A Social Norms-Based Intervention Improves Dietary Diversity among Women in Rural India: The Reduction in Anemia through Normative Innovations (RANI) Project

Abstract

Diet diversity has an important role in the prevention and treatment of anemia. Based on formative research in the community and the theory of normative social behavior, we designed an intervention to improve diet diversity among women of reproductive age. Our study, the Reduction in Anemia through Normative Innovations (RANI) Project, investigated the effect of a social norms-based intervention on diet diversity among women of reproductive age. We randomized villages in Odisha, India, into treatment or control arms, with a minimum of one village buffer between them. We assessed exposure to the intervention by frequency of self-reported images seen from the participatory learning modules, videos watched, and number of hemoglobin tests administered. We assessed diet diversity with the Food and Agriculture Organization’s Minimum Dietary Diversity for Women (MDD-W) questionnaire. We used multiple logistic regression to examine the associations between intervention and diet diversity, adjusting for covariates. Compared with baseline, diet diversity score increased in both treatment and control groups. The odds of having a diverse diet was 47% higher in the treatment group. Higher level of exposure to the RANI intervention was associated with a better diet diversity score, indicating that the intervention was effective in improving diet quality.

Keywords

• diet diversity
• women of reproductive age
• social norms
• intervention
• anemia