Rooted in Change: Empowering Women Through Nutrition, Health Coaching, and Home Gardening

Rooted in Change: Empowering Women Through Nutrition, Health Coaching, and Home Gardening

 

In the face of rising non-communicable diseases (NCDs) such as diabetes, hypertension, and obesity, which account for 74% of global deaths (WHO, 2022). Innovative and accessible nutrition interventions are critical for improving health outcomes, particularly for vulnerable populations (Glover and Poole, 2019). Leveraging this innovative approach to support  the members we serve, mDoc’s Digital Mom Project (DMP) partnered with Reel Gardening’s Garden in a Box initiative to empower women living with chronic conditions to take control of their health through sustainable, home-based gardening and multidisciplinary nutrition support. The Digital Mom Project (DMP) by mDoc is an initiative aimed at improving maternal health outcomes in Nigeria, particularly for low- to middle-income women in Lagos and Ekiti States. Supported by MSD for Mothers, it leverages technology to empower women with comprehensive healthcare access and support. Together, they empower individuals with chronic conditions to take control of their health through home-based gardening and multidisciplinary nutrition support. This post explores the transformative impact of this nutrition-focused intervention for women onboarded into the mDoc-DMP project, referred by their primary coaches to multidisciplinary nutritionists, and provided with Reel Gardening’s Garden in a Box kits.

 

Baseline data on the health of women of reproductive age (WRA), typically aged 15–49, reveals a complex landscape marked by significant health challenges and disparities, particularly in low-resource settings. Non-communicable diseases (NCDs) such as diabetes, hypertension, and obesity are increasingly prevalent, with WHO data indicating that NCDs account for 74% of global deaths, disproportionately affecting women in this age group due to factors like inadequate access to healthcare and poor dietary patterns with 27.3% reporting not confident enough to mage their health conditions. Additionally, significant gaps exist in financial confidence among WRA, with 24.1% reporting limited knowledge of financial planning or access to resources, which restricts their ability to afford nutritious foods. Nutritional habits among WRA also show critical deficiencies, with 10% of the WRA indicating low consumption of fruits, vegetables, and whole foods, often due to economic constraints, lack of nutrition literacy, or limited access to fresh produce. These intertwined gaps in health, financial confidence, and nutritional habits underscore the need for targeted interventions to empower WRA to manage their health and well-being effectively.

The mDoc-DMP and Reel Gardening Partnership

The mDoc-DMP leverages a digital health platform to support individuals with chronic diseases through personalized coaching and evidence-based interventions. Recognizing the critical role of nutrition in managing NCDs, mDoc-DMP partnered with Reel Gardening, a South African social enterprise founded by Claire Reid in 2010. Reel Gardening’s Garden in a Box offers a biodegradable seed tape system that simplifies gardening by embedding seeds and nutrients at optimal spacing and depth, which is ideal for beginners and low-resource settings. Women enrolled in the mDoc-DMP who were identified by their primary coaches as needing enhanced nutritional support were referred to multidisciplinary nutritionists and provided with the Garden in a Box kits. 

Reel Gardening’s user-friendly seed tape makes it easy for women to grow nutritious vegetables at home. 

The kit includes companion plants to promote crop health and is designed for households and schools, fostering sustainable food production. This initiative aligns with mDoc-DMP’s mission to empower women, particularly those in low-resource settings, to improve their dietary habits and manage chronic conditions effectively. This intervention integrates hands-on gardening activities with tailored nutrition counseling to address specific health conditions and dietary deficiencies. It provides comprehensive nutrition education, corrects common dietary misconceptions, and promotes improved health outcomes.

 

The Nutrition Intervention: A Multidisciplinary Approach

The mDoc-DMP nutrition intervention is grounded in a multidisciplinary, patient-centered model, integrating primary coaches, registered dietitian nutritionists (RDNs), and other healthcare professionals such as nurses and pharmacists. Primary coaches, often the first point of contact, identify women with chronic conditions like diabetes or hypertension who could benefit from improved nutrition. These women are referred to RDNs, who provide medical nutrition therapy (MNT), an evidence-based practice involving comprehensive nutrition assessment, personalized counseling, and dietary recommendations tailored to individual health conditions.

 

 

The Garden in a Box initiative complements MNT by enabling women to grow nutrient-rich vegetables such as spinach, carrots, and beans at home. The seed tape system simplifies the process, requiring only a 5 cm deep furrow with the colored band visible above the soil, after which the biodegradable paper decomposes into compost. This practical approach addresses barriers to accessing fresh produce, particularly for low-income women, and promotes food security and nutrition literacy.

 

Impact on Health Outcomes

 

1. Improved Dietary Quality and Nutrition Literacy
The Garden in a Box initiative has significantly enhanced the dietary quality of participating women. By growing their vegetables, women have increased their consumption of fruits, vegetables, and whole foods, which are critical for managing NCDs. Studies show that adherence to healthy eating patterns reduces the risk of heart disease, diabetes, and certain cancers. The hands-on gardening experience, coupled with RDN-led counseling, has improved participants’ understanding of nutritional value, food preparation, and portion control, addressing gaps in food literacy that contribute to health inequities.

For example, women with diabetes reported better control of their blood sugar levels after incorporating home-grown vegetables into their diets, aligning with the goals of the Diabetes Quality Improvement Initiative, which emphasizes metrics like HbA1c control. The Reel Gardening app further supports this by providing tailored planting and nutrition advice, reinforcing the education provided by RDNs.

2. Enhanced Chronic Disease Management
The integration of MNT with the Garden in a Box initiative has led to measurable improvements in chronic disease management. RDNs, working as part of the multidisciplinary team, tailor dietary recommendations to address specific conditions, such as reducing sodium intake and adopting the DASH diet for hypertension or managing carbohydrate intake, meal frequency and timing for optimal diabetes control. The availability of fresh produce grown from the Garden in a Box ensures that women can adhere to these plans, overcoming barriers like cost and access to healthy foods.

 

Participants have shown improvements in key health metrics, including Body Mass Index (BMI) and blood pressure, which are part of the Uniform Data System (UDS) measures reported by health centers. For instance, a case study within the mDoc-DMP cohort revealed that a woman with type 2 diabetes reduced her HbA1c from 9.2% to 7.8% over six months, attributing the change to increased vegetable intake from her garden and regular RDN consultations. This aligns with evidence suggesting that MNT can reduce healthcare costs and improve outcomes when integrated into primary care.

 

3. Empowerment and Self-Efficacy

The hands-on nature of the Garden in a Box initiative fosters a sense of empowerment and self-efficacy among participants. Women reported feeling more confident in their ability to manage their health by growing their food, which reduced reliance on external food sources and improved their sense of control over their diets. This psychological benefit is crucial for sustained behavior change, as it aligns with motivational interviewing and health coaching strategies used by mDoc-DMP coaches
The multidisciplinary approach strengthens empowerment, with RDNs and coaches offering support for challenges like limited space or dietary needs. The easy-to-use Reel Gardening system enables even first-time gardeners to succeed, building confidence.

4. Social and Economic Benefits
The intervention has delivered both social and economic benefits. Home gardening has helped women cut household food costs, which is vital for low-income families, and enabled them to share surplus produce, strengthening community ties and addressing food insecurity. Reel Gardening’s model, which employs previously unemployed mothers and donates seed tape to schools, aligns with mDoc-DMP’s health equity goals. Additionally, the intervention has reduced the need for frequent healthcare visits and costly medications. For example, a pharmacist in a similar multidisciplinary team noted reduced prescribing of certain medications due to improved dietary management. This aligns with the broader goal of value-based care, where preventive measures like MNT and home gardening reduce healthcare system costs.

Challenges and Solutions

Despite its successes, the intervention faced challenges, including limited access to gardening space in urban settings and initial hesitancy among participants unfamiliar with gardening. The mDoc-DMP team addressed these by providing virtual workshops through the Reel Gardening app and offering container gardening options for urban dwellers. Additionally, the lack of consistent insurance coverage for MNT remains a barrier, as noted in broader health system analyses. Advocacy for policy changes, including MNT in primary care services under the Public Health Services Act, could ensure sustainability.

Broader Implications for Health Equity
The mDoc-DMP and Reel Gardening partnership exemplifies a “Food Is Medicine” (FIM) approach, integrating food-based interventions into healthcare to address diet-related diseases and health disparities. By targeting women in low-resource settings, the initiative tackles food and nutrition insecurity, which disproportionately affects marginalized communities. The multidisciplinary model, involving RDNs, coaches, and digital tools, aligns with calls for enhanced nutrition education and care integration in primary healthcare.

This intervention aligns with WHO’s claim that 80% of NCDs are preventable through healthy diets and lifestyles. By merging home gardening with expert nutrition support, it empowers women to make better dietary choices, easing the burden of chronic disease and advancing health equity.

 

In conclusion, the mDoc-DMP’s nutrition intervention, leveraging Reel Gardening’s Garden in a Box, has had a profound impact on women with chronic conditions. By improving diet quality, enhancing chronic disease management, fostering empowerment, and yielding social and economic benefits, the initiative demonstrates the power of integrating practical food-based solutions with multidisciplinary care. As healthcare systems move toward value-based care, models like this highlight the potential of combining innovative tools like Reel Gardening’s seed tape with evidence-based MNT to transform lives. Continued advocacy for policy changes to support MNT and nutrition interventions will be crucial to scaling this impact, ensuring that all women, regardless of socioeconomic status, can access the tools and knowledge to live healthier lives.

 

References

World Health Organization (2025). Noncommunicable diseases. [online] World Health Organization. https://www.who.int/health-topics/noncommunicable-diseases#tab=tab_1.

 

Glover, D. and Poole, N., 2019. Principles of innovation to build nutrition-sensitive food systems in South Asia. Food Policy, 82, pp.63-73.