Male Engagement as a Strategy to Improve Household Health, Nutrition, and Parenting Practices in Mara, Tanzania

Background: Undernutrition and inadequate stimulation are significant risk factors for poor child health and development outcomes. Evidence-based nutrition and parenting interventions can improve child well-being. In Tanzania, separate nutrition and early child development (ECD) interventions have been implemented for decades through education to mothers, yet fathers also play a significant role in households. PCI and partners designed a randomized controlled trial in Mara to measure the impact of father engagement on child nutrition and ECD outcomes.

 Methods: Mothers and fathers of children under 18 months of age from 960 households in 80 villages from Butiama and Musoma districts were randomly selected and allocated to one of five trial arms: mothers nutrition only, mothers and fathers nutrition only, mothers nutrition and parenting, mothers and fathers nutrition and parenting, and control. Intervention arms each received a tailored 12-month behavior change package delivered by CHWs via peer groups and home visits; father arms also included gender-transformative activities.  At three time points, mothers and fathers are surveyed on relevant knowledge, attitudes, behaviors; young children are assessed on growth and development.

Results: The intervention successfully reached fathers; attendance averaged 83%. Monitoring data suggest high satisfaction and the likelihood of behavior change among fathers: 93% followed through with commitments made during the last group session, 98% rated the previous session to be "very good," and 86% of fathers stated they are likely to share information learned with a friend/relative. Outcome evaluation results will be available in early 2021.

 Conclusion/Recommendations: The study shows the feasibility of CHWs delivering an integrated community-based nutrition and parenting package of care to fathers and mothers and will contribute to the nutrition and ECD sectors by showcasing the potential of father engagement to transform prevailing gender norms and directly impact child nutrition and development.