Trials of Improved Practices complemented with modified recipes to improve dietary diversity of women and children in farming households in Kapchorwa, Uganda

Abstract

Diets in rural households are usually less diverse with a higher percentage composed of starchy staples and are low in cheap sources of proteins and micronutrients such as legumes, fruits and vegetables. The main objective of this study was to determine how behaviour change messages and nutritionally improved recipes facilitate diversification of legumes, vegetables and fruits in complementary feeding and meals of farming households in Kapchorwa district. A mixed-method research design was used whereby dietary behaviour was assessed using the 24-hour recall method during a cross-sectional baseline survey. This was followed by “Trials of Improved Practices (TIPs)” to determine barriers and facilitators to uptake of dietary behaviour change messages. Lastly, participatory cooking demonstrations were conducted to determine the acceptability of nutritionally improved local recipes. Quantitative analysis of Minimum Dietary Diversity of Women (MDD-W) of reproductive age showed that 61% of women assessed consumed at least five out of ten food groups. The mean frequency of food group consumption was 4.73 and SD ±1.00. Generally, all participating women consumed at least starchy staples. Vitamin A-rich fruits and vegetables were consumed by only 4% of the women and 19% ate “other fruits”. Qualitative data were analysed using Thematic Content Analysis (TCA). During the TIPs household visits, the majority of the women either tried or demonstrated a willingness to eat a variety of legumes, vegetables and fruits. They were motivated by factors such as access, availability, usual dietary practice, reduced monotony and perceived health benefits. However, uptake of recommendations were hindered by seasonality, long cooking time for legumes, cost of ingredients, lack of income, distance to the food market, previous skills. Overall, practical cooking sessions showed high acceptability of recipes with a proportion of 93% and 89% of the women selecting modified legume and vegetable dishes respectively. The acceptability of modified recipes was motivated by improved sensory attributes, reduced overall preparation time, compatibility with the local dietary practices, solid fuel saving and perceived health benefits. Conversely, cost of ingredients and distance to the market were cited as barriers to recipe acceptability. In conclusion, behaviour change messages accompanied by practical cooking and tasting of modified recipes is one of the feasible means for the adoption of improved diet-related practices that can lead to improved dietary diversification.