Behavior Change, Egg Consumption, and Child Nutrition: A Cluster Randomized Controlled Trial

BACKGROUND AND OBJECTIVES: Malnutrition is a significant contributor to child morbidity and mortality globally. Egg consumption has been associated with improved child nutrition yet is rare in rural, resource-poor settings. We test the effects of a culturally tailored behavior change intervention to increase child egg consumption. METHODS: A 3-arm cluster randomized controlled trial was conducted in rural Burkina Faso with 260 mother-child dyads. Children aged 4 to 17 months from 18 villages were included; those with reported history of malnutrition or egg allergy were excluded. Each child in the full intervention arm received 4 chickens, and mothers received the 10-month behavior change package. Participants in the partial intervention arm received only the behavior change package. RESULTS: In this analysis of 250 children, the full (beta = 4.3; P = 6.6 x 10(-12)) and the partial (beta = 1.0; P = .02) interventions significantly increased egg consumption. The full intervention also significantly increased poultry production (beta = 11.6; 95% confidence interval 8.3-15; P = 1.1 x 10(-5)) and women's decision-making about eggs (beta = .66; P = .02), and significantly decreased wasting (beta = .58; P = .03) and underweight (beta = .47; P = .02). CONCLUSIONS: The culturally tailored behavior change package significantly increased child egg consumption. When coupled with the gift of chickens, the behavior change intervention yielded a greater increase in egg consumption and significantly reduced wasting and underweight. Behavior change strategies to increase egg consumption should be considered among nutrition and health programs in resource-poor settings where poultry is available.