scholarly journals Facilitating factors and challenges of the implementation of multisectoral nutrition programmes at the community level to improve optimal infant and young child feeding practices: a qualitative study in Burkina Faso

2020 ◽  
pp. 1-12
Author(s):  
Ousmane Ouedraogo ◽  
Maimouna Halidou Doudou ◽  
Koiné Maxime Drabo ◽  
Médiatrice Kiburente ◽  
Djibril Cissé ◽  
...  
Keyword(s):  
Young Child ◽  
Qualitative Study ◽  
Burkina Faso ◽  
Community Level ◽  
Financial Resources ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Infant And Young Child ◽  
Nutrition Sensitive ◽  
Nutrition Programme

Abstract Objectives: To identify the drivers and challenges of successful nutrition programme implementation in a multisectoral, community-level approach to improve infant and young child feeding (IYCF) practices in northern Burkina Faso. Design: A qualitative study was conducted in 2019 through (i) individual interviews with key informants from five different sectors (health, agriculture, environment, livestock and education) and association staff, agents and community leaders and (ii) focus groups with mothers of children under the age of 2 years. Setting: Three health districts in the northern region of Burkina Faso implemented a multisectoral community nutrition programme to improve IYCF practices. Participants: Forty-seven implementing actors and twenty-four beneficiary mothers. Results: Factors influencing successful implementation include community participation; sector commitment and involvement; the existence of nutrition champions; capacity building; the integration of interventions; micronutrient powder distribution; the introduction of nutrition-sensitive interventions, such as the promotion of the consumption of orange-fleshed sweet potatoes; improved food production and small livestock rearing and the effective coordination of actors and complementary funding. The main challenges of the implementation of multisectorality are low participation among nutrition-sensitive sectors, a tendency for siloed work among sectors, scheduling conflicts, high actor mobility, differences in the target population by sector, a lack of technical skills among community workers, insufficient financial resources, low geographic convergence and coverage of beneficiaries, a lack of a multisectoral monitoring mechanism and accountability and insecurity. Conclusions: Strengthening sector participation, identifying a common targeting strategy and mobilising financial resources have the potential to significantly reduce barriers and improve the quality of implementation.

scholarly journals The fidelity and dose of message delivery on infant and young child feeding practice and nutrition sensitive agriculture in Ethiopia: a qualitative study from the Sustainable Undernutrition Reduction in Ethiopia (SURE) programme

2019 ◽  
Vol 38 (1) ◽  
Author(s):  
Mihretab M. Salasibew ◽  
Cami Moss ◽  
Girmay Ayana ◽  
Desalegn Kuche ◽  
Solomon Eshetu ◽  
...  
Keyword(s):  
Young Child ◽  
Qualitative Study ◽  
Behaviour Change ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Feeding Practice ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Infant And Young Child ◽  
Nutrition Sensitive

Abstract Background In Ethiopia, 38% of children under 5 years of age are stunted (low height for age). A novel government-led intervention called the Sustainable Undernutrition Reduction in Ethiopia (SURE) aims to tackle the burden of stunting by improving complementary feeding and dietary diversity among young children. The SURE programme design applies a transtheoretical model of behaviour change, whereby exposure to recommended infant and young child feeding (IYCF) and nutrition-sensitive agriculture messages is a first stage to adopting key behaviours. This qualitative study explored the fidelity and dose of the IYCF and nutrition-sensitive agriculture messages delivered by extension workers. Methods A qualitative study was conducted across four regions in Ethiopia (Oromiya, Amhara, SNNP and Tigray) between April and October 2017. Across the four regions, 81 key informant interviews, 90 FGDs and 81 observations were conducted with 180 extension workers, 18 development agents and 54 mother-father pairs. Digitally recorded audio files were transcribed verbatim, and the data were analysed based on a framework analysis approach using NVivo (version 12) by coding and categorising texts into major themes and sub-themes. Results SURE target households had the intended exposure to messages about exclusive breastfeeding, timing of initiation of complementary feeding, food groups, diversified food consumption, irrigation, rearing small animals and vegetables. Few households reported receiving messages on the content or frequency of complementary feeding of a child beyond 6 months of age. Frequency of household visits and hence exposure to SURE messages was also variable. Agricultural messages delivered during household visits focussed on improving standard agricultural practices and rarely covered the importance of nutrition-sensitive agriculture to improve household or child nutrition. Conclusion Despite variability observed in the breadth and depth of messages delivered, large-scale behaviour change communication programmes can achieve moderate to good message exposure among target groups. Qualitative data provide an in-depth insight into fidelity and may supplement our understanding of programme roll-out and implementation. Further research is required to understand longer-term message saturation including frequency and reach.

scholarly journals Associated Factors to Nutritional Status and Infant and Young Child Feeding (IYCF) Practices in Rural Area of Burkina Faso: A Study in Ouargaye Health District

2019 ◽  
Vol 5 (3) ◽  
pp. 82
Author(s):  
Siri Baperman Abdel Aziz ◽  
Bengaly Marcel ◽  
Konkonbo/Kouanda Zenab ◽  
Coulibaly Soumaila ◽  
Garanet Franck ◽  
...  
Keyword(s):  
Young Child ◽  
Nutritional Status ◽  
Burkina Faso ◽  
Rural Area ◽  
Associated Factors ◽  
Health District ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Infant And Young Child

scholarly journals What is the impact of removing performance-based financial incentives on community health worker motivation? A qualitative study from an infant and young child feeding program in Bangladesh

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jeffrey Glenn ◽  
Corrina Moucheraud ◽  
Denise Diaz Payán ◽  
Allison Crook ◽  
James Stagg ◽  
...  
Keyword(s):  
Young Child ◽  
Qualitative Study ◽  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Financial Incentives ◽  
Theory Approach ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Infant And Young Child

Abstract Background Community health worker (CHW) motivation is an important factor related to health service quality and CHW program sustainability in low- and middle-income countries. Financial and non-financial motivators may influence CHW behavior through two dimensions of motivation: desire to perform and effort expended. The aim of this study was to explore how the removal of performance-based financial incentives impacted CHW motivation after formal funding ceased for Alive and Thrive (A&T), an infant and young child feeding (IYCF) program in Bangladesh. Methods This qualitative study included seven focus groups (n = 43 respondents) with paid supervisors of volunteer CHWs tasked with delivering interpersonal IYCF counseling services. Data were transcribed, translated into English, and then analyzed using both a priori themes and a grounded theory approach. Results Results suggest the removal of financial incentives was perceived to have negatively impacted CHWs’ desire to perform in three primary ways: 1) a decreased desire to work without financial compensation, 2) changes in pre- and post-intervention motivation, and 3) household income challenges due to dependence on incentives. Removal of financial incentives was perceived to have negatively impacted CHWs’ level of effort expended in four primary ways: 1) a reduction in CHW visits, 2) a reduction in quality of care, 3) CHW attrition, and 4) substitution of other income-generating activities. Conclusions This study provides new evidence regarding how removing performance-based financial incentives from a CHW program can negatively impact CHW motivation. The findings suggest that program decision makers should consider how to construct community health work programs such that CHWs may continue to receive performance-based compensation after the original funding ceases.

scholarly journals Qualitative, longitudinal exploration of coping strategies and factors facilitating infant and young child feeding practices among mothers in rural Rwanda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jeanine Ahishakiye ◽  
Lenneke Vaandrager ◽  
Inge D. Brouwer ◽  
Maria Koelen
Keyword(s):  
Social Support ◽  
Young Child ◽  
Coping Strategies ◽  
Low Income ◽  
Complementary Feeding ◽  
Feeding Practices ◽  
Personal Factors ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Infant And Young Child

Abstract Background Mothers in low-income countries face many challenges to appropriately feed their children in the first year such as poverty, food insecurity and high workloads. However, even in the lowest income families there are mothers who succeed to feed their children according to the recommendations. In this paper, we explored the coping strategies that facilitate appropriate breastfeeding and complementary feeding practices among rural Rwandan mothers from birth to one year of a child’s life. Methods This qualitative longitudinal study recruited a purposive sample of 17 mothers who followed the infant and young child feeding recommendations (IYCF). They were selected from a larger study of 36 mothers. In-depth interviews were conducted with mothers of the total group (36 mothers) within the first week, at 4th, 6th, 9th and 12th months postpartum. Interviews were audio-recorded, transcribed verbatim and analyzed thematically. Results Coping strategies included improving mothers’ own diet for adequate breastmilk production, prioritizing child feeding over livelihood chores, livelihood diversification and mothers’ anticipatory behaviors such as preparing child’s food in advance. Some of those coping strategies were shifting overtime depending on the development of the children. Personal factors such as breastfeeding self-efficacy, religious beliefs and perceived benefits of breastfeeding were among the facilitating factors. Additionally, social support that mothers received from family members, other mothers in the community, Community Health Workers (CHWs) and health professionals played an important role. Conclusion In challenging contextual conditions, mothers manage to follow the recommended breastfeeding and complementary feeding practices through the interplay of active coping strategies, feeling to be in control and social support. Nutrition promotion interventions that aim to improve IYCF should consider strengthening mothers’ capability in gaining greater control of their IYCF practices and the factors facilitating their appropriate IYCF practices.

scholarly journals Mothers’ perceptions on and learning from infant and young child feeding videos displayed in Mother and Child Health Centers in Kenya - a qualitative and quantitative approach

2021 ◽  
pp. 1-38
Author(s):  
Lauriina Schneider ◽  
Mikko Kosola ◽  
Kerttu Uusimäki ◽  
Sari Ollila ◽  
Crippina Lubeka ◽  
...  
Keyword(s):  
Young Child ◽  
Complementary Feeding ◽  
Health Centers ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Infant And Young Child ◽  
Mother And Child Health ◽  
Mother And Child ◽  
And Child Health ◽  
Child Health Centers

Abstract Objective The objective was to explore mothers’ perceptions of educational videos on infant and young child feeding practices, and to assess whether viewing frequencies would influence maternal knowledge, attitudes and feeding practices (KAPs). Design A set of 47 videos were displayed in health centers for 6 months. At three months, we conducted focus group discussions (FGDs) with mothers and at six months, administered KAP-questionnaire-based interviews to mothers. Using a quasi-experimental design we compared groups according to video viewing frequencies. Setting The study was conducted in a slum in Nairobi and a rural area in Machakos, Kenya. We installed TV screens in waiting rooms of six Mother and Child Health Centers, where mothers could choose to watch them. Participants Forty-three mothers with children aged 0 to 48 months participated in six FGDs and 547 mothers of children aged 0 to 23 months in KAP interviews. Results The mothers from the FGDs found the videos acceptable and beneficial. Videos enhanced mothers’ learning and empowered them to support others in learning. The KAP data showed that after adjustments, breastfeeding (p=0.06) and complementary feeding knowledge (p=0.01), complementary feeding attitudes (p=0.08), as well as hygiene knowledge and practices (p=0.003) were better among mothers who had seen videos three to four times, or five or more times, compared to mothers who had seen the videos once or twice. Conclusions Videos were an accepted form of education and were beneficial when watched repeatedly. The videos could be a good addition to current IYCF education efforts in Kenya.

scholarly journals Information seeking of French parents regarding Infant and Young Child Feeding: practices, needs and determinants

2021 ◽  
pp. 1-34
Author(s):  
Sofia De Rosso ◽  
Sophie Nicklaus ◽  
Pauline Ducrot ◽  
Camille Schwartz
Keyword(s):  
Young Child ◽  
Information Seeking ◽  
Parental Education ◽  
Online Survey ◽  
Medical Condition ◽  
Communication Strategy ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Infant And Young Child ◽  
Child Age

Abstract Objective: As part of an update of feeding benchmarks targeting children aged 0 to 3 years, this study aimed to explore parental perceptions, information-seeking practices and needs concerning infant and young child feeding (IYCF) to design an efficient communication strategy. Design: Participants were recruited using the quota sampling to complete an online survey. Effects of parity, child age, prematurity, parental education and financial situation on parents’ responses were evaluated separately. Setting: France. Participants: A nationally representative sample of 1001 parents of children <4 years. Results: Parents whose child had any medical condition affecting feeding (CMC, 17%) were considered separately from healthy children’s parents. All the healthy children’s parents recognized the importance of IYCF for children’s health and growth; however, one-third considered the available advice contradictory and not guilt-free. The most used information sources were healthcare professionals (HCPs, 81%), internet (72%) and parental networks (63%). The most influential sources (mean influence ± SDs) included HCPs (7.7±1.7/10), childcare professionals (7.3±1.8/10) and parental networks (6.9±1.8/10). Parents searched for practical tips for implementing IYCF starting when their child was 5 months old. Differences regarding the type of source used by parents with higher vs. lower educations were small. Search strategies differed according to parity or child age but not to prematurity. The CMC parents reported slightly different practices and needs. Conclusions: Parents receive information from multiple sources, which can lead to confusion when deciding which advice to follow. A public health communication strategy adapted to the current parental needs should target these various sources.

scholarly journals Infant and young child feeding practices in Ethiopia: analysis of socioeconomic disparities based on nationally representative data

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Nigatu Regassa Geda ◽  
Cindy Xin Feng ◽  
Bonnie Janzen ◽  
Rein Lepnurm ◽  
Carol J. Henry ◽  
...  
Keyword(s):  
Young Child ◽  
Feeding Practices ◽  
Health Concern ◽  
Proportional Odds ◽  
Child Feeding ◽  
Gainful Employment ◽  
Young Child Feeding ◽  
Child Feeding Practices ◽  
Infant And Young Child ◽  
Unit Increase

Abstract Background Undernutrition among children is a priority area of public health concern in Ethiopia. The purpose of this study was to examine disparities in Infant and Young Child Feeding (IYCF) practices among children 6–23 months. Method Data were drawn from the 2016 Ethiopian Demographic and Health Surveys (EDHS). A total of 3240 children aged 6–23 months were used for the present analysis. The outcome variable was IYCF practice score (ranging 0–7) which was constructed based on the linear and combined effects of four sets of variables: breastfeeding, avoidance of bottle feeding, diet diversity score and minimum feeding frequency. IYCF practice score was further recoded into three categories. Proportional odds regression was used to assess the determinants of IYCF category. Results The proportional odds regression analysis showed that IYCF scores significantly decreased by 5% (Adjusted Odds Ratio (AOR) = 0.95; 95% CI: 0.93–0.97) for every unit increase in the child’s age. Households with fathers of primary and secondary and above level education were 1.37 times (95% CI: 1.14–1.66) and 1.67 times (95% CI: 1.26–2.23) more likely to be in the high IYCF category than in the poor IYCF category. The likelihood of being in the high IYCF practice category decreased for non-working mothers by 30% (AOR = 0.70; 95% CI: 0.59–0.83) compared to those working in gainful employment. The chance of being in the high IYCF practice category decreased by 29% for households with no access to radio (AOR = 0.71; 95% CI: 0.59–0.85). Those with medium and rich/richer wealth category were 1.54 times (95% CI: 1.22–1.94) and 1.40 times (95% CI: 1.11–1.75) more likely to belong to high IYCF practice category than being in poor IYCF category. For every unit increase in health service utilization, the chance of falling in higher IYCF category increases by 1.15 times (95% CI: 1.08–1.23). The chance of falling in higher IYCF practice category decreases for rural residents by 37% (AOR = 0.63; 95% CI: 0.47–0.84) compared to those residing in urban areas. Conclusion For a child, the first two years is the time span during which linear faltering of growth is most prevalent and the period when the process of becoming stunted is almost complete. This study recommends improving access to women for gainful employment, provision of economic support to poor rural women, education and promotion of nutrition messages using most accessible media and boosting the positive role of fathers in child feeding practices.

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