(P24-069-24) Effectiveness of Nutrition Education, Microfinance, and Nutrition-Integrated Couples’ Strengthening Interventions on Child Dietary Diversity in Rural Niger

Objectives: To examine the effectiveness of nutrition education (EDU) and microfinance (MF), with or without a couples’ strengthening (CS) intervention, in improving children’s dietary diversity (CDDS) and to identify effect modifiers in rural Niger.

Methods: Data was drawn from a 12-month three-arm prospective quasi-experimental study with 1,887 eligible households (n_control= 387, n_I1 = 620, n_I2 = 880) with child dietary data at both baseline and endline. CDDS was calculated out of seven food groups consumed in the past 24 hours. The difference in CDDS between endline and baseline (CDDS_diff) in control (no intervention), I1 (EDU + MF), and I2 (EDU + MF + CS) was assessed using multivariate regression with cluster robust standard errors, adjusted for baseline characteristics differing between all study arms. Potential modification effect by marriage structure, maternal age, maternal education, child age, and child sex, were assessed, considering multiple comparison with Bonferroni correction.

Results: At baseline, mean CDDS was 3.2 ± 1.2 in control, 2.8 ± 1.1 in I1, and 2.7 ± 1.1 in I2. We observed significant increase in CDDS from baseline to endline in control (CDDS_diff: 0.49, 95% CI: 0.22, 0.75), I1 (CDDS_diff: 0.55, 95% CI: 0.37, 0.74), and I2 (CDDS_diff: 0.75, 95% CI: 0.53, 0.96). However, no significant differences were observed in CDDS_diff between any of the three study arms. The null effect was consistently observed by the potential modifiers examined.

Conclusions: Short-term nutrition education and microfinance with or without couples’ strengthening did not improve CDDS. The overall poor agricultural yields and inflated food prices in 2021-2022 and the residual confounding due to unmeasured differences between the control and intervention groups may have contributed to lack of intervention impact in our analysis. Our findings highlight the need to further investigate the mechanisms that drive changes in child diets in highly food-insecure and resource-scarce settings in rural Niger.

Funding Sources: 1. Catholic Relief Services (CRS) OverOps Reserve Fund
2. Implementer-Led Design, Evidence, Analysis and Learning (IDEAL), USAID's Bureau for Humanitarian Assistance (BHA)