Effectiveness of A Community‐Based Participatory Nutrition Promotion Program to Improve Linear and Ponderal Growth in Children 6 to 24 Months of Age in Rural Eastern Ethiopia: A Cluster Randomized Trial

Appropriate complementary feeding and hygiene may reduce child undernutrition. We designed a community‐based participatory nutrition promotion (CPNP) program, adopting in part the theory of positive deviance, in Ethiopia. This program through group sessions engaged mothers in “learning by doing” around infant feeding and hygiene and utilization of affordable resources. This program was implemented in addition to the existing government nutrition programs and tested in a cluster‐randomized trial to examine its effectiveness in improving child growth. 1,790 children 6 to 12 months of age were enrolled in the trial and measured for their height and weight every three months for 12 months. 38.9% of children enrolled in the intervention area attended the CPNP program. In multi‐level mixed‐effect regression models based on longitudinal data controlling for clustering effects, children in the intervention area had a significantly greater length‐for‐age z score (LAZ)/month of 0.017 (95% CI 0.004, 0.030) and weight‐for‐age z score (WAZ)/month of 0.015 (95% CI 0.003, 0.026) compared to children in the control area. Significant differences in LAZ and WAZ scores between two groups were apparent after 6 months of program implementation and continued up to a year. Stunting, underweight, and wasting were 5–7 percentage points lower in the intervention area than the control area after a year. This new program approach was effective in improving child growth in the rural Ethiopian context. This trial was funded by KOICA, World Vision Korea, and WITH.