Analysis of the Sustenance of the Positive Deviance Hearth Strategy by Caregivers in Mudzi District, Mashonaland East, Zimb

Abstract

Post-project studies to examine the sustainability of projects, are discussed but most times they are never implemented. Mudzi district gained from a behavior change community-based nutrition intervention called Positive Deviance Hearth from 2017 to 2020 under World Vision Zimbabwe in partnership with Ministry of Health and Child Care. The nutrition program aimed to identify key growth-promoting behaviors and offer participatory adult nutrition education. This study thus sought to determine whether behaviors learnt by caregivers during the intervention (2017-2020) were maintained in child care, three years after World Vision had left. A cross-sectional study was done on 122 households, 62 of which had been exposed to Positive Deviance Hearth trainings and 60 had no prior exposure to Positive Deviance Hearth. Measurements on nutritional status, one child per household born after the 2017-2020 PD Hearth intervention and one child per household from the unexposed group were done, while their mothers were interviewed. Data was collected and uploaded using KOBO collect software and analyzed using EPI info 7.The results showed that low weight for age was more common in children of caregivers who had never been exposed to Positive Deviance Hearth (8.0%) compared to (5.0%) for Positive Deviance Hearth participants. A double proportion of positive deviant mothers (17.7%) reported continuing feeding of breastmilk to their infants beyond one year mark compared to (8.3%) of the non-participants. Positive Deviance mothers reported feeding their children more frequently (3.1 meals per day) than their counterparts (2.7 meals per day). Extremely statistically significant differences were noted in dietary composition between Positive Deviance Hearth exposed group and Positive Deviance Hearth unexposed group (p=0.003 and p=0.001, respectively). The Positive Deviance Hearth trained mothers had a 44.4% less chance of having underweight children than those who were not on the program. Results showed no significant association between caregiver exposure to PD Hearth and underweight of children (OR= 0.6, 95%CI: 0.2 – 1.9, p=0.348). Study concludes that, infant growth-promoting behaviors that were discovered through Positive Deviance Hearth and put into practice during community based sessions continued to exist. Infants born later who were not directly exposed to the program grew better as a result of these sustained behaviors by their caregivers.