Abstract
OBJECTIVE: The prevention of malnutrition in children under two approach (PM2A), women's empowerment and agricultural interventions have not been widely evaluated in relation to child diet and nutrition outcomes. The present study evaluated the effectiveness of PM2A, women's empowerment groups (WEG), farmer field schools (FFS) and farmer-to-farmer training (F2F). DESIGN: Community-matched quasi-experimental design; outcome measures included children's dietary diversity, stunting and underweight. SETTING: Communities in South Kivu, Democratic Republic of the Congo.ParticipantsA total of 1312 children from 1113 households. RESULTS: Achievement of minimum dietary diversity ranged from 22·9 to 39·7 % and was significantly greater in the PM2A and FFS groups (P<0·05 for both comparisons). Fewer than 7·6 and 5·8 % of children in any group met minimum meal frequency and acceptable diet targets; only the PM2A group differed significantly from controls (P<0·05 for both comparisons). The endline stunting prevalence ranged from 54·7 % (PM2A) to 69·1 % (F2F) and underweight prevalence from 22·3 % (FFS) to 34·4 % (F2F). No significant differences were found between intervention groups and controls for nutrition measures; however, lower prevalences of stunting (PM2A, -4 %) and underweight (PM2A and FFS, -7 %) suggest potential impact on nutrition outcomes. CONCLUSIONS: Children in the PM2A and FFS groups had better child diet measures and nutrition outcomes with the best results among PM2A beneficiaries. Interventions that address multiple aspects nutrition education, health, ration provision and income generation may be more effective in improving child diet and nutrition in resource-poor settings than stand-alone approaches.