Effect of behavior change communication through health development army on optimal nutrition and health practice of pregnant women in Ambo district, Ethiopia: a cluster randomized controlled community trial

Abstract

Background: Pregnancy is such a critical phase in a woman's life, when mother's nutritional and health status at conception and throughout pregnancy plays a key role in determining her health and well-being, as well as that of her child. Therefore, the objective of the study was to investigate the effect of Behavior Change and Communication (BCC) through women development Army on optimal nutrition and health practices of pregnant women.Methods: A cluster randomized controlled community trial (CRCCT) with baseline and end line measurements using quantitative data collection methods was conducted in Ambo district among 750 pregnant women aged 18-49 years (375 of control and 375 of intervention groups). Of which endpoint data were collected from 372 and 372 pregnant women in the intervention and control clusters, respectively. Pretested semi structured questionnaire was used to collect data. The intervention was started in July, 2018 and data collection for end line was started in October, 2018.Descriptive statistics, chi-square test, bivariate and lastly multivariate binary logistic regressions analysis was used to control confounders. Statistical analyses were conducted primarily on intention-to-treat (ITT) basis and p value <0.05 was used to declare statistical significance.Result: The overall optimal nutrition and health practice among intervention group were 62.6%, while among control group were 39.0% (p<0.0001).Being in the intervention group, educational status, estimated time to reach health institution, knowledge about nutrition and health were found significantly associated with optimal nutrition and health practices in multivariable binary logistic regression analysis (p<0.05).Conclusions: Behavior change communication (BCC) through women development army is effective in improving optimal nutrition and health practices of pregnant women. Therefore, to improve optimal nutrition and health practices of pregnant women, BCC through health development Army is recommended.Trial registration: Pan African Clinical Trial Registry: unique identification number for the registry is (PACTR201805003366358).

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“…Mother's nutritional and health status at conception and throughout pregnancy plays a key role in determining her health and well-being, as well as that of her child [1]. According to Essential Nutrition Actions (ENA) framework, optimal nutrition and health practice of pregnant women encompasses optimal quantity and quality of diet; essential micronutrient intake; diseases prevention and treatment practices and supportive life style and care [2][3][4][5].…”

“…Pregnant women need at least one extra meal a day than usual, along with plenty of safe water. Consumption of iron-rich foods and iodized salt is also important [9].…”

“…On average, a woman should gain about 12.5 kg during pregnancy. Many women gain barely half this amount because of poor diets and heavy workloads [4,9].…”

“…Malaria prevention and treatment, deworming treatment, sanitation facilities and practices are very important aspects of nutrition and health practices during pregnancy [2,4]. Minimizing a heavy work load and reducing work hours enables energy-deficient women to reduce their energy expenditure.…”

“…Minimizing a heavy work load and reducing work hours enables energy-deficient women to reduce their energy expenditure. If a pregnant woman does not reduce her work load or gets enough rest during her pregnancy, her nutrient stores may be depleted [3,5].…”