The Effect of the “first 1000 days” mass communication intervention on maternal and child feeding practices in Mekelle City, North Ethiopia

Abstract

Background: Undernutrition is a major public health concern in Ethiopia. Interventions aimed at changing child feeding practices during the critical period from conception to the child's second year (the first 1000 days), have the potential to provide long-term benefits. In 2009 G.C, the “first 1000 days” campaign was launched in Ethiopia with the goal of improving feeding behavior in the first 1000 days of a child‟s life.
Aim: To assess the effect of the “first 1000 days” mass communication intervention on maternal and child feeding practices among mothers with children under the age of two years.
Methods: A nested mixed design post intervention only study was conducted in Mekelle city, Ethiopia. A total of 602 mothers with children aged under two years of age were included in this study. Ten in-depth interviews with mothers who had children under the age of two year and three key informant interviews were conducted for the qualitative study. Multiple linear regression analysis was used to identify predictors of feeding practices. Qualitative data was analyzed using thematic analysis.
Results: Over one third of mothers (47.31%) were exposed to the “first 1000 days” campaign. Exposure (β=0.34, p<0.01; 95% CI 0.16 to 0.53), age of the child (β= 0.03, p<0.001;95% CI 0.01 to 0.04), not watching television (β=- -0.52, p=0.04;95%CI -1.02 to-0.02), non-Tigrayan (β=-0.51, p=0.01 ;95%CI -0.93 to -0.08), and being widowed (β=-1.46 p=0.03 95%CI -2.79 to -0.14) were predictors of feeding practices. The findings indicated that, women expressed enthusiasm for the media campaigns but struggled to understand some of the meanings of the messages due to the way the messenger spoke the local language. There were no pre-testing or evaluation strategies for the campaigns.
Conclusion: There is evidence that media campaigns can contribute to the improvement of recommended feeding practices. However, the quality of the message can be enhanced further and in so doing may affect behavioral change. Recognizing key behavioral determinants of feeding practices and incorporating them into campaigns designed with the local context in mind could be a critical first step in developing effective large-scale social and behavioral change programs targeted at feeding practices.