Evaluation of the Impact of Messages to Improve the Diets of Lactating Rural Bangladeshi Women on Their Dietary Practices and the of Their Breast-Fed Infants

Abstract

A community-based nutrition education intervention taught 48 Bangladeshi families with breast-feeding infants how to improve the mothers' diet. The energy adequacy of the women's diets and of 30 comparable controls averaged 65% + 14% of the FAD/WHO/ UNU requirement at baseline and declined to 55% + 7% immediately after the education (Post1) and to 52% + 6% after eight months of study (Post2). This decline was probably a seasonal effect resulting from lower food availability at Post1 and Post2. The adjusted declines in adequacy of treatments and controls did not differ at Post1 (-9.9% v.-9.5%; p = .806) when behavioural changes were expected. Adjusted declines from baseline to Post2 were significantly less for treatments than controls (-10.1% v.-15.5%; p =.001), but results may have been influenced by flooding that affected food distribution and production. Arm circumferences (MUAC) of both groups remained along the fifth percentile of the international reference. No significant differences were found between the average weight for age (WAZ) or MUAC of the breast-fed children in the two groups, although a greater percentage of control children became severely malnourished (p =.011). The evaluation raises concerns about the effectiveness of nutrition education for improving the diets of poor women if given in isolation of programmes that make improvements affordable. Evaluation of the impact of messages to improve the diets of lactating rural A rural woman's day is consumed with cooking, collecting firewood and water, cleaning and caring for children and elders. Women have no control over the food budget-the men buy and sell food in the market. Nearly 80% of women have never been to school and cannot read, write, or understand numbers at a functional level [7]. Adding to this powerlessness, the newlywed goes to live with her husband's family, often a less supportive environment than her own parents' home. Nutrition education Exposure to education and information can empower a woman to maximize the few resources around her for the health of her family [27, 28]. An education intervention to improve the diets of weaning-age children, conducted in the same setting as this study, resulted in greater energy intakes and weight gains of treatment children compared with controls [29]. This study, however, questions the sources of nutrition education alone in improving maternal diets under conditions of extreme poverty and possible discrimination against women in intrahousehold food distribution. Nutrition messages were designed for the Bangladesh Rural Advancement Committee's (BRAC) Child Survival Programme to improve lactating women's diets. Field observations suggested that, in general, the mothers wished to eat more during lactation. Yet, despite the project's promotion of low-cost traditional foods and inclusion of other family members in the teaching, the mothers reported that financial barriers limited their ability to comply with messages. This study evaluates the impact of the messages on the dietary adequacy and nu...

Five-year follow-up of a food-based vitamin A intervention in Tanzania

“…Concern has been raised about the effectiveness of nutrition education in improving the diets of poor women if given in isolation of programmes that make improvements affordable 24 . Yet, in one study increases in household income were not signi®cantly associated with the intake of dietary vitamin A to preschool children 25 .…”