MOMENTUM integrated health resilience household nutrition survey : household knowledge, attitudes, and practices in North Kivu, Democratic Republic of the Congo (DRC)

Stunting and wasting continue to be major problems. This is especially true in North Kivu, a province in the east characterized by multiple armed groups and conflicts, frequent disease outbreaks, and natural hazards. In the summer of 2022, MOMENTUM Integrated Health Resilience (MIHR) conducted a knowledge, attitudes, and practices (KAP) survey in the catchment areas of 60 MIHR-supported facilities across 10 health zones in North Kivu. Data were collected from 1,089 primary caregivers of children under 2 years of age using a onetime, cross-sectional survey. Respondents provided information about demographics, child nutrition, maternal and child dietary recall, family planning, household decision-making, and child illness. Data were cleaned and analyzed using the STATA 17 software package. Univariate statistics were computed to present frequencies of key variables, and chi-square test statistics were computed to test for differences across stratifications by age group, reading ability, and education. Logistic and linear regression analyses were used to assess the magnitude of association between demographics and key outcomes. All models controlled for clustering at the village level. Approximately 46 percent of children achieved minimum dietary diversity, 35 percent were exclusively breastfed, and only 16 percent had a minimum acceptable diet. By comparison, most caregivers achieved minimum dietary diversity. Most (88 percent) respondents reported at least some involvement in at least one household decision. Fewer than 15 percent said they had used family planning methods during the postpartum period. Frequency of a child under 5 years of age in the household with diarrhea or cough with fast/difficult breathing in the 2 weeks prior to the survey was 24 percent and 17 percent, respectively. In conclusion, children in North Kivu do not get adequate diversity in their diet and too few are exclusively breastfed. Results from this study suggest that exclusive breastfeeding in the first 6 months of life and dietary diversity thereafter should be an important program focus. Communitybased interventions like infant and young child feeding support groups and social and behavior change programming aimed at promoting breastfeeding and disputing myths around exclusive breastfeeding were recommended by key stakeholders during a KAP results workshop to address these challenges.