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An Integrated Micronutrient Powder Intervention Improved IYCF Practices Among Caregivers of Children 6-23 Months in Eastern Uganda (P10-131-19).

Objectives
We evaluated the impact of an integrated infant and young child feeding (IYCF) - micronutrient powder intervention on IYCF practices among caregivers of children 12-23 mo in Eastern Uganda.


Methods
We used pre-/post- data from two population-based, cross-sectional surveys representative of children aged 12-23 mo in Amuria (intervention) and Soroti (non-intervention) districts. Caregivers were interviewed in June/July at baseline 2015 (N = 1260) and 12 mo after implementation in 2016 (N = 1490) about their IYCF practices the day preceding the survey. Logistic regression estimated the double-difference effect of the intervention on core World Health Organization (WHO) IYCF indicators: child ever breastfed, current breastfeeding, bottle feeding, complementary foods introduced at age 6 mo, consumption of vitamin A-rich fruits or vegetables, consumption of animal-flesh foods, minimum meal frequency (MMF) (received food ≥3 times for breastfed children and ≥4 times for non-breastfed children), minimum dietary diversity (MDD) (received foods from ≥4 of 7 WHO food groups), and minimum acceptable diet (MAD) (MDD and MMF among breastfed children, and ≥2 milk feeds, MDD not including milk feeds, and MMF among non-breastfed children). Analyses were weighted and accounted for complex sampling design.


Results
After controlling for child age and sex, household wealth, household food security, and caregiver education, the intervention was positively associated with MMF (Adjusted Prevalence Difference-in-Difference [APDiD] 18.6%; 95% Confidence Interval [CI] 11.2, 26.0) and MAD (APDiD 5.6%; 95% CI 0.02, 11.2). The intervention was associated with 21.8% higher prevalence of timely introduction of complementary feeding (95% CI 13.4, 30.1) and with increased consumption of both vitamin A-rich fruits/vegetables (APDiD 23.5%; 95% CI 12.5, 34.5) and animal-flesh foods (APDiD 9.1%; 95% CI 1.5, 16.7). The intervention did not affect breastfeeding or bottle feeding practices. Despite program impact, prevalence of some IYCF practices were low in Amuria at endline including MAD (19%) and MMF (21%).


Conclusions
The integrated IYCF intervention had a positive impact on many core WHO IYCF practices; however, low endline prevalence of some indicators suggests a continued need to improve complementary feeding practices in Eastern Uganda.


Funding Sources
Funding or in kind technical support provided by the Ministry of Health Uganda, World Food Programme, and the U.S. Centers for Disease Control and Prevention (CDC).