Effect of Behavior Change Communication through the Health Development Army on Dietary Practice of Pregnant Women in Ambo District, Ethiopia: A Cluster Randomized Controlled Community Trial

Background: Given how important pregnancy is to a woman's life, both the mother's and the unborn child's health and wellbeing are greatly influenced by the mother's dietary habits during and throughout pregnancy. Therefore, the objective of the study was to investigate the effect of behavior change communication (BCC) through the health development armies on the dietary practices of pregnant women. Methods: A two-arm parallel cluster randomized controlled community trial with baseline and endline measurements using quantitative data collection methods was conducted in Ambo district among 770 pregnant women (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 main message based on intervention protocol. The intervention began in July 2018, and data collection for the endline began in October, 2018. The control group received the standard care provided by the healthcare system during an ANC visit. The study of effect measure was done using a log-binomial model to estimate the adjusted relative risk and its 95% confidence interval (CI) of the risk factors for suboptimal dietary practice. Result: At the end of the study, the overall optimal dietary practice among the intervention group was 65.1%, while among the control group it was 34.9% (p< 0.001). Pregnant women who received intervention were 41.0% less likely to be at risk of being suboptimal in dietary practice compared to pregnant women who were in the control group (ARR = 0.591, 95%CI: 0.510-0.686). Conclusions: This study revealed that behavior change communication (BCC) through the health development armies is effective in improving the dietary practices of pregnant women. As a result, BCC through the Health Development Army is recommended to enhance the dietary practices of pregnant women.