The Effect of Behavior Change Communication via the Health Development Army on Pregnant Women's Nutrition and Health Practices in Ambo District, Ethiopia: A Cluster Randomized Controlled Community Trial

Abstract

Background A woman's nutritional and physical health at conception and during her pregnancy is crucial factors in defining both her own and her unborn child's health and well-being at this crucial time in her life. Therefore, the objective of the study was to investigate the effect of Behavior Change and Communication (BCC) through the women development Army on optimal nutrition and health practices of pregnant women. Methods In the Ambo district, 770 pregnant women participated in a two-arm parallel cluster randomized controlled community trial with baseline and end-line measures (385 in control and 385 in intervention groups). Endpoint data from 372 intervention and 372 control groups were gathered, respectively. In the intervention group, health development armies delivered the BCC's main message. The intervention began in July 2018, and end point data were collected from pregnant women (n = 744) in October, 2018. The control group received the typical care provided by the healthcare system during an ANC visit. Descriptive statistics, chi-square test, bivariable and lastly multivariable binary logistic regressions analysis was used to control confounders. Statistical analyses were conducted on intention-to-treat (ITT) basis and p value <0.05 was used to declare statistical significance. Result The overall optimal nutrition and health practice were higher in the intervention group than in the control group (62.6% vs. 39.0%, P<0.001). Pregnant women who received intervention had two times higher odds of optimal nutrition and health practices compared to pregnant women who were in the control group (AOR = 2.051, 95%CI: 1.318-3.192). In a multivariable binary logistic regression analysis (p<0.05), being in the intervention group, educational status, estimated time to reach the health institution, and knowledge about nutrition and health were found to be significantly associated with optimal nutrition and health practices. Conclusions Behavior change communication (BCC) through the women's development army is effective in improving optimal nutrition and health practices of pregnant women. Therefore, to improve the optimal nutrition and health practices of pregnant women, BCC through the health development army is recommended.