Influencing the Influencers: Engaging Grandmothers and Men to improve diets of young 
children and breastfeeding mothers in Western Kenya.
Authors: Thuita F. M1
 Mukuria A. G2
 and Martin S3
1
School of Public health, University of Nairobi P. O. Box 19676-00202, KNH, Nairobi, Kenya.
 Tel: +254-2724639 Email: fthuita@uonbi.ac.ke
2 Counterpart international
3 Programme For Appropriate Technology in Health (PATH)
Introduction and Purpose: When designing programs to promote effective public health practices, it is 
important to respond to the household and community contexts within which families live. The purpose 
of this presentation is to share a study of a family-centered approach to maternal and young child 
nutrition that is being tested in Western Kenya. This approach engages grandmothers and men in local 
dialogue groups as well as community activities focused on improving their support for mothers to 
adopt optimal maternal nutrition and infant and young child feeding practices. It is anticipated that the 
strategy of engaging these family members will prove to be an effective community initiative that can be 
linked to facility-based services to improve infant and young child feeding practices in the country. 
Background: In Kenya, suboptimal infant and young child feeding practices and high rates of childhood 
diseases result in high rates of malnutrition and mortality during the first two years of life. Innovative 
approaches are needed to ensure that mothers, caregivers, family members and health workers 
understand and are empowered to support optimal feeding practices. Historically, community health 
programs target mothers and their children. Grandmothers and men are often perceived as obstacles to 
change. However, evidence shows that grandmothers and men can be engaged positively to improve 
feeding practices.
Methods: This study has four phases including a qualitative formative assessment, a quantitative 
baseline survey that collected information from the intervention and comparison groups; a community￾based intervention to engage fathers and grandmothers in nutrition that includes a process evaluation 
and a quantitative endline that will evaluate changes in knowledge and practices of fathers and 
grandmothers in dietary intake. Results from the baseline evaluation conducted with mothers, fathers, 
and grandmothers of 6-9 month olds in Western Province, Kenya in November 2011 are presented.
Results: Grandmothers and men may have a positive influence on the complementary feeding practices 
of young children if they are engaged in culturally-relevant ways. Sub-optimal practices are influenced 
by cultural beliefs, food availability, and knowledge levels. Diets of infants and young children are low in 
energy and lack variety. Feeding frequency is low and preparation and feeding methods predispose 
children to contaminated foods. Responsive feeding is rare but forced feeding is common. 
Conclusion: The family and community roles of fathers and grandmothers put them in key positions to 
positively influence infant feeding practices by supporting mothers, providing a variety of foods, and 
encouraging mothers to practice what they have learned from health workers. While there is consensus 
on the need to engage these key household influencers to improve infant and young child feeding and 
maternal nutrition, Kenya lacks a model of how best to engage them.