Effect of short-term educational intervention on complementary feeding index among infants in rural Bangladesh: a
Aminur Rahman1, Mohammad Badrul Bhuiyan2, Sumon Kumar Das3
1Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh. draminur@icddrb.org.
Insights
Promoting complementary feeding (CF) practices through education significantly improved infant nutritional status in rural Bangladesh. The developed Complementary Feeding Index (CFI) proved effective for evaluating nutritional interventions.
Area of Science:
- Public Health Nutrition
- Child Development
- Maternal and Child Health
Background:
- Adequate complementary feeding (CF) is crucial for infant growth and cognitive development.
- Evidence on the impact evaluation of the Complementary Feeding Index (CFI) is limited.
- This study addresses the need for impact evaluation of CF interventions.
Purpose of the Study:
- To examine the effect of a short-term intervention promoting CF practices on infant nutritional status.
- To evaluate the utility of the Complementary Feeding Index (CFI) in assessing nutritional interventions.
- To assess the impact of educational interventions on infant health outcomes in rural Bangladesh.
Main Methods:
- A randomized controlled trial (RCT) design was employed in rural Matlab, Bangladesh.
- 360 mother-infant pairs were assigned to an intervention (intensive counseling) or comparison group.
- The Generalized estimating equation model was used to evaluate intervention outcomes.
Main Results:
- The intervention group showed a significantly higher mean CFI and higher category CFI scores.
- A one-unit increase in CFI correlated with a 0.07 unit increase in height-for-age z-score.
- The intervention group experienced a decrease in weight-for-age z-score (WAZ), though not statistically significant.
Conclusions:
- The guided short-term nutritional intervention and developed CFI demonstrated significantly better outcomes in the intervention area.
- The CFI is a well-adaptable tool for evaluating nutritional interventions in future studies.
- Educational interventions focusing on CF practices can positively impact infant nutritional status.
Background:
Timely, adequate and appropriate Complementary Feeding (CF) is essential for the growth and cognitive development of infants, but until today, evidence-based information is scarce in terms of impact evaluation of CF index (CFI). The study aimed to examine the effect of the short-term intervention of promoting CF practices on the nutritional status of infants in rural Bangladesh.
Methods:
An educational-intervention study followed a randomized controlled trial (RCT) design (NCT03024710). Mothers and family members in the intervention arm received intensive counselling on CF through community health workers (CHWs), whereas existing healthcare services were received in the comparison arm. The study was carried out in the rural Matlab sub-district of Bangladesh between April 2011 and March 2013. In the specified study areas among 360 mother-infant pairs systematically assigned into intervention group and comparison group. Short-term educational intervention on CF was provided for the intervention group and existing services were un-intervened for the comparison group. The outcome of interventions was evaluated after the implementation period using Generalized equation estimation model.
Results:
At baseline, the study participants were not different except mean height (p = 0.04), weight-for-age Z score (WAZ) (p = 0.03) and religion (p = 0.04) in between two groups. The mean CFI was significantly higher at intervention area than the comparison and higher category of CFI (score 10 or more) was significantly higher at intervention area than comparison. After adjustment, one-unit CFI increased height-for-age z score by 0.07 units and decreased WAZ by 0.13 units in the intervention group but not significantly changed observed at comparison group.
Conclusion:
Guided short-term nutritional intervention and developed CFI indicated a significantly better score in intervention area than comparison groups and would be a well adaptable tool for future studies.
Trial Registration:
The trial was registered ( NCT03024710 ) at clinical trial registration website. Date of registration: 1/19/2017. Name of the registry: Clinical Trial.gov. Date of registration: 19/1/2017 (retrospective registered). URL of trial: https://clinicaltrials.gov/ct2/show/NCT03024710.
