Engaging men in maternal, infant and young child nutrition in rural Tanzania

Outcomes from a cluster randomized control trial and qualitative study

Bibliographic Data

ID15536747
AuthorsJessica D Rothstein (0000-0002-8503-2233, Helen Keller International, corresponding author), Rolf D W Klemm (Headquarters Nutrition Division Helen Keller International Washington District of Columbia USA), Rolf Klemm (0000-0002-8423-1943, Helen Keller International), Yunhee Kang (0000-0002-8184-9166, Johns Hopkins University), Debora Niyeha (Helen Keller International), Erin Smith (0000-0001-8381-3098, Helen Keller International Nepal), Stella Nordhagen (0000-0002-3801-3769, Global Alliance for Improved Nutrition)
Year2022
Volume19
Issue2
Pagese13460-e13460
Publication date2022-12-08
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueMaternal and Child Nutrition (JOURNAL)
Journal identifiersISSN: 1740-8695 • E-ISSN: 1740-8709
PublisherWiley (PUBLISHER • GB)
DOI10.1111/mcn.13460
PMID36482813
OpenAlexW4310951997
LanguageEN
Citations received4
References cited36

There is growing recognition that engaging men in maternal, infant and young child nutrition (MIYCN) interventions can benefit child health and disrupt harmful gender norms. We conducted a cluster-randomized controlled trial in Tanzania, which engaged men and women in behaviour change via mobile messaging (short message service [SMS]) and traditional interpersonal communication (IPC), separately and in combination. Here, we evaluate intervention effects on individual-level men's MIYCN knowledge and discuss barriers to male engagement. Eligible clusters were dispensary catchment areas with >3000 residents. Forty clusters were stratified by population size and randomly allocated to the four study arms, with 10 clusters per arm. Data on knowledge and intervention exposure were collected from 1394 men through baseline and endline surveys (March-April 2018 and July-September 2019). A process evaluation conducted partway through the 15-18-month intervention period included focus group discussions and interviews. Data were analysed for key trends and themes using Stata and ATLAS.ti software. Male participants in the short message service + interpersonal communication (SMS + IPC) group reported higher exposure to IPC discussions than IPC-only men (43.8% and 21.9%, respectively). Knowledge scores increased significantly across all three intervention groups, with the greatest impact in the SMS + IPC group. Qualitative findings indicated that the main barriers to male participation were a lack of interest in health/nutrition and perceptions that these topics were a woman's responsibility. Other challenges included meeting logistics, prioritizing income-earning activities and insufficient efforts to engage men. The use of a combined approach fusing IPC with SMS is promising, yet countering gender norms and encouraging stronger male engagement may require additional strategies

Behavior change communication · Cluster randomised controlled trial · Dispensary · Environmental health · Family medicine · Focus group · Interpersonal communication · Intervention (counseling · Population · Psychological intervention · Randomized controlled trial · Tanzania · Child Nutrition and Water Access · ICT in Developing Communities · Medicine · Mobile Health and mHealth Applications · Nursing · Psychology · Social Psychology