Gebretsadik Meseret Tamrat, Tamiru Dessalegn, Sisay Assefa Legesse, Belachew Tefera
Department of Nutrition and Dietetics, Public Health Faculty, Institute of Health, Jimma University, Jimma, Ethiopia.
Department of Epidemiology, Public Health Faculty, Institute of Health, Jimma University, Jimma, Ethiopia.
Nutr J. 2025 Jul 19;24(1):116. doi: 10.1186/s12937-025-01123-7.
Optimal development and growth in children are primarily determined by dietary practice during the first 24 months of life. However, in low-income countries, especially in sub-Saharan Africa, ensuring adequate nutrition and maternal nutritional knowledge are challenging. As a result, it is a major public health issue in Ethiopia. Therefore, it is essential to address feeding practices and knowledge gaps through behavior change communication. This study assessed the effect of behaviour change communication through the women's development army on complementary feeding practices among children aged 6-23 months in Jimma Zone, Ethiopia.
A cluster randomized controlled trial was conducted from December 2021 to November 2022 in rural Ethiopia. The study used two-stage cluster sampling to allocate villages into control and intervention groups and systematic random sampling methods to select participants. Fourteen villages were randomly chosen from 21 eligible ones, with seven clusters (villages) in each group. Initially, 438 mother-child pairs participated, and 404 pairs remained at the endline data collection. The intervention group, consisting of 219 pairs, received food-based BCC from the WDA, while the control group, also with 219 mother-child pairs, received routine health education by Health Extension workers. Data were collected through structured questionnaires and 24-hour dietary recall. The primary objective for this study was optimal complementary feeding practices. The chi-square statistic assessed sociodemographic differences, and the difference-in-differences method evaluated the intervention's effect. Generalized estimating equations were used to analyze BCC's impact and identify predictors.
The intervention group showed a 28.4% (DID: 28.4%, 95% CI: 18.1 to 38.6) improvement in optimal complementary feeding practices compared to the control group (p < 0.001). Factors associated with optimal complementary feeding practices included BCC (AOR = 5.00, 95% CI: 1.78-14.05), maternal education (AOR = 2.00, 95% CI: 1.33-3.01), not using traditional food processing methods (AOR = 0.34, 95% CI: 0.21-0.54), and maternal knowledge (AOR = 0.65, 95% CI: 0.43-0.99).
BCC, through the WDA, significantly improved complementary feeding knowledge and practices. Policymakers should support long-term BCC interventions and adopt a multi-sectoral approach to address the factors influencing child feeding practices. The study is registered retrospectively in the Pan African Clinical Trials Registry with number PACTR202106621156513 on 21/06/2021.
儿童的最佳发育和成长主要取决于生命最初24个月的饮食习惯。然而，在低收入国家，尤其是撒哈拉以南非洲地区，确保充足营养和孕产妇营养知识具有挑战性。因此，这在埃塞俄比亚是一个重大的公共卫生问题。所以，通过行为改变沟通来解决喂养习惯和知识差距至关重要。本研究评估了通过妇女发展军进行行为改变沟通对埃塞俄比亚吉马地区6至23个月儿童辅食喂养习惯的影响。
2021年12月至2022年11月在埃塞俄比亚农村进行了一项整群随机对照试验。该研究采用两阶段整群抽样将村庄分为对照组和干预组，并使用系统随机抽样方法选择参与者。从21个符合条件的村庄中随机选取14个村庄，每组7个群组（村庄）。最初有438对母婴参与，在终期数据收集时仍有404对。干预组由219对母婴组成，接受来自妇女发展军的基于食物的行为改变沟通，而对照组同样有219对母婴，接受健康推广工作者提供的常规健康教育。通过结构化问卷和24小时饮食回顾收集数据。本研究的主要目标是最佳辅食喂养习惯。卡方统计量评估社会人口统计学差异，差异法评估干预效果。使用广义估计方程分析行为改变沟通的影响并确定预测因素。
与对照组相比，干预组在最佳辅食喂养习惯方面有28.4%（差异法：28.4%，95%置信区间：18.1%至38.6%）的改善（p < 0.001）。与最佳辅食喂养习惯相关的因素包括行为改变沟通（调整后比值比 = 5.00，95%置信区间：1.78 - 14.05）、母亲教育程度（调整后比值比 = 2.00，95%置信区间：1.33 - 3.01）、不使用传统食物加工方法（调整后比值比 = 0.34，95%置信区间：0.21 - 0.54）以及母亲知识水平（调整后比值比 = 0.65，95%置信区间：0.43 - 0.99）。
通过妇女发展军进行的行为改变沟通显著改善了辅食喂养知识和习惯。政策制定者应支持长期的行为改变沟通干预措施，并采取多部门方法来解决影响儿童喂养习惯的因素。该研究于2021年6月21日在泛非临床试验注册中心进行了回顾性注册，注册号为PACTR202106621156513。
