{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:06:44Z","timestamp":1790140004376,"version":"4.0.1"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000910","name":"Conrad N. Hilton Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000910","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Timely initiation of complementary feeding for HIV-exposed infants (HEI) is essential in improving the child\u2019s health and for ensuring the child\u2019s nutritional requirements are met. ECD interventions have been integrated to HIV programs as one of the approaches to improve complementary feeding practices among HEI. However, there is limited evidence regarding the contribution of Early Childhood Development (ECD) intervention on timely initiation of complementary feeding among HEI in Tanzania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study employed a post-test-only non-equivalent comparison-group quasi-experimental design. The study evaluation was conducted in 2025, with Mbeya and Tabora regions serving as the interventiongroup, and Shinyanga and Simiyu regions as the comparison group. Both project groups shared a common characteristic of being part of the Pact-led ACHIEVE project funded by the US government (2020\u20132026), while the intervention group received an additional ECD intervention. The study participants were 658 HEI aged 6\u201312 months from both the intervention and comparison groups. The outcome variable was the timely initiation of complementary feeding while The ECD intervention was the main explanatory variable of interest, and the associations were assessed using multivariable modified Poisson regression with robust standard errors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The results from multivariable analysis revealed that the ECD intervention was significantly associated with a 10.9% higher prevalence of timely initiation of complementary feeding among HEI (aPR = 1.109, 95% CI: 1.033\u20131.191,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.004). HEI whose male caregivers engaged in childcare had 37.6% higher prevalence of timely initiation of complementary feeding than those whose male caregivers were not (aPR = 1.376, 95% CI: 1.239\u20131.529,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). HEI residing in urban areas had 12.0% lower prevalence of timely initiation of complementary feeding than their rural peers (aPR = 0.880, 95% CI: 0.803\u2013964,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.006). In addition, HEI whose caregivers had primary education had 8.0% lower prevalence of timely initiation of complementary feeding than those whose caregivers had never attended school (aPR = 0.920, 95% CI: 0.861\u20130.984,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.015).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The positive association between ECD intervention and higher prevalence ratio of timely initiation of complementary feeding among HEI may be attributed by improved caregiver nutrition knowledge and practices, male partner involvement resulted from routinely nutrition counseling sessions during paid home visits by CCWs. This finding suggests that expanding the coverage of the ECD intervention to reach more HEI, particularly those at higher risk, such as HEI living in urban areas, may help address existing barriers and contribute to improved child nutrition and overall development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1895144","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:46:55Z","timestamp":1790138815000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early childhood development intervention and timely initiation of complementary feeding among HIV exposed infants in Tanzania: a quasi-experimental study"],"prefix":"10.3389","volume":"13","author":[{"given":"Ignas","family":"Lukanga","sequence":"first","affiliation":[{"name":"Pact Tanzania","place":["Dar es Salaam, Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amon","family":"Exavery","sequence":"additional","affiliation":[{"name":"Pact Tanzania","place":["Dar es Salaam, Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Charles","sequence":"additional","affiliation":[{"name":"Pact Tanzania","place":["Dar es Salaam, Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asheri","family":"Barankena","sequence":"additional","affiliation":[{"name":"Pact Tanzania","place":["Dar es Salaam, Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisela","family":"Didas","sequence":"additional","affiliation":[{"name":"Pact Tanzania","place":["Dar es Salaam, Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Ndyetabura","sequence":"additional","affiliation":[{"name":"Pact Tanzania","place":["Dar es Salaam, Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saida","family":"Salim","sequence":"additional","affiliation":[{"name":"Pact Tanzania","place":["Dar es Salaam, Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Ventimiglia","sequence":"additional","affiliation":[{"name":"Pact Inc.","place":["Washington, DC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Kuhlik","sequence":"additional","affiliation":[{"name":"Pact Inc.","place":["Washington, DC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Levina","family":"Kikoyo","sequence":"additional","affiliation":[{"name":"Pact Tanzania","place":["Dar es Salaam, Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"B1","year":"2023","journal-title":"WHO Guideline for Complementary Feeding of Infants and Young Children 6-23 Months of Age."},{"key":"B2","volume-title":"Nurturing Care for Early Childhood Development: a Framework for Helping Children Survive and Thrive to Transform Health and Human Potential","year":"2018"},{"key":"B3","volume-title":"Guideline: the Duration of Breastfeeding, and Support from Health Services to Improve Feeding Practices among Mothers Living with HIVUpdates on HIV and Infant Feeding.","year":"2016"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e20190281","DOI":"10.1542\/peds.2019-0281","article-title":"The effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, hydrolyzed formulas, and timing of introduction of allergenic complementary foods.","volume":"143","author":"Greer","year":"2019","journal-title":"Pediatrics"},{"key":"B5","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1093\/nutrit\/nuaa143","article-title":"Complementary feeding of infants and young children 6 to 23 months of age.","volume":"79","author":"Lutter","year":"2021","journal-title":"Nutr Rev"},{"key":"B6","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1186\/s12879-022-07119-6","article-title":"Trends and effects of antiretroviral therapy coverage during pregnancy on mother-to-child transmission of HIV in Sub-Saharan Africa. 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