Interventions to Improve Infant and Young Child Feeding Practices in Ethiopia: A Systematic Review

Abstract Background: Detailed understanding of the specific types of interventions that can be implemented to increase infant and young child feeding (IYCF) is essential to improve child health and development. In Ethiopia, despite the implementation of several interventions to improve IYCF practices, no published studies have highlighted the most effective IYCF interventions in the country. This systematic review investigated the impacts of various interventions on IYCF in Ethiopia.Methods: A systematic search was conducted on seven computerized bibliographic databases (Embase, ProQuest Central, Scopus, PsycINFO, Web of Science, MEDLINE/PubMed and CINAHL) to locate experimental or quasi-experimental studies. Interventional studies that measured IYCF indicators (early initiation of breastfeeding [EIBF], exclusive breastfeeding [EBF], the introduction of complementary foods, minimum dietary diversity [MDD], minimum meal frequency [MMF] and minimum acceptable diet [MAD]) as outcome variables were included.Results: Of the thirteen eligible studies, ten studies were quasi-experimental and three studies were cluster randomised trials. Five studies showed that interventions in the form of policy advocacy, health service strengthening, interpersonal communication, community mobilisation, and mass media campaigns improved EBF. Four studies indicated that community-level and health facility breastfeeding promotions increased EIBF. Three studies for MDD and two studies for MMF indicated significant effects of policy advocacy, interpersonal communication, community mobilisation, and mass media campaigns on infants and young children. Interventions that were delivered in combination increased the impacts in improving EIBF, MDD and MMF compared to single intervention.Conclusion: Our review showed that a combination of community-level interventions improved EIBF, EBF, MDD, and MMF in Ethiopia. The improvement in IYCF in Ethiopia would require multi-prong approaches at the household and community levels along the continuum of care from conception until a child’s second birthday.

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Interventions to improve infant and young child feeding practices in Ethiopia: a systematic review

BMJ Open ◽

10.1136/bmjopen-2021-048700 ◽

2021 ◽

Vol 11 (8) ◽

pp. e048700

Author(s):

Kedir Y. Ahmed ◽

Kingsley Emwinyore Agho ◽

Andrew Page ◽

Amit Arora ◽

Felix Akpojene Ogbo

Keyword(s):

Systematic Review ◽

Young Child ◽

Health Facility ◽

Breast Feeding ◽

Experimental Studies ◽

Risk Of Bias ◽

Child Feeding ◽

Young Child Feeding ◽

Infant And Young Child ◽

Quasi Experimental

ObjectiveIn Ethiopia, despite the implementation of several interventions to improve infant and young child feeding (IYCF) practices, no published studies have highlighted the most effective IYCF interventions in the country. This systematic review investigated the impacts of various interventions on IYCF in Ethiopia.Source of informationA systematic search was conducted on seven computerised bibliographic databases (Embase, ProQuest Central, Scopus, PsycINFO, Web of Science, MEDLINE/PubMed and CINAHL) to locate experimental or quasi-experimental studies published between the year 2000 and May 2021.Study eligibility criteriaInterventional studies that measured IYCF indicators (early initiation of breast feeding (EIBF), exclusive breast feeding (EBF), the introduction of complementary foods, minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet) as outcome variables were included.Study appraisal and synthesisAll included studies were examined for biases related to interventional studies (ie, selection bias, performance bias, attrition bias, detection bias and reporting bias). Author reports of effect size measures were used to narratively report the findings of each study.ResultsOf the 23 eligible studies, 14 studies were quasi-experimental and 9 studies were cluster randomised trials (CRTs). Eight quasi-experimental studies had a serious risk of bias, while two CRTs had a high risk of bias. Four studies for EBF and six studies for EIBF showed significant impacts of policy advocacy, health service strengthening, interpersonal communication, community mobilisation and mass media campaigns. Six studies for MDD and three studies for MMF indicated significant effects of community-level and health facility complementary feeding promotions on infants and young children. Interventions that delivered in combination increased the impacts in improving EIBF, MDD and MMF compared with a single intervention.ConclusionOur review showed that 12 out of 21 eligible studies that implemented in the form of community-level and health facility interventions improved EIBF, EBF, and/or MDD in Ethiopia.Protocol registration numberPROSPERO, CRD42020155519.

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Examining the Exposure, Timing, and Frequency of Interpersonal Communication Contacts to Improve Infant and Young Child Feeding in Bangladesh, Ethiopia, and Vietnam (P10-138-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz034.p10-138-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Sunny Kim ◽

Phuong Nguyen ◽

Lan Tran ◽

Silvia Alayon ◽

Purnima Menon ◽

...

Keyword(s):

Young Child ◽

Interpersonal Communication ◽

Exclusive Breastfeeding ◽

Large Scale ◽

Food Policy ◽

Dietary Diversity ◽

Child Feeding ◽

Young Child Feeding ◽

Behavior Change Interventions ◽

Infant And Young Child

Abstract Objectives In the context of large-scale interventions to improve infant and young child feeding (IYCF) practices, we examined differences in characteristics of those exposed and not exposed to interventions; exposure to interpersonal communication (IPC), including overlap with other interventions and timing and number of contacts; and relationship between frequency of IPC contacts and IYCF practices. Methods We used endline survey data from Bangladesh (2000 mothers with children <2y, 1000 per program group), Ethiopia (1720 mother with children aged 6–23.9 mo, 1360 per group), and Vietnam (2005 mothers with children <2y, 1000 per group). Regression models were used to test differences in exposure to specific or combined interventions between two arms and relationships between the frequency of IPC contacts or exposure to interventions and IYCF practices, adjusted for child age and sex and geographic clustering. Results Those exposed to interventions had higher socioeconomic status, food security, and maternal dietary diversity. There was large overlap in exposure to IPC with other interventions in intensive-intervention areas in all 3 countries. On average, mothers received 8 visits in the last 6 mo, 2 visits in the last 3 mo, and 1 visit in the last 6 mo in Bangladesh, Ethiopia, and Vietnam respectively. In Bangladesh, there was a positive, nonsignificant association between intervention exposure and IYCF practices in intensive areas. In Ethiopia, exposure to IPC with other interventions was associated with higher odds of minimum meal frequency (OR: 1.6), minimum dietary diversity (OR: 1.8), and consumption of iron-rich foods (OR: 4.7). In Vietnam, exposure to IPC alone or with mass media was associated with 3.7 and 2.8 higher odds respectively of exclusive breastfeeding. At least monthly visits was associated with higher odds of IYCF practices in Bangladesh and Ethiopia. In Vietnam, any number of IPC visits was associated with 2 times higher odds of exclusive breastfeeding. Conclusions Effects of combined behavior-change interventions and frequency of IPC contacts may be context-specific. 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.

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The effectiveness education of counseling of infant and young child feeding as intensive to improve counseling performance of Posyandu cadres in Bogor, Indonesia

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20192138 ◽

2019 ◽

Vol 6 (6) ◽

pp. 2280

Author(s):

Siti Mutia Rahmawati ◽

Siti Madanijah ◽

Faisal Anwar ◽

Risatianti Kolopaking

Keyword(s):

Young Child ◽

Intervention Group ◽

Analysis Of Covariance ◽

Child Feeding ◽

Educational Models ◽

Young Child Feeding ◽

Infant And Young Child ◽

Before And After ◽

Quasi Experimental ◽

The Difference

Background: Cadres have an essential role in providing counseling in integrated health service post (Posyandu). Poor capacity cadres may affect information delivery to the mothers/caregivers of under-five children. This study aimed is to assess the effect education of counseling of infant and young child feeding (IYCF) as intensive on the performance of the cadres in providing IYCF counseling.Methods: The study was a quasi-experimental with a pre-post test controlled group. The subjects were 55 Posyandu cadres in Ciomas sub-district Bogor. The intervention was training for cadres using education of counseling of IYCF as intensive carried out in the classroom and the field. Data on knowledge, attitude, motivation and counseling performance of cadres before and after the training were collected using a validated structured questionnaire. The paired and independent T-test was applied to analyze the difference before and after the intervention, and analysis of covariance (ANCOVA) was applied to analyze the factors that influence cadre counseling performance.Results: Mean score of knowledge (p=0.00), attitude (p=0.00), motivation (p=0.04), and counseling performance (p=0.00) of cadres in intervention group significantly increased. There is an increase in the score of performance counseling indicators for cadre in the quantity and quality after the education of counseling of IYCF as intensive. All of the indicators of the counseling performance of cadres influenced by educational models, knowledge, attitudes and attended training (p<0.05).Conclusions: Training of cadres using the education of counseling of IYCF as intensive effectively improved the knowledge, attitude, motivation and counseling performance of IYCF practice with indicators of quantity, quality, concern, and character. The capacity building of the cadres should improve continuously through the development of various methods which are more specific and applicable.

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Family experiences of infant and young child feeding in lower-income countries: protocol for a systematic review of qualitative studies

Systematic Reviews ◽

10.1186/s13643-016-0292-7 ◽

2016 ◽

Vol 5 (1) ◽

Author(s):

Alessandra N. Bazzano ◽

Aiko Kaji ◽

Erica Felker-Kantor ◽

Lisa Saldanha ◽

John Mason

Keyword(s):

Systematic Review ◽

Young Child ◽

Qualitative Studies ◽

Lower Income ◽

Child Feeding ◽

Family Experiences ◽

Young Child Feeding ◽

Infant And Young Child ◽

Lower Income Countries

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Systematic review of infant and young child feeding practices in conflict areas: what the evidence advocates

BMJ Open ◽

10.1136/bmjopen-2020-036757 ◽

2020 ◽

Vol 10 (9) ◽

pp. e036757

Author(s):

Amna Rabbani ◽

Zahra A Padhani ◽

Faareha A Siddiqui ◽

Jai K Das ◽

Zulfiqar Bhutta

Keyword(s):

Systematic Review ◽

Young Child ◽

Breast Feeding ◽

Grey Literature ◽

Bottle Feeding ◽

Child Feeding ◽

Young Child Feeding ◽

Conflict Settings ◽

Infant And Young Child ◽

Increased Risk

BackgroundBreast feeding in conflict settings is known to be the safest way to protect infant and young children from malnourishment and increased risk of infections. This systematic review assesses the evidence on infant and young child feeding (IYCF) practices in conflict settings.MethodologyWe conducted a search in PubMed and CENTRAL and also searched for grey literature from the year 1980 to August 2019. We included studies conducted in settings inflicted with armed conflict; which comprised settings undergoing conflict, as well as, those within 5 years of its cessation. Studies were included if they discussed IYCF practices, barriers, programmes and guidelines to promote and improve IYCF practices. Two review authors independently evaluated and screened studies for eligibility and extracted data; followed by a descriptive and thematic analysis.ResultsWe included 56 studies in our review including 11 published articles and 45 reports from grey literature and broadly classified into four predetermined sections: epidemiology (n=24), barriers/enablers (n=18), programmes/interventions (n=15) and implementation guidelines (n=30). Epidemiological evidence shows that IYCF practices were generally poor in conflict settings with median prevalence of exclusive breast feeding at 25%, continued breast feeding at 29%, bottle feeding at 58.3%, introduction to solid, semisolid or soft foods at 71.1% and minimum dietary diversity at 60.3%.IYCF practices were affected by displacement, stress, maternal malnutrition and mental health, family casualties and free distribution of breast milk substitutes. To improve IYCF, several interventions were implemented; including, training of health workers, educating mothers, community networking and mobilisation, lactation-support service, baby friendly hospital initiative, mother–baby friendly spaces and support groups.ConclusionThe evidence suggests that IYCF practices are generally poor in conflict inflicted settings. However, there is potential for improvement by designing effective interventions, responsibly disseminating, monitoring and implementing IYCF guidelines as prescribed by WHO development partners, government and non-government organisations with dedicated funds and investing in capacity development.

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SystEmatic review and meta-aNAlysis of infanT and young child feeding Practices (ENAT-P) in Ethiopia: protocol

BMJ Open ◽

10.1136/bmjopen-2017-017437 ◽

2017 ◽

Vol 7 (8) ◽

pp. e017437 ◽

Cited By ~ 12

Author(s):

Tesfa Dejenie Habtewold ◽

Md. Atiqul Islam ◽

Nigussie Tadesse Sharew ◽

Shimels Hussien Mohammed ◽

Mulugeta Molla Birhanu ◽

...

Keyword(s):

Systematic Review ◽

Young Child ◽

Breast Feeding ◽

Meta Analysis ◽

National Development ◽

Child Feeding ◽

Timely Initiation ◽

Young Child Feeding ◽

Infant And Young Child ◽

Substantial Heterogeneity

IntroductionInfant and young child feeding (IYCF) is the cornerstone of infant and child survival, healthy growth and development, healthy future generations and national development. In spite of the importance of optimal nutrition in low- and middle-income countries, there has been no review conducted in Ethiopia. Thus, the aim of this systematic review and meta-analysis is to estimate the national coverage and identify the associated factors of IYCF practices in Ethiopia.MethodsPubMed, Scopus, EMBASE, CINHAL, EBSCO, Web of Science and WHO Global Health Library databases will be searched for all available publications from 1 January 2000 to 30 September 2017. All published studies on the timely initiation of breast feeding, exclusive breast feeding and timely initiation of complementary feeding practice in Ethiopia will be screened, selected and reviewed. Bibliographies of identified articles and grey literature will be hand-searched as well. Heterogeneity of studies will be quantified using Higgins's method where I2statistic >80% indicates substantial heterogeneity. Funnel plots and Egger's regression test will be used to assess potential publication bias. The Newcastle–Ottawa Scale (NOS) will be used to assess the quality of evidence and risk of bias. Meta-analysis and meta-regression will be carried out to estimate the pooled national prevalence rate and an OR of each associated factor of IYCF practices. Narrative synthesis will be performed if meta-analysis is not feasible due to the substantial heterogeneity of studies.Ethics and disseminationEthical clearance is not required for this study because primary data will not be collected. The results of this systematic review and meta-analysis will be published in a peer-reviewed journal and presented at an (inter)national research symposium.Systematic review registrationThis systematic review and meta-analysis has been registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017056768.

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