LAUSR

ABSTRACT Background Severe food and nutrition insecurity persists in Madagascar. The Atsimo Atsinanana region is among the most affected areas due to elevated poverty rates and low levels of resilience to frequent shocks. Implementing food and nutrition security (FNS) interventions could help to improve this situation, but to be effective and sustainable, intervention packages must fit the local context. Objectives To identify locally suitable options, this study assessed the perceptions of local communities in rural Atsimo Atsinanana toward a range of FNS intervention options. Methods We held 12 gender-disaggregated workshops with 80 prospective beneficiaries of an FNS project, from inland and coastal parts of the region. Preferences were elicited for 14 potential FNS interventions. Next, through participatory ex ante impact assessment, participants ranked 8 impact criteria and individually estimated expected impacts of all intervention options on these criteria. Results Overall, participants preferred interventions targeting on-farm crop, vegetable, and livestock production. Income and food self-sufficiency were ranked as the highest intervention priorities. However, intervention preferences differed by gender and geographic location. Whereas preferences for interventions targeting dietary habits were weak across genders, women had relatively stronger preferences for these interventions than men. This shows that collecting gender-disaggregated preferences can enable more gender-sensitive choice of interventions. Preferences also reflected local livelihoods, as more market-oriented coastal sites showed stronger interest in income generation than more subsistence-oriented inland sites. The ex ante impact assessments highlight positive and negative expectations for most interventions, with increased labor burden being the most prominent negative impact overall. Conclusions The findings suggest that participatory, multidimensional impact assessments before project implementation can support development stakeholders in tailoring intervention packages, considering 1) local and gendered preferences and 2) trade-offs among development objectives.