An integrated microcredit, entrepreneurial training, and nutrition education intervention is associated with better growth among preschool-aged children in rural Ghana.
BACKGROUND
Poor diet quality is a determinant of the high prevalence rates of malnutrition in Ghana. There is little evidence on the effectiveness of a multisector intervention to improve children's diets and nutritional status.


OBJECTIVE
The project tested whether participation in an entrepreneurial and nutrition education intervention with microcredit was associated with the nutritional status of children 2-5 y of age.


METHODS
A quasi-experimental 16-mo intervention was conducted with microcredit loans and weekly sessions of nutrition and entrepreneurship education for 179 women with children 2-5 y of age [intervention group (IG)]. Nonparticipating women and their children from the same villages (nonparticipant, n = 142) and from similar neighboring villages (comparison, n = 287) were enrolled. Repeated measures linear regression models were used first to examine children's weight-for-age (WAZ), height-for-age (HAZ), and body mass index-for-age (BAZ) z scores at baseline and at 4 follow-up time points ∼4 mo apart. Time, intervention status, time-by-intervention interaction terms, region of residence, household wealth rank, household head occupation, number of children <5 y of age, and child sex and age were included.


RESULTS
There was a significant interaction between the IG and time for BAZ (P = 0.02) with significant Bonferroni-corrected pairwise comparisons between the IG and comparison group (CG) at 8 mo (difference of 0.36 ± 0.09 z score, P < 0.0001). The WAZ group difference was significant between 4 and 16 mo (P = 0.01 for interaction) and peaked at 8-12 mo (differences of ∼0.28 z). The HAZ of children in the IG was significantly higher than that in the CG, reaching a 0.19 z difference at 16 mo (P < 0.05). When the fixed effects models were fitted in sensitivity analyses, some group anthropometric differences were of lower magnitude but remained significant.


CONCLUSION
An integrated package of microcredit and education may improve nutritional outcomes of children living in poor, rural communities.
['Marquis|Grace S|GS|', 'Colecraft|Esi K|EK|', 'Sakyi-Dawson|Owuraku|O|', 'Lartey|Anna|A|', 'Ahunu|Ben K|BK|', 'Birks|Katherine A|KA|', 'Butler|Lorna M|LM|', 'Reddy|Manju B|MB|', 'Jensen|Helen H|HH|', 'Huff-Lonergan|Elizabeth|E|']
D000328:Adult D015992:Body Mass Index D001835:Body Weight D002675:Child, Preschool D004032:Diet D005260:Female D005378:Financial Support D005869:Ghana D015438:Health Behavior D006266:Health Education D006293:Health Promotion D006801:Humans D008137:Longitudinal Studies D008297:Male D044342:Malnutrition D009752:Nutritional Status D012424:Rural Population D012959:Socioeconomic Factors D055815:Young Adult
nutrition education growth diet animal source foods preschool children