Community-based Nutrition Research Articles

Interplay Between Infant Nutrition and Malaria Susceptibility in West Africa: Socioeconomic, Environmental, and Cultural Perspectives

In West Africa, infant nutrition plays a pivotal role in determining susceptibility to malaria, a disease that remains a leading cause of child mortality in the region. This review explores the intricate interplay between malnutrition and malaria susceptibility among infants, emphasizing the influence of socioeconomic, environmental, and cultural factors. Malnutrition, particularly protein-energy malnutrition and micronutrient deficiencies, compromises immune function, rendering infants more vulnerable to malaria infections. Conversely, malaria exacerbates nutritional deficiencies, creating a vicious cycle that severely impacts infant health and development. This review examines how traditional beliefs, maternal education, and family dynamics shape infant feeding practices, thereby influencing nutritional status and malaria risk. It also highlights the significance of breastfeeding, the timing of complementary feeding, and the quality of complementary foods in protecting infants against malaria. The review underscores the need for targeted nutritional interventions, such as micronutrient supplementation, fortified foods, and community-based nutrition programs, which are essential in reducing the dual burden of malnutrition and malaria. These interventions must be culturally sensitive and context-specific to effectively improve health outcomes for infants in West Africa. Further, this review illuminates the complex relationship between infant nutrition and malaria susceptibility, advocating for integrated public health strategies that address both malnutrition and malaria within the unique socio-cultural and economic landscape of West Africa. Keywords: Infant Nutrition, Malaria Susceptibility, West Africa, Socioeconomic.

Maternal Malnutrition and Its Associated Adverse Pregnancy Outcomes and Childbirth in Dadu District, Sindh, Pakistan

Background: Maternal malnutrition poses serious risks to both mother and child, contributing to adverse pregnancy outcomes such as anemia, pre-eclampsia, and low birth weight. Addressing maternal malnutrition is essential for promoting healthy pregnancies and favorable birth outcomes. Methodology: The study involved 660 third-trimester pregnant women at a tertiary care hospital in Dadu district, Sindh, Pakistan. The aim was to identify the association patterns of maternal nutrition on birth outcomes to inform future programming. Data were collected using a mixed-methods approach with a snowballing technique. Bivariate and multivariate analyses were performed using R-Studio and Canvas software to analyze associations and differences related to maternal nutrition. Results: The majority of rural participants (84%) intended to deliver at DHQ Dadu, with 81% facing inconsistent family income sources, impacting food security and healthcare access. Maternal education positively correlated with healthcare service utilization, while maternal counseling had a weaker influence. Early pregnancies were prevalent, with 29% of women reporting their first pregnancy before age 20 and 6.7% before age 16. Iron and folic acid utilization was suboptimal (20.4%), and access to healthcare was hindered by distance, cost, and inconsistent coverage, particularly in rural areas. Maternal malnutrition was a significant concern, with 15.4% identified as acutely malnourished. Conclusion: The study highlights significant challenges, including socioeconomic disparities, early pregnancies, inadequate healthcare access, and poor maternal nutrition status. Targeted interventions such as improving healthcare infrastructure, enhancing maternal education, promoting early prenatal care, strengthening community-based nutrition programs, and leveraging social safety net programs can help mitigate adverse birth outcomes.

Impact of Nutrition Interventions on Vitamin and Mineral Intake among Native American Children and Parents: Insights from Food Resource Equity for Sustainable Health (FRESH) Study.

The Food Resource Equity for Sustainable Health (FRESH) study started as a tribe community-based nutrition education program in 2018, implemented with children and parents in Osage Nation. The purpose of the FRESH study is to examine the effects of a farm-to-school family intervention on diet. The FRESH study did not directly intervene on adult caregiver participants' diet, and, as far as we know, it is the first of its kind to implement a farm-to-school intervention in rural/tribally owned Early Childhood Education. Two communities received intervention and two served as wait-list controls. Outcomes included diet and other secondary health outcomes including vitamin and mineral intake. There were 193 children (n = 106 intervention; n = 87 control) and 170 adults (n = 93 intervention; n = 77 control) enrolled. Among adult caregiver participants, carbohydrate, cholesterol, and caffeine intake significantly decreased after the intervention (p < 0.05). There is a hidden hunger issue among caregivers in Native American populations. The family-based nutritional intervention, which includes educational components for caregivers, might have some effect on improving micronutrient status. Future studies focusing on key micronutrients through efficient methods are warranted.

Assessment of Nutritional Status among the School-going Adolescents in a Rural Community of Bankura District, West Bengal: A Cross-sectional Study

Abstract Background: Adolescent is a very crucial period of life for the growth and development of the body and mind. Nutrition influences growth and development throughout infancy, childhood and adolescents. Aims and Objectives: The aim of the sudy was to assess the nutritional status in terms of thinness, overweight and obesity and stunting amongst the school-going adolescents and to find out the factors related to nutritional status amongst the study subjects. Methodology: Community-based descriptive cross-sectional study was conducted amongst six rural schools of Bankura-I community development block in Bankura district from July to September 2017. With the help of a pre-designed, pre-tested, semi-structured schedule, a total of 600 adolescent students were interviewed, and clinical examinations were done. The collected information was entered into Microsoft Excel sheet and analysed using SPSS-20. Results: The mean age of the study population was 13.2 ± 2.19 years. About one-third (32.8%) of adolescent students were thin, as per body mass index for age Z-score category. Normal nutritional status was found in the majority of students (63.8%), but overweight and obesity were only 3.4% amongst the adolescent students. Stunting (31.0%) was higher amongst the late adolescents, and also that the percentage of stunting was higher in adolescent girls (35.8%) than boys (15.0%). Stunting was also significantly related with caste, SE class, family type according to number of family members and birth order of study subjects. Conclusions: School-based as well as community-based adolescent-friendly health and nutrition education and services and economic development may improve the overall health and nutritional knowledge and status of adolescents.

An Evaluation of a Community-Based Food and Nutrition Programming: FAN Leadership Institute Study

An Evaluation of a Community-Based Food and Nutrition Programming: FAN Leadership Institute Study

Break-Up With Salt (BUWS), Community-Based Nutrition Education Supporting Hypertension Prevention and Management

Break-Up With Salt (BUWS), Community-Based Nutrition Education Supporting Hypertension Prevention and Management

Assessment of a Community-Based Nutrition Program for Women and Children in Nepal Using Demographic and Health Survey.

Undernutrition is a particularly acute problem in middle- and low-income countries. The "Suaahara" program is a 5-year community-focused program in Nepal, aimed at improving the health and nutrition of pregnant and lactating women and their children under the age of 2 years. This research contributes to evidence on the impact of the "Suaahara" program in 41 treated districts compared to 34 control districts. Using the difference-in-differences method, we found that the weight-for-height z-score and body mass index z-score of children under the age of 2 in the treated districts significantly increased by 0.223 standard deviations (SDs) and 0.236 SDs, respectively, compared with the control districts 5 years before and after the program. The number of antenatal care visits (at least four visits) and safe deliveries significantly increased for pregnant women by 10.4% and 9.1%, respectively, in the treated districts compared with the control districts. The prevalence of fever in children under 2 years of age was significantly reduced by 6.2% in the treated districts. The results show the significance of a policy evaluation with transparent indicators on public health, which is necessary for policymakers so that they can propose evidence-based policy.

Facilitators and barriers to implementing complex community-based interventions for addressing acute malnutrition in low- and lower-middle income countries: A scoping review.

Background: Community-based nutrition interventions have been established as the standard of care for identifying and treating acute malnutrition among children 6-59 months in low- and lower-middle-income countries. However, limited research has examined the factors that influence the implementation of the community-based component of interventions that address severe acute malnutrition and moderate acute malnutrition among children. Aim: The objective of this review was to identify and describe the facilitators and barriers in implementing complex community-based nutrition interventions to address acute malnutrition among children in low- and lower-middle-income countries. Methods: This review used a systematic search strategy to identify existing peer-reviewed literature from three databases on complex community-based interventions (defined as including active surveillance, treatment, and education in community settings) to address severe acute malnutrition and moderate acute malnutrition in children. Results: In total, 1771 sources were retrieved from peer-reviewed databases, with 38 sources included in the review, covering 26 different interventions. Through an iterative deductive and inductive analysis approach, three main domains (household and interpersonal, sociocultural and geographical; operational and administrative) and eight mechanisms were classified, which were central to the successful implementation of complex community-based interventions to address acute child malnutrition. Conclusion: Overall, this review highlights the importance of addressing contextual and geographical challenges to support participant access and program operations. There is a need to critically examine program design and structure to promote intervention adherence and effectiveness. In addition, there is an opportunity to direct resources towards community health workers to facilitate long-term community trust and engagement.

A Public Sector Innovation in Strengthening Local Community Food Security in the Selected Municipalities of Lanao del Sur

This study presents an in-depth analysis of food security challenges in selected municipalities of Lanao del Sur, focusing on household food insecurity prevalence and proposing public sector innovations to address these issues. Conducted through a data survey spanning Lumbatan, Lumbanayague, and Sultan Dumalondong over two months, the research collected 268 responses. Findings reveal nuances in food availability and preferences, highlighting gaps in food variety and accessibility despite overall sufficiency. Contributing factors include low income, poverty, limited nutritious food, high commodity prices, and insufficient agency support, leading to perceptions of inadequate food access, availability, and affordability. Proposed interventions encompass community-based food production, price stabilization, targeted subsidies, and nutrition education campaigns, emphasizing collaborative stakeholder efforts for sustainable improvements in Lanao del Sur's food security and dietary diversity.

Designing a Community-Based Health Promotion Program for Older Adults Based on Perceived Usefulness, Service Experience, Perceived Value, and Behavioral Intention

ABSTRACT Improving nutritional intake contributes to maintaining the health and quality of life of the older population and reducing individual and societal healthcare costs. We collaborated with two community service hubs and a public health center in Taipei’s Daan District to develop a personalized community-based health and nutrition program using service design. The design was validated through a model encompassing perceived usefulness, service experience, perceived value, and behavioral intention, analyzed using PLS-SEM modeling on 76 individuals. The results showed bidirectional influences among these factors. This study provides practical recommendations for formulating public health policies and health promotion programs for older adults.

Transformative Insights: Break Up with Salt (BUWS) Program's Short-Term Influence on Hypertension Risk Factors.

Break Up with Salt (BUWS) is a four-session community-based nutrition education program aimed at reducing key controllable hypertension risk factors. This pilot study utilized a pre-post survey design to assess short-term outcomes on food behaviors (including DASH diet eating patterns), physical activity, and overall well-being, in two groups of participants. The first "pilot" group (n = 25) completed a comprehensive, 16-item survey; the second "abbreviated" group (n = 27) completed a 5-item survey. The pilot group experienced improvements in whole grain (p = 0.04), sweetened beverage consumption, watching/reducing sodium (p = 0.04) and fat (p = 0.05) consumption, and time spent sitting (p = 0.04). The abbreviated group improved confidence in using food labels (p = 0.02), following the DASH diet (p < 0.01), preparing food without salt (p = 0.03), selecting lower sodium items when eating out (p = 0.04), and making a positive lifestyle change (p = 0.01). The BUWS program provides information and teaches strategies to manage or prevent hypertension. By effectively improving diet and food behaviors, BUWS has the potential to reduce hypertension risk factors and improve the general health of participants.

Evaluation of the Effectiveness of a Bilingual Nutrition Education Program in Partnership with a Mobile Health Unit.

There are limited reports of community-based nutrition education with culinary instruction that measure biomarkers, particularly in low-income and underrepresented minority populations. Teaching kitchens have been proposed as a strategy to address social determinants of health, combining nutrition education, culinary demonstration, and skill building. The purpose of this paper is to report on the development, implementation, and evaluation of Journey to Health, a program designed for community implementation using the RE-AIM planning and evaluation framework. Reach and effectiveness were the primary outcomes. Regarding reach, 507 individuals registered for the program, 310 participants attended at least one nutrition class, 110 participants completed at least two biometric screens, and 96 participants attended at least two health coaching appointments. Participants who engaged in Journey to Health realized significant improvements in body mass index, blood pressure, and triglycerides. For higher risk participants, we additionally saw significant improvements in total and LDL cholesterol. Regarding dietary intake, we observed a significant increase in cups of fruit and a decrease in sugar sweetened beverages consumed per day. Our findings suggest that Journey to Health may improve selected biometrics and health behaviors in low-income and underrepresented minority participants.

Process Evaluation of Community-Based Nutrition Service for Under 2 Years Children in Degadamot District Using Qualitative Approach, Western Ethiopia, 2023.

Malnutrition accounts for 45% of under-5 child morbidities in Ethiopia and is a more common issue in rural communities. In that regard, Ethiopia has implemented a CBN program at the community level to improve the nutrition status of children. Despite this, malnutrition still causes a significant rate of child morbidity and mortality. The implementation status of the CBN program is unknown. Thus, this evaluation aimed to evaluate the children under 2 years in Degadamot district health posts in northwest Ethiopia. A facility-based single-case study design with qualitative-method evaluation was employed from March 28 to April 28, 2023. The evaluation focused on the availability and compliance with multiple data sources. The qualitative data were transcribed, translated, and analyzed using thematic analysis with OPEN CODE version 4.02 software. Finally, the overall program implementation was determined based on predetermined judgmental criteria. According to the predetermined judgment parameter, the overall CBN program implementation level was 62.68%, measured by the availability of resources (71.36%) and compliance of service providers (54.0%). The overall community-based nutrition program implementation in the Degadamot district health post with 2 evaluation dimensions was judged as fair based on the presetting criteria. It is better to improve the service through training HEW and HDA, distributing nutritional supplies, providing regular support, and following up with HEWs for GMP performance in the Degadamot district.

Screening for Food and Nutrition Insecurity in the Healthcare Setting: A Cross-Sectional Survey of Non-Medicaid Insured Adults in an Integrated Healthcare Delivery System.

Healthcare screening identifies factors that impact patient health and well-being. Hunger as a Vital Sign (HVS) is widely applied as a screening tool to assess food security. However, there are no common practice screening questions to identify patients who are nutrition insecure or acquire free food from community-based organizations. This study used self-reported survey data from a non-Medicaid insured adult population approximately one year after the start of the COVID-19 pandemic (2021). The survey examined the extent to which the HVS measure might have under-estimated population-level food insecurity and/or nutrition insecurity, as well as under-identified food and nutrition insecurity among patients being screened for social risks in the healthcare setting. Data from a 2021 English-only mailed/online survey were analyzed for 2791 Kaiser Permanente Northern California (KPNC) non-Medicaid insured members ages 35-85 years. Sociodemographics, financial strain, food insecurity, acquiring free food from community-based organizations, and nutrition insecurity were assessed. Data from respondents' electronic health records were abstracted to identify adults with diet-related chronic health conditions. Data were weighted to the age × sex × racial/ethnic composition of the 2019 KPNC adult membership. Differences between groups were evaluated for statistical significance using adjusted prevalence ratios (aPRs) derived from modified log Poisson regression models. Overall, 8.5% of participants reported moderate or high food insecurity, 7.7% had acquired free food from community-based organizations, and 13% had nutrition insecurity. Black and Latino adults were significantly more likely than White adults to have food insecurity (17.4% and 13.1% vs 5.6%, aPRs = 2.97 and 2.19), acquired free food from community-based organizations (15.1% and 15.3% vs 4.1%, aPRs = 3.74 and 3.93), nutrition insecurity (22.1% and 23.9% vs 7.9%, aPRs = 2.65 and 2.64), and food and nutrition insecurity (32.4% and 32.5% vs 12.3%, aPRs = 2.54 and 2.44). Almost 20% of adults who had been diagnosed with diabetes, prediabetes, ischemic CAD, or heart failure were food insecure and 14% were nutrition insecure. Expanding food-related healthcare screening to identify and assess food insecurity, nutrition insecurity, and use of community-based emergency food resources together is essential for supporting referrals that will help patients achieve optimal health.

Addressing Nutrition Risk in Older Adults in Community Settings

Nutrition risk, and subsequent malnutrition, can be common in community- dwelling older adults in Europe and other high-income regions. While a major factor in predicting loss of independence, hospitalization and mortality, they also largely preventable, but older adults often have limited supports to prevent or manage nutrition concerns in communities, compared with hospital settings. Primary care and other community settings are well-situated to provide screening and follow-up, although several barriers may exist when implementing preventative or curative interventions. Indeed, malnutrition prevalence in older adults ranges from less than 1% to almost 20% in high-income countries, which suggests there is disparity in prevention and treatment strategies. This narrative review aims to highlight the prevalence and costs of malnutrition, then focus on recent examples of community-based nutrition risk mitigation to guide the establishment of care pathways for malnutrition management in primary and community care. In particular, care pathways incorporating routine screening, which includes monitoring of dietary intake and weight of patients, with risk-based follow-up are shown to reduce nutrition risk. Likewise, leveraging both medical interventions from dietitians and non- medical interventions such as addressing food insecurity or social isolation are required to mitigate nutrition risk.

Community-based nutrition education and counselling provided during pregnancy: effects on knowledge and attitude towards iron-folic acid supplementation.

Maternal malnutrition is pervasive throughout the world, notably in sub-Saharan Africa, including Ethiopia. This study examined the effect of community-based iron-folic acid supplementation (IFAS) nutrition education on IFAS knowledge and attitude among pregnant women in urban settings in South Ethiopia. A community-based quasi-experimental study was conducted among 198 randomly selected pregnant women attending antenatal care (ANC) (99 intervention and 99 control). We used a multistage sampling technique followed by systematic sampling to select the pregnant women. Pregnant women who participated in the intervention arm received six nutrition education sessions and counselling using a health belief model (HBM), while the control group received only routine ANC services. Baseline and endline data were collected during the ANC and compared. The data was analysed using statistical package for social sciences. Analyses of the effect of the intervention were done using difference-in-difference and generalised estimation equation to allow correlation of repeated observations over time. The results indicated a significant effect of intervention on maternal knowledge towards IFAS; with intervention, group levels increased by 35 percentage points (P < 0.001). The odds of being knowledgeable at the endpoint in the intervention group were 2.6 times higher than baseline (OR = 2.67, 95% CI 1.88-3.80). There was a significant (P = 0.001) change in proportion with a favourable attitude towards IFAS between the two time points. The community-based nutrition education intervention approach has significantly improved maternal knowledge and a favourable attitude towards IFAS among pregnant women. The HBM is effective in improving knowledge and attitude among pregnant women.

Supporting Mealtime Participation Among People Living With Dementia at Home: Challenges and Strategies for Caregivers.

Approximately 60% of people living with dementia at home are unable to routinely participate in mealtime activities (e.g., eating, safe food preparation), warranting assistance to ensure people with dementia meet their health and nutritional needs. The purpose of this study was to characterize these barriers to mealtime participation and identify potential caregiver-led strategies to enhance mealtime activities. We used a qualitative descriptive approach and obtained semistructured interview data from (a) allied health professionals and (b) community-based nutrition program providers who frequently serve people with dementia. Interview data were examined by means of directed content analysis and framework methodology until data saturation was reached. Codes from our analysis were categorized according to constructs drawn from the Socio-Ecological Model for Developing and Implementing Comprehensive Dementia Care. Data were obtained from 20 participants who attributed common mealtime participation barriers to: impairments in functional status, cognitive status deficits, a lack of caregiver knowledge and skills, and unsafe living conditions. Caregiver-led strategies to overcome these barriers included: reducing auditory and visual distractions, providing written cues to perform mealtime activities, eliminating clutter and fall risk hazards, and leveraging community-based nutrition program providers (e.g., home-delivered meal providers). People with dementia face several eating and mealtime participation obstacles. Caregiver-led strategies implemented by family, friends, or community-based nutrition program providers may enhance mealtime activities at home. Findings point to opportunities to develop decision-making tools and resources for caregivers to optimize the health and nutrition of people with dementia.

Community-Based Nutrition Risk Screening in Older Adults (COMRISK): An Exploration of the Experience of Being Screened and Prevalence of Nutrition Risk in Alberta, Canada

Abstract The objectives of this feasibility study were to measure the prevalence of nutrition risk in community-dwelling older adults (CDOA, ages ≥ 65 years) and explore the perspectives of CDOA of the acceptability, value, and effectiveness of nutrition risk screening in primary care and community settings. Using the Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN)© eight-item tool (n = 276), results indicated that moderate and high nutrition risks affected 50 per cent and 8 per cent, respectively, of those screened. Interviewees (n = 16) agreed that screening is acceptable, important, and valuable (Theme One). Effectiveness was unclear, as only 3 of 16 respondents recalled being told their nutrition risk status. When articulating nutrition-related issues, a food security theme, expressed in the third person, was prominent (Theme Two). Screening for nutrition risk and receiving nutrition information in community-based settings are acceptable to CDOA and medically necessary, as evidenced by the high proportion of CDOA at moderate-high nutrition risk.

Water, sanitation and hygiene (WASH) practices and deworming improve nutritional status and anemia of unmarried adolescent girls in rural Bangladesh

BackgroundIn Bangladesh, undernutrition and anemia are more occurrent among adolescent girls. BRAC, the largest non-governmental organization (NGO), has been implementing a community-based nutrition education service package targeting adolescent girls for reducing their undernutrition and anemia.ObjectiveWe aimed to explore the underlying factors associated with nutritional status and anemia among adolescent girls under the BRAC nutrition program areas to improve their existing intervention package.MethodologyWe conducted a cross-sectional and comparative study in 2016, in 24 upazilas of Bogra, Barguna, Comilla, Dinajpur, Feni, Jessore, and Meherpur districts where the BRAC nutrition program was implemented while the remaining 27 upazilas of those districts were selected as comparison area. We followed a multistage cluster random sampling for selecting 1620 unmarried adolescent girls aged 10–19 years for interviewing in the intervention and comparison areas. Data were collected on socio-demographic information, dietary intake, morbidity, water, sanitation, and hygiene (WASH) practice, anthropometry, and serum hemoglobin (Hb) level by using a pre-structured questionnaire. The nutritional status of the adolescent girls was expressed as height-for-age Z (HAZ) and body mass index-for-age Z (BMIZ) score, while anemia referred to the serum Hb at the level of below 12 g/dl for adolescent girls. All statistical analyses were done in STATA version 17 (Chicago Inc.).FindingsThe prevalence of stunting (22.9% vs. 22.5%), thinness (12% vs. 14%), and anemia (34.5% vs. 37.3%) exhibited similarities between the intervention and comparison regions. Stunting and thinness were predictors for each other for this population group. Our findings indicated that adolescent girls who were not washing hands with soap after defecation were likely to be stunted [AOR 1.51 (95% CI 1.12–2.04)], and who did not utilize sanitary latrines had an increased likelihood of being thin [AOR 2.38 (95% CI 1.11–5.08)]. Conversely, those who did not watch television [AOR 1.69 (95% CI 1.12–2.56)] and did not have deworming tablets [AOR 1.33 (95% CI 1.07–1.64)] in the 6 months leading up to the interview had a 69% and 33% higher probability of being anemic, respectively.ConclusionFor sustainable improvement in the undernutrition and anemia of adolescent girls, integration of WASH, consistent administration of deworming tablets and broadcasting awareness programs through television are urgent to scale up the nutrition intervention programs in similar settings like Bangladesh.

Strengths, weaknesses, opportunities and threats of a community-based egg program in rural Honduras

Abstract Background Young children living in poor rural areas in Honduras are susceptible to suffering from undernutrition. About 1 in every 4 children under age 5 have stunting. Stunting during early childhood has negative consequences on an individual's life that can have short-term and lasting effects. This study's purpose was to explore the perceptions of the mothers of children that participate in a community-based nutrition-agriculture program that offers 1 egg daily to all children ages 6 to 24 months in 13 communities. Methods Using community-engaged methods, we implemented a SWOT analysis to identify strengths, weaknesses, opportunities, and threats using a semi-structured guide to conduct in-depth interviews in n = 14 participating mothers in the Hens Hatching Hope project (ClinicalTrials.gov Identifier: NCT04721197). Interviews were performed by a local community health worker in Spanish, translated to English, and analyzed via content analysis by a researcher. Main themes were identified and synthesized. Results Some of the identified strengths were the “improved community access to eggs” and “financial assistance that offset burdening household expenses”. For weaknesses “expansion of program age eligibility to accommodate multi-child households” and “no control over parent's use of eggs”. For opportunities “Implementation of external community resources” and “improve water and sanitation initiatives”, for threats “changes in political climate” and “frail farm infrastructure”. Conclusions Perception of the program is positive among all mother participants. This analysis identified multiple strengths and opportunities to 1) improve the program locally, and 2) expand the program's scope and reach. Further, this analysis identified weaknesses and potential threats that will serve to modify and improve the delivery and uptake of the intervention. Key messages • Explore program strengths, weaknesses, opportunities, and threats perceived by particpating mothers of a community-based nutrition agriculture program that provides 1 egg a day to their child's diet. • The swot analysis of participating mothers’ interviews serves in the developing contingency plans to continue the Hens Hatching Hope program.