Knowledge and Practice of Dietary Diversity among Pregnant Women: Evaluation of a Large Scale Social and Behaviour Change Program in Bangladesh


  • Abu Ahmed Shamim
  • Saidur Rahman Mashreky
  • Alamgir Kabir
  • Tarana Ferdous
  • AKM Fazlur Rahman
  • Shamim Jahan
  • Kathrin Tegenfeldt
  • Sumitro Roy
  • Saydur Rahman Siddiquee
  • Kabir Hossen
  • Iftekhar Rashid
  • Raisul Haque
  • Md. Ruhul Amin
  • Nazma Shaheen


Dietary diversity, Pregnant women, Maternal undernutrition, Social and behaviour change (SBC), Bangladesh


The objective of this study was to evaluate the effectiveness of a U.S. Agency for International Development (USAID)
supported large-scale social and behaviour change (SBC) intervention, SHIKHA Project, in improving dietary diversity
among pregnant women. Cross-sectional survey was conducted in rural southwest Bangladesh and 509, 515, and 1,275
randomly selected pregnant women were interviewed at baseline, midline, and end-line; 514 and 1016 pregnant women from
non-intervention areas were also included. SBC intervention was provided to pregnant women at both individual and group
levels by trained community health workers during the antenatal and postnatal period. Dietary diversity scores (DDS) and
knowledge scores were calculated by summing the number of food groups (from nine defined food groups) consumed by
women during 24 hours and from unprompted responses on how many food groups pregnant women should eat. The mean
knowledge score for dietary diversity was 5.04 at baseline and significantly increased by 1.68 units (95% CI: 1.51, 1.85) at
the end-line. The mean DDS at baseline was 4.28 and significantly increased by 0.45 units (95% CI: 0.34, 0.57) at the endline.
The SBC intervention was effective in improving the dietary diversity of pregnant women, which may help to meet their
additional nutritional requirements and improve pregnancy outcomes.