Effectiveness of Culturally Customised Maternal Nutrition Education for Health Professionals in Improving Their Counselling Capacity in Ethiopia
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Bahir Dar University
- Enrollment
- 174
- Locations
- 1
- Primary Endpoint
- Knowledge of the health professionals on diet during pregnancy will be the primary outcome of this study.
Study Overview
Brief Summary
Background: Inadequate dietary consumption is a primary risk factor contributing to undernutrition during pregnancy and adversely affect birth outcomes. Despite this, in Ethiopia, 59.9% to 84.8% of pregnant women have inadequate dietary intake. Maternal nutrition education on healthy diet during pregnancy is one of the cost-effective interventions to improve dietary intake of pregnant women. However, nutrition education during pregnancy is not properly implemented in the country.
Objectives: The aim of this project is to investigate effectiveness of culturally customized maternal nutrition education for health professionals in improving their counseling capacity in Ethiopia.
Methods: A two arm parallel cluster randomized controlled trial will be conducted in Bahir Dar city adminstration and Bahir Dar Zuria district, Ethiopia, from 08/01/2024-8/20/2025. A Nonadjacent cluster (health institutions) will be selected using cluster sampling technique and randomized into the intervention and control groups. Data will be collected before and after the intervention using a structured questionnaire. Effect of the intervention will be assessed using generalized linear mixed-effects models.
Intervention strategies: The intervention will be in-service training about culturally customized maternal nutrition education for health professionals working at antenatal, delivery, and postnatal care units in the capacity building group. It will be given for five days monthly for four months using education guide. Health professionals in the routine capacity building group will receive routine capacity building training that will be given by the health system.
Project outcomes: Maternal nutrition counselling practices of health professionals will be the primary outcome.
Detailed Description
Introduction: Undernutrition during pregnancy is the main risk factor contributing to intrauterine growth retardation, premature delivery, low birth weight, and maternal and child mortality in Ethiopia. Despite this, the pooled prevalence of undernutrition in the country is 29%, ranging from 13.9% to 47.9%. Sub optimal dietary intake is the primary determinant contributing to undernutrition during pregnancy and it ranges from 59.9% to 84.8% in the country. Insufficient knowledge about healthy diet during pregnancy is the predictor for having inadequate dietary intake during pregnancy. Poor counselling practice of health professionals is a leading risk factor for poor maternal knowledge.
Nutrition education during pregnancy has a positive effect along the continuum from improving maternal knowledge about healthy diet to birth outcomes. According to a study in Dessie town, nutrition education improve nutritional knowledge scores of pregnant women from 6.9 to 13.4 and their dietary practices from 56.5% to 84.1%. Besides, nutrition education during pregnancy improve women's nutritional status and birth outcomes.
However, nutrition education during pregnancy is not properly implemented in the country. The current nutrition education practice is advising pregnant women to eat one additional meal from foods available at home compared to their preconception meals. This type of education is unclear for women since what is available at home is not specific and varies across households. Taking one extra meal may not be enough for all pregnant women, as nutrient requirements vary for different women and the trimester of pregnancy.
The bottlenecks for the current nutrition education are knowledge and skill gaps among health providers, limited nutrition education materials, and weak supportive supervision and feedback. This indicates the necessity of building health professionals capacity through nutrition education that takes into account communication and counselling skills. Since,in-service nutrition training for health professionals improve their knowledge and counselling practices. However, there is a paucity of evidence on the effectiveness of maternal nutrition education for health professionals in improving their counselling capacity in Ethiopia. Therefore, this study aims to investigate the effectiveness of in-service training about culturally customized maternal nutrition education for health professionals in improving their counselling capacity in Ethiopia.
This study will bring about a change in the current nutrition education implementation practice, health professionals' nutrition education competency, and generate evidence to guide maternal nutrition interventions. This project also has a long term benefit for maternal and child nutrition improvement.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- Single (Outcomes Assessor)
Masking Description
Outcome assessors willnot be aware about the objective of this intervention.
Eligibility Criteria
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Working in Antenatal, delivery and postnatal care clinics
Exclusion Criteria
- •On annual leave during enrolment of the study participants
Arms & Interventions
capacity building arm
Health professionals in the capacity building arm will receive capacity building in-service training for the health professionals.
Intervention: The health professionals in the capacity building arm will receive in-service training about culturally customized maternal nutrition education. (Behavioral)
routine capacity building arm
Health professionals in the routine capacity building arm will receive capacity building in-service training given through the health care system.
Intervention: The health professionals in the capacity building arm will receive in-service training about culturally customized maternal nutrition education. (Behavioral)
Outcomes
Primary Outcomes
Knowledge of the health professionals on diet during pregnancy will be the primary outcome of this study.
Time Frame: One year
Health professionals' knowledge will be assessed using twenty four " yes/no " type questions on counselling and maternal diet. Health professionals who scored above 80% of knowledge assessment questions will be knowledgable, otherwise not knowledgeable.
Nutrition counselling practices of the health professionals will be the primary outcome of this study.
Time Frame: One year
Counselling practices of health professionals will also be assessed using eighteen " yes/no " type questions that will be filled by observing health professionals nutrition counseling practices. Health professionals who properly practiced more than 80% practice related activities will have good counselling practice, otherwise not.
Secondary Outcomes
- Birth weight(one year)
Investigators
Yeshalem Mulugeta Demilew
Associate professor
Bahir Dar University