scholarly journals ‘If he sees it with his own eyes, he will understand’: how gender informed the content and delivery of a maternal nutrition intervention in Burkina Faso

2020 ◽  
Vol 35 (5) ◽  
pp. 536-545 ◽  
Author(s):  
Jasmin Isler ◽  
N Hélène Sawadogo ◽  
Guy Harling ◽  
Till Bärnighausen ◽  
Maya Adam ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Maternal Nutrition ◽  
Health Workers ◽  
Nutrition Intervention ◽  
Nutrition Interventions ◽  
Group Discussions ◽  
Intervention Delivery ◽  
Meal Preparation ◽  
And Gender ◽  
Two Stages

Abstract A growing body of literature urges policymakers, practitioners and scientists to consider gender in the design and evaluation of health interventions. We report findings from formative research to develop and refine an mHealth maternal nutrition intervention in Nouna, Burkina Faso, one of the world’s most resource-poor settings. Gender was not an initial research focus, but emerged as highly salient during data collection, and thus guided lines of inquiry as the study progressed. We collected data in two stages, first using focus group discussions (FGD; n = 8) and later using FGDs (n = 2), interviews (n = 30) and observations of intervention delivery (n = 30). Respondents included pregnant women, breastfeeding mothers and Close-to-Community (CTC) providers, who execute preventative and curative tasks at the community level. We applied Morgan et al.’s gender framework to examine intervention content (what a gender-sensitive nutrition programme should entail) and delivery (how a gender-sensitive programme should be administered). Mothers emphasized that although they are often the focus of nutrition interventions, they are not empowered to make nutrition-based decisions that incur costs. They do, however, wield some control over nutrition-related tasks such as farming and cooking. Mothers described how difficult it is to consider only one’s own children during meal preparation (which is communal), and all respondents described how nutrition-related requests can spark marital strife. Many respondents agreed that involving men in nutrition interventions is vital, despite men’s perceived disinterest. CTC providers and others described how social norms and gender roles underpin perceptions of CTC providers and dictate with whom they can speak within homes. Mothers often prefer female CTC providers, but these health workers require spousal permission to work and need to balance professional and domestic demands. We recommend involving male partners in maternal nutrition interventions and engaging and supporting a broader cadre of female CTC providers in Burkina Faso.

scholarly journals Missed Opportunities for Maternal Nutrition Interventions During Antenatal Care Visits Persist in Burkina Faso

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1055-1055
Author(s):  
Césaire Ouédraogo ◽  
Sunny Kim ◽  
Rock Zagre ◽  
Rasmané Ganaba ◽  
Maurice Zafimanjaka ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Burkina Faso ◽  
Maternal Age ◽  
Maternal Nutrition ◽  
Household Composition ◽  
Nutrition Intervention ◽  
Nutrition Interventions ◽  
High Coverage ◽  
Missed Opportunities ◽  
Government Health

Abstract Objectives High coverage of any antenatal care (ANC) and near-universal coverage of iron-folic acid (IFA) supplementation is reported by nationally representative surveys in Burkina Faso. We examined the coverage of maternal nutrition interventions during ANC to assess gaps and missed opportunities in achieving global and national recommendations. Methods We used household survey data among 1920 mothers with children <6 months of age in 2 regions in Burkina Faso, collected in November-December 2019. Descriptive statistics were used to examine exposure to nutrition interventions during antenatal care throughout pregnancy and equity analyses were conducted to assess differences in exposure by maternal age (adolescents 15–19 y of age and older mothers) and education (none vs. any schooling). Results All mothers reported having attended at least one ANC visit at a health facility (mostly government health centers) during last pregnancy, but only 66.6% reported attending at least 4 visits. All consumed IFA tablets, but reported consuming 109 tablets on average during pregnancy, which was short of the recommended 180 tablets over 6 months. Only 42.7% reported receiving any nutrition counseling during ANC, with the most common messages reported on consuming one IFA tablet daily (93.4%) and eating a variety of foods (68.8%). While nearly all mothers were weighed during ANC, very few reported receiving information about weight gain. Among mothers, 14% were adolescents below 20 y, and 66.1% never attended school. For all indicators related to exposure to ANC or maternal nutrition intervention, we observed no differences by maternal age, education or other subgroups such as religion, parity or household composition. Conclusions The government health system in Burkina Faso with its widespread and uniform reach provides an opportunity for improving the low coverage of maternal nutrition interventions during ANC. Doing so will require efforts both to improve the coverage of 4 or more ANC visits and the effective integration of nutrition interventions into ANC. Funding Sources Bill & Melinda Gates Foundation, through Alive & Thrive, managed by FHI 360; and CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), led by the International Food Policy Research Institute.

scholarly journals Gaps in the implementation and uptake of maternal nutrition interventions in antenatal care services in Bangladesh, Burkina Faso, Ethiopia and India

2021 ◽  
Author(s):  
Tina Sanghvi ◽  
Phuong H. Nguyen ◽  
Manisha Tharaney ◽  
Sebanti Ghosh ◽  
Jessica Escobar‐Alegria ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Burkina Faso ◽  
Maternal Nutrition ◽  
Nutrition Interventions ◽  
Care Services

scholarly journals Human Capital and Wage Income Gains of Scaling-Up Maternal Prenatal Nutrition Interventions in Low- and Middle-Income Countries

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 887-887
Author(s):  
Nandita Perumal ◽  
Mia Blakstad ◽  
Goodarz Danaei ◽  
Gunther Fink ◽  
Mark Lambiris ◽  
...  
Keyword(s):  
Human Capital ◽  
Birth Outcomes ◽  
Low Birthweight ◽  
Maternal Nutrition ◽  
Scaling Up ◽  
Nutrition Intervention ◽  
Nutrition Interventions ◽  
Middle Income ◽  
Prenatal Nutrition ◽  
Middle Income Countries

Abstract Objectives Scaling-up nutrition interventions during pregnancy may provide human capital gains by lowering the risk of adverse birth outcomes associated with reduced long-term socioeconomic outcomes. We estimated gains in years of schooling and lifetime wages of scaling up prenatal maternal nutrition interventions for a 137 low- and middle-income countries. Methods Through a comprehensive review of the literature, we identified four prenatal maternal nutrition interventions with convincing-level of evidence for improving birth outcomes: prenatal multiple micronutrient supplements (MMS), calcium supplements, iron-folic acid supplements (IFA), and balanced protein energy supplements (BEP) among underweight pregnant women (BMI < 18.5 kg/m2). Effect sizes for intervention impact were derived from systematic reviews and random-effects meta-analysis. We focused on low birthweight (LBW) and preterm birth (PTB) as primary birth outcomes. We used the 2015 LBW and PTB prevalence estimates to calculate country-specific absolute reductions attributable to scaling-up a given prenatal nutrition invention. We then used an effect size based on a de novo review of the economics literature to quantify gains in schooling and lifetime wages due to reductions in LBW/PTB under two hypothetical scale-up scenarios of 50% and 90% coverage. Results For each country, returns on schooling and lifetime wages were estimated for scaling-up each prenatal nutrition intervention. For example, in Bangladesh, scaling-up IFA supplements from current coverage of 26% to 90% was estimated to reduce LBW prevalence by 3.2% contributing to a predicted increase of 0.11 million school years and US$153 million in wages per birth cohort. Similarly, scaling-up MMS, calcium supplements, and BEP to 90% coverage was predicted to increase schooling by 0.25, 0.17, and 0.07 million years, and wages by US$338, US$223, and US$97 million, respectively, per birth cohort. Global, regional, and national-level estimates for schooling and wage gains for each nutrition intervention will be presented. Conclusions Our findings indicate that scaling-up prenatal maternal nutrition interventions will contribute to substantial population-level increases in human capital, particularly in countries with a high burden of low birthweight or preterm birth. Funding Sources Bill and Melinda Gates Foundation.

scholarly journals Iterative Adaptation of a Maternal Nutrition Videos mHealth Intervention Across Countries Using Human-Centered Design: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Jasmin Isler ◽  
N Hélène Sawadogo ◽  
Guy Harling ◽  
Till Bärnighausen ◽  
Maya Adam ◽  
...  
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
South African ◽  
Maternal Nutrition ◽  
Health Workers ◽  
Video Adaptation ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Human Centered Design ◽  
Depth Interviews

BACKGROUND Mobile health (mHealth) video interventions are often transferred across settings. Although the outcomes of these transferred interventions are frequently published, the process of adapting such videos is less described, particularly within and across lower-income contexts. This study fills a gap in the literature by outlining experiences and priorities adapting a suite of South African maternal nutrition videos to the context of rural Burkina Faso. OBJECTIVE The objective of this study was to determine the key components in adapting a suite of maternal nutrition mHealth videos across settings. METHODS Guided by the principles of human-centered design, this qualitative study included 10 focus group discussions, 30 in-depth interviews, and 30 observations. We first used focus group discussions to capture insights on local nutrition and impressions of the original (South African) videos. After making rapid adjustments based on these focus group discussions, we used additional methods (focus group discussions, in-depth interviews, and observations) to identify challenges, essential video refinements, and preferences in terms of content delivery. All data were collected in French or Dioula, recorded, transcribed, and translated as necessary into French before being thematically coded by two authors. RESULTS We propose a 3-pronged Video Adaptation Framework that places the aim of video adaptation at the center of a triangle framed by end recipients, health workers, and the environment. End recipients (here, pregnant or lactating mothers) directed us to (1) align the appearance, priorities, and practices of the video’s protagonist to those of Burkinabe women; (2) be mindful of local realities whether economic, health-related, or educational; and (3) identify and routinely reiterate key points throughout videos and via reminder cards. Health workers (here, Community Health Workers and Mentor Mothers delivering the videos) guided us to (1) improve technology training, (2) simplify language and images, and (3) increase the frequency of their engagements with end recipients. In terms of the environment, respondents guided us to localize climate, vegetation, diction, and how foods are depicted. CONCLUSIONS Design research provided valuable insights in terms of developing a framework for video adaptation across settings, which other interventionists and scholars can use to guide adaptations of similar interventions.

scholarly journals Men perspectives on attending antenatal care visits together with their pregnant partners in Misungwi district, rural Tanzania: a qualitative study

2020 ◽  
Author(s):  
Maendeleo Boniphace ◽  
Dismas Matovelo ◽  
Rose Laisser ◽  
Hadija Swai ◽  
Victoria Yohana ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Workers ◽  
Cultural Norms ◽  
Health Providers ◽  
Group Discussions ◽  
Individual Interviews ◽  
Men 2 ◽  
Rural Tanzania ◽  
Expectant Fathers ◽  
And Gender

Abstract Background: Mens’attendance with their pregnant partners at facility-based antenatal care (ANC) visits is important for maternal and child health and gender equality yet remains uncommon in parts of rural Tanzania. This study examined men’s perspectives on attending ANC with their pregnant partners in Misungwi District, Tanzania.Methods: Twelve individual interviews and five focus group discussions were conducted using semi-structured questionnaires with fathers, expectant fathers, and in-depth interviews were done to health providers, volunteer community health workers, and village leaders. Interviews were recorded and transcribed in Swahili and later translated to English. The research team conducted thematic analysis to identify common themes among interviews. Results: We identified two broad themes on the barriers to male attendance at facility-based ANC visits: (1) Perceived exclusion during ANC visits among men (2) Traditional gender norms resulting to low attendance among men.Conclusion: Attendance at health facility for ANC visits by men with their pregnant partners in the study areas were challenged by structural and local cultural norms. At the facility men were uncomfortable to sit with women due to lack of specific waiting area for men and that they perceived to be neglected. Local cultural norms demanded women to have secrecy in pregnancy while men perceived not to have a role of being with their partners during ANC visits.

scholarly journals Men perspectives on attending antenatal care visits with their pregnant partners in Misungwi district, rural Tanzania: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maendeleo Boniphace ◽  
Dismas Matovelo ◽  
Rose Laisser ◽  
Hadija Swai ◽  
Victoria Yohani ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Workers ◽  
Cultural Norms ◽  
Health Providers ◽  
Group Discussions ◽  
Individual Interviews ◽  
Men 2 ◽  
Rural Tanzania ◽  
Expectant Fathers ◽  
And Gender

Abstract Background Mens’attendance with their pregnant partners at facility-based antenatal care (ANC) visits is important for maternal and child health and gender equality yet remains uncommon in parts of rural Tanzania. This study examined men’s perspectives on attending ANC with their pregnant partners in Misungwi District, Tanzania. Methods Twelve individual interviews and five focus group discussions were conducted using semi-structured questionnaires with fathers, expectant fathers, and in-depth interviews were done to health providers, volunteer community health workers, and village leaders. Interviews were recorded and transcribed in Swahili and later translated to English. The research team conducted thematic analysis to identify common themes among interviews. Results We identified two broad themes on the barriers to male attendance at facility-based ANC visits: (1) Perceived exclusion during ANC visits among men (2) Traditional gender norms resulting to low attendance among men. Conclusion Attendance at health facility for ANC visits by men with their pregnant partners in the study areas were challenged by structural and local cultural norms. At the facility men were uncomfortable to sit with women due to lack of specific waiting area for men and that they perceived to be neglected. Local cultural norms demanded women to have secrecy in pregnancy while men perceived not to have a role of being with their partners during ANC visits.

scholarly journals Exploring food preparation practices in families with and without school-aged childhood cancer survivors

2019 ◽  
Vol 23 (3) ◽  
pp. 410-415
Author(s):  
Margaret Raber ◽  
Karla Crawford ◽  
Tom Baranowski ◽  
Shreela V Sharma ◽  
Vanessa Schick ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
Survival Rates ◽  
Childhood Cancer Survivors ◽  
Nutrition Intervention ◽  
Food Preparation ◽  
Nutrition Interventions ◽  
Meal Preparation ◽  
Increased Risk ◽  
Healthy Family

AbstractObjective:Survival rates for paediatric cancers have increased dramatically since the 1970s, but childhood cancer survivors (CCS) are at increased risk for several chronic diseases throughout life. Nutrition interventions promoting healthy family meals may support wellness for survivors, but little research has explored CCS family food preparation habits. The goal of the present study was to describe and compare food preparation practices of CCS and non-CCS families.Design:Observational.Setting:Typical evening meal preparation events were observed and recorded in participant homes. Recordings and notes were analysed using the Healthy Cooking Index (HCI), a measure of nutrition-optimizing food preparation practices relevant to survivor wellness. Demographics, BMI and nutrient composition of prepared meals were also collected.Participants:Forty parents with a CCS or non-CCS child aged 5–17 years were recruited.Results:There were no major differences between the CCS and non-CCS families with regard to summative HCI score or specific food preparation behaviours. Meals prepared by CCS and non-CCS families had similar nutrient compositions.Conclusions:The study revealed areas for practical nutrition intervention in CCS and non-CCS families. Future studies should consider adopting and tailoring nutrition intervention methods that have been successful in non-CCS communities.

scholarly journals Iterative Adaptation of a Maternal Nutrition Videos mHealth Intervention Across Countries Using Human-Centered Design: Qualitative Study

10.2196/13604 ◽  
2019 ◽  
Vol 7 (11) ◽  
pp. e13604
Author(s):  
Jasmin Isler ◽  
N Hélène Sawadogo ◽  
Guy Harling ◽  
Till Bärnighausen ◽  
Maya Adam ◽  
...  
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
South African ◽  
Maternal Nutrition ◽  
Health Workers ◽  
Video Adaptation ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Human Centered Design ◽  
Depth Interviews

Background Mobile health (mHealth) video interventions are often transferred across settings. Although the outcomes of these transferred interventions are frequently published, the process of adapting such videos is less described, particularly within and across lower-income contexts. This study fills a gap in the literature by outlining experiences and priorities adapting a suite of South African maternal nutrition videos to the context of rural Burkina Faso. Objective The objective of this study was to determine the key components in adapting a suite of maternal nutrition mHealth videos across settings. Methods Guided by the principles of human-centered design, this qualitative study included 10 focus group discussions, 30 in-depth interviews, and 30 observations. We first used focus group discussions to capture insights on local nutrition and impressions of the original (South African) videos. After making rapid adjustments based on these focus group discussions, we used additional methods (focus group discussions, in-depth interviews, and observations) to identify challenges, essential video refinements, and preferences in terms of content delivery. All data were collected in French or Dioula, recorded, transcribed, and translated as necessary into French before being thematically coded by two authors. Results We propose a 3-pronged Video Adaptation Framework that places the aim of video adaptation at the center of a triangle framed by end recipients, health workers, and the environment. End recipients (here, pregnant or lactating mothers) directed us to (1) align the appearance, priorities, and practices of the video’s protagonist to those of Burkinabe women; (2) be mindful of local realities whether economic, health-related, or educational; and (3) identify and routinely reiterate key points throughout videos and via reminder cards. Health workers (here, Community Health Workers and Mentor Mothers delivering the videos) guided us to (1) improve technology training, (2) simplify language and images, and (3) increase the frequency of their engagements with end recipients. In terms of the environment, respondents guided us to localize climate, vegetation, diction, and how foods are depicted. Conclusions Design research provided valuable insights in terms of developing a framework for video adaptation across settings, which other interventionists and scholars can use to guide adaptations of similar interventions.

scholarly journals Men perspectives on attending antenatal care visits together with their pregnant partners in Misungwi district, rural Tanzania: a qualitative study

2021 ◽  
Author(s):  
Maendeleo Boniphace ◽  
Dismas Matovelo ◽  
Rose Laisser ◽  
Hadija Swai ◽  
Victoria Yohana ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Workers ◽  
Cultural Norms ◽  
Health Providers ◽  
Group Discussions ◽  
Individual Interviews ◽  
Men 2 ◽  
Rural Tanzania ◽  
Expectant Fathers ◽  
And Gender

Abstract Background: Mens’attendance with their pregnant partners at facility-based antenatal care (ANC) visits is important for maternal and child health and gender equality yet remains uncommon in parts of rural Tanzania. This study examined men’s perspectives on attending ANC with their pregnant partners in Misungwi District, Tanzania.Methods: Twelve individual interviews and five focus group discussions were conducted using semi-structured questionnaires with fathers, expectant fathers, and in-depth interviews were done to health providers, volunteer community health workers, and village leaders. Interviews were recorded and transcribed in Swahili and later translated to English. The research team conducted thematic analysis to identify common themes among interviews. Results: We identified two broad themes on the barriers to male attendance at facility-based ANC visits: (1) Perceived exclusion during ANC visits among men (2) Traditional gender norms resulting to low attendance among men.Conclusion: Attendance at health facility for ANC visits by men with their pregnant partners in the study areas were challenged by structural and local cultural norms. At the facility men were uncomfortable to sit with women due to lack of specific waiting area for men and that they perceived to be neglected. Local cultural norms demanded women to have secrecy in pregnancy while men perceived not to have a role of being with their partners during ANC visits.

Sign in / Sign up

Export Citation Format

Share Document