A tool to assess underlying factors to water provision among Guinean children

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.

A theory-based behavioural change communication intervention to decrease the provision of water to infants under 6 months of age in the Republic of Guinea

“…This research, which used a quasi-experimental design, was conducted in four health centers divided into the two previously mentioned regions. (20,21) Inclusion criteria for mothers of IU6M were the following: having a child aged below three months, being aged 20 years or older, having given birth through vaginal delivery and to a singleton child with a birth weight greater than 2•5 kg, and being willing to participate in the study, irrespective of whether the child is exclusively breastfed or not. Mothers of babies with severe medical conditions (e.g., AIDS, cancer), mental health issues, obstetric complications (e.g., c-section), babies with severe medical conditions (e.g., AIDS), or congenital malformations were excluded.…”

“…Since twenty health centers (10 out of 29 in Conakry and 10 out of 16 in the Kindia region, figure 1) were included in the questionnaire development phase, two centers were randomly selected respectively from the remaining 19 health facilities in Conakry and two from six in Kindia. (21) Therefore, four health centers, two in each region, were assigned randomly to each study's arm (one control and one intervention per region) (Figure 1). There were 14 km between the CG and IG in the region of Kindia and 6.5 km between the CG and IG in Conakry.…”

“…Following these steps, a questionnaire was developed and validated, then used to collect data on each construct of the extended TPB among a group of 300 mothers of IU6M. (21) For each construct, direct and indirect measurements were computed. (14,22) Results of path analyses have shown that mothers' attitude and perception of the subjective norm were more associated with the intention of providing water.…”

A Path Analysis to Identify Factors Influencing the Provision of Water in Addition to Breast Milk by Mothers of Infants under Six Months of Age in Conakry and Kindia Regions, Republic of Guinea

“…As described previously [30], eight local enumerators were recruited and trained on the study methodology. The theoretical training was complemented by in-class and field practical exercises.…”

“…The health card of each child was also checked to record their date of birth. Data on each theoretical framework's construct was collected using a validated and reliable questionnaire [30], developed based on qualitative information collected through focus-group discussions. This questionnaire includes 58 items (including one item to measure the intention) spread out, as follows for each construct: attitude, 20; subjective norm, 11; perceived control, 12; environment-related factors, 14 items.…”