Introduction

Complementary feeding practices in Northern Nigeria have traditionally involved various family members and caregivers, with fathers often playing a crucial role in providing food or financial resources. However, the nutritional quality of the food provided is not always considered, leading to suboptimal child growth and development.

In a recent study titled Implementing a Multilevel, Multicomponent Intervention to Engage Fathers in Complementary Feeding in Northern Nigeria: Barriers, Facilitators, and Suggestions for Change, colleagues and I explored the feasibility and impact of engaging fathers in improving complementary feeding practices.

In this post, I summarize the methods and findings of the study.

Methods

The study employed a comprehensive multilevel, multicomponent approach, targeting fathers of children aged 6-23 months. The intervention aimed to improve dietary diversity through community-based strategies. The research methods were designed to capture a wide range of perspectives and insights.

The research team conducted in-depth interviews (IDIs) with a diverse group of participants, including fathers, mothers, community leaders, and health workers. These interviews were structured to delve deeply into the current feeding practices, the barriers to achieving dietary diversity, and the perceptions of fathers’ roles in child nutrition. The questions were crafted to uncover the underlying reasons for the existing practices and to identify potential areas for intervention.

For instance, fathers were asked about their understanding of nutritional needs, their involvement in meal preparation, and the challenges they faced in providing diverse diets. Mothers and health workers provided complementary perspectives on the support needed from fathers and the community.

Focus group discussions (FGDs) were another critical component of the research. These discussions were held separately with fathers and mothers to explore gender-specific perspectives and experiences. The FGDs provided a platform for participants to share their views on cultural norms, their knowledge of nutrition, and the impact of community interventions. The interactive nature of FGDs allowed for a richer understanding of the social dynamics and the collective attitudes towards complementary feeding.

To quantify the prevalence of various feeding practices and attitudes towards dietary diversity, colleagues administered surveys to a larger sample of fathers. These surveys included questions about the types of foods provided to children, the frequency of meals, and the fathers’ involvement in feeding. The survey data complemented the qualitative insights from the IDIs and FGDs, providing a comprehensive picture of the feeding practices in the community.

Analysis

The data collected from the IDIs, FGDs, and surveys were analyzed using thematic analysis. This method involved several key steps to ensure a thorough and systematic examination of the data. First, the team transcribed the interviews and discussions verbatim. These transcripts were then imported into Atlas.ti, a qualitative data analysis software, which facilitated the coding process. Recurring themes and patterns in the data were then identified and categorized into meaningful groups. The process of coding and theme identification was iterative, with continuous refining of categories to capture the nuances of the participants’ responses.

The themes were further analyzed using the Consolidated Framework for Implementation Research (CFIR) constructs, originally published in 2009 and updated in 2022. The CFIR provided a structured approach to understanding the various factors influencing the implementation of the intervention. The constructs included:

• Intervention Characteristics: This construct examined the perceived benefits and challenges of the intervention. For example, how the participants viewed the intervention’s components, such as the educational materials and the community engagement strategies.
• Outer Setting: This construct assessed the external influences on feeding practices, including community norms and the availability of resources. For example, the research team explored how cultural beliefs, and economic conditions affected the fathers’ ability to provide diverse diets.
• Inner Setting: This construct evaluated the support within households and community structures, analyzing the role of family dynamics and community support in facilitating or hindering the implementation of dietary diversity practices.
• Characteristics of Individuals: This construct focused on the knowledge, beliefs, and attitudes of fathers and other caregivers. The team examined how individual factors, such as awareness of nutritional needs and willingness to change, influenced the success of the intervention.
• Process: This construct looked at the implementation strategies and their effectiveness, assessing how well the intervention was delivered and the participants’ engagement with the various components.

Findings and Implications

The study revealed several key findings that have important implications for future interventions.

We found that cultural norms surrounding gender roles is one barrier to dietary diversity and nutritional quality. Traditional beliefs often limited fathers’ involvement in child feeding, with many viewing it as primarily the mother’s responsibility. This cultural barrier was compounded by knowledge gaps, with many fathers lacking awareness of the nutritional needs of young children and the importance of dietary diversity. Economic constraints also played a significant role, with poverty and limited access to diverse foods being major obstacles.

Despite these challenges, we identified facilitators that could enhance fathers’ engagement in complementary feeding. Community support emerged as a crucial factor, with the involvement of religious and community leaders proving effective in changing perceptions and encouraging fathers’ participation. Educational interventions, such as sermon guides, reminder cards, and multimedia messages, were successful in increasing fathers’ knowledge and engagement. Practical tools, like the distribution of MDD bowls and counseling cards, helped caregivers understand and implement dietary diversity practices.

Our findings provided valuable insights for scaling up the intervention. Expanding the use of community structures and multimedia tools could help reach a broader audience. Policy support is essential, with recommendations for policies that promote male involvement in child nutrition and provide economic support to low-income families. Continuous education and support for both fathers and mothers are necessary to sustain improved feeding practices.

Conclusion

Engaging fathers in complementary feeding practices in Northern Nigeria has shown promising results in improving dietary diversity and child nutrition. The study highlights the importance of addressing cultural norms, providing practical tools, and leveraging community support to enhance fathers’ involvement. By scaling up these interventions and ensuring continuous education, there is potential to significantly improve child health outcomes in the region.

This research underscores the critical role fathers can play in child nutrition and the need for targeted interventions to support their engagement. The findings provide valuable insights for policymakers, practitioners, and researchers working to improve child health and nutrition in similar contexts.

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