Effectiveness of Context-Specific Social and Behaviour Change (SBC) Interventions in Improving Child Diet in...

In Ethiopia, malnutrition reflects stark nutritional disparities across residences and regions, with young children in rural areas exhibiting markedly poorer outcomes than their urban counterparts. This systematic review and meta-analysis evaluated the effectiveness of context-specific social and behaviour change (SBC) interventions, including nutrition education, on child nutrition, measured through changes in Minimum Dietary Diversity (MDD), Dietary Diversity Score (DDS), and child weight gain. We systematically searched PubMed, Scopus, HINARI, and Google Scholar for studies on SBC interventions in Ethiopia. After screening for eligibility, data were extracted on MDD, DDS, and weight gain. Using random-effects models, pooled risk ratios (RR) and mean differences (MD) were calculated, heterogeneity was assessed, and subgroup analyses were conducted by region to examine variations in effectiveness. A total of 33 studies met the inclusion criteria. Overall, SBC interventions were associated with improvements in child dietary diversity and weight outcomes. Children in intervention groups were 67% more likely to meet MDD (RR = 1.67; 95% CI: 1.42-1.96). Dietary diversity scores increased (MD = 0.80; 95% CI: 0.51-1.08), and child weight gain improved (MD = 1.32; 95% CI: 0.49-2.15) compared with controls. Effects were strongest in urban settings, particularly in Addis Ababa. By region, the Southern Nations, Nationalities, and Peoples' Region (SNNPR) showed the highest weight gain (MD = 2.01), while effects in Oromia and Amhara were more moderate and occasionally non-significant. Heterogeneity was high (I² = 99.64%), indicating substantial variability in effectiveness attributable to contextual differences, implementation modalities, and programme intensity across Ethiopia. In Conclusion, SBC interventions significantly improved dietary diversity and child growth outcomes in Ethiopia, although effects varied across regions. Tailoring approaches to local cultural and environmental contexts may achieve stronger impacts. Integrating SBC with initiatives that strengthen food security, enhance health service delivery, and address structural barriers is essential for maximizing effectiveness.