Engaging Fathers for Effective Child Nutrition and Development in Tanzania (EFFECTS): study protocol for a five-arm,
Insights
This study investigated bundled nutrition and parenting interventions, with or without father engagement, in Tanzania. Results will inform effective strategies for improving child nutrition and development outcomes.
Area of Science:
- Global child health
- Developmental pediatrics
- Nutritional science
Background:
- Millions of children under 5 face undernutrition and developmental deficits globally.
- Bundled nutrition and parenting interventions aim to mitigate risks for child outcomes.
- Limited evidence exists on additive benefits of bundled interventions, especially with father engagement.
Purpose of the Study:
- To test bundled nutrition and parenting programs, with and without father involvement, against nutrition programs alone.
- To evaluate the impact of involving fathers in child nutrition and development interventions.
- To compare interventions delivered to mothers' groups versus mothers' and fathers' groups.
Main Methods:
- Community-based cluster-randomized controlled trial in rural Tanzania (EFFECTS study).
- Five arms: nutrition program (mothers only), bundled program (mothers only), nutrition program (mothers & fathers), bundled program (mothers & fathers), and control.
- Primary outcomes: child dietary diversity and early child development (mental/motor). Data collected from mothers, fathers, and children over 12 months.
Main Results:
- This section is for results, which are not available in the provided abstract.
Conclusions:
- The study will provide evidence on bundled nutrition and parenting interventions for child nutrition, growth, and development.
- It will determine the benefits of engaging fathers on child and caregiver outcomes.
- Investigate pathways linking interventions to child outcomes.
Background:
Globally, 144 million children under 5 years are undernourished and 250 million do not meet their developmental potential. Multi-input interventions, such as bundled nutrition and parenting interventions, are designed to mitigate risks for multiple child outcomes. There is limited evidence that bundled interventions have additive benefits to nutrition, growth, or development outcomes. These outcomes share common risks; therefore, designing interventions to tackle these risks using a common theory of change may optimize effectiveness. Emerging evidence suggests explicit engagement of fathers may benefit child outcomes, but few trials have tested this or included data collected from fathers.
Methods:
Engaging Fathers for Effective Child Nutrition and Development in Tanzania (EFFECTS) is a community-based cluster-randomized controlled trial that will be implemented in the rural Mara Region, Tanzania. The trial aims (1) to test a bundled nutrition and parenting program delivered to mothers' groups, with or without fathers' groups, over 12 months on child and caregiving outcomes compared to a nutrition program alone, and (2) to test nutrition or bundled nutrition and parenting programs delivered to mothers' and fathers' groups over 12 months on child and caregiving outcomes compared to programs delivered to mothers alone. The trial comprises five arms: (1) mothers' groups receiving a nutrition program, (2) mothers' groups receiving a bundled nutrition and parenting program, (3) mothers' and fathers' groups receiving a nutrition program, (4) mothers' and fathers' groups receiving a bundled nutrition and parenting program, and (5) control receiving standard of care health services. The primary outcomes are child dietary diversity and early child development (mental and motor development). Parents with a child under 18 months will be enrolled in peer groups and receive twice monthly intervention by trained community health workers. Data will be collected from mothers, fathers, and children at baseline (pre-intervention), midline, and endline (post-intervention).
Discussion:
EFFECTS will generate evidence on the effects of bundled nutrition and parenting interventions on child nutrition, growth, and development outcomes; determine the benefits of engaging fathers on child, caregiving, and caregiver outcomes; and investigate common and unique pathways between treatments and child outcomes.
Trial Registration:
ClinicalTrials.gov NCT03759821. Registered on November 30, 2018.
