An unexpected bit of data: Choosing which complementary foods to promote

By Ann Jimerson, Behavior Change Specialist, Alive & Thrive

As our blog’s name, “Less Guess,” implies, we’re big on using data to make program choices. And we’re particularly glad when we can find the data we need without conducting a big new research effort. We found an excellent source in the form of a free and readily-available resource: local Demographic and Health Surveys. This “data tip,” based on Alive & Thrive’s work in Bangladesh, may help your choices too.

Here’s how it worked. Global evidence points to animal source foods, like meat, fish, poultry, and eggs, as crucial for children’s optimal growth and cognitive development. And since very few Bangladeshi children were fed these foods as recommended—starting at 6 months of age—there was plenty of room for improvement. It seemed like an obvious “small behavior” to promote.

But was it “doable”? That is, was the behavior feasible for poor Bangladeshi families?

When we suggested a focus on animal source foods, some of our partners argued that it was not ethical to suggest to families that they should offer their babies meat, fish, poultry, or eggs every day. Poor families could not afford those foods for their children. If our program promoted these foods, our partners said, we could leave families feeling poorer and more dejected.

But buried deep in the 2007 Bangladesh Demographic and Health Survey (BDHS) report, on page 157, Tina Sanghvi, our country director, found a table that made a different case.

BDHS table v2-01

This table in the 2007 Bangladesh Demographic and Health Survey (BDHS), “Foods and liquids consumed by children in the day or night preceding the interview,” offered an unanticipated bit of data for A&T’s choice of behaviors to promote. This helpful bit was on page 157.

The BDHS survey had asked mothers what foods and liquids they had given their children in the day or night preceding the interview. Not surprisingly, only 10% of children 6 to 7 months old had eaten meat, fish, poultry, or eggs. Perhaps families really were too poor to offer these foods to their children.

Instead of leaving the discussion at that, though, Tina ran her finger further down the column of figures. In the same sample of mothers, 75% said they had fed these foods the day before the survey to their children who were 2 to 3 years old. The majority of families did have the resources to feed their older children these highly valued foods on a daily basis. They apparently just weren’t convinced that it was appropriate to give these foods as early as 6 months of age.

BD diet diversity v2-01This fresh look at the BDHS won over the stakeholders. That one bit of data allowed our program partners to feel confident they could encourage mothers to feed these to their babies every day, starting as young as 6 months.

Instead of dropping that important behavior, the program planners shifted their attention to figuring out the best ways to convince mothers, families, and decision makers of every type that it was important—and safe—to feed these nutrient-rich foods to babies starting at 6 months.

That decision to promote animal source foods actively, as one part of a comprehensive program, paid off. Our aim had been to improve dietary diversity among children 6 to 24 months of age. In just four years, in the areas where the program operated most intensively, dietary diversity doubled, from 32% to 64%. Some of the greatest increases were in the animal source foods we promoted: following the program intervention, almost three times as many children in that age group ate eggs compared with before the program; six times as many ate liver or other organ meats; and twice as many ate fish.


The BDHS data helped planners feel comfortable with broadcasting this TV spot to promote animal foods for all babies over 6 months of age.

No need to guess—or base decisions on incorrect assumptions. Instead, search for data to shape your strategy. And remember that sometimes the data are there all along, waiting. You just need to track them down.