Participation in a Nutrition Education and Demonstration Program in Rural Senegal Is Associated with Higher Household Dietary Diversity

Abstract

Abstract Objectives We conducted a non-randomized evaluation of a nutrition education program delivered by Soins de Santé Primaire in rural Senegal to identify the impact of participation on household dietary diversity scores (HDDS). We also sought to understand participant's perceptions of program strengths and weaknesses. Women participated in a single education session that emphasized hygiene, selecting from a variety of food groups, risk awareness of diet-related non-communicable diseases, and a recipe demonstration of a locally-sourced, balanced meal. We hypothesized that program participation would be associated with increased HDDS. Methods We surveyed 20 female program participants sampled from two communities and compared their responses with 20 women sampled from two non-intervention communities (n = 40). Surveys collected 24-hour dietary recall to calculate a dietary diversity score using the 12-point HDDS scale. The mean difference in HDDS was evaluated between post-program and comparison groups using linear regression. Models controlled for household size, employment, education, marital status, and the Food Insecurity Experience Scale. We conducted key informant interviews with post-program participants (n = 19) to understand message recall, reported behavior change, and feedback for future sessions. Results Women in intervention households reported higher HDDS than comparison households [Mean (SE) = 9.0 (0.39) vs. 7.65 (0.24), P = .003]. In the adjusted model, program participation was positively associated with HDDS (β = 1.16, P = .041). Household food insecurity was associated with lower HDDS (β = −0.52, P = .024). Program participants recalled the importance of reducing bouillon cube usage and eating from each food group. Participants reported changes in food preparation and hygiene routines, such as adding more beans or vegetables and changing dirty dishwater often. The key improvement suggestion was to increase session frequency and expand education on hygiene and sanitation. Conclusions Low intensity nutrition education programs that include meal demonstrations may be a low-cost, effective method for improving dietary diversity among a population with moderate food insecurity in rural Senegal. Funding Sources World Renew, Services Luthériens pour le Developpement au Sénégal, and the Wheaton Human Needs and Global Resources Program.