An evaluation of the effectiveness of nutrition advisers in three rural areas of northern province.

OBJECTIVE: To evaluate the efficacy of a nutrition education intervention programme undertaken by trained local women (nutrition advisers) in rural villages in Northern Province. The programme was aimed at the caregivers of infants living in those villages. STUDY DESIGN: A cross-sectional survey design undertaken in 1989 and again in 1992. STUDY POPULATION: Female caregivers of infants living in three study villages (study area (SA)) and three control villages (control area (CA)) in Northern Province. Households were randomly selected. The response rate of households in the SA and CA was 70% (N = 1,040) at baseline and 84% (N = 1,263) after intervention. METHODS: A baseline study was undertaken in the SA and CA in 1989. A questionnaire eliciting sociodemographic data and information on dietary practices and nutritional knowledge was developed and used in the baseline study and after intervention. A nutrition education programme was undertaken by 6 trained local women (nutrition advisers) in the SA. After 2 years the survey was repeated using the same questionnaire in both the SA and CA. The SA and CA were compared with regard to breast-feeding and infant feeding practices; use of milk, brown bread, legumes and nuts; and use of school lunch boxes by older children. RESULTS: The percentage of women who initiated breast-feeding on the day of birth improved significantly in the SA from 60% to 90%. The frequency of feeding infants at 6 months improved significantly in the SA (P < 0.01). The introduction of solid foods to infants on the first day of life decreased from 26.5% to 6.3% in the SA. There were no significant differences in the SA only with regard to use of milk, brown bread, legumes, nuts, and school lunch boxes. However, some positive findings were a greater increase in the use of these items in the SA compared with the CA. CONCLUSION: A nutrition education programme undertaken by trained local women can significantly improve breast-feeding and infant feeding practices in rural areas.