Comparison between nutrition education intervention and nutrition education & homestead food production on nutritional status among selected rural secondary school students

Abstract

This study evaluated the effects of nutrition education program alone and in combination with homestead food production (HFP) inputs on nutritional status in selected rural secondary school students of Kishoreganj district. In this interventional study, 1214 students were placed into study group 1 (406), study group 2 (400) and control group (408). The study group 1 participated in nutrition education program whereas the study group 2 got HFP inputs along with nutrition education. Sociodemographic informations were collected at baseline of the study KAP related information, food security related information, anthropometric data, blood samples, school performance related information and dietary data (24 hour dietary recall along with seven days’ food frequency) were collected at baseline and after six months of follow up respectively. The data were analyzed by paired t-tests. ANOVA test was also done to see the significance level of academic performance between the groups. In all statistical tests, p values of less than or equal to 0.05 were considered significant. Most of the participants’ fathers were found to be farmer in three groups. However, among other reported occupations, business and small business were common across the groups. Percentages of illiterate mothers for study group 1, study group 2 and control group were found 11.9%, 12.8% and 8% respectively. Most of the families were found nuclear rather than the joint type in three groups. About half of the participants’ monthly per capita income were reported lower than 600 Taka among all the groups. The knowledge, attitude and practice score were compared among the groups over the study period. The KAP percent score were significantly increased in study group 1 (p < 0.001) and study group 2 (p < 0.001) after the intervention; no significant change was seen in control group (p = 0.445). Although, in the control (p <0.510) and the study group 1 (p=0.211) food insecurity followed an increasing pattern; in study group 2 it reduced significantly (p <0.001).viii Percentages of the study participants having normal BMI increased a little in the study group 1 and 2 (78 to 82.3 and 85.4 to 87.5 accordingly). In the control group, 89.1% participants’ BMI were normal at the baseline which reduced to 87% at the end of the study period of six months. The prevalence of anemia was 43.8%, 48.5% and 48.5% in the study group 1, study group 2 and control group respectively. After 6 months the prevalence of anemia increased in the control group (54.9%). One the other hand, decreased anemia prevalence was reported in study group 1 and study group 2 (35.5% and 44% respectively). The serum ferritin level which is a marker of human storage, also decreased from baseline in control group. Significant changes of the examination marks were found in all the groups after intervention. Among them the changes in study group 1 and 2 were highly significant (p = 0.00 and 0.00 respectively). It was also found that the improvement in academic performance in study group 2 was significantly higher compared to study group 1 (p = 0.007) and control group (p = 0.003). The participants of study group 2 were found to have better dietary diversity score (p =0.000) and dietary intake (significant increase in food group consumption and also in macro and micronutrients intakes) after intervention compared to others. Still they could not meet the level of RDA and most of the participants of all groups were inadequate in terms of macro and micronutrients intakes. Nutrition education and HFP program appeared to have positive impact on nutritional status of the participants of study group 2. Healthy eating bahaviour is essential for students to achieve their full academic potential, mental growth and lifelong health & well-being.