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

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.

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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

Public Health Nutrition ◽

10.1017/s136898002000347x ◽

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.

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Infant and Young Child Feeding Practices Among Chepang Community, Chitwan

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v19i1.22813 ◽

2020 ◽

Vol 19 (1) ◽

pp. 31-38

Author(s):

Iswari Luitel ◽

Rita Kumari Ban ◽

Sabika Munikar

Keyword(s):

Young Child ◽

Breast Feeding ◽

Complementary Feeding ◽

Feeding Practices ◽

Educational Status ◽

Feeding Practice ◽

Child Feeding ◽

Young Child Feeding ◽

Child Feeding Practices ◽

Infant And Young Child

Introduction: Infant and young child feeding practices play vital role for the growth and development. It is recommended to exclusively breastfed for first six months and thereafter receive complementary foods with continued breastfeeding. However Chepang, the indigenous community of Nepal depends primarily upon forest food. This study aims to determine the infant and young child feeding practices among Chepang children. Methods: A cross sectional study was conducted among the mothers of 77 children aged six to 59 months through purposive sampling. Data was collected through face to face interview taking informed written consent. The collected data were analysed for descriptive and bivariate analysis using SPSS version 21. Results: In this study, mean age of respondents was 25.92 (±7.04) years, 68.8% followed Christian religion, 51.9% were educated, only 45.5% of respondent’s spouse were educated and 51.9% belonged to nuclear family. Among the respondents, 65.7% had good breast feeding practice and 88.3% had good complementary feeding practice. Statistically significant relationship was found between breast feeding practice and educational status and also between complementary feeding practice and family type. Conclusions: This study found that respondents had good breast feeding practice and complementary feeding practice. Among the respondent, seven out of 10 had good breast feeding practice and nine out of 10 had good complementary feeding practice. Association between breast feeding practice and educational status puts light upon the need for educating and empowering women for improved infant and young child feeding practices.

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Mothers’ Competence in Child Feeding Recommendations, Complementary Feeding Practices and Determinants of Adequate Diet

10.21203/rs.3.rs-25288/v1 ◽

2020 ◽

Author(s):

VICTOR MOGRE ◽

Kingsley B Appiah ◽

Ernest K Cheyuo ◽

Abdul-Mumin Alhassan ◽

Martin A Ayanore ◽

...

Keyword(s):

Young Child ◽

Nutrition Education ◽

Complementary Feeding ◽

Dietary Diversity ◽

Feeding Practices ◽

Full Potential ◽

Child Feeding ◽

Adequate Diet ◽

Young Child Feeding ◽

Infant And Young Child

Abstract Background Appropriate complementary feeding is critical for optimal nutrition in infant and young children as it ensures their growth, health and development to attain their full potential. However, evidence shows children from developing countries do not meet the core indicators for appropriate complementary feeding. We evaluated mothers’ competency in infant and young child feeding recommendations and their association to complementary feeding practices among children aged 6–23 months.Methods This cross-sectional study included 200 children aged 6–23 months and their mothers/care givers recruited during the child welfare clinics of two health facilities in Ghana. Data was collected using a structured questionnaire. Multivariate logistic regression was used to assess determinants of appropriate diet.Results Sixty-eight percent of the mothers knew the recommended duration of continued breastfeeding, 56.5% how to ensure dietary diversity and enrich their children’s diets and 94% (n = 188) had positive attitude towards recommended infant and young child feeding practices. Majority of the mothers (92%, n = 183) practiced continued breastfeeding, 10.5% of the children met minimum diet diversity score, 39.5% minimum meal frequency and 8.5% received minimum acceptable diet. Determinants of receipt of minimum adequate diet were: having high knowledge in child feeding recommendations (100% vs. 0.0; p < 0.001) and child’s father reportedly earning enough financially (AOR = 12.1 (1.32–109.72; p = 0.027).Conclusion Poor complementary feeding practices were common and mother’s knowledge levels regarding infant and young child feeding recommendations as well as the income levels of the child’s father were important determinants of appropriate diet. Nutrition education should emphasis on improving mothers’ nutrition knowledge regarding infant and young child feeding and supporting mothers to overcome barriers to feed their children with appropriate complementary foods.

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Diversified Diet Feeding Practice is Low Compared to the WHO Recommendation in the Dabat Demographic and Health Surveillance System Site: Finding from the Baseline Survey of Nutrition Project, 2016

10.1101/553875 ◽

2019 ◽

Author(s):

Zegeye Abebe ◽

Amare Tariku ◽

Gashaw Andargie Bikes ◽

Molla Mesele Wassie ◽

Kedir Abdella ◽

...

Keyword(s):

Young Child ◽

Odds Ratio ◽

Surveillance System ◽

Dietary Diversity ◽

Feeding Practice ◽

Child Feeding ◽

Dietary Diversity Score ◽

Young Child Feeding ◽

Child Feeding Practices ◽

Infant And Young Child

AbstractIntroductionImproving infant and young child feeding practices is critical to improved nutrition, health, and development of children. The country of Ethiopia has also adopted the WHO recommendations of child feeding practices and developed the national guideline of infant and young child feeding to improve child’s nutrition and health status. However, a few children start and received appropriate complementary feeding based on the recommendation. Therefore, the study aimed to determine dietary diversity score and its associated factors among under five children at Dabat Demography Surveillance System site (HDSS), northwest Ethiopia.MethodsA cross-sectional community based study was from February to June 2016. All children aged 6-59 months old who lived in HDSS site were included in the survey. The collected data were checked and entered into Epi info version 7 and exported to STATA version 14 statistical software for analysis. Both crude odds ratio (COR) and adjusted odds ratio (AOR) with the corresponding 95% confidence interval (CI) was calculated to show the strength of association. Finally, a p-value of 0.05 was used to determine if the association was statistically significant.ResultsIn this study, about 34.87% (95%CI: 33.27, 36.49%) of the children received adequately diversified diet. The odds of receiving adequately diversified diet was higher among children whose mother had secondary and above education (AOR= 6.51; 95%CI: 4.95, 8.56), mother who had ANC (AOR = 1.90; 95%CI: 1.60, 2.26) and PNC visit (AOR= 1.31; 95%CI: 1.00, 1, 72). However, a lower dietary diversity score is observed among young children (AOR=0.59; 95%CI: 0.41, 0.85), and children from food inscured household (AOR=0.76; 95%CI: 0.63, 0.92).ConclusionsDiversified diet feeding practice is low compared to the WHO recommendation in the surveillance site. Age of the child, maternal education, ANC and PNC visit, and household food insecurity were significantly associated with Dietary diversity score of children. Hence, various actions need to scale up the current practices of child feeding by improving HHFSS, strengthening ANC and PNC counselling about child feeding options, and feeding of young infants.

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Infant and young child feeding practice among mothers of children age 6 to 23 months in Debrelibanos district, North Showa zone, Oromia region, Ethiopia

PLoS ONE ◽

10.1371/journal.pone.0257758 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0257758

Author(s):

Mathewos Mekonnen ◽

Tadele Kinati ◽

Kumera Bekele ◽

Bikila Tesfa ◽

Dejene Hailu ◽

...

Keyword(s):

Young Child ◽

Dietary Diversity ◽

Sampling Technique ◽

Health Care Facilities ◽

Outcome Variable ◽

Feeding Practice ◽

Child Feeding ◽

Cross Sectional ◽

Young Child Feeding ◽

Infant And Young Child

Background Inappropriate infant and young child feeding (IYCF) practice is the leading cause of malnutrition in children. Data is needed to identify children at risk of poor feeding practice and to target interventions to improve IYCF practices. Therefore, this study aimed to assess IYCF practice and associated factors among mothers of children age 6 to 23 months in Debrelibanos district, north Showa zone, Oromia region, Ethiopia. Method A community-based cross-sectional study design was conducted among 380 mothers of children age 6 to 23 months from March 1 to April 5, 2019. A simple random sampling technique was used to select the respondents. Data was collected using a structured interviewer-administered questionnaire that had been pretested. The data was entered into Epi-Data 3.1 and then transferred to SPSS 21 for analysis. Descriptive statistical analysis was done, and an association between an outcome variable and independent variables was examined in logistic regression models. Result Overall, 65.8% of mothers practiced appropriate IYCF practice. The study revealed that 70.5% of children started breastfeeding within one hour of birth, and 61.6% were breastfed exclusively for six months. Among studied mothers, 79.5% continued to breastfeed their children until 2 years, and 69.2% of the participants started complementary feeding timely at six months. Minimum dietary diversity was observed in 19.2% of children, while minimum meal frequency was found in 79.2%. The majority of mothers (77.6%) fed their babies with bottles. Mother’s educational status of primary school [AOR = 4.50, 95% CI: (1.38,14.61)], husband’s occupation being merchant [AOR = 6.45, 95% CI: (1.51, 27.59)]; antenatal care follows up [AOR = 3.15, % CI: (1.22, 8.12)], radio/television ownership [AOR = 7.41, 95% CI: (2.86, 19.20)], child’s sex being female [AOR = 4.78, 95% CI: (2.26, 10.064) and sufficient knowledge on child feeding [AOR = 2.82, 95% CI: (1.27, 26.26)] were independent predictors for appropriate IYCF practice. Conclusion The prevalence of appropriate infant and young child feeding practice indicators was found to be rather high among the mothers in this study. The use of a bottle to feed babies, in particular is very common among the mothers who were studied. To address child malnutrition, it is critical to educate families about proper IYCF practices. This study suggests that mothers be properly educated about IYCF recommendations at health care facilities during their visits, as well as the promotion of appropriate IYCF through various media.

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Indonesia Infant and Young Child Feeding Practice: The Role of Women’s Empowerment in Household Domain

Global Journal of Health Science ◽

10.5539/gjhs.v12n9p129 ◽

2020 ◽

Vol 12 (9) ◽

pp. 129

Author(s):

Mardiana Dwi Puspitasari ◽

Maria Gayatri

Keyword(s):

Young Child ◽

Partner Violence ◽

Dietary Diversity ◽

Reproductive Age ◽

Feeding Practice ◽

Child Feeding ◽

Lower Odds ◽

Young Child Feeding ◽

Infant And Young Child ◽

Born Child

Previous studies showed the significant association between women’s empowerment and infant and young child feeding (IYCF) practice. Only around 40% of Indonesian children met adequate IYCF practice. Hence, each dimension of women’s empowerment in the household domain must be explored. We carried out a dataset of the 2017 Indonesia Demographic and Health Survey, with samples of 4,880 mothers of reproductive age in a marriage relationship with their last-born child aged 6-23 months. Logistic regression was applied. Mother with legal asset ownerships had lower odds of her child meeting (aOR: 0.83; 95% CI: 0.72, 0.95) minimum dietary diversity (MDD), (aOR: 0.75; 95% CI: 0.65, 0.87) minimum meal frequency (MMF) and (aOR: 0.74; 95% CI: 0.61, 0.90) minimum acceptable diet (MAD). Mother who could control her own earnings had higher odds of her child meeting MDD (aOR: 1.52; 95% CI: 1.32, 1.74) and MAD (aOR: 1.62; 95% CI: 1.34, 1.94). Employed mother had higher odds of meeting MMF (aOR: 1.58; 95% CI: 1.38, 1.82). Mother who did not approve of intimate partner violence was more likely to feed her child with MDD (1.39 times), MMF (1.41 times) and MAD (2.04 times). Mother with three or more parity had lower odds of her child meeting MDD (aOR: 0.81; 95% CI: 0.79, 0.93), MMF (aOR: 0.84; 95% CI: 0.72, 0.99) and MDD (aOR: 0.80; 95% CI: 0.65, 1.00). Mother who did not approve towards domestic violence, was working, controlled her assets and had a maximum of two parity was associated with official IYCF recommendation.

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

BMC Public Health ◽

10.1186/s12889-020-10095-8 ◽

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.

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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

Public Health Nutrition ◽

10.1017/s1368980021002342 ◽

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.

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