A behavior change communication intervention, but not livelihood interventions, improves diet diversity and animal-source food consumption among Ghanaian women

Elizabeth Ludwig-Borycz; Mark L. Wilson; Esi K. Colecraft; Andrew D. Jones

doi:10.29219/fnr.v66.7570

Elizabeth Ludwig-Borycz Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
Mark L. Wilson Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
Esi K. Colecraft Nutrition and Food Science Department, University of Ghana, Accra, Ghana
Andrew D. Jones Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA

DOI: https://doi.org/10.29219/fnr.v66.7570

Keywords: Minimum Dietary Diversity for Women, fisheries, value chain intervention, women of reproductive age, microcredit, sub-Saharan Africa, low- and middle-income countries

Abstract

Background: Women of reproductive age (WRA), especially in sub-Saharan Africa, are vulnerable to micronutrient deficiencies driven largely by poor quality diets. Intervening into food value chains, on which many households in low- and middle-income countries depend for their livelihood, may be a promising approach to improving diets in these contexts.

Objective: In this pilot-scale randomized trial, we evaluated whether a multisectoral, food value chain intervention improved the diet diversity and the consumption of animal-source foods (ASFs) among WRA in Ghana.

Design: Twelve fish-smoking communities in two regions of Ghana with 296 eligible women were randomly assigned to one of three 9-month treatment arms: 1) behavior change communication (BCC) to promote improved diet quality through twice-weekly audio messages and bi-weekly peer-to-peer learning sessions; 2) BCC with microcredit to increase women’s incomes; or 3) BCC with provision of new smoke-oven technology. We assessed baseline-endline and between-treatment arm differences using a 10-food group diet diversity score (DDS), the Minimum Dietary Diversity for Women (MDD-W) indicator, and 7-day frequency of ASF consumption.

Results: Among 118 participants (39 in both treatment arm 1 and treatment arm 3, and 40 in treatment arm 2, with no participant refusals), DDS increased from a mean (SD) of 4.0 (1.3) at baseline to 5.1 (0.9) at endline (P-value < 0.0001). The proportion of women achieving the MDD-W indicator nearly doubled from baseline (35.6%) to endline (69.5%) (P-value < 0.0001). Frequency of ASF consumption similarly increased for meat and poultry (2.7 (4.1) to 4.7 (5.3); P-value < 0.0001) and eggs (1.5 (3.1) to 2.3 (4.9); P-value = 0.02). Few differences in these outcomes were observed among treatment arms.

Conclusions: A BCC intervention improved diet diversity and consumption of ASFs among participants. However, neither a group-based microcredit nor improved smoke oven intervention, both of which increased women’s income, led to additional dietary improvements.

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