The effectiveness of nutrition education: Applying the Health Belief Model in child-feeding practices to use pulses for complementary feeding in Southern Ethiopia

Abstract

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.

A Peer-Led Pulse-based Nutrition Education Intervention Improved School-Aged Children’s Knowledge, Attitude, Practice (KAP) and Nutritional Status in Southern Ethiopia

“…The mean KAP scores in the intervention group are consistent with a study reported from southern Ethiopia which indicated that after six months of pulse nutrition education, the mean knowledge, attitude and practice score of mothers on pulse-incorporated complementary feeding was significantly (p<0.05) improved from 1.09 to 9.46, 2.09 to 9.41 and 1.31 to 7.60 respectively (Mulalem, et al, 2016). In another study, fruit and vegetable consumption, created positive attitude toward healthy foods and may improve academic outcome (Silveira, et al, 2011;Wall, et al, 2012).…”

“…Another study conducted in Wolayita zone, southern Ethiopia, the mean (SD) weight for age and weight for height Z-scores of young children were significantly higher in the intervention group compared to those in the control group. The study did not find significant difference in mean (SD) height for age Z-score between the two groups at the end of the pulse nutrition education intervention (Mulalem, et al, 2016).…”

“…The major crops grown in the Woreda include Irish potato, maize, pulses (like haricot bean, Chick pea), teff, enset (false banana) and sweet potato (Sintayehu & Worku 2011;Mulalem, et al, 2016). There are 19,690 estimated school age children in Misrak Badiwacho district.…”

“…The sample size was determined based on previous studies using the mean (µ) + standard deviation (SD) of pulse consumption practice score (out of ten pulse consumption practices) 7.6+1.36 in a study conducted in Damot Gale woreda, Wolayita zone (Mulalem, et al, 2016). The expected change (Δ) from the intervention is taken to be ≈ 0.4, which ranges from 0.2 to 0.5 (for this calculation, effect size of 0.3 was taken), at 95% level of confidence (z 1 =1.96) and the power (1-) 100% is taken to be 80% (z 2 =0.84).…”

Determinants of Suboptimal Complementary Feeding Practices among Children Aged 6-23 Months in Selected Urban Slums of Oromia Zones (Ethiopia)

“…Recent Demographic Health Survey (EDHS 2011), however, shows a slight decline (stunting 44.4% and underweight 28.7%) for less than 2 years [11], which is still higher than the stunting rate (38%) for less than 5 years in Sub-Saharan Africa [1]. These were not a surprise, as complementary foods in Ethiopia are not optimal and lack nutritional quality, like many other developing countries [4,12].…”