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Effectiveness of the Women's Development Team Leaders in Delivering Nutrition Education on Pulse Sprouting in Southern Ethiopia

Effectively implemented nutrition education can provide participants with the knowledge and skills to make healthy food choices in the context of their lifestyles and economic resources. In Ethiopia, the government equips health extension workers (HEWs) to provide nutrition education to communities by enabling HEWs to transfer knowledge to women’s development team leaders (WDTLs) who in turn share the knowledge with the one-to-five network leaders (1-5NWL) and members. The objective of this study was to examine the effectiveness of WDTLs in delivering nutrition education to women as the intervention group (IG). This was compared to having trained HEWs educate women directly (the positive control group, PCG), and having women receive no specific education (negative control group, NCG). A cluster randomized trial design was used. Three kebeles (villages of 5000 people) were purposively selected from which the WDTLs were randomly selected and their respective 1-5NWL and members were participants. Nutrition education to teach pulse sprouting was provided every other week for 6 months to intervention and positive control groups. Focus group discussions and demonstrations were held to reinforce knowledge and skills. Knowledge, attitude and practice (KAP) of the women were evaluated pre and post-intervention. At baseline all three groups had similar low scores in KAP. After the education intervention, knowledge improved in IG compared to PCG (p=0.009), and both were greater than NCG (p=0.001). Attitude in IG improved more in PCG (p=0.008) and both increased compared to NCG (p=0.001). Practices improved, similarly, in IG and PCG (p=0.084) after intervention, and both were better than NCG (p=0.001). From this study, we conclude that nutrition education delivered through WDTLs, as is intended in communities in Ethiopia having HEWs, was more effective than delivery by HEWs alone. Nutrition education on pulse sprouting has the potential to bring positive changes on KAP of rural women who depend on this processing skill to provide nutritious foods for their families.