MULTI-SECTORAL INNOVATION TO LINK PRE-SCHOOL PLATFORM TO DIETARY DIVERSITY INTERVENTION Mtemi Zombwe1, Lucy Palmer2 1EQUIP-T project, Tanzania, Cambridge Education (part of Mott MacDonald Ltd) 2 International Health Team, Mott MacDonald, UK
BACKGROUND
OBJECTIVES
The period of early childhood, starting from conception, has a fundamental impact on a child’s future cognitive and physical development. Like elsewhere, Tanzania has poor Infant and Young Child Feeding (IYCF) indicators, limiting children’s achievement of their potential in later life. Tanzania has trialled and taken to scale a successful community-based model – School Readiness Programme (SRP) - as part of the UK funded Education Quality Improvement Programme – Tanzania (EQUIP-T). We tested integration of a holistic parenting intervention using the SRP platform.
The parenting intervention, named “Pre-school, Poultry and Parenting” aimed to: 1) Demonstrate whether parenting sessions can be effective in supporting positive behaviour change around IYCF and nurturing care 2) Generate information on how multi-sectoral and integrated interventions can be managed using existing structures (for sustainability) 3) Produce proof of concept to help design future Government of Tanzania led ECD interventions
APPROACH & METHODOLOGY Preschool, Poultry and Parenting (PPP) is an integrated intervention comprising weekly interactive parenting sessions over 12 weeks. It was developed by Mott MacDonald working closely with MoHCDGEC and PO-RALG in Tanzania. It built on work to develop a vaccine against Newcastle disease in poultry[1] and integrated this into a holistic parenting intervention to improve infant and young child feeding (IYCF) and other aspects of nurturing care. The intervention took place in three wards of Dodoma region in 2019-20. PPP provided families with the means to adopt better nutrition in practical and sustainable ways including: • supporting Tanzania Veterinary Laboratory Agency (TVLA) to train community members to become poultry vaccinators and providing a small “seed” grant to cover the first batch of vaccines; • incorporating expertise from the Tanzania Food and Nutrition centre (TFNC) to promote home “sack gardens” and to provide practical cooking classes demonstrating how locally grown vegetables, eggs, and other nutrient rich foods can be cooked and incorporated into weaning foods and young children’s foods. Sessions were led by the local government cadre of Community Development Officers (CDOs), along with guest speakers, to ensure the approach has an institutional home and can ultimately be scaled and sustained. Each week participants shared their experiences when they tried out new practices derived from what they learned. 1. https://www.cambridge.org/core/journals/world-s-poultry-science-journal/article/technically-sound-and-sustainable-newcastle-diseasecontrol-in-village-chickens-lessons-learnt-over-fifteen-years/0A36E26FEF7BD8372E3752701DB852CA
RESULTS
At baseline, results showed that many parents did not feed their children with adequate frequency or diversity. 30% of families in our intervention sites fed their child only once in a 24-hour period. By endline, the proportion reporting that they had fed their child once fell to 1.4% of households, while 42% fed their child four or more times, up from 18% (Figure 1). At baseline, a third of households fed their children from just one food group, 30% from only two groups and only 3% had fed their children with food from all five groups in the last 24 hours. Endline findings indicate that there had been a very significant improvement, with the proportion of children eating from all five food groups increasing from 3% to 35%, and those eating from four groups rising from 10% to almost 40% (Figure 2). Average quantity of sugar purchased by households per month also fell from 2.2 kg to 1.7 kg. Parents also reported engaging in more playful activities with their children. Parents were highly motivated to know that they possess in their own surroundings every food group to prepare nutritious food for their family. Most households created home gardens as a result of the intervention; some decided to extend the cultivation of vegetables and sell the surplus to commercial vendors at the local market.
CONCLUSION This intervention was hugely successful as a proof of concept and has much potential for further roll out to drastically improve IYCF and reduce stunting in Tanzania. By linking nutrition interventions with an educational platform, PPP proved highly motivational for parents. Using a focused and practical approach, it showed parents simple measures to take, and encouraged collective adoption of new practices. The bespoke training could be digitalised to help bring down unit costs as part of future scale up.