Degree of exposure to interventions influences maternal and child dietary practices: Evidence from a large-scale multisectoral nutrition program

The prevalence of maternal and child malnutrition in Nepal is among the highest in the world, despite substantial reductions in the last few decades. One effort to combat this problem is Suaahara II (SII), a multi-sectoral program implemented in 42 of Nepal's 77 districts to improve dietary div...

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Bibliographic Details
Published in:PloS one 2019-08, Vol.14 (8), p.e0221260-e0221260
Main Authors: Suresh, Shalini, Paxton, Anne, Pun, Bhim Kumari, Gyawali, Min Raj, Kshetri, Indra Dhoj, Rana, Pooja Pandey, Cunningham, Kenda
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age
Analysis
Biology and Life Sciences
Child
Child health
Child malnutrition
Child Nutrition Disorders - epidemiology
Child Nutrition Disorders - physiopathology
Child, Preschool
Children
Children & youth
Cross-Sectional Studies
Diet
Epidemiology
Exposure
Female
Food
Food groups
Health aspects
Health Knowledge, Attitudes, Practice
Hemoglobin
Households
Human nutrition
Humans
Infant
Infant Nutritional Physiological Phenomena
Interpersonal communication
Intervention
Keller, Helen, 1880-1968
Male
Malnutrition
Mass media
Maternal & child health
Maternal behavior
Medicine and Health Sciences
Mothers
Multiculturalism & pluralism
Nepal - epidemiology
Nutrition
Nutritional Status - physiology
People and Places
Personal communication
Platforms
Pregnancy
Prevalence studies (Epidemiology)
Public health
Radio programs
Regression analysis
Regression models
Sanitation
Social Sciences
Socioeconomic Factors
Standard deviation
Undernutrition
Womens health
Workers
Young Adult
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Summary:The prevalence of maternal and child malnutrition in Nepal is among the highest in the world, despite substantial reductions in the last few decades. One effort to combat this problem is Suaahara II (SII), a multi-sectoral program implemented in 42 of Nepal's 77 districts to improve dietary diversity (DD) and reduce maternal and child undernutrition. Using cross-sectional data from SII's 2017 annual monitoring survey, this study explores associations between exposure to SII and maternal and child DD. The study sample included 3635 mothers with at least one child under the age of five. We focused on three primary SII intervention platforms: interpersonal communication (IPC) by frontline workers, community mobilization (CM) via events, and mass media through a weekly radio program (Bhanchhin Aama); and also created an exposure scale to assess the dose-response relationship. DD was measured both as a continuous score and as a binary measure of meeting the recommended minimum dietary diversity of consuming foods from at least 5 of 10 food groups for mothers and at least 4 of 7 food groups for children. We used linear and logistic regression models, controlling for potentially confounding factors at the individual and household level. We found a positive association between any exposure to SII platforms and maternal DD scores (b = 0.09; p = 0.05), child (aged 2-5 years) DD scores (b = 0.11; p = 0.03), and mothers meeting minimum dietary diversity (OR = 1.16; p = 0.05). There were significant, positive associations between both IPC and CM events and meeting minimum DD (IPC: OR = 1.31, p = 0.05; CM: OR = 1.37; p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0221260