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Background Water access, sanitation, and hygiene (WASH) remain a public health concern in Indonesia. Proper WASH practices can decrease risk of stunting, wasting, and disease in children under the age of 2. Objective The purpose of our study is to examine if using technology to access health information and services among Indonesian women affects knowledge and behaviors regarding handwashing and defecation practices. Methods Our study is an interview-based cross-sectional survey. Participants included 1734 mothers of children under 2 years of age. These women were randomly selected and interviewed as part of a 3-stage cluster sampling technique. Our study uses data regarding WASH knowledge which includes benefits of handwashing with soap, 5 critical times of handwashing, risks of open defecation, media of disease transmission, defecation locations, and risks of open defecation. Data regarding WASH behaviors were also included: handwashing with soap, type of latrine used at home, and where defecation took place. This investigation used adjusted and unadjusted logistic and linear regression models to determine differences in WASH outcomes between those who use technology to access health information and services and those who did not. Results One result is that Indonesian women with children under 2 years of age who use technology to access health information and services are more likely to know the advantages of proper handwashing (odds ratio [OR] 2.603, 95% CI 1.666-4.067) and know the 5 critical times of handwashing (OR 1.217, 95% CI 0.969-1.528). Women who use technology to access health information are also more likely to know the risks of open defecation (OR 1.627, 95% CI 1.170-2.264) and use a type of toilet (such as a gooseneck or squat toilet) that limits risk (OR 3.858, 95% CI 2.628-5.665) compared to women who did not use technology to access health information. Conclusions Using technology to access health information and services was associated with an increase in handwashing and defecation knowledge. In the future, promoting mothers of children under 2 years of age to access health information through technology might be used to increase handwashing and defecation knowledge as well as safe defecation practices. However, further research should be done to determine how technology may increase the frequency of recommended handwashing behaviors.

Background Optimal infant and young child feeding practices (IYCFP) reduce childhood stunting and are associated with additional health benefits. In Tanzania, IYCFP are far from optimal where 32% of children under the age of 5 years are stunted. The purpose of this study was to examine whether behavior change communication focused on reducing child undernutrition was associated with improved IYCFP in Tanzania. Methods A cross-sectional survey was administered to approximately 10,000 households with children under the age of 2 at baseline and endline. Bivariate analyses and logistic regression was used to examine the relationship between exposure to behavior change communication and timely initiation of breastfeeding, exclusive breastfeeding, continued breastfeeding at one year, timely complementary feeding (CF), minimum meal frequency (MMF), minimum dietary diversity (MDD), and minimum acceptable diet (MAD). Results Mothers who heard a radio spot about IYCFP were more likely than mothers who had not heard a radio spot about IYCFP to begin complementary foods at six months. Their children were also more likely to achieve MMF, MDD, and MAD with odds ratios of 2.227 (p = 0.0061), 1.222 (p = 0.0454), 1.618 (p =  < .0001), and 1.511 (p = 0.0002), respectively. Mothers who saw a TV spot about IYCFP were more likely to have greater odds of knowing when to begin complementary feeding, feeding their child a minimally diverse diet (4 food groups or more), and serving a minimum acceptable diet with odds ratios of 1.335 (p = 0.0081), 1.360 (p = 0.0003), and 1.268 (p = 0.0156), respectively. Conclusion Exposure to behavior change communication in Tanzania was generally associated with some increased knowledge of optimal IYCFP as well as practicing IYCF behaviors. Behavior change communication planners and implementers may want to consider conducting similar campaigns as an important component of behavior change to reduce undernutrition and poor health outcomes in developing settings.

Objectives We tested the hypothesis that mothers of infants &lt; 2 y of age exposed to nutrition and health-focused radio and TV spots (M), interpersonal counselling (IPC), or both (M + IPC) were more likely than mothers with no exposure to media nor IPC to initiate breastfeeding in the first hour of life, breastfeed exclusively, introduce foods and liquids in addition to breastmilk at 6 mo, and feed the child a minimally acceptable diet. Methods Between 2016 and 2020, the Addressing Stunting in Tanzania Early (ASTUTE) project conducted a behavior change intervention in the Lake zone of Tanzania that reached 4.4 million individuals through radio and TV spots, 6.4 million through community health worker home visits, 411,000 through support groups, and 1.6 million through health facility-based counselling. We administered a cross-sectional survey to 5,000 households with children &lt; 2 y beforethe intervention and 5,000 households after program activities ended. We used bivariate analyses and logistic regression to test our hypotheses. Results Mothers exposed to M, IPC, or M + IPC were no more likely than mothers with no program exposure to breastfeed early (OR M = 0.8; IPC = 0.8; MIPC = 1.1) nor exclusively (OR M = 1.0; IPC = 0.9; M + IPC = 0.6). Program exposure was not associated with timely introduction of complementary foods but children of IPC mothers were significantly more likely to achieve minimum meal frequency (OR = 1.2, 95% CI = 1.0, 1.4) and children of IPC and M + IPC mothers were significantly more likely to achieve minimum dietary diversity (OR = 1.4, 95% CI = 1.2, 1.6; OR = 1.8, 95% CI = 1.5, 2.3). They were also more likely to be fed a minimally acceptable diet (OR for IPC = 1.5 95% CI = 1.2, 1.8; OR for M + IPC = 1.5, 95% CI = 1.2, 2.0). Adjusting for maternal age, education, and wealth attenuated our results. In separate analyses, in four of ASTUTE's five regions, reductions in stunting were 34.0% to 257.4% greater than the national average. Conclusions Exposure to mass media and IPC was not associated with breastfeeding but IPC and M + IPC children were significantly more likely than children of unexposed mothers to eat a minimally acceptable diet. In this context, program planners may wish to focus on IPC as a cost-effective approach for improving complementary feeding. Funding Sources ASTUTE was funded by UKAid (contract # PO 6803).