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Feng L, Xiang D, Wu Y. Clinical effects and safety of semi-solid feeds in tube-fed patients: a meta-analysis and systematic review. Front Nutr 2024; 11:1331904. [PMID: 38725574 PMCID: PMC11079128 DOI: 10.3389/fnut.2024.1331904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/20/2024] [Indexed: 05/12/2024] Open
Abstract
Background Enteral nutrition is a very important form of treatment for critically ill patients. This meta-analysis aimed to evaluate the clinical effects and safety of semi-solid feeds in tube-fed patients. Methods Two researchers searched PubMed, clinical trials, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Weipu databases for randomized controlled trials (RCTs) on the clinical effects and safety of semi-solid feeds in tube-fed patients until 10 October 2023. The quality evaluation tool recommended by the Cochrane Library was used to evaluate the quality of included RCTs. RevMan 5.4 software was used for data analysis. Results A total of eight RCTs involving 823 tube-fed patients were included in this meta-analysis. A synthesized outcome indicated that semi-solid feeds reduced the incidence of diarrhea (RR = 0.32, 95%CI:0.20-0.50, P < 0.001), vomiting (RR = 0.31, 95%CI:0.15-0.64, P = 0.002), abdominal distension (RR = 0.41, 95%CI:0.22-0.76, P = 0.005), length of intensive care unit (ICU) stay (MD = -3.61, 95%CI: -6.74 to -0.48, P = 0.02), and length of hospital stay (MD = -7.14, 95%CI: -10.31 to -3.97, P < 0.01) in tube-fed patients. Enteric feeding had no effect on the 30-day mortality (RR = 0.55, 95%CI: 0.19-1.56, P = 0.26). No publication bias was detected by the Egger's test results (all P > 0.05). Conclusion Semi-solid feeds are beneficial in reducing the incidence of diarrhea, abdominal distension, vomiting, and hospital stay. More high-quality studies are needed in the future to verify the effects of semi-solid feeds on mortality.
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Affiliation(s)
- Limei Feng
- Department of Neurosurgery, Wuxi No. 5 Affiliated Hospital of Jiangnan University, Wuxi No. 5 People's Hospital, Wuxi, Jiangsu, China
| | - Dingchao Xiang
- Department of Neurosurgery, Wuxi No. 5 Affiliated Hospital of Jiangnan University, Wuxi No. 5 People's Hospital, Wuxi, Jiangsu, China
| | - Youping Wu
- Department of Neurosurgical Intensive Care Unit, Wuxi Taihu Hospital, Wuxi Clinical College of Anhui Medical University, Wuxi, Jiangsu, China
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Kim SS, Ouédraogo CT, Zagré RR, Ganaba R, Zafimanjaka MG, Tharaney M, Menon P. Multiple modifiable maternal, household and health service factors are associated with maternal nutrition and early breastfeeding practices in Burkina Faso. MATERNAL & CHILD NUTRITION 2022; 19:e13457. [PMID: 36373770 PMCID: PMC9749589 DOI: 10.1111/mcn.13457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/12/2022] [Accepted: 10/26/2022] [Indexed: 11/16/2022]
Abstract
Low coverage of effective nutrition interventions in many high-burden countries, due to service provision and demand factors, result in poor uptake of recommended practices and nutrition outcomes. We examined the factors that influence maternal nutrition and early breastfeeding practices and determined the extent that the key factors could improve these practices in two regions in Burkina Faso. We used household survey data among pregnant (n = 920) and recently delivered women (n = 1840). Multivariable regression analyses were conducted to identify the determinants of a diverse diet and iron-folic acid (IFA) supplement consumption, weight monitoring during pregnancy and early initiation of breastfeeding (EIBF). Population attributable risk analysis was used to estimate how much the outcomes can be improved under optimal conditions of interventions that address the modifiable determinants. During pregnancy, 21% of women achieved minimum diet diversity (MDD-W), 70% consumed 90+ IFA tablets and 65% were weighed 4+ times; EIBF was 40%. Nutrition knowledge was associated with MDD-W (odds ratio [OR]: 3.2), 90+ IFA (OR: 1.5) and EIBF (OR: 1.9). Positive social norms and family support were associated with 90+ IFA (OR: 1.5). Early and 4+ ANC visits were associated with 90+ IFA (OR: 1.5 and 10) and 4+ weight monitoring (OR: 6.2). Nutrition counselling was associated with 90+ IFA (OR: 2.5) and EIBF (OR: 1.5). Under optimal programme conditions, 41% of women would achieve MDD-W, 93% would consume 90+ IFA, 93% would be weighed 4+ times and 57% would practice EIBF. Strengthening the delivery and uptake of interventions targeted at these modifiable factors has the potential to improve maternal nutrition practices.
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Affiliation(s)
- Sunny S. Kim
- Poverty, Health and Nutrition DivisionInternational Food Policy Research Institute (IFPRI)WashingtonDistrict of ColumbiaUSA
| | | | - Rock R. Zagré
- Poverty, Health and Nutrition DivisionIFPRIDakarSenegal
| | | | | | | | - Purnima Menon
- Poverty, Health and Nutrition DivisionIFPRINew DelhiIndia
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Part C, Filippi V, Cresswell JA, Ganaba R, Hajat S, Nakstad B, Roos N, Kadio K, Chersich M, Lusambili A, Kouanda S, Kovats S. How do high ambient temperatures affect infant feeding practices? A prospective cohort study of postpartum women in Bobo-Dioulasso, Burkina Faso. BMJ Open 2022; 12:e061297. [PMID: 36198451 PMCID: PMC9535177 DOI: 10.1136/bmjopen-2022-061297] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To examine the effects of high ambient temperature on infant feeding practices and childcare. DESIGN Secondary analysis of quantitative data from a prospective cohort study. SETTING Community-based interviews in the commune of Bobo-Dioulasso, Burkina Faso. Exclusive breastfeeding is not widely practised in Burkina Faso. PARTICIPANTS 866 women (1:1 urban:rural) were interviewed over 12 months. Participants were interviewed at three time points: cohort entry (when between 20 weeks' gestation and 22 weeks' postpartum), three and nine months thereafter. Retention at nine-month follow-up was 90%. Our secondary analysis focused on postpartum women (n=857). EXPOSURE Daily mean temperature (°C) measured at one weather station in Bobo-Dioulasso. Meteorological data were obtained from publicly available archives (TuTiempo.net). PRIMARY OUTCOME MEASURES Self-reported time spent breastfeeding (minutes/day), exclusive breastfeeding of infants under 6 months (no fluids other than breast milk provided in past 24 hours), supplementary feeding of infants aged 6-12 months (any fluid other than breast milk provided in past 24 hours), time spent caring for children (minutes/day). RESULTS The population experienced year-round high temperatures (daily mean temperature range=22.6°C-33.7°C). Breastfeeding decreased by 2.3 minutes/day (95% CI -4.6 to 0.04, p=0.05), and childcare increased by 0.6 minutes/day (0.06 to 1.2, p=0.03), per 1°C increase in same-day mean temperature. Temperature interacted with infant age to affect breastfeeding duration (p=0.02), with a stronger (negative) association between temperature and breastfeeding as infants aged (0-57 weeks). Odds of exclusive breastfeeding very young infants (0-3 months) tended to decrease as temperature increased (OR=0.88, 0.75 to 1.02, p=0.09). There was no association between temperature and exclusive breastfeeding at 3-6 months or supplementary feeding (6-12 months). CONCLUSIONS Women spent considerably less time breastfeeding (~25 minutes/day) during the hottest, compared with coolest, times of the year. Climate change adaptation plans for health should include advice to breastfeeding mothers during periods of high temperature.
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Affiliation(s)
- Chérie Part
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Véronique Filippi
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Jenny A Cresswell
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Rasmané Ganaba
- Agence de Formation de Recherche et d'Expertise en Santé pour l'Afrique (AFRICSanté), Bobo-Dioulasso, Burkina Faso
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Britt Nakstad
- Division of Child and Adolescent Health, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Pediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana
| | - Nathalie Roos
- Department of Medicine, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
| | - Kadidiatou Kadio
- Departement Biomédical et Santé Publique, Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Matthew Chersich
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Adelaide Lusambili
- Department of Population Health, Medical College, Aga Khan University, Nairobi, Kenya
| | - Seni Kouanda
- Departement Biomédical et Santé Publique, Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Sari Kovats
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
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Ninamou NR, Dupuis JB, Zagré NM, Daffé M, Blaney S. A tool to assess underlying factors to water provision among Guinean children. MATERNAL AND CHILD NUTRITION 2021; 18:e13249. [PMID: 34309178 PMCID: PMC8710118 DOI: 10.1111/mcn.13249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/19/2021] [Accepted: 07/03/2021] [Indexed: 11/30/2022]
Abstract
In many countries, water is provided to children under 6 months of age (CU6M) in addition to breast milk (BM), hence increasing the risk of child mortality and morbidity. Factors related to this practice have not been thoroughly investigated either a tool to assess them. Based on the extended theory of planned behaviour (eTPB), we aim to develop and validate a questionnaire to assess psychosocial and environmental factors that may contribute/limit the water provision in addition to BM by mothers of CU6M in the Republic of Guinea. A three‐step process was used. Ten focus group discussions (FGDs) were held to identify salient beliefs related to each of the four constructs of the eTPB. Data from FGDs were used to develop a questionnaire composed of 88 items administered to 428 mothers. Exploratory factor analyses were conducted to identify latent factors for each construct. A shorter version of the questionnaire was administered to another sample of 300 mothers. Confirmatory factor analyses (CFAs) were performed. Hancock and Mueller's H reliability indices were computed on final models to assess the tool's validity and reliability. The final questionnaire included 57 items. For all four final models, most criteria for fit indices of CFA were generally met. Reliability coefficients were all equal to or above 0.90 for each construct. This research offers a tool that could be used to investigate determinants of water provision besides BM among mothers of CU6M. Further validation in other contexts is warranted.
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Affiliation(s)
- Nèmanan Richard Ninamou
- École des sciences des aliments, de nutrition et d'études familiales, Université de Moncton, Moncton, New Brunswick, Canada
| | - Jérémie B Dupuis
- Faculté des sciences de l'éducation, Université de Moncton, Moncton, New Brunswick, Canada
| | | | - Mamady Daffé
- Division Alimentation et Nutrition, Ministry of Health, Conakry, Guinea
| | - Sonia Blaney
- École des sciences des aliments, de nutrition et d'études familiales, Université de Moncton, Moncton, New Brunswick, Canada
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Factors Affecting Complementary Feeding of Infants. A Pilot Study Conducted after the Introduction of New Infant Feeding Guidelines in Poland. Nutrients 2020; 13:nu13010061. [PMID: 33379149 PMCID: PMC7823849 DOI: 10.3390/nu13010061] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/22/2020] [Accepted: 12/24/2020] [Indexed: 01/07/2023] Open
Abstract
Adequate nutrition in the first year of life is the key prerequisite for a child’s healthy growth and development. The success of complementary feeding is influenced by various factors, including the family’s socioeconomic status, maternal age, place of residence and educational level, older children and duration of breastfeeding. Modified infant feeding guidelines were introduced in Poland in 2016. The aim of this study was to identify the factors that exert the greatest influence on infant feeding practices in the Polish population. A thorough understanding of maternal factors that are responsible for undesirable feeding practices is required to improve the mothers’ knowledge and to promote healthy feeding practices. This study was carried out in March–June 2018 and between November 2018 and March 2019 in the Region of Lublin in southeastern Poland. The mothers of children aged 9–14 months, who had introduced complementary foods, were invited to the study. A total of 441 mothers agreed to participate, and 289 of them fully and correctly completed the questionnaires. Logistic regression models were developed to assess the association between maternal factors, such as age, educational level and the nutrition knowledge score, and introduction of solid foods. The infant’s sex and birth weight and the mother’s place of residence had no significant influence on the duration of breastfeeding. The mother’s age and educational level, the number of children in the family and maternal nutrition knowledge scores contributed to significant differences in breastfeeding duration. Older mothers (30–34 years vs. 25–29 years, p = 0.001), better educated mothers (university vs. secondary school education p = 0.002) and mothers with one or two children exclusively breastfed their children for longer (17 weeks vs. 11 weeks, p = 0.002) than younger mothers with secondary school education and more than three children. Exclusive formula feeding was significantly correlated with untimely introduction of solid foods compared to exclusive breastfeeding (13 weeks vs. 19.7 weeks, p = 0.001). Mothers with nutrition knowledge scores in the upper tertile were more likely to adapt food consistency to the skills manifested by the child (88%) (OR = 1.88; Cl: 1.53–2.26, p < 0.05) and were less likely to delay the introduction of new foods that required chewing and biting (84%) (OR = 0.22; Cl: 0.09–0.34, p < 0.05) than mothers with nutrition knowledge scores in the bottom tertile. Maternal age, educational level and nutrition knowledge significantly increased the age at which infants were introduced to solid foods and the correct identification of the signs indicative of the child’s readiness to explore new tastes and foods with a new consistency. The above factors contributed to delayed, but not untimely, introduction of complementary foods (6 months of age or later), including gluten.
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Yapa HM, Drayne R, Klein N, De Neve JW, Petoumenos K, Jiamsakul A, Herbst C, Pillay D, Post FA, Bärnighausen T. Infant feeding knowledge and practice vary by maternal HIV status: a nested cohort study in rural South Africa. Int Breastfeed J 2020; 15:77. [PMID: 32873311 PMCID: PMC7466779 DOI: 10.1186/s13006-020-00317-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 08/10/2020] [Indexed: 11/10/2022] Open
Abstract
Background We investigate whether correct infant feeding knowledge and practice differ by maternal HIV status in an era of evolving clinical guidelines in rural South Africa. Methods This cohort study was nested within the MONARCH stepped-wedge cluster-randomised controlled trial (www.clinicaltrials.gov: NCT02626351) which tested the impact of continuous quality improvement on antenatal care quality at seven primary care clinics in KwaZulu-Natal, from July 2015 to January 2017. Women aged ≥18 years at delivery were followed up to 6 weeks postpartum. Clinical data were sourced from routine medical records at delivery. Structured interviews at early postnatal visits and the 6-week postnatal immunisation visit provided data on infant feeding knowledge and feeding practices respectively. We measured the relationship between maternal HIV status and (i) correct infant feeding knowledge at the early postnatal visit; and (ii) infant feeding practice at 6 weeks, using Poisson and multinomial regression models, respectively. Results We analysed data from 1693 women with early postnatal and 471 with 6-week postnatal interviews. HIV prevalence was 47% (95% confidence interval [CI] 42, 52%). Women living with HIV were more knowledgeable than women not living with HIV on correct infant feeding recommendations (adjusted risk ratio, aRR, 1.08, p < 0.001). More women living with HIV (33%; 95% CI 26, 41%) were not breastfeeding than women not living with HIV (15%; 95% CI 11, 21%). However, among women who were currently breastfeeding their infants, fewer women living with HIV (5%; 95% CI 2, 9%) mixed fed their babies than women not living with HIV (21%; 95% CI 14, 32%). In adjusted analyses, women living with HIV were more likely to avoid breastfeeding (adjusted relative risk ratio, aRRR, 2.78, p < 0.001) and less likely to mixed feed (aRRR 0.22, p < 0.001) than women not living with HIV. Conclusions Many mothers in rural South Africa still do not practice exclusive breastfeeding. Women living with HIV were more knowledgeable but had lower overall uptake of breastfeeding, compared with women not living with HIV. Women living with HIV were also more likely to practice exclusive breastfeeding over mixed feeding if currently breastfeeding. Improved approaches are needed to increase awareness of correct infant feeding and exclusive breastfeeding uptake.
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Affiliation(s)
- H Manisha Yapa
- The Kirby Institute, University of New South Wales Sydney, Sydney, Australia. .,Africa Health Research Institute (AHRI), KwaZulu-Natal, South Africa.
| | - Róisín Drayne
- School of Population Health & Environmental Sciences, King's College London, London, UK
| | - Nigel Klein
- Africa Health Research Institute (AHRI), KwaZulu-Natal, South Africa.,UCL Great Ormond Street Institute of Child Health, London, UK
| | - Jan-Walter De Neve
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Kathy Petoumenos
- The Kirby Institute, University of New South Wales Sydney, Sydney, Australia
| | - Awachana Jiamsakul
- The Kirby Institute, University of New South Wales Sydney, Sydney, Australia
| | - Carina Herbst
- Africa Health Research Institute (AHRI), KwaZulu-Natal, South Africa
| | - Deenan Pillay
- Africa Health Research Institute (AHRI), KwaZulu-Natal, South Africa.,Division of Infection & Immunity, University College London, London, UK
| | - Frank A Post
- King's College Hospital NHS Foundation Trust, London, UK
| | - Till Bärnighausen
- Africa Health Research Institute (AHRI), KwaZulu-Natal, South Africa.,Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA.,Institute for Global Health, University College London, London, UK
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Cresswell JA, Ganaba R, Sarrassat S, Somé H, Diallo AH, Cousens S, Filippi V. The effect of the Alive & Thrive initiative on exclusive breastfeeding in rural Burkina Faso: a repeated cross-sectional cluster randomised controlled trial. LANCET GLOBAL HEALTH 2020; 7:e357-e365. [PMID: 30784636 PMCID: PMC6379822 DOI: 10.1016/s2214-109x(18)30494-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 10/15/2018] [Accepted: 10/25/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND The benefits of exclusive breastfeeding on mortality, health, and development of children have been well documented. In Burkina Faso, the Alive & Thrive initiative combined interpersonal communication and community mobilisation activities with the aim of improving knowledge, beliefs, skills, and, ultimately, breastfeeding outcomes. The objective of this study was to determine the effect of the Alive & Thrive initiative on exclusive breastfeeding in Boucle du Mouhoun, Burkina Faso. METHODS We did a cluster-randomised trial with data collected with two independent, population-representative, cross-sectional surveys: a baseline survey done before the start of the initiative implementation and an endline survey done 2 years later. Rural villages in Boucle du Mouhoun, Burkina Faso, were randomly allocated by use of computer generated pseudo-random numbers, and women were eligible for participation if they had a livebirth in the 12 months preceding the survey and resided in a village selected for the study. The primary outcome was exclusive breastfeeding among infants younger than 6 months. Masking was not possible for the intervention implementation. All women who participated in the trial were included in the analysis population. The trial is registered with ClinicalTrials.gov, number NCT02435524. FINDINGS Between June 2 and July 28, 2015, 2288 mothers participated in the baseline survey and between June 12 and July 25, 2017, 2253 mothers participated in the endline survey. At endline, there was a risk difference of 38·9% (95% CI 32·2-45·6, p<0·001) between the reported prevalence of exclusive breastfeeding in the intervention group and that of the control group. INTERPRETATION A multidimensional intervention deliverable at scale in a low-income setting resulted in substantial increases in mothers' optimal breastfeeding knowledge and beliefs and in reported exclusive breastfeeding practices. However, it is possible that the findings might have been influenced by social desirability bias. FUNDING Bill & Melinda Gates Foundation, London School of Hygiene & Tropical Medicine.
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Affiliation(s)
- Jenny A Cresswell
- MARCH Centre for Maternal, Adolescent, Reproductive & Child Health, London School of Hygiene & Tropical Medicine, London, UK.
| | | | - Sophie Sarrassat
- MARCH Centre for Maternal, Adolescent, Reproductive & Child Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Henri Somé
- AFRICSanté, Bobo-Dioulasso, Burkina Faso
| | - Abdoulaye Hama Diallo
- Centre MURAZ, Bobo-Dioulasso, Burkina Faso; Université Ouaga I Pr Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
| | - Simon Cousens
- MARCH Centre for Maternal, Adolescent, Reproductive & Child Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Veronique Filippi
- MARCH Centre for Maternal, Adolescent, Reproductive & Child Health, London School of Hygiene & Tropical Medicine, London, UK
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Tran NT, Seuc A, Coulibaly A, Landoulsi S, Millogo T, Sissoko F, Yameogo WME, Zan S, Cuzin-Kihl A, Kiarie J, Gaffield ME, Thieba B, Kouanda S. Post-partum family planning in Burkina Faso (Yam Daabo): a two group, multi-intervention, single-blinded, cluster-randomised controlled trial. LANCET GLOBAL HEALTH 2020; 7:e1109-e1117. [PMID: 31303298 DOI: 10.1016/s2214-109x(19)30202-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 04/09/2019] [Accepted: 04/24/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Post-partum family planning services can prevent maternal and child morbidity and mortality in low-resource settings. We assessed the effect of a family planning intervention package on modern contraceptive use at 12 months post partum in predominantly rural Burkina Faso. METHODS Yam Daabo was a two group, multi-intervention, single-blinded, cluster randomised controlled trial. Primary health-care centres were randomly allocated to intervention or control clusters in a 1:1 ratio with only data analysts masked to the allocation assignment. Interventions comprised refresher training for the provider, a counselling tool, supportive supervision, availability of contraceptive services 7 days a week, client appointment cards, and invitation letters for partners. The primary outcome was modern contraceptive prevalence at 12 months, and secondary outcomes were modern contraceptive prevalence at 6 weeks and 6 months post partum. Analysis was by modified intention to treat. Prevalence ratios were adjusted for cluster effects and baseline characteristics. This study was registered with the Pan-African Clinical Trials Registry (PACTR201609001784334). FINDINGS From July 27-Oct 17, 2016, eight clinics were randomised and 571 women were enrolled and allocated: 286 to four intervention clusters and 285 to four control clusters. Of these, 523 completed the 12-month study exit interview (260 in the intervention group, 263 in the control group) and 523 were included in the intention-to-treat analysis. At 12 months, modern contraceptive prevalence was 55% among women who received the package and 29% among those who received routine care in control clusters (adjusted prevalence ratio 1·79, 95% CI 1·30-2·47). Significant differences in modern contraceptive prevalence were also seen between intervention and control groups at 6 weeks (42% and 10%, respectively; adjusted prevalence ratio 3·88, 95% CI 1·46-10·35) and 6 months (59% and 24%, respectively; 2·31, 1·44-3·71). INTERPRETATION A package of six low-technology interventions, aimed at strengthening existing primary health-care services and enhancing demand for these services, can effectively increase modern contraceptive use for up to a year post partum in rural settings in Burkina Faso and has the potential to be suitable in similar settings in this country and others. FUNDING Government of France.
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Affiliation(s)
- Nguyen Toan Tran
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland; Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology, Sydney, Australia.
| | - Armando Seuc
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Abou Coulibaly
- Institut de Recherche en Sciences de la Santé and Institut Africain de Santé Publique, Ouagadougou, Burkina Faso
| | - Sihem Landoulsi
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Tieba Millogo
- Institut de Recherche en Sciences de la Santé and Institut Africain de Santé Publique, Ouagadougou, Burkina Faso
| | - Fatou Sissoko
- Institut de Recherche en Sciences de la Santé and Institut Africain de Santé Publique, Ouagadougou, Burkina Faso
| | - Wambi Maurice E Yameogo
- Institut de Recherche en Sciences de la Santé and Institut Africain de Santé Publique, Ouagadougou, Burkina Faso
| | - Souleymane Zan
- World Health Organization Country Office in Burkina Faso, Ouagadougou, Burkina Faso
| | - Asa Cuzin-Kihl
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - James Kiarie
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Mary Eluned Gaffield
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Blandine Thieba
- Unité de Formation et de Recherche en Sciences de la Santé, Ouagadougou University, Ouagadougou, Burkina Faso
| | - Seni Kouanda
- Institut de Recherche en Sciences de la Santé and Institut Africain de Santé Publique, Ouagadougou, Burkina Faso
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Suboptimal infant and young child feeding practices in rural Boucle du Mouhoun, Burkina Faso: Findings from a cross-sectional population-based survey. PLoS One 2019; 14:e0224769. [PMID: 31714910 PMCID: PMC6850548 DOI: 10.1371/journal.pone.0224769] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 10/21/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION In Burkina Faso in 2016, 27% and 8% of children under-5 were estimated to suffer from stunting and wasting respectively. Here, we report on infant and young child feeding (IYCF) practices in rural areas of the Boucle du Mouhoun region. MATERIALS AND METHODS A cross-sectional population-based survey was performed in 2017 in a representative sample of mothers of children aged 6 to 23 months. IYCF practices were assessed using 24-hour dietary recall. Logistic regression was used to identify predictors of IYCF practices. All analyses accounted for sampling stratification by child's age group and for data clustering. RESULTS According to mothers' reports, 60% (95%CI 55, 65%) of children received the minimum meal frequency, but only 18% (95%CI 15, 22%) and 13% (95%CI 10, 16%) benefited from the minimum dietary diversity and the minimum acceptable diet respectively. Only 16% (95%CI 13, 20%) of mothers reported increasing breastfeeding or liquids and continued feeding during an episode of child illness. Knowledge of timely introduction of complementary foods and recommended feeding practices during an illness were low. Despite positive attitudes towards the introduction of key food groups, mother's perceived self-efficacy to provide children with these food groups every day was relatively low. DISCUSSION Our findings highlight the need for interventions to improve mothers' knowledge and practices in relation to IYCF in the Boucle du Mouhoun region. Behaviour change communication strategies have the potential to improve IYCF indicators but should be tailored to the local context. The high attendance of health facilities for preventive well-baby consultations represents an opportunity for contact with caretakers that should be exploited for promotion and child growth monitoring.
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Senghore T, Omotosho TA, Ceesay O, Williams DCH. Predictors of exclusive breastfeeding knowledge and intention to or practice of exclusive breastfeeding among antenatal and postnatal women receiving routine care: a cross-sectional study. Int Breastfeed J 2018; 13:9. [PMID: 29507600 PMCID: PMC5833059 DOI: 10.1186/s13006-018-0154-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 02/15/2018] [Indexed: 11/20/2022] Open
Abstract
Background Despite consistent evidence showing the importance of exclusive breastfeeding (EBF) for six months, it remains a sub-optimal practice in The Gambia. This study aimed at investigating the determinants of EBF knowledge and intention to or practice of EBF. Methods A cross-sectional study was conducted among 334 women receiving care at the Edward Francis Small Teaching Hospital (EFSTH) from December 2015 to February 2016. Using a structured interviewer-administered questionnaire, knowledge on EBF was determined and scored. Participants scoring above or equal to the median were determined to have sufficient EBF knowledge. Multivariate logistic regression analyses were used to identify predictors of EBF knowledge and intention to or practice of exclusive breastfeeding. Results The proportion of women with sufficient exclusive breastfeeding knowledge and intended to or practice EBF were 60.2% and 38.6% respectively, while only 34.4% received EBF counseling. Earning ≥1500 GMD monthly (Adjusted Odds Ratio [aOR] 1.98; 95% Confidence Interval [Cl] 1.24, 3.16), having positive attitude (aOR 2.40; 95% Cl 1.40, 4.10) and partner supporting EBF (aOR 2.18; 95% Cl 1.23, 3.87) predicted sufficient EBF knowledge. Mothers aged 26–34 years (aOR 0.50; 9 5% Cl 0.31, 0.82) and EBF counseling (aOR 2.68; 95% Cl 1.68, 4.29) significantly associated with intention to or practice of exclusive breastfeeding. Conclusion In conclusion, improving EBF rates will, therefore, require improved access to information on EBF targeting low socio-economically disadvantaged and older mothers. In addition, emphasis on strengthening the ongoing EBF counseling already within the health system is required.
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Affiliation(s)
- Thomas Senghore
- Department of Nursing and Reproductive Health, School of Medicine and Allied Health Sciences, University of The Gambia, P.O. Box 1646, Independence Drive, Banjul, The Gambia
| | - Tobiloba Alex Omotosho
- Department of Nursing and Reproductive Health, School of Medicine and Allied Health Sciences, University of The Gambia, P.O. Box 1646, Independence Drive, Banjul, The Gambia
| | - Omar Ceesay
- Department of Nursing and Reproductive Health, School of Medicine and Allied Health Sciences, University of The Gambia, P.O. Box 1646, Independence Drive, Banjul, The Gambia
| | - Daisy Clara H Williams
- Department of Nursing and Reproductive Health, School of Medicine and Allied Health Sciences, University of The Gambia, P.O. Box 1646, Independence Drive, Banjul, The Gambia
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