scholarly journals Effectiveness of Behaviour Change Communication for Mothers on Complementary Feeding Practices and Infants’ Nutritional Status in Nigeria

2021 ◽  
pp. 83-97
Author(s):  
Kolade Afolayan Afolabi ◽  
Adebukunola Olajumoke Afolabi
Keyword(s):  
Early Childhood ◽  
Nutritional Status ◽  
Behaviour Change ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Intervention Group ◽  
Feeding Practices ◽  
Control Group ◽  
Behaviour Change Communication ◽  
Change Communication

Introduction: The quality of feeding in early childhood depends on nutritional knowledge of mothers. Improving maternal nutrition knowledge is therefore pivotal towards promoting effective infants’ feeding behaviour. Objective: Study assessed mothers’ knowledge about complementary feeding and complementary feeding practices. Study also assessed effectiveness of Behaviour Change Communication on mothers’ knowledge and complementary feeding practices, compared the nutritional status of infants whose mothers received intervention to infants of mothers in the control group. Materials and Methods: A quasi-experimental study conducted among 204 mothers in rural and urban local government areas, South-west Nigeria between March and September, 2019. Sample size was estimated using formula for comparison of two proportions, eligible mothers were selected through multistage sampling technique. Study was conducted in three phases: pre-intervention phase, intervention and post intervention phases. Intervention: Selected mothers were randomly assigned into intervention and control groups. Mothers in the intervention group received Behavior Change Communication on complementary feeding and were followed up for six months. Data Analysis: Data was analyzed using SPSS software version 25, Chi-square and repeated analysis of variance evaluated effectiveness of intervention, level of significance was < 0.05. Results: BCC improved mothers’ knowledge about complementary feeding by 31.9% (χ2 = 21.62; p = 0.001), meal frequency by 16% (χ2 = 5.88, p = 0.01), dietary diversity by 19.6% (χ2 = 7.44, p = 0.01), minimum acceptable diet by 20.6% (χ2 = 13.09; p =0.01). Intervention also reduced under-weight by 14% (χ2 = 0.69, p = 0.01; (F(1,191) =275.34; p = 0.04) among intervention group. Conclusion: Effective nutritional intervention for mothers towards improving nutritional status of children should incorporate appropriate behaviour change approach. This approach is capable of improving nutritional status of infants and children and consequently reduce malnutrition and related complications in early childhood.

Nutrition Education and Introduction of Broad Bean—Based Complementary Food Improves Knowledge and Dietary Practices of Caregivers and Nutritional Status of Their Young Children in Hula, Ethiopia

2014 ◽  
Vol 35 (4) ◽  
pp. 480-486 ◽  
Author(s):  
Canaan Negash ◽  
Tefera Belachew ◽  
Carol J. Henry ◽  
Afework Kebebu ◽  
Kebede Abegaz ◽  
...  
Keyword(s):  
Young Children ◽  
Nutritional Status ◽  
Nutrition Education ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Intervention Group ◽  
Baseline Survey ◽  
Control Group ◽  
Broad Beans ◽  
Knowledge And Practice

Background Nutritious complementary foods are needed in countries where undernutrition and stunting are major problems, but mothers may be reluctant to change from traditional gruels. Objective To test whether a recipe-based complementary feeding education intervention would improve knowledge and practice of mothers with young children in Hula, Ethiopia. Methods A baseline survey of 200 eligible, randomly selected mother—child pairs gathered data on sociodemographic characteristics, food security status, knowledge and practices concerning complementary feeding, food group intakes of children aged 6 to 23 months by 24-hour recalls, and children's anthropometric measurements. Twice a month for 6 months, women in the intervention group received an education session consisting of eight specific messages using Alive and Thrive posters and a demonstration and tasting of a local barley and maize porridge recipe containing 30% broad beans. The control group lived in a different area and had no intervention. Results At 6 months, knowledge and practice scores regarding complementary feeding were significantly improved ( p < .001) in the intervention group but not in the control group. The intervention resulted in improvement of children's dietary diversity, as well as mean intake of energy and selected nutrients, compared with children in the control group. Changes in height and weight did not differ between the two groups. Conclusions Community-based nutrition education over 6 months that included demonstration of a local porridge recipe with broad beans added improved the complementary feeding practices of caregivers and the nutritional status of their young children.

scholarly journals SMS behaviour change communication and eVoucher interventions to increase uptake of cervical cancer screening in the Kilimanjaro and Arusha regions of Tanzania: a randomised, double-blind, controlled trial of effectiveness

2019 ◽  
Vol 5 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Erica Erwin ◽  
Kristan J Aronson ◽  
Andrew Day ◽  
Ophira Ginsburg ◽  
Godwin Macheku ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Behaviour Change ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Behaviour Change Communication ◽  
Change Communication ◽  
Catchment Areas

BackgroundCervical cancer, although almost entirely preventable through cervical cancer screening (CCS) and human papillomavirus vaccination, is the leading cause of cancer deaths among women in Tanzania. Barriers to attending CCS include lack of awareness of CCS, affordability concerns regarding screening and travel cost. We aimed to compare the effectiveness of SMS (short message service) behaviour change communication (BCC) messages and of SMS BCC messages delivered with a transportation electronic voucher (eVoucher) on increasing uptake of CCS versus the control group.MethodsDoor-to-door recruitment was conducted between 1 February and 13 March 2016 in randomly selected enumeration areas in the catchment areas of two hospitals, one urban and one rural, in Northern Tanzania. Women aged 25–49 able to access a mobile phone were randomised using a computer-generated 1:1:1 sequence stratified by urban/rural to receive either (1) 15 SMS, (2) an eVoucher for return transportation to CCS plus the same SMS, or (3) one SMS informing about the nearest CCS clinic. Fieldworkers and participants were masked to allocation. All areas received standard sensitisation including posters, community announcements and sensitisation similar to community health worker (CHW) sensitisation. The primary outcome was attendance at CCS within 60 days of randomisation.FindingsParticipants (n=866) were randomly allocated to the BCC SMS group (n=272), SMS + eVoucher group (n=313), or control group (n=281), with 851 included in the analysis (BCC SMS n=272, SMS + eVoucher n=298, control group n=281). By day 60 of follow-up, 101 women (11.9%) attended CCS. Intervention group participants were more likely to attend than control group participants (SMS + eVoucher OR: 4.7, 95% CI 2.9 to 7.4; SMS OR: 3.0, 95% CI 1.5 to 6.2).Trial registration numberNCT02680613.

scholarly journals Scaled-Up Nutrition Education on Pulse-Cereal Complementary Food Practice in Ethiopia: A Cluster-Randomized Trial

2020 ◽  
Author(s):  
Getenesh Berhanu Teshome ◽  
Susan J. Whiting ◽  
Timothy J. Green ◽  
Demelash Mulualem ◽  
Carol J. Henry
Keyword(s):  
Nutritional Status ◽  
Nutrition Education ◽  
Weight Status ◽  
Dietary Diversity ◽  
Randomized Study ◽  
Intervention Group ◽  
Complementary Food ◽  
Southern Ethiopia ◽  
Control Group ◽  
Cluster Randomized

Abstract Background Improving children's weight status through nutrition education (NE) for mothers about using pulses in complementary feeding has been demonstrated in pilot studies, but no effect on stunting was reported. The aim of the study was to evaluate the effectiveness of a 9-month pulse-nutrition education program on mothers' knowledge, attitude, and practices (KAP) towards pulses, as well as its impact on children's dietary diversity, and nutritional status. The NE was delivered by Health Extension Workers (HEWs). Methods A cluster randomized study was employed for the community-based interventional study. Twelve randomly selected villages in Sidama Zone, Southern Ethiopia were included in the study. A total of 772 mother-child pairs involved in the study; where 386 mother-child pairs in the intervention group received additional messages about pulse-cereal complementary food, and 386 pairs (the control) received only routine health education for 9 months. A survey on mothers’ KAP and anthropometric measurements of the children were taken at baseline, midline, and endline. Results At baseline and endline, maternal KAP and the dietary diversity score of the children (mean age at endline 18.8 ± 2.9 mo) were assessed. Results : Intervention mothers’ KAP improved ( p <0.001) at midline and endline compared to that of the control group, as did frequency of pulse consumption and DDS among children. At 9 months, the prevalence of stunting, wasting, and underweight was significantly reduced in the intervention group compared to the control group ( p =0.001). Conclusions NE delivered by HEWs improved KAP of mothers regarding pulse consumption and dietary diversity of children led to improved nutritional status of the children. Training HEWs on the use of pulses for CF may be an effective way to improve the health of children in Ethiopian communities.

scholarly journals The Effect of Providing Eggs Early in Complementary Feeding on Energy Intake and Dietary Diversity: The Mazira Project Randomized Controlled Trial

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 863-863
Author(s):  
Chessa Lutter ◽  
Bess Caswell ◽  
Charles Arnold ◽  
Lora Iannotti ◽  
Elizabeth Prado ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Young Children ◽  
Energy Intake ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Minimum Dietary Diversity

Abstract Objectives Complementary feeding diets in low- and middle-income countries are usually inadequate to meet requirements for healthy growth and development. Food-based interventions may prevent nutrient inadequacies provided they do not replace other nutrient-rich foods. They may also be more sustainable than manufactured food supplements. We describe the contribution of daily egg supplementation to usual energy intake, usual energy intake by food group, and minimum dietary diversity of rural Malawian infants and young children. Methods We conducted a randomized controlled trial in rural Malawi in which 660 children aged 6 to 9 months were randomly allocated to receive an egg a day for 6 months or to a control group. Dietary intake of foods and drinks was assessed at baseline, 3-month midline, and 6-month endline visits using a tablet-based mulitpass 24-hour recall. Up to two repeat recalls were collected at each timepoint in a subsample of 100 children per intervention group. Results The intervention resulted in an increased usual energy intake in the intervention group of 30 kcal at midline (P = 0.128) and 36 kcal at endline (P = 0.087). It also resulted in a 7 kcal displacement of legumes and nuts in children at endline (P = 0.059). At midline and endline, usual energy intake from eggs was about 30 kcal higher in the egg group compared to controls (P &lt; 0.0001). Compared to controls, children in the egg group were over 9 times more likely to consume eggs at midline and endline. At midline and endline more than 80% of children in the egg group consumed a minimally diverse diet compared to 53% at midline and 60% at endline in the control group. Conclusions Mothers in the egg group fed eggs to young children on a regular basis without substantial displacement of other nutrient-rich complementary foods. The intervention resulted in higher energy intake from eggs, greater dietary diversity, and an increased percentage of children meeting a minimum dietary diversity cutoff. Funding Sources Bill & Melinda Gates Foundation.

scholarly journals Effect of Behaviour Change Communication on Metabolic Syndrome and Its Markers among Ethiopian Adults: Randomized Controlled Trial

2020 ◽  
Author(s):  
Makeda Sinaga ◽  
David Lindstrom ◽  
Melese Sinaga Teshome ◽  
Tilahun Yemane ◽  
Elsah Tegene ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Behaviour Change ◽  
Intervention Group ◽  
Mean Difference ◽  
Behaviour Change Communication ◽  
Control Groups ◽  
Difference In Differences ◽  
Change Communication ◽  
The Mean

Abstract Background: Metabolic syndrome is a global public health problem affecting both developing and developed countries with major consequences on human health, social and economic development. In Ethiopia although there is an increase in the prevalence of metabolic Syndrome due to epidemiologic transition, there is no study that evaluated the effect of interventions. This study aimed to assess the effect of nutrition behaviour change communication on metabolic syndrome and its markers. Method: A individually randomized controlled trial was conducted among Ethiopian adults working in Jimma University from mid of September 2015 to December 30, 2015. A total of 224 participants were randomly allocated into intervention (n=112) and controls (n=112) groups. The list of administrative and academic staff involved in the baseline survey was used as a sampling frame. Data on socio-demographic, anthropometric, biochemical and clinical parameters were collected using trained data collectors. Difference in the differences in metabolic syndrome and its components between baseline and end line were compared by the intervention status. Multivariable logistic and linear regression models were used to isolate independent predictors of metabolic syndrome and its components, respectively. Results: Overall, there was significant difference (P<0.001) in the prevalence of metabolic syndrome between intervention (11.6%) and control groups (37.5%) on the end line survey. On multivariable logistic regression analyses, control groups were 8.5 times more likely to have metabolic syndrome compared to intervention groups (AOR=8.53, 95%CI: 3.60, 20.21, P <0.001). There was a significant mean difference in differences in most components of metabolic syndrome and other lipid profiles except HDL (P=0.717) in the intervention group. The mean difference in differences in waist circumference was 6.3 cm (P<0.001), while that of systolic blood pressure (BP) and diastolic BP were 6.1 mmHg (P< 0.001) and 3.6 mmHg (P=0.001), respectively. Likewise the difference of differences between intervention and control groups was 30.7 mg/dl (P<0.001) for T.Cholesterol, 55.5 mg/dl (P<0.001) for triglycerides, 21.9 mg/dl (P=0.015) for LDL and 22.2 mg/dl (P<0.001) for fasting blood sugar. Further multivariable linear regression analyses showed that after adjusting for many variables, there was a significant difference in difference between intervention groups in components of metabolic syndrome. For the intervention group the mean difference in differences was 6.1cm (β=6.1, P<0.001) for waist circumference and 4.2 mm Hg (β=4.2, P<0.05) for diastolic blood pressure and 6.5 mmHg (β=6.5, P<0.001) for systolic blood pressure compared with controls. Similarly, the mean difference in differences was higher in the intervention group by 19.9 mg/dl (β=19.9, P<0.05) for FBS, 57.5 mg/dl for TG (β=57.5, P<0.05), 24.40 mg/dl for LDL (β=24.4, P<0.05) and 30.9mg/dl for T.Cholestrol (β=30.9, P<0.001). This trial is retrospectively registered on Pan African Clinical Trial Registration with unique identification number of PACTR202003465339638. Conclusion: There was strong positive effect of behaviour change communication on metabolic syndrome and its components. The results imply the need for enhancing behaviour change interventions using various strategies at the community and health facility levels to curb the emerging burden of chronic non-communicable diseases in Ethiopia. Future research should examine the sustainability of such behaviour changes using a community based study.

scholarly journals Effect of Behaviour Change Communication on Metabolic Syndrome and Its Markers among Ethiopian Adults: Randomized Controlled Trial

2020 ◽  
Author(s):  
Makeda Sinaga ◽  
David Lindstrom ◽  
Melese Sinaga Teshome ◽  
Tilahun Yemane ◽  
Elsah Tegene ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Behaviour Change ◽  
Intervention Group ◽  
Mean Difference ◽  
Behaviour Change Communication ◽  
Control Groups ◽  
Difference In Differences ◽  
Change Communication ◽  
The Mean

Abstract Background: Metabolic syndrome (MetS) is a global public health problem with dire consequences on health, social and economic development. In Ethiopia although MetS has been increasing since the past few decades, there is no study that evaluated the effect of interventions. This study aimed to assess the effect of nutrition behaviour change communication on MetS and its markers.Methods: An individually randomized controlled trial was conducted using a parallel design among Ethiopian adults working in Jimma University from of September 1, 2015 to January 15, 2016 for the intervention group. A sample size of 230 was calculated using GPower 3.0 assuming an effect size of 0.4, margin of error of 0.05, power of 81%, with an intervention to control ratio of 1. The eligibility criteria include: not having any physical disability and having baseline data.. Study population was randomly selected from eligible population (n=704) and allocated into intervention (n=115) and controls (n=115) groups using simple randomization method. The intervention arm was given behaviour change communication using power point presentation, facilitated group discussion on MetS and effective dietary and life style behaviours every month for three months. An Amharic language brochure was also given after the first training and a text message reminder about key behaviours was sent to each individual every two weeks. Data on background characteristic, anthropometry, and clinical parameters and blood samples were collected by trained data collectors in the Nutrition and Dietetic Laboratory of Jimma University. The laboratory analyses were done in Mettu Karl Hospital for lipid profiles and in JUCAN project laboratory for fasting blood sugar. Primary outcomes of the study were metabolic syndrome and its components. Difference in the differences of metabolic syndrome components between baseline and endline (end of intervention) were compared by the intervention status. Multivariable linear regression models were fitted to isolate independent predictors of difference in differences of metabolic syndrome components. A multivariable logistic regression model was used to identify preditors of MetS at the end line.Results: Overall, there was a significant difference (P<0.001) in the prevalence of MetS between intervention (11.6%) and control groups (37.5%) on the end line survey. On multivariable logistic regression analyses, control groups were 8.5 times more likely to have MetS compared to intervention groups (AOR=8.53, 95%CI: 3.60, 20.21, P <0.001). There was a significant mean difference in differences in most components of metabolic syndrome and other lipid profiles except HDL (P=0.717) in the intervention group. The mean difference in differences in waist circumference was 6.3 cm (P<0.001), while that of systolic blood pressure (BP) and diastolic BP were 6.1 mmHg (P< 0.001) and 3.6 mmHg (P=0.001), respectively. Likewise the difference of differences between intervention and control groups was 30.7 mg/dl (P<0.001) for T.Cholestrol, 55.5 mg/dl (P<0.001) for triglycerides, 21.9 mg/dl (P=0.015) for LDL and 22.2 mg/dl (P<0.001) for fasting blood sugar. Further multivariable linear regression analyses showed that after adjusting for many variables, there was a significant difference in difference between intervention groups in the components of MetS. For the intervention group the mean difference in differences was 6.1cm (β=6.1, P<0.001) for waist circumference and 4.2 mm Hg (β=4.2, P<0.05) for diastolic blood pressure and 6.5 mmHg (β=6.5, P<0.001) for systolic blood pressure compared with controls. Similarly, the mean difference in differences was higher in the intervention group by 19.9 mg/dl (β=19.9, P<0.05) for FBS, 57.5 mg/dl for TG (β=57.5, P<0.05), 24.40 mg/dl for LDL (β=24.4, P<0.05) and 30.9mg/dl for T.Cholestrol (β=30.9, P<0.001). This trial is retrospectively registered on Pan African Clinical Trial Registration with unique identification number of PACTR202003465339638.Conclusion: The study demonstrated that nutrition and life style behaviour change communication has a significant positive effect in reducing metabolic syndrome and its components. Although the study was conducted in an institutional set up, the results imply that enhancing such an interevention have a great potential to curb the emerging burden of chronic non-communicable diseases in Ethiopia. Future research should examine how sustainable such behaviour changes are using a community based study.

scholarly journals Scaled-Up Nutrition Education on Pulse-Cereal Complementary Food Practice in Ethiopia: A Cluster-Randomized Trial

2020 ◽  
Author(s):  
Getenesh Berhanu Teshome ◽  
Susan J. Whiting ◽  
Timothy J. Green ◽  
Demelash Mulualem ◽  
Carol J. Henry
Keyword(s):  
Nutritional Status ◽  
Nutrition Education ◽  
Weight Status ◽  
Dietary Diversity ◽  
Intervention Group ◽  
Complementary Food ◽  
Control Group ◽  
Dietary Diversity Score ◽  
Cluster Randomized ◽  
The Impact

Abstract Background: Improving children's weight status through nutrition education (NE) for mothers about using pulses in complementary feeding has been demonstrated in pilot studies, but no effect on stunting was reported. The aim of the study was to assess the impact of a 9-month pulse-nutrition education program on improving mothers' knowledge, attitude, and practices (KAP) towards pulses, as well as its effect on children's diet diversity, and nutritional status. The NE was delivered by Health Extension Workers (HEWs). Methods: A cluster randomized study was employed for the community-based interventional study. Twelve randomly selected villages in Sidama Zone, Southern Ethiopia were included in the study. A total of 772 mother-child pairs involved in the study; where 386 mother-child pairs in the intervention group received additional messages about pulse-cereal complementary food, and 386 pairs (the control) received only routine health education for 9 months. A survey on mothers’ KAP and anthropometric measurements of the children were taken at baseline, midline, and endline. ANOVA and descriptive statistics were used to analyzed data. Results: At baseline and endline, maternal KAP and the dietary diversity score of the children (mean age at endline 18.8 ± 2.9 mo) were assessed. Intervention mothers’ KAP improved (p<0.001) at midline and endline compared to that of the control group, as did frequency of pulse consumption and Dietary Diversity Score (DDS) among children. At 9 months, the prevalence of stunting, wasting, and underweight was significantly reduced in the intervention group compared to the control group (p=0.001). Conclusions: NE delivered by HEWs improved KAP of mothers regarding pulse consumption and dietary diversity of children led to improved nutritional status of the children. Training HEWs on the use of pulses for complementary food may be an effective way to improve the health of children in Ethiopian communities. Trial Registration: Clinicaltrials.gov #NCT02638571

scholarly journals Social and behaviour change communication to improve child feeding practices in Ethiopia

2021 ◽  
Author(s):  
Abdulhalik Workicho ◽  
Sibhatu Biadgilgn ◽  
Meghan Kershaw ◽  
Rahel Gizaw ◽  
Jennifer Stickland ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Feeding Practices ◽  
Behaviour Change Communication ◽  
Child Feeding ◽  
Change Communication ◽  
Child Feeding Practices

scholarly journals Scaled-up nutrition education on pulse-cereal complementary food practice in Ethiopia: a cluster-randomized trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Getenesh Berhanu Teshome ◽  
Susan J. Whiting ◽  
Timothy J. Green ◽  
Demmelash Mulualem ◽  
Carol J. Henry
Keyword(s):  
Nutritional Status ◽  
Nutrition Education ◽  
Dietary Diversity ◽  
Intervention Group ◽  
Complementary Food ◽  
Control Group ◽  
Dietary Diversity Score ◽  
End Point ◽  
Cluster Randomized ◽  
The Impact

Abstract Background Improving children’s weight status through nutrition education (NE) for mothers about using pulses in complementary feeding has been demonstrated in pilot studies, but no effect on stunting was reported. The aim of the study was to assess the impact of a 9-month pulse-nutrition education program on improving mothers’ knowledge, attitude, and practices (KAP) towards pulses, as well as its effect on children’s diet diversity, and nutritional status. The NE was delivered by Health Extension Workers (HEWs). Methods A cluster randomized study was employed for the community-based interventional study. Twelve randomly selected villages in Sidama Zone, Southern Ethiopia were included in the study. A total of 772 mother-child pairs involved in the study; where 386 mother-child pairs in the intervention group received additional messages about pulse-cereal complementary food, and 386 pairs (the control) received only routine health education for 9 months. A survey on mothers’ KAP and anthropometric measurements of the children were taken at baseline, midpoint, and end point. ANOVA and descriptive statistics were used to analyzed data. Results At baseline and end point, maternal KAP and the dietary diversity score of the children (mean age at end point 18.8 ± 2.9 mo) were assessed. Intervention mothers’ KAP improved (p < 0.001) at midpoint and end point compared to that of the control group, as did frequency of pulse consumption and Dietary Diversity Score (DDS) among children. At 9 months, the prevalence of stunting, wasting, and underweight was significantly reduced in the intervention group compared to the control group (p = 0.001). Conclusions NE delivered by HEWs improved KAP of mothers regarding pulse consumption and dietary diversity of children led to improved nutritional status of the children. Training HEWs on the use of pulses for complementary food may be an effective way to improve the health of children in Ethiopian communities. Trial registration Clinicaltrials.gov #NCT02638571. Date of registration: 12/18/2015. Prospectively registered.

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