Effectiveness of a community‐based nutrition programme to improve child growth in rural Ethiopia: a cluster randomized trial

Abstract

Few trials have shown that promoting complementary feeding among young children is effective in improving child linear growth in resource-challenged settings. We designed a community-based participatory nutrition promotion (CPNP) programme adapting a Positive Deviance/Hearth approach that engaged mothers in 2-week nutrition sessions using the principles of 'learning by doing' around child feeding. We aimed to test the effectiveness of the CPNP for improving child growth in rural Ethiopia. A cluster randomized trial was implemented by adding the CPNP to the existing government nutrition programmes (six clusters) vs. government programmes only (six clusters). A total of 1790 children aged 6 to 12 months (876 in the intervention and 914 in the control areas) were enrolled and assessed on anthropometry every 3 months for a year. Multi-level mixed-effect regression analysis of longitudinal outcome data (n = 1475) examined the programme impact on growth, adjusting for clustering and enrollment characteristics. Compared with children 6 to 24 months of age in the control area, those in the intervention area had a greater increase in z scores for length-for-age [difference (diff): 0.021 z score/month, 95% CI: 0.008, 0.034] and weight-for-length (diff: 0.042 z score/month, 95% CI: 0.024, 0.059). At the end of the 12-month follow-up, children in the intervention area showed an 8.1% (P = 0.02) and 6.3% (P = 0.046) lower prevalence of stunting and underweight, respectively, after controlling for differences in the prevalence at enrollment, compared with the control group. A novel CPNP programme was effective in improving child growth and reducing undernutrition in this setting. © 2016 John Wiley & Sons Ltd.

Children with oedema recover better than those with severe wasting in outpatient therapeutic program at Boloso Sore district, Southwest Ethiopia

“…The ‘Outpatient Therapeutic Program (OTP)’ has been implemented in many countries in response to the burden of SAM. The program was intended to decentralize treatment of severe acute malnutrition (SAM) [ 3 – 5 ].…”

Factors influencing delivery of intersectoral actions to address infant stunting in Bogotá, Colombia – a mixed methods case study.

“…A further conceptual point for discussion regarding differences between intersectoral and multisectoral interventions for stunting arises from the analysis of factors that condition ISA. Nutrition-speci c interventions rely on the health sector (7) but there is ample recognition that many additional sectors have roles to play in nutrition-sensitive interventions (11,(30)(31)(32). During planning and implementation of the intervention against stunting in Bogotá, a lack of engagement of the health sector was frequently seen as a barrier for ISA.…”

Interventions to Improve Infant and Young Child Feeding Practices in Ethiopia: A Systematic Review  

“…Full-text eligibility checks of the remaining 25 articles excluded 12 studies. The reasons for exclusion of studies included: 2 studies were duplicates [41,42], 1 study was cross-sectional [43,44], 2 studies were based on interventions designed for reproductive-age women [45,46], 1 study used qualitative evaluation [47], 4 studies were abstracts [48][49][50][51], and 1 study designed for under-ve children [52] (Fig. 1).…”

“…Among the 13 included studies, ten were quasi-experimental studies [53][54][55][56][57][58][59][60][61][62], while the remaining three were cluster randomized trials [63][64][65]. At least one interventional study was conducted in Sothern Nations Nationalities and Peoples' Region (SNNPR) [56-58, 60, 61, 65], Oromia [53,56,57,62,66], Amhara [55][56][57]64], Tigray [56,58], and Afar [59] regions, but we did not nd published interventional study conducted in Addis Ababa and Dire Dawa city administrations, as well as Harari, Benishangu1, Gambella, or Somali regions.…”