STUDENT RESEARCH

Summary: The aim of this study was to assess the effectiveness of a combined nutrition and agricultural education intervention, delivered through community health workers and agricultural extension agents, to improve infant and young child diet and growth in the Upper Manya Krobo district of Ghana. The existing complementary feeding (CF) practices, and facilitators and barriers of CF education were identified through in-depth interviews and focus group discussions. A cluster-randomised study design was used to compare the feeding practices, nutrient intakes, and growth of infants and young children (n = 367) in two intervention groups (combined nutrition and agricultural education [IE], nutrition education only [NE]), and a control group [CT]. Each child’s diet and anthropometric data, and household demographic and agricultural production information were collected at baseline and at three-month intervals for nine months. The level of household food insecurity and its relation with infant morbidity and growth were also assessed. The results indicated that 21.6% of households in the study area were food insecure. Household food insecurity during the pre-harvest period was associated with respiratory infections in the second half of infancy, but not with diarrhea or stunting. Inclusion of animal source products, fruits, and vegetables in young children’s diet was not common in the area.

Poverty and maternal time constraints, and lack of teaching materials and language barrier, were identified as challenges to optimal CF practices and provision of CF education, respectively. At the end of the study, children in the IE were twice as likely to meet the minimum meal frequency compared to the CT children (aOR = 2.62; 95% CI; 1.11, 6.16), but energy and nutrient intakes from complementary foods, and growth indicators did not differ between the three groups. Additionally, children of mothers who attended at least one nutrition education session in the IE group tended to receive the minimum acceptable diet (aOR = 2.30, 95% CI; 0.98, 5.39, p = 0.055) compared to children in the CT group at the end of the study. Participation in the intervention was low among mothers. Future education interventions will need to increase the involvement of participants at the development phase of interventions, as a way of improving participation among caregivers of infants and young children.

Agartha Cofie | Doctoral, McGill University, Canada