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Randomized Controlled Trial
. 2017 Aug;20(11):2004-2015.
doi: 10.1017/S1368980017000660. Epub 2017 Apr 17.

Implementation, utilization and influence of a community-based participatory nutrition promotion programme in rural Ethiopia: programme impact pathway analysis

Yunhee Kang  1 , Seungman Cha  2 , Sarah Yeo  3 , Parul Christian  4
Affiliations
Randomized Controlled Trial

Implementation, utilization and influence of a community-based participatory nutrition promotion programme in rural Ethiopia: programme impact pathway analysis

Yunhee Kang et al. Public Health Nutr. 2017 Aug.

Abstract

Objective: A community-based participatory nutrition promotion (CPNP) programme, involving a 2-week group nutrition session, attempted to improve child feeding and hygiene. The implementation, utilization and influence of the CPNP programme were examined by programme impact pathway (PIP) analysis.

Design: Five CPNP programme components were evaluated: (i) degree of implementation; (ii) participants' perception of the nutrition sessions; (iii) participants' message recall; (iv) utilization of feeding and hygiene practices at early programme stage; and (v) participants' engagement in other programmes.

Setting: Habro and Melka Bello districts, Ethiopia.

Subjects: Records of 372 nutrition sessions, as part of a cluster-randomized trial, among mothers (n 876 in intervention area, n 914 in control area) from a household survey and CPNP participants (n 197) from a recall survey.

Results: Overall, most activities related to nutrition sessions were successfully operated with high fidelity (>90 %), but a few elements of the protocol were only moderately achieved. The recall survey among participants showed a positive perception of the sessions (~90 %) and a moderate level of message recall (~65 %). The household survey found that the CPNP participants had higher minimum dietary diversity at the early stage (34·0 v. 19·9 %, P=0·01) and a higher involvement in the Essential Nutrition Action (ENA) programme over a year of follow-up (28·2 v. 18·3 %; P<0·0001) compared with non-participants within the intervention area.

Conclusions: Our PIP analysis suggests that CPNP was feasibly implemented, promoted a sustained utilization of proper feeding behaviours, and enhanced participation in the existing ENA programme. These findings provide a possible explanation to understanding CPNP's effectiveness.

Keywords: Child feeding and hygiene practices; Community-based participatory nutrition promotion; Process evaluation; Programme impact pathway; Undernutrition.

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Figures

Fig. 1
Fig. 1
Conceptual programme impact pathway of the community-based participatory nutrition promotion (CPNP) programme, Habro and Melka Bello districts, Ethiopia (2012–2014). (ENA, Essential Nutrition Action; CMAM, Community-based Management of Acute Malnutrition)
Fig. 2
Fig. 2
Diagram for study flow and composition of study subjects following the programme impact pathway of the community-based participatory nutrition promotion (CPNP) programme, Habro and Melka Bello districts, Ethiopia (2012–2014)
See this image and copyright information in PMC

References

    1. Central Statistical Agency, Ethiopia (2014) Ethiopia Mini Demographic and Health Survey 2014. Addis Ababa: Central Statistical Agency.
    1. Kang Y, Kim S, Sinamo S et al.. (2016) Effectiveness of a community-based nutrition programme to improve child growth in rural Ethiopia: a cluster randomized trial. Matern Child Nutr 13, e123249. - PMC - PubMed
    1. Victora CG, de Onis M, Hallal PC et al.. (2010) Worldwide timing of growth faltering: revisiting implications for interventions. Pediatrics 125, 473–480. - PubMed
    1. Kang Y, Suh YK, Debele L et al.. (2016) Effects of a community-based nutrition promotion programme on child feeding and hygiene practices among caregivers in rural Eastern Ethiopia. Public Health Nutr (Epublication ahead of print version). - PMC - PubMed
    1. Cameron DB, Mishra A & Brown AN (2016) The growth of impact evaluation for international development: how much have we learned? J Dev Effect 8, 1–21.

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