(PTFS11-06-25) Impact of a Timed and Targeted Care for Family (ttCF) Program on Maternal and Child Nutrition in Eastern Visayas, Philippines

Objectives: This study evaluated the impact of the Timed and Targeted Care for Families (ttCF) program on maternal and child health outcomes during the first 1,000 days of life in Eastern Visayas, Philippines (2021–2025).

Methods: A quasi-experimental design was used in 6 intervention and 6 comparison areas, with 1,518 women (458 pregnant and 1,050 mothers with children < 12 mo). In intervention areas, Barangay Health Workers trained in ttCF conducted 12 household visits from pregnancy until 2 years of child age. In comparison areas, only routine health services were provided. Linear regression analyses adjusted for baseline socio-economic covariates were used to estimate program impact. The primary outcomes included child minimum dietary diversity (MDD; defined as consumption of ≥ 4 out of 7 food groups including breastfeeding), and the prevalence of stunting and wasting. Secondary outcomes were maternal MDD (≥5 out of 10 food groups), mid-upper arm circumference (MUAC) < 23 cm, and depressive disorder [Edinburgh Postnatal Depression Scale (EPDS)≥9].

Results: Out of 1518 women, 1,313 (655 in comparison and 658 in intervention) were successfully followed up 12 months. The number of home visits by BHWs was higher in the intervention vs. comparison areas both during pregnancy [mean=3.3 times (SD=2.6) vs. 1.8 (2.0)] and between birth to 6 months postpartum [2.6 visits (2.0) vs.1.3 (1.4)]; p< 0.001 for both]. No significant differences were found between the intervention and comparison areas for child MDD (23.2% vs. 24.9%; p=0.4 at follow-up only), and the prevalence of stunting [adjusted difference (adiff)= -2.6 percentage point (pp); 95%CI: -7.7, 2.5] or wasting (adiff = 1.4 pp; 95%CI: -5.0, 7.4) between groups. At maternal level, there was no difference between two areas in MDD (adiff =-6.1pp; -12.8, 0.6), or MUAC < 23 cm (adiff=-0.0 pp; -0.0, 0.0). However, ttCF home visits reduced the proportion of depression by 12.5% (95%CI: -19.4, 5.6) and EPDS by -1.2 score (95%CI: -1.9, -0.5) after adjusting for enrollment differences.

Conclusions: ttCF approach increased the frequency of home visits and reduced maternal mental health disorders. However, its impact on key maternal and child nutrition outcomes during the first 1,000 days was limited.

Funding Sources: Korea International Cooperation Agency (KOICA)