scholarly journals Homestead Food Production and Maternal and Child Dietary Diversity in Nepal: Variations in Association by Season and Agroecological Zone

2017 ◽  
Vol 38 (3) ◽  
pp. 338-353 ◽  
Author(s):  
Bishnu Dulal ◽  
Gary Mundy ◽  
Rojee Sawal ◽  
Pooja Pandey Rana ◽  
Kenda Cunningham
Keyword(s):  
Food Production ◽  
Large Scale ◽  
Dietary Diversity ◽  
Technical Support ◽  
Population Variation ◽  
Food Groups ◽  
Dietary Recall ◽  
Maternal Report ◽  
Policies And Programs ◽  
Agroecological Zone

Background: Suaahara, a large-scale integrated program, aimed to improve diets and nutritional status among women and children, in part by facilitating enhanced homestead food production (EHFP). Objective: This study examines associations between EHFP and maternal and child dietary diversity and variations by season and agroecological zone (AEZ): mountains and terai. Methods: We used data from household monitoring surveys (n = 2101 mothers; n = 994 children, 6-23 months), which included a 7-day dietary recall and maternal report on participation in 5 EHFP activities—received vegetable seeds, chicks, and technical support and participated in training and EHFP groups. We constructed binary variables for each activity and a scale (0-5) summing participation. For dietary diversity, we used the Women’s Dietary Diversity Score using 10 food groups and 7 food groups for child diets. Multivariable linear regression analyses were used to assess associations between EHFP participation and dietary diversity by season and AEZ, controlling for potential confounders and clustering. Results: In adjusted models, we found positive associations between dietary diversity and chicks, technical support, and EHFP beneficiary groups; the magnitude of the associations varied by season and AEZ. The degree of participation in 5 EHFP activities was positively associated with maternal dietary diversity in the terai (β = .24, P < .001) and mountains (β = .12, P = .01) and child dietary diversity in the terai (β = .35, P < .001) during the winter. No associations were found in the rainy season. Conclusion: Our findings highlight the potential for EHFP to address dietary diversity constraints among this population. Variation by subnational setting and seasonality suggest that policies and programs should be contextualized.

scholarly journals Dietary Silicon and Its Impact on Plasma Silicon Levels in the Polish Population

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 980 ◽  
Author(s):  
Anna Prescha ◽  
Katarzyna Zabłocka-Słowińska ◽  
Halina Grajeta
Keyword(s):  
Large Scale ◽  
Graphite Furnace ◽  
Absorption Spectrometry ◽  
Alcoholic Beverages ◽  
Published Data ◽  
Polish Population ◽  
Food Groups ◽  
Dietary Recall ◽  
Median Plasma ◽  
Silicon Level

Silicon in nutritional amounts provides benefits for bone health and cognitive function. The relationship between silicon intake from a common daily diet and silicon blood level has been scarcely elucidated, so far. The aim of this study was to analyze the associations between plasma silicon levels and the total and bioavailable silicon intake—along with the contribution of silicon made by food groups—in a healthy adult Polish population. Si intake was evaluated in 185 healthy adults (94 females and 91 males, aged 20–70) using a 3-day dietary recall and a database on the silicon content in foods, which was based on both previously published data and our own research. Fasting plasma silicon levels were measured in 126 consenting subjects, using graphite furnace atomic absorption spectrometry. The silicon intake in the Polish population differed significantly according to sex, amounting to 24.0 mg/day in women and 27.7 mg/day in men. The median plasma silicon level was 152.3 µg/L having no gender dependency but with a negative correlation with age. Significant correlations were found between plasma silicon level and total and bioavailable silicon intake, as well as water intake in the diet (r = 0.18, p = 0.044; r = 0.23, p = 0.011; r = 0.28, p = 0.002, respectively). Silicon intakes from non-alcoholic beverages, cereal foods, and carotene-rich vegetables were also positively associated with plasma silicon levels. These results may help establish dietary silicon recommendations and formulate practical advice on dietary choices to ensure an appropriate supply of silicon. The outcome of this study, however, needs to be confirmed by large-scale epidemiological investigations.

scholarly journals “I Feel like I’m Eating Rice 24 Hours a Day, 7 Days a Week”: Dietary Diversity among Asylum Seekers Living in Norway

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2293 ◽  
Author(s):  
Sigrun Henjum ◽  
Bess L. Caswell ◽  
Laura Terragni
Keyword(s):  
Dietary Intake ◽  
Asylum Seekers ◽  
Dietary Diversity ◽  
Dietary Quality ◽  
Limited Information ◽  
Food Groups ◽  
Cross Sectional ◽  
Dietary Recall ◽  
Vegetables And Fruits ◽  
Inadequate Dietary Intake

Food insecurity is widespread among asylum seekers resettled in Western countries. Limited information exists on the quality of food intake in this population. The aim of this study was to investigate dietary quality among asylum seekers living in Norwegian reception centers. This study has a cross-sectional research design. Dietary intake was assessed through a qualitative 24-hour dietary recall, and the dietary diversity score (DDS) was calculated. This study was conducted in eight Norwegian reception centers. A total of 205 adult asylum seekers (131 men and 74 women) participated in the study. The asylum seekers ate on average two meals per day, and one-third ate their first meal after noon. Mean (SD) DDS was 4.0 (1.6) and 2/3 had low dietary diversity, eating from fewer than five food groups. Women had a significantly higher mean DDS (4.5) than men (3.8) (β (95% CI): 0.47 (0.00, 0.95) and a higher consumption of vegetables and fruits. The longer the period of residence in Norway, the higher the DDS, β (95% CI): 0.01 (0.00, 0.02). The asylum seekers’ inadequate dietary intake reveals new forms of poverty and social exclusion in Europe. An inadequate dietary intake may increase the magnitude of difficulty involved in the settlement process and contribute to poorer health.

Abstract MP31: The Web-based Automated Self-administered 24-hour Dietary Recall Performs Similarly to a Traditional Interviewer-administered 24-hour Dietary Recall

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Amy F Subar ◽  
Sharon I Kirkpatrick ◽  
Francis E Thompson ◽  
Beth Mittl ◽  
Sujata Dixit-Joshi ◽  
...  
Keyword(s):  
Large Scale ◽  
Fruits And Vegetables ◽  
Saturated Fatty Acids ◽  
Response Rates ◽  
Study Groups ◽  
Food Group ◽  
Food Groups ◽  
Web Based ◽  
Dietary Recall ◽  
Before And After

Introduction: Two studies were conducted to evaluate the National Cancer Institute (NCI)’s web-based Automated Self-Administered 24-hour Recall (ASA24) system, which was developed to facilitate the collection of 24-hour dietary recalls in large-scale research. Hypothesis: Energy, nutrient and food group estimates, response rates, and preferences are comparable between ASA24 and USDA’s interviewer-administered Automated Multiple-Pass Method (AMPM). Methods: Study 1 assessed the response rates and data collected using ASA24 compared to AMPM. About 1200 participants were recruited from three integrated health systems using quota sampling to ensure representation of a range of ages and race/ethnicity groups. Participants were asked to complete two 24HRs, 4-7 weeks apart, and randomized into four study groups: 1) two ASA24s; 2) two AMPMs; 3) ASA24 first and AMPM second; and 4) AMPM first and ASA24 second. Study 2 assessed the validity of ASA24 compared to AMPM in a one-day feeding study. Eighty-one participants visited a study center to consume three meals from a buffet. All containers were unobtrusively weighed before and after each participant served him/herself; plate waste was also weighed. The next day, participants returned to the center to complete either ASA24 or AMPM. Results: Study 1: Almost all enrolled participants (95%) completed at least one recall and 80% completed two; response rates did not differ by recall mode. Estimated intakes of energy, nutrients and food groups were comparable for ASA24 and AMPM; for example, energy, 2132 vs. 2126 kcal; fat, 84.9 vs. 82.8 g; saturated fatty acids, 27.9 vs. 26.9 g; fiber, 18.4 vs. 18.4 g; and fruits and vegetables, 3.0 vs. 3.1 cup equivalents. Of participants randomized to complete one ASA24 and one AMPM, a greater percentage preferred ASA24. Study 2: The examination of foods and drinks reported showed that exact or close matches were recalled for 76.9% of items truly consumed among ASA24 respondents compared to 82.5% among AMPM respondents. Far matches were reported for 3.1% of items consumed among ASA24 respondents compared to 0.7% for AMPM. The proportions of foods or drinks consumed but not reported (exclusions) were 20.4% and 16.8% for ASA24 and AMPM, respectively. Median differences between reported and true intakes for energy, nutrient and most food groups were not significantly different between ASA24 and AMPM. Conclusion: ASA24 performs well relative to traditional interviewer-administered recalls and is feasible for use in large-scale research. The tool, which offers significant savings over interviewer-administered recalls, is publicly available from NCI and has been used in over 800 studies to collect over 113,000 dietary recalls. The tool is currently being updated to run on mobile applications.

scholarly journals Measuring dietary diversity in rural Burkina Faso: comparison of a 1-day and a 3-day dietary recall

2007 ◽  
Vol 10 (1) ◽  
pp. 71-78 ◽  
Author(s):  
M Savy ◽  
Y Martin-Prével ◽  
P Traissac ◽  
F Delpeuch
Keyword(s):  
Nutritional Status ◽  
Burkina Faso ◽  
Dietary Diversity ◽  
African Women ◽  
Body Fat Percentage ◽  
Food Groups ◽  
Fat Percentage ◽  
Dietary Recall ◽  
North East ◽  
Status Of Women

AbstractObjectivesTo compare dietary diversity scores measured over a 1-day and a 3-day period, and to assess their relationships with socio-economic characteristics and the nutritional status of rural African women.DesignA qualitative dietary recall allowed calculation of a dietary diversity score (DDS; number of food groups consumed out of a total of nine). Body mass index (BMI) and body fat percentage (BFP) were used to assess the nutritional status of women.Setting and subjectsA representative sample of 550 mothers in north-east Burkina Faso.ResultsThe DDS increased from 3.5 to 4.4 when calculated from a 1-day or a 3-day recall (P < 0.0001), although for the latter the DDS was affected by memory bias. The DDS calculated from a 1-day recall was higher when a market day occurred during the recall period. Both scores were linked to the sociodemographic and economic characteristics of the women. Women in the lowest DDS tertile calculated from the 1-day recall had a mean BMI of 20.5 kg m− 2 and 17.7% of them were underweight, versus 21.6 kg m− 2 and 3.5% for those in the highest tertile (P = 0.0003 and 0.0007, respectively). The DDS calculated from the 1-day recall was also linked to mean BFP; all these links remained significant after adjustment for confounders. For the 3-day period, no such relationships were found to be significant after adjustment.ConclusionThe DDS calculated from a 1-day dietary recall was sufficient to predict the women's nutritional status. In such a context attention should be paid to market days.

scholarly journals Impact of a Homestead Food Production Program on Dietary Diversity: Seasonal and Annual Results from the FAARM Trial in Sylhet, Bangladesh

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 694-694
Author(s):  
Jillian Waid ◽  
Amanda Wendt ◽  
Sabine Gabrysch
Keyword(s):  
International Development ◽  
Repeated Measures ◽  
Food Production ◽  
Dietary Diversity ◽  
Controlled Trial ◽  
Food Groups ◽  
Post Intervention ◽  
Production Program ◽  
Women And Children ◽  
The Impact

Abstract Objectives We examine the impact of a nutrition-sensitive agricultural program on the dietary diversity of women and children enrolled in the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) cluster-randomized controlled trial in rural Habiganj, Sylhet, Bangladesh. The homestead food production intervention, implemented by Helen Keller International, began in mid-2015 and ended in December 2018. Methods We use four data sources: 1) baseline data (all women and their youngest child, March-May 2015); 2) surveillance data (every two months - all children 6–18m and a rotating random third of women and children 19–37m,  September 2015-August 2019); 3) endline data (all women and children 6–23m,  September 2019-February 2020); 4) phone survey during the COVID-19 lockdown (a random two-thirds of women, May-June 2020). We calculated dietary diversity for women (MDDW-10) and children (WHO IYCF). Our analysis included 24,931 observations of 2,701 women and 17,445 observations of 2,162 children (6–37m). We estimate the impact of the intervention on dietary diversity using multi-level regression, controlling for clustering by settlement and repeated measures. Results Dietary diversity scores and the proportion of women and children classified as consuming adequate diets varied greatly over the year, peaking in May/June with 5.3 food groups for women (out of ten) and 3.8 food groups for children (out of seven). Over all program years, intervention women had 1.8 higher odds of consuming an adequate diet compared to control women (p &lt; 0.001). However, this benefit varied from 1.3 in the first year of the intervention (p = 0.015) to 2.3 in the last year (p &lt; 0.001), before falling to around 1.9 in the post-intervention years (p &lt; 0.001). We saw a nearly identical pattern in children. Dietary improvement was driven through incremental increases in nearly all food groups. Conclusions The intervention successfully increased dietary diversity in women and children, and these impacts persisted after the project closed, including during the COVID-19 lockdown period. Funding Sources The German Ministry for Education and Research (BMBF) is the primary funder for the FAARM trial. The U.K. Department for International Development (DFID) supported the design of the surveillance system.

scholarly journals Dr. Adequacy of nutrient intakes among pregnant Women in Northern Ghana

2020 ◽  
Vol 11 (1) ◽  
pp. 145-164
Author(s):  
Mahama Saaka
Keyword(s):  
Pregnant Women ◽  
Dietary Diversity ◽  
Average Energy ◽  
Cross Sectional Study ◽  
Northern Ghana ◽  
Food Groups ◽  
Nutrient Intakes ◽  
Cross Sectional ◽  
Dietary Recall ◽  
Nutrient Adequacy

Introduction: Adequate nutrition during pregnancy is a pre-requisite for good pregnancy outcomes as well as future wellbeing, development and quality of life of the unborn child. This analytical cross-sectional study evaluated the adequacy of nutrient intakes of pregnant women resident in northern Ghana. Methods: A total of 400 pregnant women in 25 communities in the Northern, Upper East and Upper West regions of Ghana were interviewed at the household level. The nutrient intakes were assessed using a structured 24-hour dietary recall questionnaire. A dietary diversity score (DDS) was measured as a count of food groups. A nutrient adequacy ratio (NAR) of 14 nutrients as well as mean adequacy ratio (MAR) were calculated based on the 24-hour dietary recall. Results: The average energy, protein and fat intakes were 2,770.8 ± 1,127.5 Kcal/day, 59.2 ±27.5 g/day, and 105.25±58.0 g/day, respectively. The proportion of women meeting the recommended dietary allowance (RDA) of these macro-nutrients were 58.8%, 27.0% and 50.3% respectively. The average MAR of 14 nutrients was calculated to be 68% as the overall measure of nutrient adequacy. MAR correlated positively with DDS (r = 0.24 P < 0.001). Over 50% pregnant women obtained less than 66% of the RDA for iron, calcium, riboflavin, folic acid and vitamin B12. Conclusion: Diets of the majority of these pregnant women were deficient in several nutrients. Dietary diversity scores served as a useful proxy indicator of nutrient adequacy in this sample. In order to meet the requirements for essential nutrients, more effort should be made to promote dietary diversity among pregnant women in northern Ghana.

scholarly journals Food Crop Diversity, Women's Income-Earning Activities, and Distance to Markets in Relation to Maternal Dietary Quality in Tanzania

2020 ◽  
Vol 151 (1) ◽  
pp. 186-196
Author(s):  
Isabel Madzorera ◽  
Mia M Blakstad ◽  
Alexandra L Bellows ◽  
Chelsey R Canavan ◽  
Dominic Mosha ◽  
...  
Keyword(s):  
Diet Quality ◽  
Food Production ◽  
Dietary Diversity ◽  
Crop Diversity ◽  
Dietary Quality ◽  
Food Groups ◽  
Food Crop ◽  
Double Burden ◽  
Rural Tanzania ◽  
Maternal Overweight

ABSTRACT Background Women's dietary diversity and quality are limited in low- and middle-income countries (LMICs). Nutrition-sensitive interventions that promote food crop diversity and women's access to income could improve diets and address the double burden of malnutrition in LMICs. Objectives We examined the associations among food crop diversity and women's income-earning activities with women's diet quality, as well as effect modification by access to markets, in the context of small-holder food production in rural Tanzania. Methods Data from a cross-sectional study of 880 women from Rufiji, Tanzania, were analyzed. Women's dietary intake was assessed using a food frequency questionnaire. The prime diet quality score (PDQS; 21 food groups; range, 0–42), a unique diet-quality metric for women that captures the healthy and unhealthy aspects of diet, was computed. Generalized estimating equation linear models were used to evaluate the associations of food crop diversity and women's income-earning activities with PDQS, while controlling for socio-economic factors. Results Maternal overweight (24.3%) and obesity (13.1%) were high. The median PDQS was 19 (IQR, 17–21). Households produced 2.0 food crops (SD ± 1.0) yearly. Food crop diversity was positively associated with PDQS (P &lt; 0.001), but the association was strengthened by proximity to markets (P for interaction = 0.02). For women living close (&lt;1.1 km) to markets, producing 1 additional food crop was associated with a 0.67 (95% CI, 0.22–1.12) increase in PDQS, versus a 0.40 (95% CI, 0.24–0.57) increase for women living farther away. The PDQS increased with women's salaried employment (estimate, 0.96; 95% CI, 0.26–1.67). Conclusions Household food production may interact with access to markets for sales and purchases, while nonfarm income also improves women's diet quality in rural Tanzania. Programs to improve women's diet quality should consider improving market access and women's access to income (source of empowerment), in addition to diversifying production.

scholarly journals Microbiome Signatures of Nutrients, Foods and Dietary Patterns: Potential for Personalized Nutrition from The PREDICT 1 Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1587-1587
Author(s):  
Tim Spector ◽  
Francesco Asnicar ◽  
Sarah Berry ◽  
Ana Valdes ◽  
Paul Franks ◽  
...  
Keyword(s):  
Dietary Patterns ◽  
Large Scale ◽  
Dietary Diversity ◽  
Diversity Index ◽  
Saturated Fatty Acids ◽  
Daily Intake ◽  
Food Groups ◽  
Habitual Intake ◽  
The Uk ◽  
Dietary Indices

Abstract Objectives The human gut microbiome has been linked to risk and severity of a multitude of chronic diseases, but large-scale, high-resolution studies linking it to host diet are lacking. The PREDICT 1 study (NCT03479866) enrolled 1,102 healthy US and UK adults to examine the genetic, metabolic, microbial, and meal composition/context contributions to metabolic responses to food. Here, we identify microbial features (species, genes, pathways) linked with diet and assess their potential to predict personalized food responses. Methods Dietary intake was assessed using validated EPIC (UK) and Harvard (US) semi-quantitative food frequency questionnaires (FFQs) to capture habitual intake (1 yr). Nutrient and food consumption (adjusted for energy intake) were calculated, and dietary patterns and diversity of intake were estimated. Shotgun metagenomic profiling was performed on fecal samples collected at baseline from 1,001 UK and 97 US individuals. Results We observed strong associations between overall microbial structure, as well as feature-level associations with nutrients, foods, food groups, and established dietary indices. Strongest associations were with daily intake of coffee, meat, and dairy foods, and saturated fatty acids; Spearman's r = 0.45, 0.29, 0.27 and 0.46, respectively. The Healthy Food Diversity Index and the Plant Dietary Index (PDI; comprised of healthy vs. unhealthy PDI, h-PDI, u-PDI) were strongly associated with community structure (r = 0.36, 0.34, and 0.34), highlighting the synergistic impact of dietary diversity, food quality, and microbial outcomes. We identified two clusters of microbial species with consistent, opposed correlations with ‘healthy’ and ‘unhealthy’ nutrients, food groups, and dietary indices with clear segregation between the h-PDI vs. u-PDI. These clusters were also coupled to cardiometabolic biomarkers. The associations observed in the UK cohort were reproducible in the independent US cohort. Conclusions The relationship between a healthy diet, resultant microbial signatures, and cardiometabolic outcomes strongly support the interactions between the foods we eat, the bacteria they enrich, and chronic disease outcomes, highlighting the importance of diet quality and diversity in personalized precision nutrition. Funding Sources NIHR, Wellcome Trust, Zoe Global Ltd.

scholarly journals Low dietary diversity and micronutrient adequacy among lactating women in a peri-urban area of Nepal

2015 ◽  
Vol 18 (17) ◽  
pp. 3201-3210 ◽  
Author(s):  
Sigrun Henjum ◽  
Liv Elin Torheim ◽  
Andrew L Thorne-Lyman ◽  
Ram Chandyo ◽  
Wafaie W Fawzi ◽  
...  
Keyword(s):  
Urban Area ◽  
Energy Intake ◽  
Dietary Diversity ◽  
Economic Status ◽  
Food Groups ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Lactating Women ◽  
Dietary Recall ◽  
The Mean

AbstractObjectiveThe main objectives were to assess the adequacy of the micronutrient intakes of lactating women in a peri-urban area in Nepal and to describe the relationships between micronutrient intake adequacy, dietary diversity and sociodemographic variables.DesignA cross-sectional survey was performed during 2008–2009. We used 24 h dietary recall to assess dietary intake on three non-consecutive days and calculated the probability of adequacy (PA) of the usual intake of eleven micronutrients and the overall mean probability of adequacy (MPA). A mean dietary diversity score (MDDS) was calculated of eight food groups averaged over 3 d. Multiple linear regression was used to identify the determinants of the MPA.SettingBhaktapur municipality, Nepal.SubjectsLactating women (n 500), 17–44 years old, randomly selected.ResultsThe mean usual energy intake was 8464 (sd 1305) kJ/d (2023 (sd 312) kcal/d), while the percentage of energy from protein, fat and carbohydrates was 11 %, 13 % and 76 %, respectively. The mean usual micronutrient intakes were below the estimated average requirements for all micronutrients, with the exception of vitamin C and Zn. The MPA across eleven micronutrients was 0·19 (sd 0·16). The diet was found to be monotonous (MDDS was 3·9 (sd 1·0)) and rice contributed to about 60 % of the energy intake. The multiple regression analyses showed that MPA was positively associated with energy intake, dietary diversity, women’s educational level and socio-economic status, and was higher in the winter.ConclusionsThe low micronutrient intakes are probably explained by low dietary diversity and a low intake of micronutrient-rich foods.

scholarly journals Improving maternal, infant and young child nutrition in Nepal via peer mobilization

2017 ◽  
Vol 21 (4) ◽  
pp. 796-806 ◽  
Author(s):  
Akriti Singh ◽  
Rolf DW Klemm ◽  
Gary Mundy ◽  
Pooja Pandey Rana ◽  
Bhim Pun ◽  
...  
Keyword(s):  
Child Nutrition ◽  
Large Scale ◽  
Dietary Diversity ◽  
Positive Impact ◽  
Food Groups ◽  
Health Seeking ◽  
Maternal And Child Nutrition ◽  
Study Sites ◽  
The Impact ◽  
Minimum Dietary Diversity

AbstractObjectiveTo evaluate the impact of a peer facilitator (PF) approach for improving mothers’ knowledge and practices relating to maternal and child nutrition.DesignA quasi-experimental design nested within a large-scale integrated nutrition programme, Suaahara, in Nepal. Suaahara interventions were implemented in all study sites, but peer facilitators were used in only half of the study sites.SettingRural, disadvantaged villages in three districts of Nepal: Bhojpur, Bajhang and Rupandehi.SubjectsMothers of children aged 6–23·9 months (n 1890).ResultsDifferences over time between comparison (C) and intervention (I) groups show that the PF approach had a significant positive impact on several indicators of mothers’ knowledge and practices relating to maternal and child nutrition: (i) knowing that fruits and vegetables are good for children 6–23·9 months (C: −0·7, I: 10·6; P=0·03); (ii) child dietary diversity (C: 0·02, I: 0·04; P=0·02); (iii) child minimum dietary diversity (≥4 of 7 food groups; (C: 6·9, I: 16·0; P=0·02); (iv) maternal dietary diversity (C: 0·1, I: 0·4; P=0·01); and (v) maternal minimum dietary diversity (≥4 food groups; C: 3·6, I: 14·0; P=0·03). Additionally, exposure to a PF three or more times in the past 6 months was positively associated with a small improvement in maternal (β=0·06, P=0·04) and child (β=0·06, P=0·02) dietary diversity scores. Improvements were not observed in maternal health-seeking behaviours such as number of antenatal care visits.ConclusionsPeer mobilization is a potential approach for improving health- and nutrition-related knowledge and behaviours among women in hard-to-reach communities of Nepal.

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