Discussion Paper 1804: Adding a nutrition behavior change communication component to an early childhood development intervention in Malawi: A cluster randomized trial
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In Africa south of the Sahara, including Malawi, an estimated 61 percent of children below the age of five are developmentally challenged as a result of poverty, malnutrition, and lack of early stimulation and learning opportunities. Early-childhood development (ECD) programmes, which aim to improve young children’s survival, health and development are considered one of the most cost-effective human capital investments that can be provided by governments particularly when compared to subsequent schooling interventions. Community-based Childcare Centres (CBCCs) are a key element of ECD programs in Malawi. CBCCs serve 3–5-year-olds by promoting holistic child development through provision of safe and stimulating environments, access to health and nutrition services, and capacity building for parents and caregivers. In Malawi, there are an estimated 11,000 CBCCs across the country, but many are not functional. Lack of food provision at the CBCC leads to high rates of absenteeism and is considered one of the main reasons for the closing of CBCCs. To address this, Save the Children in partnership with Chancellor College-University of Malawi developed an integrated agriculture-nutrition package that was implemented alongside the standard ECD component. This included activities to promote nutritious food production and consumption, promotion of optimal feeding and caring practices, and engagement with parents in pre-school meal planning and preparation.
The Nutrition Embedded Evaluation Program Impact Evaluation (NEEP-IE) cluster randomized control trial aimed to assess the effectiveness of implementing an agriculture and nutritional intervention through CBCCs in Malawi. A newly published IFPRI Discussion Paper presents the impact results of this control trial, focusing on child development outcomes of pre-school children during a 12 months intervention period.
The NEEP-IE trial demonstrated that CBCCs can be an effective platform to scale-up an integrated agriculture and nutrition intervention, and improve food production diversity, maternal knowledge, nutrition practices at household level and diets of pre-schoolers and their younger siblings, as well as improve linear growth in younger siblings ages 6–24 months. The study found that adding a nutrition BCC on top of a basic ECD stimulation package already involving parental and child-centre based stimulation in Malawi may improve parenting practices but has no short-term benefits on child development in pre-schoolers.
Click here to download and read the full discussion paper (776 KB).
Authors: Aulo Gelli, Melissa Gladstone, Aisha Twalibu, Theresa Nnensa, Patricia Kariger and Harold Alderman, 2019
