Paternal BCC and Child Diet Diversity in Ethiopia

HKUST IEMS Working Papers No. 82


Yaeeun Han, Seollee Park, JiEun Kim & John Hoddinott


Background: Augmenting maternal nutrition behavior change communication (BCC) activities with food vouchers or through greater engagement of fathers may play improve IYCF practices, but their impact is unknown.

Objective: We assess whether, in addition to the provision of maternal BCC, adding paternal BCC, a food voucher, or both a food voucher and paternal BCC improved child diet diversity.

Methods: We implemented a cluster randomized control trial in 92 Ethiopian villages, allocated to four treatment and one control group: (1) Maternal BCC only; (2) Maternal BCC and paternal BCC; (3) Maternal BCC and food vouchers; (4) Maternal BCC, food vouchers, and paternal BCC; and C, control. The trial lasted 16 weeks. Primary outcomes were parental IYCF nutrition knowledge, child Dietary Diversity Score and a household Food Consumption Score. Impacts were assessed using generalized estimating equations.

Results: Maternal BCC increased maternal knowledge of optimal IYCF practices and paternal BCC increases paternal knowledge of optimal IYCF practices. Paternal knowledge also increased when only mothers were exposed to nutrition BCC. All treatment arms had a statistically significant impact on children’s dietary diversity scores. Effect sizes range from 10.0% (M&V&P) to 13.2% (M), to 21.2% (M&P) to 23.2% (M&V). Adding vouchers to maternal BCC produced a larger effect than maternal BCC alone but the difference was not statistically significant (P=0.18). Adding paternal BCC to the maternal BCC treatment did not lead to a larger increase in child diet diversity. Adding paternal BCC to the maternal BCC and voucher treatment did not lead to a larger increase in child diet diversity; we reject the null (P=0.03) that these had equal effects.


Conclusion: Increased paternal involvement does not necessarily translate into improvements in child feeding outcomes. Caution should be used when considering how to engage fathers in actions that affect child nutrition outcomes.

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