Theory-based nutrition education intervention through male involvement improves the dietary diversity practice and nutritional status of pregnant women in rural Illu Aba Bor Zone, Southwest Ethiopia: A quasi-experimental study.

Abstract

Maternal undernutrition is a major public health problem that disproportionately affects women in low‐income countries. Despite attempts to address maternal nutritional needs, Ethiopia still has a high rate of undernutrition. Hence, this study aimed to evaluate the effect of theory‐based nutrition education through male engagement on dietary practice and the nutritional status of pregnant women. A pretest−posttest quasi‐experimental study was conducted among 403 pregnant women selected from 22 kebeles of Illu Aba Bor zone, Southwest Ethiopia from July to December 2019. A pre‐tested, structured interviewer‐administered questionnaire was used for data collection. A qualitative 24‐h dietary recall was used to assess dietary diversity, and the Mid‐Upper Arm Circumference was used to assess nutritional status. The intervention effect was evaluated using difference‐in‐difference, generalized estimating equation, and linear mixed‐effects models. The mean dietary diversity score differed significantly between the couple group, women‐alone and the control group (p < 0.001). According to the multivariable generalized estimating equations model, couples were 3.9 times; adjusted odds ratio (AOR) = 3.91, 95% CI: (2.57, 6.88) and women alone were 2.8 times; AOR = 2.86, 95% CI: (2.17, 3.88) more likely to consume a diverse diet than the control group. The nutritional status of the women in the couple group improved significantly by the end of the intervention (p < 0.001). This study showed that involving males in nutrition education intervention was effective in improving the dietary diversity practice and nutritional status of pregnant women. The findings imply the need for targeting couples in designing nutrition education interventions.