Integrating nutrition into health systems at community level

Impact evaluation of the community‐based maternal and neonatal health and nutrition projects in Ethiopia, Kenya, and Senegal

Bibliographic Data

ID15535581
AuthorsJacqueline K Kung’u (0000-0003-2535-7041, United States International University Africa, corresponding author), Richard Pendame (United States International University Africa), Mame Bineta Ndiaye (Université du Sahel), Mulusew Gerbaba (0000-0002-0383-7012, Jimma University), Sophie Ochola (0000-0003-0726-2428, Kenyatta University), Adama Faye (0000-0002-7849-2469, Cheikh Anta Diop University), Sulochana Basnet (0000-0002-3924-8340, University of South Carolina), Edward A Frongillo (0000-0002-8265-9815, University of South Carolina), Sara Wuehler (0000-0002-1972-0150, Nutrition International), Luz María De‐Regil (0000-0002-7509-5812, Nutrition International)
Year2018
Volume14
IssueS1
Publication date2018-02-01
Open AccessYes
TypeARTICLE
VenueMaternal and Child Nutrition (JOURNAL)
Journal identifiersISSN: 1740-8695 • E-ISSN: 1740-8709
PublisherWiley (PUBLISHER • GB)
DOI10.1111/mcn.12577
PMID29493902
OpenAlexW2789499838
LanguageEN
Citations received6
References cited20

Maternal undernutrition and mortality remain high in several African countries. Key nutrition and health interventions improve maternal and birth outcomes. Evidence is scarce on how to strengthen health systems to ensure pregnant women and newborns are reached with these interventions. We conducted three quasi-experimental nonrandomized Community Based Maternal and Neonatal Health and Nutrition projects in regions of Ethiopia, Senegal, and Kenya to demonstrate how proven nutrition interventions could be integrated into health programs to improve knowledge and practices during pregnancy, birth, and postpartum. We evaluated impact on knowledge and practices related to maternal and neonatal care using logistic regression and repeated-measures models with districts as a fixed variable and adjusted for covariates. Combined country analyses show significant positive effects of the intervention on women receiving first antenatal care visit (ANC) during first trimester (OR = 1.44; p < .001), those consuming any iron and folic acid supplement during their latest pregnancy (OR = 1.60; p = .005), those whose <6 months infants were exclusively breastfed (OR = 2.01; p=.003), those whose delivery was facility based (OR = 1.48; p=.031), and those whose postnatal care was facility based (OR = 2.15; p<.001). There was no significant differences between intervention and control groups regarding one or more and four or more ANC visits, women consuming iron and folic acid for ≥90 days, and early initiation of breastfeeding. We conclude that integrating proven nutrition interventions into health programs at community level improved components of access to and use of ANC, delivery services, and postnatal care by women in three African countries

Breast feeding · Breastfeeding · Developing country · Environmental health · Health facility · Health services · Logistic regression · Malnutrition · Population · Pregnancy · Psychological intervention · Child Nutrition and Water Access · Global Maternal and Child Health · Medicine · Nursing · Poverty, Education, and Child Welfare · Pediatrics

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