The Journal of nutrition · 2026
Effectiveness of Community-Led Complementary Feeding and Learning Sessions on Child Diet and Nutritional Status in Oromia, Ethiopia: A Quasi-experimental Cohort Study.
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Kang Yunhee, Tadesse Seifu, Telilla Mitiku, Makibila Gregory, Abdulmenan Hussen, Tadesse Lidia, Beyero Mesfin, Doocy Shannon
Аннотация
BACKGROUND: Food insecurity and child undernutrition remain critical challenges in Ethiopia. Recent humanitarian financing reductions have increased interest in low-cost, scalable approaches for preventing acute malnutrition before treatment is required. To prevent acute malnutrition, the community-led complementary feeding and learning sessions (CCFLS) approach targets children at risk of wasting through nutrition education, behavior change, and promotion of locally available foods.
OBJECTIVES: This study aims to assess the effectiveness of CCFLS on improving child feeding practices and reducing acute malnutrition risk.
METHODS: A quasi-experimental cohort study was conducted across 30 kebeles in Eastern Hararghe Zone, Oromia region, Ethiopia in 2024, enrolling 884 children aged 6-23 mo with mid-upper arm circumference (MUAC) 12.5-13.0 cm. Baseline data were collected immediately before intervention, with follow-up at 3 and 6 mo. Three-level mixed-effect regression models estimated program effects on infant and young child feeding, MUAC, and wasting prevalence.
RESULTS: CCFLS was associated with increases of 11.8 percentage points [pp, 95% confidence interval (CI): 4.8 pp, 18.8 pp] in children achieving minimum dietary diversity and 13.3 pp (95% CI: 6.4 pp, 20.3 pp) achieving minimum acceptable diet 6 mo after intervention. After adjusting for baseline MUAC, mean child MUAC increased 0.45 cm (95% CI: 0.34 cm, 0.55 cm) more in the CCFLS group than in controls. CCFLS children had 89% (risk ratio = 0.11; 95% CI: 0.04, 0.32) lower risk of becoming wasted and were 1.40 times (95% CI: 1.14, 1.73) more likely to no longer being at risk of wasting.
CONCLUSIONS: CCFLS was associated with improved dietary diversity, minimum acceptable diet, and child nutrition, with benefits sustained over 6 mo. Findings suggest that CCFLS, a low-cost community-based nutrition intervention relying on locally available foods and existing health structures, can help prevent wasting whereas reducing demand for resource-intensive treatment services. In an era of constrained humanitarian financing, preventive approaches such as CCFLS may improve child nutrition outcomes while easing pressure on overstretched nutrition systems.
OBJECTIVES: This study aims to assess the effectiveness of CCFLS on improving child feeding practices and reducing acute malnutrition risk.
METHODS: A quasi-experimental cohort study was conducted across 30 kebeles in Eastern Hararghe Zone, Oromia region, Ethiopia in 2024, enrolling 884 children aged 6-23 mo with mid-upper arm circumference (MUAC) 12.5-13.0 cm. Baseline data were collected immediately before intervention, with follow-up at 3 and 6 mo. Three-level mixed-effect regression models estimated program effects on infant and young child feeding, MUAC, and wasting prevalence.
RESULTS: CCFLS was associated with increases of 11.8 percentage points [pp, 95% confidence interval (CI): 4.8 pp, 18.8 pp] in children achieving minimum dietary diversity and 13.3 pp (95% CI: 6.4 pp, 20.3 pp) achieving minimum acceptable diet 6 mo after intervention. After adjusting for baseline MUAC, mean child MUAC increased 0.45 cm (95% CI: 0.34 cm, 0.55 cm) more in the CCFLS group than in controls. CCFLS children had 89% (risk ratio = 0.11; 95% CI: 0.04, 0.32) lower risk of becoming wasted and were 1.40 times (95% CI: 1.14, 1.73) more likely to no longer being at risk of wasting.
CONCLUSIONS: CCFLS was associated with improved dietary diversity, minimum acceptable diet, and child nutrition, with benefits sustained over 6 mo. Findings suggest that CCFLS, a low-cost community-based nutrition intervention relying on locally available foods and existing health structures, can help prevent wasting whereas reducing demand for resource-intensive treatment services. In an era of constrained humanitarian financing, preventive approaches such as CCFLS may improve child nutrition outcomes while easing pressure on overstretched nutrition systems.