Background: The role of fathers in infant and young child feeding has not been explored in Zimbabwe. To date, local research studies on the role of parents in infant and young child feeding have focused more on the mothers than the fathers, and more on breastfeeding than complementary feeding practices, which begin from 6 months of age. Purpose of study: To explore the knowledge and extent of involvement of fathers in the complementary feeding of children 6 to 23 months in Zimbabwe. Method: Through a qualitative approach, 10 fathers with children aged 6 to 23 months participated in the study. Local key informants were used to validate information given by fathers. Thematic analysis was used to identify emergent themes. Results: There has been a notable change in behaviour among the fathers in comparison to what they did 10 years ago. For example, they support their wives with household activities such as playing with the child, fetching water and firewood in bulk and cooking simple meals for their children, though the latter was generally reported as being done only during the mothers’ absence. Some of the fathers however, are still mindful of what the predominant culture defines as a father’s role in child feeding and thus only do selective activities. Major conclusion: This qualitative study, a first of its kind, delved into some of the experiences and perceptions of fathers in the complementary feeding of infants 6 to 23 months in Zimbabwe. Rich exploratory insights into the subject matter have been provided and can thus be expanded upon in future research.

The Amalima program, a United States Agency for International Development (USAID) Office of Food for Peace intervention, has been promoting Care Groups from 2014 to 2020 in a resource constrained setting in Zimbabwe. Care Groups are community-based peer-to-peer support groups for mothers, which provide a platform for promoting recommended maternal, infant and young nutrition practices. The researchers conducted a study to compare the quality of the diet for children and mothers participating in Care Groups and children and mothers not participating in Care Groups. The research was conducted in two districts (Gwanda and Tsholotsho) in Zimbabwe across 8 purposively selected sites, six years after project implementation began. A total of 242 children aged 6 to 23 months and 168 women beneficiaries were included in the study. We analysed consumption of the three non-staple food groups promoted by the Care Groups under the theme ‘Four Star Diet’ namely vegetables and fruits, legumes and animal source foods. Our results showed that children whose caregivers were members of Care Groups had a higher consumption of pulses and legumes (29% vs 1%; p = 0.00001), fruits and vegetables (33% vs 18%; p = 0.00104) and animal source foods (59% vs 26%; p = 0.00001) compared to children whose caregivers were not Care Group members. There was no difference in diet quality between women participating or not participating in Care groups. Efforts should be put in place to increase participation in Care Groups, as they serve as a key contact point to support recommended infant and young child nutrition practices during the first 1000 days of life. There is a need to explore barriers to Care Group participation and develop a strategy to address the barriers for non-Care Group participants. Future programs should explore the reasons behind the limited impact that Care Group attendance had on the diet quality for women.

Over the last decade Zimbabwe has made noteworthy progress in reducing both underweight and wasting in children under the age of five years, however one in four children in Zimbabwe is stunted. The rate in the decline of the number of children stunted still falls short of meeting the World Health Assembly target, and it goes without saying that effective, innovative community-based strategies are required by the government and development partners to accelerate the rate of stunting reduction. This paper presents experiences from using the Care Group approach for promoting improved maternal, infant and young child nutrition (MIYCN) and care based on lessons from the Amalima program, a seven-year United States Agency for International Development (USAID) Office of Food for Peace intervention. The Amalima program has been promoting Care Groups as a community and family centred approach to improve maternal and child nutrition in Zimbabwe. Care Groups are an innovative community-based strategy that has been rolled out as part of the Amalima program activities in four food and nutrition insecure districts in Zimbabwe. The final programme evaluation suggested the program succeeded in increasing the exclusive breastfeeding rate and reducing levels of nutritional stunting among children under two years. In the present discussion paper, we present the key lessons learned and strategies we believe may have contributed to making Care Group implementation effective; we highlight the modifications that we made in Care Group implementation to ensure a context appropriate approach; and we discuss how Care Groups can be integrated into the Ministry of Health and Child Care structure. The critical factors for successful Care Group implementation have been grouped into five broad categories: conduct formative research; ensure context specific approaches & adaptive management; leverage on social capital and cohesion; invest in human capital; prioritise quality assurance & reviews.

Purpose: The purpose of this scoping literature review is to explore the breadth of the available literature, and identify knowledge gaps to inform future research through the use of Rodgers evolutionary concept analysis framework. The literature review also seeks to describe the key child indices developed and their characteristics so as to guide the development of a GMP index for improved child health in Zimbabwe. Methods: The keywords growth monitoring and promotion, community health workers, caregivers of children under five years, child health indices, and index development were used to search for relevant literature from Science Direct, Google Scholar, EBSCO, and PUBMED databases in English. The initial electronic database search yielded 535 research articles, and 316 were further assessed for their relevance to the study. An additional 140 articles were excluded from the search as they did not contain adequate evidence as per the Rodgers Evolutionary Framework. After the full-text review, 80 articles out of 220 articles met the inclusion criteria. Those found to be suitable were 25 articles and were thus included in the final analysis. Results: Key Antecedents: distance and socio-cultural constraints, CHW activeness, participation of fathers in GMP activities, poor understanding and interpretation of growth charts, poor communication between caregivers and CHWs, full vaccination status and complacency; Attributes: education status of parents, knowledge, attitude, and practices of caregivers and Consequences: timely health interventions, improved child health outcomes, a platform to promote optimal child health practices of GMP activities were identified. Conclusion: More research needs to be explored to form indices that incorporate behaviour change metrics. This will lead to an increased evidence base to guide the health system, funders, and policy makers conclusively.

Objectives Amalima, a USAID Development Food Aid Program (2013–2020) led by Cultivating New Frontiers in Agriculture, supported Zimbabwean communities in Matabeleland North and South to improve food security and nutrition. In 2016, Amalima developed Indoda Emadodeni (IE), a behavior-change campaign which trained local men as Male Champions (MC) and aimed to increase their involvement in childcare, domestic chores, and support for women's participation in Amalima. Methods The IE pilot occurred in six wards in Tsholotsho and Bulilima districts from April to October 2016, involving 60 MC aged 25–67. Each MC recruited ≥ 10 male peers and hosted monthly sessions, where men discussed IE behavior change topics (i.e., men's roles in child feeding and care, household chores, and support for women in Amalima), followed by team-building soccer matches. In December 2016 during an Amalima supplementary food distribution, 100 mothers in Amalima with children < 2 years old, half with husbands in the IE pilot and half not, were randomly selected for a questionnaire about their husbands’ practice of the 12 IE target behaviors. The 12 IE behaviors in the cross-sectional questionnaire were organized by category 1) child feeding and care, 2) support for women in Amalima, and 3) household chores. Behaviors in each category were ordered and scored from poor to ideal. Each behavior was worth 1–4 points, with a total possible score of 30. An independent t-test was conducted to compare mean scores between the two groups of women sampled for the questionnaire. Results The average age of women sampled was 27.7, with a range of 17–45 years old. Most women had three children, with at least one < 2 years old. The average score among women with husbands in the IE pilot was 21.3 and the average score among women in the control group was 16.6, representing a significant difference (p value = 0.013). Conclusions These results suggest that men's participation in the Indoda Emadodeni pilot supported their improved practice of the IE target behaviors, including child feeding, care, and domestic chores. Male change agent-focused behavior change approaches, like Amalima's Indoda Emadodeni, offer a promising opportunity to increase male participation in childcare and domestic chores. Funding Sources Funding for the Amalima Development Food Aid Program was provided by the US Agency for International Development.