PMID- 31544735 OWN - NLM STAT- MEDLINE DCOM- 20201204 LR - 20230619 IS - 1475-2727 (Electronic) IS - 1368-9800 (Print) IS - 1368-9800 (Linking) VI - 23 IP - 1 DP - 2020 Jan TI - Multisectoral community development in Nepal has greater effects on child growth and diet than nutrition education alone. PG - 146-161 LID - 10.1017/S136898001900260X [doi] AB - OBJECTIVE: To compare the impact on child diet and growth of a multisectoral community intervention v. nutrition education and livestock management training alone. DESIGN: Longitudinal community-based randomized trial involving three groups of villages assigned to receive: (i) Full Package community development activities, delivered via women's groups; (ii) livestock training and nutrition education alone (Partial Package); or (iii) no intervention (Control). Household surveys, child growth monitoring, child and household diet quality measures (diet diversity (DD), animal-source food (ASF) consumption) were collected at five visits over 36 months. Mixed-effect linear regression and Poisson models used survey round, treatment group and group-by-round interaction to predict outcomes of interest, adjusted for household- and child-specific characteristics. SETTING: Banke, Nepal. PARTICIPANTS: Households (n 974) with children aged 1-60 months (n 1333). RESULTS: Children in Full Package households had better endline anthropometry (weight-for-age, weight-for-height, mid-upper-arm-circumference Z-scores), DD, and more consumption of ASF, after adjusting for household- and child-specific characteristics. By endline, compared with Partial Package or Control groups, Full Package households demonstrated preferential child feeding practices and had significantly more improvement in household wealth and hygiene habits. CONCLUSIONS: In this longitudinal study, a comprehensive multisectoral intervention was more successful in improving key growth indicators as well as diet quality in young children. Provision of training in livestock management and nutrition education alone had limited effect on these outcomes. Although more time-consuming and costly to administer, incorporating nutrition training with community social capital development was associated with better child growth and nutrition outcomes than isolated training programmes alone. FAU - Miller, Laurie C AU - Miller LC AUID- ORCID: 0000-0002-3586-2335 AD - Department of Pediatrics, Tufts University, Box 190, 800 Washington Street, Boston, MA 02111, USA. AD - Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA. AD - International Food Policy Research Institute, New Delhi, India. FAU - Neupane, Sumanta AU - Neupane S AD - International Food Policy Research Institute, New Delhi, India. FAU - Joshi, Neena AU - Joshi N AD - Heifer Nepal, Kathmandu, Nepal. FAU - Lohani, Mahendra AU - Lohani M AD - Heifer International, Little Rock, AR, USA. FAU - Rogers, Beatrice L AU - Rogers BL AD - Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA. FAU - Neupane, Shailes AU - Neupane S AD - Valley Research Group, Kathmandu, Nepal. FAU - Ghosh, Shibani AU - Ghosh S AD - Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA. FAU - Webb, Patrick AU - Webb P AD - Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA. LA - eng SI - ClinicalTrials.gov/NCT03516396 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, U.S. Gov't, Non-P.H.S. DEP - 20190923 PL - England TA - Public Health Nutr JT - Public health nutrition JID - 9808463 SB - IM EIN - Public Health Nutr. 2020 Jan;23(1):162-167. PMID: 31796139 MH - Animals MH - *Child Development MH - Child Nutritional Physiological Phenomena MH - Child, Preschool MH - Community Health Services MH - Diet/*statistics & numerical data MH - Family Characteristics MH - Feeding Behavior MH - Female MH - Health Education/*methods MH - Humans MH - Hygiene MH - Income MH - Infant MH - Livestock MH - Longitudinal Studies MH - Male MH - Nepal MH - Nutritional Sciences/education MH - *Nutritional Status MH - Nutritive Value PMC - PMC10200641 OTO - NOTNLM OT - Animal-source foods OT - Child diet OT - Child growth OT - Multisectoral community intervention OT - Nepal OT - Nutrition education OT - Women's groups EDAT- 2019/09/24 06:00 MHDA- 2020/12/15 06:00 PMCR- 2020/01/01 CRDT- 2019/09/24 06:00 PHST- 2019/09/24 06:00 [pubmed] PHST- 2020/12/15 06:00 [medline] PHST- 2019/09/24 06:00 [entrez] PHST- 2020/01/01 00:00 [pmc-release] AID - S136898001900260X [pii] AID - 00260 [pii] AID - 10.1017/S136898001900260X [doi] PST - ppublish SO - Public Health Nutr. 2020 Jan;23(1):146-161. doi: 10.1017/S136898001900260X. Epub 2019 Sep 23.