An integrated microcredit, entrepreneurial training, and nutrition education intervention is associated with better growth among preschool-aged children in rural Ghana

Grace S Marquis; Esi K Colecraft; Owuraku Sakyi-Dawson; Anna Lartey; Ben K Ahunu; Katherine A Birks; Lorna M Butler; Manju B Reddy; Helen H Jensen; Elizabeth Huff-Lonergan

doi:10.3945/jn.114.194498

An integrated microcredit, entrepreneurial training, and nutrition education intervention is associated with better growth among preschool-aged children in rural Ghana

J Nutr. 2015 Feb;145(2):335-43. doi: 10.3945/jn.114.194498. Epub 2014 Dec 10.

Authors

Affiliations

¹ School of Dietetics and Human Nutrition, McGill University, Ste. Anne-de-Bellevue, Canada Departments of Food Science and Human Nutrition grace.marquis@mcgill.ca.
² Departments of Nutrition and Food Science.
³ Agricultural Extension, and.
⁴ Animal Science, College of Agriculture and Consumer Sciences, University of Ghana, Legon, Ghana.
⁵ School of Dietetics and Human Nutrition, McGill University, Ste. Anne-de-Bellevue, Canada.
⁶ Sociology Anthropology.
⁷ Departments of Food Science and Human Nutrition.
⁸ Economics, and.
⁹ Animal Science, Iowa State University, Ames, IA.

PMID: 25644356
DOI: 10.3945/jn.114.194498

Abstract

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.

Keywords: animal source foods; diet; growth; nutrition education; preschool children.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Body Mass Index
Body Weight
Child, Preschool
Diet
Female
Financial Support
Ghana
Health Behavior*
Health Education*
Health Promotion / economics
Health Promotion / methods*
Humans
Longitudinal Studies
Male
Malnutrition / prevention & control
Nutritional Status*
Rural Population
Socioeconomic Factors
Young Adult