BackgroundStunting affects child survival and is a key indicator of child well-being. Therefore, reducing stunting is a global goal. Improving infant and young child feeding (IYCF) practices is a recommended approach to reduce the risk of mortality and ameliorate nutritional status. Behavioural change interventions have the potential to improve IYCF practices.MethodsWe evaluated the effectiveness of an innovative behavioural change strategy on caregiver’s knowledge, IYCF practices and nutritional status of children from low-income households in El Alto, Bolivia. Home visits used culturally adapted participatory play strategies to promote recommended IYCF practices. A total of 2014 households with children younger than 12 months at baseline were randomly assigned to treatment and control groups.FindingsCaregiver knowledge and IYCF practices improved by 0.2 SD, as did food expenditures on recommended foods and dietary diversity. No significant effects were detected on anthropometric indicators or anaemia. Treatment compliance was 88% of households at enrolment and 66% at completion.InterpretationParticipatory play-based behavioural change strategies are a promising delivery model to improve recommended IYCF practices. After 30 months of intervention, we found sustained positive effects on caregiver’s knowledge and IYCF practices but no effect on nutritional status. Despite the lack of effect on linear growth and anaemia, our results highlight the relevance of implementing interventions that improve IYCF practices due to their importance for early development and prevention of obesity. Other contextual variables, apart from diet, that could be limiting children’s growth potential in this population need to be identified to design holistic approaches that improve child well-being and human capital.
RESUMENEn el presente estudio se realiza la evaluación de los efectos de la migración sobre la calidad de vida de los hogares de migrantes en el departamento de Cochabamba. Para ello se construye un Indicador de Calidad de Vida (ICV) mediante un Análisis Factorial. El ICV propuesto está determinado por la riqueza material de los hogares medida como stock y como flujo, y la percepción del bienestar familiar. Para capturar los efectos de la migración sobre la calidad de vida de los hogares, tanto a nivel general como a nivel de cada componente del ICV, se construye un escenario contrafactual. Los resultados muestran que la migración internacional tiene, en promedio, un efecto neto positivo sobre la calidad de vida, pero se constatan frecuentes e intensos efectos negativos en el bienestar familiar.Palabras Clave: Migración Internacional, Bienestar, Calidad de Vida, Análisis Factorial.
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