Study setting and design
The MISAME-III study protocol has been described elsewhere in detail [The study was implemented in 6 rural health center catchment areas in the district of Houndé in the Hauts-Bassins region of Burkina Faso. The study area is characterized by a Sudano-Sahelian climate with a dry season running between September/October and April. Agricultural activity is the main livelihood in the study area, with dominantly cotton and maize production. The habitual diet during pregnancy is nondiverse [Before MISAME-III commenced, women aged between 15 and 40 years living in the study area were identified through a door-to-door census (