Nutrition education and introduction of broad bean–
based complementary food improves knowledge and
dietary practices of caregivers and nutritional status of
their young children in Hula, Ethiopia
Canaan Negash, Tefera Belachew, Carol J. Henry, Afework Kebebu, Kebede Abegaz, and
Susan J. Whiting
Abstract
Background. Nutritious complementary foods are
needed in countries where undernutrition and stunting
are major problems, but mothers may be reluctant to
change from traditional gruels.
Objective. To test whether a recipe-based comple-
mentary feeding education intervention would improve
knowledge and practice of mothers with young children
in Hula, Ethiopia.
Methods. A baseline survey of 200 eligible, randomly
selected mother–child pairs gathered data on sociodemo-
graphic characteristics, food security status, knowledge
and practices concerning complementary feeding, food
group intakes of children aged 6 to 23 months by 24-hour
recalls, and children’s anthropometric measurements.
Twice a month for 6 months, women in the intervention
group received an education session consisting of eight
specific messages using Alive and Thrive posters and a
demonstration and tasting of a local barley and maize
porridge recipe containing 30% broad beans. The control
group lived in a different area and had no intervention.
Results. At 6 months, knowledge and practice scores
regarding complementary feeding were significantly
improved (p < .001) in the intervention group but
not in the control group. The intervention resulted in
improvement of children’s dietary diversity, as well as
mean intake of energy and selected nutrients, compared
with children in the control group. Changes in height and
weight did not differ between the two groups.
Conclusions. Community-based nutrition education
over 6 months that included demonstration of a local
Canaan Negash, Afework Kebebu, and Kebede Abegaz, are
affiliated with Hawassa University, Awassa, Ethiopia; Tefera
Belachew is affiliated with Jimma University, Jimma, Ethiopia;
Carol J. Henry and Susan J. Whiting are affiliated with the
University of Saskatchewan, Saskatoon, Canada.
Please direct queries to the corresponding author: Susan
J. Whiting, College of Pharmacy and Nutrition, 110 Science
Place, University of Saskatchewan, Saskatoon SK, Canada
S7N 5C9; e-mail: Susan.whiting@usask.ca.
480 Food and Nutrition Bulletin, vol. 35, no. 4 © 2014, The Nevin Scrimshaw International Nutrition Foundation.
porridge recipe with broad beans added improved the
complementary feeding practices of caregivers and the
nutritional status of their young children.
Key words: Broad bean, complementary foods,
Ethiopia, feeding practice, infants and young children,
nutrient intake
Introduction
Child malnutrition is a global problem that now has
the attention of policy makers and politicians owing to
its severe consequences for the health and economics
of nations [1]. The first 1,000 days of life, starting with
conception, are considered critical to a child’s current
and future health. Malnourished children are more vul-
nerable to infection, which leads to unacceptably high
morbidity and mortality. Of the stages in a child’s life
where nutrition has an important role, the period from
6 to 24 months is especially critical [2]. To improve the
quantity and quality of complementary food for infants
and young children aged 6 to 24 months, effective
intervention strategies are needed, since evidence for
the effectiveness of complementary feeding strategies
has been reported as “insufficient,” especially in food-
insecure populations [2, 3].
Protein–energy malnutrition in children manifests
as underweight, defined as –2 SD below the normal
weight for age (weight-for-age z-score, WAZ); stunt-
ing, defined as –2 SD below the normal height for age
(height-for-age z-score, HAZ); and wasting, defined as
–2 SD below the normal weight for height (weight-for-
height z-score, WHZ) [4]. In Ethiopia, recent survey
data show that 44% of children are stunted and 29% are
underweight, with little difference between boys and
girls. The prevalence of stunting is higher in rural than
in urban areas (46% vs. 32%). Ten percent of Ethiopian
children are wasted, with boys at greater risk than girls
(11% vs. 8%) [5]. The inexpensive, mainly cereal-based
foods available in poor communities are low in protein
Complementary food education intervention
and micronutrients, leading to deficiencies in mothers
as well as in infants and children [6].
Complementary foods should contain high-biolog-
ical-value protein, as well as vitamins and minerals, as
outlined in the Global Strategy on Infant and Young
Child Feeding (IYCF) [7]. Animal-source foods are
therefore promoted [8]. However, these foods are
costly and are rarely available to families in developing
countries such as Ethiopia [9]. In Ethiopia only 4% of
children aged 6 to 23 months were reported as being
fed in accordance with IYCF practices [5]. One low-
cost alternative is to supplement locally grown starchy
foods with legumes (also called pulses) and use some
animal-source foods when they are available. This
practice has been promoted for many years [10] and
is built into complementary feeding advice [11], but it
has not yet gained acceptance by caregivers [12]. One
or more legume crops may be locally available and even
used in the household, yet they are often not perceived
as a suitable complementary food [12].
The value of nutrition education-based interven-
tions is uncertain [3]. A systematic review of nutrition
education interventions in both food-secure and food-
insecure settings found that in food-secure popula-
tions, there were significant improvements in some
growth parameters (height and weight gain) but not
in stunting. However, in food-insecure populations,
there were significant effects of nutrition education on
improving WAZ and HAZ, and on an absolute decrease
in stunting [3]. Nevertheless, education strategies must
be tested to ascertain if they are culturally appropriate.
We tested whether a recipe demonstration along with
evidence-based nutrition messages on complementary
feeding practices from Alive and Thrive Ethiopia [11]
would affect knowledge and practices of caregivers
and produce changes in children’s diet in southern
Ethiopia. In this study, mothers in the intervention
group received a demonstration of the broad bean-
supplemented maize–barley porridge in addition to
nutrition education twice a month for 6 months. At the
end of each session, there was time for tasting by the
infants and young children.
Methods
Study area
This study was conducted from September 2012
to March 2013, in Hula Woreda, Southern Nations
Nationalities and Peoples’ Region (SNNPR), Ethiopia.
This area is mostly rural (94%), with 60% cultivable
land. Important cash crops include maize, wheat,
barley, local varieties of cabbage, broad beans (also
called faba beans), and potatoes [12]. In this area,
women had been offered prenatal iron supplementa-
tion and infants had been offered deworming tablets,
481
but no other special programs of prenatal or postnatal
supplementation in either the control or the interven-
tion area were being conducted beyond CMAM (com-
munity based management of acute malnutrition). This
area was selected based on its potential for growing
pulses, yet it was known as an area with relatively high
food insecurity and a high number of malnourished
children [13].
Study design
The study subjects were 197 caregivers (who in this
study all happened to be mothers) of children between
the ages of 6 and 23 months at baseline, living in two
kebeles (Titicha and Debicha) of Hula Woreda. Only
caregivers who had been residents of the study area
for more than 6 months and who gave consent were
eligible for the study. Children who had signs of ill-
ness, such as persistent vomiting, coughing, diarrhea,
or fever or acute signs such as runny nose, watery eyes,
itchy eyes, red eyes, or redness around the lips and
swollen lips were also excluded. The sample size was
calculated to detect a minimum significant difference
in the proportion of wasting between children in the
intervention and control groups. Given a potential
dropout rate of 10%, the sample size for the interven-
tion and control groups was calculated as 100 for each
group. To select mother–child pairs, small areas (gots)
were randomly chosen in each kebele, and from these
gots 100 eligible participants were randomly chosen to
be in the control group and 100 were chosen to be in
the intervention group. The control area was an adja-
cent kebele that was far enough away to have little or
no contact with participants in the intervention group.
A baseline survey was performed with the use of a
pretested, structured questionnaire to assess sociode-
mographic characteristics of the family and existing
knowledge and practice of caregivers regarding com-
plementary feeding. The questionnaire was developed
in English using process validation and then translated
into the Sidamigna language. Duplicate measurements
of weight, height, and mid-upper-arm circumference
(MUAC) were taken by trained staff during the baseline
survey. Dietary intake was estimated by an interac-
tive 24-hour dietary recall. In-depth interviews were
conducted with health extension workers to assess
the existing practices and perceptions of mothers in
both the intervention and the control groups on child
feeding, food taboos, and caring practices. Points of
resistance were identified, and messages and explana-
tions were built for necessary behavior change com-
munication by the healthcare workers who delivered
the nutrition messages.
The intervention had two parts. A nutrition educa-
tion session on young child feeding was conducted
for the caregivers twice each month for 6 months,
using visual materials (posters) from Alive and Thrive
482
[11] that encouraged caregivers to properly prepare
complementary foods in eight messages, delivered by
trained nutrition educators along with the principal
investigator. The eight specific messages were: practice
responsive feeding; continue breastfeeding until the
child is at least 2 years old; feed a soft, consistent, thick
porridge; practice good hygiene and do not bottle feed;
continue to feed the child during illness; and pay atten-
tion to the amount of food; the variety of food; and to
frequency of feeding.
Each session also included a demonstration of the
preparation of the 30% broad bean porridge, followed
by tasting. Caregivers in that area typically used a
maize–barley porridge for complementary feeding,
and the 30% broad bean porridge was a modification
of this recipe [13]. The recipe had been developed and
tested previously in this area of Ethiopia. Using locally
available foods, the ingredients were added together
and cooked at the education session. The recipe con-
sisted of 1 cup of previously soaked broad beans, ½ cup
of maize flour, and 1½ cup of barley flour. Following
IYCF guidelines [11], kale, butter, and an egg were
added in the final steps. All steps in the preparation
of the porridge were demonstrated to the caregivers,
with practical training provided, and at every session
the porridge was shared among all the young children
present. The control subjects received neither of these
interventions.
At months 2 and 4 of the 6-month intervention,
mothers in the intervention group completed follow-
up questionnaires to record feeding practices such
as frequency of feeding the porridge and to rate the
acceptability of the porridge by the child. At the end
of the 6 months, an endline survey was performed in
both the intervention and the control groups to record
anthropometric characteristics of the children, 24-hour
recall of the children’s diets, and changes in knowledge
and feeding practices of caregivers with a pretested,
semistructured questionnaire.
Anthropometric measurements were performed
using calibrated equipment and standardized tech-
niques. Weight was measured to the nearest 0.1 kg with
an electronic scale (Seca 770) with the children wearing
a light shirt and without shoes. Recumbent length was
measured to the nearest 0.1 cm with a length-measur-
ing board. All anthropometric data were collected by
the principal investigator.
Data processing and analysis
The data were entered, checked for missing values and
outliers, and analyzed with SPSS, version 16.1. The
weights and heights of the children were converted
to z-scores with WHO Anthro Software. Changes in
mean weight and height as well as the indices (WHZ,
HAZ, WAZ) were compared between treatment and
control children using the independent sample t-test
C. Negash et al.
after checking for normalcy. To identify the predictors
of knowledge, attitudes, and practices, only variables
that were significantly associated at (p < .1) in the
bivariate analyses were entered into multivariable linear
regression models. In all tests, p < .05 was considered
to indicate statistical significance.
Ethical approval
Before data collection, permission was obtained from
the Hawassa University Ethical Review Committee.
The local authorities were informed about the purpose
of the study and its objectives. Prior to entry into the
study, the mothers gave oral consent after the benefits
of the study had been explained to them. Sick and
severely malnourished children were referred to health
facilities and advice was given to their parents.
Results
Sociodemographic characteristics
The baseline sociodemographic and household char-
acteristics of participants in both the intervention and
control groups are shown in table 1. The two groups
were comparable in most baseline characteristics. Only
education and income were different, with higher edu-
cation and income found in the control group. Both
study areas experienced similar degrees of food inse-
curity at baseline. Baseline physical growth assessment
and 24-hour dietary recalls were completed for 98.5%
of the 200 mother–child pairs who were recruited. In
the intervention group, the median attendance was 8
sessions, with 97% of the mothers attending at least 1
of the 12 education sessions. By the end of the interven-
tion period, physical growth assessment was completed
for 78.5% of the children in both groups, and 24-hour
recall was completed for 85% of the study participants
in both groups.
Knowledge and practice regarding complementary
feeding
At baseline, 78% of all mothers reported in the ques-
tionnaire that they had previously received advice on
complementary feeding, and almost all (96%) knew
that continuing to breastfeed during the complemen-
tary feeding period was important. Close to half of the
mothers had heard about broad bean-based comple-
mentary food, and of this group, almost all (93.8%)
knew that broad beans could be made into porridge or
combined with other food items. To quantify knowl-
edge, average scores on the eight questions were cal-
culated as the sum of correct answers (to a maximum
of 8). Knowledge of complementary feeding in the
intervention group rose from 5.8 ± 2.1 at baseline to 7.1
Complementary food education intervention 483

± 1.0 at endline (p < .001), whereas scores for the con- in the intervention were giving complementary food
trol group stayed unchanged at 6.3 ± 1.6 at both time prepared from at least four groups to the child and the
points. Multivariate analysis indicated that being in the frequency of feeding the child.
intervention group was the only demographic factor
that significantly (p < .0001) predicted an increase in Nutritional status
knowledge score.
Both study groups were similar at baseline for At baseline, the prevalence rates of stunting, wasting,
feeding practices (table 2), but there was significant and underweight among children eligible for this study
improvement only in the intervention group (p = .02). in this area of Hula were 12%, 7%, and 10%, respec-
Only the intervention group improved in learning the tively. There were no differences at baseline between
correct steps used to prepare the broad bean-based intervention and control groups when we compared
complementary food, as was intended with the educa- only those children who were measured at both base-
tion sessions. Other improvements in practice noted line and endline (80 in the intervention group and 73 in
the control group). However, baseline weight was lower
TABLE 1. Baseline characteristics of participants in interven- in control children (9.02 ± 1.49 kg) than in intervention
tion (nutrition education) and control groups, Hula Woreda, children (9.62 ± 1.90 kg), but baseline height did not
Ethiopia differ for control and intervention children (74.8 ± 6.4
Characteristic Intervention Control and 76.8 ± 8.3 cm, respectively). After 6 months of
nutrition education for the intervention mothers,
Mother in charge of care 100 97 control and intervention children had similar gains in
(no.)
weight (~ 0.9 kg) and height (~ 4 cm).
Mother’s age (no.)
15–19 yr 2 3 Dietary practices and nutrient intake
20–29 yr 72 61
30–39 yr 26 33 At baseline, the usual food eaten by most children
Child’s age—mean ± SD 15.2 ± 5.89 13.47 ± 5.16 (~ 94%) was cereal-based porridge. About 90% also
(mo) consumed milk with the porridge. More children in
the control group than in the intervention group con-
Marital status (no.)
sumed pulse foods at baseline (27% vs. 13%). At the
Married 99 96
end of the intervention, consumption of pulses, meat,
Other 1 1
vegetables, roots, fruits, and milk was significantly
Education (no.)** higher in the intervention group. Further, at the end
Illiterate 46 76 of the intervention, pulses were regularly consumed
Primary school 39 19 by 45% of intervention children and only 7% of control
Secondary school or 15 2 children. These changes in food consumption were
higher reflected in nutrient intakes of the children (table 3).
Occupation (no.) The main effect of the intervention on nutrient intakes
Housewife 67 59 was a greater increase in protein intake by intervention
Farmer 27 35 children than by control children (p < .05).
Other 6 3
Listens to radio (no.) 24 11 Discussion
Family size (no.)
<5 43 34 This study was a 6-month nutrition education interven-
≥5 57 63 tion on complementary feeding with recipe demonstra-
Income (no.)** tion and tasting of a complementary food containing
Low 49 14 maize, barley, and 30% broad beans that represented
Medium 46 83 a locally available way to enhance nutrient density for
High 5 0
infants and young children in this area of Ethiopia
[11, 13]. At the beginning of the study, children in
Food security (%) both groups were mainly fed a cereal-based porridge
Food secure 34.8 34.0 and pulse use was low. At 6 months, knowledge and
Mildly food insecure 11.6 5.7 practice scores regarding complementary feeding were
Moderately food 27.7 34.9 significantly improved (p < .001) in the intervention
insecure group but not in the control group. At baseline, the two
Severely food insecure 25.9 25.5 groups were similar except for higher levels of educa-
**p < .001. tion and income in the control group. The average rate
484 C. Negash et al.

TABLE 2. Comparison of mothers’ complementary feeding practices and use of broad bean-based comple-
mentary food at baseline and after 6 months of nutrition education intervention, Hula Woreda, Ethiopia
Baseline Endline
Practice Control Intervention Control Intervention
Currently breastfeeding (%) 99 91 90.4 83.0
Bottle-feeding (%) 5.2 8.0 2.4 3.4
Complementary feeding (%) 99 100 98.8 100
4 food groups used (%) 32 33 14.5 54.5
Handwashing before preparing food (%) 100 99 100 100
Handwashing before feeding (%) 100 99 100 96.6
Handwashing after defecation (%) 99 99 100 86.4
Frequency of feeding (%)# 25.8 28.0 32.5 52.3
Consistency: feeding thick food (%) 88.5 87 97.6 96.6
Snack provided (%) 69.8 82 88.0 95.5
Responsive feeding (%) 99 100 90.4 96.6
Broad bean used (%) 47.9 44 65.1 71.3
Practice scorea 9.1 ± 1.1 9.1 ± 1.2 9.1 ± 1.1 9.6 ± 1.1*
# defined as meeting 3 meals for children 6–11 mo, and 4 meals for children 12–24 mo.
a. Practice score = sum of practices (1= did the correct practice, 0 = did not do the correct practice).
*p = .02 compared with baseline.

TABLE 3. Dietary intakes of young children in intervention and control groups at baseline and after
6 months of nutrition education intervention, Hula Woreda, Ethiopia (mean ± SD)
Baseline Endline
Control Intervention Control Intervention
Nutrient (n = 92) (n = 100) (n = 76) (n = 81)
Energy (kcal) 717 ± 369 854 ± 496a 885 ± 542 1,045 ± 635
Protein (g) 20.6 ± 10.3 24.3 ± 17.8 21.6 ± 11.3 28.7 ± 22.6b
Fat (g) 22.5 ± 16.2 23.2 ± 15.4 35.0 ± 34.8 34.4 ± 26.7
Carbohydrate (g) 111 ± 65 145 ± 95a 127 ± 78 159 ± 105b
Iron (mg) 16.9 ± 16.1 28.9 ± 32.1a 20.9 ± 13.4 30.6 ± 21.2b
a. p < .05 between groups at baseline.
b. p < .05 between groups at endline.

of food insecurity at baseline was 65%, with no dif-
ference between the groups. However, at endline 47%
of intervention households and only 20% of control
households were food insecure. The difference between
the groups may have been related to differences in crop
success between the two areas. Despite the drop in food
security, the intervention caregivers showed improved
practices related to complementary feeding and their
children showed improvement in dietary intakes. At
the beginning of the intervention, knowledge scores of
the mothers were good in both the intervention and the
control group, but after 6 months, the control group,
with no reinforcement of these areas of knowledge,
showed a large decline. In contrast, twice-monthly
sessions improved knowledge scores in the interven-
tion group. These sessions, 2 hours in length, were
intentionally interactive, with both dialogue and recipe
demonstration. Other intervention trials focusing on
complementary feeding messages also had similar
outcomes. For example, a 1-year, village-based educa-
tional intervention in rural China showed significant
increments in knowledge among intervention mothers
and caregivers compared with controls [14].
The intervention resulted in a significant improve-
ment in some practices related to IYCF complementary
food recommendations. This is indicative of behavioral
change, albeit self-reported by questionnaire. How-
ever, at the end of the intervention period, mothers
in the intervention group used the demonstrated
broad bean recipe significantly more than did moth-
ers in the control group. Our findings are similar to
those of nutrition education trials done elsewhere. A
6-month nutrition education trial in Vietnam found
that children in the intervention group received a
greater number of feedings than comparison children
[15]. A study in Peru reported that complementary
feeding practices by mothers in an 18-month educa-
tional intervention group improved, as evidenced by
Complementary food education intervention
their offering thicker food and adding more sources
of animal protein than controls [16]. Thus, nutrition
education is effective in changing practices.
In the intervention group, the quality and quantity of
complementary food improved by the end of the inter-
vention period. More caregivers in the intervention
group used legumes (pulses), meat, vegetables, roots,
fruits, and milk for complementary food preparation.
This result is similar to those of other educational inter-
vention trials [15, 16] in which local health workers
delivered educational messages. This improvement in
our study was translated into increased mean intakes of
carbohydrates, protein, and iron by children. Further,
there was a significant increment in protein content
of complementary foods prepared by mothers in the
intervention group. Another study showed increased
protein content in complementary foods containing
animal-source foods [16].
The limitations of our study included a large age
range (6 of 23 months) of the children enrolled at base-
line and the fact that older children were outside this
range after 6 months of follow-up. This made analysis
of changes in growth parameters difficult to evaluate. A
study in Viet Nam noted only growth in younger chil-
dren (< 15 mo at baseline) rather than older (> 15 mo)
was improved in a nutrition intervention [17]. We also
did not consider the cost of this type of educational
program. Because our study involved the participation
of healthcare workers, the intervention would not be
sustainable without research funding. Therefore, exam-
ining strategies such as using peer teachers would be
the next step. The recipe included not only added broad
beans but also kale and egg (following Alive and Thrive
instructions). A strength of our research was using the
Alive and Thrive materials, which are freely available.
As no validation of these materials had been done (Y.
References
1. Black RE, Victora SG, Walker SP, Bhutta ZA, Christian
P, de Onis M, Ezzati M, Grantham-McGregor S, Katz J,
Martorell R, Uauy R, and the Maternal and Child Nutri-
tion Study Group. Maternal and child undernutrition
and overweight in low-income and middle-income
countries. Lancet 2013;382:427–51.
2. Bhutta ZA, Das JK, Rizvi A, Gaffey MF, Walker N,
Horton S, Webb P, Lartey A, Black RE, The Lancet
Nutrition Interventions Review Group, and the Maternal
and Child Nutrition Study Group. Evidence-based inter-
ventions for improvement of maternal and child nutri-
tion: what can be done and at what cost? Lancet 2013;
382:452–77.
3. Lassi ZS, Zahid GS, Das JK, Bhutta ZA. Impact of com-
plementary food and education on complementary food
on growth and morbidity of children less than 2 years of
age in developing countries: a systematic review. BMC
485
Abebe, personal communication), our study provides
evidence of their usefulness in a community setting.
Conclusions
A recipe-based educational intervention can improve
the knowledge and practice of mothers regarding com-
plementary feeding, which in turn has the potential to
improve the nutritional status of children. Children
in the intervention group consumed complementary
foods prepared from more food groups than did chil-
dren in the control group, with a resulting increase in
nutrient intake.
Authors’ contributions
Canaan Negash, Tefera Belachew, Carol J. Henry,
Afework Kebebu, Kebede Abegaz, and Susan J. Whit-
ing designed the research. Canaan Negash performed
the research. Canaan Negash, Tefera Belachew, and
Afework Kebebu analyzed the data. Canaan Negash,
Afework Kebebu, and Susan J. Whiting wrote the paper.
Canaan Negash, Susan J. Whiting, and Carol J. Henry
had primary responsibility for the final content. All
authors read and approved the final manuscript.
Acknowledgments
Financial support was provided by the Canadian
Department of Foreign Affairs, Trade and Develop-
ment, International Development Research Centre
(IDRC) Canadian International Food Security Research
Fund (CIFSRF).
Public Health 2013;13(suppl 3):S13.
4. World Health Organization. Complementary feeding
of young children in developing countries: a review
of current scientific knowledge. Geneva: WHO,1998.
Available at: http://www.who.int/nutrition/publications/
infantfeeding/WHO_NUT_98.1/en/. Accessed 11
August 2014.
5. Central Statistical Agency [Ethiopia] and ICF Inter-
national. Ethiopian Demographic and Health Survey
2011. Addis Ababa and Calverton, MD, USA: Central
Statistical Agency and ICF International. 2012. Available
at: http://dhsprogram.com/pubs/pdf/FR255/FR255.pdf
6. Umeta M, West CE, Verhoef H, Haidar J, Hautvast JG.
Factors associated with stunting in infants aged 5–11
months in the Dodota-Sire District, rural Ethiopia. J
Nutr 2003;133:1064–9.
7. WHO-UNICEF. Global strategy on infant and young
486
child feeding (IYCF) 2003. Available at: http://www.who
.int/nutrition/publications/infantfeeding/9241562218/
en/. Accessed 25 September 2014.
8. Neumann C, Harris DM. Contribution of animal source
foods in improving diet quality and function in children
in the developing world. Nutr Res 2002;22:193–220.
9. Gebriel AW. Determinants of weaning practice. Ethiop
J Health Dev 2000;14:183–9.
10. Egounlety M. Production of legume-fortified weaning
foods. Food Res Int 2002;35:233–7.
11. Alive and Thrive training materials. 2011. Available at:
http://www.aliveandthrive.org/resource/complementary
-feeding-children-6-24-months-old-training-manual-
iycf-trainers-and-promoters-. Accessed 25 September
2014.
12. Federal Democratic Republic of Ethiopia. Final Impact
Assessment Report. Volume 1: Review of EIA. October
2006. http://www-wds.worldbank.org/external/default/
WDSContentServer/WDSP/IB/2007/04/02/000020439_
20070402111952/Rendered/PDF/E15460v10CD0RE101
0V0010212710710pdf.pdf.
13. Kebebu A, Whiting SJ, Dahl WJ, Henry CJ, Kebede A.
Formulation of a complementary food with added broad
C. Negash et al.
beans (Vicia faba) in southern Ethiopia. Afr J Food
Agric Nutr Dev 2013;13(3). Available at: http://www
.ajfand.net/Volume13/No3/index3.html. Accessed 11
August 2014.
14. Guldan GS, Fan H-C, Ma X, Ni Z-Z, Xian X, Tang M-Z.
Culturally appropriate nutrition education improves
infant feeding and growth in rural Sichuan, China. J
Nutr 2000;130:1204–11.
15. Pachón H, Schroeder DG, Marsh DR, Dearden KA,
Ha TT, Lang TT. Effect of an integrated child nutri-
tion intervention on the complementary food intake of
young children in rural north Viet Nam. Food Nutr Bull
2002;23:62S–9S.
16. Penny ME, Creed-Kanashiro HM, Robert RC, Narro
MR, Caulfield LE, Black RE. Effectiveness of an educa-
tional intervention delivered through the health services
to improve nutrition in young children: a cluster-
randomised controlled trial. Lancet 2005;365:1863–72.
17. Schroeder DG, Pachón H, Dearden KA, Kwon CB, Ha
TT, Lang TT, Marsh DR. An integrated child nutrition
intervention improved growth of younger, more mal-
nourished children in northern Viet Nam. Food Nutr
Bull 2002;23:53S–61S.