Influence Of Feeding Practices Research Articles

Influence of feeding practices on Childhood illness

Background: The phase between a child's birth and the age of two years is crucial for ensuring the child’s growth and development through optimal feeding habits. Breastfeeding is considered one of the most effective methods for ensuring the health and survival of children. Aim & Objective: This study aims to access the influence of feeding practices on childhood illness. Methodology: A cross-sectional study was done among 280 mothers having children less than 2 years of age attending primary health centres adopted by the Department of Community Medicine JSS medical college, Mysuru. Data regarding feeding practices and childhood illnesses were collected using a pre-tested questionnaire prepared based in Infant and Young Child Feeding guidelines by interviewing the mothers. Result: Among the study population, 75.4% of children in urban and 75.7% of children in rural suffered from childhood illness. It was observed that childhood illness was more common among children with poor feeding practices (75.7% in rural and 93.5% in urban) and the association was found to be statistically significant. Conclusion: The study sheds light on the importance of appropriate feeding practices, which have a higher influence on a child's health.

The influence of feeding practices on under-five nutrition status in Mbinga District, Tanzania

Background: Undernutrition is a universal public health problem for both children and adults globally. It is not only a public health concern but also an impediment to global poverty reduction, productivity, and economic growth. Under-five children are among the most vulnerable groups, although it affects both women, the elderly, and youth. This study assessed the influence of feeding practices on under-five nutrition status in Mbinga District, Tanzania. This paper unveils the contribution of feeding practices to underfive nutrition status in Tanzania. Methods: A cross-sectional study involved 150 heads of households whose children aged 0–59 months were assessed to determine their anthropometric measurements. Weigh for age Z-scores, height for age Z-scores, and weight for height Z-scores. A structured questionnaire was administered to collect data from the heads of households. Data were coded and analyzed by ENA for the SMART, Statistical Package for Social Sciences (SPSS), and STATA programs. Results: It is revealed that 90.7% of under-five children in the surveyed households initiated breastfeeding within one hour of life, 72% of the children were given complementary foods before six months, maize porridge was a major complementary food, and 80% of the children consumed three to four meals per day. Their diets were not diverse as starchy staple foods were dominant. It was further found that 42% of the children were stunted, 33% were wasted, and 25% were underweight. Moreover, the results of the ordered probit regression model showed that exclusive breastfeeding, meal frequency, and food dietary diversity were positively influencing nutrition status, while household size was negatively influencing the nutrition status of the under-five. Conclusion: The study concludes that inappropriate complementary feeding, children did not receive the minimum dietary diversity, and poor child feeding practices have a positive influence on the anthropometric status of the under-five. It was recommended that education be provided to community members on appropriate child feeding practices and family planning.

Factors that influence feeding practices among parents in Puncak Alam, Selangor

Many factors influence feeding practices, such as socioeconomic status, cultural beliefs, and educational background. This study aimed to identify the factors that influence parents' eating habits in Puncak Alam, Selangor. A comprehensive feeding practices questionnaire (CFPQ) was used for data collection. A total of 201 participants responded to the questionnaire. Working mothers and non-working mothers were found to significantly influence emotion regulation and restriction for weight control feeding practices. By understanding the factors involved, efforts can be made to create a positive and sustainable nutrition environment for children in Puncak Alam, Selangor.

Urinary excretion of calcium, phosphate, magnesium, and uric acid in healthy infants and young children. Influence of feeding practices in early infancy.

Reference values for urinary calcium (Ca) and other solutes/creatinine (Cr) ratios in infants and young children are scarce. Its variation with type of lactation administered, breastfed (BF) or formula (F), is incompletely known. A total of 511 spot urine samples from 136 children, aged 6days to < 5years, was collected. Urine was collected no fasting in infants < 18months and first morning fasting in children aged 2.5-4years. Urinary osmolality, Cr, urea, Ca, phosphate (P), magnesium (Mg), and uric acid (UA) were determined. Values are expressed as solute-to-Cr ratio. Urinary values were grouped according to the child's age: 6-17days (G1), 1-5months (G2), 6-12months (G3), 13-18months (G4), and 2.5-4years (G5). G1 was excluded; Ca/Cr and UA/Cr (95th percentile) decreased with age (G2 vs. G5) from 1.64 to 0.39 and 2.33 to 0.83mg/mg, respectively. The P/Cr median rises significantly with age from 0.31 (G2) to 1.66mg/mg (G5). Mg/Cr was similar in all groups (median 0.20, 95th percentile 0.37mg/mg). Ca/Cr (95th percentile) of BF infants was 1.80mg/mg (< 3months) and 1.63mg/mg (3-5months), much higher than F infants (0.93 and 0.90mg/mg, respectively). P/Cr and P/Ca were lower in BF infants. Values for urinary Ca/Cr, P/Cr, Mg/Cr, and UA/Cr in infants and children < 5years were updated. BF infants < 6months showed higher Ca/Cr and lower P/Cr than F infants. New cutoff values to diagnose hypercalciuria in infants < 6months, according to the type of lactation, are proposed.

Household food security, child dietary diversity and coping strategies among rural households. The case of Kole District in northern Uganda

Household food security, feeding practices, dietary diversity and coping strategies to household food insecurity are largely interconnected. Using a cross sectional study approach involving 162 mothers and care givers of children 0-36 months of age in Kole district of northern Uganda, this study examined the household food security status, child dietary diversity and household coping strategies. The study revealed that a slight majority of the households (55%) were food secure although with a low level of child dietary diversity experienced (68.1% for children 6-23 months age group and 55.3% for 24-36 months age group). We found that starch-based foods derived from cereals, roots and tubers were the most predominantly used food group in child feeding (82%), with limited consumption of other essential food groups, notably fruits, vegetables, meats and dairy products (18% combined). Additionally, only 57% of children 0 to 6 months old were receiving exclusive breastfeeding, and the introduction of complementary foods is often delayed and not well planned for those above 6 months of age. Results also showed that a wide range of coping strategies are employed however the major ones were, reliance on less preferred food (54.9%), limiting portions of meals (35.2%), reducing number of meals taken in a day (29%), and gathering wild fruits and harvesting immature crops (29.6%). It was observed that household food security is a strong determinant of child dietary diversity, may influence feeding practices and the range of coping strategies applicable to households when they experience food insecurity. Furthermore, nutritional education, household size and livelihood diversity play a significant role in determining household food security status, child dietary diversity and coping with food insecurity within rural households. In conclusion, addressing household food security, and coping strategies can play an important role in improving child feeding practices and dietary diversity in rural communities.

Successful breastfeeding following a level II NICU stay in Qatar – a longitudinal study

BackgroundExclusive breastfeeding is an essential need for mothers and newborn babies, but cultural practices and employment demands significantly influence feeding practices. The association between neonatal intensive care unit (NICU) admission and breastfeeding outcomes are variable. Data for Qatar and Middle East, in particular, are limited. Hence, this study aims to estimate the rate of breastfeeding at the time of NICU discharge and the rate of successful breastfeeding after NICU discharge in Qatar during well-baby follow-ups.MethodsThis quantitative longitudinal study was conducted over 18 months from January 2019 and included neonates born in Al Wakra Hospital admitted to the NICU. Demographic data, feeding during NICU stay and at discharge were obtained from lactation charts. Data regarding feeding practices after discharge were obtained through a questionnaire administered at 4 weeks and 8 weeks in well-baby clinics. Descriptive statistics and logistic regression analyses were performed to determine the rates of breastfeeding and the association between the various factors.ResultsOf the 678 participants screened, 364 were eligible for analysis. The rates of exclusive breastfeeding were 20% (73/364), 54% (197/364) and 42% (153/364) at discharge, 4 weeks and 8 weeks, respectively. Any breastfeeding was 64% (233/364), 40% (146/364) and 43% (157/364) at discharge, 4 weeks and 8 weeks, respectively. Logistic regression analysis showed that neonates who had NICU stays longer than 4 days had a higher rate of exclusive breastfeeding at discharge (adjusted odds ratio 3.000; 95% CI 1.25, 7.198) but had a reduced rate of breastfeeding and higher rate of formula feeding during follow-ups. Although breastfeeding rates were better in preterm infants at NICU discharge, regression analysis showed that none of the other factors, including gestation and maternal education had a significant association with the rate of exclusive breastfeeding at the time of discharge or during follow-ups.ConclusionsThe overall breastfeeding rates from this level II NICU in Qatar are better than previously available data. Studies with extended follow-up and assessment of intervention methods should be planned to improve and sustain the practice of exclusive breastfeeding.

How Parenting and Family Characteristics Predict the Use of Feeding Practices among Parents of Preschoolers: A Cross-Sectional Study in Beijing, China.

Parental coercive and structured feeding practices are linked with children’s weight gain. Thus, identifying their predictors will assist in childhood obesity prevention. We explored how parents’ concerns and perceptions of children’s weight, parenting stress, parenting competence, parents’ family roles, and only child status (of both parent and child) predict the use of restriction, pressure to eat, and monitoring practices among parents of preschoolers. Parent–child dyads (n = 2990) were recruited in Beijing in 2019. Parenting competence, parents’ weight perceptions and feeding practices were assessed using the Chinese version of Parenting Sense of Competence Scale and Child Feeding Questionnaire (CFQ), respectively. Parenting stress and other variables were collected through self-administered questionnaires. Multivariate linear associations between parents’ weight perceptions and feeding practices were significant among normal-weight children. Parents’ concerns about children being overweight were positively associated with restriction and monitoring, and negatively associated with pressure to eat. Higher levels of parenting stress and parenting competence significantly improved the adoption of restriction and pressure to eat. Parents’ only child status and that of children had an impact on parents’ feeding practices. The fathers’ feeding preferences were substantially different from what mothers preferred. In conclusion, such parenting and family characteristics significantly influenced feeding practices of preschoolers’ parents. These were long neglected in China.

Community lifestyle influences feeding practices among Indonesian infants and young children

ObjectiveTo analyze the feeding practices of malnourished infants and young children aged 6–24 months old in Bogor, West Java, Indonesia. MethodFourteen mothers or caregivers who had malnourished infants and young children aged 6–24 months were interviewed, focusing on their feeding practices. Informants came from sub-districts in Bogor Regency, Indonesia, which had a higher incidence of malnutrition. The interview process was recorded. Verbatim transcripts of recorded interviews were analyzed using thematic analysis. ResultsFive major themes were identified: (1) Inappropriate practice of early initiation of breastfeeding, (2) Challenges in decision making to maintain breastfeeding, (3) Lack of complementary feeding practices, (4) Failing to follow feeding recommendations, and (5) Infant and young child feeding constraints. ConclusionThe feeding practice for malnourished infants and young children is not entirely based on the recommended standards. This situation is caused by several factors such as economic conditions, culture, parental knowledge, family and community health workers’ support. Health workers need to provide comprehensive intervention for mothers and families intensively by taking into account the culture and conditions of the related family.

Risiko gizi lebih pada anak usia prasekolah berdasarkan aspek sosio-ekonomi keluarga di Kota Kediri

Overweight in children under five has increased and will impact at an early age and cause a metabolic syndrome in adulthood. Being overweight is caused by many things, one of which is socioeconomic family. Family socioeconomic is an underlying cause that influences feeding practices. This study aimed to analyze the risk of overweight in preschool children based on family socio-economics. This study used a case-control design conducted from December 2019 to March 2020. The sample used was 66 preschool children divided into two groups with a ratio of 1:1, which was carried out by simple random sampling—data collection techniques by interviewing sample mothers related to the socioeconomic aspects of the family. Data were processed using SPSS software and categorized each variable into two categories. Data analysis using Chi-Square test. The results of this study showed: that maternal nutritional knowledge was significantly correlated with the incidence of overweight in preschool children (p= 0,041). Other socio-economic aspects (maternal age (p= 0,202), paternal age (p= 0,250), maternal education (p= 0,450), paternal education (p= 0,301), family size (p= 0,439), and family economic status (p= 0,395) were not correlated with the overweight. This study concluded that maternal nutritional knowledge was one of the factors associated with overweight in preschool children, while other socioeconomic factors were not related.

Responsive feeding education for parents with stunting babies aged 12-36 months

Background of Study: North Sulawesi Province becomes a province which has 31.4% of stunting cases. North Minahasa Regence becomes one of stunting local areas which are intervened in order to occur reduction cases which currently amounted to 29.7%. One of factors which affect stunting are mother’s knowledge which influence feeding practices. Responsive feeding is feeding practices which is recommended by WHO conducted with psychosocial approach. Responsive feeding effects on physical and mental development of babies. Mothers who live in stunting-prone area have lower responsive feeding knowledge and practice than those in non-stunting areas.Purpose of Study: for investigating the effect of feeding education with the concept of responsive feeding on the knowledge and practice of eating on stunting babies aged 12-36 months.Method of Study: This study was quantitative study with experimental quasi approach. The study was conducted in Wori District, there were 11 people in case group and 7 people in control group. The respondent criteria were mothers who had stunting toddler aged 12-36 months and were not experiencing mental health. The analysis in this study used univariate and bivariate test. Pretest was provided before education was provided and post test was conducted 2 weeks after education.Result: Univariate test which is used is chi-square test and bivariate analysis is conducted through Independent Sample T-test. The finding of this study showed that there is enhancement of knowledge on case group after responsive feeding education is given however there is no enhancement in attitude. While in control group does not experience an enhancement both knowledge and attitude after education is given.Conclusion: Providing responsive feeding education can enhance mother’s knowledge about good feeding on stunting babies although it requires education for more than 2 weeks for increasing mother’s attitude in feeding of stunting babies.

Nutrition Knowledge of Caregivers Influences Feeding Practices and Nutritional Status of Children 2 to 5 Years Old in Sekhukhune District, South Africa.

The aim of this study was to determine caregivers' nutrition knowledge and its influence on feeding practices and nutritional status on young children. A cross-sectional survey was conducted in 120 caregiver-child pairs. A validated questionnaire was used to collect caregivers' nutrition knowledge and feeding practices. Nutritional status was estimated using anthropometric measurements. Z-scores were computed using WHO Antro software. Chi-square test was used to determine the association between caregivers' nutrition knowledge and feeding practices. Significance was set at p <0.05. Forty three percent of caregivers reported health professionals as their source of nutrition information. Almost all children (94.2%) were breastfed at one stage in their lives, with 62.5% introduced to solid foods before six months. Maize meal porridge (87.5%) and bread (54.2%) were consumed daily by most of the children, while 48.3% consumed meat and meat products three to four times per week. One in eight children consumed fruits daily and 5.8% vegetables daily. Forty one percent of children were stunted. Family income showed positive correlation with the nutritional status of children (weight-for-age R = 0.207, p < .05; height-for-age R°=°0.203*, p°= .026). An association was observed between the duration of breastfeeding and alternative food, to milk (R = 0.302**, p = .001), amount of fruit consumed daily (R = 0.197*, p = .031) and number of meals consumed daily (R = 0.284**, p = .048). Conclusion: Nutrition knowledge and feeding practices of the caregivers were not satisfactory.

Nutrient concentrations affect the antimicrobial resistance profiles of cattle manures.

Antimicrobial resistance (AMR) in cattle is widespread because of the increased use of antibiotics to combat microbial diseases and enhance milk production. The cattle excreta released into the environment can be a potent source of contamination in spreading antibiotic resistance, especially upon its application in agriculture. However, the correlation of AMR profile of manure with other physico-chemical parameters is limited. Therefore, the study aimed to generate AMR profiles for manure samples collected from 25 different sites of two agriculturally important states in India, Madhya Pradesh and Uttar Pradesh. Samples were tested for physico-chemical parameters, viz., electrical conductivity, pH, total nitrogen (N), total phosphorus (P), and total potassium (K). Bacterial community analysis was done by culture-dependent and culture-independent methods. The influence of feeding practices, nutrient concentration, and bacterial abundance on antibiotic resistance profiles was observed in collected manure samples. Manures of intensive feeding animals harbored highly resistant profiles of bacteria as compared to natural grazing cattle.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11356-021-16700-6.

Associations between caesarean births and breastfeeding in the Middle East: a scoping review.

There is a paucity of published studies on factors influencing feeding practices for infants and young children born via caesarean section. To assess whether the mode of childbirth affects early initiation and exclusive breastfeeding, and to identify factors that positively or negatively influence breastfeeding after caesarean births in selected countries in the Middle East. We conducted a scoping review of publicly available population-based surveys and peer-reviewed literature on the associations between birthing mode and breastfeeding published between 2000 and 2018. The search identified 33 demographic surveys and 16 studies containing information on the mode of childbirth and breastfeeding in selected countries in the Middle East listed in PubMed, Embase, and CINAHL databases. Searches were completed in March 2019. Demographic surveys in 6 participating Middle Eastern countries demonstrated increased rates of births by caesarean section. All 3 countries with ≥ 3 datasets available demonstrated that early initiation of breastfeeding was less likely after caesarean section than after vaginal births. Eleven studies analysed differences in breastfeeding outcomes between caesarean section and vaginal births, and all of them identified significant differences between birthing modes. Five studies addressed factors influencing breastfeeding after caesarean births. Caesarean births are associated with a higher risk of delayed initiation of breastfeeding as well as early cessation of exclusive breastfeeding.

Infant temperament is associated with maternal feeding behaviors in early infancy

Parental feeding practices shape infant eating behaviors and may impact obesity risk. For example, feeding on a schedule and using food to soothe have been associated with greater infant weight gain and future obesity risk. Most studies focus on parental determinants of feeding practices, but infant temperament might influence feeding practices parents select. Studies examining associations of infant temperament with parental feeding practices in early infancy are needed. Thus, the purpose of this cross-sectional, observational study was to test the hypothesis that infant temperament would be associated with use of food to soothe and feeding on a schedule. Mother-infant dyads (N = 98) from 3 parent birth cohort studies presented for clinic visits at infant age of 3–5 months. Mothers completed a demographic questionnaire. Feeding practices (use of food to soothe and feeding on a schedule) and maternal perceptions of 3 dimensions of infant temperament (surgency, orienting/regulating, and negative affect) were collected by survey. Spearman partial correlations were used to examine if any of the 3 infant temperament dimensions were associated with use of food to soothe or feeding on a schedule, adjusting for maternal marital status, race/ethnicity, BMI, infant age at the visit, and infant weight-for-length z-score. Greater perceived infant surgency/extraversion was associated with greater use of food to calm (Spearman partial r = 0.25, p < 0.05), but not feeding on a schedule (Spearman partial r = −0.11, p = 0.31). Greater perceived infant negative affect was associated with greater use of food to calm (Spearman partial r = 0.21, p < 0.05). Perceived infant orienting/regulating was not associated with either of the feeding practices examined. These results provide evidence that as early as 3–5 months of age, perceived infant temperament is associated with maternal feeding practices which influence infant growth outcomes.

Linkages between environmental factors (WASH and energy) and Infant and Young Child Feeding practices in rural India: implications for cross-sectoral interventions for child health

Abstract As factors influencing the health and well-being of children are complex and cross-sectoral, integrated interventions are required to improve child health and hence address the Sustainable Development Goals. This paper explores linkages between environmental factors, feeding practices and potential infection pathways in India. The PANChSHEEEL project is a participatory interdisciplinary study, designed to explore HEEE (Health, Education, Engineering and Environment) factors influencing Infant and Young Child Feeding practices. This study uses data from observational transect walks and 445 household interviews from nine villages in Banswara district in India. Using the socio-ecological model, this study demonstrates how the lack of access to and quality of water resources, poor access to sanitation and hygiene practices, access to cooking fuels and flooding can influence feeding practices. The study finds that access to water, sanitation and cooking fuels can affect the preparation of food, contaminate water and food and place added time burden on caregivers. For infants, insufficient and contaminated water can lead to a higher risk of infection, diarrhoea and ultimately malnutrition. Recommendations include efforts to address waterlogging, promote safe storage of water, establish a water quality regime with stakeholders and develop appropriate, affordable and acceptable sanitation solutions.

Socio-cultural beliefs influence feeding practices of mothers and their children in Grand Popo, Benin

BackgroundMalnutrition is a major public health problem. It contributes to the high death rate among children in developing countries despite the various advocacies of institutions such as WHO and FAO and many other organisations. More research needs to be done in order to contribute to the achievement of the Sustainable Development Goals. The aim of this study was to explore socio-cultural practices and their influence on feeding practices of mothers and their children in Grand Popo, Benin.MethodsA qualitative research methodology was used with an inductive approach. A pretested discussion guide was used to conduct focus group discussions with participants in their local language. Four focus group discussions were held in 4 villages located in both the rural and the semi-urban areas with each focus group comprising seven to eight participants. The study protocol was approved by the Health Research Ethics Committee of Stellenbosch University. Focus group discussions were recorded, transcribed and translated to English. The data was analysed following the Creswell data analysis steps.ResultsAll the children were breastfed, and 56.1% of children under 6 months received breast milk exclusively. Children were introduced to family foods at 5 months with very low consumption of animal protein and fruits. Mothers and children had monotonous diets with high consumption of vegetables and maize-based meals. Food taboos, particularly during pregnancy, were revealed. Those cultural beliefs were still followed by some mothers, and food rich in nutrients were pushed aside.ConclusionsThere is a need for educational interventions to raise awareness of the negative impacts of some socio-cultural practices on the health of the mother and child.

Household Food Security, Child Dietary Diversity and Copping Strategies Among Rural Households. The Case of Kole District in Northern Uganda

Household food security, feeding practices, dietary diversity and copping strategies to household food insecurity are largely interconnected. Using a cross sectional study approach involving 162 mothers and care givers in Kole district of Northern Uganda, this study examined the scenarios of household food security status, child feeding practices, dietary diversity and copping strategies. The study revealed that majority of the households (55%) were food secure with an overall observation of low dietary diversity at the household level (72.8%), largely showing dominance of starch-based Cereals, roots and tubers (82%) and limited consumption of other food groups, notably fruits, vegetables, meats and dairy products (18% combined). In terms of feeding practices, majority of the children were fed breast milk for at least 24 months, with mandatory exclusive breastfeeding highly adhered to, but the introduction of complementary foods often delayed and not well planned. Results also showed that a wide range of coping strategies are employed however the major ones were, reliance on less preferred food (54.9%), limiting portions of meals (35.2%), reducing number of melas taken in a day (29%), and gathering wild fruits and harvesting immature crops (29.6%). Generally, it was observed that household food security is a strong determinant of dietary of child dietary diversity, may influence feeding practices and the range of coping strategies applicable to households when they experience food insecurity. It is apparent that nutritional education, household size and livelihood diversity also play a significant role in as far as household food security status, child feeding, diversity and food insecurity copping are concerned within rural households.

Factors influencing complementary feeding practices in rural and semi-urban Rwanda: a qualitative study.

The aim of the present study was to identify and describe the factors influencing feeding practices of children aged 6-23 months in Rwanda. This is a cross-sectional descriptive qualitative study. A total of ten focus group discussions were conducted separately with mothers, fathers, grandmothers and community health workers (CHWs) from five different districts in Rwanda. The discussions were recorded, transcribed verbatim, and thematically analysed using qualitative data analysis software, Atlas.ti. The study participants were mothers, fathers and grandmothers of children aged 6-23 months and CHWs in charge of child health. Caregivers' knowledge and beliefs about the benefits of breast-feeding and timely introduction of complementary food were found to be the primary individual factors facilitating good infant and young child feeding practices. The common belief of caregivers that infants should be given liquids (thin gruel, fruit juices and meat broth) as first foods instead of semi-solid foods was a barrier to good feeding practices. The community-based nutrition education and counselling programmes were facilitators of good complementary practices at the group level. At the society level, poverty in rural agrarian households was a barrier to optimal feeding practices. The study shows that there is a need to empower caregivers with more specific guidelines, especially on complementary feeding.

Characterization of Infant Feeding Practices and Related-Family Characteristics in the French Nationwide ELFE Birth Cohort.

Family characteristics such as education level or income are related to infant feeding practices. This study aimed to characterize infant feeding practices and investigate their associations with family characteristics. Analyses were performed with data from a French nationwide cohort, Etude Longitudinale Française depuis l’Enfance (ELFE). Feeding practices were characterized by two methods, a principal component analysis and a hierarchical ascendant classification (n = 8922). This characterization was conducted in three steps: considering firstly only introduction of main food groups, then also food pieces and finally adding the type of complementary food. The associations between family characteristics and the infant feeding patterns or clusters were tested by linear or multinomial regressions (n = 7556). Besides breastfeeding duration and age of first introduction of complementary foods, it appeared also important to consider specific food groups such as sweetened beverages and cow’s milk, and the introduction of food pieces, to describe feeding practices. Recommended feeding practices (longer breastfeeding, complementary food in the right period) were related to higher maternal age and education level, so was migration status, the presence of older children, low income or the mothers’ attendance to pre-birth preparation classes. The interrelations between feeding practices and family characteristics must be considered when examining the influence of feeding practices on child’s health.

Shonjibon cash and counselling: a community-based cluster randomised controlled trial to measure the effectiveness of unconditional cash transfers and mobile behaviour change communications to reduce child undernutrition in rural Bangladesh

BackgroundUndernutrition is strongly associated with poverty - levels of undernutrition are higher in poor countries than in better-off countries. Social protection especially cash transfer is increasingly recognized as an important strategy to accelerate progress in improving maternal and child nutrition. A critical method to improve nutrition knowledge and influence feeding practices is through behaviour change communication intervention. The Shonjibon Cash and Counselling study aims to assess the effectiveness of unconditional cash transfers combined with a mobile application on nutrition counselling and direct counselling through mobile phone in reducing the prevalence of stunting in children at 18 months.MethodThe study is a longitudinal cluster randomised controlled trial, with two parallel groups, and cluster assignment by groups of villages. The cohort of mother-child dyads will be followed-up over the intervention period of approximately 24 months, starting from recruitment to 18 months of the child’s age. The study will take place in north-central Bangladesh. The primary trial outcome will be the percentage of stunted children at 18 m as measured in follow up assessments starting from birth. The secondary trial outcomes will include differences between treatment arms in (1) Mean birthweight, percentage with low birthweight and small for gestational age (2) Mean child length-for age, weight for age and weight-for-length Z scores (3) Prevalence of child wasting (4) Percentage of women exclusively breastfeeding and mean duration of exclusive breastfeeding (5) Percentage of children consuming > 4 food groups (6) Mean child intake of energy, protein, carbohydrate, fat and micronutrients (7) Percentage of women at risk of inadequate nutrient intakes in all three trimesters (8) Maternal weight gain (9) Household food security (10) Number of events for child suffering from diarrhoea, acute respiratory illness and fever (11) Average costs of mobile phone BCC and cash transfer, and benefit-cost ratio for primary and secondary outcomes.DiscussionThe proposed trial will provide high-level evidence of the efficacy and cost-effectiveness of mobile phone nutrition behavior change communication, combined with unconditional cash transfers in reducing child undernutrition in rural Bangladesh.Trial registrationThe study has been registered in the Australian New Zealand Clinical Trials Registry (ACTRN12618001975280).