ABSTRACT
Suboptimal diets contribute to child malnutrition globally. The Engaging Fathers for Effective Child Nutrition and Development in Tanzania (EFFECTS) study developed interventions that engaged fathers and delivered bundled nutrition and parenting content and tested their individual and combined effects on child dietary diversity and upstream parental behaviors. In a cluster-randomized controlled trial in Mara, Tanzania, 80 villages were randomly assigned (1:1:1:1:1) to standard care, a nutrition intervention engaging either mothers or both parents, or a bundled nutrition and parenting intervention engaging either mothers or both parents. Eligible households (n = 960) had a child under 18 months at enrollment (October 2018–May 2019). Community health workers (CHWs) delivered gender-transformative social and behavior change interventions through parental peer group sessions before March 2020 and subsequently through home visits. The primary outcome, child dietary diversity, and secondary outcomes on child feeding practices, morbidity, growth, and parental behaviors were assessed prior to, during, and after intervention. Intention-to-treat analyses used generalized linear mixed models. Engaging fathers while providing bundled content increased children’s dietary diversity by 0.60 food groups/day (95% confidence interval (CI): 0.18–1.02) and 0.96 food groups/week (CI: 0.51–1.41) more than standard care. Significant interaction between father engagement and bundled content was detected for children’s consumption of dairy (p = 0.04). Positive intervention effects were detected on several maternal and paternal behaviors related to household food access via home production or local food markets, complementary feeding, and hygiene practices. Gender-transformative interventions, delivered by CHWs engaging both parents with bundled nutrition and parenting content, can synergistically improve children’s diets.
Trial registration: ACTRN1261900070419
Maternal &Child Nutrition, Volume 22, Issue 1, March 2026. Read More