Maternal nutrition practices and behaviours in the context of a Cash-Plus intervention: a qualitative study in...

In low- and middle-income countries, breaking the intergenerational cycle of malnutrition requires the promotion of healthy nutrition practices and behaviours during pregnancy and early motherhood.

This study aimed to explore nutrition practices and behaviours among pregnant women and mothers of children under 2 years who were exposed to the Cash-Plus intervention in tribal districts of Rajasthan, India.

Data was collected in December 2024 through in-depth interviews with 46 women which included parity-2 pregnant women and mothers of young children (below 2 years of age), 36 husbands and 34 other family members; plus 7 focus group discussions with 23 frontline workers of four intervention districts. A framework analysis approach was used to identify emerging concepts around practices and behaviours.

Participants were positive about the intervention, potentially reflecting the study design. They reported improved practices related to antenatal care, pregnancy weight monitoring and gain, dietary diversity, early and exclusive breastfeeding, and child feeding. These were influenced by the combined effect of consistent interpersonal counselling from trained frontline workers and conditional cash transfers. Counselling improved knowledge and motivation, while cash transfers enabled adoption of resource-dependent practices. Involvement of husbands and mothers-in-law supported the uptake and sustenance of practice and behaviours, alongside emerging peer and community influences.

The Cash-Plus intervention supported improvements in maternal and child nutrition practices and behaviours through interacting behavioural, economic and social pathways. Findings highlight the importance of integrated, family-centred approaches that address knowledge and structural barriers, alongside ensuring inclusive intervention design in vulnerable settings.