the studies relevant to that Collaboration from the conceptualization, design, and production of intervention and outcome combination. The searchable filters will the EGM. We will also consult the Bill and Melinda Gates Foundation cover interventions, study design, study status (completed and and other similar stakeholders (e.g., MasterCard Foundation) for their ongoing), country and region, and location (Malhotra, 2021; input at every stage of the EGM development. We will work with White, 2018). relevant stakeholders to disseminate the final EGM amongst relevant organizations, institutions, and networks. The EGM will be a public good; it will be published in an open‐access journal so that it is 3.4.7 | Critical quality appraisal of studies accessible to everyone. We anticipate that the findings of our EGM will inform future decision‐making on research and funding priorities Appraising the quality of the primary studies will require the use of on infrastructure, nutritious diets, WEE, and gender equality. a checklist per the study design employed in each primary research, which is time‐consuming. Hence, given the tight deadline for delivering the EGM, we will not appraise the quality of the primary 3.7 | Plans to update EGM studies. We are not also appraising the quality of reviews included in the EGM as the number of reviews included in the EGM is very The proposed EGM will be updated every two years when sufficient few. However, we will code and present the study designs further studies and resources become available. 18911803, 2023, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/cl2.1353 by University of Ghana - Accra, Wiley Online Library on [02/10/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License ODEI OBENG‐AMOAKO ET AL. | 11 of 15 3.8 | Sources of technical and financial support • Gloria Odei Obeng‐Amoako, a nutrition specialist at ICED and experienced in research, has been working in the field of This EGM will be developed in collaboration with Campbell nutrition, public health, and epidemiology for over a decade. Collaboration. Campbell Collaboration has a track record of experience in EGM production and capacity building for EGM. EGM methods expertise Campbell Collaboration will provide technical backstopping, while • David Sarfo Ameyaw, the CEO/President of ICED and the the Bill and Melinda Gates Foundation will give technical input principal investigator (PI) of this EGM. He has several years from the funder's perspectives and financial support to produce of experience in international development, monitoring, and the proposed EGM. evaluation, EGM, and research. ACKNOWLEDGMENTS All team members are skillful in research methodologies, We wish to thank Prof. Howard White for his valuable feedback and including literature search, data collection, and statistical analysis. guidance on the design of this EGM. We are thankful to The team has been trained by Campbell Collaboration and is Suchi Malhotra and Ashrita Saran for their dedication and support to therefore capable of carrying out the EGM processes like searching the team throughout the EGM development process. Our appreciation for studies, assessing their eligibility, critical quality appraisal of goes to the Associate. Prof. Hamdiyah Abena Alhassan at the University studies, and data extraction and coding. of Development Studies, Tamale, Ghana, and Dr. Armah Ralph Nii Armah affiliated with the Institute of Statistical Social and Economic Research, Information retrieval expertise the University of Ghana for their contribution to the development of the The authors will be supported by Mr. Rodney Malesi, an experienced EGM. We also wish to thank Campbell Collaboration for their technical Senior Librarian affiliated with the United States International University, support and the training programs offered to our team on EGM. We are Kenya. Mr. Malesi is an astute librarian and expert in literature retrieval grateful to the BMGF team for their review and invaluable feedback on and has been involved in several systematic reviews and EGMs. Two the scope of the EGM. The authors are also thankful to the BMGF for research assistants, Edward Kusi Asafo‐Agyei and Clarice Panyin Nyan (a providing financial support for this EGM. Ph.D. candidate at the University of Ghana) will assist with screening, coding, and quality appraisal of studies and papers to be included in the CONTRIBUTIONS OF AUTHORS EGM under the daily supervision of Gloria Odei Obeng‐Amoako and Content expertise: Pacem Kotchofa. Gloria Odei Obeng‐Amoako will assist with the • David Sarfo Ameyaw, the CEO/President of ICED, is the PI for the coordination of the daily EGM‐related activities to ensure smooth proposed EGM and a content expert in food security and implementation of the protocol and the production of the EGM. Ashrita infrastructural projects in developing countries. He has over 30 years Saran will provide support on any methodological issues that may arise of experience in leadership and practical experience in international during the EGM production. development, monitoring and evaluation, learning, research, and EGM. • Takyiwaa Manuh, the gender specialist and a distinguished University Statistical analysis Professor, Emerita, is a subject matter expert in women's empower- All the team members are skillful in statistical analysis useful for the ment and gender equality. She brings to the team several years of proposed EGM production and the generation of the technical report experience, skills, and knowledge of women's empowerment and that will accompany the EGM. gender equality in shaping the content of the EGM. • Charles Yaw Okyere is a lecturer at the Department of Agricultural DECLARATIONS OF INTEREST Economics and Agribusiness, University of Ghana, Legon, and a The authors declare that they have no conflicts of interest. Research Associate at ICED. Charles Yaw Okyere holds a Doctor Though the BMGF team will be consulted for their perspectives of Agricultural Sciences (Dr. Agr.) degree from the University of on the design of the EGM, they will not be involved in the search Bonn, Germany. His research interest is to generate rigorous for literature, screening, coding, and quality appraisal of the evidence for policy making through applying behavioral, experi- papers to be included in the EGM as well as the production of mental, and quasi‐experimental economic techniques to agricul- the EGM. ture, health, education, and welfare. • Solomon Zena Walelign, the research director of ICED, is an SOURCES OF SUPPORT experienced environmental and resource economist with expertise in Internal sources forest sciences. He is also a consultant at the World Bank and an Adjunct Assistant Professor at the University of Gondar. He brings • New Source of support, Other research experience from Nepal, Ethiopia, Kenya, and Tanzania to the team. External sources • Pacem Kotchofa, the nutrition specialist at ICED, has expertise in international development and agricultural economics. • No sources of support provided 18911803, 2023, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/cl2.1353 by University of Ghana - Accra, Wiley Online Library on [02/10/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 12 of 15 | ODEI OBENG‐AMOAKO ET AL. ORCID Bryan 2022 Gloria Adobea Odei Obeng‐Amoako https://orcid.org/0000-0001- Bryan, E., & Garner, E. (2022). Understanding the pathways to women's 5004-3701 empowerment in Northern Ghana and the relationship with small‐ scale irrigation. Agriculture and Human Values, 39(3), 905–920. 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