Implementation, utilization and influence of a community-based participatory nutrition promotion programme in rural Ethiopia: programme impact pathway analysis

Yunhee Kang, Seungman Cha, Sarah Yeo, Parul S Christian

Research output: Contribution to journalArticle

Abstract

Objective: A community-based participatory nutrition promotion (CPNP) programme, involving a 2-week group nutrition session, attempted to improve child feeding and hygiene. The implementation, utilization and influence of the CPNP programme were examined by programme impact pathway (PIP) analysis. Design: Five CPNP programme components were evaluated: (i) degree of implementation; (ii) participants’ perception of the nutrition sessions; (iii) participants’ message recall; (iv) utilization of feeding and hygiene practices at early programme stage; and (v) participants’ engagement in other programmes. Setting: Habro and Melka Bello districts, Ethiopia. Subjects: Records of 372 nutrition sessions, as part of a cluster-randomized trial, among mothers (n 876 in intervention area, n 914 in control area) from a household survey and CPNP participants (n 197) from a recall survey. Results: Overall, most activities related to nutrition sessions were successfully operated with high fidelity (>90 %), but a few elements of the protocol were only moderately achieved. The recall survey among participants showed a positive perception of the sessions (~90 %) and a moderate level of message recall (~65 %). The household survey found that the CPNP participants had higher minimum dietary diversity at the early stage (34·0 v. 19·9 %, P=0·01) and a higher involvement in the Essential Nutrition Action (ENA) programme over a year of follow-up (28·2 v. 18·3 %; P<0·0001) compared with non-participants within the intervention area. Conclusions: Our PIP analysis suggests that CPNP was feasibly implemented, promoted a sustained utilization of proper feeding behaviours, and enhanced participation in the existing ENA programme. These findings provide a possible explanation to understanding CPNP’s effectiveness.

Original languageEnglish (US)
Pages (from-to)1-12
Number of pages12
JournalPublic Health Nutrition
DOIs
StateAccepted/In press - Apr 17 2017

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Ethiopia
Hygiene
Feeding Behavior
Mothers
Surveys and Questionnaires

Keywords

  • Child feeding and hygiene practices
  • Community-based participatory nutrition promotion
  • Process evaluation
  • Programme impact pathway
  • Undernutrition

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Public Health, Environmental and Occupational Health

Cite this

@article{82f89ebbf66c4156b070d6a996169a7e,
title = "Implementation, utilization and influence of a community-based participatory nutrition promotion programme in rural Ethiopia: programme impact pathway analysis",
abstract = "Objective: A community-based participatory nutrition promotion (CPNP) programme, involving a 2-week group nutrition session, attempted to improve child feeding and hygiene. The implementation, utilization and influence of the CPNP programme were examined by programme impact pathway (PIP) analysis. Design: Five CPNP programme components were evaluated: (i) degree of implementation; (ii) participants’ perception of the nutrition sessions; (iii) participants’ message recall; (iv) utilization of feeding and hygiene practices at early programme stage; and (v) participants’ engagement in other programmes. Setting: Habro and Melka Bello districts, Ethiopia. Subjects: Records of 372 nutrition sessions, as part of a cluster-randomized trial, among mothers (n 876 in intervention area, n 914 in control area) from a household survey and CPNP participants (n 197) from a recall survey. Results: Overall, most activities related to nutrition sessions were successfully operated with high fidelity (>90 {\%}), but a few elements of the protocol were only moderately achieved. The recall survey among participants showed a positive perception of the sessions (~90 {\%}) and a moderate level of message recall (~65 {\%}). The household survey found that the CPNP participants had higher minimum dietary diversity at the early stage (34·0 v. 19·9 {\%}, P=0·01) and a higher involvement in the Essential Nutrition Action (ENA) programme over a year of follow-up (28·2 v. 18·3 {\%}; P<0·0001) compared with non-participants within the intervention area. Conclusions: Our PIP analysis suggests that CPNP was feasibly implemented, promoted a sustained utilization of proper feeding behaviours, and enhanced participation in the existing ENA programme. These findings provide a possible explanation to understanding CPNP’s effectiveness.",
keywords = "Child feeding and hygiene practices, Community-based participatory nutrition promotion, Process evaluation, Programme impact pathway, Undernutrition",
author = "Yunhee Kang and Seungman Cha and Sarah Yeo and Christian, {Parul S}",
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AB - Objective: A community-based participatory nutrition promotion (CPNP) programme, involving a 2-week group nutrition session, attempted to improve child feeding and hygiene. The implementation, utilization and influence of the CPNP programme were examined by programme impact pathway (PIP) analysis. Design: Five CPNP programme components were evaluated: (i) degree of implementation; (ii) participants’ perception of the nutrition sessions; (iii) participants’ message recall; (iv) utilization of feeding and hygiene practices at early programme stage; and (v) participants’ engagement in other programmes. Setting: Habro and Melka Bello districts, Ethiopia. Subjects: Records of 372 nutrition sessions, as part of a cluster-randomized trial, among mothers (n 876 in intervention area, n 914 in control area) from a household survey and CPNP participants (n 197) from a recall survey. Results: Overall, most activities related to nutrition sessions were successfully operated with high fidelity (>90 %), but a few elements of the protocol were only moderately achieved. The recall survey among participants showed a positive perception of the sessions (~90 %) and a moderate level of message recall (~65 %). The household survey found that the CPNP participants had higher minimum dietary diversity at the early stage (34·0 v. 19·9 %, P=0·01) and a higher involvement in the Essential Nutrition Action (ENA) programme over a year of follow-up (28·2 v. 18·3 %; P<0·0001) compared with non-participants within the intervention area. Conclusions: Our PIP analysis suggests that CPNP was feasibly implemented, promoted a sustained utilization of proper feeding behaviours, and enhanced participation in the existing ENA programme. These findings provide a possible explanation to understanding CPNP’s effectiveness.

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