Nutrition education to improve dietary intake and micronutrient nutriture among children in less-resourced areas: a randomised controlled intervention in Kabarole district, western Uganda

Abstract

Objective: To determine whether nutrition education targeting the child-feeding practices of low- income rural caregivers will reduce anaemia and improve vitamin A nutriture of the young children in their care. Design: A controlled intervention trial, based on experiential learning theory. Forty-six women completed a nine-session nutrition education programme, while controls (n = 43) concurrently engaged in sewing classes. Setting: Two rural farming communities in the Kabarole district, western Uganda. Subjects: Less literate, low-income rural female caregivers and the children in their care (6-48 months). Outcome measures: Caregivers’ child-feeding practices and the children’s nutritional status were assessed at baseline, one month after intervention (Follow-up 1) and one year from baseline (Follow-up 2). Results: Caregivers in the intervention group reported improved child snacking patterns, food-selection practices, meal adequacy, and food variety. Children in the intervention group recorded lower haemoglobin levels at baseline (9.86 vs. 10.70 g/dl) and caught up with controls at Follow-up 1 (10.06 vs. 10.78 g/dl). However, changes were not sustained. Mean retinol-binding protein improved from 0.68 μmol/l (95% CI: 0.57-0.78) to 0.91 μmol/l (95% CI: 0.78-1.03) among intervention children, but remained approximately the same in controls. Vitamin A nutriture was influenced by infections. Conclusion: Nutrition education significantly improved feeding practices and children’s nutritional status. The effectiveness and sustainability of this programme can be enhanced if nutrition education is integrated into other food-production and public health programmes.