Engaging fathers to support child nutrition increases frequency of children's animal source food consumption in Rwanda.

Abstract

Although social support from fathers is associated with improved child feeding practices, evidence on feasible, acceptable, and effective ways to involve fathers in supporting child nutrition, including animal source food (ASF) consumption, is limited. This study was a follow-on to a trial that tested the effects of social and behavior change communication (SBCC) targeted mainly at mothers to promote ASF consumption by children in households that received an exotic or crossbred cow through the government of Rwanda's Girinka "One Cow Per Poor Family" program (NCT0345567). A delayed SBCC intervention was provided to mothers in the non-intervention arms prior to the present pre/post study, which targeted fathers in households across the trial study arms. Baseline and endline surveys with a cohort of 149 fathers with a child <5 years were used to evaluate the effects of a SBCC intervention for fathers on their children's ASF consumption and on fathers' knowledge, awareness, and support for children's ASF consumption. Qualitative data collected from fathers, mothers, and program implementers were used to assess feasibility and acceptability of the intervention for fathers. The SBCC intervention comprised group meetings led by model fathers, text messages, print materials, and megaphone blasts. The odds of children consuming any type of ASF ≥2 times in the last week increased from baseline to endline (OR 4.9, 95% CI 1.9, 12.3), as did the odds consuming milk, eggs, and beef, but not fish. Fathers' mean ASF knowledge and awareness scores increased from baseline to endline (knowledge: 2.3 to 3.5 out of 4 items, P<0.001; awareness: 2.5 to 3.0 out of 3 items, P<0.001), with the largest changes observed in knowledge of timing of introduction of milk and other ASFs. The percentage of fathers who offered two or more supportive actions for their children's milk and other ASF consumption increased from baseline to endline (milk: 19.5% to 31.5%, P = 0.017; other ASFs: 18.8% to 37.6%, P<0.001). Fathers appreciated gaining knowledge on child nutrition in a setting specifically for men and liked the print materials that offered clear actions they could take to support their children's ASF consumption. This study shows that an SBCC intervention for fathers can improve children's ASF consumption and increase fathers' knowledge, awareness, and support for children's nutrition.