Differences in Complementary Feeding Practices within the Context of the WASH Benefits Randomized, Controlled Trial of Nutrition, Water, Sanitation, and Hygiene Interventions in Rural Kenya

• DOI: 10.1096/fasebj.31.1_supplement.165.1
• Publication Date: 2023-11-26T17:16:59Z
• Authors: Kendra Byrd; Anne Williams; Holly N. Dentz; Marion Kiprotich; Gowthami Rao; Charles D. Arnold; A. Clair Null; Kathryn G. Dewey; Christine P. Stewart
• Keywords: Behavior change communication

Background and Objective Poor complementary feeding practices are associated with linear growth faltering in early childhood. The objective of this study was to evaluate the among households that participated a randomized controlled trial water, sanitation, hygiene, nutrition interventions rural Kenya. Methods Households were enrolled from rural, western Kenya cluster‐randomized one eight arms, including water (W); sanitation (S); hygiene (H); combination three arms (WSH); (N); WSH+N; passive control arm; double‐sized active arm. With each intervention, families behavior change communication (BCC) programs complemented hardware they received, which adapted through formative research. In N WSH+N received messages on breastfeeding practices, addition lipid‐based nutrient supplements (LNS) for infants 6–24 months age. These delivered monthly by health promoters, who selected local villages, trained staff BCC messaging. After year enumerators surveyed mothers ascertain dietary diversity, frequency, infant intake. For outcome, we collapsed non‐nutrition into two groups, analyzed pairwise comparisons using mixed log binomial model, robust standard errors account design effect. Results A total 3,526 surveyed, their between 7–14 mean (SD) number food groups consumed past 24 hours 3.6 (1.1) fed mean(SD) 3.4(1.6) times/day. We found 60.4% achieved criteria minimum diversity (MDD, ≥4 groups), 73.7% meal frequency (MMF, ≥2 feeds 6–8 mo olds or ≥3 9–23 olds), while 46.7% reached minimally adequate diet (MAD). There higher prevalence achieving MDD (63.6% versus 59.4% arms), though difference only marginally significant (PR: 1.22, 95% CI: 0.99 – 1.49). no differences those met MMF MAD groups. Conclusion Kenya, along LNS modestly more likely achieve compared arms. Behavior alone may not be effective at improving without addressing other factors, such as resource constraints. Support Funding Information source: Funded grant UC Berkeley Bill Melinda Gates Foundation additional support National Institutes Health.