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

The typical high-starch, low diversity diet in developing countries is associated withundernutrition, morbidity and mortality. Previous research with households inMukurwe-ini Division (Central Kenya) found that members of a community-baseddairy development group were more food secure and had higher intake of certainmicronutrients compared with non-members; however, the prevalence of inadequateintake of multiple micronutrients was high among all women. A nutrition educationintervention was developed to enhance women’s nutrition knowledge and food skills toultimately improve diet quality and micronutrient intakes for women and their families.In addition, it was proposed that the intervention effects would be greater for dairygroup members. The Mukurwe-ini study group consisted of 88 women in four dairymembership-duration categories (n=4 x 22) and non-member women (n=23). The studygroup was previously selected using chain referral sampling. For the intervention,women from each duration-group and non-member women were randomly allocated tointervention (n=55) and control (n=56) groups. Nutrition knowledge and dietary intake(24-hour recall) data were collected from all women over three weeks immediatelyprior to the intervention (baseline) and again, six months post-intervention, inindividual face-to-face interviews. The intervention encouraged food-based strategiesto improve intake of vitamin A, iron and zinc and was developed and delivered incollaboration with a Kenyan dietitian. WFood2 was used to compute food and nutrientintakes, dietary diversity and the phytate:zinc molar ratio. Descriptive statistics andlinear and logistic regressions analyses were performed using Stata10. Independent ofdairy-group membership, a larger proportion of intervention group women, comparedto control group women, had the targeted nutrition knowledge and practiced thestrategies 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 dependenton dairy-group membership status. Positive intervention effects on intake of vitamin Aand C were found for non-member women. This study provided evidence that certainintervention effects were dependent on poverty reduction and that all women were ableto make positive dietary changes when informed. There is a need to examine longertermimpacts of nutrition education interventions and to explore effective methods todisseminate nutrition information and food-based strategies.Key words: nutrition intervention, micronutrients, food-based strategy, rural, women,dairy, smallholder farme