Effects of a home-based participatory play intervention on infant and young child nutrition: A randomised evaluation among low-income households in El Alto, Bolivia

Sebastian Martinez, Julia Johannsen, Gaston Gertner, Jorge Franco, Ana B.Perez Exposito, Rosario M. Bartolini, Irma Condori, Jhovanna Flores Ayllon, Ramiro Llanque, Nohora Alvarado, Christian Lunstedt, Cecilia Ferrufino, Teresa Reinaga, Mauricio Chumacero, Carlos Foronda, Santiago Albarracin, Ana Maria Aguilar

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background Stunting affects child survival and is a key indicator of child well-being. Therefore, reducing stunting is a global goal. Improving infant and young child feeding (IYCF) practices is a recommended approach to reduce the risk of mortality and ameliorate nutritional status. Behavioural change interventions have the potential to improve IYCF practices. Methods We evaluated the effectiveness of an innovative behavioural change strategy on caregiver's knowledge, IYCF practices and nutritional status of children from lowincome households in El Alto, Bolivia. Home visits used culturally adapted participatory play strategies to promote recommended IYCF practices. A total of 2014 households with children younger than 12 months at baseline were randomly assigned to treatment and control groups. Findings Caregiver knowledge and IYCF practices improved by 0.2 SD, as did food expenditures on recommended foods and dietary diversity. No significant effects were detected on anthropometric indicators or anaemia. Treatment compliance was 88% of households at enrolment and 66% at completion. Interpretation Participatory play-based behavioural change strategies are a promising delivery model to improve recommended IYCF practices. After 30 months of intervention, we found sustained positive effects on caregiver's knowledge and IYCF practices but no effect on nutritional status. Despite the lack of effect on linear growth and anaemia, our results highlight the relevance of implementing interventions that improve IYCF practices due to their importance for early development and prevention of obesity. Other contextual variables, apart from diet, that could be limiting children's growth potential in this population need to be identified to design holistic approaches that improve child well-being and human capital.

Original languageEnglish
Article numbere000687
JournalBMJ Global Health
Volume3
Issue number3
DOIs
StatePublished - Nov 2018

Bibliographical note

Funding Information:
Funding Baseline data collection and part of the programme’s implementation costs were funded by the Inter-American Development Bank (IDB) grant BO-T1181 (ATN/JO-13606-BO), ‘Improving Child Nutrition Services in Bolivia’, a technical cooperation project financed through a donation from the IDB’s Japan Special Fund Poverty Reduction Program (JPO) and executed by the CSRA, in coordination with the Ministry of Health and local public health centres in El Alto. Endline data collection was conducted by the Center for Generation of Information and Statistics (CEGIE) at the Bolivian Private University and funded through the IDB grant BO-T1259 (ATN/OC-15554-BO), ‘Effectiveness Of Community Interventions to Reduce Child Malnutrition’, executed by the IDB.

Funding Information:
Baseline data collection and part of the programme’s implementation costs were funded by the Inter-American Development Bank (IDB) grant BO-T1181 (ATN/ JO-13606-BO), ‘Improving Child Nutrition Services in Bolivia’, a technical cooperation project financed through a donation from the IDB’s Japan Special Fund Poverty Reduction Programme (JPO) and executed by the CSRA, in coordination with the Ministry of Health and local public health centres in El Alto. Endline data collection was conducted by the Center for Generation of Information and Statistics at the Bolivian Private University and funded through the IDB grant BO-T1259 (ATN/ OC-15554-BO), ‘Effectiveness of Community Interventions to Reduce Child Malnutrition’, executed by the IDB. All opinions in this paper are those of the authors and do not necessarily represent the views of the JPO, CSRA, Ministry of Health or of the IDB, its Executive Directors or the governments they represent.

Publisher Copyright:
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved.

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