Effectiveness of Triple Benefit Health Education Intervention on Knowledge, Attitude and Food Security towards Malnutrition among Adolescent Girls in Borno State, Nigeria

Abstract

Knowledge and attitude are essential components of food security as malnutrition remains a critical public health concern among adolescents. The study evaluates the effectiveness of a Triple Benefit Health Education Intervention on knowledge, attitude and food security towards malnutrition among adolescent girls. This was a cluster randomized controlled trial among 417 randomly selected adolescent girls aged 10 to 19 years old in Maiduguri, Borno state, Nigeria from October 2019 to March 2020. About 208 respondents were assigned to experimental while 209 to control group, respectively, using an opaque sealed envelope. A structured questionnaire using KoBo Collect Toolbox was used for the collection of data at baseline, three and six-months post intervention while the data collected were analyzed using generalized estimating equation (GEE). The outcome of the baseline shows no statistically significant difference in sociodemographic characteristics, knowledge, attitude and food security between experimental and control groups. The study reveals a statistically significant difference between experimental and control groups for knowledge (p < 0.001; p < 0.001), attitude (p < 0.001; p < 0.001) and food security (p = 0.026; p = 0.001) at three and six-months post intervention, respectively. The triple benefit health education intervention package employed in this study can serve as an intervention tool to combat malnutrition among adolescent girls in Nigeria at large.

Behaviour change interventions improve maternal and child nutrition in sub-Saharan Africa: a systematic review

“…The 71 articles were published between 2004-2022 and included cluster randomised control trials (RCT)(n=38) (20, 39–75) , study evaluations(n=13) (52, 56, 68, 76–86) , quantitative studies(n=11) (87–100) , mixed methods studies(n=5) (88, 89, 101–103) , qualitative studies(n=3) (104–106) , and national case studies(n=2) (107, 108) . Behaviour change interventions were identified from 18 sub-Saharan African countries: Ethiopia(n=18) (42, 58, 59, 62, 64, 67, 68, 70, 79–81, 92–95, 100) , South Africa(n=8) (40, 41, 45, 46, 66, 87–89) , Malawi(n=8) (43, 44, 71, 77, 78, 82, 85, 106) , Kenya(n=5) (39, 96, 101, 102, 104) , Burundi(n=5) (48–52) , Nigeria(n=5) (73, 90, 97, 99, 105) , Burkina Faso(n=5) (48, 54, 56, 74, 109) , Ghana(n=4) (84, 91, 108) , Madagascar(n=2) (20, 75) , Zambia(n=2) (83, 110) ,Tanzania(n=2) (47, 72) and one each from, Central African Republic (107) , Mali (63) , Mozambique (65) , Rwanda (69) , Senegal (103) , Togo (61) , and Uganda (53) . A total of 30 studies were graded as low risk of bias, 30 as medium, and 11 as high (Table 2) .…”

“…Interventions aimed to address psychosocial outcomes including nutrition knowledge (n=17) (40–42, 44–46, 58, 61, 71, 73, 84, 90, 94, 96, 97, 103, 104) , practices (e.g. food/recipes preparation, healthy eating)(n=5) (42, 90, 94, 96, 98) , attitudes (n=6) (42, 45, 46, 62, 90, 94) , intentions (n=4) (45, 46, 62, 99) and confidence in eating healthy food (n=1) (104) .…”

Challenging the Status Quo to Shape Food Systems Transformation from a Nutritional and Food Security Perspective

“…In this context, attitude and knowledge of health, food, and nutrition can be one of the keys to facing food insecurity in several countries. Health and nutritional education are imperative to fight malnutrition [ 1 , 2 , 3 , 4 ]. Knowledge in these aspects is essential in tackling misinformation and promoting good food choices.…”

“…Knowledge in these aspects is essential in tackling misinformation and promoting good food choices. Since birth, it can be constructed along life using households, schools, the internet, and other channels to allow learning on food, health, and nutrition and stimulate adequate food choices [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ].…”

“…Adequate and healthy diets imply choosing and consuming balanced and adequate foods on nutrients and amount, variety, and sustainable aspects. Therefore, achieving the main social, economic, environmental, cultural, and security goals [ 1 , 3 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. Food production must also be alert to the waste produced in the food chain related to environmental pollution and food waste that could be used to feed food-insecure people [ 10 , 15 , 17 ].…”