Behavioural insights to support increased consumption of quality protein maize by young children: a cluster randomised trial in Ethiopia
Introduction Biofortified crops have tremendous potential to improve child nutrition. We tested whether complementing the distribution of quality protein maize (QPM) with a package of interventions informed by behavioural insights could support greater consumption of QPM by young children and transl...
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BMJ Publishing Group
2020-12-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/5/12/e002705.full |
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| author | Dan Han Margaret McConnell Jessica Cohen Katherine Donato Nilupa S Gunaratna Masresha Tessema Hugo De Groote |
| author_facet | Dan Han Margaret McConnell Jessica Cohen Katherine Donato Nilupa S Gunaratna Masresha Tessema Hugo De Groote |
| author_sort | Dan Han |
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| description | Introduction Biofortified crops have tremendous potential to improve child nutrition. We tested whether complementing the distribution of quality protein maize (QPM) with a package of interventions informed by behavioural insights could support greater consumption of QPM by young children and translate into improved growth.Methods We conducted a cluster-randomised trial in Oromia, Ethiopia. Clusters of households with a child between 6 and 35 months were randomised into an arm receiving QPM seed only (320 households, 203 clusters) or an arm receiving QPM seed and a child consumption targeting intervention (290 households, 183 clusters). The intervention package included tools to help caregivers keep QPM separate from conventional maize and to earmark QPM specifically for child consumption, as well as encouragement regarding cooking QPM specifically for young children. We analysed the impact of the intervention on food storage, cooking and consumption behaviours and on anthropometric measures (weight-for-age, height-for-age z scores).Results The consumption targeting intervention increased the probability of child consumption of QPM in the past week by 17.3 percentage points (pp) (95% CI 9.4 pp to 25.1 pp; p<0.01), increased the probability that QPM flour was stored separately from conventional maize by 46.5 pp (95% CI 38.3 pp to 54.7 pp; p<0.01) and increased the probability that caregivers cooked QPM specifically for young children in the past week by 14.4 pp (95% CI 7.9 pp to 20.9 pp; p<0.01). These effects persisted, but were attenuated, 10 months postintervention. No significant effects on anthropometric outcomes were found.Conclusions Enhancing the distribution of new, biofortified crop varieties with a consumption targeting campaign can change storage, cooking and consumption behaviours. However, these improved behaviours did not translate into increased growth in this setting.Trial registration number NCT02710760 and AEARCTR0000786. |
| format | Article |
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| language | English |
| publishDate | 2020-12-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Global Health |
| spelling | doaj-art-5459ab462c6d4b039a88aa7ef9f96c5a2025-08-20T02:21:04ZengBMJ Publishing GroupBMJ Global Health2059-79082020-12-0151210.1136/bmjgh-2020-002705Behavioural insights to support increased consumption of quality protein maize by young children: a cluster randomised trial in EthiopiaDan Han0Margaret McConnell1Jessica Cohen2Katherine Donato3Nilupa S Gunaratna4Masresha Tessema5Hugo De Groote6Lee Kuan Yew School of Public Policy, National University of Singapore, SingaporeDepartment of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA2 Department of Global Health and Population, Harvard University, Boston, Massachusetts, USABoston Consulting Group, Denver, Colorado, USAPublic Health, Purdue University, West Lafayette, Indiana, USA2 Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, EthiopiaSocioeconomics Program, CIMMYT Kenya, Nairobi, KenyaIntroduction Biofortified crops have tremendous potential to improve child nutrition. We tested whether complementing the distribution of quality protein maize (QPM) with a package of interventions informed by behavioural insights could support greater consumption of QPM by young children and translate into improved growth.Methods We conducted a cluster-randomised trial in Oromia, Ethiopia. Clusters of households with a child between 6 and 35 months were randomised into an arm receiving QPM seed only (320 households, 203 clusters) or an arm receiving QPM seed and a child consumption targeting intervention (290 households, 183 clusters). The intervention package included tools to help caregivers keep QPM separate from conventional maize and to earmark QPM specifically for child consumption, as well as encouragement regarding cooking QPM specifically for young children. We analysed the impact of the intervention on food storage, cooking and consumption behaviours and on anthropometric measures (weight-for-age, height-for-age z scores).Results The consumption targeting intervention increased the probability of child consumption of QPM in the past week by 17.3 percentage points (pp) (95% CI 9.4 pp to 25.1 pp; p<0.01), increased the probability that QPM flour was stored separately from conventional maize by 46.5 pp (95% CI 38.3 pp to 54.7 pp; p<0.01) and increased the probability that caregivers cooked QPM specifically for young children in the past week by 14.4 pp (95% CI 7.9 pp to 20.9 pp; p<0.01). These effects persisted, but were attenuated, 10 months postintervention. No significant effects on anthropometric outcomes were found.Conclusions Enhancing the distribution of new, biofortified crop varieties with a consumption targeting campaign can change storage, cooking and consumption behaviours. However, these improved behaviours did not translate into increased growth in this setting.Trial registration number NCT02710760 and AEARCTR0000786.https://gh.bmj.com/content/5/12/e002705.full |
| spellingShingle | Dan Han Margaret McConnell Jessica Cohen Katherine Donato Nilupa S Gunaratna Masresha Tessema Hugo De Groote Behavioural insights to support increased consumption of quality protein maize by young children: a cluster randomised trial in Ethiopia BMJ Global Health |
| title | Behavioural insights to support increased consumption of quality protein maize by young children: a cluster randomised trial in Ethiopia |
| title_full | Behavioural insights to support increased consumption of quality protein maize by young children: a cluster randomised trial in Ethiopia |
| title_fullStr | Behavioural insights to support increased consumption of quality protein maize by young children: a cluster randomised trial in Ethiopia |
| title_full_unstemmed | Behavioural insights to support increased consumption of quality protein maize by young children: a cluster randomised trial in Ethiopia |
| title_short | Behavioural insights to support increased consumption of quality protein maize by young children: a cluster randomised trial in Ethiopia |
| title_sort | behavioural insights to support increased consumption of quality protein maize by young children a cluster randomised trial in ethiopia |
| url | https://gh.bmj.com/content/5/12/e002705.full |
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