The nutritional education intervention
nutritional health behaviors
Before the onset of the intervention, training of trainers was given to eight BSc midwives for three days on the topics to be covered in each session. Maternal nutrition education intervention guideline was adapted and prepared based on the WHO recommendation of essential nutrition actions (ENA) for improving maternal nutrition guidance and maternal nutrition operational guidance for LMICs [The social and behavioral change communication intervention (SBC) was given to a group of pregnant women for six months in three sessions at their nearby health posts. During each SBC session, women from the husband group attended counseling with their husbands. Similarly, women from the peer group attended the intervention with their peers (the peer group was two from each cluster). Overall, the intervention was provided three times; one session per trimester. Once at the beginning of the intervention (after enrolment) in the first trimester, once during the second, and once during the third trimester.At the end of each session, a summary of the importance of dietary diversity, especially the intake of fruits and vegetables was given as a key message. The intervention used the trans-theoretical model which stipulates individuals’ motivation and readiness to change behavior over time [In this study, the model was used to offer direction for what types of variables and processes may be important in shaping maternal nutritional health behaviors and thus need to be addressed in the intervention. The duration of education per session was 1–2 hrs. The topics of education were tested by other scholars [