A behaviour change intervention with lipid‐based nutrient supplements had little impact on young child feeding indicators in rural Kenya

• Type of Material: Article
• Authors: Kendra Byrd, University of California Davis; Holly N. Dentz, University of California Davis; Anne Williams, Emory University; Marion Kiprotich, Innovations for Poverty Action, Kakamega Kenya; Amy J. Pickering, Tufts University; Ronald Omondi, Center for International Policy Research, Mathematica Policy Research; Osborne Kwena, Center for International Policy Research, Mathematica Policy Research; Gouthami Rao, Innovations for Poverty Action, Kakamega Kenya; Charles D. Arnold, University of California Davis; Benjamin F. Arnold, University of California Berkeley; Kathryn G. Dewey, University of California Davis; John M. Colford, University of California Davis; Clair Null, Innovations for Poverty Action, Kakamega Kenya; Christine P. Stewart, University of California Davis
• Language: English
• Date: 2019-01-01
• Publisher: Wiley Open Access
• Publication Version: Final Published Version
• Copyright Statement: © 2018 John Wiley & Sons Ltd.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1111/mcn.12660
• Title of Journal or Parent Work: Maternal and Child Nutrition
• Volume: 15
• Issue: 1
• Grant/Funding Information: None declared
• Keywords: Kenya; infant and young child feeding indicators; behaviour change communication; cluster‐randomized trial; child feeding; complementary foods; lipid‐based nutrient supplement
• Research Categories: Health Sciences, Public Health; Health Sciences, Nutrition; Health Sciences, Human Development

Abstract

Poor infant and young child feeding (IYCF) practices are associated with linear growth faltering. Our objective was to evaluate the impact of a nutrition and water and sanitation for health intervention on three IYCF indicators—minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) in Kenyan children. Households were randomized into one of eight groups: (a) active control; (b) passive control; (c) water quality (W); (d) sanitation (S); (e) handwashing (H); (f) combined Water, Sanitation, and Handwashing; (g) nutrition (N); and (h) combined WSH + N. In the N and WSH + N arms, community‐based promoters counselled households on optimal IYCF practices, and small‐quantity lipid‐based nutrient supplements (SQ‐LNS) were provided to children 6–24 months of age. Twelve months (Year 1) and 24 months (Year 2) after interventions began, enumerators surveyed mothers to ascertain IYCF practices. We made pairwise comparisons of each intervention arm versus the active control arm using log binomial models. In total, 3,652 caretakers were surveyed at Year 1 and 4,987 caretakers at Year 2. Compared with the active control, there were no differences in any of the arms in MDD, MMF, or MAD, aside from an increase in MDD at Year 1 in the nutrition only arm but not in the combined WSH + N arm (N: 68%; WSH + N: 61%; C: 61%; N arm prevalence ratio: 1.13 95% CI [1.01, 1.25]). In this setting, a nutrition behaviour change communication intervention had little impact on IYCF indicators. The provision of SQ‐LNS was not detrimental to current IYCF indicators in the community.