World Vision Ethiopia had implemented a two years Essential Nutrition Promotion (ENP) Project, using the Positive Deviance/Hearth (PD Hearth) approach, in two Kebeles of Jeju District from June 2007 to September 2009. The PD Hearth approach identifies those behaviors practiced by the mothers or caretakers of well-nourished children from poor families and transfers such positive practices to others in the community with malnourished children. The study investigated whether there are improvements sustained three years after the program was terminated. A Cross-sectional survey was administered to a total of 249 children, 123 of them randomly selected from two Kebeles that had previously participated in the program and 126 children from a neighboring comparison two Kebeles. All the sample children 6-59 months of age were measured, and mothers of children under 24 months interviewed. The children born after the completion of the program in the intervention area were significantly better nourished than those in the comparison area, with adjusted mean weight-for-age Z scores of -0.963 versus -1.308 (p < 0.05), respectively. More intervention area mothers of under 24 months children were currently breastfeeding, at the time (100%) as compared with comparison area mothers (94.2%, p < 0.05). Frequency of complementary feeding to the 6-24 months children was better among the intervention area mothers as compared to their counterparts, 4.24 versus 3.83 per day, respectively (p < 0.05). Intervention area mothers reported that they often washed their hands before feeding their children (97.6% vs. 89.4%, p < 0.05). More intervention area mothers (97.0%) also reported that their family members use pit latrines rather than open defecation as compared to the comparison families (89.3%) (p < 0.05). The PD behaviors practiced through the hearth sessions might have sustained years after program completion, and might have contributed to better nutritional status of the children.
Table of Contents
1. INTRODUCTION
1.1. Significance of the Study
1.2. Statement of the Problem
1.3. Research Objectives
1.4. Research Question
2. LITERATURE REVIEW
2.1. Causes of Malnutrition & Country Situation
2.2. Common Approaches of Nutrition Intervention
2.3. The Positive Deviance/Hearth (PD/Hearth) approach
2.3.1. The Positive Deviance (PD) approach
2.3.2. The Hearth approach
3. MATERIALS AND METHODS:
3.1. Description of the Study Area
3.2. Research Design
3.3. Study Period
3.4. Source Population
3.5. Study Population
3.6. Sampling
3.7. Variables
3.8. Instruments
3.9. Data Collection
3.10. Data Analysis
3.11. Ethical Consideration
4. RESULTS AND DISCUSSION
4.1. Demographic and Socioeconomic Characteristics of the Households
4.2. Child Nutritional Status
4.3. Child Feeding and Care Practices
4.4. Hygiene and Health Seeking Behaviors
4.5. Limitations and Strength
5. CONCLUSION AND RECOMMENDATION
6. REFERENCES
7. APPENDICES
7.1. Consent & Data Collection Forms (English version)
7.2. Consent & Data Collection Forms (Afan Oromo version)
Research Objectives and Focus
The primary objective of this study is to assess and compare the nutritional status and the feeding and care practices of children under five years of age in areas where the PD/Hearth intervention program was previously implemented versus non-intervention areas within the Jeju District of the Oromia Regional State.
- Comparison of child nutritional status between intervention and non-intervention groups.
- Evaluation of sustained impact of the PD/Hearth approach three years post-intervention.
- Assessment of maternal feeding and child care behaviors.
- Analysis of hygiene and health-seeking behaviors in the study communities.
Excerpt from the Book
2.3. The Positive Deviance/Hearth (PD/Hearth) approach
A PD/Hearth Nutrition Program uses the “positive deviance” approach to identify those behaviors practiced by the mothers or caretakers of well-nourished children from poor families and to transfer such positive practices to others in the community with malnourished children (CORE Group, 2003).
A cohort study, to monitor a community-based nutrition activities from the first cycle, of 50 program children and 55 comparison children in Leogane, Haiti indicated that children continued to gain weight as fast as or faster than the international standard median six months, after participating in a Hearth program (Bolles et al., 2002).
Analysis of primary data from project internal database was done to assess the implementation of Positive Deviance Approach in Aceh Besar District of Indonesia. The study showed that, out of the 894 children participated, 38.1% of them gained catch-up growth and 28.6% gained normal growth (Hidayat, 2009).
A cohort of 700 children, all with second or third degree malnutrition, participated in the Hearth program, by Save the Children/US in Vietnam, in 1991. Follow-up two years later showed that of these same children, only 3% were still second and third degree malnourished. Fifty-nine percent of all Hearth participants were rehabilitated to normal and 38% to first degree malnutrition. This initial level of improvement was observed 14-23 months after participation in the Hearth (CORE Group, 2003).
Summary of Chapters
1. INTRODUCTION: Outlines the prevalence and impact of malnutrition in Ethiopia and introduces the PD/Hearth approach as a community-based solution to address these nutritional challenges.
2. LITERATURE REVIEW: Reviews existing literature on the causes of malnutrition, current Ethiopian health situations, and global evidence regarding the effectiveness of the PD/Hearth approach.
3. MATERIALS AND METHODS: Describes the study area, research design, sampling techniques, and the instruments used for data collection and analysis.
4. RESULTS AND DISCUSSION: Presents the findings regarding household socio-demographics, child nutritional outcomes, and feeding/care practices, followed by a discussion on the program's perceived effectiveness.
5. CONCLUSION AND RECOMMENDATION: Concludes that the intervention showed positive long-term results and provides recommendations for scaling up the approach and conducting further longitudinal research.
Keywords
Hearth, positive deviance, malnutrition, nutrition, World Vision Ethiopia, Essential Nutrition Promotion, Jeju, Kebele, stunting, wasting, child care, community health, breastfeeding, complementary feeding, socioeconomic factors
Frequently Asked Questions
What is the core focus of this research?
The research focuses on evaluating the effectiveness and sustainability of the Positive Deviance/Hearth (PD/Hearth) nutritional intervention program implemented by World Vision Ethiopia in the Jeju District.
What are the primary thematic areas covered?
The study covers child nutritional status, breastfeeding and complementary feeding practices, hygiene conditions, health-seeking behaviors, and socio-demographic factors.
What is the main objective of the study?
The goal is to determine if children in areas that participated in the PD/Hearth intervention show better nutritional outcomes compared to children in non-intervention areas, three years after the program ended.
Which scientific methods were employed?
The study utilized a comparative cross-sectional survey design with quantitative data collection, including anthropometric measurements of children and structured interviews with their caregivers.
What is addressed in the main chapters?
The main chapters provide a background on malnutrition, a detailed methodology of the cluster sampling used, a presentation of statistical results comparing the two groups, and a conclusion on the program's legacy.
Which keywords define this work?
Key terms include PD/Hearth approach, child malnutrition, Ethiopia, nutritional status, community health intervention, and breastfeeding practices.
How was the sample population selected?
The population was sampled from four rural Kebeles in the Jeju District using probability proportional to size (PPS) for cluster selection and the EPI method for house-to-house surveys.
What was the main finding regarding breastfeeding?
The study found a significant difference in the current breastfeeding status of mothers, with 100% of mothers in the intervention area still breastfeeding compared to 94.2% in the comparison area.
Did the intervention influence hygiene behaviors?
Yes, significantly more mothers in the intervention area reported washing their hands before feeding their children compared to those in the non-intervention area.
What conclusion does the author draw about the PD/Hearth program?
The author concludes that the PD/Hearth approach is a proven, effective, and sustainable method for tackling child malnutrition by utilizing local wisdom and empowering caregivers.
- Citation du texte
- Negassa Kinfu (Auteur), 2013, Comparison of Child Nutritional Status Between Positive Deviance/Hearth (PD/Hearth) Intervention and Non-Intervention Areas in Jeju District, Arsi Zone, Oromia Regional State, Munich, GRIN Verlag, https://www.grin.com/document/299040
