Effect of Behavioral Change Communication and Livestock Feed Intervention on Dietary Practices in a Kenyan Pastoral Community: A Randomized Controlled Trial

Background: Low dietary diversity is a key driver for undernutrition and remains a significant public health challenge in low- and middle-income countries. This study evaluated the effect of nutritional counselling and provision of livestock feed, aimed at sustaining milk production, on the dietary diversity of women and children in a pastoralist setting. Methods: A cluster randomized controlled trial was conducted among households in Laisamis sub-county, north-eastern Kenya, assigned to one of three arms: (1) livestock feed during critically dry periods, (2) livestock feed plus enhanced nutritional counselling, or (3) control. Dietary diversity for mothers and children was assessed every six weeks over two years. Panel difference-in-difference regression models estimated intervention effects on dietary outcomes. Results: A total of 1,734 households participated (639 in arm 1, 585 in arm 2, 510 control). Provision of livestock feed, alone or combined with counselling, significantly improved child minimum dietary diversity (MDD), minimum acceptable diet (MAD), and women’s dietary diversity (MDD-W), while reducing child food poverty during dry seasons and overall. Nutritional counselling enhanced gains, with effects evident from the first month. Improvements were mainly driven by increased consumption of cereals, legumes, nuts, seeds, milk, fruits, and vegetables. Milk intake among children aged 6–23 months was consistently higher in intervention arms compared to control during dry seasons and throughout follow-up. Conclusion: Ensuring livestock survival through feed provision sustains milk consumption and improves dietary diversity in pastoralist populations. When combined with nutritional counselling, these interventions strengthen the link between animal and human health, with important implications for food security.