Associations between parents' exposure to a multisectoral programme and infant and young child feeding practices in Nepal

Abstract

In Nepal, an at‐scale, multisectoral programme— Suaahara (2011–2023)—aims to improve nutrition behaviours. Suaahara II (2016–2023) transitioned from a mother/child dyad focus to explicitly targeting all family members. Evidence is scant, however, regarding how exposure by men to social and behaviour change interventions relates to nutrition outcomes. This study uses a 2019 cross‐sectional monitoring dataset to test associations between maternal and male household head exposure to Suaahara II interventions (interacting with a frontline worker, participating in a community event or listening to the Bhanchhin Aama radio programme) and adoption of three infant and young child feeding practices: minimum dietary diversity, minimum acceptable diet and sick child feeding, in households with a child under 2 years ( n = 1827). Maternal exposure to Suaahara II had a positive association with minimum dietary diversity (OR: 1.71, 95% CI [1.27, 2.28], P < 0.001), minimum acceptable diet (OR: 1.60, 95% CI [1.19, 2.14], P = 0.002) and increased feeding to a sick child (OR: 2.11, 95% CI [1.41, 3.17], P < 0.001). Male household head exposure was only associated with increased feeding to a sick child (OR: 2.21, 95% CI [1.27, 3.84], P = 0.005). Among households with an exposed mother, having an exposed male household head nearly tripled the odds of appropriate sick child feeding (OR: 2.90, 95% CI [1.57, 5.34], P = 0.001) but was not significantly associated with the other two outcomes. These findings suggest that the relationships between exposure to nutrition programmes and outcomes are complex and further research is needed to understand variation by family member, behavioural outcome and context.

Social and economic factors influencing intrahousehold food allocation and egg consumption of children in Kaduna State, Nigeria

“…Some studies have shown that men have limited participation in direct decision‐making related to breastfeeding and complementary feeding, suggesting that gendered constructed norms obstruct men's involvement in child nutrition (Dewey & Begum, 2011 ; Kansiime et al, 2017 ). Studies from Nepal found that males are more inclined to get involved in child nutrition in cases when they participate in social networks (Kulkarni et al, 2021 ) or when children are sick (Cunningham et al, 2021 ).…”

Can Anganwadi services strengthening improve the association between maternal and child dietary diversity? Evidence from Project Spotlight implemented in tribal dominated Gadchiroli and Chandrapur districts of Maharashtra, India

“…Project spotlight is an example that demonstrates the effectiveness of local interventions as it offers greater focus and targeting potential of resources to improve system capacities to address such perennial but addressable concern of maternal and child undernutrition. Project Spotlight, however, is not unique in such efforts and there is increasing evidence emerging from other geographies (such as Nepal and Uttar Pradesh in India) that interventions on dietary counseling and behavior change can trigger improvements in dietary diversity among children [ 24 , 25 ].…”

“…Where, RR is relative risks (odds), P e is the prevalence of the food group of interest and PDD is potential dietary diversity. The estimations were carried out using Stata package regpar [ 25 ]. The estimated PDD value can be interpreted as the percentage increase in child dietary diversity that would be observed if there is a cent per cent consumption from a selected food group with other factors remaining unchanged.…”

A Qualitative Evaluation Study of The Infant and Young Child Feeding Counselling

“…A study by Semahegn et al showed that mothers who started breastfeeding before the age of 6 months were caused by a lack of mother's knowledge (Agumasie Semahegn, Gezahegn Tesfaye, 2014). Generally, in the family, the person who plays an important role in decision-making for IYCF practices is the mother (Cunningham et al, 2021), but it turns out that a study by Firdausya and Hardini found that some grandmothers told the mothers to give food to their babies when they were under six months old (Firdausya & Hardini, 2020). However, this study showed that mothers who have good IYCF knowledge and attitude towards appropriate IYCF practices have not been successful in implementing IYCF practices according to recommendations because neither caregivers nor grandmothers do not necessarily have the same positive knowledge and attitudes as well as mothers.…”