Effectiveness of an Educational Manual to Promote Infant Feeding Practices in Primary Health Care

Objective: To test the hypothesis that a continuing educational strategy (ie, “the manual”) in primary health-care improves infant feeding practices among infants under 1 year of age. Methods: A before and after study was conducted at primary health-care units in Embu das Artes, Brazil. The intervention was the use of a manual created to support continuing educational activities on breastfeeding and complementary feeding to be performed by tutors of Estratégia Amamenta e Alimenta Brasil with health-care teams, in a period of 8 months. Five hundred sixty-one mothers before and 598 mothers after intervention were interviewed about breastfeeding and complementary feeding practices. Multivariate analysis was performed using Poisson multilevel regression to test the hypothesis. Results: Lack of minimum food diversity (before 62.9%; after 50.3%) and lack of food adequacy (before 77.5%; after 63.3%) decreased significantly. Regression analysis confirmed that infants after the intervention had lower prevalence of inadequacy of complementary feeding. While the intervention did not show significant association with exclusive breastfeeding, it showed association with the improvement of complementary feeding practices. Conclusions: The manual is a continuing educational strategy that improved complementary feeding practices in primary health care.

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Effectiveness of an educational manual to promote infant feeding practices in primary health care

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1003 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

G R B Relvas ◽

G S Buccini ◽

L Potvin ◽

S I Venancio

Keyword(s):

Health Care ◽

Primary Health Care ◽

Continuing Education ◽

Infant Feeding ◽

Primary Healthcare ◽

Complementary Feeding ◽

Feeding Practices ◽

Infant Feeding Practices ◽

Healthcare Teams ◽

Primary Health

Abstract Background Breastfeeding and adequate complementary feeding in the first years of life provide short- and long-term benefits for child health. However, breastfeeding and adequate complementary feeding prevalence's are low. In Brazil, the Estratégia Amamenta e Alimenta Brasil (EAAB) aims to improve the quality of the assistance provided by primary healthcare teams to ultimately improving infant feeding practices in the Brazilian population. In primary healthcare units, continuing education in breastfeeding and complementary feeding is facilitated by EAAB tutors. A Manual to Support EAAB Tutor (the Manual) was developed following a problem-based learning methodology. This study aimed to evaluate the effectiveness of using the Manual by analyzing exclusive breastfeeding and complementary feeding indicators. Methods A before and after study was conducted at primary healthcare units in Embu das Artes, Brazil. The intervention consisted in the use of the Manual by EAAB tutors who performed some comprehensive training activities with healthcare teams, in a period of 8 months. Subjects consisted of mothers of infants under one year of age attended at primary healthcare units. 561 mothers before and 598 mothers after intervention were interviewed about breastfeeding and complementary feeding practices. Multivariate analysis was performed using Poisson multilevel regression to test the hypothesis. Results Lack of minimum food diversity (before 62.9%; after 50.3%) and lack of food adequacy (before 77.5%; after 63.3%) decreased significantly. Regression analysis confirmed that infants after the intervention had lower prevalence of inadequacy of complementary feeding. While the intervention did not show significant association with exclusive breastfeeding, it showed association with the improvement of complementary feeding practices. Conclusions The Manual is a continuing educational strategy that improved complementary feeding practices in primary health care. Key messages The use of a continuing education strategy grounded on a problem-based learning methodology was effective to produce improvements in complementary feeding practices in primary health care. The 'Manual to Support EAAB Tutor' consists of a tool that has the potential to be adapted for different contexts and easy to disclose to all EAAB tutors in the country.

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The infant-feeding practices of mothers enrolled in the prevention of mother-to-child transmission of HIV programme at a primary health care clinic in the Mpumalanga province, South Africa

South African Family Practice ◽

10.1080/20786204.2009.10873875 ◽

2009 ◽

Vol 51 (4) ◽

pp. 337-339 ◽

Cited By ~ 3

Author(s):

IS Ukpe ◽

J Blitz ◽

J Hugo ◽

M Theledi

Keyword(s):

South Africa ◽

Health Care ◽

Primary Health Care ◽

Infant Feeding ◽

Infant Feeding Practices ◽

Child Transmission ◽

Care Clinic ◽

Mpumalanga Province ◽

Primary Health ◽

Mother To Child

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Evaluation of Emergency Health-Care Initiatives to Reduce Overcrowding in a Referral Medical Complex, Jeddah, Saudi Arabia

Saudi Journal of Health Systems Research ◽

10.1159/000517487 ◽

2021 ◽

pp. 1-6

Author(s):

Khalid Alabbasi ◽

Estie Kruger ◽

Marc Tennant

Keyword(s):

Health Care ◽

Primary Health Care ◽

Public Hospital ◽

Waiting Times ◽

Care Centre ◽

Health Care Centre ◽

Transfer Policy ◽

Primary Health ◽

Before And After ◽

Ed Visits

Purpose: Excessive delays and emergency department (ED) overcrowding have become an increasingly major problem for public health worldwide. This study was to assess the key strategies adopted by an ED, at a public hospital in Jeddah, to reduce delays and streamline patient flow. Materials and Methods: This study was a service evaluation for a Saudi patient population of all age-groups who attended the ED of a public hospital for the period between June 2016 and July 2019. The Saudi initiative to reduce the ED visits at the King Abdullah Medical Complex hospital has started on August 7, 2018. The initiative was to apply an urgency transfer policy which outlines the procedures to follow when patients arrive to the ED where they are reviewed based on the Canadian Triage and Acuity Scale (CTAS). Patients with less-urgent conditions (category 4 and 5) are referred to a primary health-care practice (where a family medicine consultant is available). Patients with urgent conditions (category 1–3) are referred to a specialized health-care centre if the service is not currently provided. To test the effectiveness of ED initiative on reducing the overcrowd, data were categorized into before and after the initiative. The bivariate analysis χ2 tests and 2 sample t-tests were run to explore the relationship of gender and age with dependent variable emergency. Results: A total of 233,998 patients were included in this study, 61.8% of them were males and the average age of ED patients were 35.5 ± 18.6 years. The majority of cases were those classified as “less urgent” (CTAS 4), which accounted for 65.4%. Number of ED visits before and after the initiative was 67 and 33%, respectively. ED waiting times after the initiative have statistically significantly decreased across all acuity levels compared to ED waiting times before the initiative. Conclusion and Implication: The findings suggest that the majority of patients arrive to the ED with less-urgent conditions and arrived by walking-in. The number of cases attending the ED significantly decreased following the introduction of the urgency transfer policy. Referral for less-urgent patients to primary health-care centre may be an important front-end operational strategy to relieve congestion.

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Infant Feeding Practices in Kaski District, Pokhara

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v32i1.5339 ◽

2012 ◽

Vol 32 (1) ◽

pp. 23-27

Author(s):

S Basnet ◽

E Gauchan ◽

K Malla ◽

T Malla ◽

DP Koirala ◽

...

Keyword(s):

Infant Feeding ◽

Complementary Feeding ◽

Feeding Practices ◽

Economic Factors ◽

Infant Feeding Practices ◽

Factors Associated ◽

Awareness Campaigns ◽

Prelacteal Feeds ◽

Initiation Of Breastfeeding ◽

Socio Economic Factors

Background: Children in developing countries are prone to infectious diseases due to insufficient and inappropriate feeding practices. Socio-demographic and socio-economic factors directly and indirectly play a role in influencing infant feeding practices. This study was conducted to assess the socio-demographic and economic factors associated with initiation of breastfeeding, complimentary feeding, and the various prelacteal feeds practiced in Kaski, Pokhara. Materials and Methods: In this prospective study, interviews were conducted to 500 mothers at Manipal Teaching Hospital who brought their child for treatment. The interviews were conducted in a questionnaire format relating to their demographic and financial statuses. Results: A total of 500 mothers were questioned, out of which 86.6% gave their child breastmilk as its first food. 47% initiated breastfeeding within half an hour of child’s birth. 86% gave Jaulo as the first complementary food to their children. About 26% of the mothers gave complementary feeding to their children before the recommended time of 6 months. Conclusion: Initiation of breastfeeding after life and complementary feeding practices overall has improved from previous studies. There is still need of making awareness campaigns and such in order to further improve this trend. Key words: Breastfeeding; Complimentary feeding; Malnourishment DOI: http://dx.doi.org/10.3126/jnps.v32i1.5339 J. Nepal Paediatr. Soc. Vol.32(1) 2012 23-27

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Determinants of child wasting in Bhutan. Insights from nationally representative data

Public Health Nutrition ◽

10.1017/s1368980016002111 ◽

2016 ◽

Vol 20 (2) ◽

pp. 315-324 ◽

Cited By ~ 4

Author(s):

Víctor M Aguayo ◽

Nina Badgaiyan ◽

Laigden Dzed

Keyword(s):

Infant Feeding ◽

Complementary Feeding ◽

Feeding Practices ◽

Western Region ◽

Infant Feeding Practices ◽

Very Young Children ◽

Multiple Indicator ◽

The Western Region ◽

Nationally Representative ◽

Prelacteal Feeds

AbstractObjectiveTo characterize the epidemiology of wasting and identify the main predictors of wasting, severe wasting and poor weight-for-height in children.DesignWe analysed a nationally representative sample of 2028 children (Multiple Indicator Survey, 2010).SettingRoyal Kingdom of Bhutan.SubjectsChildren aged 0–23 months.ResultsWasting prevalence was significantly higher among infants aged 0–11 months than among children aged 12–23 months (12·0 v. 6·7 %; P=0·004) and among boys than girls (11·0 v. 7·5 %; P=0·04). Children from the Western region had 63 % higher odds of being wasted than children from the Central/Eastern regions (adjusted OR (AOR)=1·63; 95 % CI 1·14, 2·34). Poor feeding practices were among the most significant predictors of wasting and severe wasting. Children who were given prelacteal feeds in the first days of life had 2·5 times higher odds of being severely wasted than those who were not (AOR=2·49; 95 % CI 1·19, 5·19); inadequate complementary feeding in children aged 0–23 months was associated with 58 % higher odds of being wasted (AOR=1·58; 95 % CI 1·02, 2·47) and 2·3 times higher odds of being severely wasted (AOR=2·28; 95 % CI 1·13, 4·58). The association of poor infant feeding practices with wasting and severe wasting was particularly significant in infants (0–11 months).ConclusionsProgrammes for the detection and treatment of severely wasted children need to prioritize very young children (0–11 months), particularly in the Western region. Programmes for the prevention of wasting need to prioritize the improvement of complementary foods and feeding practices in children aged 6–23 months.

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Infant Feeding Practice of Mother attending Pediatric out Patients Department in A Tertiary Care Center

Bangladesh Journal of Child Health ◽

10.3329/bjch.v37i3.18616 ◽

2014 ◽

Vol 37 (3) ◽

pp. 138-141 ◽

Cited By ~ 1

Author(s):

Tamanna Begum ◽

SK Azimul Hoque ◽

Md Rafiqul Islam ◽

Soofia Katoon ◽

Azanta Rani Shah

Keyword(s):

Infant Feeding ◽

Breast Feeding ◽

Complementary Feeding ◽

Care Center ◽

Tertiary Care ◽

Feeding Practices ◽

Global Strategy ◽

Feeding Practice ◽

Infant Feeding Practices ◽

Cross Sectional

Background: Appropriate breastfeeding and complementary feeding practices are the fundamental to childrens nutrition, health and survival during the first year of life. WHO and UNICEF have articulated a global strategy for poor infant feeding practices directly and indirectly contributes to under nutrition, morbidity and mortality in infant. Objective: This study was designed to determine the breast feeding (BF) and complementary feeding (CF) practices in study population. Methodology: This descriptive cross sectional study was carried out in Pediatrics out patients department (OPD) of Shahid Surhawardy Medical College and Hospital, from January 2009 to December 2009. Feeding history of total 250 babies age >6 months to <1 year was taken from mothers. Results: Among 250 total babies, prelacteal feed was given in 29.2%(73/250), colostrum was given in 79.2%(198/250) and exclusive breast feeding upto six months was given in 24%(60/250) babies. CF was started in 242 babies and it was too early before six months in 29.6%(74/250) cases. Amount of CF was adequate in 66.9%(162/ 242) and composition of CF was good enough in 58.3%(141/242) babies. Conclusion: In this study CF was introduced before 6 months in one third babies and amount was inadequate in same numbers of children. There is need for promotion and protection of optimal infant feeding practices for improving nutritional status of our children. DOI: http://dx.doi.org/10.3329/bjch.v37i3.18616 Bangladesh J Child Health 2013; Vol.37(3): 138-141

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