4. Discussion
SHOP
The Basotho women included in the current study were characterized by low levels of education and unemployment. The lack of amenities such as own sanitation, running water and electricity are evidence of the poverty that is endemic to Lesotho. The widespread limited food availability and access in Lesotho (In terms of self-efficacy, the intervention was successful in improving the confidence of women to eat a healthy diet every day. Before the intervention, hardly 40% indicated that they had confidence in their ability to do so. The nutrition education delivered to the intervention group thus seemed to reaffirm the women's confidence in the foods that they should eat. In framing this intervention on a social cognition model, the study was consistent with other studies that determined the effectiveness of dietary interventions to promote healthy eating using psychological based interventions (Before the intervention, almost all women reported that they had maize-meal in their homes, while about 90% had vegetables (more than 80% grew vegetables in their gardens), leaving little room for improvement due to the nutrition education intervention. On the other hand, improvements were seen in the availability of dried beans, milk, fruits, breakfast cereal, and rice. These improvements are evidence that the nutrition education intervention improved self-efficacy in making healthy food choices. For any health behavior to be performed effectively, individuals must believe in their competency to successfully perform the behaviors in question (Although most participants in the current study grew and ate vegetables, most studies report a low intake of vegetables. Nutrition education interventions to improve fruit and vegetable consumption report varying levels of effectiveness, despite most people knowing that fruit and vegetable consumption is positively associated with health benefits (At baseline, < 40% of all women had self-efficacy in removing fat from meat before cooking; in engaging in physical activity for 30 min or longer at least three times a week; and in reducing the amount of salt they used in food. After the intervention, women in the intervention group's self-efficacy to perform health-promoting behaviors relating to food in all these items improved significantly. Similarly, high self-efficacy was found to predict an intention to choose and consume low fat and low sodium foods among North American students (Before the intervention, very few women in the current study compiled a budget or planned food purchases in advance. After the intervention, women in the intervention group were no longer purchasing food every day, indicating that they had learned to plan food purchases. In contrast, the comparison group was not enabled to change this behavior. Improvements in the ability to shop using a list indicate growth in self-efficacy about the importance of budgeting, planning and making healthy food choices.Generally having high self-efficacy reduces stress levels (An improved perception of personal control as defined by an internal locus of control is predictive of health protective behavior (Shehu and Mokgwathi found that internal locus of control was predictive of internal resilience and its relationship with physical education among adolescents in Botswana (We acknowledge that the inclusion of two areas that were relatively accessible to the research team may introduce a bias in terms of the representation of women in Lesotho. Although there is a general view that poverty is worse in rural areas, the African Food Security Urban Network (AFSUN) reports that the urban poor in Maseru may be the most food insecure in the country (