Emo-Demo: Combining Science and Innovation for Community-Based Child Feeding Interventions in East Java, Indonesia

Background/Aims: GAIN piloted emotive, interactive, and surprising ways of improving infant and child feeding in the form of 'emotional demonstrations' or emo-demos. This study aimed to assess the effectiveness of emo-demo approaches in improving the quality of infant and young children feeding including breastfeeding. Methods: A cluster randomized controlled trial (cRCT) was conducted in 12 sub-districts in Malang and Sidoarjo. The emodemo sessions were inserted within the existing integrated health post (Posyandu) activities and antenatal classes between 2015 and 2017. The outcome of the intervention was assessed by repeated cross-sectional surveys. A total of 2,435 caregivers who took care of children under two completed the interviews initially, while 2 years later, the number went to 2,740 caregivers. Results: Approximately 45% of the intervention group and less than 1% of the comparison group had attended an emo-demo session 3 months priors to the survey (p < 0.000). Children who were taken care by the caregivers from the intervention group were significantly more likely to achieve a minimum dietary diversity score of ≥4 food groups (OR = 1.69 [95% CI: 1.2–2.39], p = 0.003) and consume iron-rich foods (OR = 1.66 [95% CI: 1.14–2.42], p = 0.008). The emo-demo sessions also significantly improved complementary feeding practices. Conclusions: GAIN is currently working with the Ministry of Health and local universities to improve and expand the content of the emo-demos and scale-up this intervention through Posyandu.