Engaging Fathers to Improve Dietary Diversity in Northern Nigeria: Perspectives From Community and Religious Leaders, Community Health Extension Workers, and Parents

Abstract

ObjectivesIn Kaduna State, Nigeria, Alive & Thrive implemented a multilevel, multicomponent intervention to engage fathers to support dietary diversity among 6–23 month olds. The objectives of this implementation research were to (1) examine the experiences of community health extension workers (CHEWs) and community and religious leaders trained to deliver the intervention, and (2) explore mothers’ and fathers’ experiences with intervention components. MethodsAfter 12 months of implementation, we conducted in-depth interviews with 12 CHEWs and 12 community and religious leaders, and 16 separate focus group discussions (FGDs) with mothers and fathers of children 6–23 months. Interview and FGD transcripts were coded in Atlas.ti and analyzed thematically. ResultsThe intervention was feasible for religious and community leaders and CHEWs to implement and acceptable to families. Religious leaders incorporated complementary feeding and father support into their sermons, community leaders promoted recommended feeding practices to fathers through community meetings, and some CHEWs talked with fathers about dietary diversity during home visits. Mothers and fathers suggested CHEWs schedule home visits with fathers or attend men’s community meetings to better engage them. Mothers noted the credibility of religious leaders encouraged fathers to be more involved. Religious and community leaders and CHEWs valued training and monthly supervisory meetings. They suggested additional awareness-raising activities could clarify the intervention scope and purpose for community members. Mothers and fathers valued the posters, child feeding bowls, pamphlets, text and recorded voice messages, and CBO meetings. CHEWs and community and religious leaders asked for increased printed materials, bowls, and transportation allowances. Several participants noted that high costs were a barrier to providing recommended foods, and some described strategies to overcome them. ConclusionsReligious and community leaders encouraged fathers to become more involved in complementary feeding. Fathers indicated that contacts through multiple channels motivated them to support recommended practices. Funding SourcesAlive & Thrive initiative, managed by FHI Solutions, funded by the Bill & Melinda Gates Foundation, Irish Aid, Tanoto Foundation, UNICEF, World Bank.