Mid-program impact on feeding frequency and dietary diversity among infants and young children in rural Malaw

Abstract Number Theme Presentation Type Cover Approved
0233 Efficacy or effectiveness of micronutrient interventions Poster Not Approved


Abstract Content


In 2014, the Government of Malawi, with technical support from WFP, launched a large-scale nutrition program in a rural district, where the prevalence of undernutrition is high. The program provides lipid-based nutrient supplements (LNS) to children 6-<24mo and a social behavior change communications (SBCC) package promoting optimal infant and young child feeding. In an impact evaluation, we characterized infant dietary patterns and evaluated the one-year mid-program impact on feeding frequency and dietary diversity.


The study design was quasi-experimental with a program (P) and comparison (C) district. Cross-sectional data were collected at baseline (BL:January-March,2014; n=2,364) and midline (ML:January-March,2015; n=2,361). Feeding frequency (breastfeeding and meal) and dietary diversity (Dietary Diversity Score [DDS]; range=0-7) were derived using 24-hour dietary recall data. Program impact was estimated using Difference-in-Differences (DID) and Kernel Propensity Score Matching (PSM)-DID analyses.


Program exposure did not significantly reduce mean 24-hour breastfeeding frequency (P:ML=13.9; C:ML=15.4, DID=0.74) or home meal frequency (P:ML=3.4; C:ML=3.8, DID=0.6) (p’s>0.05). DDS remained low at midline with children across districts, but improvements in DDS favored the program district (P:BL=2.3; C:BL=2.6; P:ML=2.4; C:ML=2.6, DID=0.14) (p=0.07).The proportion of children consuming grains, dairy, and meats increased by 3.6%, 1.1%, and 9.2%, respectively, in the program vs. comparison district (p’s<0.05), whereas legume intake decreased by 7.3% (p<0.05). In PSM-DID analyses, food group findings remained significant, while the marginal impact on DDS was attenuated (p=0.22).


LNS combined with SBCC did not displace breastfeeding or home foods (except legumes) and may have led to improved consumption of some food groups.

Our website uses cookies to ensure you have the best experience.
Please visit our Privacy Policy page for more information.