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Impact of a Comprehensive Nutrition Program on Infant and Young Child Feeding (IYCF) Practices among Children aged 6 to <24 Months in Rural Malawi
Author(s) -
Hurley Kristen M,
Kang Yunhee,
Monclus Assumpta Bou,
RuelBergeron Julie,
Oemcke Rachel,
Wu Lee Shu Fune,
Mitra Maithilee,
Phuka John,
Christian Parul
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.891.13
Subject(s) - dietary diversity , breastfeeding , medicine , propensity score matching , baseline (sea) , environmental health , meal , demography , pediatrics , geography , food security , agriculture , biology , archaeology , pathology , fishery , sociology
Given the high prevalence of child stunting, the Government of Malawi, with technical support from the World Food Program, launched a large scale comprehensive nutrition program that provides daily LNS to children 6 to <24 months of age and a behavior change communications (BCC) package promoting optimal breastfeeding, meal frequency, and dietary diversity. The objective of this study was to evaluate the one‐year program impact on caregivers’ IYCF practices in Malawi . The study design was quasi‐experimental with one program district and one comparison district. The program impact was measured using cross‐sectional baseline (January‐March, 2014; n=2,364) and midline (January‐March, 2015; n=2,361) survey data. Estimates of impact over one year were generated using Difference in Difference (DID) and Kernel Propensity Score Matching Difference‐in‐Differences (PSM‐DID) analyses using both baseline and midline data in both districts. Dietary diversity remained low at midline with 83.5% of children across both districts not consuming home foods from 4 or more food groups (out of a possible 7) in the past 24 hours. However, improvements in dietary diversity scores (DDS) trended towards being greater in the program district, as compared to the comparison district (p=0.07). Assuming that the nutrient‐density of the LNS was similar to animal meat, the addition of LNS consumption to the DDS increased it by 0.43‐points (p<0.001), and led to a 7.1% improvement in minimum dietary diversity (MDD) and Minimum Adequate Diet (MAD) in the program district as compared to the comparison district (both p<0.05). These results were attenuated in the PSM‐DID analysis with only differences in the DDS including LNS consumption remaining significant (0.4, p<0.05). The frequency of continued breastfeeding and optimal meal frequency were high at midline and did not differ across districts (p>0.05). Some benefits to IYCF practices were found, especially when LNS was included in the DDS calculation. These findings suggest that in the presence of high food insecurity, IYCF messaging and even high knowledge (which appears to exist in both districts) may be ineffective at improving dietary diversity in infants and young children without the provision of a supplemental food. Support or Funding Information This study was funded by Children's Investment Fund Foundation, UK.