A qualitative investigation of adolescent participation in Care Groups for improved maternal and child nutrition: experiences from rural Zimbabwe

Abstract

The Amalima program in Matabeleland North and Matabeleland South Provinces of Zimbabwe, an intervention funded by the United States Agency for International Development (USAID) Office of Food for Peace, promoted Care Groups from 2014-2020. Care Groups are community peer- to- peer support groups that provide a platform for promoting optimal nutrition and health for pregnant and lactating women, as well as children 6-23 months of age through training sessions run by community group leaders to promote recommended maternal, infant and young child nutrition practices. A qualitative study was conducted to describe adolescent mother inclusion and participation in Care Groups, highlighting key enablers and barriers for participation. A total of 28 in-depth interviews were conducted with adolescents in Care Groups, as well as adolescents not participating in Care Groups. Focus group discussions were also held with family members of adolescents. The key enablers for Care Group participation by adolescent mothers were found to include the motivation to learn how to take care of their children, the social and interactive benefits, family support, and positive facilitator attitudes. Key barriers to participation were workload and chores at home, lack of family support, and lack of adolescent-friendly approaches amongst facilitators. Key recommendations include training facilitators on adolescent-friendly approaches and group dynamics so they can better understand and relate to adolescents.

Influence of care group participation on infant and young child feeding, dietary diversity, WASH behaviours and nutrition outcomes in rural Zimbabwe

“…8 The limited available evidence in Zimbabwe show that CGS improved infant and young child feeding (IYCF), water, sanitation and hygiene (WASH) behaviours and practices and has opportunity to include various age groups such as adolescents. [9][10][11][12] The results agree with findings from Kenya, 13 Mozambique, 14 as well as other settings. 15 The Zimbabwe Resilience Building Fund (ZRBF) project was piloted in 18 districts to mainstream nutrition via the CGA to promote social behaviour change.…”

“…The CGA has strengthened communities’ resilience to repeated shocks 8. The limited available evidence in Zimbabwe show that CGS improved infant and young child feeding (IYCF), water, sanitation and hygiene (WASH) behaviours and practices and has opportunity to include various age groups such as adolescents 9–12. The results agree with findings from Kenya,13 Mozambique,14 as well as other settings 15…”

“…This consisted of accurately recalling, describing and/or computing food and drink consumed in her 24 hours or the day before the interview. 19 The latter mentioned 12 food groups were used to calculate Household Dietary Diversity Scores (HDDS): (1) cereals, (2) roots and tubers, (3) vegetables, (4) fruits, (5) meat, poultry and offal, (6) eggs, (7) fish and seafood, (8) pulse, legumes and nuts, (9) milk and milk products, (10) oil/ fats, (11) sugar/honey and ( 12) miscellaneous. Households that have consumed one of the above-mentioned food groups within the last 24 hours receive a score of 1 vs a score of 0 if the food was not consumed.…”

The effect of care groups on infant and young child feeding, dietary diversity and WASH behaviours in rural Zimbabwe: A case-control study

“…The care group approach is a promising model to promote behaviour change towards improved IYCF practices in low income settings, where health workers have heavy workloads 9 . Few studies done in Zimbabwe evaluating overall effectiveness of the care group approach have found that this approach has improved IYCF, WASH behaviours and practices and has opportunity to include various age groups such as adolescents [9][10][11][12] . No study has been done to evaluate the effectiveness of the care group SBCC strategy on selected behaviours, nutrition and health outcomes.…”