INFANT AND YOUNG CHILD DIET Did the agriculture-nutrition education improve child diet (> 6 months)? 80 Increased number of children consuming eggs & diverse diet 70 No intervention effect on stunting 39% Had a diverse diet (%) 27 24 Consumed eggs (%) 32 21 23 23 Control Intervention Control Intervention WHO diverse diet ≥ 4 of 7 food groups = grains; roots & tubers; legumes & nuts; dairy products; flesh foods; eggs; vitamin A-rich fruits & vegetables; other fruits & vegetables Average age at measurement Baseline = 10 months Endline = 30 months In the intervention group, the chance of children… * eating eggs tended to be higher by 60%, and * having a diverse diet was 90% higher compared to the control. Notes: “We were taught how to prepare good food; not just any kind of food. The food must play a specific role in our body. We must eat healthy foods, energy giving foods, body building foods and protective foods. You must eat all these foods every day so that you will be strong and healthy” [FGD, Community based Growth Promotion].

Nutritional status indicators for all children (%) INFANT AND YOUNG CHILD NUTRITION (GROWTH) Did the agriculture-nutrition education affect children’s growth? Control Intervention Median for a healthy population 24.1 25.3 15.5 14.1 Length-for-age 0.25 Z-scores * Stunted (%) Length-for-age (Z-score) Average age at measurement Baseline = 10 months Endline = 30 months Control Intervention * p<0.05; no effect on weight-for-age and weight-for-length Nutritional status indicators for all children (%) Moderate Severe Baseline Endline Stunted 14.7 24.6 3.1 3.3 Underweight 13.2 12.4 3.0 1.9 Wasted 6.3 0.8 0.5 Notes:

Relationship to hemoglobin* Relationship to hemoglobin* INFANT AND YOUNG CHILD NUTRITION (HEMOGLOBIN) What factors are associated with child’s hemoglobin among infants in Upper Manya Krobo district? Infants 0-5.9 months (n=579) Relationship to hemoglobin* B (SE) Exclusive breastfeeding (BF) None 0.10 (0.16) Maternal Hb (g/dL) Higher 0.18 (0.05) Caesarean section Lower -0.55 (0.25) BF within 1h after birth -1.06 (0.30) Infant had fever in past 2 wk -0.63 (0.20) Infant age (mo) -2.32 (0.18) Age2 and Age* BF within 1 hr included in model. *at least p<0.05 11.2 10.6 Infants 6-12 months (n=504) Relationship to hemoglobin* B (SE) Maternal Hb (g/dL) Higher 0.16 (0.04) Infant age (mo) 0.08 Maternal education (none) Lower -0.43 (0.21) Infant sex (male) -0.38 (0.12) *at least p<0.05 Notes:

Relationship to anemia* INFANT AND YOUNG CHILD NUTRITION (ANEMIA) How rapidly does anemia increase with age among Upper Manya Krobo infants? What factors are associated with anemia among infants? Relationship to anemia* Odds ratio (95% CI) Infants 0-5.9 months (n=579) Infant had fever in the past 2 weeks More than doubled the odds 2.7 (1.3 to 5.5) Infants 6-12 months (n=504) Infant sex (male) Almost doubled the odds 1.7 (1.2 to 2.6) Maternal education (none) 1.9 (1.1 to 3.3) Maternal hemoglobin (g/dL) Decreased odds by almost 20% 0.8 (0.7 to 0.95) * At least p<0.05; as compared to the reference group (e.g., not with fever) Rate of anemia (%) Age (months) Notes:

Relationship with stimulation* Relationship to stimulation* INFANT AND YOUNG CHILD PSYCHOSOCIAL STIMULATION How much psychosocial child stimulation happens in Upper Manya Krobo households at the beginning of Nutrition Links ? How is stimulation related to mental development? Relationship with stimulation* Standardized beta Receptive milestones (Infant understands commands)1 Increased 0.13 Expressive milestones (Infant communicates wants/needs)1 0.21 Cognitive milestones (Infant processing/memory abilities)2 0.24 At least p<0.05; n=316; modified Development Milestones Checklist II & Bayley 1 Other factors that increase are: age, length-for-age 2 Other factor that increases is: age Stimulation score Child age (months) Score: based on 6 mother-reported items on availability of books and play materials in the home What factors are associated stimulation? Notes: Relationship to stimulation* Standardized beta Child’s age Increased 0.55 Child’s dietary diversity 0.17 * p<0.001; n=1081