The effect of nutrition and health behavior change communication through community‐level actors on the nutritional status of pregnant women in the Ambo district, Ethiopia: A randomized controlled trial

Pregnant women in Ethiopia often had trouble understanding the normal nutrition and health information given by health professionals and found it inconsistent. Undernutrition is still a significant public health problem as a result. Hence, this trial aimed to assess the effect of nutrition and health behavior change communication using the community‐level actors on the nutritional status of pregnant women. Cluster‐randomized controlled community trial with baseline and endline measurements were used. Endpoint data from 744 pregnant women (372 intervention and 372 control groups) were gathered, respectively. In the intervention group, the community‐level actors delivered the behavior change communication main message based on intervention protocol. The control group got nutrition information during their ANC visits but did not receive the behavior change communication intervention. Binary generalized estimating equations regression analyses adjusted for baseline covariates were used to test effects of the intervention on nutritional status. Following the trial's implementation, the prevalence of undernutrition in the intervention arm fell by 10% from the baseline (23.7% vs. 13.7%) and was 13.7% lower than in the control arm (13.7% vs. 27.4%, p = <.001). Pregnant women in the intervention group showed significantly lower risk of undernutrition than the control group (ARR = 0.21; 95% CI 0.14–0.30). This study showed that engaging community actors to communicate about nutrition and health behavior change was successful in enhancing pregnant women's nutritional status. Therefore, nutrition and health behavior change communication through the community‐level actors is recommended to improve the nutritional status of pregnant women.