Effect of nutrition education on improving dietary diversity of children aged 6-23 months in Horo district, Oromia region, Ethiopia

Background: Unmet minimum dietary diversity (MDD) feeding practices in poor nations place children at high risk of undernutrition and its related effects, which are far-reaching and difficult to correct later in life. Objective: This study aimed to assess the effect of maternal nutrition education and another determinant on the dietary diversity of children aged 6-23 months. Methods: A community-based cluster randomized trial study design was conducted from July 2019 to January 2020 in the Horo district. Twenty-three kebeles were assigned to two clusters. From two clusters, two kebeles were selected by simple random sampling. Two kebeles were assigned as intervention (150) and control (150) groups by the lottery method, at the end of the line as intervention (139) and control (137) groups. Simple random sampling techniques were used to select the study subjects. The nutrition education intervention, which lasted three months and consisted of eight sessions, was given to the intervention group, which was made up of mothers and other caregivers of children aged 6-23 months. Data entry into Epi-data and analysis were done using IBM SPSS version 26 computer software. At a 95% confidence level, values with P <= 0.05 were considered statistically significant. B-ivariable and multivariable conditional fixed-effect logistic regression analyses were done to identify the determinants of the dietary diversity score. Variables with a p-value of less than 0.05 were considered statistically significant. The crude odds ratio (COR) and adjusted odds ratio (AOR) were used to describe the strength and direction of the association. Result: The result was that the proportion of children with a good dietary diversity score was 52 (34.7%) and 40 (26.7%) in the control group and intervention groups at baseline, respectively. Household food security [AOR = 4.06, 95% CI: (2.45, 6.73] and being in the intervention group [AOR = 1.90, 95% CI: (1.10, 3.29] were both positive predictors of the dietary diversity score, while maternal age (35-45 years) was a negative predictor. Conclusion: At baseline, a high proportion of children aged 6-23 months did not receive the World Health Organization's minimum dietary diversity recommendation for both groups. The consumption of animal sources and vitamin-A-rich fruits and vegetables was poor among both groups. At the end of the day, after nutrition education, the dietary diversity score improved in the intervention groups but not in the control groups. New strategies and programs should be made at all levels to improve childhood nutritional status. This includes providing nutrition education for mothers aged between 35 and 45 years old.