RESUMEN
BACKGROUND: Schools are an attractive platform for improving the dietary knowledge, attitudes and behaviors of children and their families, yet limited nutrition knowledge amongst educators can impede nutrition education efforts. Information and communication technology (ICT) can potentially overcome this barrier, yet there is limited evidence for its effectiveness in school settings in low- and middle-income countries. METHODS: We implemented a randomized field experiment in 50 schools in the North Region of Cameroon to assess the effectiveness of a school-based nutrition education program at improving the nutrition knowledge of fifth and sixth grade students and their parents. We evaluate the relative effectiveness of video-based versus typical classroom instruction. Nutrition knowledge is assessed using a pre-post questionnaire and analyzed using analysis of covariance. RESULTS: We find that students exposed to the video treatment improved their nutrition knowledge scores by 0.45 standard deviation more (equivalent to an additional 1.3 out of 14 correct answers) than students that received traditional classroom instruction. There is no differential impact of video on the nutrition knowledge scores of parents. CONCLUSION: Videos can improve knowledge gains compared with typical classroom instruction, but questions remain as to the conditions under which videos and other ICT are most effective as instructional tools.
RESUMEN
Nutrition-sensitive agriculture programmes have the potential to improve child nutrition outcomes, but livestock intensification may pose risks related to water, sanitation and hygiene (WASH) conditions. We assessed the impact of SELEVER, a nutrition- and gender-sensitive poultry intervention, with and without added WASH focus, on hygiene practices, morbidity and anthropometric indices of nutrition in children aged 2-4 years in Burkina Faso. A 3-year cluster randomised controlled trial was implemented in 120 villages in 60 communes (districts) supported by the SELEVER project. Communes were randomly assigned using restricted randomisation to one of three groups: (1) SELEVER intervention (n = 446 households); (2) SELEVER plus WASH intervention (n = 432 households); and (3) control without intervention (n = 899 households). The study population included women aged 15-49 years with an index child aged 2-4 years. We assessed the effects 1.5-years (WASH substudy) and 3-years (endline) post-intervention on child morbidity and child anthropometry secondary trial outcomes using mixed effects regression models. Participation in intervention activities was low in the SELEVER groups, ranging from 25% at 1.5 years and 10% at endline. At endline, households in the SELEVER groups had higher caregiver knowledge of WASH-livestock risks (∆ = 0.10, 95% confidence interval [CI] [0.04-0.16]) and were more likely to keep children separated from poultry (∆ = 0.09, 95% CI [0.03-0.15]) than in the control group. No differences were found for other hygiene practices, child morbidity symptoms or anthropometry indicators. Integrating livestock WASH interventions alongside poultry and nutrition interventions can increase knowledge of livestock-related risks and improve livestock-hygiene-related practices, yet may not be sufficient to improve the morbidity and nutritional status of young children.
