A Community-Based Positive Deviance/Hearth Infant and Young Child Nutrition Intervention in Ecuador Improved Diet and Reduced Underweight

Abstract

ObjectiveUnderweight and stunting are serious problems in Ecuador that require interventions in the first 2 years of life. The researchers assessed the effectiveness of a Positive Deviance (PD)/Hearth community-based intervention using local foods to improve infant and young children's nutrition. DesignA quasi-experimental nonrandomized study was conducted between March and October, 2009. SettingThe intervention and study were implemented in the Ecuadorian highlands provinces of Chimborazo and Tungurahua. ParticipantsEighty mother–child pairs in 6 intervention communities and 184 mother–child pairs in 9 comparison communities. InterventionMothers met in participatory peer-led PD/Hearth cooking and nutrition education sessions for 12 days. Main Outcome MeasuresDietary intake and nutritional status were collected at baseline and 6-month follow-up. AnalysisMultiple linear and logistic regression were used for growth outcomes, and ANCOVA for mean dietary intakes. ResultsMothers in the intervention were 1.3–5.7 times more likely to feed their children the promoted foods (P < .05). Children in the intervention consumed a higher percentage of recommended intakes for iron, zinc, vitamin A, protein, and energy (P < .05) at follow-up and had improvements in weight-for-age z-score (β = .17; 95% confidence interval, 0.01–0.31). Likelihood of underweight was reduced for children in the intervention (odds ratio = 0.36; 95% confidence interval, 0.13–0.96) Conclusions and ImplicationsThe PD/Hearth interventions support mothers to improve infant and young children's nutrition practices and reduce underweight.