Complementary foods (CFs) in Ethiopia are cereal based and adding locally grown pulses (legumes) to CF would provide needed nutrients. To assess the effects of nutrition education (NEd) using Health Belief Model (HBM) in promoting pulses for CF, a 6-month quasi-experimental study was conducted in 160 mother-child pairs. Knowledge, attitude, and practice (KAP) questions were given to mothers at baseline, midline, and endline, along with anthropometric measurements of children. NEd involving discussions and recipe demonstrations was given twice monthly for 6 months to the intervention group (n = 80) while control mothers received usual education. At baseline, mothers' KAP scores were low at both sites; at 3 and 6 months of NEd, mean KAP scores of mothers increased (p < 0.05) compared to the control site. Significant improvements in children's mean weight, weight for height, and weight for age occurred in the intervention site only. Nutritional status of children improved after providing mothers with pulse-based NEd.
In Ethiopia many women do not practice appropriate complementary feeding (CF). The Health Belief Model (HBM) asserts that change in behavior is determined after consideration of severity, benefit, and barriers to change. This study examined the effectiveness of 3 months of HBM-based education compared to the traditional (didactic) method on CF practices of mothers, with no education as control, using three randomized groups. One hundred sixty-six mother-infant (6-18 months) pairs were recruited. At baseline and after intervention, knowledge, perceptions, and practices about CF and related areas were determined. It was only diet diversity that increased significantly in the HBM group (from 3.05±0.94 food groups to 3.79±0.82, p<.05) while the other two groups had no change. Improvements in food groups were most noticeable as legumes & nuts (from 35.6% use to 83.9% in HBM group). Thus, nutrition education about diet diversity improvement needs to be conducted promotes behavior change.
Introduction: Complementary feeding presents a challenge for very young children in Ethiopia as these foods are generally thin cereals providing little protein and micronutrients. We tested whether an egg-a-day and eggshell powder (ESP) providing calcium (Ca) will improve nutritional status of young children in a 6-month randomized controlled cluster trial in Southern Ethiopia. Methods: Study sites were randomly selected kebeles (villages) and assigned to Intervention and Control groups. All eligible children 6-12 months were enrolled. Each child in Intervention kebeles received a gift of two egg laying chickens (n=122); families received education on poultry production and consumption of egg. ESP (500 mg Ca) was given to children at ≥12 mo. The Control group (n=128) had standard nutrition education. Baseline and endline outcome measures included knowledge, attitude, and practice (KAP) of caregivers on the feeding of egg and ESP, anthropometry, child dietary intake frequencies, egg sensitivities, hemoglobin, and morbidity symptoms. Results: Egg and ESP consumption in Intervention children averaged 17 days/month compared to < 1 in Controls. KAP of mothers improved only in the intervention group (p<0.001). No true egg allergy occurred, however, 7.5% of Intervention children were sensitive to eggs. Linear regression analysis showed the egg+ESP intervention increased weight-forage z-score by 0.24 (95% CI, 0.11-0.37) and reduced underweight (RR, 0.35; 95% CI, 0.16-0.74). Stunting prevalence increased in both groups, but by 28 % less in the treatment group (RR, 0.72; 95% CI, 0.53-0.98) compared with control. Mean hemoglobin increased and anemia decreased in both groups, however, much greater anemia reduction [52% (RR, 0.48; 95% CI, 0.24-0.96)] was seen in the treatment group. Conclusion: Promotion of egg and ESP consumption with poultry intervention significantly improved the nutritional status of young children, demonstrating the potential of an integrated approach to contribute to the country"s target to reduce malnutrition.
Animal source foods such as eggs are often lacking in complementary foods in Ethiopia, a country with a high rate of malnutrition in under 5-year-old children. It is recommended that young children receive an egg a day, but rural households often cannot afford them or do not have experience raising chickens. The aim of this study was to conduct a poultry intervention, providing two chickens to households with a young child, stipulating that the child was the owner, and required an egg a day. This randomized, controlled, community trial was conducted in southern Ethiopia with children 6-12 mo living in selected kebeles. Chickens were gifted to families who guaranteed that eggs would be fed to the child in the Intervention, along with education on poultry production and promotion of eggs for children. Eggshell powder (ESP) was encouraged for use as a calcium supplement by children ≥ 1 y. Control kebeles continued with existing nutrition education for the 6-month trial. Baseline and end line outcome measures included child consumption of eggs, ESP, and poultry production. Other outcome measures will be reported elsewhere. Egg consumption by children was significantly improved only in the intervention group from 0.8 to 17 eggs/month (p < 0.001). ESP consumption got community acceptance with an average consumption of a child in the intervention group for 17 days/month (p < 0.001). Poultry production increased in the Intervention communities even when child-owned chickens were excluded from analysis (from 138 to 251 chickens) while in the Control communities, the number of chickens decreased (from 219 to 101). Cage construction improved in the Intervention communities, however, losses of chickens occurred. A 6-month poultry intervention that emphasized child ownership and provided education for poultry and nutrition education resulted in families increasing livestock numbers, and children eating on average more than half an egg a day.
Dietary calcium binds Fluoride (F), thus preventing excess F absorption. We aimed to assess the efficacy of supplementing calcium-containing Eggshell Powder (ESP) on F absorption using urine F excretion and on fluorosis symptoms. In total, 82 women (41 Intervention Group, IG; 41 Control Group, CG) were recruited; overall, 39 in each group completed the trial. Morning spot urine was collected before (baseline, BL) and after (endline, EL) the intervention that was 6-months daily supplementation with 2.4 g ESP (providing ~1000 mg of calcium). Dental, skeletal, and non-skeletal fluorosis assessments was carried out at BL and, except for dental, at EL. Relative risk (RR) and linear generalized estimating equation were used to compare outcomes between groups. At BL, urinary F excretion in the IG and CG groups was similar, ~10 mg/L. At EL, urinary F excretion in IG women was six-fold lower (β = −6.1 (95% CI: −7.1, −5.1)) compared to CG. The risk of developing skeletal and non-skeletal fluorosis were significantly (p < 0.001) reduced in the intervention group. A significant reduction in urinary F excretion and reduction in many fluorosis symptoms were observed among women supplemented with calcium-containing ESP, thus providing evidence for using this dietary calcium source for mitigation of fluorosis. Clinical trials registration: NCT03355222.
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