Effects of a community-based nutrition promotion programme on child feeding and hygiene practices among caregivers in rural Eastern Ethiopia

Abstract

Objective: To evaluate the effectiveness of a community-based participatory nutrition promotion (CPNP) programme involving a 2-week group nutrition session in improving child feeding and hygiene practices among caregivers.

Design: Cluster randomized trial. In the intervention area (six clusters), the CPNP programme was added to the context of government nutrition programmes; the control area (six clusters) received the government programme only. Child feeding practices were assessed every 3 months using a 24 h dietary recall questionnaire, and hand washing with soap was assessed every 6 months, over a period of 12 months. Feeding and hygiene measures at each visit were scored and the scores summed up for the entire follow-up period.

Setting: Habro and Melka Bello districts, Ethiopia.

Subjects: Randomly selected mothers with a child aged 6-12 months (n 1790).

Results: A total of 1199 mothers, 629 in the control and 570 in the intervention areas, were assessed at all visits and included in the analysis. Mothers in the intervention area showed higher scores than those in the control area regarding meal frequency (difference: 1·04, 95 % CI 0·35, 1·73), composite feeding score_1 (difference: 1·25, 95 % CI 0·37, 2·13; a summing score of currently breast-feeding, meal frequency and dietary diversity) and composite feeding score_2 (difference: 1·40, 95 % CI 0·49, 2·32; a summing score of meal frequency and dietary diversity). However, there were no differences in the scores of breast-feeding, dietary diversity and hand washing between the two areas (all P>0·05).

Conclusions: The CPNP programme was effective in improving some child feeding behaviours in rural Eastern Ethiopia.

Keywords: Community-based participatory nutrition promotion; Composite feeding scores; Effectiveness evaluation; Ethiopia; Infant and young child feeding.

Fig. 1

CONSORT (Consolidated Standards of Reporting Trials) flow diagram for trial participants from enrolment through the 12-month follow-up, Habro and Melka Bello districts, Ethiopia (2012–2014). Each child was followed up regardless of previous follow-up status, except for cases where the family had permanently moved or child death. The total number of children to be visited at each follow-up visit was calculated by subtracting previous permanently moved or death cases from 914 in the control area and 876 in the intervention area (CMAM, Community-based Management of Acute Malnutrition; CPNP, community-based participatory nutrition promotion; ENA, Essential Nutrition Action)

Fig. 2

Child feeding and hygiene scores among study subjects in the control area () and intervention area (), Habro and Melka Bello districts, Ethiopia (2012–2014). Values are unadjusted means with their 95 % confidence intervals represented by vertical bars for: (a) currently breast-feeding score; (b) meal frequency score; (c) dietary diversity score; (d) composite feeding score_1 (score_1); (e) composite feeding score_2 (score_2); and (f) hand washing score. n 1199 for (a), (b), (c), (d) and (e); n 1350 for (f). Score_1 was constructed based on scores of breast-feeding, dietary diversity and meal frequency; score_2 was based on scores of dietary diversity and meal frequency