Communication to improve feeding practices for infants and young children

Feeding children orange-fleshed sweetpotatoes (OFSP) can help to alleviate vitamin A deficiency. Growing these improved sweetpotatoes is a necessary step, but is not enough. Mothers and caregivers also need training and support to learn how to prepare food safely while retaining vitamins to improve their young children’s nutrition. Integrated communication strategies using different channels are more effective than a one-off message.

Malnutrition is a major public health problem in many developing countries. In Kenya, vitamin A deficiency is particularly serious, afflicting 34% of children under five years of age – more than 2.4 million. Many low-income households rely on roots, tubers and bananas, so it is important to make these crops more nutritious. Plant breeders are enriching these crops to make them higher in specific micronutrients that vulnerable populations need. OFSP, for example, is an excellent source of vitamin A. Growing the crops is a first step, but agriculture alone will not solve malnutrition. Multidisciplinary expertise is needed, and many partners must work together. Local people need training to learn the best ways to feed the new varieties to their children.

Mothers and caregivers learning how to prepare food safely while retaining vitamins to improve their young children’s nutrition. H. Rutherford/CIP

CIP and partners in western Kenya have been working for 10 years to bring the benefits of OFSP to vulnerable children by combining agriculture, health and nutrition. A recent study under the SUSTAIN (Scaling Up Sweetpotato Through Agriculture and Nutrition) research project compared the effectiveness of different social and behavior change communication strategies for promoting good practices using OFSP for improved infant and young child feeding. Janet Mwende Mutiso of the University of Nairobi, and Julius Juma Okello of CIP interviewed a sample of 665 mothers and caregivers of Homa Bay County to understand the impact of the training. About 17% of the women had participated in mothers-to-mothers clubs, 33% received one-on-one nutrition counseling, 78% attended health talks and 39% had attended a cooking demonstration.

The different communication strategies were carefully designed and implemented based on lessons from previous interventions. At the mothers-to-mothers clubs, nutrition education was given by community health volunteers using counseling cards developed by SUSTAIN to explain feeding practices. The nutrition counseling involved one-on-one nutrition talks with mothers of babies with acute nutrition cases, who deserved more attention. Mothers who attended health talks at the health clinics also received coupons that gave them access to subsidized OFSP planting material from local vine multipliers. The cooking demonstrations were especially designed to show how to prepare OFSP for toddlers.

All of these communication strategies promoted feeding practices to improve the nutrition of young children: age-appropriate meal frequency (little kids need to be fed more often), a diverse diet (with four groups of food per day), the right texture and amount of food for small children and feeding children OFSP roots and OFSP leaves.

To assess the effectiveness of the communication, the women’s responses were analyzed in four categories of similar ages: 1) pregnant mothers with children under two; 2) mothers of babies five months old and younger; 3) moms with kids from six to 23 months and 4) other women aged 19 to 49 years who cared for under-twos. The women in the last two groups were more likely to adopt the practices, probably because more of them had attended health talks where benefits of OFSP were discussed.

Interactive strategies that included face-to-face communication with mothers were the most effective. Combining several strategies and communicating more frequently enhanced learning more than using just one strategy. “This kind of study provides important evidence for designing effective nutrition support programs. These also need to be cost-effective if we want to reach millions of children. It is therefore essential that we can recommend to government services and other agencies what communication interventions provide the best value for money,” says Simon Heck of CIP, the leader of the SUSTAIN project.

The study also revealed that OFSP can be an effective entry point for starting to change diets and children’s feeding practices. 11% of the participating women gave their children fully diverse diets, and 35% offered meals in the right frequency. 21% fed their children OFSP roots and 11% gave them OFSP leaves. “Most children below six years old prefer the OFSP to their other staple foods, making it easy to reach them with OFSP,” says Robert Mwanga, plant breeder at CIP.