{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:46:25Z","timestamp":1792057585140,"version":"4.4.0"},"reference-count":49,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":84,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005068","name":"Jimma University","doi-asserted-by":"publisher","award":["JUIH\/IRB\/555\/2023"],"award-info":[{"award-number":["JUIH\/IRB\/555\/2023"]}],"id":[{"id":"10.13039\/501100005068","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100015611","name":"Samara University","doi-asserted-by":"publisher","award":["SU\/1078\/2019"],"award-info":[{"award-number":["SU\/1078\/2019"]}],"id":[{"id":"10.13039\/501100015611","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp;amp; Child Nutrition"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      Suboptimal complementary feeding remains a major public health concern in Ethiopia, particularly among pastoralist and agro\u2010pastoral communities where mobile livelihoods hinder access to conventional health services. In these settings, numerous studies have highlighted the potential of leveraging culturally embedded leadership structures to enhance health promotion efforts. This study examined whether engaging traditional Dala leaders as agents of Nutrition Behavior Change Communication (DALA\u2010BCC) could improve complementary feeding indicators among infants and young children in the agro\u2010pastoral areas of northern Ethiopia. A cluster\u2010randomized controlled trial was conducted in Dubti District, Afar Region, involving 16 non\u2010adjacent clusters randomly assigned to intervention and control arms (eight each). A total of 474 mother\u2013infant pairs (237 per arm) were enrolled at 6\u201317 months of age and followed over 6 months. Over a 6\u2010month period, the intervention group received DALA\u2010BCC delivered by Dala leaders, consisting of monthly group sessions and cooking demonstrations during the first 3 months, followed by home\u2010based individualized counseling from Month 3 to Month 6, while the control group continued usual care. Core infant and young child feeding (IYCF) indicators were measured at baseline and endline. At end line, the intervention group achieved higher rates of minimum dietary diversity (MDD) (39.7% vs. 24.7%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), minimum meal frequency (MMF) (67.9% vs. 47.6%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and minimum acceptable diet (MAD) (28.6% vs. 12.1%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Generalized estimating equation (GEE) analysis showed significant time \u00d7 group interactions, indicating greater improvements in the intervention group for MDD (RR\u2009=\u20092.43; 95% CI: 1.35\u20134.39), MMF (RR\u2009=\u20092.08; 95% CI: 1.25\u20133.48), and MAD (RR\u2009=\u20092.35; 95% CI: 1.10\u20135.04). The findings demonstrate that the DALA\u2010BCC intervention significantly improved complementary feeding practices, highlighting the effectiveness of culturally grounded, community\u2010led nutrition strategies in Agro\u2010pastoral settings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PACTR202311816542918. Registered 10 November 2023.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/mcn.70254","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T11:37:43Z","timestamp":1790163463000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Dala\u2010Led Behavior Change Communication on Complementary Feeding Practices in Infants and Young Children: A Cluster\u2010Randomized Controlled Trial in Agro\u2010Pastoral Settings of Afar Region, Ethiopia"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4692-9774","authenticated-orcid":false,"given":"Anwar Seid","family":"Ali","sequence":"first","affiliation":[{"name":"Department of Human Nutrition &amp; Dietetics Faculty of Public health, Institute of Health Jimma University Jimma Oromia Region Ethiopia"},{"name":"Departments of Nursing College of Medical and Health Sciences Samara University Semera Afar Region Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5455-9457","authenticated-orcid":false,"given":"Tefera","family":"Belachew","sequence":"additional","affiliation":[{"name":"Department of Human Nutrition &amp; Dietetics Faculty of Public health, Institute of Health Jimma University Jimma Oromia Region Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0565-7610","authenticated-orcid":false,"given":"Shemsu","family":"Kedir","sequence":"additional","affiliation":[{"name":"Departments of Public Health College of Medicine and Health Sciences Werabe University Werabe Central Ethiopia Region Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9752-5417","authenticated-orcid":false,"given":"Kalkidan Hassen","family":"Abate","sequence":"additional","affiliation":[{"name":"Department of Human Nutrition &amp; Dietetics Faculty of Public health, Institute of Health Jimma University Jimma Oromia Region Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.4236\/fns.2020.116038"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PONE.0238355"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0238355"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/WBER\/LHAE023"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/S40795\u2010025\u201001137\u20108\/TABLES\/7"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/S41598\u2010025\u201002366\u20104"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/S12937\u2010023\u201000907\u2010Z"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/134.9.2342"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/MCN.12660"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/BMJ.E5661"},{"key":"e_1_2_10_12_1","doi-asserted-by":"crossref","unstructured":"CSA and ICF.2016. Ethiopia Demographic and Health Survey 2016. Addis Ababa Ethiopia and Rockville Maryland USA.https:\/\/doi.org\/10.2147\/ahmt.s148434.","DOI":"10.2147\/AHMT.S148434"},{"key":"e_1_2_10_13_1","unstructured":"CSA.2007. Agricultural Sample Survey (AgSE2001). Report on Area and Production \u2010 Afar Region version 1.1. Addis Ababa Ethiopia."},{"key":"e_1_2_10_14_1","unstructured":"CSA.2022. Population Projection of Ethiopia for All Regions: Federal Democratic Republic of Ethiopia Central Statistical Agency."},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/NU13030825"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/6731815"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/MCN.13030"},{"key":"e_1_2_10_18_1","volume-title":"Ethiopia Mini Demographic and Health Survey 2019: Key Indicators","author":"EPHI and ICF","year":"2019"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PONE.0212775"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/NU12123851"},{"key":"e_1_2_10_21_1","volume-title":"Minimum Dietary Diversity for Women: A Guide for Measurement, Minimum Dietary Diversity for Women","author":"Fao F.","year":"2016"},{"key":"e_1_2_10_22_1","unstructured":"FMOH.2014. 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