Effectiveness of the Positive Deviance Health 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 Keywords: Positive Deviance Hearth Model, Child Nutrition, Wasting, Underweight, Community-Based Intervention, Quasi-Experimental Study