Effect of nutrition education and dairy group membership on nutrition knowledge, practices and diet quality for rural Kenyan farm women

Abstract

The typical high-starch, low diversity diet in developing countries is associated with
undernutrition, morbidity and mortality. Previous research with households in
Mukurwe-ini Division (Central Kenya) found that members of a community-based
dairy development group were more food secure and had higher intake of certain
micronutrients compared with non-members; however, the prevalence of inadequate
intake of multiple micronutrients was high among all women. A nutrition education
intervention was developed to enhance women’s nutrition knowledge and food skills to
ultimately improve diet quality and micronutrient intakes for women and their families.
In addition, it was proposed that the intervention effects would be greater for dairy
group members. The Mukurwe-ini study group consisted of 88 women in four dairy
membership-duration categories (n=4 x 22) and non-member women (n=23). The study
group was previously selected using chain referral sampling. For the intervention,
women from each duration-group and non-member women were randomly allocated to
intervention (n=55) and control (n=56) groups. Nutrition knowledge and dietary intake
(24-hour recall) data were collected from all women over three weeks immediately
prior to the intervention (baseline) and again, six months post-intervention, in
individual face-to-face interviews. The intervention encouraged food-based strategies
to improve intake of vitamin A, iron and zinc and was developed and delivered in
collaboration with a Kenyan dietitian. WFood2 was used to compute food and nutrient
intakes, dietary diversity and the phytate:zinc molar ratio. Descriptive statistics and
linear and logistic regressions analyses were performed using Stata10. Independent of
dairy-group membership, a larger proportion of intervention group women, compared
to control group women, had the targeted nutrition knowledge and practiced the
strategies to improve intake of vitamin A (76% vs 67%, respectively) and zinc and iron
(soaked beans and maize 80% vs 13%; avoided tea with meals 67 % vs 5%,
respectively). A positive effect of the intervention on dietary diversity was dependent
on dairy-group membership status. Positive intervention effects on intake of vitamin A
and C were found for non-member women. This study provided evidence that certain
intervention effects were dependent on poverty reduction and that all women were able
to make positive dietary changes when informed. There is a need to examine longerterm
impacts of nutrition education interventions and to explore effective methods to
disseminate nutrition information and food-based strategies.

Key words: nutrition intervention, micronutrients, food-based strategy, rural, women,
dairy, smallholder farmer