AN EVALUATION OF A NUTRITION PROGRAM, POSITIVE DEVIANCE HEARTH INTERVENTION, IN MIGORI COUNTY, KENYA

Abstract

Positive Deviance Hearth program is designed to rehabilitate malnourished children, enable the families to sustain their rehabilitation at home on their own and to prevent malnutrition in younger siblings. However, PD Hearth monitoring system in Migori only assesses program rehabilitation, one of the three PD Hearth objectives. There was need for evaluation to measure outcomes of the PD three fold purposes. The objectives of this study were to assess the extent to which PD Hearth intervention rehabilitates malnourished children, determine the level to which PD Hearth enables families to sustain rehabilitation at home on their own, establish the degree to which PD Hearth prevents malnutrition among the younger siblings and ultimately identify the practices which influence PD Hearth outcomes. A pipeline quasi-experimental design and mixed methods were used to collect data and perform statistical analyses. Single stage cluster sampling was used to identify 53 and 54 intervention and comparison families and children in five communities and 36 younger siblings of the children in the intervention. In Migori County weight measurements of the children in the intervention aged 6 to 59 months at admission were retrieved from Family Aids Care and Education Services programme activities reports at the entry, exit and graduation stages. Anthropometric measurements (height and weight) for these children, their younger siblings and comparison children were taken. In addition, research assisted questionnaires were administered to caregivers of the children in the intervention while the community health workers and area chiefs were interviewed using a pretest questionnaire. Using computer programmes WHO Anthro 2005, SAS 9.1 for Windows, SPSS version 16.0 and Microsoft Office Excel 2007 statistical analyses was computed and positivist approach used to make inference of the study findings. A probability value of ≤0.05 was considered significant. The findings indicated that PD Hearth program rehabilitated acute malnutrition but not chronic malnutrition and it had a spillover effect in younger siblings. The results also found that increased feeding frequency made the largest unique contribution to weight gain. Therefore, it is expected that the County government of Migori and the cooperating partners will scale up PD Hearth program to prevent acute malnutrition in the County.