Evaluation of a social network intervention on child feeding practices and caregiver knowledge

Abstract

Food insecurity and poor infant and young child feeding (IYCF) practices contribute to undernutrition. The Kanyakla Nutrition Program was developed in rural Kenya to provide knowledge alongside social support for recommended IYCF practices. Utilizing a social network approach, the Kanyakla Nutrition Program trained community health workers (CHWs) to engage mothers, fathers, and grandparents in nutrition education and discussions about strategies to provide instrumental, emotional, and information support within their community. The 12-week programme included six sessions and was implemented on Mfangano Island, Kenya, in 2014-2015. We analysed intervention effects on (a) nutrition knowledge among community members or CHWs and (2) IYCF practices among children 1-3 years. Nutrition knowledge was assessed using a postintervention comparison among intervention (community, n = 43; CHW, n = 22) and comparison groups (community, n = 149; CHW, n = 64). We used a quasiexperimental design and difference-in-difference to assess IYCF indicators using dietary recall data from an ongoing cohort study among intervention participants (n = 48) with individuals living on Mfangano Island where the intervention was not implemented (n = 178) before the intervention, within 1 month postintervention, and 6 months postintervention. Findings showed no effect of the intervention on IYCF indicators (e.g., dietary diversity and meal frequency), and less than 15% of children met minimum acceptable diet criteria at any time point. However, knowledge and confidence among community members and CHWs were significantly higher 2 years postintervention. Thus, a social network approach had an enduring effect on nutrition knowledge, but no effects on improved IYCF practices.

Effects of Nutrition Education on Improving Knowledge and Practice of Complementary Feeding of Mothers with 6- to 23-Month-Old Children in Daycare Centers in Hawassa Town, Southern Ethiopia: An Institution-Based Randomized Control Trial

“…e score was given one (1) for correct and favorable or healthy complementary feeding practice and Zero (0) for not wrong answer and not favorable or unhealthy complementary feeding practices. A score of <50% was classified as poor while that of 50% and more was classified as good for either complementary feeding knowledge or complementary feeding practice [24]. e pretest and posttest minimum dietary diversity was determined with reference to the World Health Organization (WHO) recommendations.…”

Exploring the Influence of Social Norms on Complementary Feeding: A Scoping Review of Observational, Intervention, and Effectiveness Studies

“…Nine interventions trained community or religious leaders or health workers to advocate, mobilize, and implement activities to influence CF behaviors and norms in communities ( 53 , 59 , 60 , 64 – 76 ). For example, the Kanyakla Nutrition Program trained CHWs to facilitate community discussions and serve as community ambassadors promoting nutrition practices through modeling and informal conversations ( 72 , 73 ).…”

“…Participants in Mwanzo Bora described increases in male support and involvement in IYCF practices, and this change was attributed to SBC promotion activities and inclusion of community leaders ( 60 ). Women respondents in the Kanyakla project reported that greater men's participation in nutrition programs led to improvements in nutrition practices ( 73 ). SPRING-Niger also found program participation led to increased discussion of child's nutrition and CF among some couples ( 79 ).…”

“…Five evaluations assessed changes in CF knowledge: 3 on mothers’ knowledge of CF practices ( 65 , 66 , 68 , 78 ), 1 on grandmothers’ nutrition knowledge ( 74 ), and 1 in community health volunteers’ nutrition knowledge ( 73 ). All included comparison or nonintensive communities and all but 1 study ( 65 ) found significant improvements in CF knowledge.…”

“…Less commonly measured outcomes included responsive feeding practices (1 study) and appropriate handwashing practices or use of soap and water (4 studies). Five programs measured stunting or height-for-age z score (HAZ) ( 73 , 78 ). As described in more detail in Table 4 and below, 13 of the 15 evaluations that measured CF practices reported improvements in at least some CF practices, with 2 reporting nonsignificant effects or a decrease in optimal practices.…”