A Comparative Study on the Effectiveness of Nutrition Education among Caregivers on Dietary Diversification on Children in Urban vs. Rural Central Kajiado, Kenya

Abstract

Dietary diversification is essential for optimal child nutrition, particularly in regions facing food insecurity like Kajiado County, Kenya. This study examined the demographic and socio-economic characteristics of mothers and evaluated the effectiveness of a nutrition education intervention on dietary diversity among caregivers of children aged 6–59 months in both rural and urban areas of Kajiado Central. The intervention was guided by Social Cognitive Theory, targeting children’s skills and confidence to eat healthy foods. A mixed-methods approach was employed, involving 294 participants equally drawn from rural and urban settings. Caregivers received structured nutrition education, and changes in their nutrition knowledge and children's dietary diversity scores (DDS) were measured pre- and post-intervention. Quantitative data were analyzed using SPSS Version 26, while qualitative insights from focus group discussions were thematically analyzed. The majority of caregivers were female (98.6%), with notable differences in age, marital status, household size, and income between rural and urban areas. While both groups demonstrated high levels of education and nutrition knowledge, dietary diversity remained low, particularly in rural areas. Post-intervention, urban caregivers showed a statistically significant improvement in dietary diversity (mean DDS increase from 5.15 to 6.35, p = 0.002), while rural improvements were marginal and not statistically significant (mean DDS increase from 3.15 to 3.45, p = 0.074). Qualitative findings revealed cultural beliefs, limited market access, and male-dominated decision-making as key barriers in rural settings, whereas urban caregivers cited financial constraints and time limitations. The study concludes that while nutrition education improves knowledge, its effectiveness on behavior change is contingent on addressing structural, economic, and cultural barriers. A multifaceted, context-specific approach is recommended to sustainably enhance dietary practices.