Hens Hatching Hope: A Community-Based Egg Project Aiming To Improve Nutritional and Health Status of Young Children in Rural Honduras

Objectives : Honduras exhibits a high stunting [length-for-age z-scores (LAZ)< -2] prevalence in children < 5 years. This community-public-private-academic coalition designed, implemented, and evaluated the effectiveness of an egg intervention aiming to improve the nutrition and health of children living in 13 rural Honduran communities.

Methods : This community-based cluster non-randomized, controlled trial was informed by the community-health improvement process and socio-ecological frameworks. Women-led egg farms supplied 1 egg/day to n=200 children ages 6-24 mo living in 13 communities [egg]. Control [ctrl] communities (n=12) were selected from neighboring municipalities and matched to intervention communities based on size and received the standard of care [education]. Sociodemographic, anthropometric, and morbidity variables, were collected between Jan/2021 and Jan/2022 at baseline-6 and 12-mo post. Changes were compared with linear/generalized linear mixed-models adjusted by cluster, sex, age, maternal education, assets, and baseline outcomes. A SWOT analysis was performed using a semi-structured interview guide and content analysis among 13 female parents and 12 egg farm owners.

Results : Egg vs. ctrl baseline to 6-, and 12-mo changes of: LAZ=[(6mo)=-0.04, p=0.661; (12mo)=0.12, p=0.187], weight-for-length/heigh z-scores=[(6mo)= -0.06, p=0.521; (12mo)=-0.02,p=0.784], and diarrhea=[(6mo-AOR=1.76; 95%CI(0.77,4.04), p=0.181; (12mo)=1.69; 95%CI (0.53,5.42), p=0.378].
Lower odds of respiratory infections were observed for egg vs. ctrl at 6- and 12-mo, respectively: [6mo AOR=0.28;95%CI(0.12,0.63), p=0.002; 12mo AOR=0.30; 95%CI(0.12,0.75), p=0.010].
Qualitative findings indicated that the eggs intended to the infant/toddler (subject participant) were shared among multiple family members.

Conclusions : Lower odds of respiratory infections were sustained in the egg vs. ctrl group. Additional nutritional and health outcomes were non-significant at 6- or 12-mo. Ongoing follow-up will offer insights on the intervention effectiveness in growth, morbidity, food access/security, and dietary diversity.