Child feeding practices are improved by a behavior change communications strategy using a small peer group approach in rural Haiti

We compared child feeding practices (CFP) in rural Haitian communities exposed to two models for delivering food aid & behavior change communication (BCC) within a maternal & child health & nutrition program: a preventive model (P), targeting all children 6–24 mo; or a recuperative model (R), targeting malnourished children under 5 y. Twenty paired clusters of communities were randomized to the models. BCC, designed using formative research, was delivered to small peer groups & was identical in P & R from pregnancy to early lactation (to 6 mo). Thereafter, the focus in P was on age‐specific messages for optimal CFP & in R on needs of the malnourished child. Baseline & endline surveys (3 yr apart; N~1500) assessed maternal recall of CFP. No baseline differences were seen. At endline, P area children had greater dietary diversity & were more likely to have received an extra meal after diarrhea (p<0.05); most other differences favored P but were small. Larger differences were found btn baseline & endline for both models, & btn participants & non‐participants. Exclusive breastfeeding increased from 42% at baseline to 92%; non‐participants were 4 times more likely to report introducing liquids or semi‐solids at < 6 mo (p<0.05). Results suggest that a well‐designed BCC program improved many important CFP even as Haiti's food security deteriorated [Support: USAID through FANTA/AED, World Vision‐Haiti, German Govt., WFP]