Effectiveness of the Positive Deviance Hearth Model in Enhancing Nutritional Status among Children in Kilifi County

Abstract

BACKGROUND Childhood malnutrition poses global developmental and health risks. Rabai sub-county, Kilifi County, Kenya, struggles with high rates of wasting and underweight children aged 6-59 months. The Positive Deviance Hearth Model, promoting local practices for improved child nutrition, has global potential but lacks exploration in Rabai. This study evaluates its impact, offering insights for evidence-based strategies against malnutrition and informing community interventions in comparable settings. METHODOLOGY This study employed a quasi-experimental design, four sub-locations from two different wards in Rabai Sub County were selected. Two sub-locations served as the intervention group with the Positive Deviance Hearth Model, while the other two acted as the control group. Baseline and end-line assessments were conducted to assess childhood wasting and underweight prevalence, analyzed using chi-square tests to compare nutritional status changes. RESULTS The baseline characteristics of the participants between the intervention and control groups were found to be remarkably similar. A total of 750 respondents were assessed, with 371 in the control group and 379 in the intervention group. Pre-intervention showed no significant difference in wasting (χ²=0.54, df=1, p=0.46). Post-intervention, a substantial reduction in wasting was seen in the intervention group (χ²=38.54, df=1, p<0.001). For underweight, no significant difference was found initially (χ²=1.06, df=1, p=0.30), but a remarkable reduction in underweight was observed in the intervention group at the end-line survey (χ²=35.78, df=1, p<0.001). CONCLUSION This study demonstrates the Positive Deviance Hearth Model's effectiveness in improving child nutrition, highlighting the relevance of context-specific interventions in addressing child malnutrition in similar regions.