The Effect of Harvest Lentil Vegetable Blend Combined with a Theory Based Nutrition Education Intervention on Turkana Children’s Health Outcomes

Purpose: The purpose of this study was twofold: (i) to assess children’s nutritional status, child feeding practices, household food security and WASH practices, and caregivers’ knowledge and psychosocial factors towards complementary feeding practices. (ii) To assess the effect of a theory-based nutrition education intervention combined with child consumption of Harvest Lentil Vegetable Blend on the nutritional status of Turkana children aged 6-59 months and WASH practices, child feeding practices, nutrition knowledge, attitudes, subjective norms, perceived behavioral control, and intentions towards recommended child feeding practices among Turkana caregivers of children aged 6-59 months. Methods: This was a two-month-long quasi-experimental controlled trial. In total, 318 Turkana children aged 6 months to 59 months and their primary caregivers (n = 284) were recruited for the study. Children in the intervention group received one daily meal of supplemental food six days a week for a total of eight weeks, and their caregivers received a four-module, theory-based nutrition education intervention on complementary feeding and WASH practices. Children in the control group received one packet of supplemental food on the days of data collection, while their caregivers received no nutrition education intervention. The outcome measures of this study were children’s anthropometric measurements, water, sanitation, and hygiene (WASH) practices, child feeding practices, and caregivers’ knowledge and constructs of the theory of planned behavior regarding child feeding practices. Linear mixed effects models and the generalized estimating equations (GEEs) were used to assess the effect of the intervention. Results: At baseline, 19.9%, 25.5%, and 25% of children were affected by stunting, wasting, and underweight, respectively. The majority of caregivers were unable to read and write (84.8%) and were severely food insecure (98.6%). The intervention was effective in increasing caregivers’ nutrition knowledge scores (P = 0.032) and attitude scores (P < 0.001). Additionally, compared to the control group, children in the intervention group were more likely to consume animal source foods (P < 0.001), meet minimum dietary diversity (P = 0.046), and consume significantly more meals at the study endpoint (P < 0.001). Furthermore, the nutrition education intervention was effective in reducing the practice of open defecation (P = 0.040) and in increasing the practice of water disinfection (P = 0.020) and washing hands before cooking (P = 0.030). This study further observed a trend of greater improvement across all indicators of child nutrition status in the intervention group compared to the control group. However, none of these improvements were statistically significant. Conclusion: A well-designed nutrition education intervention coupled with an onsite blanket supplementary feeding program was associated with significant improvements in key complementary feeding practices and WASH practices.