Journal Article

A multi‐sectoral community development intervention has a positive impact on diet quality and growth in school‐age children in rural Nepal

Lohani, Mahendra, Neupane, Sumanta, Miller, Laurie C., Joshi, Neena

2024

Overview

Poor diet quality (diet diversity and animal‐source food [ASF] consumption) during childhood negatively affects growth, development, behaviour and physiologic function in later life. Relatively less is known about the impact of poor diet on the growth of school‐age children compared to children <5 years of age, especially in low/middle‐income countries. A better understanding of delivery strategies for effective interventions to improve diet and hence growth in school‐age children is needed. A 36‐month longitudinal controlled impact evaluation in rural Nepal assessed the nutrition and growth of children <5 years of age in families assigned via community clusters to full package intervention (community development, training in nutrition [during pregnancy and for children <5 years] and livestock husbandry), partial package (training only) or control (no inputs). Concurrent data were collected prospectively (baseline plus additional four rounds) on school‐age children (5–8 years at baseline) in these households; the present study analysed findings in the cohort of school‐age children seen at all five study visits (n = 341). Diet quality improved more in the full package school‐age children compared to those in partial package or control households. full package children consumed more ASF (β +0.40 [CI 0.07,0.73], p < 0.05), more diverse diets (β +0.93 [CI 0.55,1.31], p < 0.001) and had better head circumference z‐scores (β +0.21 [CI 0.07,0.35], p < 0.01) than control children. In conclusion, a multi‐sectoral community development intervention was associated with improvements in diet and growth of school‐age children in rural Nepal even though the intervention focused on the diet of children <5 years of age. The diet and growth of school‐age children can be favourably influenced by community‐level interventions, even indirectly. A multi‐sectoral community development intervention has helped improve the diet of school‐aged children in Nepal. At baseline, animal‐source food (ASF) consumption did not vary significantly among the three groups. However, compared to baseline, the full package intervention group saw a nearly threefold increase in ASF consumption, along with an increase in dietary diversity score (DDS) by approximately 30%. Key messages Relatively less is known about the factors that influence diet quality and growth in school‐age children compared to younger children, especially in low‐ and middle‐income countries. Better diet quality and growth were found among school‐age children whose families participated in an impact study multi‐sectoral intervention compared to children in control families or those whose families only received nutrition training. Diet and growth of school‐age children can be favourably influenced by community‐level interventions.

• Publisher: John Wiley & Sons, Inc,John Wiley and Sons Inc,Wiley
• Subject: Age / Age groups / Anemia / Animal husbandry / Animal-based foods / animal‐source foods / Child / Child development / Child Development - physiology / child diet / child growth / Child Nutritional Physiological Phenomena - physiology / Child, Preschool / Childhood / Children / Children & youth / Cohort analysis / Community development / Comparative studies / Diet / Diet - methods / Diet - statistics & numerical data / diet diversity / Dietary supplements / Education / Families & family life / Female / Food consumption / Households / Humans / Intervention / Livestock / Longitudinal Studies / Low income groups / Male / Nepal / Nutrition / Nutrition assessment / Nutrition research / Nutritional Status / Original / Pregnancy / Rural areas / Rural Population - statistics & numerical data / Rural poverty / Schools / school‐age population / Social development / Teenagers / Training