Integrating poultry and nutrition education to improve dietary diversity among rural Kenyan women

Background: Malnutrition among women of reproductive age (WRA) in Kenya reflects a dual burden: persistent undernutrition alongside increasing rates of overweight and obesity, with widespread micronutrient deficiencies. Dietary diversity, a proxy for nutrient adequacy, remains low—particularly in rural and peri-urban areas—exacerbated by socioeconomic and educational disparities. Objective: To assess the impact of poultry interventions, with and without integrated nutrition education, on dietary diversity among WRA in smallholder households in Kakamega and Bomet Counties, Kenya. Methods: A cluster-randomized implementation study was conducted among poultry-keeping households across selected villages in Kakamega and Bomet. Villages were randomly assigned to one of three groups: (1) Poultry Only, (2) Poultry plus Nutrition Education, and (3) Control. A total of 324 households (108 per group) were enrolled. The Minimum Dietary Diversity for Women (MDD-W) was assessed at baseline (August–September 2023) and at endline (December 2024) using 24-hour dietary recall and descriptive statistical analysis. Results: Significant improvements in dietary diversity were observed in both intervention groups. In Bomet, MDD-W achievement increased from 9% to 61% in the Poultry Only group and from 41% to 78% in the Poultry + Nutrition Education group. In Kakamega, MDD-W improved from 41% to 78% in the Poultry Only group and from 44% to 97% in the Poultry + Nutrition group. The control group in Kakamega also improved (from 41% to 79%), while the control group in Bomet showed no significant change. Higher educational attainment in Kakamega may have contributed to the greater gains observed. Conclusion: Both poultry provision and nutrition education independently improved women's dietary diversity, with the combined intervention demonstrating the greatest impact. Educational disparities influenced intervention outcomes, highlighting the need for locally tailored, nutrition-sensitive agricultural strategies to effectively address malnutrition among WRA in rural settings.