Topical Area: Global Nutrition

Objectives : We evaluated the impact of an integrated infant and young child feeding (IYCF) – micronutrient powder intervention on IYCF practices among caregivers of children 12-23 mo in Eastern Uganda.

Methods : We used pre-/post- data from two population-based, cross-sectional surveys representative of children aged 12-23 mo in Amuria (intervention) and Soroti (non-intervention) districts. Caregivers were interviewed in June/July at baseline 2015 (N=1260) and 12 mo after implementation in 2016 (N=1490) about their IYCF practices the day preceding the survey. Logistic regression estimated the double-difference effect of the intervention on core World Health Organization (WHO) IYCF indicators: child ever breastfed, current breastfeeding, bottle feeding, complementary foods introduced at age 6 mo, consumption of vitamin A-rich fruits or vegetables, consumption of animal-flesh foods, minimum meal frequency (MMF) (received food ≥3 times for breastfed children and ≥4 times for non-breastfed children), minimum dietary diversity (MDD) (received foods from ≥4 of 7 WHO food groups), and minimum acceptable diet (MAD) (MDD and MMF among breastfed children, and ≥2 milk feeds, MDD not including milk feeds, and MMF among non-breastfed children). Analyses were weighted and accounted for complex sampling design.

Results : After controlling for child age and sex, household wealth, household food security, and caregiver education, the intervention was positively associated with MMF (Adjusted Prevalence Difference-in-Difference [APDiD] 18.6%; 95% Confidence Interval [CI] 11.2, 26.0) and MAD (APDiD 5.6%; 95% CI 0.02, 11.2). The intervention was associated with 21.8% higher prevalence of timely introduction of complementary feeding (95% CI 13.4, 30.1) and with increased consumption of both vitamin A-rich fruits/vegetables (APDiD 23.5%; 95% CI 12.5, 34.5) and animal-flesh foods (APDiD 9.1%; 95% CI 1.5, 16.7). The intervention did not affect breastfeeding or bottle feeding practices. Despite program impact, prevalence of some IYCF practices were low in Amuria at endline including MAD (19%) and MMF (21%).

Conclusions : The integrated IYCF intervention had a positive impact on many core WHO IYCF practices; however, low endline prevalence of some indicators suggests a continued need to improve complementary feeding practices in Eastern Uganda.

Funding Sources : Funding or in kind technical support provided by the Ministry of Health Uganda, World Food Programme, and the U.S. Centers for Disease Control and Prevention (CDC).

Presenting Author(s)

• NF

  Nicole Ford

  Nutrition Scientist
  U.S. Centers for Disease Control and Prevention (McKing Corp. contractor)

Co-Author(s)

• LR

  Laird Ruth

  Micronutrient Specialist
  U.S. Centers for Disease Control and Prevention (McKing Corp. Contractor)

• SN

  Sarah Ngalombi

  Senior Nutritionist
  Uganda Ministry of Health

• AL

  Abdelrahman Lubowa

  Consultant
  Makerere University

• SH

  SIti Halati

  Nutrition Officer
  UN World Food Programme

• MA

  Martin Ahimbisibwe

  Nutrition chief
  United Nations World Food Programme

• RB

  Rhona Baingana

  Makerere University

• RW

  Ralph Whitehead

  Health Scientist
  U.S. Centers for Disease Control and Prevention

• CM

  Carine Mapango

  International Research Nutritionist/Biologist
  U.S. Centers for Disease Control and Prevention

• MJ

  Maria Elena Jefferds

  U.S. Centers for Disease Control and Prevention