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Alive & Thrive (A&T) is an initiative that supports the scaling up of nutrition interventions to save lives, prevent illnesses, and contribute to healthy growth and development through improved maternal nutrition, breastfeeding and complementary feeding practices. In Burkina Faso, A&T and the Ministry of Health will develop and test the integration of an intensive package of maternal nutrition interventions into existing antenatal care (ANC) services delivered through government health facilities. These include intensified counseling and support on dietary diversity and quality during pregnancy, counseling on iron-folic acid (IFA) supplementation, counseling on the importance of ANC and increasing the number of ANC visits and contacts, adequate weight-gain monitoring, and promotion of early and exclusive breastfeeding. The evaluation will use a two-arm cluster-randomized, non-masked trial design, consisting of two cross-sectional surveys of pregnant and recently delivered women (i.e. with a child under 6 months of age).
Adequate maternal nutrition is important for maternal health and wellness and represents a major determinant of pregnancy outcomes. In low-and middle-income countries, maternal and child malnutrition is a public health concern resulting in increases of morbidity and mortality. In Burkina Faso, despite continued improvement, the adjusted maternal mortality ratio (371 deaths per 100,000 live births) and the neonatal mortality rate (25 deaths per 1,000 live births) remain high. Routine ANC offers opportunities to receive a broad range of health promotion and prevention services including support for adequate nutritional care for pregnant women and their newborns.
A&T Burkina Faso, with the Ministry of Health, will develop and test the integration of an intensive package of maternal nutrition interventions into existing ANC services delivered through government health facilities that will align with the latest global recommendations. These include intensified counseling and support on dietary diversity and quality during pregnancy, counseling on IFA supplementation, counseling on the importance of ANC and increasing the number of ANC visits and contacts, adequate weight-gain monitoring, and promotion of early and exclusive breastfeeding. The impacts of these intensive interventions in users of government ANC services will be compared with standard ANC services, and used to provide the Ministry of Health and its partners with important information needed to scale up interventions to achieve the new ANC recommendations.
The evaluation will use a two-arm cluster-randomized, non-masked trial design, consisting of two cross-sectional surveys of pregnant and recently delivered women (i.e. with a child under 6 months of age). The study will be implemented in two health districts (Boromo and Toma) in the Boucle du Mouhoun region, and two health districts (Dande and Lena) in the Hauts-Bassins region. The unit of randomization is the health and social promotion center (CSPS) catchment area. 40 CSPS in Boucle du Mouhoun and 40 CSPS in Hauts-Bassins will be randomly assigned to intervention/control.
The objectives of the proposed evaluation are to answer the following questions:
1. Is it feasible to integrate locally relevant maternal nutrition interventions based on the WHO ANC guidelines into existing ANC services delivered through government health facilities?
2. Can the coverage and utilization of key nutrition interventions (nutrition counseling, weight gain monitoring, IFA supplement consumption) be improved by integrating nutrition-focused social and behavior change communication (SBCC; community mobilization and interpersonal communication) and systems strengthening approaches into existing ANC services?
3. Can the quality of diets (dietary diversity and adequate intake of micronutrients, protein, and energy) among pregnant women and early breastfeeding practices (early initiation of and exclusive breastfeeding) be improved by the nutrition-focused SBCC interventions?
4. What are the barriers and opportunities for completing 8 ANC contacts?
Maternal Dietary Diversity
Health Facility Level Interventions, Community Level Interventions, Health System Level Interventions
International Food Policy Research Institute
District of Columbia
International Food Policy Research Institute
Published on BioPortfolio: 2019-11-12T18:25:30-0500
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