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Effectiveness of Nutrition Education Intervention on Pulse use in Complementary Food for Rural Mothers and on Nutritional Status of Children aged 6-24 Months in Sidama Zone, Southern Ethiopia



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In Ethiopia, the majority of young children consume cereal crops and undiversified diets. Both dietary quality and diversity can be improved through the promotion of complementary foods (CF) containing pulses, which are nutrient-rich and locally available. However, their consumption by young children is low. This cluster randomization study aimed to determine the effectiveness of a nine-month nutrition education intervention on pulse use in CFs in Sidama Zone. The intervention was directed at rural Ethiopian mothers and delivered by trained Health Extension Workers (HEWs). A total of 771 mother-child pairs were selected from 12 randomly selected kebeles where 386 mother-child pairs were in the intervention group and received education about the use of pulses. Data collection at baseline, midline when possible, and endline were as follows: in-depth interviews with the HEWs before their training and after the study; mothers' knowledge, attitudes, and practices (KAP); 24-hour recall of each child's diet; anthropometric measurements of the children; and a venous blood drawn (from a sub-sample of 97 children) for serum iron and zinc analysis. Midway, due to severe drought and flood, two kg of haricot bean seed and fertilizer were distributed to the mothers in the intervention group, with control women receiving one kg at the end of the study. At baseline, no significant differences in participants' characteristics were found between the intervention and control groups: 90% of the mothers had poor KAP regarding the benefits of pulses and household pulse processing techniques; the mean diet diversity score (DDS) was low (2.2 ±1); the children exhibited high rates of undernutrition. At endline, compared to the control, the intervention group showed marked improvements in mothers' KAP, as all mothers scored >70% for KAP questions and more than 80% of them started using pulses in CF. DDS (i.e., 3.7±1.4) and children’s nutrition status in the intervention group were improved. Before their training, the HEWs displayed poor KAP on the health benefits of pulses and household processing techniques. After training, their KAP improved, with most in the intervention group indicating that the study had enhanced their knowledge and skills. This study provides evidence for policy-makers, program planners, and researchers about the need to promote pulses and incorporating them into CFs.  



Complementary Food, Ethiopia, Household Food Processing, Health Extension Workers, Nutrition Education, Pulse



Doctor of Philosophy (Ph.D.)


Pharmacy and Nutrition





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