Improving Nutrition in Children Under Two Through Increased Egg Consumption in Burkina Faso: The Un Oeuf Project
A project led by Sarah L. McKune
Summary of the Project
In a partnership between the University of Florida, Hawassa University, Ethiopia, the Institut de l’Environnement et de Recherches Agricoles (INERA), Kamboinsé Agricultural Environmental and Training Research Center (CREAF), and St. Thomas d’Aquin University in Burkina Faso, Dr. McKune led the Un Enfant, Un Oeuf, Par Jour (One Child, One Egg, Each Day; Un Oeuf) study, which designed and tested a culturally-tailored behavior change communication (BCC) intervention to increase egg consumption and improve child nutrition by increasing poultry production and women’s decision-making. The primary outcome of the one-year cluster randomized controlled trial was egg consumption. Child nutritional status (stunting, wasting, and underweight), women’s decision-making and poultry production were monitored, measured and reported as secondary outcomes. The study was conducted with mother-child dyads in 18 rural villages in Burkina Faso, which were randomly selected and assigned to one of three intervention arms; all participants in a village received the same treatment.
Three research arms were included in the study design:
1) full intervention, which included the gifting of 4 chickens and a culturally-tailored BCC package;
2) partial intervention, which included only the culturally-tailored BCC package (no chickens); and
3) control, which received no intervention.
Each child in the full intervention arm received four chickens: three were gifted to the child by a community champion (though purchased by the project), designating the child the beneficiary of the flock and its egg production, and one additional chicken was provided by the child’s family. Mother-child dyads in the full and partial intervention arms both received the BCC package, which included monthly integrated nutrition and agriculture (INA) trainings; individual counseling of mothers during monthly monitoring sessions; distribution of a culturally appropriate, picture-based flipbook that reinforced key messages; development and fostered use of a project jingle; and engagement of strategically targeted community leaders as champions of the project. In a One Health approach, community health workers and agricultural extension workers collaboratively conducted monthly INA trainings for 10 months, beginning in July 2018 and ending in May 2019. Topics included the benefits of egg consumption, household hygiene and sanitation, infant and child feeding practices, and chicken husbandry practices. Individual monthly counseling sessions were provided during monitoring visits to caregivers receiving the full and partial intervention. During these visits, data collectors used women’s flipbooks, comprised of culturally-tailored images, to reinforce topics and provide support to mothers.
Summary of Results
Results indicate that the BCC strategy was effective, as poultry production, women’s decision-making surrounding eggs, and egg consumption all increased significantly. Child egg consumption in the full intervention arm increased from 0.1 to 6.3 eggs per week, with 95% of children ultimately eating 4 or more eggs per week. In the partial intervention group, where only the BCC package was implemented, child egg consumption increased from 0.0 to 2.4 eggs per week. The full intervention significantly increased poultry production and both the full and partial interventions significantly increased women’s decision-making. These findings contribute to prior research, which has shown that empowering women and providing education around health and nutrition are effective strategies to increase child dietary diversity, and demonstrate that high quality foods, such as eggs, can be added through thoughtful BCC strategies.
In the partial intervention arm, where only trainings were conducted but no chickens gifted, egg consumption still increased, compared to the control arm, but did not reach the level observed in the full intervention arm, where participants received livestock assets in addition to the trainings. These differences manifested in nutritional impact in the full intervention group, whereby both wasting and undernutrition in children were significantly improved. Though not statistically significant at p = .05, a lesser positive effect was also seen with the partial intervention. The intervention showed no significant effect on child stunting.
McKune, S. et al. In Press, 2020. “Behavior change, egg consumption, and child nutrition: A Cluster Randomized Controlled Trial”. Pediatrics.
Stark, H., Omer, A., Wereme N’Diaye, A., Sapp. A., Moore, E., and McKune, S. 2020. “The Un Oeuf study: Design, methods, and baseline data from a cluster randomized controlled trial to increase child egg consumption in Burkina Faso”. Maternal and Child Nutrition.