Addressing child undernutrition in Tanzania with the ASTUTE program

Abstract

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.

The Impact of a Large-Scale Social and Behavior Change Communication Intervention in the Lake Zone Region of Tanzania on Knowledge, Attitudes, and Practices Related to Stunting Prevention

“…rendering any additional significant improvements in the population statistically challenging. For example, in their analysis of endline-only ASTUTE data, Beckstead et al [9] found significant associations between exposure to SBCC radio programming and a variety of IYCF practices as well as significant associations between SBCC television programming and IYCF knowledge. Significant findings between SBCC exposure and enline data from Beckstead et al may be helpful in gauging the impact of SBCC programming on indicators that are high at each of the three data collection periods in the current study.…”

“…IMA partnered with Development Media International (DMI)-its partner in the development and implementation of radio and TV spots-to design and conduct baseline, midline, and endline surveys to inform program direction and to assess impact during, in the middle, and at the end of the program. Numerous studies exploring the associations of key health outcomes and exposure to core program elements and indicators at either baseline, midline, or endline have been published previously [9][10][11][12][13][14][15][16][17][18]. Associations between knowledge of key health-promoting behaviors included in SBCC programming and stunting prevention have been significant [10,13,15].…”