Behavior Change Interventions Delivered through Interpersonal Communication, Agricultural Activities, Community Mobilization, and Mass Media Increase Complementary Feeding Practices and Reduce Child Stunting in Ethiopia

Autor: Phuong H. Nguyen, Elizabeth Drummond, Purnima Menon, Edward Frongillo, Marie T. Ruel, Yewelsew Abebe, Yisehac Yohannes, Sunny S. Kim, Manisha Tharaney
Rok vydání: 2019
Předmět:
Zdroj: The Journal of Nutrition
ISSN: 0022-3166
Popis: Background Appropriate infant and young child feeding practices are critical for optimal child growth and development, but in Ethiopia, complementary feeding (CF) practices are very poor. Alive & Thrive (A&T) provided intensive behavior change interventions through 4 platforms: interpersonal communication (IPC), nutrition-sensitive agricultural activities (AG), community mobilization (CM), and mass media (MM). Objectives The aim of this study was to evaluate the impact of A&T intensive compared with nonintensive interventions (standard nutrition counseling and agricultural extension service and less intensive CM and MM) on CF practices and knowledge and child anthropometric outcomes. Methods We used a cluster-randomized evaluation design with cross-sectional surveys among households with children aged 6–23.9 mo [n = 2646 at baseline (2015) and n = 2720 at endline (2017)]. We derived difference-in-difference impact estimates (DDEs) and conducted dose–response and path analyses to document plausibility of impacts. Results At endline, exposure to IPC was 17.8–32.3%, exposure to AG was 22.7–36.0%, exposure to CM was 18.6–54.3%, and exposure to MM was 35.4% in the intensive group. Minimum dietary diversity and minimum acceptable diet increased significantly in the intensive group but remained low at endline (24.9% and 18.2%, respectively). Significant differential declines in stunting prevalence were observed (DDE: −5.6 percentage points; P
Databáze: OpenAIRE