title: An integrated microcredit, entrepreneurial training, and nutrition education intervention is associated with better growth among preschool-aged children in rural Ghana.
abstract: BACKGROUND
  Poor diet quality is a determinant of the high prevalence rates of malnutrition in Ghana. There is little evidence on the effectiveness of a multisector intervention to improve children's diets and nutritional status.
  
  
  OBJECTIVE
  The project tested whether participation in an entrepreneurial and nutrition education intervention with microcredit was associated with the nutritional status of children 2-5 y of age.
  
  
  METHODS
  A quasi-experimental 16-mo intervention was conducted with microcredit loans and weekly sessions of nutrition and entrepreneurship education for 179 women with children 2-5 y of age [intervention group (IG)]. Nonparticipating women and their children from the same villages (nonparticipant, n = 142) and from similar neighboring villages (comparison, n = 287) were enrolled. Repeated measures linear regression models were used first to examine children's weight-for-age (WAZ), height-for-age (HAZ), and body mass index-for-age (BAZ) z scores at baseline and at 4 follow-up time points ∼4 mo apart. Time, intervention status, time-by-intervention interaction terms, region of residence, household wealth rank, household head occupation, number of children <5 y of age, and child sex and age were included.
  
  
  RESULTS
  There was a significant interaction between the IG and time for BAZ (P = 0.02) with significant Bonferroni-corrected pairwise comparisons between the IG and comparison group (CG) at 8 mo (difference of 0.36 ± 0.09 z score, P < 0.0001). The WAZ group difference was significant between 4 and 16 mo (P = 0.01 for interaction) and peaked at 8-12 mo (differences of ∼0.28 z). The HAZ of children in the IG was significantly higher than that in the CG, reaching a 0.19 z difference at 16 mo (P < 0.05). When the fixed effects models were fitted in sensitivity analyses, some group anthropometric differences were of lower magnitude but remained significant.
  
  
  CONCLUSIONS
  An integrated package of microcredit and education may improve nutritional outcomes of children living in poor, rural communities.
authors: School of Dietetics and Human Nutrition, McGill University, Ste. Anne-de-Bellevue, Canada Departments of Food Science and Human Nutrition grace.marquis@mcgill.ca.
authors: Grace S
authors: GS
authors: Marquis
authors: Departments of Nutrition and Food Science.
authors: Esi K
authors: EK
authors: Colecraft
authors: Agricultural Extension, and.
authors: Owuraku
authors: O
authors: Sakyi-Dawson
authors: Departments of Nutrition and Food Science.
authors: Anna
authors: A
authors: Lartey
authors: Animal Science, College of Agriculture and Consumer Sciences, University of Ghana, Legon, Ghana.
authors: Ben K
authors: BK
authors: Ahunu
authors: School of Dietetics and Human Nutrition, McGill University, Ste. Anne-de-Bellevue, Canada.
authors: Katherine A
authors: KA
authors: Birks
authors: Sociology Anthropology.
authors: Lorna M
authors: LM
authors: Butler
authors: Departments of Food Science and Human Nutrition.
authors: Manju B
authors: MB
authors: Reddy
authors: Economics, and.
authors: Helen H
authors: HH
authors: Jensen
authors: Animal Science, Iowa State University, Ames, IA.
authors: Elizabeth
authors: E
authors: Huff-Lonergan
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D002675:Child, Preschool; D004032:Diet; D005260:Female; D005378:Financial Support; D005869:Ghana; D015438:Health Behavior; D006266:Health Education; D006293:Health Promotion / Q000191:economics / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D044342:Malnutrition / Q000517:prevention & control; D009752:Nutritional Status; D012424:Rural Population; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: animal source foods; diet; growth; nutrition education; preschool children