Intervention fidelity
Based on the Health Behavioral Change Consortium recommendations the intervention given was assessed by fidelity criteria checklist [The study took equal numbers of clusters for intervention and control groups. Non-adjacent clusters (health centers) were selected to prevent information contamination. The trial used a control group and counseling guide. The intervention process was pretested before the implementation of the trial. Each woman in intervention arm received equal number, length of contact and frequencies of counseling session.A Counseling skill training was given using training manual, and it includes a role-play and mock counseling practice. The training session has pre and post-training tests and practical evaluation. Process evaluation of the counseling session was done for randomly selected sessions by process evaluator. Participants, counselors, and data collectors were blinded to the study hypotheses. Additionally, the data entry process was blinded by labeling the data with a unique number until analysis was finalized. The counseling process was supervised by principal investigator and supervisors. Intervention receipt was assessed by awareness of the women on diet during pregnancy through interviewing about their understanding of the core contents of the intervention.