Association for Public Policy Analysis & Management

Background: Young children in developing countries often maintain poor diets, evidenced by strikingly low dietary diversity. Through formative research, we identified the lack of knowledge and affordability as key barriers to improved infant and young child feeding (IYCF) practices in Ethiopia. The aim of this study is to investigate ways to promote healthy IYCF by analyzing the impacts of an IYCF behavior change communication (BCC) program and food vouchers on mother’s IYCF knowledge and practices.

Method: Using clustered randomized design, we compare the effects of two independent interventions—IYCF BCC program (BCC) and food vouchers (voucher)—on four study groups: BCC only, voucher only, BCC and voucher, and the control group. The BCC program offered weekly group IYCF sessions to mothers who has children between 4 to 20 months of age for 16 weeks, employing participatory learning methods. The voucher program provided food vouchers worth approximately 10 USD per month for four months, which could be used at nearby markets. We identified 640 eligible households residing in 78 villages in Ejere through census.

Between September 2017 and March 2018, 78 villages were randomly assigned to one of the four study groups: BCC only (15 villages, 101 eligible households), voucher only (14 villages, 96 eligible households), BCC and voucher (13 villages, 154 eligible households), and control (36 villages, 289 eligible households). All eligible mothers living in treatment villages were invited to participate in the program to which the village she lives in was assigned to.

Findings: We find that BCC significantly increases mothers' IYCF knowledge. The BCC and voucher interventions increase spending on healthy food items including animal products and fruits and vegetables, especially among the BCC and voucher group. We also examine child dietary diversity score (CDDS) as a measure of children's dietary quality. We find corresponding results that BCC and voucher interventions improve children’s dietary quality significantly, while food vouchers alone do not. The impacts are largest for those treated by both BCC and food vouchers, and we find suggestive evidence for stunting reduction in this group.