Hagos, Seifu (BSc, MPH, MSc, PHD)Mohammedsanni, Afrah2018-10-302023-11-052018-10-302023-11-052018-01http://etd.aau.edu.et/handle/123456789/13429Background: The first 1,000 days of life, from the first day of pregnancy until the child is 24 months old is a critical window of opportunity for health and development. It is essential for pregnant women to have adequate knowledge in order to achieve optimal nutritional status during pregnancy. Antenatal care is a key unit for provision of nutrition information for pregnant women. It is critical for health care providers to have adequate knowledge and skill necessary to be able to provide sufficient nutritional information for pregnant women. However, studies show lack of adequate knowledge and skill among health care providers. Objective: To evaluate the effectiveness of nutrition education and counseling in improving knowledge and dietary behavior of pregnant women. Method: We conducted a cluster randomized controlled trial in Addis Ababa, Ethiopia. Health centers were allocated to intervention and control arms using a matched-pair randomization scheme. 40 health care providers from intervention arm were trained on pregnancy nutrition and counseling skills. 683 pregnant women (347 from intervention and 336 from control) were included from 20 health centers. We estimated deference in deference (DID) impact of intervention using mixed-effect linear regression with health center catchment area as random effect. Result: Pregnant women’s knowledge on food groups, use of iron folic acid supplement, benefits of balanced diet and consequence of under nutrition showed a significant improvement (P <0.001) Pregnant women of intervention arm were observed to have a significantly higher knowledge on using iodized salt (difference in proportion (DP) 24.3% vs 1.7; DID 23%), duration of iron folic acid supplementation (DP 70.9% vs 3.4; DID 68%) and having one additional meal (DP 54.3% vs 4.3; DID 49.9%). Significant improvement was also observed on dietary diversity (DP 39.0% vs 4.5; DID 32.3%) and having one additional meal to the diet (DP 36.7% vs 24.7; DID 12.8%). Pregnant women of intervention arm improved their consumption of dairy per week (DID 1.2). Intake of iron folic acid supplement has shown an improvement of 3 more days per week (D 4.9 vs 1.6; DID 3.2). However, effect of knowledge on initiation of breast feeding (P = 0.089) and dietary frequency of grains (P = 0.067) appears to be statistically insignificant. Conclusion: Nutrition education and counseling improves pregnant women’s nutritional knowledge and dietary behavior in urban settings.en-USnutrition,pregnant womenThesis