Nutrition Knowledge and Dietary Intake in Pregnancy in Rural Malawi: Comparing Supplementary Nutrition Education and -Counseling With Routine Antenatal Care

Abstract

Objectives To describe and compare changes in nutrition knowledge, perception and dietary habits between the intervention and control group and to evaluate the effects of nutrition knowledge on dietary diversification among the two study groups. Methods This study was a two armed randomised control trial. We recruited 257 women (gestational week 9–12) of which 195 (76%) were available for analyses: intervention 92; Control 103) the women were assessed at inclusion (baseine) and two weeks before the expected date of delivery (study end-point) for differences in nutrition knowledge, perception (using a structured questionnaire) and dietary habits (assessing dietary diversity score). We performed descriptive analyses to assess these differences between the two study groups. Three-level linear multilevel regression models with random intercept and random effect of time on participant at level 1 and village level 2 were used to expore the association between nutrition knowledge and dietary habits Results Our results show that both nutrition knowledge and dietary diversity improved in both study groups, but the improvement were significantly higher in the intervention group at study-end point. Increase in nutrition knowledge was associated with improved dietary diversity only among women in the intervention group. Moreover, women in the intervention group improved their nutrition perception and behaviour. Conclusions Our results provide evidence that poor nutrition knowledge is a barrier to consumption of healthy diet during pregnancy, thus supporting the relevance for augmenting nutrition education offered at ANC with supplementary and community-based nutrition interventions. We thus suggest that efforts should be made to strengthen the education component of ANC services as these are decentralized and locally accessible in Malawi and other low-income countries Funding Sources This project was funded by the University of Oslo, The Global Health and Vaccination Program (GLOBVAC) of the research council of Norway and by the Throne Holst foundation.